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Over-diagnosis Of Reflux In Infants Leads To Needless Medication

Calling gastroesophageal reflux a disease increases parents' wish for medication, symptoms are frequently over-treated in infants, according to new research

ANN ARBOR, Mich., April 1, 2013 /PRNewswire-USNewswire/ -- Medications used to treat gastroesophageal reflux disease, or GERD, are some of the most widely used medications in children less than one year old.

But in a new study, researchers from the University of Michigan and the University of Missouri concluded that physicians often label common symptoms in infants, such as crying and spitting up, as disease. Frequent use of the GERD label can lead to overuse of medication, according to study published today online ahead of print in the journal Pediatrics.

The study found that doctors' use of the label GERD prompted parents to request medication for their baby even when they had been advised that the medication would probably be ineffective.

"As doctors we need to appreciate that the words we use when talking with patients and parents have power – the power to make a normal process seem like a disease.  As pediatricians, our job is to make sick children healthy, not to make healthy children sick," says Tarini, who also is an investigator in U-M's Child Health Evaluation and Research Unit.

In the study, researchers surveyed parents coming into a pediatric clinic in Michigan about how they would respond to a hypothetical clinical scenario describing an infant who cries and spits up excessively but is otherwise healthy. Parents were randomly assigned to receive one of multiple vignettes. In some vignettes, the doctor gave a diagnosis of GERD; in others the doctor did not provide a disease label.

Additionally, half the parents were told that existing medications are probably ineffective; the rest were not given information about medication effectiveness. Parents who received a GERD diagnosis were interested in medicating their infant, even when told that medications were ineffective. Parents not given a disease label were interested in a prescription only when the doctor did not discuss whether the medication was effective.

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