Are physicians ready to comply with the guidelines for diagnosis and management of Helicobacter pylori-associated diseases: the survey results 2020–2021
-
Published:2021-11-22
Issue:7
Volume:49
Page:455-468
-
ISSN:2587-9294
-
Container-title:Almanac of Clinical Medicine
-
language:
-
Short-container-title:Alʹm. klin. med.
Author:
Bordin D. S.1ORCID, Krolevets T. S.2ORCID, Livzan M. A.2ORCID
Affiliation:
1. ГБУЗ г. Москвы «Московский клинический научно-практический центр имени А.С. Логинова ДЗМ»;
A.I. Yevdokimov Moscow State University of Medicine and Dentistry;
Tver State Medical University 2. Omsk State Medical University
Abstract
Objective: To assess compliance of physicians with diagnostic and management guidelines for H. pylori-associated diseases with a question-naire-based survey.Materials and methods: We conducted an anonymous voluntary online survey of 775 physicians of the following specialties: internal medicine 459 (59.2%), gastroenterology 279 (36%), and endoscopy 34 (4.4%). The respondents expressed their level of agreement with the questionnaire items as follows: 0 – I do not know, 1 – disagree, 2 – partially agree, and 3 – fully agree.Results: 613 (79.4%) of the physicians fully agreed to diagnose and treat H. pylori in patients with chronic atrophic gastritis, 602 (78.0%) in the 1 st degree relatives of gastric cancer patients, 525 (68.0%) in patients with chronic superficial gastritis, 423 (54.8%) in peptic ulcer at remission, and 336 (43.4%) in those with dyspepsia syndrome. The physicians were equally compliant with eradication therapy in the patients, for whom long term use of proton pump inhibitors (PPI) or non-steroid anti-inflammatory drugs (NSAID) is being planned (386 (50.0%) and 397 (51.4%), respectively). Internists were less compliant with diagnosis and management of H. pylori in patients taking both PPI (χ2 = 66.525, p = 0.004) and NSAID (χ2 = 103.354, p = 0.003). Among the primary diagnostic tools for H. pylori the physicians preferred 13/14С-urease breath test (545 physicians, or 70.6%) and gastric bioptate morphology (574, or 74.4%), and among the control diagnostic methods they chose fаeces analyses (enzyme-linked immunosorbent assay and polymerase chain reaction). The respondents considered bismuth-enhanced standard triple therapy with clarithromycin to be the most effective regimen for the 1 st line eradication therapy (606, 78.5%). To increase the efficacy of eradication therapy, the physicians were more prone to administer esomeprazole or rabeprazole (70.6%), bismuth-based agents (79.4%), than to use rebamipid (35%), probiotics (44.9%) and/or to double PPI doses (44.2%). The respondents expressed their concerns with low patient compliance to treatment (59.4%) and limited diagnostic capabilities (49.4%).Conclusion: Physician's compliance with the guidelines on diagnosis and management of H. pylori-associated diseases is adequate and might depend on both their awareness and availability of the proposed diagnostic and therapeutic methods.
Publisher
Moscow Regional Research and Clinical Institute (MONIKI)
Reference39 articles.
1. Sugano K, Tack J, Kuipers EJ, Graham DY, El-Omar EM, Miura S, Haruma K, Asaka M, Uemura N, Malfertheiner P, faculty members of Kyoto Global Consensus Conference. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64(9): 1353–1367. doi: 10.1136/gutjnl-2015-309252. 2. Malfertheiner P, Megraud F, O'Morain CA, Gisbert JP, Kuipers EJ, Axon AT, Bazzoli F, Gasbarrini A, Atherton J, Graham DY, Hunt R, Moayyedi P, Rokkas T, Rugge M, Selgrad M, Suerbaum S, Sugano K, El-Omar EM, European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection – the Maastricht V/ Florence Consensus Report. Gut. 2017;66(1): 6–30. doi: 10.1136/gutjnl-2016-312288. 3. Ivashkin VT, Mayev IV, Lapina TL, Sheptulin AA, Trukhmanov AS, Baranskaya YK, Abdulkhakov RA, Alekseyeva OP, Alekseyenko SA, Dekhnich NN, Kozlov RS, Klyaritskaya IL, Korochanskaya NV, Kurilovich SA, Osipenko MF, Simanenkov VI, Tkachev AV, Khlynov IB, Tsukanov VV. [Diagnostics and treatment of Helicobacter pylori infection in adults: Clinical guidelines of the Russian gastroenterological association]. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(1): 55–70. Russian. doi: 10.22416/1382-4376-2018-28-1-55-70. 4. Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2): 212–239. doi: 10.1038/ajg.2016.563. 5. Cheng HC, Liou JM, Luo Jiing-Chyuan, Chiu CT, Wu MS, Lee YC, Wu CY, Wu DC, Hsu PI, Chang CC, Chang WL, Lin JT, Sheu BS. The implementation of the consensus on the management of Helicobacter pylori and barriers to consensus. Helicobacter. 2018;23(5):e12533. doi: 10.1111/hel.12533.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|