Variation in the use of H. pylori tests in UK general practice – a qualitative study

Abstract

SUMMARYBackground: Although serology is the main Helicobacter pylori test used by general practitioners in the UK, there is no information available on variation in requesting rates. Aim: To explore the reasons for any variation in H. pylori serology testing by general practices in the UK using qualitative methods. Methods: Serology requesting rates were determined using laboratory and population data. Staff from randomly selected practices in the lowest and highest quintiles of testing attended focus groups to discuss the management of H. pylori and dyspepsia. Transcribed data were analysed using an interpretative phenomenological approach. Results: Serology submission varied 600-fold (0.1-59/ 1000 population/year) and H. pylori positivity rate

Patients' attitudes to Helicobacter pylori breath and stool antigen tests compared to blood serology

“…Few GPs use or know about stool antigen tests or UBTs and there is concern amongst primary care clinicians in the UK that the stool test will not be culturally acceptable to patients. 7,8 GPs have suggested that patients and practices would accept stool testing if appropriately counselled about the improved accuracy over blood serology, and the ease of implementation in the practice setting. 9 There have not been any UK studies examining the acceptability of helicobacter stool tests.…”

Re‐infection following successful eradication of Helicobacter pylori infection

“…This is an important distinction given the well-documented lack of awareness among most general practitioners of the limitations of available tests for this organism. 2 More importantly, the authors do not state the proportion of their patients whose primary H. pylori infection was diagnosed serologically, a method with an inadequate positive predictive value (with high false-positive rates) when employed using commercially available kits in low prevalence populations such as that of England. [3][4][5][6] If, as the authors' other recent study suggests, 7 the majority of the patients included in the present study had their primary H. pylori infection diagnosed serologically by their general practitioner, one can only conclude that their estimate of the recurrence rate of this infection is flawed.…”