Abstract
Background: Helicobacter pylori eradication regimens have failure rates under 10%, however little information is available on the effect of treatment success in reducing the subsequent prescription of anti-ulcer medications in primary care.
Aims: To determine, using a large prescription database in eastern Ireland, the success of presumptive eradication therapy in improving symptoms of dyspepsia in primary care, as judged by a reduction in the subsequent prescription of anti-ulcer medications.
Methods: In a cross-sectional study, we identified 3847 patients who received a prescription for eradication therapy for Helicobacter pylori, including 826 who were followed for 9-11 months. Those who subsequently received anti-ulcer medications were deemed failures to obtain symptom relief.
Results: For 3847 patients with a median follow-up of 8 months, the failure rate was 49%. Of 826 patients, followed for a longer period (9-11 months), the overall failure rate was 56% (range 44-62% depending on the eradication regimen used). Age over 65 years (hazard ratio = 1.57, 95% confidence interval = 1.29-1.91, P<0.001), prior use of anti-ulcer medications (hazard ratio = 1.97, 95% confidence interval = 1.63-2.37, P<0.001) and prior use of aspirin/NSAIDs (hazard ratio = 1.43, 95% confidence interval = 1.18-1.73, P<0.001) all predicted failure to obtain relief of symptoms of dyspepsia from eradication therapy.
Conclusions: Such high failure rates of eradication therapy in reducing the subsequent consumption of anti-ulcer medications have both clinical and economic implications for the use of eradication therapy for Helicobacter pylori in primary care.
| Original language | English |
|---|---|
| Pages (from-to) | 1769-1775 |
| Number of pages | 6 |
| Journal | Alimentary Pharmacology & Therapeutics |
| Volume | 15 |
| DOIs | |
| Publication status | Published - 2001 |
Keywords
- NONULCER DYSPEPSIA
- GENERAL-PRACTICE
- DUODENAL-ULCER
- MANAGEMENT
- INFECTION
- ENDOSCOPY
- COMMUNITY
- DISEASE
- TRIAL
Cite this
Lack of symptom benefit following presumptive Helicobacter pylori eradication therapy in primary care. / Williams, David; O'Kelly, P.; Feely, J.
In: Alimentary Pharmacology & Therapeutics, Vol. 15, 2001, p. 1769-1775.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lack of symptom benefit following presumptive Helicobacter pylori eradication therapy in primary care
AU - Williams, David
AU - O'Kelly, P.
AU - Feely, J.
PY - 2001
Y1 - 2001
N2 - Background: Helicobacter pylori eradication regimens have failure rates under 10%, however little information is available on the effect of treatment success in reducing the subsequent prescription of anti-ulcer medications in primary care.Aims: To determine, using a large prescription database in eastern Ireland, the success of presumptive eradication therapy in improving symptoms of dyspepsia in primary care, as judged by a reduction in the subsequent prescription of anti-ulcer medications.Methods: In a cross-sectional study, we identified 3847 patients who received a prescription for eradication therapy for Helicobacter pylori, including 826 who were followed for 9-11 months. Those who subsequently received anti-ulcer medications were deemed failures to obtain symptom relief.Results: For 3847 patients with a median follow-up of 8 months, the failure rate was 49%. Of 826 patients, followed for a longer period (9-11 months), the overall failure rate was 56% (range 44-62% depending on the eradication regimen used). Age over 65 years (hazard ratio = 1.57, 95% confidence interval = 1.29-1.91, P<0.001), prior use of anti-ulcer medications (hazard ratio = 1.97, 95% confidence interval = 1.63-2.37, P<0.001) and prior use of aspirin/NSAIDs (hazard ratio = 1.43, 95% confidence interval = 1.18-1.73, P<0.001) all predicted failure to obtain relief of symptoms of dyspepsia from eradication therapy.Conclusions: Such high failure rates of eradication therapy in reducing the subsequent consumption of anti-ulcer medications have both clinical and economic implications for the use of eradication therapy for Helicobacter pylori in primary care.
AB - Background: Helicobacter pylori eradication regimens have failure rates under 10%, however little information is available on the effect of treatment success in reducing the subsequent prescription of anti-ulcer medications in primary care.Aims: To determine, using a large prescription database in eastern Ireland, the success of presumptive eradication therapy in improving symptoms of dyspepsia in primary care, as judged by a reduction in the subsequent prescription of anti-ulcer medications.Methods: In a cross-sectional study, we identified 3847 patients who received a prescription for eradication therapy for Helicobacter pylori, including 826 who were followed for 9-11 months. Those who subsequently received anti-ulcer medications were deemed failures to obtain symptom relief.Results: For 3847 patients with a median follow-up of 8 months, the failure rate was 49%. Of 826 patients, followed for a longer period (9-11 months), the overall failure rate was 56% (range 44-62% depending on the eradication regimen used). Age over 65 years (hazard ratio = 1.57, 95% confidence interval = 1.29-1.91, P<0.001), prior use of anti-ulcer medications (hazard ratio = 1.97, 95% confidence interval = 1.63-2.37, P<0.001) and prior use of aspirin/NSAIDs (hazard ratio = 1.43, 95% confidence interval = 1.18-1.73, P<0.001) all predicted failure to obtain relief of symptoms of dyspepsia from eradication therapy.Conclusions: Such high failure rates of eradication therapy in reducing the subsequent consumption of anti-ulcer medications have both clinical and economic implications for the use of eradication therapy for Helicobacter pylori in primary care.
KW - NONULCER DYSPEPSIA
KW - GENERAL-PRACTICE
KW - DUODENAL-ULCER
KW - MANAGEMENT
KW - INFECTION
KW - ENDOSCOPY
KW - COMMUNITY
KW - DISEASE
KW - TRIAL
U2 - 10.1046/j.1365-2036.2001.01100.x
DO - 10.1046/j.1365-2036.2001.01100.x
M3 - Article
VL - 15
SP - 1769
EP - 1775
JO - Alimentary Pharmacology & Therapeutics
JF - Alimentary Pharmacology & Therapeutics
SN - 0269-2813
ER -