title: Helicobacter pylori management in non-steroidal anti-inflammatory drug therapy patients in primary care.
abstract: Non-steroidal anti-inflammatory drugs (NSAIDs) may cause gastroduodenal ulcers and its complications. Helicobacter pylori infection is recognized as an additional risk factor for ulcer development, its eradication in NSAIDs users being recommended. In this cross-sectional study, during a 1-week period, consecutive patients who were routinely visiting in 58 primary care clinics were enrolled. A questionnaire was used to collect clinical data on the patients who were chronically taking NSAIDs. Patients with age >65 years, a personal history of peptic ulcer, concomitant therapy with steroids, anti-coagulants, multiple NSAIDs, or relevant co-morbidities were considered at high risk for NSAIDs gastroduodenal complications. Data on H. pylori infection management were collected. Overall, H. pylori was searched for in 140 (16.1%) out of 869 patients receiving chronic NSAID therapy, and it was eventually cured in 43 (72.9%) of the infected cases. In detail, H. pylori status was not investigated in 670 (77.1%) of those patients at high risk of NSAID-related gastroduodenal lesions, including 516 patients ≥65 years old, and 154 younger, but with at least 1 adjunctive risk factor. In addition, 234 (35%) of these high-risk patients were not receiving any gastric mucosa protection. Our data find that H. pylori infection is investigated in fewer than one of every five NSAID-user patients in primary care. The low alertness towards such an infection in these patients suggests a need for prompt implementation of current guidelines.
authors: Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Via E. Morosini, 30, 00153 Rome, Italy. zullo66@yahoo.it
authors: Angelo
authors: A
authors: Zullo
authors: Cesare
authors: C
authors: Hassan
authors: Diodato
authors: D
authors: Oliveti
authors: Alberto
authors: A
authors: Chiriatti
authors: Diana Anna Elisa
authors: DA
authors: Chiuri
authors: Gemma
authors: G
authors: Marotti
authors: Lara
authors: L
authors: Morelli
authors: Sergio
authors: S
authors: Morini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced / Q000453:epidemiology; D011320:Primary Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal