Document Detail


Survey of primary care physicians' approach to gastroesophageal reflux disease in elderly patients.
MedLine Citation:
PMID:  11487605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although gastroesophageal reflux disease (GERD) is a common condition, 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 primary care physicians throughout the United States. Physicians were questioned using a case-based format about the approach to a symptomatic patient with 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 respondents were either internists (37%) or family practice physicians (56%) in 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 symptomatic patient, most often in a step-up approach beginning with H(2)-receptor blockers. Diagnostic testing, usually endoscopy, was recommended appropriately in patients with alarm symptoms. Proton-pump inhibitors were most often recommended 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 H(2)-receptor blockers was also commonly recommended in these scenarios. CONCLUSIONS: The management of symptomatic GERD in elderly patients appears similar to the management of GERD in other patients. Empiric therapy was frequently recommended in a step-up approach, and diagnostic testing was appropriate. Combination therapy with cisapride and an acid-reducing agent was commonly recommended.
Authors:
C M Wilcox; G Heudebert; J Klapow; R Shewchuk; L Casebeer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journals of gerontology. Series A, Biological sciences and medical sciences     Volume:  56     ISSN:  1079-5006     ISO Abbreviation:  J. Gerontol. A Biol. Sci. Med. Sci.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-06     Completed Date:  2001-08-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9502837     Medline TA:  J Gerontol A Biol Sci Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  M514-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA. mel_wilcox@gihep.uab.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Anti-Ulcer Agents / administration & dosage*
Attitude of Health Personnel
Endoscopy, Digestive System
Female
Gastroesophageal Reflux / diagnosis*,  drug therapy*
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Physical Examination
Physician's Practice Patterns / statistics & numerical data*
Primary Health Care / methods*
Prognosis
Sex Distribution
United States
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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