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Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux

Background: Reflux occurs in 50% of healthy infants at some point. This is most often a physiological condition and does not require drug treatment. Various studies have shown that the use of drugs affecting gastric acidity (DAGAs) in infants is increasing. This entails disadvantages such as unneces...

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Autores principales: Gorsen, Santina, Boussery, Koen, Van Winckel, Myriam, Demeyer, Rolinde, Tommelein, Eline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712772/
https://www.ncbi.nlm.nih.gov/pubmed/33238424
http://dx.doi.org/10.3390/pharmacy8040226
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author Gorsen, Santina
Boussery, Koen
Van Winckel, Myriam
Demeyer, Rolinde
Tommelein, Eline
author_facet Gorsen, Santina
Boussery, Koen
Van Winckel, Myriam
Demeyer, Rolinde
Tommelein, Eline
author_sort Gorsen, Santina
collection PubMed
description Background: Reflux occurs in 50% of healthy infants at some point. This is most often a physiological condition and does not require drug treatment. Various studies have shown that the use of drugs affecting gastric acidity (DAGAs) in infants is increasing. This entails disadvantages such as unnecessary exposure of infants to medication and their side effects and a higher cost to society. Objective: To get an image of the current practice in Flanders regarding diagnosis and treatment of gastro-oesophageal reflux disease (GORD) in infants and the associated use of DAGAs. To this end, we determined both parents’ and health care providers’ experiences and perceptions about these treatments. Method: An observational cross-sectional study was conducted in April and May 2019. We developed a questionnaire for parents and three different questionnaires for health care providers (HCPs), including midwives, general practitioners, paediatricians and community pharmacists (CPs). The questionnaire for parents was only available through an online platform. HCPs were questioned face-to-face and through an online platform. Results: This study made clear that the counselling of children with GORD is multidisciplinary as the median number of counselling HCPs is 3 (interquartile range (IQR) = 2–4). 63% of the included 251 parents also seek support through online forums and groups. 60% of parents report that no physical tests were performed before DAGAs were prescribed and 39% of parents additionally state they perceived no effect of the prescribed DAGAs. Although parents reported to understand HCPs well (average score 7.4/10), satisfaction with care and information provision was scored lower (between 4.8 and 6.1/10). On the other hand, 234 HCPs answered the questionnaire, of which 89 midwives, 78 community pharmacists and 67 physicians. Only 45 HCPs indicate that guidelines to diagnose or treat GORD are clear. Physicians confirm they perform very little physical testing before starting DAGAs. Provided nonmedical measures to patients are largely in line with the European guidelines, however perceived effectiveness is moderate. Conclusion: Parents are in need for more information about tests, nutrition and (non)medical measures. HCPs on the other hand are in need for clear guidelines on diagnosing and treating GORD.
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spelling pubmed-77127722020-12-04 Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux Gorsen, Santina Boussery, Koen Van Winckel, Myriam Demeyer, Rolinde Tommelein, Eline Pharmacy (Basel) Article Background: Reflux occurs in 50% of healthy infants at some point. This is most often a physiological condition and does not require drug treatment. Various studies have shown that the use of drugs affecting gastric acidity (DAGAs) in infants is increasing. This entails disadvantages such as unnecessary exposure of infants to medication and their side effects and a higher cost to society. Objective: To get an image of the current practice in Flanders regarding diagnosis and treatment of gastro-oesophageal reflux disease (GORD) in infants and the associated use of DAGAs. To this end, we determined both parents’ and health care providers’ experiences and perceptions about these treatments. Method: An observational cross-sectional study was conducted in April and May 2019. We developed a questionnaire for parents and three different questionnaires for health care providers (HCPs), including midwives, general practitioners, paediatricians and community pharmacists (CPs). The questionnaire for parents was only available through an online platform. HCPs were questioned face-to-face and through an online platform. Results: This study made clear that the counselling of children with GORD is multidisciplinary as the median number of counselling HCPs is 3 (interquartile range (IQR) = 2–4). 63% of the included 251 parents also seek support through online forums and groups. 60% of parents report that no physical tests were performed before DAGAs were prescribed and 39% of parents additionally state they perceived no effect of the prescribed DAGAs. Although parents reported to understand HCPs well (average score 7.4/10), satisfaction with care and information provision was scored lower (between 4.8 and 6.1/10). On the other hand, 234 HCPs answered the questionnaire, of which 89 midwives, 78 community pharmacists and 67 physicians. Only 45 HCPs indicate that guidelines to diagnose or treat GORD are clear. Physicians confirm they perform very little physical testing before starting DAGAs. Provided nonmedical measures to patients are largely in line with the European guidelines, however perceived effectiveness is moderate. Conclusion: Parents are in need for more information about tests, nutrition and (non)medical measures. HCPs on the other hand are in need for clear guidelines on diagnosing and treating GORD. MDPI 2020-11-23 /pmc/articles/PMC7712772/ /pubmed/33238424 http://dx.doi.org/10.3390/pharmacy8040226 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gorsen, Santina
Boussery, Koen
Van Winckel, Myriam
Demeyer, Rolinde
Tommelein, Eline
Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux
title Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux
title_full Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux
title_fullStr Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux
title_full_unstemmed Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux
title_short Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux
title_sort perspectives of parents and health care providers about (non)medical treatment in infants with reflux
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712772/
https://www.ncbi.nlm.nih.gov/pubmed/33238424
http://dx.doi.org/10.3390/pharmacy8040226
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