Article: Comparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study

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TitleComparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study
AuthorsHu, WHC1
Lam, SK1
Lam, CLK1
Wong, WM1
Lam, KF1
Lai, KC1
Wong, YH1
Wong, BCY1
Chan, AOO1
Chan, CK1
Leung, GM1
Hui, WM1
KeywordsDyspeptic patients
Empirical endoscopy
H pylori test-and treat
Issue Date2006
PublisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
CitationWorld Journal Of Gastroenterology, 2006, v. 12 n. 31, p. 5010-5016 [How to Cite?]
AbstractAim: 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$4343, $1771 and $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. © 2006 The WJG Press. All rights reserved.
ISSN1007-9327
2011 Impact Factor: 2.471
2011 SCImago Journal Rankings: 0.189
ISI Accession Number IDWOS:000240185800011
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorHu, WHC
dc.contributor.authorLam, SK
dc.contributor.authorLam, CLK
dc.contributor.authorWong, WM
dc.contributor.authorLam, KF
dc.contributor.authorLai, KC
dc.contributor.authorWong, YH
dc.contributor.authorWong, BCY
dc.contributor.authorChan, AOO
dc.contributor.authorChan, CK
dc.contributor.authorLeung, GM
dc.contributor.authorHui, WM
dc.date.accessioned2010-09-06T09:20:36Z
dc.date.available2010-09-06T09:20:36Z
dc.date.issued2006
dc.description.abstractAim: 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$4343, $1771 and $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. © 2006 The WJG Press. All rights reserved.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationWorld Journal Of Gastroenterology, 2006, v. 12 n. 31, p. 5010-5016 [How to Cite?]
dc.identifier.epage5016
dc.identifier.hkuros124069
dc.identifier.isiWOS:000240185800011
dc.identifier.issn1007-9327
2011 Impact Factor: 2.471
2011 SCImago Journal Rankings: 0.189
dc.identifier.issue31
dc.identifier.openurl
dc.identifier.pmid16937497
dc.identifier.scopuseid_2-s2.0-33748323445
dc.identifier.spage5010
dc.identifier.urihttp://hdl.handle.net/10722/86728
dc.identifier.volume12
dc.languageeng
dc.publisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
dc.publisher.placeChina
dc.relation.ispartofWorld Journal of Gastroenterology
dc.relation.referencesReferences in Scopus
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshCost-Benefit Analysis
dc.subject.meshDyspepsia - diagnosis
dc.subject.meshEndoscopy - economics - methods
dc.subject.meshFemale
dc.subject.meshHelicobacter Infections - diagnosis
dc.subject.meshHelicobacter pylori - metabolism
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPrimary Health Care - methods
dc.subjectDyspeptic patients
dc.subjectEmpirical endoscopy
dc.subjectH pylori test-and treat
dc.titleComparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong