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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?]
DOI: http://dx.doi.org/10.3748/wjg.v12.i31.5010
 
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
2013 Impact Factor: 2.433
2013 SCImago Journal Rankings: 1.022
 
DOIhttp://dx.doi.org/10.3748/wjg.v12.i31.5010
 
ISI Accession Number IDWOS:000240185800011
 
ReferencesReferences in Scopus
 
DC FieldValue
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_OA_fulltext
 
dc.identifier.citationWorld Journal Of Gastroenterology, 2006, v. 12 n. 31, p. 5010-5016 [How to Cite?]
DOI: http://dx.doi.org/10.3748/wjg.v12.i31.5010
 
dc.identifier.doihttp://dx.doi.org/10.3748/wjg.v12.i31.5010
 
dc.identifier.epage5016
 
dc.identifier.hkuros124069
 
dc.identifier.isiWOS:000240185800011
 
dc.identifier.issn1007-9327
2013 Impact Factor: 2.433
2013 SCImago Journal Rankings: 1.022
 
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
 
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Author Affiliations
  1. The University of Hong Kong