IMPLEMENTATION OF GUIDELINES ON STROKE PREVENTION

The aim of the present paper was to study the implementation of new me dical knowledge. We investigated whether Danish doctors have implement ed new national guidelines for oral anticoagulation of atrial fibrilla tion. An anonymous questionnaire with six standardized case stories wa s sent to 315 general practitioners in the county of Viborg and Ringko bing, 79 heads of departments of medicine and cardiology, and 20 heads of departments of neuromedicine across the country. The answers showe d that the Danish doctors recommended anticoagulant therapy only to a low extent for this group of patients despite the guidelines and the s cientific evidence. The reasons for not choosing anticoagulant therapy were lack of knowledge concerning risk of stroke associated with the disease, worries about the disadvantages of the treatment, and lack of knowledge of its benefits. It is concluded that despite solid scienti fic documentation and an intensive implementation process of guideline s, issued by well-known respected colleagues in a small homogeneous co untry as Denmark (5 million inhabitants), knowledge of new research fi ndings varies greatly and is generally limited. To obtain optimal use of new research findings, a powerful implementation effort must be rec ommended and the study reveals a need for a closer link between resear ch and post-graduate education.