T Rosemann1, S Joos, J Szecsenyi. 1. Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Vossstrasse 2, 69115 Heidelberg, Deutschland. thomas.rosemann@med.uni-heidelberg.de
Abstract
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. CONCLUSION: 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.
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. CONCLUSION: 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.
Authors: Brian M Berman; Lixing Lao; Patricia Langenberg; Wen Lin Lee; Adele M K Gilpin; Marc C Hochberg Journal: Ann Intern Med Date: 2004-12-21 Impact factor: 25.391
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Authors: D T Felson; R C Lawrence; P A Dieppe; R Hirsch; C G Helmick; J M Jordan; R S Kington; N E Lane; M C Nevitt; Y Zhang; M Sowers; T McAlindon; T D Spector; A R Poole; S Z Yanovski; G Ateshian; L Sharma; J A Buckwalter; K D Brandt; J F Fries Journal: Ann Intern Med Date: 2000-10-17 Impact factor: 25.391
Authors: Thomas Rosemann; Thorsten Körner; Michel Wensing; Jochen Gensichen; Christiane Muth; Stefanie Joos; Joachim Szecsenyi Journal: BMC Public Health Date: 2005-07-19 Impact factor: 3.295