Comparison in Adherence to Treatment between Patients with Mild–Moderate and Severe Reflux Esophagitis: A Prospective Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Population
2.2. Endoscopy Procedure
2.3. Data Collection
2.4. Definition of the Study Variables
2.5. Potential Confounders
2.6. Statistical Analysis
2.7. Sample Size Calculation
2.8. Ethical Aspects
3. Results
3.1. Description of the Study Sample
3.2. Adherence to Recommendations and Utilization of Healthcare Services
3.3. Bivariate Analysis of Associations of Demogrpahics and Clinical Factors with Adherence
3.4. Multivariable Logistic Regression Models for Factors Associated with Adherence
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Ethics Approval
Abbreviations
BMI | Body Mass Index |
CI | Confidence Interval |
EE | Erosive Esophagitis |
GERD | Gastro-esophageal Reflux Disease |
OR | Odds Ratio |
PPI | Proton pump inhibitors |
RDQ | Reflux Disease Questionnaire |
SD | Standard Deviation |
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Overall n = 149 | EE Grades A/B (n = 99) | EE Grades C/D (n = 50) | p * | |
---|---|---|---|---|
Mean age at baseline (years), (SD) | 44.5 (15.1) | 43.8 (14.4) | 46.1 (16.4) | 0.40 |
Mean age at follow up (years), (SD) | 46.2 (14.9) | 45.0 (14.4) | 48.5 (15.9) | 0.20 |
Sex | 0.05 | |||
Male | 99 (66.4%) | 61 (61.6%) | 38 (76.0%) | |
Female | 50 (36.6%) | 38 (38.4%) | 12 (24.0%) | |
Ethnicity | 0.28 | |||
Arabs | 138 (92.6%) | 93 (93.9%) | 45 (90.0%) | |
Jews | 11 (7.4%) | 6 (6.1%) | 5 (10.0%) | |
BMI (kg/m2) ((continuous variable) (mean), (SD)) | 28.4 (4.6) | 28.0 (4.9) | 29.0 (3.8) | 0.23 |
BMI (categorical) | 24 (24.2%) | 5 (10.0%) | ||
BMI 20–24 (normal) | 48 (48.4%) | 25 (50.0%) | 0.03 | |
BMI 25–29 (overweight) | 27 (27.2%) | 20 (40.0%) | ||
BMI ≥ 30 (obesity) | ||||
Marital status | 0.05 | |||
Married | 108 (72.5%) | 68 (68.4%) | 41 (82.0%) | |
Not married (single, divorced, widow) | 40 (27.5%) | 31 (31.6%) | 9 (18.0%) | |
Number of schooling, years, mean, (SD) | 11.7 (3.3) | 12.1 (3.3) | 10.8 (3.2) | 0.03 |
Smoking | 0.20 | |||
Ever smoker (past and current) | 60 (40.3%) | 37 (37.4%) | 23 (46.0%) | |
Never smoker | 89 (59.7%) | 62 (62.6%) | 27 (64.0%) | |
Alcohol consumption | 0.38 | |||
Yes | 15 (10.1%) | 9 (9.1%) | 6 (12.0%) | |
No | 102 (68.5%) | 90 (90.9%) | 44 (44.0%) | |
Physical activity for 30 min at least once a week | 0.53 | |||
Yes | 47 (31.5%) | 31 (31.3%) | 16(32.0%) | |
No | 102 (68.5%) | 68 (68.7%) | 34 (68.0%) |
EE Grades A/B (n = 99) | EE Grades C/D (n = 50) | p * | |
---|---|---|---|
Adherence to treatment, yes | 85 (85.8%) | 29 (59.2%) | <0.001 |
PPI therapy recommended at the endoscopy report | 72 (72.7%) | 27 (67.5%) | 0.53 |
PPI therapy duration documented at the endoscopy report | 28 (38.9%) | 6 (12.0%) | 0.12 |
Type of PPI | 0.14 | ||
Nexium | 35 (35.5%) | 36 (72.0%) | |
Lanton | 24 (24.2%) | 7 (14.0%) | |
Omepradex | 21 (21.2%) | 6 (12.0%) | |
Contraloc | 1 (1.0%) | 1 (2.0%) | |
Dose of PPI recommended | 0.71 | ||
20 mg | 58 (58.6%) | 27 (54.6%) | |
30 mg | 24 (24.2%) | 7 (14.0%) | |
40 mg | 17 (17.2%) | 16 (32.0%) | |
Dietary recommendation by physician | 37 (37.4%) | 20 (40.0%) | 0.85 |
Did you change your dietary habits as recommended? | 0.85 | ||
Yes | 32 (32.3%) | 17 (34.0%) | |
No | 67 (67.7%) | 33 (66.0%) | |
Did you change your diet as recommended | 0.50 | ||
Yes | 17 (17.2%) | 11 (22.0%) | |
No | 82 (82.8%) | 39 (78.0%) | |
Visit to specialist in gastroenterology | 0.12 | ||
Yes | 10 (10.1%) | 10 (20.0%) | |
No | 89 (89.9%) | 40 (80.0%) | |
Referral to a dietician | 0.73 | ||
Yes | 6 (6.1%) | 4 (8.0%) | |
No | 93 (93.9%) | 46 (92.0%) | |
Visit to a dietician | 1.00 | ||
Yes | 20 (20%) | 12 (25.0%) | |
No | 80 (80.0%) | 37 (74.0%) | |
Emergency room visit due to GERD symptoms | 0.38 | ||
Yes | 17 (17.2%) | 12 (24.0%) | |
No | 82 (82.8%) | 38 (76.0%) |
Adherence to Treatment (n = 107) | No Adherence to Treatment (n = 41) | p * | |
---|---|---|---|
Degree of esophagitis | <0.001 | ||
EE–C/D | 20 (18.7%) | 29 (70.7%) | |
EE–A/B | 87 (81.3%) | 12 (29.3%) | |
Sex | 0.84 | ||
Male | 70 (65.4%) | 28 (68.3%) | |
Female | 37 (34.6%) | 13 (31.7%) | |
BMI (kg/m2) (categorical) | 0.87 | ||
BMI 20–24 | 22 (20.8%) | 7 (17.1%) | |
BMI 25–29 | 51 (48.1%) | 21 (51.2%) | |
BMI ≥ 30 | 33 (31.1%) | 13 (31.7%) | |
Marital status | 0.30 | ||
Unmarried | 26 (74.5%) | 14 (34.1%) | |
Symptoms severity (RDQ) | 0.57 | ||
Regurgitation scale above median | 43(40.2%) | 19 (46.3%) | |
Heartburn scale above median | 49(45.8%) | 19 (46.3%) | 1.00 |
Dyspepsia scale above median | 43 (40.2%) | 18 (43.9%) | 0.71 |
PPI treatment at endoscopy report | 99 (79.4%) | 19 (51.4%) | 0.001 |
Married | 80 (75.5%) | 27 (65.9%) | |
BMI (kg/m2) ((continuous) (mean), (SD)) | 28.23 (4.2) | 28.93 (5.3) | 0.82 |
Age, mean, (SD) | 43.55 (14.1) | 47.29 (16.7) | 0.13 |
Number of schooling years mean, (SD) | 12.02 (3.2) | 10.71 (3.4) | 0.03 |
Charlson’s index, mean, (SD) | 1.41 (2.4) | 2.04 (2.7) | 0.26 |
Variable | OR (95% CI) | p |
---|---|---|
Marital status | <0.001 | |
(Unmarried vs. married) | 0.23 (0.08–0.69) | |
Age (years) | 0.97 (0.94–1.01) | 0.24 |
Sex | 0.62 | |
(Female vs. male) | 0.78 (0.29–2.06) | |
Schooling years | 1.04 (0.90–1.21) | 0.53 |
Esophagitis severity | <0.001 | |
(C/D vs. A/B) | 0.06 (0.02–0.17) | |
BMI (kg/m2) (categorical) | ||
BMI 20–24 | Reference | |
BMI 25–29 | 1.52 (0.43–5.36) | 0.54 |
BMI ≥ 30 | 1.91 (0.49–7.40) | 0.34 |
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Mari, A.; Na’amnih, W.; Gahshan, A.; Ahmad, H.S.; Khoury, T.; Muhsen, K. Comparison in Adherence to Treatment between Patients with Mild–Moderate and Severe Reflux Esophagitis: A Prospective Study. J. Clin. Med. 2022, 11, 3196. https://doi.org/10.3390/jcm11113196
Mari A, Na’amnih W, Gahshan A, Ahmad HS, Khoury T, Muhsen K. Comparison in Adherence to Treatment between Patients with Mild–Moderate and Severe Reflux Esophagitis: A Prospective Study. Journal of Clinical Medicine. 2022; 11(11):3196. https://doi.org/10.3390/jcm11113196
Chicago/Turabian StyleMari, Amir, Wasef Na’amnih, Aiman Gahshan, Helal Saied Ahmad, Tawfik Khoury, and Khitam Muhsen. 2022. "Comparison in Adherence to Treatment between Patients with Mild–Moderate and Severe Reflux Esophagitis: A Prospective Study" Journal of Clinical Medicine 11, no. 11: 3196. https://doi.org/10.3390/jcm11113196
APA StyleMari, A., Na’amnih, W., Gahshan, A., Ahmad, H. S., Khoury, T., & Muhsen, K. (2022). Comparison in Adherence to Treatment between Patients with Mild–Moderate and Severe Reflux Esophagitis: A Prospective Study. Journal of Clinical Medicine, 11(11), 3196. https://doi.org/10.3390/jcm11113196