AIM: To investigate usefulness of adherence to gastro-esophageal reflux disease (GERD) guideline established by the Spanish Association of Gastroenterology.

METHODS: Prospective, observational and multicentre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily practice. Patients (aged > 18 years) were eligible for inclusion if they had typical symptoms of GERD (heartburn and/or acid regurgitation) as the major complaint in the presence or absence of accompanying atypical symptoms, such as dyspeptic symptoms and/or supraesophageal symptoms. Diagnostic and therapeutic decisions should be made based on specific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive disease specialists.

RESULTS: Endoscopy was indicated in 123 (41%) patients: 50 with alarm symptoms, 32 with age > 50 years without alarm symptom. Seventy-two patients (58.5%) had esophagitis (grade A, 23, grade B, 28, grade C, 18, grade D, 3). In the presence of alarm symptoms, endoscopy was indicated consistently with recommendations in 98% of cases. However, in the absence of alarm symptoms, endoscopy was indicated in 33% of patients > 50 years (not recommended by the guideline). Adherence for proton pump inhibitors (PPIs) therapy was 80%, but doses prescribed were lower (half) in 5% of cases and higher (double) in 15%. Adherence regarding duration of PPI therapy was 69%; duration was shorter than recommended in 1% (4 wk in esophagitis grades C-D) or longer in 30% (8 wk in esophagitis grades A-B or in patients without endoscopy). Treatment response was higher when PPI doses were consistent with guidelines, although differences were not significant (95% vs 85%).

CONCLUSION: GERD guideline compliance was quite good although endoscopy was over indicated in patients > 50 years without alarm symptoms; PPIs were prescribed at higher doses and longer duration.

• Gastro-esophageal reflux disease
• Clinical practice guidelines
• Adherence to guidelines
• Treatment of gastro-esophageal reflux disease

• Cross-Sectional Studies
• Female
• Gastroesophageal Reflux/diagnosis
• Gastroesophageal Reflux/therapy
• Humans
• Male
• Middle Aged
• Primary Health Care
• Retrospective Studies
• Spain

• Adult
• Aged
• Antacids/therapeutic use
• Chest Pain/etiology
• Cross-Sectional Studies
• Drug Resistance
• Dyspepsia/etiology
• Female
• Gastroesophageal Reflux/complications
• Gastroesophageal Reflux/drug therapy
• Humans
• Laryngopharyngeal Reflux/etiology
• Male
• Middle Aged
• Overweight/complications
• Polypharmacy
• Prospective Studies
• Proton Pump Inhibitors/therapeutic use
• Risk Factors
• Severity of Illness Index
• Treatment Failure

• Adult
• Aged
• Algorithms
• Anti-Ulcer Agents/therapeutic use
• Europe/epidemiology
• Female
• Gastroesophageal Reflux/diagnosis
• Gastroesophageal Reflux/epidemiology
• Gastroesophageal Reflux/therapy
• Health Resources/statistics & numerical data
• Humans
• Male
• Middle Aged
• Office Visits/statistics & numerical data
• Practice Patterns, Physicians'
• Primary Health Care
• Recurrence
• Retrospective Studies