Do all patients in primary care who may benefit from eradication of Helicobacter pylori have access to effective care?

The purpose of this study was to identify those patients who would benefit from eradication therapy for Helicobacter pylori and to understand the scal e of service changes needed to implement eradication therapy. All general practices in Bradford Health Authority were invited to take par t in the study. Patients who had received more than one repeat prescription for proton pump inhibitors or H-2 receptor antagonists in the previous twe lve months were identified using the repeat prescription systems in the par ticipating practices. Their case notes were examined and the relevant data items extracted by a trained project worker. Forty-four out of 100 practices agreed to take part and they accounted for a population or 262 647 people, Or that population, 2.3% (6037) of patients were on long-term acid suppressing treatment. Seventy-nine percent (n = 47 84) of patients on long-term acid suppression had a diagnosis recorded in t he records, 17% (n = 1028) had duodenal ulcer, 5% (n = 278) gastric ulcer a nd the rest, 58% (n = 3478), consisted or patients labelled as dyspepsia, h eartburn, gastritis, and non-ulcer dyspepsia. Only 131 (10%) of those patie nts with peptic ulcer had been prescribed eradication therapy. Endoscopy an d barium meal examinations had been used to confirm the diagnosis in 2715 p atients. In the remaining patients there was no information in the case not es to suggest whether the diagnosis had been confirmed by investigations. A substantial proportion of patients previously diagnosed as having peptic u lcer have not been offered eradication therapy demonstrating a delay in get ting research evidence into practice. To ensure all patients within a healt h district who may benefit from eradication therapy, do benefit, a systemat ic approach including access to additional investigative facilities is requ ired.