title: A win for the patient: Direct patient notification improves treatment rates of active Helicobacter pylori infection.
abstract: BACKGROUND
  Current international guidelines recommend the commencement of effective eradication therapy as soon as active Helicobacter pylori (H. pylori) infection is confirmed. At our institution, all positive Campylobacter-like Organism (CLO) test results were automatically communicated to general practitioners (GPs) via a standardised letter, which also advised the commencement of eradication therapy. Despite this endeavour, a clinical audit conducted in 2011 demonstrated that only 66 per cent of confirmed H. pylori-positive South Auckland patients received eradication treatment and only 83 per cent of these patients received treatment within one month.
  
  
  OBJECTIVE
  Improve the timely initiation of H. pylori eradication therapy through direct patient notification.
  
  
  METHODS
  A prospective clinical audit of 109 consecutive outpatients with a positive CLO test identified at gastroscopy. In addition to standard general practitioner notification, patients were also directly notified of their positive CLO test result via a standardised letter, which provided information about H. pylori and its disease associations as well as advising patients to seek consultation with their GP to commence eradication therapy. Dispensing data was examined using Test Safe electronic records to determine the total uptake and timing of treatment compared to data from a preliminary 2011 audit.
  
  
  RESULTS
  Ninety-five per cent of H. pylori-positive patients received standard triple therapy; therefore, treatment of active H. pylori infection was significantly higher when patients were directly notified in addition to standard GP notification, when compared to GP notification alone (95 per cent vs 66 per cent, p<0.001). All patients who received eradication therapy did so within one month of notification, a significant improvement compared to data from the previous audit in 2011 (100 per cent vs. 83 per cent, p<0.001).
  
  
  CONCLUSIONS
  Direct patient notification using a standardised letter is a simple and economical strategy that significantly improves the timely initiation of eradication therapy for active H. pylori infection. This has since been integrated into standard practice at our District Health Board (DHB).
authors.affiliation: Department of Internal Medicine, Middlemore Hospital, South Auckland, New Zealand.
authors.forename: Sriharan
authors.initials: S
authors.lastname: Selvaratnam
authors.affiliation: Department of Internal Medicine, Middlemore Hospital, South Auckland, New Zealand.
authors.forename: Joey
authors.initials: J
authors.lastname: Yeoh
authors.affiliation: Department of Gastroenterology, Middlemore Hospital, South Auckland, New Zealand.
authors.forename: John
authors.initials: J
authors.lastname: Hsiang
authors.affiliation: Department of Gastroenterology, Middlemore Hospital, South Auckland, New Zealand.
authors.forename: Alasdair B
authors.initials: AB
authors.lastname: Patrick
keywords: H. pylori; Helicobacter pylori; patient education; triple therapy