Management of gastro-oesophageal reflux disease in primary care: a European observational study

Abstract

Objective:

To describe the management of gastro-oesophageal reflux disease (GERD) in primary care, as part of the RANGE (Retrospective ANalysis of GERD) study.

Methods:

Over 4 months, at 134 primary care practices in six European countries, 12 815 patients consulted for GERD-related reasons. A random selection of these patients was invited to enter the study. Data were then collected retrospectively (from the initial consultation) and prospectively (from a follow-up visit). This included information on GERD diagnosis, symptoms and complications, medication use and healthcare resource utilisation.

Results:

Of 12 815 patients who underwent consultation for GERD-related reasons, 2678 were randomly selected and accepted the invitation to participate in the study. Across countries, 28–47% of patients reported a significant GERD symptom load at initial consultation. Thereafter, 30–100% of patients were prescribed a proton pump inhibitor (PPI), but a significant GERD symptom load was still experienced by 15–30% (all patients combined) at follow-up (median 5.0–7.5 months after initial consultation). In the majority of patients (65–88%), no diagnostic procedures were performed between initial consultation and follow-up. During the follow-up period, the most common form of healthcare utilisation comprised additional GERD-related consultations with a physician.

Conclusions:

The findings of this pan-European study indicate that current management of primary care patients with GERD is far from optimal, and accounts for a marked burden on patients and healthcare systems alike. A more structured approach to GERD management, by tailoring treatment according to the impact of the disease, may reduce this burden.

Key words::

• Disease management
• Gastro-oesophageal reflux disease
• Healthcare utilisation
• Primary care

Transparency

Declaration of funding

This study was supported by AstraZeneca.

Declaration of financial/other relationships

J.P.G. has disclosed that he is the recipient of educational/research grants and consulting fees from AstraZeneca. A.C. has disclosed that he has no relevant financial relationships. D.K. has disclosed that he is the recipient of research grants from Abbott and speaker fees from Janssen, AstraZeneca and Falk (Galenica). J.H. has disclosed that he is the recipient of speaker fees from AstraZeneca. L.A. has disclosed that he is the recipient of research grants and speaker fees from AstraZeneca and is a former advisory board member for Orexo AB. H.J. has disclosed that he is the recipient of speaker fees from AstraZeneca. M.T. is an employee of AstraZeneca.

Acknowledgements

The authors thank Steve Winter, from Wolters Kluwer Pharma Solutions (Chester, UK), who provided medical writing support funded by AstraZeneca.