Pharmacy Intervention Matters: Improving the Quality of Care of Helicobacter pylori Treatment

Objectives: Helicobacter pylori (HP) infection has an estimated prevalence of ~4.4 billion individuals worldwide. Clinical manifestations range from asymptomatic to mucosa-associated lymphoid tissue lymphoma. Effective eradication depends on both appropriate treatment selection and patient adherence. The study aims were compare HP eradication rates, antibiotic regimen selection and confirmation testing between patients managed by a clinical pharmacist versus standard care. Methods: A retrospective review of adults diagnosed and treated for HP was performed between March 2019 and November 2021. Patients were divided into two sequential cohorts: a pre-pharmacy group receiving standard care, and a pharmacist intervention group in which a clinical pharmacist managed treatment and documented HP eradication. Data analyzed included multiple demographic and clinical factors. Eradication was assessed by intention-to-treat (ITT) and per-protocol analysis with proportions compared using chi-square or Fisher’s Exact Test for low cell counts. Results: A total of 134 patients were diagnosed and treated for HP during the study period: 38 in the pre-pharmacy group and 96 in the pharmacist intervention group. In ITT analysis, successful eradication did not differ significantly between groups. Per-protocol analysis revealed significantly higher eradication in the pharmacist group. Antibiotic regimens overall differed between the cohorts with less use of clarithromycin-based triple therapy and greater use of non-bismuth quadruple (concomitant) therapy in the pharmacist group. Other evaluated items were not significantly different between groups. Conclusions: Clinical pharmacist HP care management was associated with more consistent, guideline-concordant antibiotic regimen selection and higher eradication rates among patients completing confirmatory testing. These findings support a role for pharmacist-led HP care for process improvement including regimen selection and eradication testing; prospective studies with systematic confirmatory testing are needed to determine the model’s effect on eradication itself.