Knowledge and practice of family medicine and internal medicine residents toward the management of gastroesophageal reflux disease in Riyadh, Saudi Arabia

BACKGROUND: Accurate diagnosis and management of gastroesophageal reflux disease (GERD) remain a challenge in the primary care setting. The objective was to assess GERD management's knowledge and practice and its association with the family and internal medicine residents. METHODS: A cross-sectional study between January 2019 and September 2020 among the family and internal medicine residents in Riyadh, Saudi Arabia. Residents answered a self-administrated questionnaire about knowledge and practices of GERD management. RESULTS: A total of 596 residents were included in the current study. The average age was 26.8 ± 2.1 years, and 54.5% of the residents were males. The median knowledge score was 62.5%. The majority (89.8%) of the residents were using acid suppression drugs empirically, mainly proton-pump inhibitors (75.8%), for <8-week durations (69.7%) being taken before meals (84.7%). Frequent diagnostic testing for GERD included urea breath test (50.7%), 24-hour pH-metry/24-hour pH probe (47.3%), and upper endoscopy with biopsy (40.7%). Frequent causes for referral included gastrointestinal bleeding (82.6%), weight loss/appetite loss (82.2%), and failure of therapy (78.7%). Better knowledge was associated with older age, family medicine training, better referral practices, frequent reporting of atypical symptoms, and reading recent guidelines. CONCLUSIONS: We are reporting a moderate knowledge level among a group of family and internal medicine residents trained in Riyadh hospitals. Practices were generally good with some areas that need improvement, especially diagnostic testing. There is an urgent need for educational programs that target family and internal medicine residents, such as education courses that include lectures and clinical discussions with the senior staff. Also, we suggest health care organizations in Saudi Arabia establish well-structured Saudi National GERD Guidelines.