Optimizing Helicobacter pylori therapy through gastroenterologist education: A prospective interventional study

Table 1 Demographic and clinical data of participating physicians, n (%)

Variant	Result
Age
31-40 years old	16 (80.0)
41-50 years old	4 (20.0)
Sex
Male	9 (45.0)
Female	11 (55.0)
Education
Bachelor	11 (55.0)
Master	8 (40.0)
Doctor and above	1 (5.0)
Professional qualifications
Resident physician	2 (10.0)
Attending physician and above	10 (50.0)
Associate chief physician	8 (40.0)
Monthly average number of patients counseled for H. pylori infection
Less than 5 cases	1 (5.0)
6-10 cases	5 (25.0)
11-20 cases	8 (40.0)
More than 20 cases	6 (30.0)
Number of patients counseled for H. pylori infection
Less than 300 cases	11 (55.0)
More than 300 cases	9 (45.0)

H. pylori: Helicobacter pylori.

Table 2 Demographic and clinical data of patients, n (%)/median (interquartile range)

Variant	Before training (n = 500)	After training (n = 500)	t/χ2 test		Multilevel logistic regression model
			t/χ2	P value	Coefficient/OR	P value
Age (years)	48.5 (38.0, 58.0)	47.0 (37.0, 57.0)	-0.934	0.346	1.034	0.216
Sex			1.02	0.312	0.88	0.312
Male	258 (51.6)	242 (48.4)
Female	242 (48.4)	258 (51.6)
BMI (kg/m2)	24.0 (21.8, 26.2)	24.0 (22.0, 25.7)	-0.099	0.921	0.033	0.871
Smoking			2.53	0.112	0.78	0.109
Yes	123 (24.6)	102 (20.4)
No	377 (75.4)	398 (79.6)
Drinking			2.05	0.152	0.81	0.150
Yes	143 (28.6)	123 (24.6)
No	357 (71.4)	377 (75.4)
Education
Primary school	221 (44.2)	209 (41.8)	1.43	0.489	1.21	0.239
Middle school	144 (28.8)	139 (27.8)			1.17	0.350
College	135 (27.0)	152 (30.4)
History of antibiotic allergy			0.52	0.472	0.88	0.620
Yes	28 (5.6)	23 (4.6)
No	472 (94.4)	477 (95.4)
Gastric cancer family history			0.32	0.572	1.09	0.767
Yes	13 (2.6)	16 (3.2)
No	487 (97.4)	484 (96.8)
Endoscopy			0.07	0.799	0.96	0.787
Yes	220 (44.0)	216 (43.2)
No	280 (56.0)	284 (56.8)

BMI: Body mass index; OR: Odds ratio.

Table 3 Comparisons before and after training

	Group A	Group B	χ2 test		Logistic regression model		Linear mixed model
	Before training	After training	χ2	P value	OR	95%CI	Effect size	95%CI	P value
H. pylori eradication rates
ITT analysis	58.59% (290/495)	71.63% (356/497)	18.58	< 0.001	1.785	1.370-2.325	0.132	0.049-0.214	0.004
PP analysis	81.23% (290/357)	88.56% (356/402)	8.01	0.005	1.788	1.191-2.684	0.079	0.018-0.139	0.012
Standardization rates of H. pylori eradication therapies	71.0% (355/500)	89.6% (448/500)	54.57	< 0.001	3.519	2.490-4.974	0.186	0.054-0.312	0.008
Patient review rate	71.4% (357/500)	80.4% (402/500)	11.07	0.001	1.643	1.225-2.204	0.090	0.031-0.149	0.005
Adverse reaction documentation rates for physicians	21.0% (103/490)	21.2% (104/491)	0.00	0.951	1.01	0.743-1.372	-0.001	-0.052-0.051	0.984

H. pylori: Helicobacter pylori; CI: Confidence interval; OR: Odds ratio; ITT: Intention-to-treat; PP: Per-protocol.

Table 4 Comparison of Helicobacter pylori eradication rates before and after training according to physicians’ experience

	ITT analysis				PP analysis
	Before training	After training	χ2	P value	Before training	After training	χ2	P value
According to treatment experience
Inexperienced physicians	56.8% (155/273)	72.2% (197/273)	14.10	< 0.001	78.7% (155/197)	86.0% (197/229)	3.98	0.046
Experienced physicians	60.8% (135/222)	71.0% (159/224)	5.14	0.023	84.4% (135/160)	91.9% (159/173)	4.56	0.033
According to ITT analysis of H. pylori eradication rates before training
Physicians with eradication rates below 80%	51.4% (203/395)	68.3% (271/397)	23.45	< 0.001	78.4% (203/259)	88.3% (271/307)	10.11	0.001
Physicians with eradication rates no less than 80%	87.0% (87/100)	85.0% (85/100)	0.17	0.684	88.8% (87/98)	89.5% (85/95)	0.02	0.876
According to PP analysis of H. pylori eradication rates before training
Physicians with eradication rates below 85%	45.7% (112/245)	65.6% (162/247)	19.69	< 0.001	72.7% (112/154)	87.1% (162/186)	10.11	0.001
Physicians with eradication rates no less than 85%	71.2% (178/250)	77.6% (194/250)	2.69	0.101	87.7% (178/203)	89.8% (194/216)	0.48	0.490

H. pylori: Helicobacter pylori; ITT: Intention-to-treat; PP: Per-protocol.