Systematic review: the epidemiology of gastro-oesophageal reflux disease in primary care, using the UK General Practice Research Database.
BACKGROUND
Gastro-oesophageal reflux disease (GERD) is a common diagnosis in primary care; however, there has been no comprehensive review of the epidemiology of GERD in this setting.


OBJECTIVE
To review systematically articles that used the General Practice Research Database to study the epidemiology of GERD.


METHODS
Systematic literature searches.


RESULTS
Seventeen articles fulfilled the inclusion criteria. The incidence of GERD in primary care was 4.5 new diagnoses per 1000 person-years in 1996 (95% CI: 4.4-4.7). A new diagnosis of GERD was associated with being overweight, obese or an ex-smoker. Prior diagnoses of ischaemic heart disease, peptic ulcer disease, nonspecific chest pain, nonspecific abdominal pain, chronic obstructive pulmonary disease and asthma were associated with a subsequent new GERD diagnosis. A first diagnosis of GERD was associated with an increased risk of a subsequent diagnosis of oesophageal adenocarcinoma, oesophageal stricture, chronic cough, sinusitis, chest pain, angina, gallbladder disease, irritable bowel syndrome or sleep problems. Mortality may be higher in patients with a GERD diagnosis than in those without in the first year after diagnosis, but not long term.


CONCLUSIONS
The General Practice Research Database is an effective way of studying the epidemiology of GERD in a large population-based primary care setting.
El-Serag
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Michael E DeBakey Department of Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA. hasheme@bcm.tmc.edu
Hill
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Jones
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D005194:Family Practice; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D011320:Primary Health Care; D006113:United Kingdom / Q000453:epidemiology