{Reference Type}: Journal Article
{Title}: Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management.
{Author}: Huguet JM;Ferrer-Barceló L;Suárez P;Barcelo-Cerda S;Sempere J;Saracino IM;Fiorini G;Vaira D;Pérez-Aísa Á;Jonaitis L;Tepes B;Castro-Fernandez M;Pabón-Carrasco M;Keco-Huerga A;Voynovan I;Lucendo AJ;Lanas Á;Martínez-Domínguez SJ;Alfaro Almajano E;Rodrigo L;Vologzanina L;Bordin DS;Gasbarrini A;Babayeva G;Lerang F;Leja M;Kupčinskas J;Rokkas T;Marcos-Pinto R;Meštrović A;Gridnyev O;Phull PS;Smith SM;Boltin D;Buzás GM;Kral J;Şimşek H;Matysiak-Budnik T;Milivojevic V;Marlicz W;Venerito M;Boyanova L;Doulberis M;Capelle LG;Cano-Català A;Moreira L;Nyssen OP;Mégraud F;O'Morain C;Gisbert JP; ;
{Journal}: United European Gastroenterol J
{Volume}: 12
{Issue}: 6
{Year}: 2024 Jul 29
{Factor}: 6.866
{DOI}: 10.1002/ueg2.12569
{Abstract}: <B>BACKGROUND: </B>Adherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy.<BR><B>OBJECTIVE: </B>To determine which factors influence compliance with treatment.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.