Assessment of medication adherence in Helicobacter pylori positive patients on standard triple therapy: a prospective study
Keywords:Helicobacter pylori, Standard triple therapy, Rapid urease test, MGL adherence
Background: In the current study patient compliance to the standard triple therapy were assessed. The objective behind this research was to assess the patient medication adherence to the standard triple therapy in Helicobacter pylori infection.
Methods: A prospective study was carried out for a period of 1 year and samples were taken from the gastroenterology department. Patient who was RUT (rapid urease test) positive by endoscopy were considered as H. pylori infected and they were prescribed with standard triple therapy. This regimen involves amoxicillin 1000 mg and clarithromycin 500 mg and proton pump inhibitor (PPI) twice a day for 14 days. Adherence to this triple therapy was assessed during the study. Medication adherence assessed using Morisky, Green and Levine (MGL) adherence scale. MGL adherence questionnaire was given to patients during first week and second week of therapy. The patients will be counselled regarding the drug administration, drug related problems and the infection. They were also provided with written instructions in leaflets. 88 patients were analyzed.
Results: In this study, 84 patients had a good adherence 95.5%; but other 4.5% didn't fully comply with the physician's order. After the first week of standard triple therapy, adherence was increased to a mean score from 2.193±0.1301 to 3.5227±0.0704 in the second week. The medication adherence score significantly increased along with patient counselling.
Conclusions: Medication adherence was improved in the 14 days course along with patient education helped to comply with the standard triple therapy.
Barkun A, Leontiadis G. Systematic review of the symptom burden, quality-of-life impairment, and costs associated with peptic ulcer disease. Am J Med. 2010;123(4):358-66.
Tripathi KD. Drugs for Peptic Ulcer and Gastroesophageal Reflux disease. In: Essentials of Medical Pharmacology. 7th Ed. New Delhi, Jaypee Brothers Medical Publishers (P) LTD; 2013:651-658.
Shrestha SS, Bhandari M, Thapa SR, Shrestha R, Poudyal R, Purbey B, et al. Medication adherence pattern and factors affecting adherence in Helicobacter pylori eradication therapy. Kathmandu University Med J. 2016;14(53):58-64.
Lind T, Veldhuyzen VZS, Unge P, Spiller R, Bayerdorffer E, Morain CO, et al. Eradication of Helicobacter pylori Using One‐week Triple Therapies Combining Omeprazole with Two Antimicrobials: The MACH I Study. National Library Med. 1996;1:138-44.
Eidan FA, Elnay MJC, Scott MG, Connel MJB. Management of Helicobacter pylori eradication-the influence of structured counselling and follow-up. Br J Clin Pharmacol. 2002;53(2):163-71.
Lefebvre M, Chang HJ, Morse A, Veldhuyzen SVZ. Karen Jean Goodman and can help Working Group. Adherence and barriers to H. pylori treatment in Arctic Canada. Int J Circumpolar Health. 2013;72(1):22791.
Paula AM, Patricia AF, Alves FDC, Jose C. How to measure (or not) compliance to eradication therapy. Pharmacy Practice. 2006;4(2):88-94.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(19):487-97.
Schwartz GF. Identifying and measuring patient adherence and persistency. Adv stud Ophthalmol. 2007;4(3):68-71.
Abbasinazari M, Sahraee Z, Mirahmadi M. The Patient’s Adherence and Adverse Drug Reactions (ADRs) which are Caused by Helicobacter pylori Eradication Regimens. J Clin Diagnos Res. 2013;7(3):462-6.
Gaspretto M, Pescarin M, Guariso G. Helicobacter eradication therapy: current availabilities. ISRN Gastroenterol. 2012;2012:186734.
Mansour NM, Hashash JG, Halabi EM, Ghaith O, Maasri K, Sukkarieh I, et al. A randomized trial of standard-dose versus half-dose rabeprazole, clarithromycin and amoxicillin in the treatment of helicobacter pylori infection. Eur J Gastroenterol Hepatol. 2011;23:865-70.
Muzaffar MUD, Muzzafer MM, Sajad S, Yawar Y, Majid KR, Intikhab M, et al. Sequential therapy versus standard triple therapy in helicobacter eradication. Global J Digestive Dis. 2018;4(3):6.
Wang J, Zhang G, Xiaona H, Liu Y, Zhijun B, Huang Y. Two weeks triple therapy has a higher Helicobacter pylori eradication rate than 1-week therapy: a single-center randomized study. Saudi J Gastroenterology. 2015;21(6):355-9.
Mamori S, Higashida A, Kawara F, Ohnishi K, Takeda A, Senda E, et al. Age dependent eradication of Helicobacter pylori in Japanese patients. World J Gastroenterol. 2010;16:4176-9.
Fuller R. Probiotics in human medicine. Ann Med. 1990;22:37-41.
Lewis SJ, Freedman AR. Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal diseases. Alimen Pharmacol Ther. 1998;12:807-22.
Armuzzi A, Cremonini F, Bartolozzi F, Canducci F, Candelli M, Ojetti V, et al. The effect of oral administration of Lactobacillus GG on antibiotic‐associated gastrointestinal side‐effects during Helicobacter pylori eradication therapy. Alimentary Pharmacol Therap. 2001;15:163-9.