Twice daily short‐message‐based re‐education could improve Helicobacter pylori eradication rate in young population: A prospective randomized controlled study

Abstract

Background To investigate the effects of twice daily short‐message‐based re‐education (SMRE) before taking medicine for Helicobacter pylori (H pylori) eradication. Materials and Methods Treatment‐naive patients with H pylori infection were prescribed 14‐day quadruple regimen consisting of lansoprazole 30 mg, colloidal bismuth pectin 200 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily. Patients were randomly allocated to SMRE group or control group. Patients in control group received oral and written instructions at outpatient clinic. In contrast, patients in the SMRE group received extra short messages including dosage and time of administration twice daily. Successful H pylori eradication was assessed using the 13C‐urea breath test 6 weeks after treatment. The compliance, adverse events, and patient satisfaction were also analyzed. Results A total of 310 patients were enrolled in the intention‐to‐treat (ITT) and 283 in the per‐protocol (PP) analysis. For young patients, the eradication rates were significantly higher in SMRE group than those in control group in PP analysis (88.6% vs 71.2%, P = 0.036), while for patients of all age groups, the eradication rate improvements were not statistically significant. The eradication rates in SMRE group and control group were 74.2% and 67.7% (P = 0.211) in ITT analysis and 82.1% and 73.4% (P = 0.078) in PP analysis, respectively. The compliance in SMRE group was significantly better than that in control group (84.8% vs 72.8%, P = 0.011). Conclusions Twice daily SMRE could improve the eradication rate in young population, as well as the compliance with treatment during H pylori eradication.

AGA Clinical Practice Update on the Management of Refractory Helicobacter pylori Infection: Expert Review

“…Two recent large randomized controlled trials from China demonstrated that the use of an interactive smartphone medical application 20 and text-based reminders 21 during treatment improved adherence to primary therapy. These adjunctive systems are worthy of further investigation in the United States for refractory H pylori infection and would provide information on which approaches might be more effective in certain populations compared with others; for example, based on characteristics such as age, race and ethnicity, educational level, access, and language.…”

Current status of Helicobacter pylori eradication and risk factors for eradication failure

“…It is, therefore, worthwhile to explore methods to improve the eradication rate. A previous study reported that patient compliance is an indispensable factor influencing treatment results[ 21 ]. In addition, high-dose PPI and amoxicillin dual therapy could decrease the use of unnecessary antibiotics, which is a promising alternative approach[ 22 , 23 ].…”

Review: Treatment of Helicobacter pylori Infection 2019

“…72 In Japan, a study looked at an enhanced compliance program by getting pharmacists to provide instruction for patients being prescribed eradication therapy but found modest, if any, benefit with 91% achievement in the intervention group compared to 88% in the group getting vonoprazan without special pharmacist instruction with a slight benefit in cost-effectiveness ratio (223 vs 224). 75 74 In China, it was shown that sending patients short phone text messages could increase compliance and improve adherence to therapy.…”

“…74 In China, it was shown that sending patients short phone text messages could increase compliance and improve adherence to therapy. 75…”