Gastro-oesophageal reflux disease--impact of guidelines on GP management.

BACKGROUND This program examined the impact of clinical guidelines and a 3 year self audit process on general practitioners' diagnosis and management of gastro-oesophageal reflux disease. METHODS Nine hundred and sixty-six Australian GPs participated in a retrospective five step clinical audit reporting on data for 28,622 patients. RESULTS General practitioners demonstrated significant improvements in their diagnosis and management of gastro-oesophageal reflux disease across the audit period, including: a significant 3% decrease in use of endoscopy; improved GP assessment and identification fo risk factors and exacerbants; significant increase in GP recommendations for patient weight loss and dietary changes (7 and 10% respectively); a significant 4% reduction in patient use of medications that may exacerbate reflux symptoms. DISCUSSION The findings provide a snapshot of current diagnostic and management practices in Australian general practice, and highlight the benefits of clinical audit as a tool for eliciting evidence based, guideline driven practice change.