Has education about Helicobacter pylori infection been effective? Worldwide survey of primary care physicians.
BACKGROUND
Confusion exists among physicians about the management of Helicobacter pylori (H. pylori) infection. We aimed to survey primary care physicians' (PCP) knowledge and management of H. pylori-related diseases.


METHODS
Four-hundred and seventy randomly selected PCP from 29 countries were surveyed.


RESULTS
The pathological role of H. pylori was of less concern in South Africa than the rest of the world (63% compared to 93%). The causal relationship between H. pylori and gastric and duodenal ulcers and gastric cancer was accepted by 81%, 85%, and 61% of respondents, respectively. Endoscopy was used by 62% of respondents to diagnose the infection. Histology was used by 61% of European participants for diagnosis compared to 3% in North American and 0% in South Africa. Proton-pump inhibitor (PPI)-based triple therapies were prescribed by 89% of respondents. Physicians in Oceania (35%) and South Africa (45%) were less concerned about bacterial resistance than respondents elsewhere. Sixty-three percent of respondents considered H. pylori relevant to dyspepsia management and 66% treated new dyspepsia empirically, compared to 18% who chose endoscopic diagnosis and 13% who used a H. pylori test and treat strategy. For persistent or recurrent infection, 56% of South African physicians treated with another regimen compared to 33% of PCP from elsewhere. Ninety-one percent of European participants agreed that current information on H. pylori management is helpful and 68% of PCP from other regions considered the information to be adequate.


CONCLUSIONS
Current guidelines on the management of H. pylori infection have been useful for PCP worldwide. Contrasting answers to some questions may reflect differences in health care systems, epidemiology and approaches to the management of H. pylori infection between countries.
Huang
Jiaqing
J
Department of Gastroenterology, McMaster University Medical Centre, Hamilton, Ontario, Canada.
Lam
Shiu Kum
SK
Malfertheiner
Peter
P
Hunt
Richard H
RH
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D005762:Gastroenterology / Q000193:education*; D014943:Global Health; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology; D010821:Physicians, Family / Q000193:education*; D017410:Practice Guidelines as Topic; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents