Structured management strategy based on the Gastro-oesophageal Reflux Disease (GERD) Questionnaire (GerdQ) vs. usual primary care for GERD: pooled analysis of five cluster-randomised European studies.
BACKGROUND
Response to treatment among primary care patients with gastro-oesophageal disease (GERD) is variable.


OBJECTIVE
The GERD Management Project (GMP) evaluated the effectiveness of a structured management approach to GERD vs. standard treatment (usual care).


METHODS
Data from five cluster-randomised clinical trials in adult primary care patients with symptoms of GERD were pooled. The structured pathway was based on the self-administered GERD Questionnaire (GerdQ) and was compared with standard treatment.


RESULTS
1734 patients were enrolled (structured treatment, n=834; standard treatment, n=900). The difference in the mean GerdQ score change from baseline favoured the structured pathway (-0.61; 95% CI: -0.88, -0.34; p<0.001). The odds ratio for an indication for treatment revision at the end of follow-up (structured vs. standard treatment) was 0.39 (95% CI: 0.29, 0.52; p=0.001).


CONCLUSIONS
Management of primary care patients with GERD can be improved by systematic stratification of patients using a patient management tool such as the GerdQ.
Digestive Functional Disorders Unit, Hospital Universitario La Fe, Valencia, Spain. jponceg@medynet.com
J
J
Ponce
V
V
Garrigues
L
L
Agréus
E
E
Tabaglio
M
M
Gschwantler
E
E
Guallar
M
M
Tafalla
J
J
Nuevo
J
J
Hatlebakk
D016000:Cluster Analysis; D019091:Critical Pathways; D005260:Female; D005764:Gastroesophageal Reflux / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires