Survey results highlight lack of adherence to H. pylori infection guidelines
There is a lack of adherence to current guidelines for the diagnosis, testing and treatment of Helicobacter pylori infection, suggesting the need for new and simpler treatments, according to a study published in GastroHep Advances.
“H. pylori is the most common chronic bacterial infection in humans,” Colin W. Howden, MD, Professor Emeritus of gastroenterology at the University of Tennessee Health Science Center, told Healio. “Infection can lead to peptic ulcer disease and other serious conditions, including gastric cancer. In this real-world study, we found a general lack of adherence to current guidelines for the diagnosis and treatment of this highly prevalent infection. Consequently, only 29% of physicians were satisfied with current treatment options.”
The 2017 ACG guidelines recommend testing for active infection of H. pylori and eradication treatment for all patients who test positive. However, previous studies have shown that adherence to these guidelines is suboptimal among both gastroenterologists and primary care physicians.
Howden and colleagues investigated current practices by analyzing survey results from 251 physicians who treat patients with H. pylori infection and past/current dyspepsia. Researchers also reviewed survey results and data from the medical records of 77 patients.
According to study results, 19.5% of patients were diagnosed by serology; 6.5% of gastroenterologists (GIs) used urea breath tests compared with 50% of family physicians/general practitioners (FPs/GPs). Researchers also found that 68.6% of GIs and 79.8% of FPs/GPs used clarithromycin/amoxicillin/proton pump inhibitor triple therapy as first-line treatment.
Physicians in the study reported that 52.9% of patients experienced dyspepsia daily, and 46.8% of patients said complete resolution of dyspepsia indicated their treatment was effective. Results also showed that 59.7% of patients took all of their prescribed medications, 59.7% of patients preferred taking fewer pills and 45.5% preferred convenience packs.
In terms of treatment goals, 69.3% of physicians chose improvement in overall symptoms, while 92.2% of patients favored improvement in dyspepsia. Only 28.7% of physicians reported being satisfied with current treatment options.
“This research further reinforces the need to develop new treatment options that are more efficacious and simpler for patients to adhere to,” Howden and colleagues wrote.
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