Survey of the opinions, knowledge and practices of surgeons and internists regarding Helicobacter pylori test-and-treat policy.
BACKGROUND
Helicobacter pylori infection is highly prevalent and may cause disease in 10% to 15% of infected individuals: duodenal and gastric ulcer, gastric cancer and gastric lymphoma. Guidelines for a test-and-treat policy have been published by the European H. pylori working group in Maastricht.


OBJECTIVE
To assess the current approach to H. pylori-related diseases, indications for testing and eradication therapy, among internists and surgeons of a University affiliated medical center.


METHODS
A 15-items questionnaire was formulated according to the Maastricht II test-and-treat recommendation and distributed among the physicians of 6 internal medicine departments and the department of surgery. The questionnaires were completed anonymously at the department's staff meeting, under the supervision of the head of the department. All questions required a yes/no answer; the maximum possible score was 15. The relative ratio (RR) of correct answers was calculated for every question and by subgroups as follows: all participants, internists, surgeons, experts and residents in internal medicine and surgery.


RESULTS
The response rate was 68% (55 out of 80 physicians). Total score for all participants was 10.9 (RR = 0.73), significantly lower than the maximum score of 15 (RR = 1.00). The internists had significantly higher average score than the surgeons for 2 questions: causative agent in gastric cancer (p = 0.003) or gastric lymphoma (p = 0.003), 1 question about triple therapy, PPI, penicillin and azythromycin being not recommended (p = 0.022), and for 1 question of test-and-treat policy: should this strategy apply to family members of gastric cancer patients (p = 0.045). Only 56% of the internists and 21% of surgeons knew what MALToma is, and the correlation with H. pylori infection.


CONCLUSIONS
Knowledge of Surgeons and Internists regarding infection and correlation with diseases or test and treat policy should be improved.
Niv
Yaron
Y
Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Belinson Campus, Petach-Tikva, Israel. yniv@clalit.org.il
Abuksis
Galia
G
D000046:Academic Medical Centers / Q000592:standards; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D003625:Data Collection; D004359:Drug Therapy, Combination; D005756:Gastritis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D013502:General Surgery / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D016480:Helicobacter pylori; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D007557:Israel; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis / Q000628:therapy; D010406:Penicillins / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000628:therapy
D000900:Anti-Bacterial Agents; D010406:Penicillins; D017963:Azithromycin