Abstract

Gastroesophageal reflux disease (GERD) is one of the most common diseases seen in primary care practice. To reduce the negative effects, such as esophageal narrowing, erosions, and precancerous lesions, from uncontrolled or inadequately managed GERD, primary care providers must stay up to date on evidence-based research and integrate the most current guidelines, The American College of Gastroenterology (ACG) updated guidelines for proper management of GERD in 2021, into practice. The guidelines recommend lifestyle modifications, proper pharmacological treatment with proton pump inhibitors (PPIs) for an eight-week course, and proper follow-up and/or referral if unimproved. The purpose of this research study was to conduct chart reviews of documentation to identify if primary care providers followed current ACG guidelines. After contacting the Mississippi University for Women’s Institutional Review Board and receiving permission to conduct chart reviews at four primary care clinics in Southeastern Mississippi, the current researchers collected data from 465 patients’ charts to assess if current guidelines were being followed by Mississippi primary care providers. The quantitative retrospective study revealed the majority of primary care providers managed GERD adequately, according to current ACG guidelines. Although the data collection initially included all primary care providers, such as nurse practitioners, medical doctors, doctors of osteopathic medicine, and physicians’ assistants, only nurse practitioners and medical doctors were included in the study due to the specific clinics utilized for data collection. Overall, the study revealed nurse practitioners as more compliant than medical doctors with adhering to current ACG guidelines for management of GERD. If Mississippi primary care providers manage GERD according to the ACG guidelines, better patient outcomes can be achieved. By recommending lifestyle modifications, such as weight loss, elevation of the head of bed, refraining from eating two to three hours prior to bedtime, and avoiding trigger foods, reduction of the negative effects of GERD can be piloted. Correct pharmacological treatment with an eight-week course of PPIs can also reduce the negative outcomes produced by GERD without overtreatment that can lead to other issues, like osteoporosis. If failure of combined therapies occur, referral to a specialist should be made for further treatment. The findings also reiterate the importance of timely follow-up. By following the guidelines, primary care providers can improve patient outcomes through reducing the physical strains of GERD and the economical strains of improper management and treatment of the prevalent disease.

Degree

Master of Science in Nursing (MSN)

Department

Graduate Nursing

Degree Date

2022

First Advisor

Emily Stidham

Second Advisor

Dr. Alena Groves

Third Advisor

Dr. Sally Pearson

Document Type

Thesis

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