Therespectiverolesofgeneralpractitioners andspecialistsinthemanagementofmostdiseasesisnotclearlyde®nedanddyspepsiaisno exception.Ideally,thedivisionoftasksshould bebasedonthecharacteristicsofdiVerentdiseasesandonspeci®cobjectives. Theprevalenceofdyspepsiarangesbetween 20and40%inindustrialisedcountriesand roughly25%ofpatientsseekmedicalhelp, whereastheremainderoftenself-medicate.1 Althoughfrequentlyidiopathic(orfunctional), dyspepsiacanbesecondarytoavarietyofserious(andsometimesfatal)organic,systemic andmetabolicdiseasesthatneedtobe identi®ed.Functionaldyspepsiaalsoprecipitatesasubstantialreductioninthequalityof lifeofaVectedpatientswithrelevantcostsfor society.Thecurrenteconomicrestrictionspreventreferralofeverypatientandcorrectmanagementofdyspepsiaisaformidabletask. Prospectivestudieshavebeenundertakento establishtherespectiveeVectivenessofdiVerentdoctorsinthemanagementofsomegastroenterologicaldiseases.Zarlingetalcompared theeYcacyofmanagementofacutediverticulitisprovidedbygeneralpractitioners,internistsandgastroenterologists,andobserved shorterhospitalstayandlowerreadmission ratesinpatientstreatedbygastroenterlogists.2 Unlikeacutediverticulitis,dyspepsiaisavery heterogeneousconditionandnosimilarstudies areavailableasyet.Tacklingthefollowing questionsmayhelptoelucidatetheremitof diVerentdoctors. +Whatdrivesadyspepticindividualto consultaphysician? +DodiVerentdoctorsseediVerenttypesof dyspepticpatients? +Whatisthediagnosticyieldofanextensive work-upbyaspecialist? +ShoulddiVerentdoctorsadoptdiVerent strategiesforthemanagementofdyspepsia? +Whatisthemostcost-eVectivewaytomanagedyspepsia?
Stanghellini V., Tosetti C., Barbara G., Salvioli B., De Giorgio R., Corinaldesi R. (1998). Management of dyspeptic patients by general practitioners and specialists. GUT, 43(1), S21-S23 [10.1136/gut.43.2008.s21].
Management of dyspeptic patients by general practitioners and specialists
Stanghellini V.;Tosetti C.;Barbara G.;Salvioli B.;De Giorgio R.;Corinaldesi R.
1998
Abstract
Therespectiverolesofgeneralpractitioners andspecialistsinthemanagementofmostdiseasesisnotclearlyde®nedanddyspepsiaisno exception.Ideally,thedivisionoftasksshould bebasedonthecharacteristicsofdiVerentdiseasesandonspeci®cobjectives. Theprevalenceofdyspepsiarangesbetween 20and40%inindustrialisedcountriesand roughly25%ofpatientsseekmedicalhelp, whereastheremainderoftenself-medicate.1 Althoughfrequentlyidiopathic(orfunctional), dyspepsiacanbesecondarytoavarietyofserious(andsometimesfatal)organic,systemic andmetabolicdiseasesthatneedtobe identi®ed.Functionaldyspepsiaalsoprecipitatesasubstantialreductioninthequalityof lifeofaVectedpatientswithrelevantcostsfor society.Thecurrenteconomicrestrictionspreventreferralofeverypatientandcorrectmanagementofdyspepsiaisaformidabletask. Prospectivestudieshavebeenundertakento establishtherespectiveeVectivenessofdiVerentdoctorsinthemanagementofsomegastroenterologicaldiseases.Zarlingetalcompared theeYcacyofmanagementofacutediverticulitisprovidedbygeneralpractitioners,internistsandgastroenterologists,andobserved shorterhospitalstayandlowerreadmission ratesinpatientstreatedbygastroenterlogists.2 Unlikeacutediverticulitis,dyspepsiaisavery heterogeneousconditionandnosimilarstudies areavailableasyet.Tacklingthefollowing questionsmayhelptoelucidatetheremitof diVerentdoctors. +Whatdrivesadyspepticindividualto consultaphysician? +DodiVerentdoctorsseediVerenttypesof dyspepticpatients? +Whatisthediagnosticyieldofanextensive work-upbyaspecialist? +ShoulddiVerentdoctorsadoptdiVerent strategiesforthemanagementofdyspepsia? +Whatisthemostcost-eVectivewaytomanagedyspepsia?| File | Dimensione | Formato | |
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