Objective: The aim of the present study was to describe the management of gastro-esophageal reflux disease (GERD) by primary care physicians (PCPs).
Methods: This prospective survey was conducted in patients with suspected or previously diagnosed GERD. PCPs completed questionnaires at first consultation (M0) and at a 3-month follow-up visit (M3).
Results: 2 474 patients were available for analysis at M0 and 1 993 at M3. GERD was the reason for consultation in 84% of patients; 33% were consulting about reflux symptoms for the first time. Symptoms occurred once daily in 55% of patients and were considered very disruptive or incapacitating by 51%. Upper gastrointestinal endoscopy was performed at any time in 57% of patients and at M0 in 20%. Only 48% of demands for endoscopy agreed with current recommendations and this rate was not influenced by PCP training in the previous 6 months. Lifestyle measures were recommended in 95% of patients at M0. Proton pump inhibitors were prescribed in 98%, to be taken "on-demand" in 22-57% depending on symptom frequency. Therapeutic management was considered as very satisfactory by 81% of patients.
Conclusions: GERD managed in primary care is severe, leading to expensive, but effective diagnostic investigations and treatments. Agreement with recommendations for endoscopy is poor.