Gastro-oesophageal reflux disease--impact of guidelines on GP management.
BACKGROUND
This program examined the impact of clinical guidelines and a 3 year self audit process on general practitioners' diagnosis and management of gastro-oesophageal reflux disease.


METHODS
Nine hundred and sixty-six Australian GPs participated in a retrospective five step clinical audit reporting on data for 28,622 patients.


RESULTS
General practitioners demonstrated significant improvements in their diagnosis and management of gastro-oesophageal reflux disease across the audit period, including: a significant 3% decrease in use of endoscopy; improved GP assessment and identification fo risk factors and exacerbants; significant increase in GP recommendations for patient weight loss and dietary changes (7 and 10% respectively); a significant 4% reduction in patient use of medications that may exacerbate reflux symptoms.


CONCLUSIONS
The findings provide a snapshot of current diagnostic and management practices in Australian general practice, and highlight the benefits of clinical audit as a tool for eliciting evidence based, guideline driven practice change.
Kirby
Catherine N
CN
Department of General Practice, Monash University, East Bentleigh, Victoria.
Piterman
Leon
L
Nelson
Mark R
MR
Dent
John
J
D000863:Antacids / Q000627:therapeutic use*; D001315:Australia; D005194:Family Practice / Q000706:statistics & numerical data*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008485:Medical Audit / Q000379:methods*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors
D000863:Antacids; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors