Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice
There appears to be a disconnect between current guidelines for Helicobacter pylori testing and treatment, and clinical practice, including physician beliefs and actual prescribing patterns. In particular, there are markedly different approaches in primary and secondary care, and country- specific d...
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| Format: | Article |
| Language: | English |
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Wiley
2003-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2003/401397 |
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| _version_ | 1832555962990329856 |
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| author | Nicholas J Talley |
| author_facet | Nicholas J Talley |
| author_sort | Nicholas J Talley |
| collection | DOAJ |
| description | There appears to be a disconnect between current guidelines for
Helicobacter pylori testing and treatment, and clinical practice, including
physician beliefs and actual prescribing patterns. In particular, there are
markedly different approaches in primary and secondary care, and country-
specific differences in eradication therapy for H pylori infection.
Although most physicians do not believe that H pylori causes nonulcer
dyspepsia, the majority appear to prescribe eradication. Less information
is available on the management of H pylori infection and gastroesophageal
reflux disease, and more marked differences in attitudes and
practice occur in this condition. Even in peptic ulcer disease, where most
clinicians both in primary and in secondary care believe H pylori should
be eradicated, there is often a breakdown in the translation of this belief
into practice. There is also confusion in terms of treatment regimens
applied for H pylori eradication. Eradication regimens are less successful
in practice than in clinical trials. Furthermore, a sizable proportion of
patients with peptic ulcer remain symptomatic despite cure of the ulcer
diathesis, which may undermine confidence. Therapeutic confusion
about what to prescribe, side effects limiting compliance, bacterial resistance,
and socioeconomic factors may all impair therapeutic success with
eradication therapy in practice. Unfortunately, it has been well documented
that guidelines alone are likely to have little or no impact in practice.
Publication in a journal is unlikely to lead to effective
implementation in primary care. On the basis of available evidence, clinical
behaviour is most likely changed when guidelines are developed by
the peer group of clinicians for whom they were intended, are disseminated
through a specific educational program, and are implemented by applying,
preferably during the consultation, specific reminders. |
| format | Article |
| id | doaj-art-e210cd964b6c406485fe442f277c4f11 |
| institution | Kabale University |
| issn | 0835-7900 |
| language | English |
| publishDate | 2003-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology |
| spelling | doaj-art-e210cd964b6c406485fe442f277c4f112025-02-03T05:46:45ZengWileyCanadian Journal of Gastroenterology0835-79002003-01-0117Suppl B21B24B10.1155/2003/401397Helicobacter pylori Management: How to Improve the Therapeutic Confusion in PracticeNicholas J Talley0Department of Medicine, University of Sydney, Nepean Hospital, New South Wales, AustraliaThere appears to be a disconnect between current guidelines for Helicobacter pylori testing and treatment, and clinical practice, including physician beliefs and actual prescribing patterns. In particular, there are markedly different approaches in primary and secondary care, and country- specific differences in eradication therapy for H pylori infection. Although most physicians do not believe that H pylori causes nonulcer dyspepsia, the majority appear to prescribe eradication. Less information is available on the management of H pylori infection and gastroesophageal reflux disease, and more marked differences in attitudes and practice occur in this condition. Even in peptic ulcer disease, where most clinicians both in primary and in secondary care believe H pylori should be eradicated, there is often a breakdown in the translation of this belief into practice. There is also confusion in terms of treatment regimens applied for H pylori eradication. Eradication regimens are less successful in practice than in clinical trials. Furthermore, a sizable proportion of patients with peptic ulcer remain symptomatic despite cure of the ulcer diathesis, which may undermine confidence. Therapeutic confusion about what to prescribe, side effects limiting compliance, bacterial resistance, and socioeconomic factors may all impair therapeutic success with eradication therapy in practice. Unfortunately, it has been well documented that guidelines alone are likely to have little or no impact in practice. Publication in a journal is unlikely to lead to effective implementation in primary care. On the basis of available evidence, clinical behaviour is most likely changed when guidelines are developed by the peer group of clinicians for whom they were intended, are disseminated through a specific educational program, and are implemented by applying, preferably during the consultation, specific reminders.http://dx.doi.org/10.1155/2003/401397 |
| spellingShingle | Nicholas J Talley Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice Canadian Journal of Gastroenterology |
| title | Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice |
| title_full | Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice |
| title_fullStr | Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice |
| title_full_unstemmed | Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice |
| title_short | Helicobacter pylori Management: How to Improve the Therapeutic Confusion in Practice |
| title_sort | helicobacter pylori management how to improve the therapeutic confusion in practice |
| url | http://dx.doi.org/10.1155/2003/401397 |
| work_keys_str_mv | AT nicholasjtalley helicobacterpylorimanagementhowtoimprovethetherapeuticconfusioninpractice |