T1079 Health-Related Quality of Life in Primary Care Patients with GERD, Identified with Gastro-Esophageal Reflux Disease Questionnaire (GERD-Q)

Abstract

enablement and patient satisfaction. Methods: Patients under treatment for GORD by 26 family practitioners in 5 primary care centres in the UK who had consented to take part in a quality improvement project completed survey instruments including the Gastro-oesophageal reflux disease Impact Scale (GIS), QOLRAD, EQ5D, HADS, PEI (Patient Enablement Instrument) and GPAQ (General Practice Assessment of Quality consultation subscale). Results: We studied 327 patients, of whom 54% were women, mean age 63.7 years (range 23-93), with a mean duration of GORD of 6.0 years (range 0.2-70). 62% of patients had contacted their primary care physician for GORD during the previous 12 months, mean consultation rate 2.8 (range 1-40). 14% consulted a gastroenterologist (mean 1.7 consultations; range 1-6) and 17% reported having an endoscopy. The mean GIS score was 15.3 (range 933), indicating significant persistence of symptoms; with around 25% reporting persistent heartburn, regurgitation, abdominal pain, interference with sleeping and symptoms affecting eating. Similarly, 26% said that these symptoms affected their performance in the daytime. The mean QOLRAD score was 150.5 (range 49-178), and the mean EQ5D score was 72.3 (range 10-100). Persistent symptoms were correlated with anxiety (r=0.478, p<0.0005), and depression (r=0.471, p<0.0005), and were significantly inversely correlated with satisfaction with GP consultations (r=-0.301, p<0.0005). Quality of life was inversely related to persisting anxiety (r=-0.516, p<0.0005), depression (r=-0.546, p<0.0005) and reduced satisfaction with GP consultations (r=0.255, p<0.0005). There was no association between symptom severity or QOL and patient enablement Conclusion: In a representative population of patients with GORD managed in primary care in the UK around 25% report persisting symptoms and substantial impacts on their quality of life. These problems appear to be in part related to existing anxiety and depression and to relatively low scores on patient enablement and patient satisfaction instruments and offer a range of opportunities to improve management.