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cost effectiveness medical gerd treatment

Mototsugu Kato, Noriko Ito, Mamiko Demura, Kimitoshi Kubo, Katsuhiro Mabe, Naohiko Harada
Introduction: The first drug selected for treatment of gastro-oesophageal reflux disease (GERD) and prevention of the recurrence is a proton pump inhibitor (PPI), but recently, a potassium-competitive acid blocker (P-CAB) was put on the market in Japan. Its onset of effect is faster than PPI, and it takes more than 2 days to recover acid secretion after the withdrawal period. Therefore, unlike PPI, the usefulness of every other day administration or discontinuous administration is expected...
2018: BMJ Open Gastroenterology
Waseem M Seleem, Amr Shaaban Hanafy, Samir I Mohamed
OBJECTIVE: Despite the therapeutic and surgical interventions for the management of gastroesophageal reflux disease (GERD), yet the high cost and the post-operative complications had led to a significant socioeconomic burden. The aim was to evaluate the safety and efficacy of endoscopic band ligation (EBL) in the management of refractory GERD. METHODS: A total of 150 patients with refractory GERD were assigned to an EBL group (banding was done at four quadrants just at the gastroesophageal junction (GEJ) (n = 75) or to a control group (optimized dose of PPI, n = 75)...
April 2018: Scandinavian Journal of Gastroenterology
Daniela Gonçalves-Bradley, Jaspreet K Khangura, Gerd Flodgren, Rafael Perera, Brian H Rowe, Sasha Shepperd
BACKGROUND: In many countries emergency departments (EDs) are facing an increase in demand for services, long waits, and severe crowding. One response to mitigate overcrowding has been to provide primary care services alongside or within hospital EDs for patients with non-urgent problems. However, it is unknown how this impacts the quality of patient care and the utilisation of hospital resources, or if it is cost-effective. This is the first update of the original Cochrane Review published in 2012...
February 13, 2018: Cochrane Database of Systematic Reviews
Feroze Sidwa, Alessandra L Moore, Elaine Alligood, P Marco Fisichella
OBJECTIVE: To review the current literature on the role of antireflux surgery (ARS) for the treatment of extraesophageal manifestations of GERD. The extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, laryngopharyngeal reflux, and asthma. They are responsible for significant morbidity in affected patients and a high economic burden on healthcare resources. We recently published a larger review on the symptoms, diagnosis, medical, and surgical treatment of the extraesophageal manifestations of GERD...
October 2017: World Journal of Surgery
Bryan P Fitzgerald, Kelly M Conn, Joanne Smith, Andrew Walker, Amy L Parkhill, James E Hilbert, Elizabeth A Luebbe, Richard T Moxley
Myotonic dystrophy (DM) and facioscapulohumeral muscular dystrophy (FSHD) are the two most common adult muscular dystrophies and have progressive and often disabling manifestations. Higher levels of medication adherence lead to better health outcomes, especially important to patients with DM and FSHD because of their multisystem manifestations and complexity of care. However, medication adherence has not previously been studied in a large cohort of DM type 1 (DM1), DM type 2 (DM2), and FSHD patients. The purpose of our study was to survey medication adherence and disease manifestations in patients enrolled in the NIH-supported National DM and FSHD Registry...
December 2016: Journal of Neurology
Robert A Ganz
Treatment of gastroesophageal reflux disease in the United States today is binary, with the majority of patients with gastroesophageal reflux disease being treated with antisecre-tory medications and a minority of patients, typically those with volume regurgitation, undergoing Nissen fundoplication. However, there has been increasing dissatisfaction with proton pump inhibitor therapy among a significant number of patients with gastroesophageal reflux disease owing to cost, side effects, and refractory symptoms, and there has been a general reluctance to undergo surgical fundoplication due to its attendant side-effect profile...
July 2016: Gastroenterology & Hepatology
Deepanshu Jain, Shashideep Singhal
Gastroesophageal reflux disease (GERD) is a chronic, progressive, and costly medical condition affecting a substantial proportion of the world population, predominantly the Western population. The available treatment options for patients with refractory GERD symptoms are limited to either laparoscopic surgery with significant sequelae or potentially lifelong, high-dose proton pump inhibitor therapy. The restoration of the antireflux competence of the gastroesophageal junction at the anatomic and physiologic levels is critical for the effective long-term treatment of GERD...
March 2016: Clinical Endoscopy
Cheguevara Afaneh, Veronica Zoghbi, Brendan M Finnerty, Anna Aronova, David Kleiman, Thomas Ciecierega, Carl Crawford, Thomas J Fahey, Rasa Zarnegar
INTRODUCTION: Early referral for catheter-based esophageal pH monitoring is more cost-effective than empiric proton-pump inhibitor (PPI) therapy to diagnose gastroesophageal reflux disease (GERD). We hypothesize that BRAVO wireless pH monitoring will also demonstrate substantial cost-savings compared to empiric PPI therapy, given its superior sensitivity and comfort. METHODS: We reviewed 100 consecutive patients who underwent wireless pH monitoring for suspected GERD at our institution...
August 2016: Surgical Endoscopy
Annemarie L Lee, Roger S Goldstein
COPD is a long-term condition associated with considerable disability with a clinical course characterized by episodes of worsening respiratory signs and symptoms associated with exacerbations. Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal conditions in the general population and has emerged as a comorbidity of COPD. GERD may be diagnosed by both symptomatic approaches (including both typical and atypical symptoms) and objective measurements. Based on a mix of diagnostic approaches, the prevalence of GERD in COPD ranges from 17% to 78%...
2015: International Journal of Chronic Obstructive Pulmonary Disease
X Sun, W Shang, Z Wang, X Liu, X Fang, M Ke
This study investigated the effectiveness of diaphragm biofeedback training (DBT) for patients with gastroesophageal reflux disease (GERD). A total of 40 patients with GERD treated at the Peking Union Medical College Hospital between September 2004 and July 2006 were randomized to receive DBT and rabeprazole proton pump inhibitor (PPI) or rabeprazole alone. The DBT + rabeprazole group received DBT during the 8-week initial treatment; the rabeprazole group did not. During the 6-month follow up, all patients took acid suppression according to their reflux symptoms, and the patients in the DBT + rabeprazole group were required to continue DBT...
October 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Stacy B Menees, Amanda Guentner, Samuel W Chey, Richard Saad, William D Chey
BACKGROUND: The aim of this study was to assess how US gastroenterologists perceive and utilize over-the-counter (OTC) and prescription medications for gastroesophageal reflux disease (GERD) and chronic constipation (CC). METHODS: A total of 3,600 randomly selected American Gastroenterological Association (AGA) members were mailed a 27-question survey that assessed their perceptions and use of OTC and prescription medications. The χ(2) test and Student's t-test were utilized for bivariate analysis...
November 2015: American Journal of Gastroenterology
Ying Chen
Over the past decade, incidence of gastroesophageal reflux disease (GERD) showed an increasing trend resulting from factors, including lifestyle and dietary habits; however, both etiology and pathological mechanisms remain controversial. GERD occurs as a result of a variety of mechanisms and there is no single factor. Symptoms of GERD are often non-typical, with a likelihood of being overlooked by non-gastroenterology professionals. Therefore, improving GERD awareness in non-gastroenterology practitioners, along with early diagnosis and treatment, provide potential benefit to clinicians and patients alike...
May 2015: Expert Review of Gastroenterology & Hepatology
Kyle A Perry, Thai H Pham, Stuart J Spechler, John G Hunter, W Scott Melvin, Vic Velanovich
Gastroesophageal reflux disease affects at least 10 % of people in Western societies and produces troublesome symptoms and impairs patients' quality of life. The effective management of GERD is imperative as the diagnosis places a significant cost burden on the United States healthcare system with annual direct cost estimates exceeding 9 billion dollars annually. While effective for many patients, 30-40 % of patients receiving medical therapy with proton pump inhibitors experience troublesome breakthrough symptoms, and recent evidence suggests that this therapy subjects patients to increased risk of complications...
March 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Luke M Funk, James Y Zhang, Joseph M Drosdeck, W Scott Melvin, John P Walker, Kyle A Perry
BACKGROUND: The long-term cost effectiveness of medical, endoscopic, and operative treatments for adults with gastroesophageal reflux disease (GERD) remains unclear. We sought to estimate the cost effectiveness of medical, endoscopic, and operative treatments for adults with GERD who require daily proton pump inhibitor (PPI) therapy. METHODS: A Markov model was generated from the payer's perspective using a 6-month cycle and 30-year time horizon. The base-case patient was a 45-year-old man with symptomatic GERD taking 20 mg of omeprazole twice daily...
January 2015: Surgery
Kevin M Reavis, Kyle A Perry
Gastroesophageal reflux disease (GERD) is a common and costly chronic medical condition affecting millions of patients. It is associated with substantial morbidity and negatively impacts quality of life. Reflux of gastric contents into the esophagus damages the esophageal mucosa and is associated with conditions including esophagitis and esophageal stricture. While GERD is most commonly seen in Western populations, changes in dietary patterns and the global increase in obesity have led to a pronounced increase in its prevalence worldwide...
July 2014: Expert Review of Medical Devices
Markku Voutilainen
The prevalence of GORD has increased. GORD causes significant impairment of the quality of life and is the most costly gastrointestinal disease. In patients aged under 55 years and without alarming symptoms and signs, treatment may be started without endoscopy. Proton pump inhibitors are the most effective medical treatment. Most GORD patients have normal oesophageal findings on endoscopy. If medical treatment fails, the diagnosis of GORD should be verified. The indications for surgical treatment, i.e. laparoscopic fundoplication, include the failure of medical treatment, severe erosive esophagitis, regurgitation as the main symptom, and severe GORD with large hiatal hernia...
2014: Duodecim; Lääketieteellinen Aikakauskirja
Andrew J Gawron, Dustin D French, John E Pandolfino, Colin W Howden
BACKGROUND: Gastroesophageal reflux disease (GERD) contributes to substantial medication use and costs worldwide. Economic evaluations provide insight into the value of healthcare, taking into account cost, quality, and benefits of particular treatments. OBJECTIVES: Our objectives were to systematically review the existing literature to identify economic evaluations of GERD management strategies, to assess the scientific quality of these reports, and to summarize the economic outcomes of these evaluations...
August 2014: PharmacoEconomics
Tuomo Rantanen
Although fundoplication has been found effective in the treatment of reflux disease, its long-term results have raised doubts due to the large number of patients taking acid blocker medication after the operation. Based on the five-year follow-up of the REFLUX study, reflux symptoms and quality of life associated with reflux were improved after the operation. Laparoscopic fundoplication was found to be a cost-effective form of treatment among those having a chronic reflux disease. The operation can be recommended for treating reflux disease in patients exhibiting a non-optimal PPI drug response...
2014: Duodecim; Lääketieteellinen Aikakauskirja
Anantha Madhavan, Karthik Maruthachalam, Yirupaiahgari Krishnaiah Setty Viswanath
Laparoscopic antireflux surgery is a recognized procedure for patients diagnosed with gastroesophageal reflux disease whose symptoms are refractory to medical treatment. We describe a novel and cost-effective technique that aids in mobilization and retraction of the gastroesophageal junction before repair of the diaphragmatic crural defect. After hiatal dissection and creation of a posterior gastric wrap, an index suture (2-0 ethibond) is placed across the wrap. This is used to retract the gastroesophageal junction and expose the crura for repair and "required facilitate fixation of fundus to the crura (fundopexy)...
December 2014: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Stuart Jon Spechler
Barrett's esophagus, the condition in which metaplastic columnar epithelium that predisposes to cancer development replaces the squamous epithelium that normally lines the distal esophagus, is a complication of gastroesophageal reflux disease (GERD). Metaplasia is a potentially reversible condition, and partial regression of Barrett's metaplasia has been documented with effective medical or surgical therapy for GERD. The important issue for patient management is not whether antireflux treatment causes Barrett's esophagus to regress, but rather whether antireflux therapy prevents cancer in Barrett's esophagus...
2014: Digestive Diseases
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