Gastro-oesophageal reflux disease. Impact of guidelines on GP management

Abstract

Background This program examined the impact of clinical guidelines and a 3 year self audit process on general practitioners’ diagnosis and management of gastro-oesophageal reflux disease. Methods Nine hundred and sixty-six Australian GPs participated in a retrospective five step clinical audit reporting on data for 28 622 patients. Results General practitioners demonstrated significant improvements in their diagnosis and management of gastro-oesophageal reflux disease across the audit period, including: • a significant 3% decrease in use of endoscopy • improved GP assessment and identification of risk factors and exacerbants • significant increases in GP recommendations for patient weight loss and dietary change (7 and 10% respectively) • a significant 4% reduction in patient use of medications that may exacerbate reflux symptoms. Discussion The findings provide a snapshot of current diagnostic and management practices in Australian general practice, and highlight the benefits of clinical audit as a tool for eliciting evidence based, guideline driven practice change.