Lack of symptom benefit following presumptive Helicobacter pylori eradication therapy in primary care

David Williams, P. O'Kelly, J. Feely

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 languageEnglish
Pages (from-to)1769-1775
Number of pages6
JournalAlimentary Pharmacology & Therapeutics
Volume15
DOIs
Publication statusPublished - 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 journalArticle

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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.",
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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

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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 -