Dyspepsia management in primary care: A management trial

M. T. Cuddihy, G. R. Locke, D. Wahner-Roedler, R. Dierkhising, A. R. Zinsmeister, K. Hall Long, Nicholas J. Talley

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim was to evaluate the outcomes associated with four initial management strategies in new patients presenting to primary care physicians with dyspepsia. Patients with new symptoms (no alarm features) were randomised to empirical therapy (n = 11), Helicobacter pylori (HP) serology (n = 8), HP breath testing (n = 11) or oesophagogastroduodenoscopy (n = 13). Dyspepsia and health-related quality of life were assessed using standardised questionnaires at entry, 6 and 24 weeks post-trial enrolment. Outcomes were assessed by structured telephone interview every 6 weeks. In the initial HP testing arms, 21% were positive; 27% in the oesophagogastroduodenoscopy arm had inflammatory changes without ulcers at baseline. The majority (67%) received over the counter medication after initial management. Symptom-free status was similarly common in all groups (p = 0.49); only 20% pursued further evaluation. Total billed charges were higher in the oesophagogastroduodenoscopy group ($2077) vs. empirical therapy ($512), despite excluding the charge for initial oesophagogastroduodenoscopy, but overall, no effects on total medical charges were detected (p = 0.10). Regardless of initial management, most patients remained symptomatic, yet did not return for health care visits or undergo endoscopies. The cost of upfront endoscopy may not be the best choice for patients presenting with new dyspepsia.

Original languageEnglish (US)
Pages (from-to)194-201
Number of pages8
JournalInternational Journal of Clinical Practice
Volume59
Issue number2
DOIs
StatePublished - Feb 2005

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Digestive System Endoscopy
Dyspepsia
Primary Health Care
Helicobacter pylori
Endoscopy
Primary Care Physicians
Serology
Ulcer
Quality of Life
Interviews
Delivery of Health Care
Costs and Cost Analysis
Therapeutics

Keywords

  • Dyspepsia
  • Economic analysis
  • Management
  • Randomised controlled trial

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cuddihy, M. T., Locke, G. R., Wahner-Roedler, D., Dierkhising, R., Zinsmeister, A. R., Long, K. H., & Talley, N. J. (2005). Dyspepsia management in primary care: A management trial. International Journal of Clinical Practice, 59(2), 194-201. https://doi.org/10.1111/j.1742-1241.2005.00372.x

Dyspepsia management in primary care : A management trial. / Cuddihy, M. T.; Locke, G. R.; Wahner-Roedler, D.; Dierkhising, R.; Zinsmeister, A. R.; Long, K. Hall; Talley, Nicholas J.

In: International Journal of Clinical Practice, Vol. 59, No. 2, 02.2005, p. 194-201.

Research output: Contribution to journalArticle

Cuddihy, MT, Locke, GR, Wahner-Roedler, D, Dierkhising, R, Zinsmeister, AR, Long, KH & Talley, NJ 2005, 'Dyspepsia management in primary care: A management trial', International Journal of Clinical Practice, vol. 59, no. 2, pp. 194-201. https://doi.org/10.1111/j.1742-1241.2005.00372.x
Cuddihy MT, Locke GR, Wahner-Roedler D, Dierkhising R, Zinsmeister AR, Long KH et al. Dyspepsia management in primary care: A management trial. International Journal of Clinical Practice. 2005 Feb;59(2):194-201. https://doi.org/10.1111/j.1742-1241.2005.00372.x
Cuddihy, M. T. ; Locke, G. R. ; Wahner-Roedler, D. ; Dierkhising, R. ; Zinsmeister, A. R. ; Long, K. Hall ; Talley, Nicholas J. / Dyspepsia management in primary care : A management trial. In: International Journal of Clinical Practice. 2005 ; Vol. 59, No. 2. pp. 194-201.
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