Leitlinienorientierung deutscher Hausärzte bei der Diagnostik und Therapie der arteriellen Hypertonie und des Diabetes mellitus

Objectives:The paper examines to what degree German primary care physicians know and work along the rules established in guidelines for arterial hypertension and diabetes mellitus. Methods:HYDRA is a 2-stage cross-sectional point prevalence study with 1912 participating primary care settings throughout Germany including 45125 patients. A pre-study questionnaire to assess doctors practice patterns was used. Subsequently doctors completed a structured clinical appraisal with a diagnostic workup and characterization of the current treatments provided. All patients filled out a questionnaire. Results:Pre-study results show that only every second primary care physician manages the patients according to established guidelines. Further, physicians estimated their own work as problematic and not always successful. Guideline-oriented doctors were more likely to report hypertension and diabetes treatment patterns that also match guideline’s recommendations. Conclusions:The study shows a considerable degree of dissatisfaction with the quality of their work among primary care physicians. Guideline-oriented doctors however reveal more frequently formally adequate management characteristics. This encouraging aspect suggests the need of more successful implementation of medical guidelines in order to achieve improved evidence-based medicine and better patient-oriented health care. Copyright Birkhäuser-Verlag Basel 2004