Although guidelines for the assessment and treatment of mental disorders in childhood and adolescence have been available in Germany for several years, there are barely any data on adherence to guidelines in national routine care. Therefore, the study aimed at a nationwide evaluation of guideline adherence (GA) for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in German routine care in various groups of health care providers (HCPs). Besides a detailed description of GA, the study focused on examining possible differences between professional groups. Furthermore, data based on global self-reports of clinicians were compared with ratings of documented care in individual patients. Protocols of 73 clinicians regarding their handling of ADHD in routine care for 167 patients were rated according to German guideline recommendations for ADHD care. GA was measured as the proportion of components fulfilled in each individual patient as documented by the HCP. The results were compared to a preceding interview with clinicians regarding their GA. Multilevel models were constructed to detect differences in GA between professional groups. Based on mandatory guideline components, adherence rates of 38.9–72.7% were found and classified as moderate (33.3% < GA ≤ 66.6%) to high (GA > 66.6%). The comparison of the GA between the professional groups generally yielded only small differences. Correlations between GA reported globally by the HCPs and GA documented and rated for individual cases were low. Overall, most rates of GA for ADHD in German routine care lay within a moderate range. Targets for enhancement of GA may be the involvement of teachers and schools in the treatment process, the implementation of psychoeducational methods in general, as well as a careful examination of patients, including monitoring of treatment effects during titration trials. The development of further strategies to monitor the quality of ADHD routine care is needed.

尽管德国已有数年的儿童和青少年精神障碍评估和治疗指南，但几乎没有关于遵守国家常规护理指南的数据。因此，该研究旨在对德国常规护理中各组医疗服务提供者（HCP）中患有注意力缺陷/多动障碍（ADHD）的儿童和青少年进行评估和治疗的指南遵守（GA）进行全国性评估。除了对GA的详细说明外，该研究还侧重于研究专业群体之间的可能差异。此外，将基于临床医生整体自我报告的数据与对单个患者的已记录护理评分进行了比较。根据德国关于多动症护理的指南建议，对73名临床医生在167名患者的常规护理中处理多动症的方案进行了评估。如HCP记录的那样，GA被衡量为每个患者中满足的成分比例。将结果与先前就其GA进行的临床医生访谈进行了比较。构建了多级模型以检测专业群体之间的GA差异。根据强制性指导原则，发现依从性为38.9–72.7％，分类为中度（33.3％<GA≤66.6％）至高（GA> 66.6％）。专业组之间的GA对比通常只产生很小的差异。HCP在全球范围内报告的GA与针对个别案例记录和评估的GA之间的相关性很低。总体，在德国常规护理中，ADHD的大多数GA率处于中等水平。增强GA的目标可能是教师和学校参与治疗过程，一般采用心理教育方法，以及对患者进行仔细检查，包括在滴定试验期间监测治疗效果。需要制定进一步的策略来监测ADHD常规护理的质量。