Patients with the condition commonly known as heartburn may benefit from lifestyle interventions rather than just medication, suggest researchers in this month's British Journal of General Practice (BJGP).

Gastro-oesophageal reflux disease (GORD) affects between 20% and 40% of the population in the western world and 32 million prescriptions for proton pump inhibitors (PPIs) were issued in 2008 in the UK at a cost of £220 million a year.

Researchers from Bucks New University in Middlesex and Kings College London are suggesting that an educational programme for GORD sufferers, perhaps offered by nurses in primary care, might make a difference in reducing the amount of medication used.

The study gave 42 people being prescribed medication for GORD symptoms a 1.5 hour educational session each week over four weeks, then interviewed them on their symptoms and their affect on their lives after three months. Participants were encouraged to record their symptoms, look at their diet, learn about managing stress, set goals for themselves and identify their three biggest problems relating to GORD.

The authors write: "Following the intervention, patients felt more in control, believed that their treatment could help them, experienced fewer symptoms, were less concerned about their illness and had a greater understanding of and were less affected by their reflux than before the intervention.

"The intervention improved patients' perception of their illness at three months, and improved their illness experience in many areas including testing patients' sense of control, perception and understanding of their condition, and also symptom severity.

"There was no improvement in symptoms that prevent patients from eating or drinking what they like, which may reflect the fact that, despite reporting symptoms, patients did not let these interfere with what they wanted to consume anyway."

Br J Gen Pract 2010; 60: 891-896).

Also in this month's BJGP

Stanton and colleagues provide a valuable overview of the evidence guiding clinical decision making in patients with respiratory tract symptoms and infections, and offer a series of practical suggestions aimed at improving their management

In their study from Oslo, Hoye and co-workers discovered that deferred prescribing was not always endorsed by GPs, and emphasise the need for careful negotiation and the provision of information to patients when issuing wait-and-see prescriptions.

A non-drug approach to the management of hypertension is also explored in a systematic review from Ireland suggesting that patients have an important role to play in the effective management of this condition

The BJGP's golden anniversary is marked in the Back Pages by a series of short pieces by all but one of its editors, tracing the development of one of the world's oldest and most influential primary care publications.

Source: Royal College of General Practitioners