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10-04-2013 | Gastroenterology | Article

Pediatric GERD label should be used with caution

Abstract

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medwireNews: Parents are more interested in requesting acid-reducing medications for their children when symptoms of crying and excessive regurgitation are labelled as gastroesophageal reflux disease (GERD), researchers say.

The researchers found that parents of children with a GERD diagnosis were interested in medication even after being told that it was ineffective.

Authors Laura Scherer (University of Missouri, Columbia, USA) and colleagues say that the findings suggest that the GERD label may be contributing to medication overuse.

"Unnecessary use of medication is costly, especially for families without insurance, the over-use of medications can be a needless expense," said Scherer in a press statement.

"In addition, the long-term side effects of the medication frequently prescribed to children diagnosed with GERD have not been fully studied."

The study included 175 parents attending a general pediatric clinic, of whom 37 said that one or more of their children had previously been diagnosed with GERD.

The parents were initially given vignettes which described symptoms potentially indicating GERD, including excessive crying and regurgitation in a 1-month-old child.

In the second part of the vignette, the physician offers a trial of acid-suppressant medication. However, half of the parents were told that the child had a GERD diagnosis and half were not. Additionally, half were told that the medication was unlikely to be effective, while the other half were not given any information on efficacy.

The authors found that parents who received the GERD label in the vignette were more interested in medication than parents who did not. Furthermore, the former group of parents were interested in medication regardless of information on its inefficacy, while parents without a GERD diagnosis were only interested in medication when they were allowed to assume it was effective.

Interestingly, there was no significant influence of the GERD label on the parents' perception of disease severity.

"This suggests that the GERD label influenced parents' judgments not by changing their perceptions of the illness itself, but rather by changing their assumptions about what kind of interventions would be most appropriate," the authors write in Pediatrics.

Scherer and colleagues say that their study indicates that physicians could reduce parental interest in medications by not labelling symptoms as GERD and by explaining to parents that acid reflux medications are not effective.

"Doctors may inadvertently encourage the use of questionable medical interventions and foster medicalization of minor pediatric illnesses by using labels that increase patients' perceived need for treatment," they conclude.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter

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