Survey of dyspepsia management in community.
BACKGROUND
Dyspepsia is a common complaint and represents an important health problem in the community. The aim of the study was to survey the diagnostic approach and management of dyspepsia and Helicobacter pylori (H. pylori) infection by primary care physicians.


METHODS
Questionnaires were given to 70 medical officers (MO) working in government polyclinics and 70 general practitioners (GP) in private practice.


RESULTS
Questionnaires were returned from 68 MO's (response rate 97%) and 61 GP's (response rate 87%). Only 20% of MO and 50% of GP prescribed H. pylori eradication therapy. Of those who have prescribed eradication therapy, 70% would confirm H. pylori infection before therapy (50% for gastroscopy, 19% for Urea Breath test, 25% for laboratory based serology, 6% for office based serology test kits). 85% would prescribe triple therapy against 15% for dual therapy. Proton pump inhibitor (PPI) is the acid suppression agent most commonly prescribed (77%) in regimens of eradication therapy; the remaining would prescribe either bismuth subcitrate or H2 antagonists. Only 8% of respondents would confirm eradication after therapy.


CONCLUSIONS
Less than half of the primary care physicians surveyed prescribed H. pylori eradication therapy. The main reason given for not prescribing therapy was lack of facility for testing the infection. Of those who prescribed eradication therapy, majority would order the correct and reliable investigations to confirm the infection. Most of them would prescribe triple therapy which is the recommended eradication regimens.
Luman
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Department of Gastroenterology, Singapore General Hospital, Singapore.
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H S
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D003153:Community Health Services; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology*; D019538:Health Care Surveys; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D009942:Organometallic Compounds / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires; D014508:Urea
D006635:Histamine H2 Antagonists; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D014508:Urea; C002791:bismuth tripotassium dicitrate