P2030 - Treatment Patterns, Goals, Satisfaction, and Adherence in the Management of H. pylori Infection in the United States: Results From the Study of Acid-Related Disorders (SOARD)

Colin W. Howden, MD, FACG¹, Stuart Spechler, MD², Michael Vaezi, MD³, Mark Fendrick, MD⁴, Corey Pelletier, PhD⁵, Rinu Jacob, PharmD⁵, Stephen Brunton, MD^6
1University of Tennessee College of Medicine, Germantown, TN; ²Baylor University Medical Center, Dallas, TX; ³Vanderbilt University Medical Center, Nashville, TN; ⁴University of Michigan, Ann Arbor, MI; ⁵Phathom Pharmaceuticals, Florham Park, NJ; ⁶Primary Care Education Consortium, Vallejo, CA

Introduction: The Study of Acid-Related Disorders (SOARD) explored perceptions of disease burden by physicians, and patients who had H. pylori (HP) infection and dyspepsia.

Methods: Physicians completed an online survey between October 2020 and May 2021 recording preferred treatments (tx), tx goals, tx satisfaction and perceived disease burden. A subset completed chart review data of patients with HP and dyspepsia who had received a PPI as part of their tx. Data included diagnosis history and tx prescribed. The same patients completed a survey capturing data on tx goals, satisfaction and adherence.

Results: 251 physicians (102 gastroenterologists [GIs] and 149 family/general practice physicians [FP/GPs]) completed the survey; 16 GIs and 24 FP/GPs provided chart review data on 77 patients. Patients’ mean age was 45.7 years; 66% were women. Median time since diagnosis was 142.5 days (range 6 days - 17.5 years).

Patients treated by GIs and FP/GPs were diagnosed differently. All GI patients received an endoscopy (FP/GP 37%), and 77% histology (FP/GP 9%), 7% urea breath test (UBT) (FP/GP 50%), and none received serology (FP/GP 33%). Preferred 1^st line tx was PPI, amoxicillin and clarithromycin (PAC) for 68% GIs and 78% FP/GPs; 68% of patients treated by GIs and 63% by FP/GPs received PAC 1^st line.

Physicians estimated that 29% of patients would require a 2^nd line tx due to failure of 1^st line. In the patient sample, 36% received a 2^nd line tx, and 9% a 3^rd line. Only 29% of physicians strongly agreed that they were satisfied with current tx options; 57% of patients were not completely satisfied. Treatment goals are reported in the Table.

40% of patients reported not being adherent with tx, often due to forgetfulness (90%), failing to complete the course (75%), or not understanding instructions (48%).

Discussion: Empiric PAC is the most frequently used 1^st line treatment despite national guideline recommendations [1]. A proportion of physicians and patients were dissatisfied with tx options, with physicians reporting higher satisfaction levels than patients. Almost a third of patients failed 1^st line tx. Non-invasive tests for active infection are not widely used in practice, although use of UBT by FP/GPs is increasing. Patient adherence with treatment was suboptimal. New tx options that provide better patient outcomes and satisfaction would be beneficial.
1. Chey W D et al. ACG Clinical Guideline: Treatment of Helicobacter pylori infection. Am J Gastroenterol 2017; 112: 212–239



Disclosures:


Colin W. Howden, MD, FACG¹, Stuart Spechler, MD², Michael Vaezi, MD³, Mark Fendrick, MD⁴, Corey Pelletier, PhD⁵, Rinu Jacob, PharmD⁵, Stephen Brunton, MD⁶. P2030 - Treatment Patterns, Goals, Satisfaction, and Adherence in the Management of H. pylori Infection in the United States: Results From the Study of Acid-Related Disorders (SOARD), ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.