Korean J Gastroenterol.  2009 Dec;54(6):364-370. 10.4166/kjg.2009.54.6.364.

Clinical Practice Patterns of Gastroenterologists for Initial and Maintenance Therapy in Gastroesophageal Reflux Disease: A Nationwide Online Survey in Korea

• Chung SJ
• Kim SG
• Jung HC
• Song IS
• Kim JS

• KMID: 1775935
• DOI: http://doi.org/10.4166/kjg.2009.54.6.364

Abstract

BACKGROUND/AIMS
Gastroesophageal reflux disease (GERD) is a chronic condition and accompanied by frequent relapses. We aimed to evaluate the clinical practice patterns of gastroenterologists for initial and maintenance therapy of GERD in Korea. METHODS: We administered a nationwide, multi-center, and questionnaire-based online survey between December 2007 and January 2008. The questionnaire consisted of 15 questions about prescribing patterns of initial and maintenance therapy for GERD. RESULTS: A total of 371 gastroenterologists participated in the survey with the response rate of 77%. For mild cases of GERD, the most common choice of initial therapy was full dose proton-pump inhibitors (PPIs) (59%), followed by half dose PPIs (20%), and H2 receptor antagonists (4%). For severe cases, full dose PPIs were prescribed in 99%. Almost all gastroenterologists agreed to the need for maintenance therapy. For both mild (95%) and severe (99%) cases of GERD, gastroenterologists preferred the use of PPI-based maintenance regimen. The preferred maintenance strategy for GERD was continuous therapy in erosive esophagitis (67%), and on-demand therapy in non-erosive reflux disease (68%). The overall duration of the therapy (initial+maintenance) was 7.7+/-5.1 wk in mild cases and 15.0+/-9.4 wk in severe cases. The duration of maintenance therapy was affected by symptom severity, followed by symptom frequency and endoscopic finding. CONCLUSIONS: In this study, a majority of the gastroenterologists is aware of importance on PPI-based pharmacological treatment for GERD. Further studies are needed to clarify the appropriate strategy and duration of maintenance therapy.

Keyword

Gastroesophageal reflux disease; Maintenance therapy; Survey

MeSH Terms

Adult
Aged
Female
*Gastroenterology
Gastroesophageal Reflux/*drug therapy
Humans
Male
Middle Aged
Online Systems
*Physician's Practice Patterns
Proton Pump Inhibitors/therapeutic use
Questionnaires
Republic of Korea
Time Factors

Figure

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  Fig. 1. Medication of choice for maintenance therapy in mild and severe gastroesophageal reflux disease. GERD, gastroesophageal reflux disease; PPI, proton pump inhibitor; H2RA, H2 receptor antagonist.

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  Fig. 2. Maintenance strategy of choice for mild and severe gastroesophageal reflux disease. EE, erosive esophagitis; NERD, non-erosive reflux disease.

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  Fig. 3. Total duration of treatment for mild and severe gastroesophageal reflux disease. GERD, gastroesophageal reflux disease.

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