P1225 - Helicobacter pylori Eradication Testing: A Quality Assurance Evaluation of Provider Ordering Rates & Patient Adherence

Bharat Ponnaganti, MD¹, Charles P. Cavalaris, MD², Judah Kreinbrook, BS³, Liza Plafsky, MD¹, Kristen Tessiatore, MD¹, Nicole L. Miller, MD², Rafael Rivera Sepulveda, MD², Chukwudumebi Uche, DO², Ruhi Vasavada, MD¹, Alexander Pinizzotto, MD¹, Wesley Wright, MD¹, Krishen Patel, MD⁴, Brian Black, MD², Ambuj Kumar, MD¹, Jason Colizzo, MD¹, Wojciech Blonski, MD, PhD^5
1University of South Florida, Tampa, FL; ²University of South Florida Morsani College of Medicine, Tampa, FL; ³Duke University School of Medicine, Durham, NC; ⁴Unviersity of South Florida, Tampa, FL; ⁵James A. Haley Veteran's Hospital and USF Health, Tampa, FL

Introduction: Helicobacter pylori (H. pylori) is one of the most prevalent chronic bacterial infections worldwide and is associated with gastric mucosa damage leading to peptic ulcer disease, MALT lymphoma or gastric adenocarcinoma if left untreated. Current treatment recommendation includes quadruple therapy followed by eradication testing 4-6 weeks after treatment. Such testing is critical as remaining H. pylori warrants salvage therapy or longer treatment durations to avoid persistent infection and subsequent morbidity. We aimed to evaluate our facility’s adherence to treatment guidelines and eradication testing over a five -year period, establishing a baseline measurement for subsequent quality improvement if warranted.

Methods: We performed a retrospective cohort study on all consecutive patients with H. pylori testing ordered via endoscopic biopsy and/or stool antigen testing from January 1^st, 2016 – December 31^st, 2021, at our single institution. Inclusion criteria were 1) positive H. pylori on endoscopic biopsy/pathology report & 2) prescribed therapy. All data was extracted from the electronic health record (EHR). Details of eradication testing and demographics were extracted from the EHR. Results are summarized and reported using descriptive statistics.

Results: Of the 1061 patients that tested positive for H.pylori, 1014 were prescribed treatment and included in the study. Patient demographics, characteristics and treatment regimens are reported in Table 1. Most patients received triple or quadruple therapy. Of these 1014 patients, eradication testing was ordered in 450 patients (44%) and completed in 398 patients (88%) (Figure 1-3). Of these 398 patients who completed eradication testing, 357 patients tested negative (89%) (Figure 4).

Discussion: The findings show a significantly low rate of eradication testing orders. These results emphasize the urgent need for interventions and strategies to increase the adherence to eradication testing for H.pylori by providers and patients at our institution. Future goals for our study include a multidisciplinary review of interventions to increase eradication testing compliance among providers and patients, and to evaluate the impact of these measures on H.pylori burden.




Disclosures:


Bharat Ponnaganti, MD¹, Charles P. Cavalaris, MD², Judah Kreinbrook, BS³, Liza Plafsky, MD¹, Kristen Tessiatore, MD¹, Nicole L. Miller, MD², Rafael Rivera Sepulveda, MD², Chukwudumebi Uche, DO², Ruhi Vasavada, MD¹, Alexander Pinizzotto, MD¹, Wesley Wright, MD¹, Krishen Patel, MD⁴, Brian Black, MD², Ambuj Kumar, MD¹, Jason Colizzo, MD¹, Wojciech Blonski, MD, PhD⁵. P1225 - Helicobacter pylori Eradication Testing: A Quality Assurance Evaluation of Provider Ordering Rates & Patient Adherence, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.