Adherence to best practice guidelines in dyspepsia

A survey comparing dyspepsia experts, community gastroenterologists and primary-care providers

B. M.R. Spiegel, M. Farid, M. G.H. Van Oijen, L. Laine, Colin Howden, E. Esrailian

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. Aim To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). Methods We administered a vignette survey to elicit knowledge and beliefs about dyspepsia including a set of 16 best practices, to three groups: (i) dyspepsia experts; (ii) community gastroenterologists and (iii) PCPs. Results The expert, community gastroenterologist and PCP groups endorsed 75%, 73% and 57% of best practices respectively. Gastroenterologists were more likely to adhere with guidelines than PCPs (P < 0.0001). PCPs were more likely to define dyspepsia incorrectly, overuse radiographic testing, delay endoscopy, treat empirically for Helciobacter pylori without confirmatory testing and avoid first-line proton pump inhibitors (PPIs). PCPs had more concerns about adverse events with PPIs [e.g. osteoporosis (P = 0.04), community-acquired pneumonia (P = 0.01)] and higher level of concern predicted lower guideline adherence (P = 0.04). Conclusions Gastroenterologists are more likely than PCPs to comply with best practices in dyspepsia, although compliance remains incomplete in both groups. PCPs harbour more concerns regarding long-term PPI use and these concerns may affect therapeutic decision making. This suggests that best practices have not been uniformly adopted and persistent guideline-practice disconnects should be addressed.

Original languageEnglish (US)
Pages (from-to)871-881
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume29
Issue number8
DOIs
StatePublished - Apr 1 2009

Fingerprint

Dyspepsia
Practice Guidelines
Primary Health Care
Proton Pump Inhibitors
Guidelines
Guideline Adherence
Gastroenterologists
Surveys and Questionnaires
Pylorus
Endoscopy
Osteoporosis
Compliance
Pneumonia
Decision Making

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

Adherence to best practice guidelines in dyspepsia : A survey comparing dyspepsia experts, community gastroenterologists and primary-care providers. / Spiegel, B. M.R.; Farid, M.; Van Oijen, M. G.H.; Laine, L.; Howden, Colin; Esrailian, E.

In: Alimentary Pharmacology and Therapeutics, Vol. 29, No. 8, 01.04.2009, p. 871-881.

Research output: Contribution to journalArticle

@article{1d8cedda0f7d4b54a123f309261457cc,
title = "Adherence to best practice guidelines in dyspepsia: A survey comparing dyspepsia experts, community gastroenterologists and primary-care providers",
abstract = "Background Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. Aim To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). Methods We administered a vignette survey to elicit knowledge and beliefs about dyspepsia including a set of 16 best practices, to three groups: (i) dyspepsia experts; (ii) community gastroenterologists and (iii) PCPs. Results The expert, community gastroenterologist and PCP groups endorsed 75{\%}, 73{\%} and 57{\%} of best practices respectively. Gastroenterologists were more likely to adhere with guidelines than PCPs (P < 0.0001). PCPs were more likely to define dyspepsia incorrectly, overuse radiographic testing, delay endoscopy, treat empirically for Helciobacter pylori without confirmatory testing and avoid first-line proton pump inhibitors (PPIs). PCPs had more concerns about adverse events with PPIs [e.g. osteoporosis (P = 0.04), community-acquired pneumonia (P = 0.01)] and higher level of concern predicted lower guideline adherence (P = 0.04). Conclusions Gastroenterologists are more likely than PCPs to comply with best practices in dyspepsia, although compliance remains incomplete in both groups. PCPs harbour more concerns regarding long-term PPI use and these concerns may affect therapeutic decision making. This suggests that best practices have not been uniformly adopted and persistent guideline-practice disconnects should be addressed.",
author = "Spiegel, {B. M.R.} and M. Farid and {Van Oijen}, {M. G.H.} and L. Laine and Colin Howden and E. Esrailian",
year = "2009",
month = "4",
day = "1",
doi = "10.1111/j.1365-2036.2009.03935.x",
language = "English (US)",
volume = "29",
pages = "871--881",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Adherence to best practice guidelines in dyspepsia

T2 - A survey comparing dyspepsia experts, community gastroenterologists and primary-care providers

AU - Spiegel, B. M.R.

AU - Farid, M.

AU - Van Oijen, M. G.H.

AU - Laine, L.

AU - Howden, Colin

AU - Esrailian, E.

PY - 2009/4/1

Y1 - 2009/4/1

N2 - Background Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. Aim To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). Methods We administered a vignette survey to elicit knowledge and beliefs about dyspepsia including a set of 16 best practices, to three groups: (i) dyspepsia experts; (ii) community gastroenterologists and (iii) PCPs. Results The expert, community gastroenterologist and PCP groups endorsed 75%, 73% and 57% of best practices respectively. Gastroenterologists were more likely to adhere with guidelines than PCPs (P < 0.0001). PCPs were more likely to define dyspepsia incorrectly, overuse radiographic testing, delay endoscopy, treat empirically for Helciobacter pylori without confirmatory testing and avoid first-line proton pump inhibitors (PPIs). PCPs had more concerns about adverse events with PPIs [e.g. osteoporosis (P = 0.04), community-acquired pneumonia (P = 0.01)] and higher level of concern predicted lower guideline adherence (P = 0.04). Conclusions Gastroenterologists are more likely than PCPs to comply with best practices in dyspepsia, although compliance remains incomplete in both groups. PCPs harbour more concerns regarding long-term PPI use and these concerns may affect therapeutic decision making. This suggests that best practices have not been uniformly adopted and persistent guideline-practice disconnects should be addressed.

AB - Background Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. Aim To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). Methods We administered a vignette survey to elicit knowledge and beliefs about dyspepsia including a set of 16 best practices, to three groups: (i) dyspepsia experts; (ii) community gastroenterologists and (iii) PCPs. Results The expert, community gastroenterologist and PCP groups endorsed 75%, 73% and 57% of best practices respectively. Gastroenterologists were more likely to adhere with guidelines than PCPs (P < 0.0001). PCPs were more likely to define dyspepsia incorrectly, overuse radiographic testing, delay endoscopy, treat empirically for Helciobacter pylori without confirmatory testing and avoid first-line proton pump inhibitors (PPIs). PCPs had more concerns about adverse events with PPIs [e.g. osteoporosis (P = 0.04), community-acquired pneumonia (P = 0.01)] and higher level of concern predicted lower guideline adherence (P = 0.04). Conclusions Gastroenterologists are more likely than PCPs to comply with best practices in dyspepsia, although compliance remains incomplete in both groups. PCPs harbour more concerns regarding long-term PPI use and these concerns may affect therapeutic decision making. This suggests that best practices have not been uniformly adopted and persistent guideline-practice disconnects should be addressed.

UR - http://www.scopus.com/inward/record.url?scp=62849093013&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62849093013&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2009.03935.x

DO - 10.1111/j.1365-2036.2009.03935.x

M3 - Article

VL - 29

SP - 871

EP - 881

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 8

ER -