Are the guidelines for chronic disease surveillance in primary care evidence-based?

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Pathology tests have a unique place in the management of chronic diseases. They are used to guide the management of the disease; assess risks and compliance; and enable the early detection of adverse events, complications and the development of secondary diseases. Primary care clinicians use guidelines for common chronic conditions such as type 2 diabetes, chronic kidney disease, and hypertension to know what tests to recommend to patients and how often. With pathology test rates rising, with an estimated annual cost of £ 1.8 billion for primary care in the UK1– and the potential for harm caused by over-testing, it is important to consider the evidence base for these recommendations.

In this article, we review the UK's current guideline surveillance strategies for patients with type 2 diabetes, chronic renal failure, and hypertension (Box 1), highlighting the uncertainties of these recommendations and the need for further research.

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