Department of Gastroenterology, University of São Paulo, School of Medicine, São Paulo, Brazil.
Dis Esophagus. 2012 Feb;25(2):107-13. doi: 10.1111/j.1442-2050.2011.01227.x. Epub 2011 Jul 21.
To assess adherence to proton pump inhibitor (PPI) treatment and associated variables in patients with gastroesophageal reflux disease (GERD). Cross-sectional and prospective comprising 240 consecutive adult patients, diagnosed with GERD for whom continuous use of standard or double dose of omeprazole had been prescribed. Patients were ranked as ne-GERD (162: 67.5%) or e-GERD classified according to the Los Angeles classification as A (48:20.0%), B (21:8.6%), C (1:0.5%), D (1:0.5%), and Barrett's esophagus (7:2.9%). The Morisky questionnaire was applied to assess adherence to therapy and a GERD questionnaire to assess symptoms and their impact. Adherence was correlated with demographics, cotherapies, comorbidities, treatment duration, symptoms scores, endoscopic findings, and patient awareness of their disease. 126 patients (52.5%) exhibited high level of adherence and 114 (47.5%) low level. Youngers (P= 0.002) or married (O.R. 2.41, P= 0.03 vs. widowers) patients had lower levels of adherence; symptomatic patients exhibited lower adherence (P= 0.02). All other variables studied had no influence on adherence. Patients with GERD attending a tertiary referral hospital in São Paulo exhibited a high rate of low adherence to the prescribed PPI therapy that may play a role in the therapy failure. Age <60 years, marital status and being symptomatic were risk factors for low adherence.
评估胃食管反流病（GERD）患者质子泵抑制剂（PPI）治疗的依从性及其相关变量。这项横断面和前瞻性研究包括 240 例连续的成年患者，这些患者被诊断为 GERD，连续使用标准剂量或双倍剂量奥美拉唑治疗。根据洛杉矶分类，患者被分为非 GERD（162 例：67.5%）或 e-GERD（A 级 48 例：20.0%，B 级 21 例：8.6%，C 级 1 例：0.5%，D 级 1 例：0.5%，巴雷特食管 7 例：2.9%）。应用 Morisky 问卷评估治疗依从性，GERD 问卷评估症状及其影响。将依从性与人口统计学、共治疗、合并症、治疗持续时间、症状评分、内镜检查结果和患者对疾病的认识相关联。126 例（52.5%）患者表现出高度的依从性，114 例（47.5%）患者表现出低度的依从性。年轻患者（P=0.002）或已婚患者（OR 2.41，P=0.03 比鳏夫）依从性较低；有症状的患者依从性较低（P=0.02）。所有其他研究变量对依从性没有影响。在圣保罗的一家三级转诊医院就诊的 GERD 患者表现出对处方 PPI 治疗高度不依从，这可能在治疗失败中发挥作用。年龄<60 岁、婚姻状况和有症状是低依从性的危险因素。
