Transcript L-05_Kavin - Advocatehealth.com

Educating The Patient With Gastroesophageal Reflux Disease (GERD):
More Must Be Done At the Primary Care Level.
Naser Khan MD, Sarosh Bukhari DO, Asif Lakha MD, Baseer Qazi MD,
Nancy Davis MA, Hymie Kavin MD.
Department of Medicine, Division of Gastroenterology
Results
Introduction:
• Despite the advent of potent acid
suppressive medications such as
proton pump inhibitors, GERD
continues to be a significant
problem.
•
333 out of 333 patients that gave
informed consent completed the
survey.
•
49.5% (165) patients were male.
•
Mean age was 43.7 ± 13.1 years.
•
33.9% (113) patients claimed that
they did not have an in-depth
discussion with their primary care
physician regarding lifestyle
modifications and risk factors
affecting GERD.
• Nearly 20 million American’s suffer
from the disease and nearly 20
percent of the entire western
population suffers from the disease.
• In a poll conducted by the NY times,
it has been shown that only 15% of
patients fully understand what their
doctors tell them, and that 50%
leave their doctors' offices uncertain
of what they are supposed to do to
take care of themselves.
•
•
Of those taking a PPI, 39.4% (98) of
patients did not know the correct
time to take their medication.
•
Only 32.7% (109) patients were
aware that elevating the head of the
bed or placing pillows under their
head and neck to elevate their torso
while sleeping was associated with
less GERD symptoms.
Methods:
• After informed consent was
obtained, a multiple choice
question survey was administered
in person to 333 patients carrying
a diagnosis of GERD in the
primary care setting.
74.7% (249) patients were taking a
PPI.
•
Patients that had an in-depth
discussion with their primary care
doctor (PCP) were more likely to
know the best position to sleep in
order to avoid the symptoms of
GERD. (p=0.049)
Conclusions:
• Patients that had an in-depth
discussion with their primary care
doctor were more likely to know that
weight reduction through exercise and
smoking cessation was associated
with reduced GERD symptoms.
(p<0.001).
• 82.3% (274) patients were unaware
that coffee, alcohol, milk and citrus
drinks can all be associated with
worsening GERD symptoms.
• 31.8% (106) patients were unaware
that untreated GERD can be
associated with a condition that can
result in cancer of the esophagus.
•
Patients that had an in-depth
discussion with their PCP were more
likely to know that eating six smaller
sized meals was better than eating 3
regular sized meals and fried food s
in reducing the symptoms of GERD.
• In our study, one-third of patients
did not have an in-depth
discussion with their primary
care physician regarding GERD
and its modifiable risk factors.
• Patients that had an in-depth
discussion were likely to be
educated better with regards to
GERD.
• Because GERD affects at least
20% of the entire western
population and is associated with
increased healthcare costs and
reduced quality of life, more
emphasis should be placed in
the education of the patient
suffering from this disease at the
primary care level.