What do heartburn sufferers expect from proton pump inhibitors when prescribed for the first time?

Based on several consensus reports, the official goals of gastroesophageal reflux disease (GERD) treatment are symptom relief, healing of esophagitis, prevention of complications and also prevention of relapses. The aim of the present study was to evaluate the expectations of heartburn sufferers referred to primary endoscopic examination in a prescribed proton-pump-inhibitor (PPI) therapy, also in relation to the official treatment goals.

A group of 91 patients has been sent to the Division of Gastroenterology of the Public Hospital of Zell am See for a first endoscopic examination because of recurrent GERD-related symptoms. All patients (59 men, 32 females), mean age 44.8 years (range 28 to 63 years), treated their symptoms themselves using over-the-counter medication and/or life-style modification and diet. Subsequent to endoscopic examination and medical prescription all patients were asked about their expectations in a prescribed PPI therapy (open technique).

Of the complete sample, only 4 patients (4.4%) had no real expectations in the prescribed antireflux medication. The leading expectations were: 1) an improvement in (61%) or elimination of (33%) perceived symptoms; 2) healing of esophagitis (50%); 3) in 46% of the patients a return to normal daily life and in 44% an improvement in quality of life respectively. Thirty-six percent expected no further therapy following this initial treatment and 34% no side-effects of PPI treatment.

The leading patient-related expectations in PPI therapy are related to their perceived symptomatology, an improvement in quality of life, healing of esophagitis, and also a long-term efficacy of treatment. Most of these factors expected by the patients are in relation to the official treatment goals, but especially aspects such as quality of life and normal daily activities should be included as endpoints of treatment.