改善华中地区基于家庭的幽门螺杆菌感染防控及管理策略的患者依从性及其影响因素。

Improved Patient Adherence to Family-Based Helicobacter pylori Infection Control and Management Strategy in Central China and Its Influencing Factors.

机构信息

Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China.

Department of Gastroenterology and Hepatology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China.

出版信息

Helicobacter. 2024 Jul-Aug;29(4):e13114. doi: 10.1111/hel.13114.

DOI:10.1111/hel.13114

PMID:39031966

Abstract

BACKGROUND

Patient adherence status to the newly introduced family-based Helicobacter pylori (H. pylori) infection control and management strategy remains unclear, so are its influencing factors. We aim to investigate family members' adherence and its influencing factors during the family-based H. pylori infection management practice for related disease prevention.

MATERIALS AND METHODS

Based on our previously family-based H. pylori survey in 2021, 282 families including 772 individuals were followed up 2 years after the initial survey to compare if the investigation and education might improve family member's adherence. The participant's adherence to H. pylori infection awareness, retest, treatment, publicity, gastroscopy, and hygiene habits were followed up, and their influencing factors were also analyzed.

RESULTS

The overall participant's adherence to recommendations on H. pylori awareness, retest, treatment, publicity, gastroscopy, and hygiene habits were 77% (187/243), 67.3% (138/205), 60.1% (211/351), 46.5% (107/230), 45.6% (159/349), and 39.1% (213/545), respectively; and all showed improvements compared with their prior survey stages. The top reasons for rejection to treatment, retest, and gastroscopy were forgetting or unaware of H. pylori infection (30.3%), busy (32.8%), and asymptomatic (67.9%), respectively. Independent risk factor for low adherence to treatment was occupation (e.g., staff: OR 4.49, 95% CI 1.34-15.10). Independent favorable factors for treatment adherence were individuals at the ages of 18-44 years (OR 0.19, 95% CI 0.04-0.89) and had a large family size (e.g., four family members: OR 0.15, 95% CI 0.06-0.41); for retest adherence, it was individuals at the ages of 60-69 years (OR 0.23, 95% CI 0.06-0.97); for gastroscopy adherence, it was individuals at the age of 60-69 years (OR 0.46, 95% CI 0.28-0.75), and with gastrointestinal symptoms (OR 0.57, 95% CI 0.36-0.90).

CONCLUSIONS

Family-based H. pylori management increases individual adherence to treatment, retest, and awareness, and there are also improved adherence to gastroscopy, publicity, and personal hygiene recommendations; further efforts are required to enhance the individual adherence rate for related disease prevention.

摘要

背景

新引入的基于家庭的幽门螺杆菌（H. pylori）感染控制和管理策略的患者依从性状况尚不清楚，其影响因素也是如此。我们旨在研究家庭在基于家庭的 H. pylori 感染管理实践中预防相关疾病期间的依从性及其影响因素。

材料和方法

基于我们 2021 年进行的基于家庭的 H. pylori 调查，对 282 个家庭（共 772 人）进行了随访，随访时间为初次调查后 2 年，以比较调查和教育是否可以提高家庭成员的依从性。我们对参与者对 H. pylori 感染意识、复查、治疗、宣传、胃镜检查和卫生习惯的依从性进行了随访，并分析了其影响因素。

结果

总体而言，参与者对 H. pylori 意识、复查、治疗、宣传、胃镜检查和卫生习惯建议的依从率分别为 77%（187/243）、67.3%（138/205）、60.1%（211/351）、46.5%（107/230）、45.6%（159/349）和 39.1%（213/545），与之前的调查阶段相比均有所提高。拒绝治疗、复查和胃镜检查的主要原因分别是忘记或不知道自己感染了 H. pylori（30.3%）、忙碌（32.8%）和无症状（67.9%）。治疗依从性低的独立危险因素是职业（例如，员工：OR 4.49，95%CI 1.34-15.10）。治疗依从性的独立有利因素是年龄在 18-44 岁的个体（OR 0.19，95%CI 0.04-0.89）和大家庭规模（例如，四口之家：OR 0.15，95%CI 0.06-0.41）；对于复查依从性，年龄在 60-69 岁的个体（OR 0.23，95%CI 0.06-0.97）是有利因素；对于胃镜检查依从性，年龄在 60-69 岁的个体（OR 0.46，95%CI 0.28-0.75）和有胃肠道症状的个体（OR 0.57，95%CI 0.36-0.90）是有利因素。