In dyspepsia few data are available from the primary care setting on how selective, risk-factor-oriented endoscopy compares with mandatory endoscopy in the diagnostic outcome and in direct and secondary costs.
We studied this in a two-armed multicentre trial (oméga-project) with primary care physicians.
Patients were enrolled and treated by primary care physicians and referred to a gastroenterologist for upper gastrointestinal endoscopy (UGE).
Patients were enrolled in the study if they had had epigastric complaints for more than 1 month and no obvious signs or history of organic disease.
In the first arm of the study endoscopy was mandatory, in the second selective, i.e. according to a predefined risk profile.
Patients enrolled were treated with prokinetic drugs for 2 months.
A further indication for endoscopy was non-response to treatment (reduction of the initial symptoms score by less than two-thirds) in the study with selective endoscopy and relapse within the 2-month follow-up period in both studies.
The direct costs from number of consultations with the primary care physician, UGEs, number of prescriptions per patient and also absenteeism in days per week were carefully registered in both groups.
All 172 patients of the mandatory endoscopy study and 203/656 patients enrolled in the selective endoscopy study had an UGE (125 at admission, 78 in the follow-up period). (...)
Mots-clés Pascal : Dyspepsie, Diagnostic, Influence, Gastroscopie, Duodénoscopie, Temps attente, Relation, Symptomatologie, Evolution, Coût, Morbidité, Secondaire, Etude comparative, Homme, Appareil digestif pathologie, Endoscopie, Economie santé
Mots-clés Pascal anglais : Dyspepsia, Diagnosis, Influence, Gastroscopy, Duodenoscopy, Waiting time, Relation, Symptomatology, Evolution, Costs, Morbidity, Secondary, Comparative study, Human, Digestive diseases, Endoscopy, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0311050
Code Inist : 002B13B03. Création : 15/07/1997.