Are guidelines for monitoring chronic disease in primary care evidence based

### What you need to know Pathology tests have a unique place in management of chronic diseases. They are used to guide disease management; assess risk and compliance; and enable early detection of adverse events, complications, and development of secondary diseases. Primary care clinicians rely on guidelines for common chronic diseases such as type 2 diabetes, chronic kidney disease, and hypertension to inform them which tests they should recommend to their patients and how frequently these should be done. With rates of pathology tests rising—at an estimated annual cost of £1.8bn to primary care in the UK1—and the potential for harm from over-testing, it is important to consider the evidence base for these recommendations. In this article, we review monitoring strategies in current UK guidelines for patients with type 2 diabetes, chronic kidney disease, and hypertension (box 1), highlighting the uncertainties in these guidelines and the need for further research. Box 1 ### Search strategy and guideline selection We searched for published UK guidelines for the management of patients with type 2 diabetes, chronic kidney disease stages 1-3*, or hypertension using the following sources: The following guidelines are included in this review:RETURN TO TEXT