Naguib Rania, Alfawaz Amjad S, Alqahtani Arwa M, Balkhasl Kholoud M, Alnafee Reem A, Naji Sabrin N
Clinical Science Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, KSA.
Internal Medicine Department, Faculty of Medicine, Alexandria University, Egypt.
J Family Med Prim Care. 2020 Aug 25;9(8):4181-4189. doi: 10.4103/jfmpc.jfmpc_585_20. eCollection 2020 Aug.
Gastroesophageal reflux disease (GERD) was frequently managed by residents as they are the first physician who encounter the patient. This study was conducted to explore the knowledge and practice of physicians in the treatment of GERD and to compare between residents and consultants regarding their knowledge and practice.
A cross-sectional study, self-administered questionnaire.
Esophagogastroduodenoscopy (EGD) was the most commonly used method to screen for Barrett's esophagus for symptoms for 5 or more years. The most frequent guideline used was the American College of Gastroenterology (ACG) guideline. The most commonly used diagnostic tool for evaluating uncomplicated reflux disease was upper endoscopy with biopsy. Empiric trial with acid suppression was the most commonly used and proton pump inhibitors (PPIs) was the first-line treatment. The most common combination with PPI was prokinetic drugs, most often domperidone. The preferred maintenance strategy was the 'on demand' maintenance mode. Step-down strategy was commonly recommended. A total of 26% of residents and 37% of consultants could achieve a score of good knowledge. Overall patterns of knowledge and practice of GERD diagnosis and management were comparable between residents and consultants with only minor controversy in their knowledge and practice.
The overall patterns of knowledge and practice of GERD diagnosis and management are comparable among residents and consultants but still there are areas of controversy and confusion. A good knowledge score was found among only a quarter of residents and 37% of consultants.
The public health implications of deviations from evidence-based practice should be studied and implementing evidence-based practice should be emphasized.
胃食管反流病（GERD）常由住院医师进行管理，因为他们是首批接触患者的医生。本研究旨在探讨医生在GERD治疗方面的知识与实践，并比较住院医师和会诊医师在知识与实践方面的差异。
一项横断面研究，采用自填式问卷。
食管胃十二指肠镜检查（EGD）是筛查症状持续5年或更长时间的巴雷特食管最常用的方法。最常使用的指南是美国胃肠病学会（ACG）指南。评估非复杂性反流病最常用的诊断工具是上消化道内镜检查及活检。经验性抑酸试验是最常用的方法，质子泵抑制剂（PPI）是一线治疗药物。与PPI最常见的联合用药是促动力药物，最常用的是多潘立酮。首选的维持策略是“按需”维持模式。通常推荐采用逐步减量策略。共有26%的住院医师和37%的会诊医师能够获得良好的知识评分。住院医师和会诊医师在GERD诊断和管理的知识与实践总体模式上具有可比性，仅在知识和实践方面存在一些小的争议。
住院医师和会诊医师在GERD诊断和管理的知识与实践总体模式上具有可比性，但仍存在争议和困惑的领域。仅四分之一的住院医师和37%的会诊医师获得了良好的知识评分。
应研究偏离循证实践对公共卫生的影响，并强调实施循证实践。
