Less than 40% of PCPs Provided Guideline-Recommended H. pylori Eradication Treatment

The number of primary care physicians (PCPs) that complied with recommended Helicobacter pylori (H. pylori) treatment recommendations remained suboptimal even after a targeted education intervention, according to a study published recently in Annals of Gastroenterology.

Currently accepted recommendations call for the addition of nitroimidazole to traditional clarithromycin (CLA)-based triple therapy for H. pylori eradication in treatment-naïve patients in regions with a high rate of CLA resistance.

In this study, researchers from Israel sent more than 2,000 PCPs a questionnaire assessing H. pylori. treatment first in 2015 (314 respondents) and again in 2018 (321 respondents).

After the 2015 survey found that the majority of PCPs in Israel continued to prescribe triple therapy for H. pylori eradication, Doron Boltin, MBBS, of Rabin Medical Center, and colleagues advanced a national education initiative to address these gaps in care.

The education initiative included distribution of printed materials to PCPs nationally, educational outreach visits performed by trained personnel, and the transfer of key statements from the Maastricht/Florence V Consensus Report over a preexisting social media platform.

The number of physicians who recommended the four-drug treatment protocol increased almost tenfold from 3.8% in 2015 to 37.1% in 2018 (P < .001). Additionally, the number of physicians who recommended bismuth- or levofloxacin-based therapy for second-line treatment more than doubled from 30.3% in 2015 to 77.1% in 2018 (P < .001).

Both exposure to printed educational materials (P = .04) and to the social media platform (P < .001) were independent predictors for a four-drug treatment protocol recommendation.

“Targeted education of PCPs seems to be an effective method to increase compliance with guidelines for the treatment of H. pylori. Internet and social media platforms may be the most effective means to enhance information-sharing between PCPs and gastroenterologists, and thereby enable a streamlined approach to H. pylori treatment,” the researchers wrote. “Nevertheless, fewer than 40% of PCPs provide H. pylori treatment consistent with guideline recommendation[s].”