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 24 November 2017

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News

H pylori community screening and eradication is feasible

H pylori screening and eradication programs reduce the number of people consulting for dyspepsia, although a targeted eradication strategy may be preferable due to costs, reports this week's British Medical Journal.

News image

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Dr Athene Lane and colleagues evaluated a community based Helicobacter pylori screening and eradication program.

The research team assessed the impact of this programme on the incidence of dyspepsia, resource use, and quality of life.

The team also conducted a cost consequences analysis.

The H pylori screening programme was followed by randomized placebo controlled trial of eradication in 7 general practices in England.

The researchers screened 10,537 unselected people aged 20 to 59 years for H pylori infection.

Of the 1636 participants who tested positive, 1558 were randomized to H pylori eradication treatment or placebo.

The team followed up 99% of these patients for 2 years.

The patients received intervention ranitidine bismuth citrate 400 mg and clarithromycin 500 mg twice daily for 2 weeks or placebo.

35% fewer participants consulted for dyspepsia over 2 years
British Medical Journal

The main outcome measures included primary care consultation rates for dyspepsia 2 years after randomisation.

Secondary outcomes were dyspepsia symptoms, resource use, National Health Insurance costs, and quality of life.

In the eradication group, 35% fewer participants consulted for dyspepsia over 2 years compared with the placebo group.

The researcher noted that 29% fewer participants had regular symptoms.

The National Health Insurance costs were greater per participant in the eradication group over 2 years.

The team observed that the cost of eradication treatment was $146 per participant.

No difference in quality of life existed between the two groups.

Dr Lane's team concluded, “Community screening and eradication of H pylori is feasible in the general population.”

“It led to significant reductions in the number of people who consulted for dyspepsia and had symptoms 2 years after treatment.”

“These benefits have to be balanced against the costs of eradication treatment, so a targeted eradication strategy in dyspeptic patients may be preferable.”

BMJ 2006: 332: 199-204
30 January 2006

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