Clinical practice pattern of gastroenterologists, primary care physicians, and otolaryngologists for the management of GERD in the Asia-Pacific region: The FAST survey

Abstract

Background and Aim: The clinical practice patterns of gastroenterologists, primary care physicians, and otolaryngologists for the management of gastroesophageal reflux disease (GERD) in the Asia-Pacific region are unknown. Respective medical professionals from seven countries of the Asia-Pacific region were invited to participate in a questionnaire survey. Methods: Five hundred and eighty-five medical professionals (221 gastroenterologists, 205 primary care physicians, and 159 otolaryngologists) participated in the survey. Three different versions of the questionnaire were used for each medical specialty. The questionnaire inquired about the prevalence, diagnosis, and management strategy of GERD for the respective medical professionals. Results: All three medical specialties agreed that GERD is increasing and the most common diagnostic strategy used for patients with mild symptoms of GERD was 'treat before testing'. Gastroenterologists preferred 'test before treating' for patients with severe symptoms, but primary care physicians and otolaryngologists preferred 'treat before testing' for severe cases. Most medical professionals had heard of the proton pump inhibitor (PPI) empiric trial but only 33-52% of them had used it before. For mild and severe cases of GERD, gastroenterologists preferred the use of PPIs, while primary care physicians and otolaryngologists reserved PPIs for severe cases of GERD. Gastroenterologists preferred 'step down' approach, while the other two specialties preferred 'step-up' approach for the management of GERD. The preferred maintenance strategy for GERD was daily maintenance therapy among the three medical specialties. Conclusion: A clear evidence-based management strategy for the management of GERD is warranted in the Asia-Pacific region. © 2004 Blackwell Publishing Asia Pty Ltd.