Recurrence and Its Impact on the Health-related Quality of Life in Patients with Gastroesophageal Reflux Disease: A Prospective Follow-up Analysis.
OBJECTIVE
Limited data exist on the outcome of gastroesophageal reflux disease (GERD) treatment and its impact on the health-related quality of life (HRQoL) in the Asian population. This study aims to evaluate the treatment outcomes, to investigate the factors associated with recurrence, and to evaluate the impact of the treatment outcome on the HRQoL in a Korean GERD population.


METHODS
This was a prospective, multicenter study involving a total of 824 GERD patients. The response to treatment was assessed at week 4 (or week 8 for the patients who did not achieve complete resolution [CR] at week 4). The EQ-5D questionnaire was used at baseline, end of treatment, and first recurrence to assess the HRQoL. To assess GERD symptoms, contact of patients by phone at 1, 6, and 12 months following treatment was carried out.


RESULTS
CR was achieved in 65.6% and recurrence was observed in 47.8% following treatment. CR and recurrence rates did not differ by the presence of esophagitis. Multivariate analysis revealed that acid regurgitation (odds ratio 2.249; 95% confidence interval 1.293-3.912; P= 0.004) and both acid regurgitation and heartburn (odds ratio 2.330; 95% confidence interval 1.392-3.901; P= 0.001) were independent risk factors for GERD recurrence. EQ-5D scores were more improved in patients with CR than in those without CR, and worsened more during follow-up in patients with recurrence than in those without recurrence.


CONCLUSIONS
We should achieve complete symptom relief and attempt to prevent recurrence in GERD patients to improve their HRQoL.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yang Won
YW
Min
Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
Yong Woon
YW
Shin
Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea.
Gab Jin
GJ
Cheon
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Kyung Sik
KS
Park
Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
Hyun Soo
HS
Kim
Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Chong-Il
CI
Sohn
Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
Tae Nyeun
TN
Kim
Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea.
Hyeung Cheol
HC
Moon
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Poong-Lyul
PL
Rhee
Gastroesophageal reflux; Quality of life; Recurrence; Therapy