Guideline Adherence in Dyspepsia Investigation and Treatment

Abstract

Introduction: The impact of dyspepsia guidelines on clinical practice may be poor. Provider adherence with dyspepsia guidelines was examined to determine their impact on clinical practice.
 Methods: Provider adherence with the 2005 American College of Gastroenterology Guidelines for the Management of Dyspepsia and the 2017 American College of Gastroenterology and Canadian Association of Gastroenterology joint Dyspepsia Management Guidelines was assessed on a national level using data from the National Ambulatory Medical Care Survey (NAMCS). Patient visit data, including reason for visit of dyspepsia, diagnosis of dyspepsia, or diagnosis of H. pylori infection from NAMCS years 2012 through 2015, were used. Provider adherence with dyspepsia management guidelines was determined based upon provision of at least one recommended test or treatment for dyspepsia.
 Results: Providers appeared to adhere to the 2005 ACG guidelines for 49.7% of patient visits. Providers appeared to adhere to the 2017 ACG/CAG guidelines for 51.0% of patient visits.
 Conclusions: Provider adherence with the 2005 ACG and the 2017 ACG/CAG Dyspepsia Management Guidelines was determined to be low in this study, highlighting the need to increase evidence-based medical treatment and efficient resource use for dyspepsia.

Functional dyspepsia: a multifaceted problem in gastroenterology

“…Пациентов с диспепсией делят на лиц с неуточненной диспепсией, если они не подвергались исследованию, уточненной при установленной ФД или уточненной, но не относящейся к ФД [6]. Рефрактерная ФД характеризуется наличием постоянных симптомов диспепсии в течение как минимум 8 нед, эти симптомы не купируются при применении не менее 2 схем терапии [7,8].…”

“…Домперидон почти не проникает через гематоэнцефалический барьер и поэтому не вызывает экстрапирамидных расстройств и почти не вызывает побочных эффектов [6].…”

Gastroscopy Yield in the Young: Comprehensive Assessment of Endoscopic and Histologic Findings—A Comparative Study

“…Despite these recommendations, several observations have documented poor adherence to these guidelines, with gastroscopy still being widely performed in young adults, often without signifcant fndings [11,12]. Importantly, data regarding the use and outcome of gastroscopy for young individuals under 50 years presenting with upper GI symptoms other than dyspepsia are scarce and were not evaluated in a large-scale study [13].…”