首页|Clinical usefulness of adherence to gastro-esophageal reflux disease guideline by Spanish gastroenterologists

Clinical usefulness of adherence to gastro-esophageal reflux disease guideline by Spanish gastroenterologists

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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 ＞ 50years 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.

Gastro-esophageal reflux diseaseClinical practice guidelinesAdherence to guidelinesTreatment of gastro-esophageal reflux disease

Fermín Mearin、Julio Ponce、Marta Ponce、Agustín Balboa、Miguel A González、Javier Zapardiel

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Service of Gastroenterology,Centro Medico Teknon, 08022 Barcelona, Spain

Digestive Disease Unit, Hospital Quiron, 46010 Valencia, Spain

Centro de Investigacion Biomedica

Service of Gastroenterology, Hospital Universitario La Fe, 46026 Valencia, Spain

Biostatistics, Innovex-Grupo Quintiles Espana, 28033 Madrid, Spain

Medical Department AstraZeneca Farmaceutica, 28033 Madrid, Spain

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2012

10.3748/wjg.v18.i35.4885

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(35)
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