Eryilmaz Aylin, Basal Yesim, Gunel Ceren, Basak Sema, Ture Mevlut, Elatik Hakan, Basak Okay
Department of Otorhinolaryngology, Faculty of Medicine, Adnan Menders University, Aydin, Turkey.
Department of Biostatistics, Faculty of Medicine, Adnan Menders University, Aydin, Turkey.
Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4377-4384. doi: 10.1007/s00405-016-4180-5. Epub 2016 Jul 4.
Laryngopharyngeal reflux (LPR) is a type of reflux, seen with complaints of hoarseness, chronic cough, and globus sensation, different from gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the awareness, knowledge, and practices of family physicians and trainees who were being trained in medical branches other than ENT and to determine the effective factors on decision making for diagnosis of this disorder. The study was designed as a two-stage study. At the first stage, a data collection tool, involving 29 questions by which the knowledge, awareness, and applications of the physicians about LPR would be determined, was developed with 12 specialists, using Delphi method. At the second stage, 101 family physicians replied the questionnaire online. For 45 trainees other than ENT, the questionnaire was filled face-to-face by one of the investigators. In patients admitted with complaints of hoarseness, lasting longer than 2 weeks, cough, lasting longer than 3 weeks, and globus sensation, the physicians considered LPR as the preliminary diagnosis with rates of 88.4, 82.2, and 62.8 %, respectively. 87.0 % of physicians, participating in the study, started treatment for reflux empirically in patients having complaints of hoarseness, chronic cough, and globus sensation; however, only 29.0 % of physicians prescribed this treatment for periods of 3 or 6 months. 69.9 % of physicians, participating in the study, made a diagnosis of reflux in general during their daily practices; only 6.9 % made the discrimination between LPR and GERD. Of all physicians, 27.9 % prescribed double-dose PPI or H2.
喉咽反流(LPR)是一种反流类型,表现为声音嘶哑、慢性咳嗽和咽部异物感等症状,与胃食管反流病(GERD)不同。本研究的目的是评估家庭医生以及非耳鼻喉科医学专业实习生对喉咽反流的认知、知识掌握情况及实践情况,并确定影响该疾病诊断决策的相关因素。本研究设计为两阶段研究。在第一阶段,采用德尔菲法与12名专家共同开发了一个包含29个问题的数据收集工具,用以确定医生对喉咽反流的知识、认知及应用情况。在第二阶段,101名家庭医生在线回复了问卷。对于45名非耳鼻喉科实习生,由一名研究人员面对面填写问卷。对于因声音嘶哑持续超过2周、咳嗽持续超过3周以及咽部异物感而入院的患者,医生将喉咽反流分别作为初步诊断的比例为88.4%、82.2%和62.8%。参与研究的医生中,87.0%会针对有声音嘶哑、慢性咳嗽和咽部异物感症状的患者经验性地开始进行反流治疗;然而,只有29.0%的医生将这种治疗持续3个月或6个月。参与研究的医生中,69.9%在日常诊疗中一般会诊断为反流;只有6.9%能区分喉咽反流和胃食管反流病。在所有医生中,27.9%会开具双倍剂量的质子泵抑制剂(PPI)或H2受体拮抗剂。