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.
Huguet, J. M., Ferrer-Barceló, L., Suárez, P., Barcelo-Cerda, S., Sempere, J., Saracino, I. M., Fiorini, G., Vaira, D., Pérez-Aísa, Á., Jonaitis, L., Tepes, B., Castro-Fernandez, M., Pabón-Carrasco, M., Keco-Huerga, A., Voynovan, I., Lucendo, A. J., Lanas, Á., Martínez-Domínguez, S. J., Alfaro Almajano, E., Rodrigo, L., Vologzanina, L., Bordin, D. S., Gasbarrini, A., Babayeva, G., Lerang, F., Leja, M., Kupčinskas, J., Rokkas, T., Marcos-Pinto, R., Meštrović, A., Gridnyev, O., Phull, P. S., Smith, S. M., Boltin, D., Buzás, G. M., Kral, J., Şimşek, H., Matysiak-Budnik, T., Milivojevic, V., Marlicz, W., Venerito, M., Boyanova, L., Doulberis, M., Capelle, L. G., Cano-Català, A., Moreira, L., Nyssen, O. P., Mégraud, F., O'Morain, C., Gisbert, J. P., (Abstract) Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management, <<UNITED EUROPEAN GASTROENTEROLOGY JOURNAL>>, N/A; (N/A): N/A-N/A. [doi:10.1002/ueg2.12569] [https://hdl.handle.net/10807/277638]
Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management
Gasbarrini, Antonio;
2024
Abstract
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.
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