Page 87 - Ebook-Book JCMS 2025

Adherence to Helicobacter pylori Management Consensus in
Clinical Practice at Two Tertiary Hospitals: A Large Cohort
Retrospective Study
Pudit Chinniyomwanich1, Puth Muangpaisarn2, Rapat Pittayanon1,3*
1 Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University
2 Division of Gastroenterology, Department of Internal Medicine, Phrapokklao Hospital
3 Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn
University
*Corresponding Author E-mail: rapat.p@chula.ac.th
Background: Abstract
Many countries have launched Helicobacter pylori (HP) management guidelines to
assist physicians based on regional data. However, adherence is often assessed using
questionnaires, which may not accurately reflect real-world data. This study aims to assess
adherence to the Thailand Consensus on HP management through a retrospective chart
review at two tertiary care hospitals in Thailand.
Methods: This retrospective study was conducted at King Chulalongkorn Memorial Hospital (KCMH)
in the capital and Phrapokklao Hospital (PPK) in a province. Medical records of patients
diagnosed with HP infection, confirmed by esophagogastroduodenoscopy (EGD) with rapid
urease test (RUT) between 2019 and 2021, were reviewed. Data collected included patient
demographics, indications for HP testing, pre-EGD preparation, HP treatment regimens,
and follow-up practices period.
Results: Conclusion: A total of 2,136 medical records were reviewed: 1,987 from KCMH and 149 from PPK. Most
patients were Thai nationals under universal health coverage. In terms of pre-diagnostic
preparation, almost 98.5% of patients at KCMH discontinued proton pump inhibitors (PPIs)
≥2 weeks, compared to 83.9% at PPK (p < 0.001). Antibiotic discontinuation ≥4 weeks
was higher at KCMH (98.6% vs 95.3%, p = 0.009). For first-line, the majority of patients at
KCMH (74.6%) received PPIs-based triple therapy for 14 days, while 77.5% at PPK received
concomitant therapy. HP eradication was confirmed in 78% at KCMH vs 44.1% at PPK.
Eradication rates were comparable (95.9% at PPK vs 89.4% at KCMH: p = 0.139).
This study highlighted significant differences in adherence between two hospitals. KCMH
exhibited higher rates of diagnostic adherence and eradication confirmation. These
findings suggested an opportunity to the upcoming consensus or guidelines to address the
limitations of healthcare service outside the capital. This could motivate physician to better
follow the recommendations, ultimately enhancing the quality of national healthcare across
the country.
Harmony in health: Innovation for Sustainable Medicine
85