PRACTICE PATTERNS OF PRIMARY CARE PHYSICIAN ON CLINICAL MANAGEMENT OF GERD IN GUJRANWALA PAKISTAN

Dr. Naveed Aslam*

ABSTRACT

Background: Gastro-esophageal Reflux disease (GERD) is the most commonly managed condition by primary care physicians while little is known about perception and practice patterns for its clinical management. Objective: To observe the practice patterns used for the diagnosis and management of GERD, among primary care physicians of Gujranwala - Pakistan. Methodology: A pilot study was conducted from September 2017 to March 2018 in Gujranwala – Pakistan. Knowledge, Attitude, and Practice (KAP) survey questionnaire were utilized in this study, comprised of 8 items related to clinical practices and diagnosis of GERD. Physicians from age between 30 to 85 years of both genders, with a minimum of two years of current clinical experience, were included in this study. The study was conducted according to the guidelines of Good Epidemiology Practice and the data was analyzed through SPSS version 21.0. Results: A total of 81 physicians (79% males & 21% females) with a mean age of 38.18+11.21 years were asked to fill the questionnaire for their practice in GERD management. Out of all, 53.1% physicians had 10 years of work experience while only 4.9% had up to 40 years of practicing experience and dealt with an average of 52.4% GERD complaints per week. Around 77% of the physicians reported that they rely on medical history for diagnosis. 79% preferred management through proton pump inhibitors (PPIs) as first-line treatment, 12% preferred prokinetic agents and 54.3% favored lifestyle modifications along with medication. Conclusion: Lifestyle modifications along with medication is the most deployed practice while the effective therapeutic agent was found to be PPIs. It has also been observed that national clinical practices are complimenting with international guidelines for GERD diagnosis & management.

Keywords: Gastro-esophageal, preferred management, proton pump Inhibitors, heart burn.