The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition launched a provider and public education campaign in 2002 to raise awareness of gastroesophageal reflux disease (GERD).
Dr Diego Diaz and colleagues determined the effectiveness of campaign messages.
The research team conducted a knowledge, attitudes, and practice styles survey of pediatric providers.
Understanding the spectrum of management styles of GERD in children is critical to achieve better health outcomes and reduce health care costs.
|66% of the members order diagnostic testing in routine practice|
|Journal of Pediatric Gastroenterology|
The knowledge, attitudes, and practice styles questionnaire was administered to 6000 randomly selected members of the American Academy of Pediatrics.
A total of 1245 members responded.
The research team found that 82% worked in a primary care setting, and 18% in subspecialty practices.
Overall, 66% of the members order diagnostic testing in routine practice, 54% start testing for GERD in neonates, and 38% start testing after 1 month of age.
The team noted that the most common tests ordered were barium esophagram, and esophageal pH monitoring.
GERD treatment with acid suppression before ordering diagnostic testing was a choice of 82% of the respondents.
However, the researchers observed that 19% believed acid suppression was best achieved by H2 blockers.
If acid suppression was indicated, then only 36% followed guideline recommendations for therapy duration.
The team noted that under those circumstance, 52% followed guideline recommendations for dosing.
Antireflux surgery was recommended only as a last resort by 92%.
The research team found that 69% of providers believed the amount of GERD-related information available was not enough.
Respondents who were not aware of available GERD practice guidelines ranged from 74% to 92%.
Dr Diaz's team concludes, "Pediatric providers appear to frequently order diagnostic testing and treatment for GERD, yet knowledge about evidence-based GERD management among this random sample appeared limited."
"Moreover, a significant number of providers were not aware of different guideline publications."