Becker's Clinical Quality & Infection Control

12 PATIENT SAFETY & OUTCOMES 45% of patients infected with H. pylori do not receive proper treatment, 1st of its kind study finds By Ashleigh Hollowell A new study published in Nature found major gaps in the treatments of patients infected with Helicobacter pylori, bacteria that can lead to stomach ulcers and is persistently found to be a risk factor for gastric cancer — the fourth-deadliest cancer worldwide. It is something that nearly 36 percent of U.S. adults are infected with at some point. Normally, H. pylori can be treated with antibiotics early on, but when le untreated can lead to detrimental health outcomes. However, this treatment, sometimes referred to as "HP eradication," has seen rising rates of failure in the U.S. because of antibiotic resistance. Specifically, these gaps were found in the selection of both first- and second-line therapy for infected patients. One major reason behind the gaps, is a lack of information. "In the U.S., there are no large-scale HP registries to track local HP antibiotic resistance rates and regimen-specific success rates, nor are HP antibiotic susceptibility data easy to obtain," the authors of the study wrote. Which is why researchers, led by Shailja Shah, MD, set out to understand more about treatment patterns in patients with the diagnosis. e study — which is said to be the first of its kind to analyze U.S. population-based analysis to review current HP treatment patterns and eradication rates — found that "45.3 percent of patients with HP infection either did not receive a guideline-recommended treatment or received a potentially inappropriate regimen based on prior antibiotic use." "I commend Dr. Shailja Shah and the co-authors for this critical evaluation of H. pylori infection and its treatment in the U.S. population," Yanghee Woo, MD, a surgical oncologist and gastric cancer specialist at City of Hope in Duarte, Calif., told Becker's in reaction to the findings. Dr. Woo was not involved in the study, but as a gastric cancer expert herself, stressed the importance of more research in this area. "is study highlights the gaps in guidelines and clinical practice by identifying areas where improved real-world practices can help eradicate H. pylori infections," Dr. Woo told Becker's. "e findings of this study strongly support the urgent call for a national policy- directed comprehensive program to address H. pylori infections in the U.S. and improve the cancer health of our ethnic communities." In the study's conclusion, Dr. Shah and her team point out the massive need for additional research as well as consistent and thorough tracking of HP data throughout the U.S., commenting that "there are major opportunities to improve post-eradication testing and registration of patients undergoing treatment." n US spends most on healthcare but has worse outcomes: 6 report findings By Mariah Taylor T he U.S. spends two to four times as much on healthcare as most other high-income countries, but the health outcomes lag behind, a new Commonwealth Fund study found. "U.S. Healthcare from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes" is an ongoing report by the Commonwealth Fund that compares healthcare spending and outcomes, health status and healthcare usage in the U.S. with 12 other high- income nations and the average for all 38 Organization for Economic Co-operation and Development members. The U.S. remained the only nation within the OECD that does not offer universal health coverage despite spending nearly 18 percent of its GDP on healthcare, according to the report. Here are five other findings: 1. The U.S. has the lowest life expectancy at 77 years compared to the 80 years average for other wealthy nations. 2. The U.S. has the highest rates of avoidable deaths from causes such as diabetes, hypertensive disease and certain cancers. 3. The U.S. has the highest COVID-19 death rate among high-income countries, at 3,000 deaths in every 1 million cases between Jan. 22, 2020, and Jan. 18, 2023. 4. Physical assault, which includes gun violence, is seven times higher in the U.S. than in other high-income countries, except New Zealand. 5. U.S. infant and maternal deaths are more than triple the rate of most other high-income countries. "Americans are living shorter, less healthy lives because our health system is not working as well as it could be," lead author Munira Gunja, senior researcher for the Commonwealth Fund's International Program in Health Policy and Practice Innovations, said in the report. "To catch up with other high-income countries, the administration and Congress would have to expand access to healthcare, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population." n

• Cover