{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T05:47:43Z","timestamp":1740894463627,"version":"3.38.0"},"reference-count":12,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2010,11,26]],"date-time":"2010-11-26T00:00:00Z","timestamp":1290729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:p> Background: Gastroesophageal reflux disease (GERD) has a major impact at the primary care level and there is a need to evaluate whether the diagnosis and therapeutic management of GERD in Europe needs to be improved. <\/jats:p><jats:p> Methods: This project was designed to test the hypothesis that a new primary care management strategy would improve outcomes for patients with GERD, compared with usual care, in Europe. The analysis pools five separate cluster-randomized studies conducted in Austria, Italy, Norway, Spain and Sweden. These studies used a strategy based on the self-administered GerdQ questionnaire to stratify adult patients with symptoms of heartburn or regurgitation according to the frequency and impact of symptoms. A score of \u22658 indicates a high probability of suffering GERD. Patients with a GerdQ impact score \u22642 were treated with generic proton-pump inhibitors according to local guidance, and patients with an impact score \u22653 were treated with esomeprazole 40\u2009mg once daily. <\/jats:p><jats:p> Results: In total, 2400 patients were enrolled across the five studies. The protocols were modified by individual countries according to their local guidelines\/requirements. In Norway, the new management strategy was compared with traditional routine endoscopy and 24-hour pH-metry, and encompassed proton-pump inhibitor reimbursement restrictions. Outcome measures differed by country, but included control of GERD symptoms, self-rated health status and work productivity, treatment changes, specialist referrals and physician adherence. GERD-related use of healthcare resources was also evaluated. <\/jats:p><jats:p> Conclusion: The pooled analysis will determine whether a locally adapted primary care management strategy for GERD, using GerdQ as a patient-tailored diagnostic and therapeutic evaluation tool, is beneficial compared with usual care across five countries with different standard approaches to GERD management and control. <\/jats:p>","DOI":"10.1177\/1756283x10387060","type":"journal-article","created":{"date-parts":[[2010,11,27]],"date-time":"2010-11-27T01:43:28Z","timestamp":1290822208000},"page":"11-26","source":"Crossref","is-referenced-by-count":2,"title":["Structured management strategy <i>versus<\/i> usual care for gastroesophageal reflux disease: rationale for pooled analysis of five European cluster-randomized trials"],"prefix":"10.1177","volume":"4","author":[{"given":"Julio","family":"Ponce","sequence":"first","affiliation":[{"name":"Hospital Universitario La Fe, Valencia and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente","family":"Garrigues","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Fe, Valencia and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Agr\u00e9us","sequence":"additional","affiliation":[{"name":"Center for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erminio","family":"Tabaglio","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana Medicina Generale, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gschwantler","sequence":"additional","affiliation":[{"name":"Wilhelminenspital, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliseo","family":"G\u00fcallar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica","family":"Tafalla","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Medical Department, AstraZeneca, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Nuevo","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Medical Department, AstraZeneca (Parque Norte), Serrano Galvache 56, 28033 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan G.","family":"Hatlebakk","sequence":"additional","affiliation":[{"name":"Haukeland University Hospital, Bergen, 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