Adherence to Maastricht V/Florence consensus report for the management ofHelicobacter pyloriinfection among primary care physicians and medical students in Croatia: A cross‐sectional study

Abstract

Background Helicobacter pylori (H pylori) eradication is becoming increasingly difficult. The aim of our study was to determine the knowledge of current guidelines and attitude in the diagnosis and treatment of H pylori infection in primary care physicians (PCPs) and medical students in Croatia. Materials and Methods A study was conducted among PCPs and medical students to evaluate adherence to Maastricht V consensus guidelines. Questionnaire was distributed by e‐mail to 2338 PCPs offices in Croatia and to the medical students from the University of Split School of Medicine. Responses were collected electronically from June 22 to August 22, 2020. Results Two hundred forty‐nine PCPs and 169 medical students were included in the study. Bismuth or non‐bismuth‐based quadruple therapy as first‐line treatment for H pylori was the choice of 4.8% of PCPs and 13% of students, while 66.3% PCPs and 79.9% students would choose clarithromycin‐based triple therapy. Bismuth‐based quadruple therapy was the most preferred second line of treatment for 45.4% of PCPs and 34.9% of students. Only 2.8% PCPs and 7.1% of students would correctly recommend first and second line of treatment for H. pylori infection. A larger proportion of students than PCPs would prefer C13‐urea breath test (50.3% vs 6.4%). Only 59.0% PCPs would treat for H pylori in all patients including the asymptomatic ones. Students more frequently recognized the link between H pylori and gastric cancer compared with PCPs (92.9% vs 73.5%). Conclusions Primary care physicians and medical students’ knowledge of H pylori guidelines are insufficient in Croatia and ask for additional training.

Follow-up analysis and histopathological study of gastric mucosa in patients withHelicobacter pyloriinfection

“…H. pylori is believed to be one of the main driving forces in the progression of non-cardia gastric cancers from acute gastritis to chronic gastritis, followed by atrophic gastritis and eventually progressing to malignancy. 12 H. pylori has the characteristics of cluster reproduction and tissue-specific adsorption. H. pylori initially colonizes the mucus layer covered by the epithelium of the gastric mucosa, and then penetrates to the mucus layer and specifically adheres to the surface mucus cytoplasm.…”

Adherence to international guidelines for the management ofHelicobacter pyloriinfection among gastroenterologists and gastroenterology fellows in Italy: A Survey of the Italian Federation of Digestive Diseases ‐ FISMAD

“…To our knowledge, this is the most comprehensive study assessing practice patterns of gastroenterologists and gastroenterology fellows in the diagnosis and treatment of H. pylori infection in Europe. Previous studies reported either attitudes of primary care physicians 18 or practices of gastroenterologists, but not gastroenterology fellows, with particular focus on the first‐line treatment of H. pylori 14 . Another comprehensive survey on the adherence of gastroenterologists to guideline for the management of H. pylori infection was carried out in China 15 .…”

Did an introduction of CONSORT for abstracts guidelines improve reporting quality of randomised controlled trials’ abstracts onHelicobacter pyloriinfection? Observational study

“…Recent studies had shown more obstacles to successful management of the disease, such as insufficient knowledge of H. pylori guidelines among primary care physician and medical students. 18 Additional problem was a poor accordance between treatment regimens and drug pack sizes. 19 Those challenges could contribute to antimicrobial resistance, affect adherence, lead to more medication errors and worse outcomes for the patients.…”

“… 19 Those challenges could contribute to antimicrobial resistance, affect adherence, lead to more medication errors and worse outcomes for the patients. 18 19 Another obstacle to improved H. pylori eradication could be the poor integration of the latest research into the practice due to insufficient reporting quality. So far, the quality of published RCT abstracts in the field of gastroenterology, the cornerstone of evidence based medicine practice, remained unknown.…”