Management of gastroesophageal reflux disease by primary care physicians and gastroenterologists: a prospective study of patients' records.
BACKGROUND
We previously compared the perceptions and practices of primary care physicians (PCP) and gastroenterologists (GE) in the management of gastroesophageal reflux disease (GORD), but the data were only declarative statements.


OBJECTIVE
The aim of the present study was to analyze the respective management of GORD by PCP and GE on the basis of patients' records, and to look for any discrepancies between the declared and actual practices in both groups of physicians in the management of GORD.


METHODS
A representative sample of French physicians was asked to enroll two consecutive patients with frequent and typical symptoms of GORD into a prospective observational survey.


RESULTS
A total of 136 PCP and 91 GE participated in the survey and enrolled 271 and 182 patients, respectively, with frequent GORD symptoms (453 patients in total). Patients consulting GE were slightly younger, and had waited longer before arranging a consultation despite having symptom severity and impact on daily life similar to those visiting PCP. Most patients enrolled by GE had undergone upper GI endoscopy (95% versus 64% from PCP, P<0.01). In both groups of physicians, recourse to endoscopy for their patients was more frequent than they estimated. Prescription therapies for GORD were usually Proton Pump Inhibitors (PPI) in both groups of physicians and were in keeping with the declared findings.


CONCLUSIONS
Despite differences between patients' characteristics, the management of frequent GORD was similar by both groups of physicians. The reasons why both groups of physicians underrated their actual recourse to endoscopy for their patients warrant further investigation.
Bretagne
J-F
JF
Service des maladies de l'appareil digestif, hôpital Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes, France. jean-francois.bretagne@chu-rennes.fr
Honnorat
C
C
Richard-Molard
B
B
Soufflet
C
C
Barthélemy
P
P
D005260:Female; D005762:Gastroenterology; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies