The TETRA study: a prospective evaluation of Helicobacter pylori 'test-and-treat' strategy on 736 patients in clinical practice.
OBJECTIVE
To prospectively evaluate the effectiveness of the test-and-treat strategy in a large group of dyspeptic patients in clinical practice.


METHODS
Patients with ulcer-like dyspepsia, < 45 years, without alarm symptoms, were prospectively studied. Helicobacter pylori infection was diagnosed with the 13C-urea-breath-test, and eradication or symptomatic treatment was prescribed accordingly. 'Symptomatic improvement' was defined as the percentage of patients with a decrease of > or = 2 levels in the dyspepsia-severity-score or with no symptoms after treatment. Health status and use of health resources were also assessed. Endoscopy was performed in therapeutic failures.


RESULTS
Out of 736 patients initially included, 422 received eradication, and 314 symptomatic therapy; 87% returned at 6 weeks and 67% at 6 months. At 6 months, 'symptomatic improvement' was achieved in 73% and 54% of the patients, in eradication and symptomatic groups, respectively (p < .001), and overall in 66%. A reduction of 78% in mean self-assessment visual analogical score was observed at 6 months. More than 50% of patients were 'much better' at control visits. Endoscopy (18%) and physician's visits (13%) were the main health resources used. No gastric or oesophageal cancer was diagnosed.


CONCLUSIONS
This large prospective study shows that the test-and-treat strategy is effective and safe for management of dyspeptic patients in clinical practice.
Gisbert
Javier P
JP
Department of Gastroenterology, Hospital Universitario de la Princesa, Madrid, Spain.
Badía
Xavier
X
Roset
Montserrat
M
Pajares
José María
JM
D000328:Adult; D001944:Breath Tests; D002247:Carbon Isotopes / Q000032:analysis; D004415:Dyspepsia / Q000175:diagnosis* / Q000188:drug therapy*; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000473:pathology; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009819:Office Visits; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology; D016896:Treatment Outcome; D014508:Urea / Q000378:metabolism
D002247:Carbon Isotopes; D014508:Urea