Guidelines on the management of H-pylori in primary care: development of an implementation strategy

Background. Clinical guideline programmes as being developed in many Europe an countries contribute to quality of care in general practice. The applica bility of multicountry guidelines will depend on country-specific circumsta nces. Implementation programmes are required for optimal compliance with gu idelines. Objective. In order to achieve optimal follow-up of the European Society fo r Primary Care Gastroenterology (ESPCG) Helicobacter pylori guidelines in g eneral practice, we analysed factors that might obstruct compliance at nati onal level, and integrated this in implementation programmes. Method. Discussion groups in eight participating countries reviewed epidemi ological characteristics and diagnostic and therapeutic resources that woul d hinder applicability. The groups also indicated potential constraints to optimal compliance and developed a national implementation programme. Results. Helicobacter pylori infection rates and peptic ulcer incidence var y widely across Europe, as do the availability, access and reimbursement of diagnostic test facilities for H.pylori. Minor adaptation of the ESPCG gui delines is required in some countries. Implementation programmes have been developed and partially carried out in all countries. Conclusion. A pan-European approach to H.pylori guideline development shoul d result in a framework of best practice into which nationally specific det ails can be incorporated, thus guaranteeing optimal follow-up of the guidel ines and true improvement of dyspepsia management in primary care.