title: [The use of guidelines in the primary care management of hypertension and diabetes].
abstract: OBJECTIVE
  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 45,125 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.
authors.affiliation: Institut für Klinische Pharmakologie und Forschungsverbund Public Health Sachsen und Sachsen-Anhalt e.V., TU Dresden. Public.Health@mailbox.tu-dresden.de
authors.forename: Nicole
authors.initials: N
authors.lastname: Wagner
authors.forename: David
authors.initials: D
authors.lastname: Pittrow
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Kirch
authors.forename: Beate
authors.initials: B
authors.lastname: Küpper
authors.forename: Petra
authors.initials: P
authors.lastname: Krause
authors.forename: Michael
authors.initials: M
authors.lastname: Höfler
authors.forename: Peter
authors.initials: P
authors.lastname: Bramlage
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011785:Quality Assurance, Health Care
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents