Survey of the adherence to the consensus of gastroesophageal reflux disease before and after the implementation course

J Formos Med Assoc. 2018 May;117(5):440-449. doi: 10.1016/j.jfma.2017.05.012. Epub 2017 Jun 13.


Background/purpose: The prevalence of Gastroesophageal reflux disease (GERD) is increasing worldwide, including Asia. Although several consensus reports have been published, little is known regarding the adherence of the physicians on the consensus of GERD. We aimed to survey the agreements and adherence of physicians to the Taiwan GERD consensus before and after the continual medical education (CME) courses.

Methods: Two-hundred and twenty-seven physicians, including 81 fellows of gastroenterology, 135 qualified gastroenterologists, and 11 non-gastroenterologist attending physicians were invited to the CME course. Their agreements and adherence to the statements before and after the CME course were assessed by the pre-defined questionnaire with the aid of electronic keypads. The adherence rate before and after the CME course were compared by the McNemar test to indicate the changes in their willingness to follow the statements in clinical practice.

Results: The rates of agreement of the 227 participating physicians were uniformly greater than 80% for all of the 22 statements. However, the adherence rates were lower than 80% in 16 statements before the CME intervention. The adherence rates were significantly (p < 0.05) increased in 15 of these 16 statements after the CME intervention. The adherence rate can be improved to greater than 80% for those statements with high level of evidence.

Conclusion: Although physicians agreed with the statements, the pre-CME survey disclosed limited adherence rates to the statements. The education intervention through the CME courses can improve the adherence of consensus statement, especially for those with higher level of evidence.

Keywords: Adherence; Barrier; Consensus; Education; Gastroesophageal reflux disease.

MeSH terms

  • Consensus*
  • Education, Medical, Continuing*
  • Female
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / drug therapy*
  • Guideline Adherence*
  • Humans
  • Male
  • Physicians
  • Proton Pump Inhibitors / therapeutic use


  • Proton Pump Inhibitors