Perceptions and Practices of Primary Care Providers in Europe and the US in the Diagnosis and Treatment of Irritable Bowel Syndrome: A Multinational Survey
Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic
Typ dokumentu časopisecké články
PubMed
39568286
PubMed Central
PMC11748826
DOI
10.1111/nmo.14967
Knihovny.cz E-zdroje
- Klíčová slova
- diagnosis, disorders of gut‐brain interaction (DGBI), epidemiology, functional gastrointestinal disorders (FGID), irritable bowel syndrome (IBS), primary care, treatment,
- MeSH
- dospělí MeSH
- lékaři primární péče * MeSH
- lékařská praxe - způsoby provádění * statistika a číselné údaje MeSH
- lidé MeSH
- postoj zdravotnického personálu * MeSH
- primární zdravotní péče * MeSH
- průzkumy a dotazníky MeSH
- syndrom dráždivého tračníku * diagnóza terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Spojené státy americké MeSH
BACKGROUND: The knowledge and proficiency of primary care practitioners (PCPs) in diagnosing and managing irritable bowel syndrome (IBS) remain generally low and variable internationally. This variability is partly due to a lack of familiarity with the Rome Foundation diagnostic criteria and treatment guidelines for this condition. METHODS: We conducted an electronic survey of PCPs in the United States and nine European countries to assess their understanding of IBS pathophysiology; the use of Rome IV criteria in diagnosis, knowledge of and frequency in prescribing various recommended treatments; and the likelihood of referring patients with suspected IBS to subspecialists. RESULTS: Most PCPs in the United States and Europe perceive IBS as a diagnosis of exclusion rather than a definitive diagnosis. They also believe IBS is underdiagnosed in primary care and challenging to diagnose confidently. The majority of PCPs consider diet as a crucial component of IBS management. Notably, US PCPs reported greater confidence than their European counterparts in recommending dietary interventions such as increased dietary fiber, a low FODMAP diet, and gluten restriction. Conversely, both groups exhibited moderate to high confidence in recommending over-the-counter treatments. European PCPs showed greater confidence in treating IBS with antispasmodics and secretagogues, while US PCPs expressed greater confidence in prescribing neuromodulators. Additionally, US PCPs were more likely to refer patients with suspected IBS to a gastroenterologist, whereas both US and European PCPs showed similar referral patterns to dietitians and referred very few patients to mental health providers. Both US and European PCPs reported that IBS is moderately to extremely difficult to treat effectively and emphasized the importance of a strong and longitudinal doctor-patient relationship in managing the condition. CONCLUSION: Despite the Rome Foundation recommendations and criteria to support a positive diagnosis of IBS, most PCPs still rely on exclusionary investigations such as endoscopy and a serologic workup, while a significant percentage suggest referring patients to gastroenterologists.
4th Local Primary Care Team Municipality Practice Academic Practice of Heraklion Crete Greece
Department of Family Medicine University of Michigan Medical School Ann Arbor Michigan USA
Division of Family Medicine and Primary Care Karolinska Institutet Stockholm Sweden
Faculty of Medicine University of Tartu Tartu Estonia
Health Center Zagreb West Family Medicine Practice Zagreb Croatia
Institute of General Practice 1st Faculty of Medicine Charles University Prague Czech Republic
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