Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

Objective: The objective of this selective EBM review is to determine whether or not is metoclopramide effective in treating symptoms in diabetic gastroparesis?

Study Design: Systematic review of 1 controlled randomized double blinded study, 1 controlled randomized open label study, and 1 controlled open label case analysis published in peer reviewed journals between 2012-2014, all in English language.

Data Sources: 1 randomized double blinded study, 1 randomized open label study, and 1 case analysis comparing symptom reduction of gastroparesis after the intervention of nasal and oral metoclopramide compared to placebo controls. These sources were found using PubMed and OVID.

Outcomes Measured: Patients graded their symptoms on a scale and graded the severity of each symptom after the use of nasal and oral metoclopramide. The studies gave patients different scales to measure the severity of each symptom which included a Symptom Assessment Questionnaire (SAQ), Gastroparesis Cardinal Symptom Index Daily Diary, and a Clinical Patient Grading Assessment Scale (CPGAS).

Results: Conclusively, the studies did not show a reduction in symptoms after the intervention for gastroparesis in diabetic patients. Only one study demonstrated symptom reduction to be statistically significant while the other two studies did not.

Conclusions: The use of metoclopramide did not show an improvement in gastroparesis symptoms as assessed by patients after the use of the medication from these studies. More RCT need to be done to prove this scientifically rather than through patient report due to bias or misunderstanding of scoring and through a trial using same comparison groups for a longer duration.

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