Optimizing testing and treatment of Helicobacter pylori infection in patients with acutely bleeding gastroduodenal ulcers: an interventional study.

Objective: To determine whether dissemination of inpatient practice guidelines for Helicobacter pylori management improves the testing and treatment rates of patients admitted with acute upper gastrointestinal (GI) bleeding from gastric or duodenal ulcers. Design: Prospective, non-randomized, interv...

Descripción completa

Detalles Bibliográficos
Publicado en:Journal of Clinical Outcomes Management Vol. 10; no. 7; pp. 365 - 371
Autores principales: Wong RCK, Catanzaro A, Gonet JA, Chak A, Sivak MV Jr., Cooper GS
Formato: clinical trial research tables/charts Journal Article
Publicado: Frontline Medical Communications 2003 Jul
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106742281&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 106742281
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        10796533
        Z0E
      jtl: Journal of Clinical Outcomes Management
      issn: 10796533
      maglogo: N
    pubinfo:
      dt: 2003 Jul
      vid: 10
      iid: 7
      pid: 11942
      pub: Frontline Medical Communications
      place: Newark, New Jersey
    artinfo:
      ui:
        106742281
        106742281
        2004091822
        106742281
      ppf: 365
      ppct: 6
      formats:
      tig:
        atl: Optimizing testing and treatment of Helicobacter pylori infection in patients with acutely bleeding gastroduodenal ulcers: an interventional study.
      aug:
        au:
          Wong RCK
          Catanzaro A
          Gonet JA
          Chak A
          Sivak MV Jr.
          Cooper GS
        affil: Division of Gastroenterology (Wearn 247), University Hospitals of Cleveland, 11100 Euclid Ave, Cleveland, OH 44106-5066
      sug:
        subj:
          Helicobacter Infections Diagnosis
          Helicobacter Infections Drug Therapy
          Peptic Ulcer Diagnosis
          Peptic Ulcer Drug Therapy
          Chi Square Test
          Clinical Trials
          Data Analysis Software
          Data Analysis, Statistical
          Descriptive Statistics
          Helicobacter Pylori
          Medication Compliance
          P-Value
          Human
      ab: Objective: To determine whether dissemination of inpatient practice guidelines for Helicobacter pylori management improves the testing and treatment rates of patients admitted with acute upper gastrointestinal (GI) bleeding from gastric or duodenal ulcers. Design: Prospective, non-randomized, interventional study. Setting and patients: 189 patients admitted to a single, urban academic medical center with a primary diagnosis of acute upper GI bleeding from gastric or duodenal ulcers between January 1998 and June 1999. The patients were managed by 18 gastroenterology physicians (12 staff, 6 private practice). Outcome measures: Rate and type of testing used for the diagnosis of H. pylori infection and the rate of initiation of appropriate anti-H. pylori therapy. Interventions: Outcomes were measured during a 6-month baseline period before dissemination of guidelines to gastroenterologists and during a 1-year period after dissemination of guidelines. In the year following dissemination, chart reminders and contacts by a physician opinion leader were used to increase physicians' adherence to the guidelines. Results: Testing for H. pylori increased from 78% in the baseline group (n = 58) to 88% in the postintervention group (n = 131) (P= 0.081). Testing for H. pylori using the rapid urease method increased from 27% in the baseline group to 51% in the postintervention group (P = 0.004). There was a highly significant increase in the rate of initiation of appropriate anti-H. pylori therapy (before hospital discharge) from 45% in the baseline group to 84% in the postintervention group (P < 0.001). Conclusion: H. pylori treatment can be markedly improved in patients admitted with acutely bleeding gastroduodenal ulcers by the active promotion of inpatient care guidelines.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N