Pharmacotherapy circles and family doctor guidelines

>Kassenärztliche Vereinigung Hessen, BKK Vor Ort

Therapy CircleData Cockpits

The concept of pharmacotherapy circles as data-supported quality assurance was developed in the early 1990s by the Research Group for Primary Medical Care (now PMV research group) in cooperation with the pharmacotherapy consultants of KV Hessen. It was tested and implemented in Hessen in 1995. Since then, PMV research group has supervised numerous circles and regularly evaluated their work. Our research group also moderates and supports the guideline group Hessen - GP pharmacotherapy.

The aim of the data-supported circle work was to promote the quality and cost-effectiveness of pharmacotherapy in GP care under the given practice conditions. The PMV research group compiled practice-specific prescription analyses for the circles on the basis of the prescription and diagnosis data of the participating doctors, which were collected in person and pseudonymised. For the Circle sessions, the data is prepared in relation to groups, so that the participants have a common basis for critical reflection and exchange of experience for the optimisation of the prescription method.

The circles are moderated by colleagues working as family doctors, who are supported by the PMV research group with moderation documents and further training (duration until 2017).

The topics for the circle meetings were derived from the spectrum of chronic diseases and care problems in family medicine. The selection was guided by aspects such as new treatment concepts, controversially discussed therapies or frequent and cost-intensive illnesses such as asthma/COPD, chronic heart failure, diabetes mellitus type II, lipid metabolism disorders, hypertension/CHD, gastrointestinal complaints, pain and medication therapy in old age.

The Guideline Group Hesse was founded in 1998 with the aim of developing GP guidelines on selected topics of pharmacotherapy for work in pharmacotherapy circles. Responsibility for the content of the guidelines lies with the guidelines group. Since 2010, the guidelines have been developed jointly with DEGAM in cooperation with members of the "Standing Guidelines Commission of the German Society of General and Family Medicine" (DEGAM), the only scientific society for general medicine in Germany. The moderation of the guideline meetings, the scientific support and conception of the development of guidelines for general practitioners has been carried out by the PMV research group, University of Cologne, since the beginning.

Current CPGs can be accessed via the DEGAM CPG portal and the AWMF.

The guideline Multimedication (2012) was awarded the vdek Zukunftspreis 2012. In 2021, the update and upgrading to S3 level took place within the framework of the EVITA project (Institute of General Practice, University of Frankfurt) funded by the Innovation Fund. The GP guideline Multimedication is available here.

Further - not updated - GP guidelines can be found here:

Leitlinie geriatrisches Asssessment

Leitlinie Geriatrie Teil 1

Leitlinie Geriatrie Teil 2

Leitlinie Palliativversorgung

Leitlinie Psychosomatik

Duration: 1995–2021
Project partners: Physician guideline group Hessen
Methods: Therapy Circle, Data Cockpits, Statistical Analyses, Development of Guidelines, Evaluation
Topics: Supply curves, Pharmacotherapy
Data: Data preparation, Claims data


Schubert I für die Leitliniengruppe Hessen.
Multimedikation in der Hausarztpraxis. KV H aktuell 2021; 2: 4-15

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Schubert I, Feßler J, Harder S, Muth C.
Müssen es wirklich so viele Medikamente sein? Der Hausarzt 2015; 18: 42-46

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Muth C, Beyer M, Schubert I, Junius-Walker U.
Geeignete Patienten für das Geriatrische Assessment auswählen: ein Praxistest zur Leitlinie. Zeitschrift für Allgemeinmedizin 2016; 92(7/8): 308-313

Link Full Text

Leitliniengruppe Hessen, Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin.
Hausärztliche Leitlinie Multimedikation. Empfehlungen zum Umgang mit Multimedikation bei Erwachsenen und geriatrischen Patienten. 2013;

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Schubert I, Heymans L, Feßler J.
Hausärztliche Leitlinie Palliativversorgung: Ergebnisse einer Akzeptanzbefragung in Qualitätszirkeln der Hausarztzentrierten Versorgung. Medizinische Klinik 2010; 105: 135-141

Link Abstract

Schubert I, Lappe V, Heymans L, Ihle P, Feßler J.
Gelesen ist noch nicht getan: Hinweise zur Akzeptanz von hausärztlichen Leitlinien. Eine Befragung in Zirkeln der Hausarztzentrierten Versorgung (HZV). Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 2009; 103: 5-12

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Schubert I, Köster I, Ihle P, von Ferber L.
The development of indicators for assessing the quality of prescribing of lipid-lowering drugs. Data taken from the pharmacotherapeutic quality circles in Hesse, Germany. International Journal of Clinical Pharmacology and Therapeutics 2001; 39: 492-498

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Leitliniengruppe Hessen.
Hausärztliche Leitlinie Gesprächsführung. 2006;

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Leitliniengruppe Hessen.
Hausärztliche Leitlinie Getriatrie - Teil 1. Allgemeine Geriatrie. 2008;

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Leitliniengruppe Hessen.
Hausärztliche Leitlinie Getriatrie - Teil 2. Spezielle Geriatrie. 2008;

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von Ferber L, Schubert I, Köster I, Ihle P.
Rechnet sich eine Fortbildung in Pharmakotherapie für Hausärzte? Die Ersatzkasse 2002; 6: 227-231

von Ferber L, Schubert I, Köster I, Ihle P.
Pharmakotherapie für Hausärzte. Ja, aber wie? Die Ersatzkasse 2002; 7; 267-271