title: Helicobacter pylori eradication in dyspeptic primary care patients: a randomized controlled trial of a pharmacy intervention.
abstract: OBJECTIVE
  To determine the effectiveness of structured adherence counseling by pharmacists on the eradication of Helicobacter pylori when using a standard drug treatment regimen.
  
  
  METHODS
  Randomized controlled clinical trial.
  
  
  METHODS
  Nonprofit group-practice health maintenance organization (HMO).
  
  
  METHODS
  HMO primary care providers referred 1,393 adult dyspeptic patients for carbon 14 urea breath testing (UBT).
  
  
  METHODS
  Those whose tests were positive for H pylori (23.3%) were provided a standard antibiotic regimen and randomly assigned to receive either usual-care counseling from a pharmacist or a longer adherence counseling session and a follow-up phone call from the pharmacist during drug treatment. All subjects were given the same 7-day course of omeprazole, bismuth subsalicylate, metronidazole, and tetracycline hydrochloride (OBMT). Dyspepsia symptoms were recorded at baseline and following therapy.
  
  
  RESULTS
  The main outcome was eradication of H pylori as measured by UBT at 3-month follow-up. Secondary outcomes were patient satisfaction and dyspepsia symptoms at 3-month follow-up.
  
  
  RESULTS
  Of the 333 participants randomly assigned to treatment, 90.7% completed the 3-month follow-up UBT and questionnaires. Overall eradication rate with the OBMT regimen was 80.5% with no significant difference in eradication rates between the 2 groups (P=0.98). Conclusions In this study, additional counseling by pharmacists did not affect self-reported adherence to the treatment regimen, eradication rates, or dyspepsia symptoms but did increase patient satisfaction.
authors.affiliation: Kaiser Permanente Center for Health Research, 3800 North Interstate Ave Portland, OR 97227, USA. victor.j.stevens@kpchr.org
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shneidman
authors.forename: Richard E
authors.initials: RE
authors.lastname: Johnson
authors.forename: Myde
authors.initials: M
authors.lastname: Boles
authors.forename: Paul E
authors.initials: PE
authors.lastname: Steele
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D010595:Pharmacists; D011795:Surveys and Questionnaires; D016896:Treatment Outcome