Gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease (GORD) disease is important to understand in primary care as reflux symptoms such as heartburn are common and can lead to significant impairment in the quality of life for your patients.

Dr Grace Lee, Deputy Director Goodfellow Unit, talks with Dr John Perry about optimizing management of a patient with gastro-oesophageal reflux disease.

John is a Gastroenterologist and Endoscopist at Waitemata DHB and Waitemata Gastroenterologists.

Topic covered:

  • Identifying lifestyle factors that may impact the course of illness.
  • When further investigations may be warranted.
  • Lifestyle as medicine and optimising medical management.
  • Take-home messages.

 

Resources

  

Peer group discussion points

Lifestyle measures are good option for non-erosive reflux disease or mild disease and they may alleviate the need for further medication.

  • Is this currently a strategy that you use in your initial consultation(s)? Have you identified any further lifestyle changes from the MedTalk that you will be able to add to your toolkit for reflux management?

  • Do you follow up on whether these changes have worked or need to be modified?

  • Lifestyle changes can be challenging. Are there tools, resources that you use to support your patients?  What about local community groups that your patient that can connect with?

Proton pump inhibitors such as omeprazole should always be periodically reviewed to see if they are still indicated for patient management.

  • Do you regularly monitor your prescribing of proton pump inhibitors? If so, how do you do this? 

  • Have you utilized any audit tools to identify those that may be able to come off the medication?

  • Encouraging people to change their medications can be challenging.  How do you approach the conversation of decreasing or stopping their medications?

  • Are there resources that you can share with your peer group that you draw on to help with this process, such as those listed above?

Keeping accurate medical records is integral in providing good patient care and continuity of care.  Information should be structured and easily accessible – medical history, family history, ethnicity and lifestyle screening are particularly important for assessment and management of GORD.

  • How to you ensure that record keeping is update to date?

  • Are you aware there are clinical record audits from the RNZCGP that can improve the quality of your record keeping?

  • Accuracy of ethnicity records may further identify those at greater risk from h. pylori infection or gastric cancer such as Maori, Pacific and Asian groups.  How does your practice collate ethnicity?

  • Have you considered using an ethnicity data audit tool to assess your current practice and to identify areas of improvement? 

This MedTalk is supported by

Date Published: 
Friday, September 6, 2019