摘要
AIM:To investigate usefulness of adherence to gastroesophageal reflux disease(GERD) guideline established by the Spanish Association of Gastroenterology.METHODS:Prospective,observational and multicentre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily practice.Patients(aged > 18 years) were eligible for inclusion if they had typical symptoms of GERD(heartburn and/or acid regurgitation) as the major complaint in the presence or absence of accompanying atypical symptoms,such as dyspeptic symptoms and/or supraesophageal symptoms.Diagnostic and therapeutic decisions should be made based on specific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive disease specialists.RESULTS:Endoscopy was indicated in 123(41%) patients:50 with alarm symptoms,32 with age > 50 years without alarm symptom.Seventy-two patients(58.5%) had esophagitis(grade A,23,grade B,28,grade C,18,grade D,3).In the presence of alarm symptoms,endoscopy was indicated consistently with recommendations in 98% of cases.However,in the absence of alarm symptoms,endoscopy was indicated in 33% of patients > 50 years(not recommended by the guideline).Adherence for proton pump inhibitors(PPIs) therapy was 80%,but doses prescribed were lower(half) in 5% of cases and higher(double) in 15%.Adherence regarding duration of PPI therapy was 69%;duration was shorter than recommended in 1%(4 wk in esophagitis grades C-D) or longer in 30%(8 wk in esophagitis grades A-B or in patients without endoscopy).Treatment response was higher when PPI doses were consistent with guidelines,although differences were not significant(95% vs 85%).CONCLUSION:GERD guideline compliance was quite good although endoscopy was over indicated in patients > 50 years without alarm symptoms;PPIs were prescribed at higher doses and longer duration.
AIM： TO investigate usefulness of adherence to gastro- esophageal reflux disease （GERD） guideline established by the Spanish Association of Gastroenterology. METHODS： Prospective, observational and multi- centre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily practice. Patients （aged 〉 18 years） were eligible for inclusion if they had typical symptoms of GERD （heartburn and/or acid regurgitation） as the major complaint in the presence or absence of accompany- ing atypical symptoms, such as dyspeptic symptoms and/or supraesophageal symptoms. Diagnostic and therapeutic decisions should be made based on spe- cific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive dis- ease specialists. RESULTS： Endoscopy was indicated in 123 （41%） patients： 50 with alarm symptoms, 32 with age 〉 50 years without alarm symptom. Seventy-two patients （58.5%） had esophagitis （grade A, 23, grade B, 28, grade C, 18, grade D, 3）. In the presence of alarm symptoms, endoscopy was indicated consistently with recommendations in 98% of cases. However, in the absence of alarm symptoms, endoscopy was indicated in 33% of patients 〉 50 years （not recommended by the guideline）. Adherence for proton pump inhibitors （PPIs） therapy was 80%, but doses prescribed were lower （half） in 5% of cases and higher （double） in 15%. Adherence regarding duration of PPI therapy was 69%; duration was shorter than recommended in 1% （4 wk in esophagitis grades C-D） or longer in 30% （8 wk in esophagitis grades A-B or in patients without endoscopy）. Treatment response was higher when PPI doses were consistent with guidelines, although differ- ences were not significant （95% vs 85%）. CONCLUSION： GERD guideline compliance was quite good although endoscopy was over indicated in pa- tients 〉 50 years without alarm symptoms; PPIs were prescribed at higher doses and longer duration.
基金
Supported by AstraZeneca Farmaceutica
