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Heather
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Reged: 12/09/02
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Posts: 6624
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Loc: Seattle, WA
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Psychological factors as a predictor of treatment response in patients with heartburn
03/04/06 12:39 PM
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Psychological factors as a predictor of treatment response in patients with heartburn: A pooled analysis of clinical trials
Authors: Wiklund, Ingela1; Carlsson1, Rolf1; Carlsson, Jonas1; Glise, Hans1
Source: Scandinavian Journal of Gastroenterology, Volume 41, Number 3, Number 3/March 2006, pp. 288-293(6)
Objective . A pooled analysis, using data from three prospective, randomized, double-blind, placebo-controlled, clinical studies, was undertaken to determine the relationship between well-being and subsequent clinical response to acid suppressant therapy in 1887 adult patients with reflux symptoms (with/without endoscopically verified erosive esophagitis).
Material and methods . Well-being was assessed at study entry using the Psychological General Well-Being (PGWB) Index. Patients were assessed for complete relief of heartburn (absence of symptoms in the preceding 7 days) after 4 weeks' treatment (omeprazole 10 or 20?mg once daily; ranitidine 150?mg twice daily).
Results . Multiple logistic regression analysis identified baseline PGWB Index total score and anxiety score as independent prognostic indicators of treatment response in endoscopy-positive patients ( n =1333). Thus, the likelihood of achieving complete heartburn relief was impaired by high baseline levels of anxiety or a low total well-being score. In the endoscopy-negative group, high levels of depression and low vitality scores affected treatment response adversely. Furthermore, age (for endoscopy-positive patients only) and body mass index (for endoscopy-negative patients only) showed an association with treatment outcome. Gender seemed to have no prognostic value on treatment outcome.
Conclusions . Patient well-being may be a useful prognostic indicator in patients presenting with reflux symptoms, with a high level of anxiety predicating against a response to acid suppressant therapy, particularly in those with normal endoscopic findings.
http://www.ingentaconnect.com/content/tandf/sgas/2006/00000041/00000003/art00007
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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