European pediatricians' approach to children with ger symptoms: Survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines

Paolo Quitadamo, Alexandra Papadopoulou, Tobias Wenzl, Vaidotas Urbonas, C. M Frank Kneepkens, Enriqueta Roman, Rok Orel, Danijela Jojkić Pavkov, Jorge Amil Dias, Yvan Vandenplas, Aco Kostovski, Erasmo Miele, Alberto Villani, Annamaria Staiano

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective: The aim of this study was to evaluate the current implementation of the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines, and to assess proton pump inhibitors' (PPIs) prescribing patterns among pediatricians from different European countries. Methods: A randomly identified sample of general pediatricians distributed across 11 European countries. They were asked to complete a case report-structured questionnaire investigating their approaches to infants, children, and adolescents with symptoms suggestive of gastroesophageal reflux. Results: A total of 567 European general pediatricians completed the study questionnaire. Only 1.8% of them showed complete adherence to the guidelines. Forty-six percent of them reported that they diagnose gastroesophageal reflux disease based on clinical symptoms irrespective of the age of the child; 39% prescribe PPIs in infants with unexplained crying and/or distressed behavior and 36% prescribe PPIs in infants with uncomplicated recurrent regurgitation and vomiting; 48% prescribed PPIs in children younger than 8 to 12 years with vomiting and heartburn, without specific testing; 45% discontinue PPI therapy abruptly rather than tapering the dose. The overall rate of pediatricians overprescribing PPIs was 82%. Conclusions: The overall results of our survey show that the majority of pediatricians are unaware of 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition reflux guidelines and often prescribe PPIs despite a lack of efficacy for the symptoms being treated. The overdiagnosis of gastroesophageal reflux disease places undue burden on both families and national health systems, which has not been affected by the publication of international guidelines.

Original languageEnglish
Pages (from-to)505-509
Number of pages5
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume58
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Gastroenterology
Proton Pump Inhibitors
Guidelines
Gastroesophageal Reflux
Pediatrics
Nutrition Policy
Vomiting
Guideline Adherence
Crying
Heartburn
Surveys and Questionnaires
Pediatricians
Family Health
Publications

Keywords

  • gastroesophageal reflux disease
  • guidelines
  • survey

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

European pediatricians' approach to children with ger symptoms : Survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines. / Quitadamo, Paolo; Papadopoulou, Alexandra; Wenzl, Tobias; Urbonas, Vaidotas; Kneepkens, C. M Frank; Roman, Enriqueta; Orel, Rok; Pavkov, Danijela Jojkić; Dias, Jorge Amil; Vandenplas, Yvan; Kostovski, Aco; Miele, Erasmo; Villani, Alberto; Staiano, Annamaria.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 58, No. 4, 2014, p. 505-509.

Research output: Contribution to journalArticle

Quitadamo, P, Papadopoulou, A, Wenzl, T, Urbonas, V, Kneepkens, CMF, Roman, E, Orel, R, Pavkov, DJ, Dias, JA, Vandenplas, Y, Kostovski, A, Miele, E, Villani, A & Staiano, A 2014, 'European pediatricians' approach to children with ger symptoms: Survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines', Journal of Pediatric Gastroenterology and Nutrition, vol. 58, no. 4, pp. 505-509. https://doi.org/10.1097/MPG.0b013e3182a69912
Quitadamo, Paolo ; Papadopoulou, Alexandra ; Wenzl, Tobias ; Urbonas, Vaidotas ; Kneepkens, C. M Frank ; Roman, Enriqueta ; Orel, Rok ; Pavkov, Danijela Jojkić ; Dias, Jorge Amil ; Vandenplas, Yvan ; Kostovski, Aco ; Miele, Erasmo ; Villani, Alberto ; Staiano, Annamaria. / European pediatricians' approach to children with ger symptoms : Survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines. In: Journal of Pediatric Gastroenterology and Nutrition. 2014 ; Vol. 58, No. 4. pp. 505-509.
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abstract = "Objective: The aim of this study was to evaluate the current implementation of the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines, and to assess proton pump inhibitors' (PPIs) prescribing patterns among pediatricians from different European countries. Methods: A randomly identified sample of general pediatricians distributed across 11 European countries. They were asked to complete a case report-structured questionnaire investigating their approaches to infants, children, and adolescents with symptoms suggestive of gastroesophageal reflux. Results: A total of 567 European general pediatricians completed the study questionnaire. Only 1.8{\%} of them showed complete adherence to the guidelines. Forty-six percent of them reported that they diagnose gastroesophageal reflux disease based on clinical symptoms irrespective of the age of the child; 39{\%} prescribe PPIs in infants with unexplained crying and/or distressed behavior and 36{\%} prescribe PPIs in infants with uncomplicated recurrent regurgitation and vomiting; 48{\%} prescribed PPIs in children younger than 8 to 12 years with vomiting and heartburn, without specific testing; 45{\%} discontinue PPI therapy abruptly rather than tapering the dose. The overall rate of pediatricians overprescribing PPIs was 82{\%}. Conclusions: The overall results of our survey show that the majority of pediatricians are unaware of 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition reflux guidelines and often prescribe PPIs despite a lack of efficacy for the symptoms being treated. The overdiagnosis of gastroesophageal reflux disease places undue burden on both families and national health systems, which has not been affected by the publication of international guidelines.",
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AU - Dias, Jorge Amil

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N2 - Objective: The aim of this study was to evaluate the current implementation of the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines, and to assess proton pump inhibitors' (PPIs) prescribing patterns among pediatricians from different European countries. Methods: A randomly identified sample of general pediatricians distributed across 11 European countries. They were asked to complete a case report-structured questionnaire investigating their approaches to infants, children, and adolescents with symptoms suggestive of gastroesophageal reflux. Results: A total of 567 European general pediatricians completed the study questionnaire. Only 1.8% of them showed complete adherence to the guidelines. Forty-six percent of them reported that they diagnose gastroesophageal reflux disease based on clinical symptoms irrespective of the age of the child; 39% prescribe PPIs in infants with unexplained crying and/or distressed behavior and 36% prescribe PPIs in infants with uncomplicated recurrent regurgitation and vomiting; 48% prescribed PPIs in children younger than 8 to 12 years with vomiting and heartburn, without specific testing; 45% discontinue PPI therapy abruptly rather than tapering the dose. The overall rate of pediatricians overprescribing PPIs was 82%. Conclusions: The overall results of our survey show that the majority of pediatricians are unaware of 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition reflux guidelines and often prescribe PPIs despite a lack of efficacy for the symptoms being treated. The overdiagnosis of gastroesophageal reflux disease places undue burden on both families and national health systems, which has not been affected by the publication of international guidelines.

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