Barriers to Helicobacter pylori management among the regular health screening population at a tertiary hospital healthcare centre in China: results from a qualitative analysis

Objectives We aimed to better understand patients’ perspectives on Helicobacter pylori ( H. pylori ) treatment to develop tailored interventions for improving adherence. Design We conducted a qualitative study using semi-structured, in-depth interviews from September to December 2024. Setting The study was conducted at a large, university-affiliated healthcare centre which provides comprehensive health check-up services to a geographically diverse adult population. Participants Individuals aged between 35 and 65 years old who had tested positive for H. pylori infectio n by 13C urea breath test in two consecutive annual health screenings and who had received their most recent H. pylori screening results within the past 6 months were enrolled. Results Of the 23 participants involved in this study, 13 (56.5%) were male, with age ranging from 39 to 62 years. Five key themes emerged from the analysis: (1) Participants perceived H. pylori as common but not serious, with limited understanding of its association with gastric cancer, (2) Physician recommendations and familial concerns acted as primary cues to treatment initiation, (3) Barriers included low perceived severity, reinfection concerns, side effects, time constraints and absence of symptoms or family history, (4) Adherence was challenged by treatment side effects and lack of follow-up testing and (5) Despite low treatment completion, participants reported engaging in preventive behaviours such as using separate utensils and reducing dining out. Conclusions Barriers to H. pylori eradication among health screening populations are multifaceted, involving informational deficits, cultural dining norms and logistical hurdles. Interventions should enhance physician-patient communication, emphasise follow-up testing and address misconceptions about reinfection and disease risk. Strengthening general practitioners’ capacity for evidence-based H. pylori management and integrating post-screening educational support are essential for improving eradication rates and reducing infection-related morbidity.