Study of the Completion of Follow-up After Helicobacter Pylori Eradication Therapy

Background: Because no therapeutic regimens have an eradication rate of 100%, post-treatment evaluation is necessary to ensure that adequate eradication therapy for Helicobacter pylori has been provided. The fact that not all patients are evaluated after eradication therapy is a serious concern for both the medical care system and medical economy.Method: We performed a retrospective study of 411 patients who received first-line H. pylori eradication therapy at Fuyoukai Murakami Hospital from October 1, 2014 to March 31, 2016. We calculated the rate of post-treatment follow-up at 1 year after completing the eradication therapy. In addition, we excluded 76 patients who definitely received post-treatment evaluation because of follow-up appointments with gastroenterologists (n = 29) or return visits to other physicians (n = 47) and included 335 patients in the final study population. We used logistic regression models for identifying the relevant factors contributing to the completion of post-eradication follow-up.Results: The rate of completion of post-eradication follow-up was 78.8% (324/411). Multivariate analysis revealed that the adjusted odds ratios for age (≥ 48 years), gender (female) and preventive measures for gastric cancer (esophagogastroduodenoscopy after radiographic screening for gastric cancer and a desire to be examined for H. pylori infection) were 1.85 [95% confidence interval (CI): 1.11–3.09; p < 0.05], 1.89 [95% CI: 1.07–3.34; p < 0.05] and 4.01 [95% CI: 1.61–10.0; p < 0.01], respectively.Conclusion: Age ≥ 48 years, female gender and preventive measures for gastric cancer were independently related to a higher rate of completion of post-eradication follow-up

Al ziende blind: over het waarom van crises en hoe ze te vermijden

With this contribution the authors want to indicate why organizational crises emerge and what aspects can contribute to their detection and prevention. They argue that crisis detection and prevention necessitates a multilayered and multidisciplinary approach. More in particular they focus on the interaction between a product and a process vision on crisis preparedness. In this they elaborate on the role of procedures and the way organizations can cope with this by means of sensemaking, double loop learning and practical drift.status: publishe