The Challenges of Helicobacter pylori Infection: What You Need to Know About Evaluation and Eradication

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Program Overview:

Helicobacter pylori is a prevalent, chronic infection that is linked to the development of dyspeptic symptoms, peptic ulcer disease, and gastric malignancy. Most patients with H pylori infection present to their primary care clinicians with undifferentiated dyspepsia. Accurate diagnosis and effective management of H pylori infection hinge on thorough knowledge of current guidelines as well as close adherence to these recommendations.

The majority of patients with suspected H pylori should be tested for infection prior to treatment. However, many primary care clinicians are not conducting such testing in all appropriate patients. Both endoscopic and nonendoscopic tests are available for this purpose. In populations with a low pretest probability of H pylori infection, nonendoscopic tools such as the urea breath test and fecal antigen test are associated with superior positive predictive value when compared with antibody tests. Current guidelines can help clinicians weigh the advantages and disadvantages of various treatment regimens.  Newer sequential regimens are also generating interest and are undergoing clinical investigation. Post-treatment testing should be performed to document eradication of infection.  

Learning Objectives:

After completing this activity, the participant will be able to

• Identify patients in whom diagnostic testing for H pylori infection is indicated and determine the most appropriate tests for detecting infection, confirming eradication in specific situations as defined by guidelines
• Identify the issues around H pylori treatment to communicate to patients including the complexity of and the rationale for the treatment plan

Accreditation/Designation Statement:

Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Target Audience:

This activity is targeted to all physicians and other healthcare professionals who treat patients with H pylori infection.

Release Date: July 29, 2009
Expiration Date: July 29, 2010

Medium: Podcast

Acknowledgement of Commercial Support:

This activity was developed from the live Best Practices in Primary Care™ program held in New York, New York, on March 21, 2009, and is funded by Otsuka America Pharmaceutical, Inc.

Method of Participation:

To receive CME credit for this activity, you need to listen to the program. Upon finishing the podcast, complete the post-test and evaluation and fill out all required personal information. To receive your CME certificate you will need to pass the post-test with 70% accuracy or better.

Post-test and Evaluation:

After completing this activity, click on the Post-test button at the end of the program. If you receive less than 70% on the post-test, you will be returned to the beginning of the activity to review the presentation again. Upon successful completion of the post-test, you will be asked to fill out a program evaluation form and prompted to print your CME certificate.

Statement of Disclosure and Independence:

It is the policy of Primary Care Network, Inc. to ensure all its sponsored educational activities are planned, developed, and conducted in accordance with the ACCME’s Essential Areas and Policies. In accordance with ACCME requirements, Primary Care Network has Conflict of Interest and Disclosure Policies that are designed to ensure that Primary Care Network sponsored educational activities are fair balanced, independent, evidence-based and based on scientific rigor.

Primary Care Network’s Resolution of Personal Conflicts of Interest (COI) Policy aims to ensure that all conflicts are resolved prior to the activity, content is developed and presented free of commercial bias, and is in the interest of promoting improvements or quality in healthcare. All individuals who are in a position to influence and/or control content of a Primary Care Network sponsored activity are required to disclose to the participants any real or apparent conflict of interest related to the activity. The educational content is also reviewed for independence and content validation by an independent external clinical reviewer and internal clinical reviewer. Independence is also monitored through the activity and overall program evaluation process.

The opinions, ideas, recommendations, and perspectives expressed in the accompanying presentations at this Primary Care Education program are those of the program authors and presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations or perspectives of their affiliated institutions, Primary Care Network, Primary Care Education, Advisory Boards and Consultants, or the activity’s commercial supporters.

Planning Committee and Disclosures:

Barbara Saldinger
Editorial Manager, In 2 Med Ed
New York, NY

Barbara Saldinger declares that neither she nor any immediate family member currently has a financial interest, arrangement, or affiliation with any pharmaceutical company and/or medical device company.

Nicholas J. Talley, MD, PhD
Chair, Department of Internal Medicine
Mayo Clinic Florida
Jacksonville, FL

Dr. Talley is on the advisory board for Addex Pharma, Astellas Pharma US, AstraZeneca, Callisto Pharma, Eisai, Microbia, Novartis, Salix, and Wyeth. He is a consultant for Meritage Pharma, Metabolic Pharma, Proctor & Gamble, and Steigerwald Arzneimittel GmbH. He has received research grants from Dynogen, GlaxoSmithKline, and Novartis.

Joan Weiss
President, In 2 Med Ed
New York, NY

Joan Weiss declares that neither she nor any immediate family member currently has a financial interest, arrangement, or affiliation with any pharmaceutical company and/or medical device company.

Faculty and Disclosures:

Nicholas J. Talley, MD, PhD
Chair, Department of Internal Medicine
Mayo Clinic Florida
Jacksonville, FL

Dr. Talley is on the advisory board for Addex Pharma, Astellas Pharma US, AstraZeneca, Callisto Pharma, Eisai, Microbia, Novartis, Salix, and Wyeth. He is a consultant for Meritage Pharma, Metabolic Pharma, Proctor & Gamble, and Steigerwald Arzneimittel GmbH. He has received research grants from Dynogen, GlaxoSmithKline, and Novartis.
                                                 
Joseph A. Lieberman III, MD, MPH
Professor, Family Medicine
Jefferson Medical College
Philadelphia, PA

Dr. Lieberman is on the advisory board for sanofi-aventis, Somaxon, Takeda, and Wyeth. He is on the speaker’s bureau for sanofi-aventis and Takeda.

Review Committee Disclosure:

In accordance with PCN policy, all content is reviewed by external independent peer reviewers for balance, objectivity, and commercial bias.  The peer reviewers, staff, and other individuals who control content have no relevant financial relationships to disclose.

Unlabeled Use Declaration:

During their presentation(s), faculty may discuss an unlabeled use or an investigational use not approved for a commercial product. Each faculty member is required to disclose this information to the audience when referring to an unlabeled or investigational use.

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