H pylori testing in primary care increases endoscopy rates

Patients without Helicobacter pylori infection are unlikely to have treatable disease at endoscopy. One idea for reducing the workload of endoscopy departments is therefore to test patients in primary care and refer only those with positive results. However, in a randomised controlled trial Delaney et al (p 898) found that "test and endoscopy" increased the proportion of patients receiving endoscopy from 25% to 40%. The patients in the test and endoscopy group had no greater improvement in symptoms or quality of life compared with those receiving usual management. Therefore the strategy cannot be justified.


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Relevant Article

Randomised controlled trial of Helicobacter pylori testing and endoscopy for dyspepsia in primary care
B C Delaney, S Wilson, A Roalfe, L Roberts, V Redman, A Wearn, and F D R Hobbs
BMJ 2001 322: 898. [Abstract] [Full Text] [PDF]

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