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- Agréus, L, et al.
(författare)
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Natural History of Gastroesophageal Reflux Disease and Functional Abdominal Disorders : A Population-Based Study
- 2017
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Ingår i: American Journal of Gastroenterology. - : Wolters Kluwer. - 0002-9270 .- 1572-0241. ; 96, s. 2905-
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Symptomatic gastroesophageal reflux disease (GERD), dyspepsia, and irritable bowel syndrome (IBS) are generally considered to be chronic conditions, but community-based studies are sparse, and long-term natural history data are unavailable. We aimed to determine the natural history of these conditions.Methods: A representative Swedish sample (20-79 yr) completed a validated questionnaire over the preceding 3 months. The survey was repeated after 1 and 7 yr in the same target group (n = 1290, 1260, and 1065; response rates 90%, 87%, and 82%, respectively; 79% responded to all three mailings).Results: The prevalence of GERD symptoms remained stable, whereas the prevalence of IBS increased over time, independent of aging. Dyspepsia decreased with advancing age. Although more than half of those with IBS reported the same symptom profile after 1 and 7 yr, there was a substantial symptom fluctuation and symptom profile flux between those reporting dyspepsia, IBS, or minor symptoms. Only a minority with GERD (<10%) changed to dyspepsia and/or IBS, or vice versa. The symptom-free patients remained symptom-free or reported only minor symptoms in > or = 90% of cases.Conclusion: There seem to be two distinct populations of symptom reporters, those with dyspepsia or IBS, and those with GERD.
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- Agréus, Lars, et al.
(författare)
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Predictors and non-predictors of symptom relief in dyspepsia consultations in primary care
- 2008
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Ingår i: Digestive Diseases. - : S. Karger AG. - 0257-2753 .- 1421-9875. ; 26:3, s. 248-255
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We aimed to evaluate if the course of dyspepsia is influenced by medical consultation in primary care. DESIGN, SETTING AND PATIENTS: Australian general practitioners (n = 27) recruited 157 dyspeptic patients, of whom 94 were eligible for follow-up. Dyspepsia, comorbidity, quality of life, emotional status, locus of control and consultation satisfaction were measured at baseline and follow-up (mean 3 months). MAIN OUTCOME MEASURE: Response was defined as improvement of dyspepsia over time on the Nepean Dyspepsia Index score. RESULTS: Dyspepsia improved in 82% (n = 77). There was no significant change in non-gastrointestinal symptoms. Half were worried or stressed by their symptoms, and 85% wanted reassurance, a need that (univariately) differentiated responders from non-responders (p = 0.02). Most patients seen in primary care with dyspepsia improved. If the doctor believed it was likely that the patient would follow their recommendations, the patient was nearly five times as likely to be a responder (OR 4.9, 95% CI 1.2-19.0). The only other significant predictor was acid suppression therapy (OR 3.5, 95% CI 1.1-10.9). CONCLUSION: Most primary care visits for dyspepsia are followed by improvement, which may be predicted in part by indicators of patient compliance. Prescription of acid suppression therapy may also improve outcome in dyspepsia
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- Arrelöv, Britt, et al.
(författare)
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Influence of local structural factors on physicians' sick-listing practice : a population-based study
- 2005
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 15:5, s. 470-4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physicians have a central role as gatekeepers to the social security system, includingsick-listing. Variation in physicians’ sick-listing practices has been demonstrated in several studies. Theobjective of this study was to determine whether local structural factors affect sick-listing practice.Methods: A total of 57 563 consecutive sick-listing certificates, issued during 4 months in 1995 and2 months in 1996, were collected from the local branches of the National Social Insurance Office ineight Swedish counties. County code, local community population size and presence of a hospital in thearea were used as indicators of local structural factors. Length of the sick-listing certificates and of thesick-listing episodes were used as outcome variables. Results: After ajustment for the influence of categoryof issuing physician, patients’ age, sex and diagnosis (‘case mix’), and type of certificate there was alarge variation of the length of the sick-listing certificates and of the sick-listing episodes betweencounties, between communities of various size and between communities with or without a hospitalin the area. All these factors were independently and significantly correlated to the length of thecertificate and of the sick-listing episode. Conclusions: The results support the hypothesis that physicians’sick-listing practice is influenced by local structural factors.
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