Clinical trial: knowledge of negative Helicobacter pylori status reduces subsequent dyspepsia-related resource use.
BACKGROUND
Screening for Helicobacter pylori reduces dyspepsia and dyspepsia-related costs in positive individuals.


OBJECTIVE
To assess effect of knowledge of H. pylori status on healthcare-seeking in negative individuals.


METHODS
H. pylori-negative subjects in a community screening programme were randomized to placebo triple therapy or informed of their negative H. pylori status. Dyspepsia-related resource data were extracted from primary care records at 2 years, and National Health Service reference costs were applied to calculate the total cost per subject. Proportions of individuals incurring any cost were compared using a relative risk (RR) and 95% confidence interval (CI). Differences in costs were compared using an independent sample t-test.


RESULTS
A total of 1353 H. pylori-negative individuals were randomized to placebo whilst 1355 were informed of their infection status. In the placebo arm, 212 (16%) subsequently incurred any dyspepsia-related cost compared to 172 (13%) informed of their infection status (RR of incurring cost = 0.81; 95% CI: 0.67-0.97). Those informed of their infection status incurred lower costs (mean saving per individual = pound 11.02; 95% CI: - pound 3.52 to 25.56).


CONCLUSIONS
H. pylori-negative individuals informed of infection status sought health care for dyspepsia less often than those who were unaware. Population screening may reduce dyspepsia-related costs in uninfected, as well as infected individuals.
Ford
A C
AC
Centre for Digestive Diseases, Leeds General Infirmary, Leeds, UK. alexf12399@yahoo.com
Forman
D
D
Nathan
J
J
Crocombe
W D
WD
Axon
A T R
AT
Moayyedi
P
P
D000328:Adult; D000477:Alkylating Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000191:economics / Q000627:therapeutic use*; D017291:Clarithromycin / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004415:Dyspepsia / Q000191:economics; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000191:economics / Q000627:therapeutic use*; D010437:Peptic Ulcer / Q000188:drug therapy / Q000191:economics; D014011:Tinidazole / Q000191:economics / Q000627:therapeutic use*
D000477:Alkylating Agents; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D014011:Tinidazole; D017291:Clarithromycin; D009853:Omeprazole