Survey of primary care physicians' approach to gastroesophageal reflux disease in elderly patients

Citation
Cm. Wilcox et al., Survey of primary care physicians' approach to gastroesophageal reflux disease in elderly patients, J GERONT A, 56(8), 2001, pp. M514-M517
Citations number
9
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Public Health & Health Care Science","Medical Research General Topics
Journal title
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
ISSN journal
1079-5006 → ACNP
Volume
56
Issue
8
Year of publication
2001
Pages
M514 - M517
Database
ISI
SICI code
1079-5006(200108)56:8<M514:SOPCPA>2.0.ZU;2-L
Abstract
Background. Although gastroesophageal reflux disease (GERD) is a common con dition, little is known regarding physicians' approach to the diagnosis and management of GERD in elderly patients. Methods. We surveyed by facsimile a random sample of 14,000 practicing prim ary care physicians throughout the United States. Physicians were questione d using a case-based format about the approach to a symptomatic patient wit h GERD including the use of empiric therapy, the role of diagnostic testing , and the drugs of choice to treat GERD, Results. A total of 2241 surveys (16%) was returned and tabulated. Most res pondents were either internists (37%) or family practice physicians (56%) i n solo or group practice, and 74% had been in practice for 11 or more years . There were 1980 (90%) respondents who evaluated more than 6 patients per week with GERD. Empiric therapy was commonly recommended for the symptomati c patient, most often in a step-up approach beginning with H-2-receptor blo ckers. Diagnostic testing, usually endoscopy, was recommended appropriately in patients with alarm symptoms. Proton-pump inhibitors were most often re commended for patients failing to respond to over-the-counter H-2-receptor blockers and for those with endoscopic esophagitis; the use of cisapride in combination with H2-receptor blockers was also commonly recommended in the se scenarios. Conclusions. The management of symptomatic GERD in elderly patients appears similar to the management of GERD in other patients. Empiric therapy was f requently recommended in a step-up approach, and diagnostic testing was app ropriate. Combination therapy with cisapride and an acid-reducing agent was commonly recommended.