Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Laboratory of Translational Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Helicobacter. 2022 Apr;27(2):e12880. doi: 10.1111/hel.12880. Epub 2022 Feb 12.
Helicobacter pylori (H. pylori) infections are of serious concern due to the associated risk of gastric cancer. However, many patients have poor medication and therapy compliance, which makes it difficult to eradicate their infections. This points to the need for stronger educational interventions aimed at enhancing compliance, thus increasing the potential for treatment success. As such, this study conducted a meta-analysis to clarify the effects of enhanced patient education (EPE) programs for H. pylori.
We searched electronic databases (PubMed, EMBASE, Web of Science, and Cochrane Library) for randomized controlled trials (RCTs) on health education for patients infected with H. pylori from inception to June 2021. The primary outcome was the eradication rate of H. pylori, while the secondary outcomes included the incidence of individual adverse symptoms, treatment compliance, clinical symptom remission after treatment, and patient satisfaction. We used the fixed or random-effects model to pool the risk ratio (RR), with 95% confidence interval. We also conducted sensitivity and subgroup analyses.
Our search returned seven relevant studies across a total of 1,433 patients. Compared with controls, EPE was significantly associated with improved H. pylori eradication rates (RR = 1.16, 95%CI: 1.04-1.29, p = 0.006) and patient compliance (RR = 1.48, 95%CI: 1.14-1.93, p = 0.003). A subgroup analysis also showed that EPE benefits were consistent across patients with different eradication programs, WeChat intervention plans, and intervention frequencies (p < 0.05). However, there were no significant differences in the total adverse effects, common side effects (diarrhea, nausea, abdominal pain, taste disorder, and skin rash), or discontinuation rate (p > 0.05).
Patient education is inexpensive, safe, and convenient. In this context, our findings suggest that enhanced educational interventions have positive effects on both the H. pylori eradication rate and adherence among infected patients, and thus constitute promising complements to clinical treatment regimens.
由于与胃癌相关的风险，幽门螺杆菌（H. pylori）感染受到严重关注。然而，许多患者的药物治疗和治疗依从性较差，这使得根除其感染变得困难。这表明需要更强有力的教育干预措施来提高依从性，从而提高治疗成功的可能性。因此，本研究进行了荟萃分析，以阐明增强患者教育（EPE）计划对 H. pylori 的影响。
我们从成立到 2021 年 6 月，在电子数据库（PubMed、EMBASE、Web of Science 和 Cochrane Library）中搜索了针对 H. pylori 感染患者的健康教育培训的随机对照试验（RCT）。主要结局是 H. pylori 的根除率，次要结局包括个体不良反应的发生率、治疗依从性、治疗后临床症状缓解和患者满意度。我们使用固定或随机效应模型来汇总风险比（RR），置信区间为 95%。我们还进行了敏感性和亚组分析。
我们的搜索共返回了 7 项涉及 1433 名患者的相关研究。与对照组相比，EPE 与 H. pylori 根除率的提高显著相关（RR=1.16，95%CI：1.04-1.29，p=0.006）和患者依从性（RR=1.48，95%CI：1.14-1.93，p=0.003）。亚组分析还表明，EPE 的益处在不同的根除方案、微信干预计划和干预频率的患者中是一致的（p<0.05）。然而，总不良反应、常见副作用（腹泻、恶心、腹痛、味觉障碍和皮疹）或停药率无显著差异（p>0.05）。
患者教育既经济实惠又安全方便。在这种情况下，我们的研究结果表明，增强教育干预措施对感染患者的 H. pylori 根除率和依从性都有积极影响，因此构成了对临床治疗方案的有前途的补充。
