D0686 - Pharmacy Intervention Matters: Improving the Quality of Care of Helicobacter pylori Treatment

Pooja J. Mude, DO¹, Apryl Cronley, MD¹, Nimisha Vasandani, ², Ahmad Alkaddour, MD², Carlos Palacio, MD, MPH³, Kenneth J. Vega, MD, FACG⁴, John Erikson L. Yap, MD^4
1Augusta University Medical Center, Augusta, GA; ²Medical College of Georgia, Augusta, GA; ³University of Florida College of Medicine, Jacksonville, FL; ⁴Augusta University Medical College of Georiga, Augusta, GA

Introduction: Helicobacter pylori (HP) infection has an estimated prevalence of ~4.4 billion individuals worldwide. Clinical features range from asymptomatic to mucosa-associated lymphoid tissue lymphoma. It is important to ensure effective eradication, including patient compliance and appropriate treatment courses. The study aim was to compare HP treatment managed by a clinical pharmacist to standard care with regard to medication compliance and successful eradication.

Methods: A retrospective review of adult patients diagnosed and treated for HP at our center was performed between 3/2019 and 11/2021. All included individuals were then divided into 2 groups. The pre-pharmacy group (3/2019 to 6/2020) received standard care for HP infection while the pharmacist intervention group (7/2020 to 11/2021) had a clinical pharmacist manage treatment and document eradication or persistence of HP upon completion as the primary outcome variable. Data analyzed included age, gender, BMI, alcohol use, drug/tobacco use, pre-treatment symptoms, diagnostic method (gastric biopsy, stool antigen, urea breath test), EGD results, pharmacologic treatment, clinic follow-up type, confirmation test type/result, post-treatment symptoms and any previous HP therapy.

Results: A total of 134 patients were diagnosed and treated for HP in the study period. Thirty-eight (38) patients had standard HP treatment and were considered the pre-pharmacy intervention group while 96 patients had HP therapy managed by a clinical pharmacist comprising the pharmacist intervention group. The pharmacist intervention group was more likely to complete eradication confirmation testing (26% vs 10.5%, p< 0.05). Additionally, pharmacist intervention group patients had lower rates of incomplete eradication compared to the pre-pharmacy group (7.3% vs 28.9%, p=0.009). Increased use of triple therapy was noted in the pre-pharmacy group vs a regimen of PPI, clarithromycin, amoxicillin, and metronidazole among those managed by the clinical pharmacist (p=0.001). Clinical and demographic factors as well as method of diagnosis, EGD findings or previous treatment were not different between groups.

Discussion: Clinical pharmacist intervention improved care of patients with HP treated at our academic center by increasing eradication rates, more appropriate selection of antibiotic regimens and improved rates of follow up for confirmation testing. Such a HP care model should be considered at other institutions with difficulty obtaining successful HP eradication.



Disclosures:


Pooja J. Mude, DO¹, Apryl Cronley, MD¹, Nimisha Vasandani, ², Ahmad Alkaddour, MD², Carlos Palacio, MD, MPH³, Kenneth J. Vega, MD, FACG⁴, John Erikson L. Yap, MD⁴. D0686 - Pharmacy Intervention Matters: Improving the Quality of Care of Helicobacter pylori Treatment, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.