Robert Will, MHS, Tiffany Luong, MPH, Jessica Romero, MS, Rebecca Hill, DrPH, Qiaoling Chen, MS, Bechien Wu, MD Kaiser Permanente, Pasadena, CA Introduction: Successful eradication is key to reducing the burden of H pylori. This study characterized patient and provider characteristics related to eradication failure within a diverse US integrated health system. Methods: We conducted a retrospective cohort study of 30,390 Kaiser Permanente Southern California adult members between 2008-2023 who were diagnosed with H pylori via stool antigen test, received treatment, and had follow-up stool antigen tests within 1 year of diagnosis. We defined unsuccessful eradication as a positive confirmatory stool antigen test within 1 year of diagnosis. Patients without follow-up testing were excluded from the study. We fit a generalized estimating equations (GEE) model to evaluate the relationship between unsuccessful eradication and patient characteristics (e.g., sociodemographics, used interpreter) and provider characteristics (e.g., age, sex, specialty). Results: Most patients were < 50 years old (52%), female (66%), and Hispanic (66%), followed by White (12%), Asian (11%), and Black (8%). Most spoke English as their primary language (72%) and did not require an interpreter (77%). For most patients, their provider was < 50 years old (75%), female (55%), and a primary care physician (97%). The overall rate of successful eradication was 73%. Hispanic patients were more likely to have unsuccessful eradication than White patients (White vs. Hispanic, OR=0.78, CI 0.71–0.85, P < .001) and Black patients (Black vs. Hispanic, OR=0.87, CI 0.78–0.97, P=0.013). Compared to patients from least deprived neighborhoods, patients from more deprived and most deprived neighborhoods had higher odds of unsuccessful H pylori eradication (More deprived vs. Least deprived, OR=1.12, CI 1.02–1.24, P=0.021) (Most deprived vs. Least deprived, OR=1.13, CI 1.02–1.26, P=0.022). Patients whose provider was a primary care physician had higher odds of unsuccessful eradication compared to those whose provider was a gastroenterologist (OR=1.38, CI 1.06–1.79, P=.016). Discussion: Our study identifies racial disparities in H pylori eradication among Hispanic patients, highlights neighborhood deprivation as a crucial factor in successful eradication, and spotlights a difference in treatment outcomes between provider specialties indicating an area for potential support and improvement in primary care settings.
Disclosures: Robert Will indicated no relevant financial relationships. Tiffany Luong indicated no relevant financial relationships. Jessica Romero indicated no relevant financial relationships. Rebecca Hill indicated no relevant financial relationships. Qiaoling Chen indicated no relevant financial relationships. Bechien Wu indicated no relevant financial relationships.
Robert Will, MHS, Tiffany Luong, MPH, Jessica Romero, MS, Rebecca Hill, DrPH, Qiaoling Chen, MS, Bechien Wu, MD. P3444 - Unequal Eradication: Patient and Provider Factors Associated with <i>H. pylori</i> Treatment Failure, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
