Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management
Por:
Huguet, Jose M., Ferrer-Barcelo, Luis, Suarez, Patricia, Barcelo-Cerda, Susana, Sempere, Javier, Saracino, Ilaria Maria, Fiorini, Giulia, Vaira, Dino, Perez-Aisa, Angeles, Jonaitis, Laimas, Tepes, Bojan, Castro-Fernandez, M., Pabon-Carrasco, Manuel, Keco-Huerga, Alma, Voynovan, Irina, Lucendo, Alfredo J., Lanas, Angel, Martinez-Dominguez, Samuel J., Alfaro Almajano, Enrique, Rodrigo, Luis, Vologzanina, Ludmila, Bordin, Dmitry S., Gasbarrini, Antonio, Babayeva, Gueluestan, Lerang, Frode, Leja, Marcis, Kupcinskas, Juozas, Rokkas, Theodore, Marcos-Pinto, Ricardo, Mestrovic, Antonio, Gridnyev, Oleksiy, Phull, Perminder S., Smith, Sinead M., Boltin, Doron, Buzas, Gyoergy Miklos, Kral, Jan, Simsek, Halis, Matysiak-Budnik, Tamara, Milivojevic, Vladimir, Marlicz, Wojciech, Venerito, Marino, Boyanova, Lyudmila, Doulberis, Michael, Capelle, Lisette G., Cano-Catala, Anna, Moreira, Leticia, Nyssen, Olga P., Megraud, Francis, O'Morain, Colm, Gisbert, Javier P.
Publicada:
1 jul 2024
Ahead of Print:
1 abr 2024
Resumen:
Background: Adherence to Helicobacter pylori (H. pylori) eradication
treatment is a cornerstone for achieving adequate treatment efficacy.
Objective: To determine which factors influence compliance with
treatment. Methods: A systematic prospective non-interventional registry
(Hp-EuReg) of the clinical practice of European gastroenterologists.
Compliance was considered adequate if >= 90% drug intake. Data were
collected until September 2021 using the AEG-REDCap e-CRF and were
subjected to quality control. Modified intention-to-treat analyses were
performed. Multivariate analysis carried out the factors associated with
the effectiveness of treatment and compliance. Results: Compliance was
inadequate in 646 (1.7%) of 38,698 patients. The non-compliance rate was
higher in patients prescribed longer regimens (10-, 14-days) and rescue
treatments, patients with uninvestigated dyspepsia/functional dyspepsia,
and patients reporting adverse effects. Prevalence of non-adherence was
lower for first-line treatment than for rescue treatment (1.5% vs. 2.2%;
p < 0.001). Differences in non-adherence in the three most frequent
first-line treatments were shown: 1.1% with proton pump inhibitor +
clarithromycin + amoxicillin; 2.3% with proton pump inhibitor
clarithromycin amoxicillin metronidazole; and 1.8% with bismuth
quadruple therapy. These treatments were significantly more effective in
compliant than in non-compliant patients: 86% versus 44%, 90% versus
71%, and 93% versus 64%, respectively (p < 0.001). In the multivariate
analysis, the variable most significantly associated with higher
effectiveness was adequate compliance (odds ratio, 6.3 [95%CI, 5.2-7.7];
p < 0.001). Conclusions: Compliance with Helicobacter pylori eradication
treatment is very good. Factors associated with poor compliance include
uninvestigated/functional dyspepsia, rescue-treatment, prolonged
treatment regimens, the presence of adverse events, and the use of
non-bismuth sequential and concomitant treatment. Adequate treatment
compliance was the variable most closely associated with successful
eradication.
Filiaciones:
Hosp Gen Univ Valencia, Dept Gastroenterol, Valencia, Spain
Univ Politecn Valencia, Dept Appl Stat & Operat Res & Qual, Valencia,
Spain
Univ Bologna, IRCCS S Orsola Polyclin, Bologna, Italy
Agencia Sanitaria Costa Sol, Red Invest Serv Salud Enfermedades Cron
REDISSEC, Marbella, Spain
Lithuanian Univ Hlth Sci, Dept Gastroenterol, Kaunas, Lithuania
AM DC Rogaska, Dept Gastroenterol, Rogashka Slatina, Slovenia
Hosp Univ Valme, Unidad Aparato Digest, Seville, Spain
AS Loginov Moscow Clin Sci Ctr, Dept Gastroenterol, Moscow, Russia
Hosp Gen Tomelloso, Dept Gastroenterol, Tomelloso, Spain
CIBER Enfermedades Hepat & Digest CIBERehd, Madrid, Spain
Inst Invest Sanitaria Princesa, Madrid, Spain
Inst Invest Sanitaria Castilla La Mancha IDISCAM, Tomelloso 13700, Spain
Hosp Clin Univ Lozano Blesa, Serv Aparato Digest, Zaragoza, Spain
Inst Invest Sanitaria Aragon IIS Aragon, Zaragoza, Spain
CIBEREHD, Zaragoza, Spain
Univ Oviedo, Dept Gastroenterol, Oviedo, Spain
Dept Gastroenterol, Gastrocentr, Perm, Russia
AS Loginov Moscow Clin Sci Ctr, Dept Pancreat Biliary & Upper Digest
Tract Disorde, Moscow, Russia
AI Yevdokimov Moscow State Univ Med & Dent, Dept Propaedeut Internal Dis
& Gastroenterol, Moscow, Russia
Tver State Med Univ, Dept Outpatient Therapy & Family Med, Tver, Russia
IRCCS, Fdn Policlin Univ Agostino Gemelli, Med Interna & Gastroenterol,
Rome, Italy
Azerbaijan State Adv Training Inst Doctors, Dept Therapy, Baku,
Azerbaijan
Mem Clin, Baku, Azerbaijan
Ostfold Hosp Trust, Dept Gastroenterol, Gralum, Norway
Digest Dis Ctr, Dept Gastroenterol, Riga, Latvia
Univ Latvia, Inst Clin & Prevent Med, Riga, Latvia
Henry Dunant Hosp, Dept Gastroenterol, Athens, Greece
Univ Porto, Ctr Hosp Univ Porto, Inst Ciencias Biomed Abel Salazar, Dept
Gastroenterol, Porto, Portugal
Ctr Res Hlth Technol & Informat Syst CINTESIS, P-4200450 Porto, Portugal
Univ Split, Univ Hosp Split, Dept Gastroenterol, Sch Med, Split, Croatia
Govt Inst LT, LT Malaya Therapy Natl Inst Natl Acad Med Sci Ukra, Div
Study Digest Dis & Comorbid Noncommunicable Di, Kharkiv, Ukraine
Aberdeen Royal Infirm, Dept Digest Disorders, Aberdeen, Scotland
Trinity Coll Dublin, Fac Hlth Sci, Dublin, Ireland
Rabin Med Ctr, Div Gastroenterol, Petah Tiqwa, Israel
Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel
Ferencvaros Hlth Ctr, Dept Gastroenterol, Budapest, Hungary
Inst Clin & Expt Med, Hepatogastroenterol Dept, Prague, Czech Republic
Charles Univ Prague, Fac Med 2, Dept Internal Med, Prague, Czech
Republic
Hacettepe Univ, Div Gastroenterol & Hepatol, Sch Med, Ankara, Turkiye
Hop Hotel Dieu, Dept Gastroenterol, CHRU Nantes, Nantes, France
Univ Belgrade, Sch Med, Clin Ctr Serbia, Dept Gastroenterol, Belgrade,
Serbia
Pomeranian Med Univ, Dept Gastroenterol, Szczecin, Poland
Ctr Digest Dis, Endoklin, Szczecin, Poland
Otto von Guericke Univ Hosp, Dept Gastroenterol Hepatol & Infect Dis,
Magdeburg, Germany
Med Univ Sofia, Dept Gastroenterol, Med Microbiol, Sofia, Bulgaria
Kantonsspital Aarau, Med Univ Dept, Div Gastroenterol & Hepatol, Aarau,
Switzerland
Gastroklinik, Horgen, Switzerland
Meander Med Ctr, Dept Gastroenterol & Hepatol, Amersfoort, Netherlands
Althaia Xarxa Assistencial Univ Manresa, GOES Res Grp, Manresa, Spain
Univ Barcelona, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst
Invest Biomed August Pi & Sunyer IDIBAPS, Hosp Clin,Serv Anat Patol,
Barcelona, Spain
Univ Autonoma Madrid UAM, Hosp Univ La Princesa, Ctr Invest Biomed Red
Enfermedades Hepat & Digest, Inst Invest Sanitaria Princesa IIS
Princesa,Gastro, Madrid 28006, Spain
Univ Bordeaux, INSERM, U1312, Bordeaux, France
Hosp Univ Princesa, Gastroenterol Unit, C Diego Leon 62, Madrid 28006,
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