The interaction between research and practice: a pan-European approach to managing H-pylori infection in primary care

The transposition of evidence into clinical care presents many challenges. New knowledge may be immediately translatable to the practice setting, with barriers to be overcome before implementation. The early guidelines on Hel icobacter pylori management presented an overview but were not able to take into account local factors and health care traditions, such as the non-ava ilability of tests and established primary-secondary care relationships. Pr imary care is a specific speciality across most of Europe, existing within different health care systems and clinical traditions. The creation of H.py lori management guidelines, aimed at European primary care but adaptable to local national circumstances, presented a challenge in methodology and for mulation. The process exposed similarities but also tensions between differ ing health care systems, as well as variations in the conditions in which G Ps practise. Clinical differences, such as varying ulcer prevalence and dru g resistance rates, highlighted the importance of guidelines being adaptabl e. This paper analyses the European Society for Primary Care Gastroenterolo gy process of pan-European primary care agreement towards H.pylori manageme nt and how diverse views, traditions and national settings were reconciled through an evidence-based approach.