Helicobacter pylori-associated peptic ulcer disease: A retrospective analysis of post-treatment testing practices.

Journal Article (Journal Article)

BACKGROUND & AIMS: Guidelines recommend that patients with Helicobacter pylori (H. pylori)-associated peptic ulcer disease (PUD) receive H. pylori eradication therapy followed by post-treatment testing to prove eradication; however, post-treatment testing rates are suboptimal and barriers to testing are poorly understood. Our aim was to identify factors that predicted receipt of post-treatment testing. METHODS: We performed a retrospective cohort study of 152 patients with H. pylori-associated PUD diagnosed between 2007 and 2015 at a large tertiary medical center in the United States, who received standard eradication therapy and ambulatory follow-up within one year. The primary outcome of interest was receipt of post-treatment testing. Logistic regression models compared post-treatment testing rates in those diagnosed while outpatient vs inpatient, patients with vs without repeat endoscopy, and patients with vs without gastroenterology (GI) clinic follow-up. Propensity scores controlled for age, sex, race, ulcer location, and symptom persistence. RESULTS: Among 152 patients, 67 (44%) patients received post-treatment testing. There were significant differences in post-treatment testing rates in those diagnosed as outpatients vs inpatients (57% vs 33%; OR 3.87, P = 0.001) and in patients with vs without GI follow-up (62% vs 11%; OR 9.85, P < 0.0001). CONCLUSIONS: The rate of testing for eradication after treatment in patients with H. pylori- associated PUD was low. However, this was significantly improved in patients who have GI follow-up and whose diagnosis was made in the outpatient setting. Our study demonstrates a clear opportunity for quality improvement initiatives.

Full Text

Duke Authors

Cited Authors

  • Feder, R; Posner, S; Qin, Y; Zheng, J; Chow, S-C; Garman, KS

Published Date

  • December 2018

Published In

Volume / Issue

  • 23 / 6

Start / End Page

  • e12540 -

PubMed ID

  • 30246287

Electronic International Standard Serial Number (EISSN)

  • 1523-5378

Digital Object Identifier (DOI)

  • 10.1111/hel.12540


  • eng

Conference Location

  • England