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治疗胃食管反流病的全科医生和胃肠病学专家的执业风格、知识与态度。

Practice styles, knowledge and attitudes of general practitioners and gastroenterology specialists who treat gastroesophageal reflux disease.

作者信息

Carter Dan, Dickman Ram

机构信息

Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Medical Center.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Medicine (Baltimore). 2018 Dec;97(52):e13781. doi: 10.1097/MD.0000000000013781.

Abstract

As little is known on the subject, our aim was to compare practice styles, knowledge and attitudes of general practitioners (GPs), and gastroenterology specialists (GIs) regarding the treatment of gastroesophageal reflux disease (GERD).An internet survey designed by the authors was sent nationwide and randomly to 290 GIs and 1312 GPs. We assessed for the burden of GERD, indications for referral for a GI consultation, criteria for proton pump inhibitors (PPIs) selection, and main unmet treatment needs.Forty (14%) GIs and 132 (10%) GPs returned the questionnaire. Both groups treat 13 to 14 GERD patients weekly (mean age 41-50 years). The most common first and second line drug of choice in both groups was omeprazole and esomeprazole, respectively. GIs stated that the most important consideration for the selection of treatment was high safety profile, whereas GPs considered it to be a rapid symptomatic relief. In the case of first and second line PPI failures, GIs tended to prescribe a non PPI treatment, whereas GPs restarted esomeprazole. GIs stated that the most prevalent conceived limitations of PPI treatment were nighttime heartburn and undesirable side effects, whereas GPs considered treatment inflexibility and drug interactions.GIs and GPs hold different practice styles, knowledge, and attitudes on the treatment of GERD. Our findings ascertain the need for the development of updated National Clinical Guidelines focusing on GERD.

摘要

由于对此主题了解甚少,我们的目的是比较全科医生(GPs)和胃肠病学专家(GIs)在胃食管反流病(GERD)治疗方面的实践方式、知识和态度。作者设计的一项网络调查在全国范围内随机发送给290名胃肠病学专家和1312名全科医生。我们评估了GERD的负担、转诊至胃肠病学专家咨询的指征、质子泵抑制剂(PPIs)的选择标准以及主要未满足的治疗需求。40名(14%)胃肠病学专家和132名(10%)全科医生回复了问卷。两组每周治疗13至14名GERD患者(平均年龄41 - 50岁)。两组中最常用的一线和二线药物分别是奥美拉唑和埃索美拉唑。胃肠病学专家表示,选择治疗方法时最重要的考虑因素是高安全性,而全科医生认为是快速缓解症状。在一线和二线PPI治疗失败的情况下,胃肠病学专家倾向于开非PPI治疗药物,而全科医生则重新使用埃索美拉唑。胃肠病学专家表示,PPI治疗最普遍的设想局限性是夜间烧心和不良副作用,而全科医生认为是治疗灵活性和药物相互作用。胃肠病学专家和全科医生在GERD治疗方面持有不同的实践方式、知识和态度。我们的研究结果确定了制定侧重于GERD的最新国家临床指南的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79e7/6314753/8e45a2d92e30/medi-97-e13781-g003.jpg

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