Assessing the appropriateness of the management of gastro-oesophageal reflux in Australian children: a population-based sample survey
| Autor: | Hseun P. Ting, Harriet Hiscock, Jeffrey Braithwaite, Louise Wiles, Gaston Arnolda, Glen Farrow, David J. Moore, Peter Hibbert, Meagan Warwick, Charlotte J. Molloy |
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| Přispěvatelé: | Arnolda, Gaston, Hiscock, Harriet, Moore, David, Farrow, Glen, Hibbert, Peter D, Wiles, Louise K, Ting, Hseun P, Molloy, Charlotte J, Warwick, Meagan, Braithwaite, Jeffrey |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adolescent Urinalysis Referral Science Paediatric research Irritability Article Diagnosis Differential 03 medical and health sciences 0302 clinical medicine children Surveys and Questionnaires 030225 pediatrics Health care medicine Humans 030212 general & internal medicine Medical prescription Child Multidisciplinary medicine.diagnostic_test Crying business.industry Medical record GOR Infant Newborn Australia Infant Proton Pump Inhibitors Guideline Translational research Diet gastro-oesophageal Child Preschool Population Surveillance Emergency medicine Gastroesophageal Reflux Medicine medicine.symptom business |
| Zdroj: | Scientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) Scientific Reports |
| Popis: | Gastro-oesophageal reflux (GOR) is a common physiological state in infants and young children, with gastro-oesophageal reflux disease (GORD) its pathological manifestation. Management of GOR/GORD requires elimination of possible underlying causes, parental reassurance, modification of feeding and symptom mitigation, monitoring, and referral to paediatricians if warning signs are present. Published clinical practice guidelines (CPGs) seek to support clinicians and improve management. This study aimed to measure the proportion of Australian GOR/GORD paediatric care that was in line with CPG recommendations. National and international CPGs for GOR/GORD were systematically identified and candidate indicators extracted; a Delphi process selected 32 indicators relevant to Australian paediatric care in 2012 and 2013. Medical records were identified in General Practices, the offices of general paediatricians, Emergency Departments and inpatient settings. Adherence to indicators was assessed by nine trained paediatric nurses undertaking retrospective medical record review. Medical records were reviewed in 115 healthcare sites; identifying 285 children, three-quarters aged infants at the first presentation was higher if they were healthy and thriving (86.9% adherence: 95% CI 86.0–96.8), intermediate if they had feeding refusal (73.1%: 95% CI 56.0–86.3) and lower if they presented with irritability and unexplained crying (58.8%: 95% CI 28.2–85.0). A guideline targeting Australian health professionals caring for infants and children with GOR/GORD is warranted, highlighting the importance of differential diagnostic testing and avoidance of acid-suppression medication in infants. |
| Databáze: | OpenAIRE |
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