PMID- 30568943
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2307-8960 (Print)
IS  - 2307-8960 (Electronic)
IS  - 2307-8960 (Linking)
VI  - 6
IP  - 15
DP  - 2018 Dec 6
TI  - Management of gastroesophageal reflux disease: Patient and physician 
      communication challenges and shared decision making.
PG  - 892-900
LID - 10.12998/wjcc.v6.i15.892 [doi]
AB  - Gastroesophageal reflux disease (GERD) is a common upper esophageal condition and 
      typical symptoms can include heartburn and sensation of regurgitation while 
      atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and 
      nausea. Typically, diagnosis is presumptive given the presence of typical and 
      atypical symptoms and is an indication for empiric therapy. Treatment management 
      can include lifestyle modifications and/or medication therapy with proton pump 
      inhibitor (PPI) class being the preferred and most effective. Complete symptom 
      resolution is not always achieved and long-term PPI therapy can put patients at 
      risk for serious side effects and needless expense. The brain-gut connection and 
      hypervigilance plays an important role in symptom resolution and treatment 
      success, especially in the case of non-PPI responders. Hypervigilance is a 
      combination of increased esophageal sensory sensitivity in combination with 
      exaggerated threat perception surrounding esophageal symptoms. Hypervigilance 
      requires a different approach to GERD managements, where continued PPI therapy 
      and surgery are usually not recommended. Rather, helping physicians and patients 
      understand the brain-gut connection can guide and improve care. Education and 
      reassurance should be the main pillars or treatment. However, it is important not 
      to suggest the symptoms are due to anxiety alone, this often leads to patient 
      dissatisfaction. Patient dissatisfaction with treatment reveals the need for a 
      more patient-centered approach to GERD management and better communication 
      between patients and providers. Shared decision making (SDM) with the 
      incorporation of patient-reported outcomes (PRO) promotes patient adherence and 
      satisfaction. SDM is a joint discussion between clinician and patient in which a 
      mutually shared solution is explored for GERD symptoms. For SDM to work the 
      physician needs to capture patients' perceptions which may not be obtained in the 
      standard interview. This can be done through the use of PROs which promote a 
      dialogue with patients about their symptoms and treatment priorities in the 
      context of the SDM patient encounter. SDM could potentially help in the 
      management of patient expectations for GERD treatment, ultimately positively 
      impacting their health-related quality of life.
FAU - Klenzak, Scott
AU  - Klenzak S
AD  - Department of Psychiatry, Cape Fear Valley Health System, Fayetteville, NC 28304, 
      United States.
FAU - Danelisen, Igor
AU  - Danelisen I
AD  - School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, United 
      States.
FAU - Brannan, Grace D
AU  - Brannan GD
AD  - School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, United 
      States.
FAU - Holland, Melissa A
AU  - Holland MA
AD  - College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 
      27506, United States.
FAU - van Tilburg, Miranda Al
AU  - van Tilburg MA
AD  - College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 
      27506, United States.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - World J Clin Cases
JT  - World journal of clinical cases
JID - 101618806
PMC - PMC6288517
OTO - NOTNLM
OT  - Gastroesophageal reflux disease
OT  - Patient satisfaction
OT  - Patient-physician communication
OT  - Patient-reported outcomes
OT  - Psychosocial
OT  - Shared decision making
COIS- Conflict-of-interest statement: The authors have no conflict of interest to 
      declare.
EDAT- 2018/12/21 06:00
MHDA- 2018/12/21 06:01
PMCR- 2018/12/06
CRDT- 2018/12/21 06:00
PHST- 2018/09/04 00:00 [received]
PHST- 2018/11/16 00:00 [revised]
PHST- 2018/11/24 00:00 [accepted]
PHST- 2018/12/21 06:00 [entrez]
PHST- 2018/12/21 06:00 [pubmed]
PHST- 2018/12/21 06:01 [medline]
PHST- 2018/12/06 00:00 [pmc-release]
AID - 10.12998/wjcc.v6.i15.892 [doi]
PST - ppublish
SO  - World J Clin Cases. 2018 Dec 6;6(15):892-900. doi: 10.12998/wjcc.v6.i15.892.