Inadequate medical treatment of patients with coronary artery disease by primary care physicians in Germany.
OBJECTIVE
The DETECT study was performed to obtain representative data about the frequency, distribution, and treatment of patients with coronary artery disease (CAD) in the primary care setting in Germany.


RESULTS
The DETECT study was a cross-sectional clinical- epidemiological survey of a nationally representative sample of 3795 primary care offices and 55,518 patients. Overall, 12.4% of patients were diagnosed with CAD. Stable angina pectoris and myocardial infarction were the most frequent (4.2%) subgroups, followed by status post (s/p) percutaneous coronary interventions (PCI, 3.0%) and s/p coronary bypass surgery (2.2%). Patients with CAD were prescribed AT1 receptor antagonists (in 19.4% of cases), beta blockers (57.2%), ACE inhibitors (49.9%), antiplatelet agents (52.7%), statins (43.0%), and long-term nitrates (24.5%). When comparing all CAD patients with social health care insurance to those who had private insurance, private patients had significantly higher rates of revascularisation procedures and use of preventive medications.


CONCLUSIONS
Great potential remains for improving secondary prevention in primary care in Germany to reduce the risk of further coronary or vascular events, especially in patients with social health care insurance.
Bischoff
B
B
Cardiology Practice and Heart Diagnostic Center, Am Isarkanal 36, 81379 Munich, Germany.
Silber
Sigmund
S
Richartz
B M
BM
Pieper
L
L
Klotsche
J
J
Wittchen
H-U
HU
D000293:Adolescent; D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010821:Physicians, Family; D015995:Prevalence; D011446:Prospective Studies
D002317:Cardiovascular Agents