Endoscopy 2004; 36 - 11
DOI: 10.1055/s-2004-834499

Dyspepsia Prescribing by Primary Care Physicians (PCPS) – The Impact of an Open Access Urea Breath Test Service

HJ O'Connor 1, K Bennett 1, O Thornton 1, M Dobson 1, MJ Buckley 1, C O'Morain 1, A Qasim 1, J Feely 1
  • 1Dept of Gastroenterology, Adelaide and Meath Hospital, Dublin 24 and Dept of Pharmacology and Therapeutics, St James's Hospital, Dublin 8

Aims: The H Pylori Unit at the Adelaide & Meath Hospital provides an open access Urea breath test (UBT) service for PCP's. The aim was to assess the impact of UBT results on prescribing patterns by PCP's.

Methods: 805 patients (M 298:F 507; mean age 48) attending their first UBT during Jan 2001-Dec 2002 were studied. Data were linked to prescribing data from the General Medical Services scheme. Prescription of H pylori eradication therapy (HPET) was assessed 3 months following the UBT and antisecretory therapy (AST) in the year prior to and following the UBT.

Results: 374 (46.5%) had a positive UBT and 431 (53.5%) had a negative test. Only 226 (60.4%) of the positive test patients were prescribed a recommended triple therapy regime and 25% received no treatment. Of negative test patients, 7.2% received triple or dual therapy. In the year following the UBT, AST was prescribed for 26% of the negative group compared with 15% of the positive group receiving triple therapy.

Conclusions: These results show clear under-prescribing and inappropriate prescribing of HPET despite positive test results, and suggest that PCP's are commonly not acting on the results of H pylori testing.