Testing for Helicobacter pylori in primary care: trouble in store?

2.50
Hdl Handle:
http://hdl.handle.net/10541/91932
Title:
Testing for Helicobacter pylori in primary care: trouble in store?
Authors:
Foy, R; Parry, J M; Murray, L; Woodman, Ciaran B J
Abstract:
STUDY OBJECTIVE: To assess the role of testing for Helicobacter pylori in the management of dyspeptic patients in primary care. DESIGN: Selective review of literature frequently quoted to support use of H pylori testing. MAIN RESULTS: Testing for H pylori and referral of only positive cases for endoscopy aims to reduce the number of "unnecessary" endoscopies. Patients with negative results may receive short-term reassurance and subsequently place fewer demands on health services. However, studies to date have only assessed this practice in secondary care settings. Given the relatively high prevalence of both dyspepsia and H pylori infection, the transfer of this practice to primary care may lead to a paradoxical increase in endoscopy referrals. Identification of H pylori and prescribing of eradication treatment also aims to reduce endoscopy referrals. No primary care trials have yet assessed this approach. Given that fewer than one in four of dyspeptic patients have peptic ulceration, a high proportion may fail to respond to eradication treatment and subsequently require referral for endoscopy. The longer term clinical and psychosocial sequelae of treating or labelling patients with an infection associated with gastric cancer remain unknown. CONCLUSIONS: Given uncertainty concerning the possible adverse effects of H pylori testing in primary care, we suggest a moratorium on its use in this setting until results from relevant clinical trials become available.
Affiliation:
Centre For Cancer Epidemiology, University of Manchester, Christie Hospital NHS Trust, Withington.
Citation:
Testing for Helicobacter pylori in primary care: trouble in store? 1998, 52 (5):305-9 J Epidemiol Community Health
Journal:
Journal of Epidemiology and Community Health
Issue Date:
May-1998
URI:
http://hdl.handle.net/10541/91932
PubMed ID:
9764281
Type:
Article
Language:
en
ISSN:
0143-005X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorFoy, Ren
dc.contributor.authorParry, J Men
dc.contributor.authorMurray, Len
dc.contributor.authorWoodman, Ciaran B Jen
dc.date.accessioned2010-02-12T12:23:47Z-
dc.date.available2010-02-12T12:23:47Z-
dc.date.issued1998-05-
dc.identifier.citationTesting for Helicobacter pylori in primary care: trouble in store? 1998, 52 (5):305-9 J Epidemiol Community Healthen
dc.identifier.issn0143-005X-
dc.identifier.pmid9764281-
dc.identifier.urihttp://hdl.handle.net/10541/91932-
dc.description.abstractSTUDY OBJECTIVE: To assess the role of testing for Helicobacter pylori in the management of dyspeptic patients in primary care. DESIGN: Selective review of literature frequently quoted to support use of H pylori testing. MAIN RESULTS: Testing for H pylori and referral of only positive cases for endoscopy aims to reduce the number of "unnecessary" endoscopies. Patients with negative results may receive short-term reassurance and subsequently place fewer demands on health services. However, studies to date have only assessed this practice in secondary care settings. Given the relatively high prevalence of both dyspepsia and H pylori infection, the transfer of this practice to primary care may lead to a paradoxical increase in endoscopy referrals. Identification of H pylori and prescribing of eradication treatment also aims to reduce endoscopy referrals. No primary care trials have yet assessed this approach. Given that fewer than one in four of dyspeptic patients have peptic ulceration, a high proportion may fail to respond to eradication treatment and subsequently require referral for endoscopy. The longer term clinical and psychosocial sequelae of treating or labelling patients with an infection associated with gastric cancer remain unknown. CONCLUSIONS: Given uncertainty concerning the possible adverse effects of H pylori testing in primary care, we suggest a moratorium on its use in this setting until results from relevant clinical trials become available.en
dc.language.isoenen
dc.subjectStomach Canceren
dc.subject.meshAged-
dc.subject.meshBreath Tests-
dc.subject.meshDyspepsia-
dc.subject.meshFamily Practice-
dc.subject.meshFemale-
dc.subject.meshHelicobacter Infections-
dc.subject.meshHelicobacter pylori-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPatient Selection-
dc.subject.meshPeptic Ulcer-
dc.subject.meshReferral and Consultation-
dc.subject.meshSensitivity and Specificity-
dc.subject.meshStomach Neoplasms-
dc.titleTesting for Helicobacter pylori in primary care: trouble in store?en
dc.typeArticleen
dc.contributor.departmentCentre For Cancer Epidemiology, University of Manchester, Christie Hospital NHS Trust, Withington.en
dc.identifier.journalJournal of Epidemiology and Community Healthen
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