The influence of antisecretory therapy adherence on the risk of the development of gastropathy induced by the administration of nonsteroidal anti-inflammatory agents
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2019;18(4):60-66.
Objectives. To assess the degree of adherence to therapy with proton-pump inhibitors (PPIs) among patients with rheumatoid arthritis who have been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for a long time.
Material and methods. In a one-time comparative study aimed at assessing the influence of adherence to antisecretory therapy on the risk of gastropathy development induced by taking NSAIDs (NSAIDs-gastropathy), 56 patients (9 men and 47 women) were involved who were ill with rheumatoid arthritis and received NSAIDs and PPIs for a long time. The evaluation of adherence to PPIs therapy was carried out using the universal Medication Adherence Questionnaire. On the basis of the data obtained, all respondents were divided into three groups: with low (group I), medium (group II) and high (group III) adherence to preventive PPIs treatment.
Results. More than half of those who participated in the study (55.4%) had low or medium adherence to this therapy. Low adherence to PPIs therapy was diagnosed in 21.4% of cases.
In group I, NSAIDs-gastropathy was found statistically significantly more common than in group III (χ2=8.39; p=0.004). The odds ratio (OR) for the development of NSAIDs-gastropathy in group I compared with group III was 24.0 (95% CI: 2.41–238.94). Also in group I, NSAIDs-gastropathy was revealed statistically more often in comparison with group II (χ2=4.10; p=0.043). OR of occurrence of NSAIDs-gastropathy in group I compared to group II amounted to 8.50 (95% CI: 1.33–54.13).
Conclusions. In case of low adherence to PPIs therapy, erosive-ulcerative mucosal damage to the gastroduodenal zone, induced by NSAIDs, was observed 24.0 times more frequently compared with high adherence and 8.5 times more often in comparison with average adherence to this drug therapy.
Key words: nonsteroidal anti-inflammatory drugs, adherence, antisecretory drugs, proton-pump inhibitors.
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Information about authors:
Dikareva E.A. – Candidate of Medical Sciences, associate professor of the General Practitioner Chair with the course of Outpatient Therapy, Vitebsk State Order of Peoples’ Friendship Medical University.