Working together across international boundaries: improving the primary-secondary care network

Much of the discussion in the international dyspepsia healthcare community has been about how practical it is to apply clinical guidelines and whether the division between primary care and certain aspects of secondary care can be adequately reconciled. This article will review some of the recent concepts in dyspepsia management that have touched on primary care and examine the barriers to the worldwide implementation of these guidelines. Closer collaboration between gastroenterologists and general practitioners depends on overcoming these barriers and adapting guidelines to suit local circumstances. These differ across Europe with regard to economic, health service and clinical factors.