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13. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

02.11. bis 03.11.2006, Berlin

Treatment of Patients with Concomitant Coronary Heart Disease and Diabetes Mellitus in Primary Care: Results from the DETECT Study

Meeting Abstract

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  • corresponding author H.-U. Wittchen - Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 13. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie. Berlin, 02.-03.11.2006. Düsseldorf: German Medical Science GMS Publishing House; 2006. Doc06gaa13

The electronic version of this article is the complete one and can be found online at:

Published: October 30, 2006

© 2006 Wittchen.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Context: The primary care sector is of key importance for the management of patients with diabetes mellitus (DM) and coronary heart disease (CHD). Patients with both conditions are at particularly high risk of cardiovascular morbidity and mortality and have special needs for care. Aims: To describe the prevalence and comorbidity of DM and CHD in primary care as well as the frequency of medical and lifestyle interventions

Material/Methods: DETECT (‘Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment’; is a large-scale, nationally representative, cross-sectional clinical-epidemiological study with a prospective-longitudinal component in primary care. Based on a sample of 3,188 physicians and over 55,519 patients the clinical and therapeutic profiles were evaluated.

Results: According to the clinician’s diagnosis the prevalence of DM was 15.3% and of CHD 12.4%. 28.3% of the DM patients had concomitant CHD and conversely, 34.8% of the CHD patients concomitant DM. In the both diagnostic group 93.8% of patients received medication for their cardiac problems, and 76.7% of patients were on antidiabetics. ACE-inhibitors (56.2%), betablockers (55.6%), antiplatelet agents (54.9%) and statins (45.5%) were the most frequently prescribed CHD drugs, followed by long-term nitrates (24.6%) and AT1-antagonists (22.2%). Regarding antidiabetic medication, most patients received metformin (35.9%) insulin (34.6%) and sulfonylurea (28.7%) followed by glucosidase inhibitors (7.2%), glinides (3.4%) and glitazones (2.6%). Only 64.2% received diet and exercise interventions and 18.5% of the current smokers any smoking cessation treatments.

Conclusion: Results indicate that a significant proportion of DM and CHD patients in primary care and co-morbid patients in particular are not managed as intensively as suggested by current international guidelines. Especially the degree of mandatory non-drug interventions to change the patients high-risk behaviour is deficient. There is a considerable need to improve quality of care of DM and CHD patients in primary care in Germany.