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How do clinicians practicing in the U.S. manage Helicobacter pylori-related gastrointestinal diseases? A comparison of primary care and specialist physicians



How do clinicians practicing in the U.S. manage Helicobacter pylori-related gastrointestinal diseases? A comparison of primary care and specialist physicians



American Journal of Gastroenterology 93(4): 553-561



We sought to examine the extent to which physicians recognize H. pylori as a causal agent in peptic ulcer disease or as a potential cofactor in other gastrointestinal diseases, and to observe how this knowledge has influenced diagnostic and therapeutic practices. We used a national mail survey in the U.S. between February and May of 1996, querying 5994 U.S. physicians (family/general practitioners [FPs], internists [IMs], and gastroenterologists) selected at random from three different membership databases of professional associations. The response rate was 52%. More than 95% of physicians who treat symptoms empirically would prescribe acid suppressant therapy rather than anti-H. pylori therapy. Between 43% and 66% of physicians, varying in frequency by medical specialty, would treat the infection in H. pylori-positive patients with nonulcer dyspepsia. In confirmed peptic ulcer disease, between 88% and 100% of physicians would treat the H. pylori infection, depending on the physician group and whether or not the presentation of an ulcer was recurrent. Although 103 distinct anti-H. pylori regimens were reported, 89% of the gastroenterologists and 70% of the primary care physicians (PCPs) used combinations of antimicrobials with reported cure rates of at least 80%. General knowledge regarding H. pylori-associated diseases was widespread among primary care physicians and gastroenterologists. However, anti-H. pylori therapies judged ineffective were reported as the first choice regimen by 5% of gastroenterologists and 18% of primary care physicians. Gastroenterologists appear to implement the latest scientific developments in the field rapidly whereas PCPs manifest a delayed response, due to either insufficient knowledge or to other factors influencing their approach to treatment.

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Accession: 046277941

Download citation: RISBibTeXText

PMID: 9576447

DOI: 10.1111/j.1572-0241.1998.164_b.x


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