%0 Journal Article
%T Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management.
%A Huguet JM
%A Ferrer-Barceló L
%A Suárez P
%A Barcelo-Cerda S
%A Sempere J
%A Saracino IM
%A Fiorini G
%A Vaira D
%A Pérez-Aísa Á
%A Jonaitis L
%A Tepes B
%A Castro-Fernandez M
%A Pabón-Carrasco M
%A Keco-Huerga A
%A Voynovan I
%A Lucendo AJ
%A Lanas Á
%A Martínez-Domínguez SJ
%A Alfaro Almajano E
%A Rodrigo L
%A Vologzanina L
%A Bordin DS
%A Gasbarrini A
%A Babayeva G
%A Lerang F
%A Leja M
%A Kupčinskas J
%A Rokkas T
%A Marcos-Pinto R
%A Meštrović A
%A Gridnyev O
%A Phull PS
%A Smith SM
%A Boltin D
%A Buzás GM
%A Kral J
%A Şimşek H
%A Matysiak-Budnik T
%A Milivojevic V
%A Marlicz W
%A Venerito M
%A Boyanova L
%A Doulberis M
%A Capelle LG
%A Cano-Català A
%A Moreira L
%A Nyssen OP
%A Mégraud F
%A O'Morain C
%A Gisbert JP
%A
%J United European Gastroenterol J
%V 12
%N 6
%D 2024 Jul 29
%M 38685613
%F 6.866
%R 10.1002/ueg2.12569
%X 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.