A survey of primary-care pediatricians regarding the management of Helicobacter pylori infection and celiac disease

Amir Ben Tov, Wasef Na'Amnih, Amna Bdair-Amsha, Shlomi Cohen, Judith Tzamir, Gabriel Chodick, Khitam Muhsen

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Adherence of primary-care pediatricians to guidelines in pediatric gastroenterology is essential to achieve optimal clinical outcomes. The study aim was to examine adherence of primary-care pediatricians to the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition guidelines on the management of Helicobacter pylori (H. pylori) infection and celiac disease. Methods: We conducted a cross-sectional study during March-July 2017 using the survey platform of Maccabi Healthcare Services, the second largest state-mandated health organization in Israel. We sent the study questionnaire to a random sample of 300 pediatricians via electronic mails and to increase the response rate, we performed a telephone interview. Overall, 108 (36%) pediatricians provided completed questionnaires. Results: Using professional guidelines for the management of H. pylori infection and celiac disease was reported by 34 and 37% of pediatricians, respectively. Referral to H. pylori testing was reported by 78 and 52% of pediatricians in children with suspected duodenal ulcer and unexplained iron deficiency anemia, respectively, with the stool antigen enzyme immunoassay being mostly (51%) used as the first choice diagnostic test. Most pediatricians reported prescription of triple therapy; proton pump inhibitors/clarithromycin/amoxicillin (59%) or metronidazole (21%). For celiac disease, overall adherence to all guidelines was high both for initial evaluation and for confirmation of diagnosis. Conclusions: Adherence to the guidelines on management of H. pylori infection was low, while adherence to the guidelines on celiac disease management was high among primary-care pediatricians. Educational interventions are needed to improve H. pylori infection management among primary-care pediatricians.

Original languageEnglish
Article number88
JournalIsrael Journal of Health Policy Research
Volume8
Issue number1
DOIs
StatePublished - 27 Dec 2019

Keywords

  • Celiac disease
  • Diagnosis
  • Guidelines
  • Helicobacter pylori
  • Pediatricians
  • Survey
  • Treatment

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