Bell JC, et al. - Researchers studied the infants aged <1 year presenting to general practitioners (GPs) with reflux and gastro-oesophageal reflux disease (GORD), to gain insights into the diagnosis and management of these entities. With regards to the management part, acid suppressants may be overprescribed. No superior benefits of acid suppressants were seen in infants when compared with placebo; instead, significant negative side effects may be noted, however, guidelines are inconsistent. There is a need for clear, concise and consistent guidance. On the part of GPs and parents, gaining an understanding regarding what is normal and limitations of medical therapy is required. Moreover, there is a need for a greater understanding of the influences on GP prescribing practices, of parents’ knowledge and attitudes and of the pressures on parents of infants with these conditions.

Methods

• Researchers performed a nationally representative, prospective, cross-sectional survey of GP activity in Australia, 2006–2016 (Bettering the Evaluation And Care of Health Study), wherein an annual record by a random sample of around 1000 GPs providing details for 100 consecutive visits with consenting, unidentified patients, was studied.
• Outcome measures included diagnoses of reflux and GORD and their management including prescribing of acid-suppressant medicines (proton pump inhibitors (PPIs) and histamine receptor antagonists (H2RAs)) and counselling, advice or education.

Results

• Data showed 512 (2.7%) of all infants’ visits included a diagnosis of reflux (n=413, 2.2%) or GORD (n=99, 0.5%).
• From 2006 to 2016, a decrease in the diagnostic rates for reflux and increase for GORD was reported.
• The occurrence of acid suppressants prescribing was reported in 43.6% visits for reflux and 48.5% visits for GORD, these findings were similar to rates of counselling, advice or education (reflux: 38.5%, GORD: 43.4% of visits).
• They noted that prescribing of PPIs increased (statistically significant only for visits for reflux), while prescribing of H2RAs decreased.