Follow-up care after a diagnosis of Helicobacter pylori infection in an Asian immigrant cohort.
OBJECTIVE
To study the rate at which Helicobacter pylori infection is treated in an immigrant cohort after diagnosis by esophagogastroduodenoscopy (EGD).


BACKGROUND
Gastric cancer is the second leading cause of cancer death worldwide, and is especially prevalent in East Asia; immigrants from this part of the world remain at higher risk. Infection with H. pylori is a known risk factor for gastric cancer. There have been no studies of completion of H. pylori treatment in immigrant populations.


METHODS
Prospective cohort study of East Asian immigrants diagnosed with H. pylori infection who underwent EGD in a gastric cancer screening protocol. Our primary outcome was self-report or chart evidence of completion of treatment of H. pylori.


RESULTS
Sixty-eight of the 126 participants (54%) tested positive for H. pylori infection on EGD. Forty-nine (72%) were seen for a follow-up visit at one of the clinics involved in the study. According to clinic records, 39 of these 49 participants (57% of all H. pylori-positive participants) were prescribed treatment. Only 31 participants (46%) completed treatment. Of possible explanatory factors, only having a "regular doctor" was significantly associated with treatment completion (odds ratio=5.6; 95% confidence interval, 1.2-25.0).


CONCLUSIONS
In a sample of Asian immigrants, the rate of treatment of H. pylori infection, a potentially modifiable risk factor, was lower than expected. Having a "regular doctor" appeared to increase the likelihood of receiving appropriate follow-up care.
Cho
Alex
A
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC 27705, and Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, USA. alex.cho@duke.edu
Chaudhry
Amina
A
Minsky-Primus
Lisa
L
Tso
Alan
A
Perez-Perez
Guillermo
G
Diehl
David L
DL
Marcus
Stuart G
SG
Gany
Francesca M
FM
D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001208:Asia / Q000208:ethnology; D004359:Drug Therapy, Combination; D004641:Emigration and Immigration; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents