Mari Amir, Na'amnih Wasef, Gahshan Aiman, Ahmad Helal Saied, Khoury Tawfik, Muhsen Khitam
Gastroenterology Department, Nazareth Hospital, Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan 5290002, Israel.
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
J Clin Med. 2022 Jun 3;11(11):3196. doi: 10.3390/jcm11113196.
Purpose: Gastro-esophageal reflux disease (GERD) is prevalent and causes erosive esophagitis (EE) with varying degrees of severity (A to D according to the Los Angeles Classification). Adherence to medical therapy is crucial for treatment success. We compared adherence to treatment recommendations between patients with EE grades C/D and A/B. Methods: A follow-up study was conducted during 2019−2020 among GERD patients who underwent a diagnostic gastroscopy 1−4 years earlier. Telephone interviews were conducted with patients diagnosed with severe EE grades C/D (n = 99) and randomly selected patients with mild−moderate EE grades A/B (n = 50). Patients with grades A/B were classified as adherent if they took proton pump inhibitors (PPIs) for 2−3 months as recommended. Patients with grades C/D were classified as adherent if they took medications for a prolonged period (>6 months) and performed a follow-up endoscopy as recommended. Results: The mean age of the participants was 44.6 years (SD = 15.1). The mean duration of PPIs therapy in patients with EE grades A/B was 9.4 months (SD = 8.7). Fourteen (14.2%) patients with EE grades A/B were non-adherent to treatment, compared to 21 (40.8%) patients with EE grades of C/D: adjusted OR = 0.06; CI 95% 0.02−0.18, p < 0.001. Follow-up endoscopy was performed by 44% of EE−C/D patients. Unmarried patients compared to married ones were less adherent (adjusted OR = 0.23; 95% CI 0.08−0.69, p < 0.001). Conclusions: Patients with esophagitis (EE−A/B) were more adherent to medical therapy when compared to patients with more severe esophagitis (EE−C/D).
胃食管反流病（GERD）很常见，可导致不同严重程度的糜烂性食管炎（EE，根据洛杉矶分类法分为A至D级）。坚持药物治疗对治疗成功至关重要。我们比较了C/D级和A/B级EE患者对治疗建议的依从性。方法：在2019 - 2020年期间，对1 - 4年前接受过诊断性胃镜检查的GERD患者进行了一项随访研究。对诊断为严重C/D级EE的患者（n = 99）和随机选择的轻度 - 中度A/B级EE患者（n = 50）进行了电话访谈。A/B级患者如果按建议服用质子泵抑制剂（PPI）2 - 3个月，则被分类为依从。C/D级患者如果长期服药（>6个月）并按建议进行随访内镜检查，则被分类为依从。结果：参与者的平均年龄为44.6岁（标准差 = 15.1）。A/B级EE患者的PPI治疗平均持续时间为9.4个月（标准差 = 8.7）。A/B级EE患者中有14名（14.2%）不依从治疗，而C/D级EE患者中有21名（40.8%）：调整后的比值比 = 0.06；95%置信区间0.02 - 0.18，p < 0.001。44%的C/D级EE患者进行了随访内镜检查。与已婚患者相比，未婚患者的依从性较差（调整后的比值比 = 0.23；95%置信区间0.08 - 0.69，p < 0.001）。结论：与更严重食管炎（EE - C/D）患者相比，食管炎（EE - A/B）患者对药物治疗的依从性更高。
