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Helicobacter pylori ‐associated peptic ulcer disease: A retrospective analysis of post‐treatment testing practices
Author(s) -
Feder Rachel,
Posner Shai,
Qin Yi,
Zheng Jiayin,
Chow SheinChung,
Garman Katherine S.
Publication year - 2018
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12540
Subject(s) - medicine , helicobacter pylori , retrospective cohort study , ambulatory , logistic regression , gastroenterology , disease , cohort
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.