[Challenges and current approaches in the development of psychiatric living guidelines in Germany].

Outdated guidelines can cause inadequate care. To counter this problem a dynamic updating process for guidelines is being internationally discussed (living guidelines). This process has specific challenges. The rhythm of updating has to be determined and a priori criteria have to be defined, which indicate that a substantial change of the medical practice is needed in order to then update individual recommendations. Digital tools have to be identified that can support a dynamic updating. Their (further) development has to be oriented to the specific requirements and needs of the trialogically composed guideline development teams. Recommendations have to be examined from the user perspective. The current guideline development methods that are still divergent, have to be harmonized and specific needs with respect to the cross-linking of guidelines have to be taken into account. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) supports and accompanies scientific projects dealing with the challenges of the dynamics of guideline development. From the first results of "Guide2Guide", a project funded by the Innovation Fund, it can be summarized that the development of living guidelines is a complex dynamic process that has only just started internationally and in Germany. It demands a special engagement of the guideline developers including representatives of patients and relatives, to responsibly work long term and flexibly. Digital tools can be useful in various process steps but at present they still have to be meaningfully linked into the process. Central elements of the development of S3 guidelines will continue to require substantial working time of the experts in the trialogue. In order for living guidelines to be actually used dissemination and implementation have to be integrated into the dynamic process.