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- Title
Development of a refractory gastro-oesophageal reflux score using an administrative claims database.
- Authors
Gerson, L. B.; Bonafede, M.; Princic, N.; Gregory, C.; Farr, A.; Balu, S.
- Abstract
Aliment Pharmacol Ther 2011; 34: 555-567 Summary Background Approximately one-third of gastro-oesophageal reflux disease (GERD) patients demonstrate refractory symptoms following treatment with proton pump inhibitor (PPI) therapy. Aim To develop a refractory GERD score that can be applied to predict patients' healthcare utilisation. Methods We enrolled adults (≥18 years) with a diagnosis of GERD. Refractory GERD was evaluated on an 8-point scale where 1 point was given for each of the following criteria: doubling, addition, or switching of GERD medication dose, receipt of a GERD-related endoscopic procedure or surgery, or ≥3 GERD-related outpatient visits. Refractory GERD was defined as the presence of two or more points. Results A total of 135 139 GERD patients (44% male) were analysed with a mean (±s.d.) age of 52.9 ± 15 years. The mean overall refractory GERD score was 1.12 ± 1.2 (range 0-8 on an 8-point scale); 31% of patients had refractory GERD with a mean score of 2.56 ± 0.82. Among patients with refractory GERD, 31% doubled their GERD medication, 28% added a new GERD medication, 60% switched GERD medications, 54% had a GERD-related procedure and 1% had a GERD-related surgery. Patients with refractory GERD were more likely to be female (59% vs. 55%, P < 0.001) and had a higher co-morbidity score (0.78 vs. 0.56, P < 0.001). The overall mean costs for refractory patients during the study period were significantly higher compared with treatment-responsive patients ($18 088 ± $36 220 vs. $11 044 ± $22 955, P < 0.001). Conclusions Refractory GERD was present in approximately one-third of the GERD patients. We created a GERD refractory score that could define need for increased anti-reflux therapy and predict higher healthcare resource utilisation.
- Subjects
GASTROESOPHAGEAL reflux; PROTON pump inhibitors; ESOPHAGUS diseases; ENDOSCOPIC surgery; DISEASE prevalence; PATIENTS
- Publication
Alimentary Pharmacology & Therapeutics, 2011, Vol 34, Issue 5, p555
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2011.04755.x