Do urea breath test (UBT) referrals for <i>Helicobacter pylori</i> testing match the clinical guidelines in primary care practice? A prospective observational study

Horowitz, Noya; Anat, Beit-Or; Moshe, Leshno; Gennady, Polishchouk; Halpern, Zamir; Moshkowitz, Menachem

doi:10.1111/j.1365-2753.2008.01039.x

Cited by 4 publications

(6 citation statements)

References 23 publications

(27 reference statements)

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“…There has been a clear increase in the number of H pylori diagnostic tests requested by PCPs in the last years . This situation has accompanied a change in the management of H pylori infection to PCPs compared with the last decades, where H pylori was mainly treated by GSs.…”

Section: Discussionmentioning

confidence: 99%

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Management of Helicobacter pylori infection at the primary care level. The implementation of specific counseling improves eradication rates

et al. 2019

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Background Management of Helicobacter pylori infection has been expanded from the gastroenterology specialist (GS) to primary care physicians (PCPs), with a large increase in requests for urea breath tests (UBT). Due to the lack of evidence at this level, we evaluated the appropriateness of UBT indications and treatment for H pylori infections between PCPs and GSs and the effect of introducing specific counseling to PCPs. Materials and Methods This was a quasi‐experimental study. Phase I included 650 consecutive UBT requested by PCPs (400) and GSs (250). Indications and treatments were classified as appropriate or inappropriate based on national guidelines. Data on eradication rates were also collected. In phase II, 240 UBT and patients' treatment outcomes were analyzed after individually counseling PCPs on both aspects. Results Of 1049 UBT, inappropriate indications in phase I were significantly higher in tests requested by PCP compared with GS (35.9% vs 7.2%; P < 0.001). Inappropriate treatment regimens were significantly higher for PCPs in phase I (65.8% vs 26.4%; P < 0.001). Consequently, eradication rates were significantly lower in patients treated by PCPs compared with those treated by GS (63.7% vs 81.4%; P = 0.004). A significant increase in adherence to appropriate treatment regimens (75.8% vs 34.2%; P < 0.001) and eradication rates (79.2% vs 63.7%; P = 0.002) were observed in the PCP group after counseling; however, the appropriateness of indications did not improve. Conclusions Patients infected with H pylori managed at the primary care level had poorer outcomes. The introduction of specific counseling for PCPs significantly improved treatment management, but not indications.

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Section: Discussionmentioning

confidence: 99%

“…There has been a clear increase in the number of H pylori diagnostic tests requested by PCPs in the last years. 14,19 indication was gastroesophageal reflux (GERD). These figures are similar to those reported previously in other countries.…”

Section: Discussionmentioning

confidence: 99%

Management of Helicobacter pylori infection at the primary care level. The implementation of specific counseling improves eradication rates

et al. 2019

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“…As UBT is a very accurate test , there should be strict inclusion and exclusion criteria at clinic settings to avoid significant high false negative rates. Better education of referring physicians and staff operating the machine is needed to ensure a valid test . We suggest the following guidelines:…”

Section: Discussionmentioning

confidence: 99%

Helicobacter Pylori Breath Testing in an Open Access System has a High Rate of Potentially False Negative Results due to Protocol Violations

et al. 2012

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“…a single UBT, 4 weeks after treatment was as effective as two serial breath tests in confirming H. pylori eradication and the incremental cost of the second breath test was very high with no incremental clinical benefit [21]. A study performed in Israel to evaluate the indications for UBT used by primary care doctors and to examine the appropriateness of these indications to the accepted guidelines of the Maastricht Consensus Report revealed a substantial noncompliance with guidelines for H. pylori testing among primary care doctors in this country [22].…”

Section: Non‐molecular Methodsmentioning

confidence: 99%

Diagnosis of Helicobacter pylori Infection

et al. 2009

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The articles published this last year in the field of Helicobacter pylori diagnosis reported the development of in vivo histology, small improvements in some invasive methods (urease test, culture, and histology) and new kits for the stool antigen tests. They also contributed to increasing our knowledge, by further exploration into specific conditions for the urea breath test and into the significance of cagA antibodies. The role of serum markers of atrophy was also confirmed. Molecular methods are still being developed for direct genotyping, detection of H. pylori and its clarithromycin resistance, either by polymerase chain reaction or fluorescent in-situ hybridization. For the first time, there was a report on a possible interest of magnetic resonance spectroscopy.

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Do urea breath test (UBT) referrals for Helicobacter pylori testing match the clinical guidelines in primary care practice? A prospective observational study

Abstract: Nearly 45% percent of UBT referrals in primary care practice were inappropriate, and a significant number of dyspeptic patients should have been referred to endoscopy. These findings show a substantial non-compliance with guidelines for H. pylori testing among primary care doctors.

Cited by 4 publications

References 23 publications

Management of Helicobacter pylori infection at the primary care level. The implementation of specific counseling improves eradication rates

Management of Helicobacter pylori infection at the primary care level. The implementation of specific counseling improves eradication rates

Helicobacter Pylori Breath Testing in an Open Access System has a High Rate of Potentially False Negative Results due to Protocol Violations

Diagnosis of Helicobacter pylori Infection

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