Abstract
Background Helicobacter pylori testing has been suggested as an alternative to endoscopy for young patients with dyspepsia. Secondary care studies have suggested that demand for endoscopy among this group could be reduced by up to 74%. However, the effect of H. pylori testing in the primary care setting, where the majority of dyspepsia is managed, is unclear.
Aim To determine the effects of providing a H. pylori serology service for GPs upon demand for open access endoscopy.
Design of study A prospective randomised controlled trial.
Setting Forty-seven general practices in Gloucestershire.
Method General practices were stratified by endoscopy referral rate and randomised into two groups. The intervention group was provided with access to H. pylori serology testing and encouraged to use it in place of endoscopy for patients aged under 55 years with dyspepsia. Endpoints were referral for endoscopy and serology use.
Results There was a significant reduction in referrals for endoscopy in the intervention group compared to the control group: 18.8% (95% confidence interval = 5.0 to 30.6%; P = 0.009).
Conclusions Providing GPs with H. pylori serology testing reduced demand for open access endoscopy, but by less than previous studies had predicted.
- Received January 21, 2002.
- Revision received May 22, 2002.
- Accepted October 13, 2005.
- © British Journal of General Practice, 2006.