The effect of proton pump inhibitors (PPIs) along with health education intervention on gastroesophageal reflux disease (GERD) and the disease impact scale

Objectives: Gastroesophageal Reflux Disease (GERD) has become a public health issue in Taiwan; however, current clinical treatment focuses only on surgery or drugs to inhibit gastric acid secretion, and seldom takes into consideration the effect of concurrent health education which includes diet, lifestyle modification, and disease knowledge, attitude and practice (KAP). The aims of this study were to evaluate the concurrent effects of health education and Proton Pump Inhibitors (PPIs) on diet, lifestyle changes, KAP, the modified GERD impact scale (mGIS), and severity of the condition as determined by endoscopy, and to further explore the predictors of difference on the modified GERD impact scale (AmGIS). Methods: A 6-8 week randomized controlled trial was conducted at a medical center between 2010 and 2011. This involved 181 gastroenterology outpatients with GERD. Participants were randomly assigned to one of two treatment strategies: 89 in the medication management (PPIs) only group and 92 in the medication management (PPIs) plus concurrent health education group. Results: The experimental group was significantly better than the control group in avoiding or decreasing related risk factors, increasing disease KAP, and decreasing mGIS. Multiple linear regression (stepwise) analysis showed that improved knowledge (ß=1.221, t=2.716), sleeping with the head of the bed raised (ß=0.539, t=12.344) and avoiding or decreasing eating sweets (ß=0.101, t=3.644) were ΔmGIS predictors. Conclusions: PPIs and concurrent health education may be the best way to improve patients' diet, lifestyle, and disease related KAP, and reduce the severity of clinical symptoms.