Abstract
BackgroundThe impact of gastroesophageal reflux disease (GERD) on the daily lives of patients managed in primary care is not well known. We report the burden of GERD in a large population of patients managed in primary care, in terms of symptoms and impact on patients' daily lives.MethodsRANGE (Retrospective ANalysis of GERD) was an observational study that was conducted at 134 primary care sites across six European countries. All adult subjects who had consulted their primary care physician (PCP) during a 4-month identification period were screened retrospectively and those consulting at least once for GERD-related reasons were identified. From this population, a random sample of patients was selected to enter the study and attended a follow-up appointment, during which the Reflux Disease Questionnaire (RDQ), the GERD Impact Scale (GIS) and an extra-esophageal symptoms questionnaire were self-administered. Based on medical records, data were collected on demographics, history of GERD, its diagnostic work-up and therapy.ResultsOver the 4-month identification period, 373,610 subjects consulted their PCP and 12,815 (3.4%) did so for GERD-related reasons. From 2678 patients interviewed (approximately 75% of whom reported taking medication for GERD symptoms), symptom recurrence following a period of remission was the most common reason for consultation (35%). At the follow-up visit, with regard to RDQ items (score range 0–5, where high score = worse status), mean Heartburn dimension scores ranged from 0.8 (Sweden) to 1.2 (UK) and mean Regurgitation dimension scores ranged from 1.0 (Norway) to 1.4 (Germany). Mean overall GIS scores (range 1–4, where low score = worse status) ranged from 3.3 (Germany) to 3.5 (Spain). With regard to extra-esophageal symptoms, sleep disturbance was common in all countries in terms of both frequency and intensity.ConclusionIn this large European observational study, GERD was associated with a substantial impact on the daily lives of affected individuals managed in the primary care setting.
Highlights
The impact of gastroesophageal reflux disease (GERD) on the daily lives of patients managed in primary care is not well known
The negative effect of GERD on health-related quality of life (HRQOL) is becoming better defined as researchers increasingly make use of patient-reported outcome (PRO) instruments to investigate the impact of GERD symptoms in large populations [4]
Studies conducted in the Swedish general population assessing the impact of the severity and frequency of GERD symptoms on HRQOL have found that even symptoms rated as mild are associated with a clinically meaningful reduction in well-being [6], and that weekly symptoms are likely to have a clinically significant adverse impact on most aspects of patients' daily lives [7]
Summary
The impact of gastroesophageal reflux disease (GERD) on the daily lives of patients managed in primary care is not well known. We report the burden of GERD in a large population of patients managed in primary care, in terms of symptoms and impact on patients' daily lives. The German ProGERD study, for example, determined that patients with symptoms of GERD had substantially impaired HRQOL in terms of both physical and psychosocial aspects of wellbeing compared with the general population, and felt restricted as a result of food and drink problems, disturbed sleep, and impaired vitality and emotional wellbeing [5]. The impact of symptoms of GERD among patients who are managed and treated in primary care has not been well studied
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