572
REDUCTION OF DISPARITIES IN H. PYLORI TREATMENT AND ERADICATION FOLLOWING IMPLEMENTATION OF A MULTIDISCIPLINARY TREATMENT PROGRAM.
Date
May 19, 2024
Background: Worldwide, Helicobacter pylori (HP) remains one of the most frequent etiologies of gastric cancer, peptic ulcer disease, and gastritis. Following major changes in the standard of care, reflected in the American College of Gastroenterology HP Guidelines, our institution implemented in July 2018 a Multidisciplinary Treatment Program for HP (MTPHP) within the Division of Gastroenterology.
Methods: We retrospectively identified all patients with histopathological confirmed HP at our institution between October 2016 and July 2022. Two physicians individually collected patient-level data from the EMR, and a full-dataset analysis was done. We used Pearson χ2 and Fisher’s methods, as appropriate, to test for unadjusted differences of proportion. Subsequently, a multivariable logistic regression model adjusted for patient race/ethnicity and language preference was utilized.
Results: During the study period 1002 had histologically confirmed HP of which 386 (38.52%) were enrolled part in the MTPHP, and 616 (61.48%) were not. A significant change was observed following implementation of the MTPHP in: (1) the global treatment rates improved from (79.1% v. 98.7%, p<0.0001), (2) follow-up testing rates (35.06% v. 51.81%, p<0.0001), and (3) eradication success rates (81.19% v. 95.45%, p=0.000008). Outcomes by race/ethnicity had considerable improvement within the MTPHP. Post-implementation eradication success amongst these groups met the international quality benchmark of ≥90% (Figure 1). Our multivariable models showed the effect of the MTPHP was robust to the effects of the covariates.
Conclusions: The MTPHP improved clinical outcomes and decreased racial/ethnic disparities in outcomes observed pre-implementation. The MTPHP was associated with eradication success regardless of treatment choice, race/ethnicity, or preferred language. (Figure 2.)
This demonstrates that overall positive clinical benchmarks can benefit from the implementation of a structured multidisciplinary program.
Methods: We retrospectively identified all patients with histopathological confirmed HP at our institution between October 2016 and July 2022. Two physicians individually collected patient-level data from the EMR, and a full-dataset analysis was done. We used Pearson χ2 and Fisher’s methods, as appropriate, to test for unadjusted differences of proportion. Subsequently, a multivariable logistic regression model adjusted for patient race/ethnicity and language preference was utilized.
Results: During the study period 1002 had histologically confirmed HP of which 386 (38.52%) were enrolled part in the MTPHP, and 616 (61.48%) were not. A significant change was observed following implementation of the MTPHP in: (1) the global treatment rates improved from (79.1% v. 98.7%, p<0.0001), (2) follow-up testing rates (35.06% v. 51.81%, p<0.0001), and (3) eradication success rates (81.19% v. 95.45%, p=0.000008). Outcomes by race/ethnicity had considerable improvement within the MTPHP. Post-implementation eradication success amongst these groups met the international quality benchmark of ≥90% (Figure 1). Our multivariable models showed the effect of the MTPHP was robust to the effects of the covariates.
Conclusions: The MTPHP improved clinical outcomes and decreased racial/ethnic disparities in outcomes observed pre-implementation. The MTPHP was associated with eradication success regardless of treatment choice, race/ethnicity, or preferred language. (Figure 2.)
This demonstrates that overall positive clinical benchmarks can benefit from the implementation of a structured multidisciplinary program.
Presenter
Speakers
Beth Israel Deaconess Medical Center
Tracks
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