The TETRA study:: A prospective evaluation of Helicobacter pytori 'test-and-treat' strategy on 736 patients in clinical practice

被引:29
作者
Gisbert, JP
Badía, X
Roset, M
Pajares, JM
机构
[1] Hosp Univ Princesa, Dept Gastroenterol, Madrid, Spain
[2] Hlth Outcomes Res Europe, Barcelona, Spain
[3] Hosp Univ Santa Creu & St Pau, Dept Epidemiol, Barcelona, Spain
关键词
dyspepsia; Helicobacter pylori; proton pump inhibitor; test and treat; treatment;
D O I
10.1111/j.1083-4389.2004.00195.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aims. To prospectively evaluate the effectiveness of the test-and-treat strategy in a large group of dyspeptic patients in clinical practice. Methods. Patients with ulcer-like dyspepsia, < 45 years, without alarm symptoms, were prospectively studied. Helicobacter pylori infection was diagnosed with the C-13-urea-breath-test, and eradication or symptomatic treatment was prescribed accordingly. 'Symptomatic improvement' was defined as the percentage of patients with a decrease of ≥2 levels in the dyspepsia-severity-score or with no symptoms after treatment. Health status and use of health resources were also assessed. Endoscopy was performed in therapeutic failures. Results. Out of 736 patients initially included, 422 received eradication, and 314 symptomatic therapy; 87% returned at 6 weeks and 67% at 6 months. At 6 months, 'symptomatic improvement' was achieved in 73% and 54% of the patients, in eradication and symptomatic groups, respectively (p <.001), and overall in 66%. A reduction of 78% in mean self-assessment visual analogical score was observed at 6 months. More than 50% of patients were 'much better' at control visits. Endoscopy (18%) and physician's visits (13%) were the main health resources used. No gastric or oesophageal cancer was diagnosed. Conclusion. This large prospective study shows that the test-and-treat strategy is effective and safe for management of dyspeptic patients in clinical practice.
引用
收藏
页码:28 / 38
页数:11
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