Approach to Treatment of Dyspepsia in Primary Care

Background:The value of the "test-and-treat" strategy in the approach to dyspepsia has been evaluated only in a few secondary care studies.Most patients with dyspepsia, however, are treated by their primary care physician.This study evaluated the test-and-treat strategy in primary care.Methods: Patients consulting their general practitioners for dyspepsia were randomized to either direct openaccess endoscopy with Helicobacter pylori testing or a testand-treat strategy by H pylori serology.In the 12-month follow-up period, any additional treatment or referral for investigations was left at the discretion of the general practitioner.At the end of the study, data were collected concerning the number of endoscopies, changes in symptom severity and quality of life, patient satisfaction, and the use of medical resources.