Predictors and non-predictors of symptom relief in dyspepsia consultations in primary care.
OBJECTIVE
We aimed to evaluate if the course of dyspepsia is influenced by medical consultation in primary care.


METHODS
Australian general practitioners (n = 27) recruited 157 dyspeptic patients, of whom 94 were eligible for follow-up. Dyspepsia, comorbidity, quality of life, emotional status, locus of control and consultation satisfaction were measured at baseline and follow-up (mean 3 months).


METHODS
Response was defined as improvement of dyspepsia over time on the Nepean Dyspepsia Index score.


RESULTS
Dyspepsia improved in 82% (n = 77). There was no significant change in non-gastrointestinal symptoms. Half were worried or stressed by their symptoms, and 85% wanted reassurance, a need that (univariately) differentiated responders from non-responders (p = 0.02). Most patients seen in primary care with dyspepsia improved. If the doctor believed it was likely that the patient would follow their recommendations, the patient was nearly five times as likely to be a responder (OR 4.9, 95% CI 1.2-19.0). The only other significant predictor was acid suppression therapy (OR 3.5, 95% CI 1.1-10.9).


CONCLUSIONS
Most primary care visits for dyspepsia are followed by improvement, which may be predicted in part by indicators of patient compliance. Prescription of acid suppression therapy may also improve outcome in dyspepsia.
Agréus
Lars
L
Center for Family and Community Medicine, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden. lars.agreus@ki.se
Talley
Nicholas J
NJ
Sheen
Adrian
A
Johansson
Sven-Erik
SE
Jones
Michael P
MP
Svardsudd
Kurt
K
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001315:Australia; D004415:Dyspepsia / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods*; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome