Zhang Xiaotao, Anandasabapathy Sharmila, Abrams Julian, Othman Mohamed, Badr Hoda J
Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, Texas.
Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas.
Glob Adv Health Med. 2021 Mar 8;10:21649561211001346. doi: 10.1177/21649561211001346. eCollection 2021.
Lifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett's Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population.
Patients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported on lifestyle risk factors, adherence determinants (e.g., perceived benefits/barriers, risk, intentions), QOL, and intervention preferences.
Most patients (56%) had uncontrolled reflux, were overweight/obese (65.1%), and had low dietary fiber intake (91%). Many (45%) reported poor QOL. Patients' perceived risk of developing esophageal cancer was high, but their behavior change intentions were low. Despite receiving lifestyle counseling from physicians, there were no significant changes in patients' QOL or lifestyle risk factors over time. Nonetheless, patients indicated strong interest in internet (62.6%) and multimedia programs (57.9%) addressing acid reflux and weight control.
BE patients reported uncontrolled reflux, poor QOL, and multiple lifestyle risk factors that did not change over time. Despite low levels of intention for making lifestyle changes, patients were interested receiving more information about controlling acid reflux, suggesting a potential teachable moment and opportunity for web-based and multimedia multiple behavior interventions that seek to control acid reflux symptoms through weight loss and a high fiber diet.
通过生活方式咨询来实现健康体重、戒烟和减少饮酒是巴雷特食管（BE）管理的基石。然而，对于患者是否做出这些推荐的生活方式改变，或者不依从对其生活质量（QOL）的影响，我们知之甚少。本研究对BE患者的生活方式风险因素、生活质量和干预偏好进行了特征描述，作为为该人群制定生活方式改变干预措施的第一步。
确诊为BE的患者（N = 106）在监测内镜检查就诊时（基线）以及3个月和6个月随访时完成调查。患者报告了生活方式风险因素、依从性决定因素（如感知到的益处/障碍、风险、意图）、生活质量和干预偏好。
大多数患者（56%）有未控制的反流，超重/肥胖（65.1%），膳食纤维摄入量低（91%）。许多患者（45%）报告生活质量差。患者认为患食管癌的风险很高，但他们改变行为的意图很低。尽管接受了医生的生活方式咨询，但随着时间的推移，患者的生活质量或生活方式风险因素没有显著变化。尽管如此，患者对解决胃酸反流和体重控制问题的互联网（62.6%）和多媒体节目（57.9%）表现出浓厚兴趣。
BE患者报告有未控制的反流、生活质量差和多种生活方式风险因素，且这些因素随时间没有改变。尽管改变生活方式的意愿较低，但患者有兴趣获得更多关于控制胃酸反流的信息，这表明存在一个潜在的可教育时机，以及通过基于网络和多媒体的多种行为干预来控制胃酸反流症状的机会，这些干预措施旨在通过减肥和高纤维饮食来实现。
