Comparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: a one-year study.
World J Gastroenterol
; 12(31): 5010-6, 2006 Aug 21.
Article
em En
| MEDLINE
| ID: mdl-16937497
ABSTRACT
AIM:
To investigate the optimal strategy to treat dyspeptic patients in primary care.METHODS:
Dyspeptic patients presenting to primary care outpatient clinics were randomly assigned to (1) empirical endoscopy, (2) H pylori test-and-treat, and (3) empirical prokinetic treatment with cisapride. Early endoscopy was arranged if patients remained symptomatic after 2 wk. Symptom severity, quality-of-life (SF-36) as well as patient preference and satisfaction were assessed. All patients underwent endoscopy by wk 6. Patients were followed up for one year.RESULTS:
Two hundred and thirty four patients were recruited (163 female, mean age 49). 46% were H pylori positive. 26% of H pylori tested and 25% of empirical prokinetic patients showed no improvement at wk 2 follow-up and needed early endoscopy. 15% of patients receiving empirical cisapride responded well to treatment but peptic ulcer was the final diagnosis. Symptom resolution and quality-of-life were similar among the groups. Costs for the three strategies were HK dollar 4343, dollar 1771 and dollar 1750 per patient. 66% of the patients preferred to have early endoscopy.CONCLUSION:
The three strategies are equally effective. Empirical prokinetic treatment was the least expensive but peptic ulcers may be missed with this treatment. The H pylori test-and-treat was the most cost-effective option.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Helicobacter pylori
/
Infecções por Helicobacter
/
Dispepsia
/
Endoscopia
Tipo de estudo:
Clinical_trials
Limite:
Adolescent
/
Adult
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Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
World J Gastroenterol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
China