Management of gastro-esophageal reflux disease in primary care. Results from an observational study of 2,474 patients (AO).
OBJECTIVE
The aim of the present study was to describe the management of gastro-esophageal reflux disease (GERD) by primary care physicians (PCPs).


METHODS
This prospective survey was conducted in patients with suspected or previously diagnosed GERD. PCPs completed questionnaires at first consultation (M0) and at a 3-month follow-up visit (M3).


RESULTS
2 474 patients were available for analysis at M0 and 1 993 at M3. GERD was the reason for consultation in 84% of patients; 33% were consulting about reflux symptoms for the first time. Symptoms occurred once daily in 55% of patients and were considered very disruptive or incapacitating by 51%. Upper gastrointestinal endoscopy was performed at any time in 57% of patients and at M0 in 20%. Only 48% of demands for endoscopy agreed with current recommendations and this rate was not influenced by PCP training in the previous 6 months. Lifestyle measures were recommended in 95% of patients at M0. Proton pump inhibitors were prescribed in 98%, to be taken "on-demand" in 22-57% depending on symptom frequency. Therapeutic management was considered as very satisfactory by 81% of patients.


CONCLUSIONS
GERD managed in primary care is severe, leading to expensive, but effective diagnostic investigations and treatments. Agreement with recommendations for endoscopy is poor.
Jian
Raymond
R
Department of Gastroenterology, Hôpital Européen Georges Pompidou, AP-HP, Paris.
Hassani
Zahir
Z
El Kebir
Sohéla
S
Barthélemy
Philippe
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005602:France; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000628:therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors