Orvosi hetilap · 2002
[How do Hungarian family physicians think about Helicobacter pylori? Results of national survey].
СтатьяНазвание и аннотация: Перевод в очереди
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Magyar Anna, Papp János
Аннотация
UNLABELLED: INTRODUCTION, AIMS: In spring of 2000 a national survey was conducted on the diagnostic and therapeutic attitudes of Hungarian family practitioners concerning Helicobacter pylori.
RESULTS: Based on responses, endoscopy, urea breath test and serology are easily available to 98, 42 and 48% of family practitioners respectively. Only 45% of responders performs Helicobacter pylori testing him/herself, while 82% prescribes eradication therapy without a gastroenterologist. In the second part of the questionnaire responders had to decide in 15 routine clinical cases, whether to perform Helicobacter pylori testing, and if so, whether to be satisfied with noninvasive testing or also to perform an endoscopy. Responses comply with international and Hungarian national recommendations, reflecting at the same time the uncertainties inherent in medical literature. Five responses of Hungarian family practitioners differed from the recommendations of literature. Two questions were related to screening Helicobacter pylori: in a complaint-free patient family practitioners are not inspired to perform a screening either in the case of familiarity of gastric cancer or in that of duodenal ulcer known from the individual case history. Helicobacter pylori testing is often superfluously suggested to young patients suffering from gastro-esophageal reflux disease. An empirical approach is revealed by the fact, that in cases of Helicobacter pylori positive duodenal ulcer, when eradication eliminates complaints, 41% of family practitioners would not test result of eradication. At the same time it is considered a mistake, that in case of young patients with a Helicobacter pylori positive gastric ulcer, being free of complaints after eradication, 66% of physicians refrains from endoscopic control.
CONCLUSIONS: The possibilities, education, diagnostic and therapeutic skills as to diseases due to Helicobacter pylori of Hungarian family practitioners seems to be appropriate. In education emphasis should be primarily placed on screening and post-eradication tasks. Guidelines should be offered to family practitioners concerning controversary issues (gastro-esophageal reflux disease, dyspepsia, administration of non-steroid anti-inflammatory drugs).
RESULTS: Based on responses, endoscopy, urea breath test and serology are easily available to 98, 42 and 48% of family practitioners respectively. Only 45% of responders performs Helicobacter pylori testing him/herself, while 82% prescribes eradication therapy without a gastroenterologist. In the second part of the questionnaire responders had to decide in 15 routine clinical cases, whether to perform Helicobacter pylori testing, and if so, whether to be satisfied with noninvasive testing or also to perform an endoscopy. Responses comply with international and Hungarian national recommendations, reflecting at the same time the uncertainties inherent in medical literature. Five responses of Hungarian family practitioners differed from the recommendations of literature. Two questions were related to screening Helicobacter pylori: in a complaint-free patient family practitioners are not inspired to perform a screening either in the case of familiarity of gastric cancer or in that of duodenal ulcer known from the individual case history. Helicobacter pylori testing is often superfluously suggested to young patients suffering from gastro-esophageal reflux disease. An empirical approach is revealed by the fact, that in cases of Helicobacter pylori positive duodenal ulcer, when eradication eliminates complaints, 41% of family practitioners would not test result of eradication. At the same time it is considered a mistake, that in case of young patients with a Helicobacter pylori positive gastric ulcer, being free of complaints after eradication, 66% of physicians refrains from endoscopic control.
CONCLUSIONS: The possibilities, education, diagnostic and therapeutic skills as to diseases due to Helicobacter pylori of Hungarian family practitioners seems to be appropriate. In education emphasis should be primarily placed on screening and post-eradication tasks. Guidelines should be offered to family practitioners concerning controversary issues (gastro-esophageal reflux disease, dyspepsia, administration of non-steroid anti-inflammatory drugs).