Success of GERD therapy hinges on medication type and physician bedside manner

Patient satisfaction with their medications and the quality of interactions with their doctor reflect the success of gastroesophageal reflux disease (GERD) therapy, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

"Although patient satisfaction is a complex issue, improvements in recognition of GERD can improve management of the disease as well as patient satisfaction with their care and treatment," said Peter Bytzer, MD, PhD, of Copenhagen University and lead author of the study. "Patient satisfaction can be influenced by a number of factors including treatment regimen, general level of well-being, the 'bedside manner' of the physician, the patient's expectations and the quality of patient/physician communication."

The researchers found that patients who were given prescriptions for proton pump inhibitors (PPIs) tended to be more satisfied than those given H2-receptor antagonists. Partial responders were likely to be more dissatisfied than patients whose symptoms were fully resolved. In addition, a decrease in health-related quality of life (HRQoL) was associated with greater dissatisfaction. In fact, decreasing HRQoL was correlated with decreasing satisfaction with medical care in general. Patients were more likely to be satisfied if they were taken seriously by their physician and if their symptoms were investigated. They were also more likely to be satisfied if the patient/physician consultation was interactive.

"Of the various factors influencing patient satisfaction, the quality of patient/physician communication is probably the most amenable to improvement. This can be done by using validated questionnaires to help physicians identify more effectively which symptoms patients have, and the impact of these symptoms on the patient's well-being," added Dr. Bytzer.

Researchers reviewed the possible reasons why patients were dissatisfied with the way their disease is managed. Studies published between 1970 and 2007 were identified from PubMed, EMBASE and the author's existing database; 11 studies were found to be appropriate for use in this review. A key strength of this review was the fact that the searches identified a wide range of studies with varying methodologies.

Typically characterized by frequent or troublesome heartburn and/or acid regurgitation, GERD is a chronic, painful condition that impairs HRQoL. GERD may result in disturbed sleep, reduced productivity at work and impaired daily activities. Despite the efficacy of PPIs as therapeutics for patients with GERD, a number of studies have shown that a proportion of patients with the disease are not satisfied with their treatment. In fact, population-based surveys show that at least one-third of individuals taking medication for GERD are not satisfied with their treatment. This is particularly true for those taking over-the-counter medicines to relieve symptoms.

To learn more about heartburn and GERD, read the AGA patient brochure on this topic at www.gastro.org/patient.

About the AGA Institute

The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include 17,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. www.gastro.org.

About Clinical Gastroenterology and Hepatology

The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit www.cghjournal.org.