Attending Training Courses on Barrett’s Esophagus Improves Adherence to Guidelines: A Survey from the Italian Society of Digestive Endoscopy

Background Little is known on practice patterns of endoscopists for the management of Barrett’s esophagus (BE) over the last decade. Aims Our aim was to assess practice patterns of endoscopists for the diagnosis, surveillance and treatment of BE. Methods All members of the Italian Society of Digesti...

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Bibliographic Details
Published in:Digestive diseases and sciences 2021-09, Vol.66 (9), p.2888-2896
Main Authors: Zagari, Rocco Maurizio, Eusebi, Leonardo Henry, Galloro, Giuseppe, Rabitti, Stefano, Neri, Matteo, Pasquale, Luigi, Bazzoli, Franco
Format: Article
Language:English
Subjects:
Barrett Esophagus - epidemiology
Barrett Esophagus - therapy
Biochemistry
Chronic Disease Indicators
Curriculum
Diagnosis
Dysplasia
Education - methods
Endoscopy
Endoscopy, Digestive System - education
Endoscopy, Digestive System - methods
Endoscopy, Digestive System - standards
Esophagus
Female
Gastroenterology
Guideline Adherence - standards
Hepatology
Humans
Italy - epidemiology
Male
Medical diagnosis
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original
Original Article
Practice Guidelines as Topic
Practice Patterns, Physicians' - organization & administration
Practice Patterns, Physicians' - standards
Practice Patterns, Physicians' - trends
Quality Improvement
Questionnaires
Societies, Medical
Strategic planning (Business)
Study and teaching
Surveillance
Surveys
Trade and professional associations
Transplant Surgery
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Summary:Background Little is known on practice patterns of endoscopists for the management of Barrett’s esophagus (BE) over the last decade. Aims Our aim was to assess practice patterns of endoscopists for the diagnosis, surveillance and treatment of BE. Methods All members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnaire-based survey. The questionnaire included questions on demographic and professional characteristics, and on diagnosis and management strategies for BE. Results Of the 883 SIED members, 259 (31.1%) completed the questionnaire. Of these, 73% were males, 42.9% had > 50 years of age and 68.7% practiced in community hospitals. The majority (82.9%) of participants stated to use the Prague classification; however 34.5% did not use the top of gastric folds to identify the gastro-esophageal junction (GEJ); only 51.4% used advanced endoscopy imaging routinely. Almost all respondents practiced endoscopic surveillance for non-dysplastic BE, but 43.7% performed eradication in selected cases and 30% practiced surveillance every 1–2 years. The majority of endoscopists managed low-grade dysplasia with surveillance (79.1%) and high-grade dysplasia with ablation (77.1%). Attending a training course on BE in the previous 5 years was significantly associated with the use of the Prague classification (OR 4.8, 95% CI 1.9–12.1), the top of gastric folds as landmark for the GEJ (OR 2.45, 95% CI 1.27–4.74) and advanced imaging endoscopic techniques (OR 3.33, 95% CI 1.53–7.29). Conclusions Practice patterns for management of BE among endoscopists are variable. Attending training courses on BE improves adherence to guidelines.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-020-06615-6