Clinical trial: knowledge of negative Helicobacter pylori status reduces subsequent dyspepsia-related resource use

Summary Background  Screening for Helicobacter pylori reduces dyspepsia and dyspepsia-related costs in positive individuals. Aims  To assess effect of knowledge of H. pylori status on healthcare-seeking in negative individuals. Methods H. pylori-negative subjects in a community screening programme were randomized to placebo triple therapy or informed of their negative H. pylori status. Dyspepsia-related resource data were extracted from primary care records at 2 years, and National Health Service reference costs were applied to calculate the total cost per subject. Proportions of individuals incurring any cost were compared using a relative risk (RR) and 95% confidence interval (CI). Differences in costs were compared using an independent sample t-test. Results  A total of 1353 H. pylori-negative individuals were randomized to placebo whilst 1355 were informed of their infection status. In the placebo arm, 212 (16%) subsequently incurred any dyspepsia-related cost compared to 172 (13%) informed of their infection status (RR of incurring cost = 0.81; 95% CI: 0.67–0.97). Those informed of their infection status incurred lower costs (mean saving per individual = £11.02; 95% CI: −£3.52 to 25.56). Conclusions H. pylori-negative individuals informed of infection status sought health care for dyspepsia less often than those who were unaware. Population screening may reduce dyspepsia-related costs in uninfected, as well as infected individuals.