PMID- 27178517
OWN - NLM
STAT- MEDLINE
DCOM- 20171002
LR  - 20171002
IS  - 1532-818X (Electronic)
IS  - 0196-0709 (Linking)
VI  - 37
IP  - 3
DP  - 2016 May-Jun
TI  - Evaluation of a laryngopharyngeal reflux management protocol.
PG  - 245-50
LID - S0196-0709(16)00010-7 [pii]
LID - 10.1016/j.amjoto.2016.01.008 [doi]
AB  - PURPOSE: To evaluate the effectiveness of a protocol for management of patients 
      with laryngopharyngeal reflux (LPR) in a multi-provider clinic. MATERIALS AND 
      METHODS: This is a retrospective cohort study of 188 patients treated for LPR. A 
      standardized clinical protocol for diagnosis and management was instituted in 
      2012. Two cohorts were established: those managed according to the protocol, and 
      those who were not. For patients managed with the LPR protocol, diagnosis was 
      made using clinical judgment, guided by the Reflux Symptom Index (RSI) and Reflux 
      Finding Score (RFS). Patients were treated with proton pump inhibitors (PPI) with 
      the goal of weaning therapy after symptom resolution. Response to therapy was 
      rated using a global rating scale with three response levels: no response, 
      partial response, and complete response. The primary outcome measure was complete 
      response to therapy and the secondary outcome measures were any response 
      (complete or partial) and successful wean off PPI therapy. RESULTS: The patients 
      treated with the LPR protocol had higher rates of complete response (p<0.001). 
      There was no statistically significant difference in rates of any response 
      (complete or partial) between the two groups (p=0.08). Patients treated using the 
      LPR protocol were more likely to be successfully weaned off PPI therapy 
      (p=0.006). CONCLUSIONS: The use of an LPR protocol improved treatment 
      effectiveness in our clinic, highlighting the role of clinical protocols in 
      reducing variability in care, thereby improving patient outcomes.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Gupta, Nikita
AU  - Gupta N
AD  - Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at 
      Mount Sinai, New York, NY.
FAU - Green, Ross W
AU  - Green RW
AD  - Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at 
      Mount Sinai, New York, NY.
FAU - Megwalu, Uchechukwu C
AU  - Megwalu UC
AD  - Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at 
      Mount Sinai, New York, NY; Department of Otolaryngology, Queens Hospital Center, 
      Jamaica, NY. Electronic address: megwaluu@yahoo.com.
LA  - eng
PT  - Journal Article
DEP - 20160122
PL  - United States
TA  - Am J Otolaryngol
JT  - American journal of otolaryngology
JID - 8000029
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - *Clinical Protocols
MH  - Female
MH  - Humans
MH  - Laryngopharyngeal Reflux/diagnosis/etiology/*therapy
MH  - Laryngoscopy
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2016/05/15 06:00
MHDA- 2017/10/03 06:00
CRDT- 2016/05/15 06:00
PHST- 2015/12/10 00:00 [received]
PHST- 2016/01/18 00:00 [accepted]
PHST- 2016/05/15 06:00 [entrez]
PHST- 2016/05/15 06:00 [pubmed]
PHST- 2017/10/03 06:00 [medline]
AID - S0196-0709(16)00010-7 [pii]
AID - 10.1016/j.amjoto.2016.01.008 [doi]
PST - ppublish
SO  - Am J Otolaryngol. 2016 May-Jun;37(3):245-50. doi: 10.1016/j.amjoto.2016.01.008. 
      Epub 2016 Jan 22.