Korean J Gastroenterol.  2023 Oct;82(4):180-189. 10.4166/kjg.2023.032.

Diagnosis and Treatment of GastroEsophageal Reflux Disease at the Primary Health Care Clinics in Korea

• Kim YS
• Kang DH
• Park HC
• Oh TH
• Kim YS

• KMID: 2547288
• DOI: http://doi.org/10.4166/kjg.2023.032

Abstract

Background/Aims
The prevalence of GERD and treatment costs are continuously rising in Korea, and the importance of primary health care clinics where the most treatment of actual patients is conducted is increasing. In this study, the diagnosis of GERD, selection of therapeutic drugs, and treatment methods in primary health care clininics were investigated through a large-scale multi-dimensional surveys.
Methods
From January 2015 to December 2018, the study data of 18,010 patients with GERD were retrospectively investigated based on eletronic medical record at 542 primary health care clinics in Korea.
Results
Among all GERD patients, endoscopy was used for diagnosis in 16.11% of cases, and the most frequently performed in gastroenterology department (28.85%). The average BMI and the proportion of patients in stages 1 to 3 of obesity were highest in the ERD group, and the majority of the severity of ERD group was mild. Symptoms of the patients with GERD were mainly heartburn, gastric acid reflux, and chest pain. Drug treatment was performed in most of the patients with GERD, and PPI was the main drug, and Esomeprazol was prescribed the most among the main ingredients, and the ratio of PPI alone was high. The rate of symptom improvement after GERD treatment was slightly higher in the ERD group (75.91%) and the NERD group (74.36%) than in the GERD diagnosed without endoscopy group (63.89%).
Conclusions
In domestic primary health care clinics, the majority were diagnosed with GERD without endoscopy on the basis of symptoms. The most preferred treatment for GERD was PPI, which was prescribed alone in the majority.

Keyword

GERD; Primary health care clinic

Figure

• 

  Fig. 1 Status of PPI use in patients with GERD. A: Dexlansoprazole, B: Esomeprazole, C: Ilaprazole, D: Lansoprazole, E: Omeprazole, F: Pantoprazole, G: Rabeprazole, H: Non-ppi. PPI, proton pump inhibitor; GERD, gastroesophageal reflux disease.

• 

  Fig. 2 PPI prescription method. A: PPI (single), B: Prokinetics (single), C: PPI+Prokinetics (combination), D: PPI+Prokinetics+gastric mucosal protection (antacid) (combination), E: PPI+ gastric mucosal protection (antacid) (combination), F: H2 receptor blocker (single), G: Others. PPI, proton pump inhibitor.

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