Clinical pharmacist practitioner-led clinic improves Helicobacter pylori treatment and eradication testing: A quality improvement initiative.

Abstract

Purpose: Many patients treated for Helicobacter pylori (HP) do not complete guideline-recommended post-treatment eradication testing. Patients diagnosed via esophagogastroduodenoscopy (EGD) face unique barriers due to fragmented handoffs between providers. We describe the development and early outcomes of a Clinical Pharmacist Practitioner (CPP)-led clinic designed to improve HP management for EGD-diagnosed patients.

Summary: We developed a centralized CPP-led clinic to assume responsibility for HP regimen selection, eradication test ordering, and follow-up. The option for referral to this clinic was integrated into an existing EGD results notification workflow for patients with newly diagnosed HP. Comparing a pre-intervention period (October 2022-March 2024, n=105) to a post-intervention period (May 2024-October 2025, n=111), guideline-concordant prescribing increased from 32.4% to 90.8% (p<0.001), testing completion within 6 months increased from 37.1% to 61.3% (adjusted odds ratio 2.88, p<0.001), and eradication among tested patients improved from 82.1% to 92.6%. With extended follow-up, testing completion increased from 62.9% pre-intervention to 84.7% post-intervention (p<0.001), and eventual eradication among those tested increased from 87.9% to 98.9% (p=0.003).

Conclusion: A centralized CPP-led clinic significantly improved guideline-concordant prescribing, eradication testing completion, and confirmed eradication for EGD-diagnosed HP patients. This scalable model addresses care fragmentation by centralizing the complete care pathway for HP management.