Survey of the opinions, knowledge and practices of surgeons and internists regarding Helicobacter pylori test-and-treat policy

J Clin Gastroenterol. 2003 Feb;36(2):139-43. doi: 10.1097/00004836-200302000-00010.

Abstract

Background: Helicobacter pylori infection is highly prevalent and may cause disease in 10% to 15% of infected individuals: duodenal and gastric ulcer, gastric cancer and gastric lymphoma. Guidelines for a test-and-treat policy have been published by the European H. pylori working group in Maastricht.

Goals: To assess the current approach to H. pylori-related diseases, indications for testing and eradication therapy, among internists and surgeons of a University affiliated medical center.

Study: A 15-items questionnaire was formulated according to the Maastricht II test-and-treat recommendation and distributed among the physicians of 6 internal medicine departments and the department of surgery. The questionnaires were completed anonymously at the department's staff meeting, under the supervision of the head of the department. All questions required a yes/no answer; the maximum possible score was 15. The relative ratio (RR) of correct answers was calculated for every question and by subgroups as follows: all participants, internists, surgeons, experts and residents in internal medicine and surgery.

Results: The response rate was 68% (55 out of 80 physicians). Total score for all participants was 10.9 (RR = 0.73), significantly lower than the maximum score of 15 (RR = 1.00). The internists had significantly higher average score than the surgeons for 2 questions: causative agent in gastric cancer (p = 0.003) or gastric lymphoma (p = 0.003), 1 question about triple therapy, PPI, penicillin and azythromycin being not recommended (p = 0.022), and for 1 question of test-and-treat policy: should this strategy apply to family members of gastric cancer patients (p = 0.045). Only 56% of the internists and 21% of surgeons knew what MALToma is, and the correlation with H. pylori infection.

Conclusion: Knowledge of Surgeons and Internists regarding infection and correlation with diseases or test and treat policy should be improved.

Publication types

  • Comparative Study

MeSH terms

  • Academic Medical Centers / standards
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Data Collection
  • Drug Therapy, Combination
  • Gastritis / complications
  • Gastritis / diagnosis
  • Gastritis / therapy
  • General Surgery* / statistics & numerical data
  • Guideline Adherence* / statistics & numerical data
  • Health Knowledge, Attitudes, Practice*
  • Helicobacter Infections / complications
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / therapy*
  • Helicobacter pylori*
  • Humans
  • Internship and Residency* / statistics & numerical data
  • Israel
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / therapy
  • Penicillins / therapeutic use
  • Peptic Ulcer / complications
  • Peptic Ulcer / diagnosis
  • Peptic Ulcer / therapy
  • Practice Guidelines as Topic
  • Referral and Consultation* / statistics & numerical data
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / therapy

Substances

  • Anti-Bacterial Agents
  • Penicillins
  • Azithromycin