PMID- 27647519
OWN - NLM
STAT- MEDLINE
DCOM- 20180312
LR  - 20180312
IS  - 1873-4588 (Electronic)
IS  - 0892-1997 (Linking)
VI  - 31
IP  - 3
DP  - 2017 May
TI  - A Mixed-Methods Study of Patient Views on Reflux Symptoms and Medication 
      Routines.
PG  - 381.e15-381.e25
LID - S0892-1997(16)30195-3 [pii]
LID - 10.1016/j.jvoice.2016.06.024 [doi]
AB  - OBJECTIVES: Gastroesophageal reflux disease is a chronic disorder often 
      accompanied by laryngopharyngeal reflux. Speech-language pathologists are tasked 
      with treating these patients with voice, dysphagia, and/or reflux therapy. This 
      study investigated patient-reported reasons for reduced compliance with 
      recommended reflux treatment and the top symptoms in patients with reflux, 
      dysphagia, and voice symptoms. STUDY DESIGN: This study used a cross-sectional 
      qualitative and quantitative mixed-methods design to identify and describe 
      patients' reflux symptoms and reflux medication routines. METHODS: Fifty-one 
      patients completed a face-to-face, semistructured interview, a questionnaire, and 
      the Reflux Symptom Index (RSI). Interview transcripts were coded by authors for 
      concepts in two cycles. RESULTS: During the 51 interviews, the top four reported 
      symptoms were heartburn (n = 17), mucous (n = 11), dysphagia, and globus 
      (n = 10). Further, 62.7% (n = 32/51) described an incorrect routine in taking 
      their proton pump inhibitor (PPI): taking it with other pills, taking it with 
      food/drink, and uncertainty about which pill is for reflux. RSI scores were 
      moderately correlated with patient-reported reflux severity (r = 0.62, 
      P < 0.0001, r(2) = 0.34). Correct compliance with PPI timing was not enough to 
      significantly lower RSI scores more than those who did not comply (an average RSI 
      of 20.0 vs. 25.9, P = 0.1252). CONCLUSIONS: Literature has not described the most 
      relevant reflux-related symptoms and why PPI compliance is notoriously poor, from 
      the patients' perspective. The results of this study confirm that PPI compliance 
      is poor, and the reasons for poor compliance could have been prevented with 
      patient education. Even when PPI compliance was adequate, symptoms like globus, 
      mucous, voice dysfunction, and dysphagia persisted. Other interventions such as 
      evidence-based diet and behavioral changes should be a part of 
      voice/dysphagia/reflux therapy.
CI  - Copyright (c) 2017 The Voice Foundation. Published by Elsevier Inc. All rights 
      reserved.
FAU - Pisegna, Jessica M
AU  - Pisegna JM
AD  - Boston University Medical Center, FGH Building 820 Harrison Ave., Boston, 
      Massachusetts 02118; Boston University, Sargent College, 635 Commonwealth Ave., 
      Boston, Massachusetts 02215. Electronic address: jpisegna@bu.edu.
FAU - Yang, Sky
AU  - Yang S
AD  - Santa Clara Valley Medical Center, 751 South Bascom, San Jose, California 95128.
FAU - Purcell, Audrey
AU  - Purcell A
AD  - Fairhaven Healthcare Center, 476 Varnum Ave., Lowell, Massachusetts 01854.
FAU - Rubio, Alix
AU  - Rubio A
AD  - Boston University Medical Center, FGH Building 820 Harrison Ave., Boston, 
      Massachusetts 02118.
LA  - eng
PT  - Journal Article
DEP - 20160916
PL  - United States
TA  - J Voice
JT  - Journal of voice : official journal of the Voice Foundation
JID - 8712262
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cross-Sectional Studies
MH  - Deglutition Disorders/etiology/physiopathology
MH  - Female
MH  - Gastroesophageal Reflux/complications/*drug therapy/physiopathology/psychology
MH  - Heartburn/etiology/physiopathology
MH  - Humans
MH  - Interviews as Topic
MH  - Laryngopharyngeal Reflux/etiology/physiopathology
MH  - Male
MH  - *Medication Adherence
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*administration & dosage/adverse effects
MH  - Qualitative Research
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Voice
MH  - Voice Disorders/etiology/physiopathology
OTO - NOTNLM
OT  - PPI
OT  - dysphagia
OT  - qualitative
OT  - reflux
OT  - voice
EDAT- 2016/09/21 06:00
MHDA- 2018/03/13 06:00
CRDT- 2016/09/21 06:00
PHST- 2016/05/24 00:00 [received]
PHST- 2016/06/29 00:00 [revised]
PHST- 2016/06/30 00:00 [accepted]
PHST- 2016/09/21 06:00 [pubmed]
PHST- 2018/03/13 06:00 [medline]
PHST- 2016/09/21 06:00 [entrez]
AID - S0892-1997(16)30195-3 [pii]
AID - 10.1016/j.jvoice.2016.06.024 [doi]
PST - ppublish
SO  - J Voice. 2017 May;31(3):381.e15-381.e25. doi: 10.1016/j.jvoice.2016.06.024. Epub 
      2016 Sep 16.