Beneficios del tratamiento erradicador de la infección por Helicobacter pylori en pacientes ulcerosos en un centro de atención primaria
Benefits of treatment to eradicate helicobacter pylori infection in patients with ulcers attending a primary care centre
R. Azagra Ledesmaa,
, E. Gené Tousb, J.M. Bonet Simób, F. Solé Sanchob, X. Calvet Calvoc
Autor para correspondencia
razagral@cconline.es
Correspondencia: CAP Badia del Vallés. C/ Bética, s/n. 08214 Badia del Vallés (Barcelona).
Correspondencia: CAP Badia del Vallés. C/ Bética, s/n. 08214 Badia del Vallés (Barcelona).
a Médico de Familia y Farmacólogo Clínico. CAP Badia del Vallès. Barcelona. CAP Badia del Vallés (Barcelona) y Corporació Sanitària Parc Taulí (Sabadell). Barcelona
b Especialista en Medicina Familiar y Comunitaria. CAP Badia del Vallès. Barcelona. CAP Badia del Vallés (Barcelona) y Corporació Sanitària Parc Taulí (Sabadell). Barcelona
c Unidad de Aparato Digestivo. Servicio de Medicina. Corporació Sanitària Parc Taulí. Sabadell. Barcelona. CAP Badia del Vallés (Barcelona) y Corporació Sanitària Parc Taulí (Sabadell). Barcelona
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Azagra" "apellidos" => "Ledesma" "email" => array:1 [ 0 => "razagral@cconline.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "E. Gené" "apellidos" => "Tous" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J.M. Bonet" "apellidos" => "Simó" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "F. Solé" "apellidos" => "Sancho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "X. Calvet" "apellidos" => "Calvo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Médico de Familia y Farmacólogo Clínico. CAP Badia del Vallès. Barcelona. CAP Badia del Vallés (Barcelona) y Corporació Sanitària Parc Taulí (Sabadell). Barcelona" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Especialista en Medicina Familiar y Comunitaria. CAP Badia del Vallès. Barcelona. CAP Badia del Vallés (Barcelona) y Corporació Sanitària Parc Taulí (Sabadell). Barcelona" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Aparato Digestivo. Servicio de Medicina. Corporació Sanitària Parc Taulí. Sabadell. Barcelona. CAP Badia del Vallés (Barcelona) y Corporació Sanitària Parc Taulí (Sabadell). Barcelona" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: CAP Badia del Vallés. C/ Bética, s/n. 08214 Badia del Vallés (Barcelona)." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Benefits of treatment to eradicate <span class="elsevierStyleItalic">helicobacter pylori</span> infection in patients with ulcers attending a primary care centre" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-09-29" "fechaAceptado" => "1999-09-29" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec195145" "palabras" => array:4 [ 0 => "Atención primaria" 1 => "Estudio clínico" 2 => "Estudio económico" 3 => "<span class="elsevierStyleItalic">Helicobacter pylori</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la evolución clínica y la utilización de recursos sanitarios en atención primaria un año después del tratamiento erradicador de Helicobacter pylori (Hp) en pacientes con úlcera péptica e infección por Hp.</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo sobre el efecto de una intervención.</p> <span class="elsevierStyleSectionTitle">Ámbito del estudio</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Centro de atención primaria urbano y reformado.</p> <span class="elsevierStyleSectionTitle">Pacientes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ciento dos pacientes con enfermedad ulcerosa péptica e infección por Hp.</p> <span class="elsevierStyleSectionTitle">Intervención</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Tratamiento erradicador de Hp.</p> <span class="elsevierStyleSectionTitle">Mediciones y resultados principales</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">a)</span> número de visitas totales (VT); <span class="elsevierStyleItalic">b)</span> visitas por dispepsia (VD); <span class="elsevierStyleItalic">c)</span> número de brotes ulcerosos (BU), y <span class="elsevierStyleItalic">d)</span> fármacos consumidos para tratamiento de la dispepsia. De los pacientes tratados un 79,4% era varón. La edad media global fue de 47,8 ± 12,4 años. Después de la intervención, disminuyeron significativamente las VT (de 8,3 a 6,6; p < 0,001), las VD (3,1 a 1,1; p < 0,00001), y los BU (de 1,2 a 0,06; p < 0,00001). El número medio de fármacos prescritos para la dispepsia por paciente disminuyó de 1,24 a 0,43 (p < 0,0001). La prescripción de ranitidina pasó de 72,7 a 13,8 días (p < 0,001) y la de omeprazol disminuyó de 35,1 a 12,2 días (p < 0,03). El ahorro total estimado por paciente fue de 26.792 pts. con valores económicos de 1998.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En nuestro medio el tratamiento erradicador en pacientes ulcerosos Hp (+) disminuye las necesidades de asistencia y la prescripción de medicamentos antiulcerosos. Ya durante el primer año esto supone un beneficio clínico para estos pacientes y un ahorro económico importante para la sanidad pública.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To evaluate the clinical evolution and the use of Primary Care health resources one year after treatment to eradicate Helicobacter pylori (Hp) infection in patients with peptic ulcers and Hp infection.</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Retrospective study on the effect of an intervention.</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Urban, reformed primary care centre.</p> <span class="elsevierStyleSectionTitle">Patients</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">102 patients with peptic ulcers and Hp infection.</p> <span class="elsevierStyleSectionTitle">Intervention</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Treatment to eradicate Hp.</p> <span class="elsevierStyleSectionTitle">Measurements and main results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">a) Total medical attendance; b) attendance for dyspepsia; c) number of ulcerous outbreaks; d) medicines taken to treat dyspepsia. 79.4% of the patients treated were male. Overall mean age was 47.8 ± 12.4. After the intervention, total attendance (from 8.3 to 6.6, p < 0.001), attendance for dyspepsia (from 3.1 to 1.1, p < 0.00001), and ulcerous outbreaks (from 1.2 to 0.06, p < 0.00001) all dropped sharply. The mean number of medicines prescribed for dyspepsia per patient fell from 1.24 to 0.43, p < 0.0001. Ranitidine prescription fell from 72.7 to 13.8 days (p < 0.001); and omeprazol from 35.1 to 12.2 days (p < 0.03). Estimated total saving per patient was 26792 pesetas at 1998 values.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Treatment in primary care to eradicate Hp (+) in ulcerous patients reduced the needs of attendance and the prescription of drugs for ulcers. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 2 | 1 | 3 |
| 2024 Octubre | 13 | 12 | 25 |
| 2024 Septiembre | 12 | 17 | 29 |
| 2024 Agosto | 9 | 17 | 26 |
| 2024 Julio | 8 | 20 | 28 |
| 2024 Junio | 9 | 22 | 31 |
| 2024 Mayo | 24 | 22 | 46 |
| 2024 Abril | 20 | 33 | 53 |
| 2024 Marzo | 36 | 39 | 75 |
| 2024 Febrero | 20 | 33 | 53 |
| 2024 Enero | 21 | 28 | 49 |
| 2023 Diciembre | 26 | 33 | 59 |
| 2023 Noviembre | 21 | 59 | 80 |
| 2023 Octubre | 49 | 52 | 101 |
| 2023 Septiembre | 11 | 30 | 41 |
| 2023 Agosto | 16 | 21 | 37 |
| 2023 Julio | 11 | 46 | 57 |
| 2023 Junio | 20 | 29 | 49 |
| 2023 Mayo | 15 | 5 | 20 |
| 2023 Abril | 5 | 7 | 12 |
| 2023 Marzo | 8 | 7 | 15 |
| 2023 Febrero | 17 | 7 | 24 |
| 2023 Enero | 9 | 11 | 20 |
| 2022 Diciembre | 23 | 7 | 30 |
| 2022 Noviembre | 49 | 18 | 67 |
| 2022 Octubre | 25 | 23 | 48 |
| 2022 Septiembre | 27 | 23 | 50 |
| 2022 Agosto | 28 | 34 | 62 |
| 2022 Julio | 15 | 17 | 32 |
| 2022 Junio | 17 | 10 | 27 |
| 2022 Mayo | 25 | 26 | 51 |
| 2022 Abril | 27 | 27 | 54 |
| 2022 Marzo | 17 | 7 | 24 |
| 2022 Febrero | 24 | 12 | 36 |
| 2022 Enero | 27 | 8 | 35 |
| 2021 Diciembre | 28 | 12 | 40 |
| 2021 Noviembre | 24 | 20 | 44 |
| 2021 Octubre | 25 | 17 | 42 |
| 2021 Septiembre | 16 | 11 | 27 |
| 2021 Agosto | 15 | 8 | 23 |
| 2021 Julio | 23 | 10 | 33 |
| 2021 Junio | 25 | 8 | 33 |
| 2021 Mayo | 14 | 14 | 28 |
| 2021 Abril | 24 | 24 | 48 |
| 2021 Marzo | 48 | 16 | 64 |
| 2021 Febrero | 35 | 11 | 46 |
| 2021 Enero | 17 | 11 | 28 |
| 2020 Diciembre | 20 | 11 | 31 |
| 2020 Noviembre | 23 | 12 | 35 |
| 2020 Octubre | 26 | 12 | 38 |
| 2020 Septiembre | 22 | 5 | 27 |
| 2020 Agosto | 16 | 17 | 33 |
| 2020 Julio | 19 | 8 | 27 |
| 2020 Junio | 12 | 5 | 17 |
| 2020 Mayo | 13 | 10 | 23 |
| 2020 Abril | 15 | 11 | 26 |
| 2020 Marzo | 24 | 13 | 37 |
| 2020 Febrero | 21 | 11 | 32 |
| 2020 Enero | 17 | 28 | 45 |
| 2019 Diciembre | 29 | 36 | 65 |
| 2019 Noviembre | 8 | 7 | 15 |
| 2019 Octubre | 25 | 14 | 39 |
| 2019 Septiembre | 21 | 8 | 29 |
| 2019 Agosto | 13 | 11 | 24 |
| 2019 Julio | 13 | 10 | 23 |
| 2019 Junio | 71 | 53 | 124 |
| 2019 Mayo | 121 | 130 | 251 |
| 2019 Abril | 49 | 27 | 76 |
| 2019 Marzo | 9 | 8 | 17 |
| 2019 Febrero | 8 | 6 | 14 |
| 2019 Enero | 7 | 5 | 12 |
| 2018 Diciembre | 7 | 7 | 14 |
| 2018 Noviembre | 4 | 11 | 15 |
| 2018 Octubre | 6 | 13 | 19 |
| 2018 Septiembre | 3 | 5 | 8 |
| 2018 Agosto | 0 | 5 | 5 |
| 2018 Julio | 1 | 4 | 5 |
| 2018 Junio | 3 | 4 | 7 |
| 2018 Mayo | 3 | 11 | 14 |
| 2018 Abril | 1 | 6 | 7 |
| 2018 Marzo | 4 | 5 | 9 |
| 2018 Febrero | 0 | 6 | 6 |
| 2018 Enero | 1 | 1 | 2 |
| 2017 Diciembre | 7 | 6 | 13 |
| 2017 Noviembre | 1 | 9 | 10 |
| 2017 Octubre | 2 | 3 | 5 |
| 2017 Septiembre | 1 | 10 | 11 |
| 2017 Agosto | 3 | 1 | 4 |
| 2017 Julio | 1 | 6 | 7 |
| 2017 Junio | 12 | 20 | 32 |
| 2017 Mayo | 11 | 10 | 21 |
| 2017 Abril | 12 | 2 | 14 |
| 2017 Marzo | 13 | 4 | 17 |
| 2017 Febrero | 4 | 5 | 9 |
| 2017 Enero | 2 | 3 | 5 |
| 2016 Diciembre | 9 | 3 | 12 |
| 2016 Noviembre | 11 | 3 | 14 |
| 2016 Octubre | 14 | 4 | 18 |
| 2016 Septiembre | 10 | 4 | 14 |
| 2016 Agosto | 9 | 1 | 10 |
| 2016 Julio | 7 | 1 | 8 |
| 2016 Junio | 33 | 0 | 33 |
| 2016 Mayo | 31 | 3 | 34 |
| 2016 Abril | 36 | 0 | 36 |
| 2016 Marzo | 39 | 1 | 40 |
| 2016 Febrero | 23 | 1 | 24 |
| 2016 Enero | 19 | 0 | 19 |
| 2015 Diciembre | 35 | 0 | 35 |
| 2015 Noviembre | 21 | 0 | 21 |
| 2015 Octubre | 16 | 0 | 16 |
| 2015 Septiembre | 32 | 0 | 32 |
| 2015 Agosto | 17 | 0 | 17 |
| 2015 Julio | 18 | 0 | 18 |
| 2015 Junio | 5 | 0 | 5 |
| 2015 Mayo | 8 | 0 | 8 |
| 2015 Abril | 8 | 0 | 8 |
| 2015 Marzo | 13 | 0 | 13 |
| 2015 Febrero | 9 | 0 | 9 |
| 2015 Enero | 22 | 0 | 22 |
| 2014 Diciembre | 30 | 0 | 30 |
| 2014 Noviembre | 7 | 0 | 7 |
| 2014 Octubre | 20 | 0 | 20 |
| 2014 Septiembre | 15 | 0 | 15 |
| 2014 Agosto | 23 | 0 | 23 |
| 2014 Julio | 14 | 0 | 14 |
| 2014 Junio | 9 | 0 | 9 |
| 2014 Mayo | 5 | 0 | 5 |
| 2014 Abril | 10 | 0 | 10 |
| 2014 Marzo | 5 | 0 | 5 |
| 2014 Febrero | 6 | 0 | 6 |
| 2014 Enero | 4 | 0 | 4 |
| 2013 Diciembre | 8 | 0 | 8 |
| 2013 Noviembre | 18 | 0 | 18 |
| 2013 Octubre | 7 | 0 | 7 |
| 2013 Septiembre | 6 | 0 | 6 |
| 2013 Agosto | 5 | 0 | 5 |
| 2013 Julio | 2 | 0 | 2 |
| 2000 Abril | 1002 | 0 | 1002 |
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