Τίτλος:
European pediatricians' approach to children with ger symptoms: Survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: The aim of this study was to evaluate the current implementation of the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines, and to assess proton pump inhibitors' (PPIs) prescribing patterns among pediatricians from different European countries. Methods: A randomly identified sample of general pediatricians distributed across 11 European countries. They were asked to complete a case report-structured questionnaire investigating their approaches to infants, children, and adolescents with symptoms suggestive of gastroesophageal reflux. Results: A total of 567 European general pediatricians completed the study questionnaire. Only 1.8% of them showed complete adherence to the guidelines. Forty-six percent of them reported that they diagnose gastroesophageal reflux disease based on clinical symptoms irrespective of the age of the child; 39% prescribe PPIs in infants with unexplained crying and/or distressed behavior and 36% prescribe PPIs in infants with uncomplicated recurrent regurgitation and vomiting; 48% prescribed PPIs in children younger than 8 to 12 years with vomiting and heartburn, without specific testing; 45% discontinue PPI therapy abruptly rather than tapering the dose. The overall rate of pediatricians overprescribing PPIs was 82%. Conclusions: The overall results of our survey show that the majority of pediatricians are unaware of 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition reflux guidelines and often prescribe PPIs despite a lack of efficacy for the symptoms being treated. The overdiagnosis of gastroesophageal reflux disease places undue burden on both families and national health systems, which has not been affected by the publication of international guidelines. Copyright 2014 by ESPGHAN and NASPGHAN. Unauthorized reproduction of this article is prohibited.
Συγγραφείς:
Quitadamo, P.
Papadopoulou, A.
Wenzl, T.
Urbonas, V.
Kneepkens, C.M.F.
Roman, E.
Orel, R.
Pavkov, D.J.
Dias, J.A.
Vandenplas, Y.
Kostovski, A.
Miele, E.
Villani, A.
Staiano, A.
Περιοδικό:
Journal of Pediatric Gastroenterology and Nutrition,
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
proton pump inhibitor, article; Belgium; child; clinical practice; crying; distress syndrome; echography; esophageal pH monitoring; gastroesophageal reflux; gastrointestinal endoscopy; Germany; good clinical practice; Greece; health care survey; heartburn; human; irritability; Italy; Lithuania; lower respiratory tract infection; Macedonia (republic); medical society; Netherlands; pediatrician; physical examination; Portugal; practice guideline; prescription; priority journal; prospective study; recurrent disease; reflux esophagitis; school child; Serbia; Slovenia; Spain; stomach acid; thorax pain; vomiting; weight reduction; complication; Europe; gastroesophageal reflux; heartburn; inappropriate prescribing; infant; laryngopharyngeal reflux; pediatrics; practice guideline; questionnaire; statistics and numerical data; vomiting, Child; Crying; Europe; Gastroesophageal Reflux; Guideline Adherence; Heartburn; Humans; Inappropriate Prescribing; Infant; Laryngopharyngeal Reflux; Pediatrics; Physician's Practice Patterns; Practice Guidelines as Topic; Proton Pump Inhibitors; Questionnaires; Recurrence; Vomiting
DOI:
10.1097/MPG.0b013e3182a69912
