Adherence of primary care providers to implementing recommendations for the diagnosis and treatment of Helicobacter pylori-associated dyspepsia: survey results
Background. A few studies that have examined a general practitioners’ (GPs) adherence to guidelines on the management of Helicobacter pylori (Hp)-associated diseases indicate poor quality of care for this common population group in various parts of the world. In Ukraine, this issue has not been inve...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Zaslavsky O.Yu.
2025-06-01
|
| Series: | Gastroenterologìa |
| Subjects: | |
| Online Access: | https://gastro.zaslavsky.com.ua/index.php/journal/article/view/673 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background. A few studies that have examined a general practitioners’ (GPs) adherence to guidelines on the management of Helicobacter pylori (Hp)-associated diseases indicate poor quality of care for this common population group in various parts of the world. In Ukraine, this issue has not been investigated until now. Aim: to study the GP’s adherence to contemporary guidelines on the management of patients with dyspepsia, including the unified clinical protocols for primary care in dyspepsia and peptic ulcer approved by the Ministry of Health of Ukraine. Materials and methods. A survey of 132 GPs was conducted using the MS Forms online questionnaire. It included 3 clinical cases with typical clinical manifestations of dyspepsia associated with Hp infection. It was proposed to determine the list of appropriate tests for primary and final Hp diagnosis, as well as to select adequate eradication regimens from 8 patterns. Results. The most popular methods for primary Hp diagnosis were as follows: the determination of fecal antigen to Hp (51.5 % of respondents); 13C-urea breath test (50 % of respondents); and the rapid urease test during upper esophagogastroduodenoscopy (38.6 % of respondents). However, 7.6 % of GPs incorrectly recommended the ammonia breath test; 8.3 % of GPs incorrectly opted for IgM testing instead of total serum antibody assessment. Moreover, despite the absence of “red flag symptoms” in the provided clinical cases, 36.4 % of respondents suggested upper endoscopy and other unnecessary tests in case of a positive Hp-test. Only 1.5 % proposed a progressive approach of determining Hp sensitivity to clarithromycin by the polymerase chain reaction. 43.9 % of GPs selected the correct Hp eradication regimens, whilst taking into account the hypothesised high prevalence of primary antibiotic resistance in Ukraine. 14.4 % of respondents chose both adequate and inadequate regimens. 40 % of GPs confused primary and secondary therapy or were limited to prescribing standard triple therapy. Among family doctors, the prescription of probiotics in combination with eradication is popular (55.3 %). In 42 % of cases with a persistence of dyspeptic symptoms after successful eradication of Hp, GPs referred patients to secondary care specialists, and 43 % attempted to manage this on their own, by prescribing adequate imaging tests and symptomatic therapy. 13 % of GPs . This survey revealed insufficient adherence to current guidelines on the diagnosis and treatment of Hp-infection among the GPs from the Vinnytsia region, which generally coincides with the situation in other countries. Improvements in the system of continuing medical education alongside realistic motivational mechanisms are promising. |
|---|---|
| ISSN: | 2308-2097 2518-7880 |