The evaluation and treatment of patients with dyspepsia and Helicobacter pylori infection in Korean primary care physician

Kim, Soo Jin; Kim, Hak Yang; Lee, Ja Young; Kim, Sung Eun; Lee, Jin Seo; Kang, Ki Joo; Kim, Kyung Ho; Park, Joon Yong; Kim, Jong Hyeok; Lee, Jin Heon; Yoo, Jae Young; Kim, Auk; Shin, Sung Tae

Abstract

BACKGROUND: Although Helicobacter pylori infection is now known to be the most common cause of various gastrointestinal diseases and progress in our knowledge about H. pylori is remarkable, whether this knowledge is transferred to general community of practicing physicians is questionable. We wished to investigate the clinical practice and prescribing patterns for dyspepsia and H. pylori infection in primary care in Korea.
METHODS
We obtained information about the patterns of practice from reply to questionnaire by mail to physician. We restricted our study to the primary care physicians registered on the Korean Association of Internal Medicine Practitioners. The questionnaire was made of three compartments, which were diagnostic evaluation of dyspepsia, indication and methods of diagnosis and management in H. pylori infection.
RESULTS
In case with initial visit of dyspeptic patient, 64.1% of physicians prescribe prokinetics (85.7%), antacid (61.5%), histamine-2-receptor blockers (59.4%), initially. The indications of H. pylori test were as follows; 91.6% in gastric ulcer including scar, 85.3% in duodenal ulcer, 59% in patient-want cases, 51.9% in gastric cancer, 42.7% in gastritis, and 22.8% in gastro-oesophageal reflux disease. And the indications of H. pylori eradication were as follows; 90.6% in gastric ulcer, 88.7% in duodenal ulcer, 35% in gastric cancer, 30.7% in gastritis, 23.5% in patient-want cases, and 24.8% in gastro-oesophageal reflux disease. In addition, 79.7% of physicians prescribe triple therapy including clarithromycin and amoxicillin for H. pylori eradication.
CONCLUSION
From this study, we obtained more information about the clinical practice and prescribing patterns about dyspepsia and H. pylori related diseases. More studies are needed to prepare the guidelines for H. pylori under close cooperation between primary care physicians and tertiary hospitals.