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Management of gastro-oesophageal reflux disease in primary care: a European observational study

Abstract Objective: To describe the management of gastro-oesophageal reflux disease (GERD) in primary care, as part of the RANGE (Retrospective ANalysis of GERD) study. Methods: Over 4 months, at 134 primary care practices in six European countries, 12 815 patients consulted for GERD-related reasons. A random selection of these patients was invited to enter the study. Data were then collected retrospectively (from the initial consultation) and prospectively (from a follow-up visit). This included information on GERD diagnosis, symptoms and complications, medication use and healthcare resource utilisation. Results: Of 12 815 patients who underwent consultation for GERD-related reasons, 2678 were randomly selected and accepted the invitation to participate in the study. Across countries, 28–47% of patients reported a significant GERD symptom load at initial consultation. Thereafter, 30–100% of patients were prescribed a proton pump inhibitor (PPI), but a significant GERD symptom load was still experienced by 15–30% (all patients combined) at follow-up (median 5.0–7.5 months after initial consultation). In the majority of patients (65–88%), no diagnostic procedures were performed between initial consultation and follow-up. During the follow-up period, the most common form of healthcare utilisation comprised additional GERD-related consultations with a physician. Conclusions: The findings of this pan-European study indicate that current management of primary care patients with GERD is far from optimal, and accounts for a marked burden on patients and healthcare systems alike. A more structured approach to GERD management, by tailoring treatment according to the impact of the disease, may reduce this burden.