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Published on: May 23, 2025
At-Home Urea Breath Testing Demonstrates Increased Patient Uptake, High Satisfaction Rates, and Reduction in Carbon
Conor Costigan1, Edric Leung1, Sandeep Sihag1
1Department of Gastroenterology, Tallaght University Hospital, D24 NR0A Dublin, Ireland.
Insights
A virtual clinic for the C13 urea breath test (UBT) for H. pylori is feasible in Ireland. This home-based approach improves patient attendance and significantly reduces carbon emissions and travel time.
Area of Science:
- Gastroenterology
- Environmental Health
- Digital Health
Background:
- Healthcare contributes significantly to global carbon emissions, with gastroenterology being a major source.
- Missed hospital appointments lead to poor patient outcomes and resource waste.
- The COVID-19 pandemic accelerated virtual clinic adoption, but tele-diagnostics lag behind.
Purpose of the Study:
- To evaluate the feasibility of a virtual C13 urea breath test (UBT) clinic for H. pylori diagnosis in Ireland.
- To assess patient attendance, environmental impact, and satisfaction with a home-based UBT service.
Main Methods:
- Patients received C13 UBT kits for home use.
- Virtual video appointments with GI lab technicians guided patients through the test procedure.
- Completed tests were returned via local GPs, post, or hospital drop-off for analysis.
Main Results:
- 423 virtual appointments were analyzed; 22% test positivity matched in-person rates.
- Virtual patients showed significantly higher attendance rates (OR = 153.9, p = 0.0004).
- The virtual UBT clinic saved 9943.5 Km of travel, 254 person-hours, and 1.24 metric tonnes of CO2.
- 92% of patients rated the home testing experience as 'good' or 'excellent'.
Conclusions:
- Home-based H. pylori testing via virtual clinics is effective and acceptable.
- This model reduces the need for invasive procedures like endoscopy.
- Virtual UBT clinics offer a sustainable solution, decreasing carbon emissions and improving healthcare efficiency.
Abstract:
Background/Objectives: Healthcare accounts for approximately 4.4% of global carbon emissions. Gastroenterology is a particularly heavy producer, with professional organisations outlining targets to move towards carbon neutrality. Missed hospital appointments, associated with poor medical outcomes, also represent physical and economic waste to the sector. COVID-19 expedited the shift toward virtual clinics, but tele-diagnostics have not expanded similarly. We aimed to assess the feasibility of a virtual C13 urea breath test clinic for H. pylori in Ireland. Methods: C13 urea breath test kits were provided to patients in the community, who were subsequently invited to book an online video appointment with a GI lab technician to assist them in performing the test at home. Completed tests were returned to the hospital via local GP, by post, or a specified hospital drop-off point, and analysed using our standard protocol. Results: 423 virtual appointments were reviewed. 135 (32%) were male, and the mean age was 42 years. The test positivity rate was 22%, similar to a matched in-person testing cohort (21%). In all, there were no non-attenders, and two cancellations. Virtual patients were more likely to attend their appointments (OR = 153.9, p = 0.0004) than in-person patients. Virtual UBT appointments saved 9943.5 Km of road journeys, equivalent to 254 person-hours of travel time and 1.24 metric tonnes of CO2. Additionally, 300 (71%) patients returned a feedback questionnaire, of which 276 (92%) rated the overall home breath test experience as 'good' or 'excellent'. Conclusions: Home testing for H. pylori is effective, acceptable, and reduces both reliance on invasive procedures such as endoscopy and carbon emissions.
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