Survey of the adherence to the consensus of gastroesophageal reflux disease before and after the implementation course

Jyh-Ming Liou; Bor-Shyang Sheu; Yi-Chia Lee; Hsiu-Chi Cheng; Wei-Lun Chang; Deng-Chyang Wu; Ping-I Hsu; Chun-Ying Wu; Ming-Shiang Wu; Cheng-Tang Chiu; Jaw-Town Lin

doi:10.1016/j.jfma.2017.05.012

Survey of the adherence to the consensus of gastroesophageal reflux disease before and after the implementation course

J Formos Med Assoc. 2018 May;117(5):440-449. doi: 10.1016/j.jfma.2017.05.012. Epub 2017 Jun 13.

Authors

Affiliations

¹ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
² Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: sheubs@mail.ncku.edu.tw.
³ Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁴ Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming University, Taiwan.
⁶ Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
⁷ Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
⁸ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. Electronic address: jawtown@gmail.com.

PMID: 28622974
DOI: 10.1016/j.jfma.2017.05.012

Abstract

Background/purpose: The prevalence of Gastroesophageal reflux disease (GERD) is increasing worldwide, including Asia. Although several consensus reports have been published, little is known regarding the adherence of the physicians on the consensus of GERD. We aimed to survey the agreements and adherence of physicians to the Taiwan GERD consensus before and after the continual medical education (CME) courses.

Methods: Two-hundred and twenty-seven physicians, including 81 fellows of gastroenterology, 135 qualified gastroenterologists, and 11 non-gastroenterologist attending physicians were invited to the CME course. Their agreements and adherence to the statements before and after the CME course were assessed by the pre-defined questionnaire with the aid of electronic keypads. The adherence rate before and after the CME course were compared by the McNemar test to indicate the changes in their willingness to follow the statements in clinical practice.

Results: The rates of agreement of the 227 participating physicians were uniformly greater than 80% for all of the 22 statements. However, the adherence rates were lower than 80% in 16 statements before the CME intervention. The adherence rates were significantly (p < 0.05) increased in 15 of these 16 statements after the CME intervention. The adherence rate can be improved to greater than 80% for those statements with high level of evidence.

Conclusion: Although physicians agreed with the statements, the pre-CME survey disclosed limited adherence rates to the statements. The education intervention through the CME courses can improve the adherence of consensus statement, especially for those with higher level of evidence.

Keywords: Adherence; Barrier; Consensus; Education; Gastroesophageal reflux disease.

MeSH terms

Consensus*
Education, Medical, Continuing*
Female
Gastroesophageal Reflux / diagnosis
Gastroesophageal Reflux / drug therapy*
Guideline Adherence*
Humans
Male
Physicians
Proton Pump Inhibitors / therapeutic use

Substances

Proton Pump Inhibitors