P1209 - Concordance of Helicobacter pylori Testing in the Outpatient Setting With Latest ACG Guidelines, Cross-Sectional Study, and a Quality Improvement Project

Usama Abu-Heija, MBBS¹, Abu-Heija Ahmad, MD², Saqr Alsakarneh, MD³, Syed Madeeha Sadiq, MD¹, Mohammad Darweesh, MD¹, Musa Rasheed, MD¹, Rupal Shah, MD^1
1East Tennessee State University, Johnson City, TN; ²Wayne State University, Detroit, MI; ³University of Missouri-Kansas City, Kansas City, MO

Introduction: Helicobacter pylori (H. pylori) is highly prevalent and is associated with a significant disease burden in the GI tract. The American College of Gastroenterology recommends testing for H. pylori using stool antigen test (SAT), urea breath test (UBT), or biopsy in all patients with active or history of peptic ulcer disease (PUD) (excluding previously cured H. pylori infection), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer. Our study’s objective was to evaluate the adequacy of testing for H pylori in the outpatient setting among patients with a documented indication for H. pylori testing in the form of a cross sectional study. We will also be discussing more effective ways to maximize screening.

Methods: We retrospectively collected data from the outpatient records of five primary care clinical practices in the East Tennessee area between February 2017 and September 2022. We collected indications for H. pylori testing, patient demographics, and results of testing. International Classification of disease 10^th edition codes for (PUD, MALT, gastric cancer) were used to filter through the results and to cross match them with ordered tests (UBT, SAT). We excluded patients who had a previous endoscopic evaluation and biopsies to evaluate for H pylori.

Results: A total of 249 patients met inclusion criteria. Among our patients we had more females 62.7%. Most common diagnostic indication necessitating testing was PUD in 242 (97.2%), followed by history of gastric cancer in 3 (1.2%), and MALT lymphoma in 4 (1.6%). Only 10.8% (27) were adequately tested, among those tested 17 had a UBT and 10 had a SAT.

Discussion: H. pylori eradication has been a focus of interest in numerous clinical guidelines due to the large burden of disease associated with infection. The first step in achieving eradication lies in adequate H. pylori testing in at-risk individuals. As part of our quality improvement project, we will be implementing several interventions to improve testing in the outpatient setting. Our interventions will include both systematic and didactic approaches. We are implementing a hard-stop in the electronic medical record system to identify those at risk and add testing as part of their treatment plan, as well as didactics on the available testing modalities presented to our primary care providers. There is significant room for improvement given our low testing rate at the current stage.




Disclosures:


Usama Abu-Heija, MBBS¹, Abu-Heija Ahmad, MD², Saqr Alsakarneh, MD³, Syed Madeeha Sadiq, MD¹, Mohammad Darweesh, MD¹, Musa Rasheed, MD¹, Rupal Shah, MD¹. P1209 - Concordance of Helicobacter pylori Testing in the Outpatient Setting With Latest ACG Guidelines, Cross-Sectional Study, and a Quality Improvement Project, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.