[The management of osteoarthritis by general practitioners in Germany: comparison of self-reported behaviour with international guidelines].
BACKGROUND
In most countries, guidelines for the treatment of osteoarthritis (OA) are available. However, in Germany, no guideline for the primary care sector is available. The care provider of most patients is the general practitioner (GP). The aim of the study was to investigate the approaches in diagnosing and treating OA of German GPs and to assess adherence to international guidelines.


METHODS
Cross-sectional study using a structured questionnaire with a random sample of 144 GPs.


RESULTS
Regarding diagnosis, the importance of X-rays was overestimated. Regarding treatment approaches, exercising and weight reduction were regarded as primary treatment targets. Pharmacological treatment approaches were somewhat guideline oriented, but conservative approaches such as physical therapy were overestimated as invasive treatments such as intra-articular injections were underestimated in its benefit.


CONCLUSIONS
Establishing a guideline specifically for primary care and increasing guideline adherence could help to prevent the present overuse of X-rays and the high amount of referrals to orthopaedics, save costs and reduce inadequate treatments.
Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Vossstrasse 2, 69115 Heidelberg, Deutschland. thomas.rosemann@med.uni-heidelberg.de
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Rosemann
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Joos
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Szecsenyi
D000328:Adult; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005194:Family Practice; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D010003:Osteoarthritis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed