Dikareva E.A.
The influence of the adherence to the therapy with proton pump inhibitors on the occurrence rate of gastropathy induced by the nonsteroidal anti-inflammatory drugs intake
Education establishment "Vitebsk State Order of Peoples’ Friendship Medical University"
Abstract.
The aim of the research was to study the influence of the adherence to proton pump inhibitors (IPP) therapy on the development frequency of erosive-ulcerous lesions of the gastroduodenal mucous membrane (MM) in patients suffering from rheumatoid arthritis (RA), psoriatic arthritis (PA) and osteoarthrosis (OA). 186 patients, who for a long time used nonsteroidal anti-inflammatory drugs (NSAID) were examined. 120 persons out of them took IPP for preventive purposes and 66 – did not use this group of drugs. There were no differences in age, disease duration and the used nonsteroidal anti-inflammatory drugs (NSAID) between these groups. The adherence to the IPP pharmacotherapy was estimated with the help of survey by Medication Adherence Questionnaire (MAQ) of 120 patients taking IPP. The erosive-ulcerous lesions of MM of the stomach and duodenum were determined with the videooesophagogastroduodenoscopy. All the patients were examined by means of this method. The results of the questionnairing with MAQ use permitted to identify subgroups of the patients with low, middle and high adherence to the IPP therapy. Gastropathy induced by the NSAID intake (NSAID-gastropathy) was determined in 50,0% of cases in patients, who did not take IPP, in 62,07% of the examined persons with low adherence, in 9,52% – with middle adherence and in 2,04% of patients – with high adherence to the IPP therapy. NSAID-gastropathy occurred more often in patients with low adherence to the IPP therapy in comparison with those, who had high (h2=32,44; p<0,001) and middle (<2=19,76; p<0,001) adherence to this therapy. Less than a half of the examined patients (40,83%) strictly followed doctor’s instructions concerning the IPP intake with the purpose of preventing NSAID-gastropathy. Low adherence to the preventive IPP using led to the increase of the erosive-ulcerous lesions rate in the gastroduodenal MM. It can be discussed as an additional risk factor of NSAID-gastropathy development in patients taking NSAID for a long time.
Key words: proton pump inhibitors, adherence to the therapy, NSAID-gastropathy.
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