Lack of follow-up in Helicobacter pylori eradication treatment: Results from the European registry on Helicobacter pylori management.
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Cantú-Germano Elisa, Moreira Leticia, Pérez-Aisa Ángeles, Martínez-Domínguez Samuel J, Voynovan Irina, Bujanda Luis, Jonaitis Laimas, Tepes Bojan, Garre Ana, Lucendo Alfredo J, Lerang Frode, Butler Thomas, Mahmudov Umud, Huguet Jose M, Tejedor-Tejada Javier, Bogomolov Pavel, Beales Ian Lp, Phull Perminder S, Pabon-Carrasco Manuel, Castro-Fernández Manuel, Alekseenko Sergey, Pavoni Matteo, Zaytsev Oleg, Bumane Renate, Denkovski Maja, Cajal Manuel D, Tatiana Ilchishina, Areia Miguel, Keco-Huerga Alma, Babayeva Gülüstan, Bermejo Fernando, Simsek Halis, Buzás György M, Losurdo Giuseppe, Bordin Dmitry S, Kupcinskas Juozas, Smith Sinead M, Gasbarrini Antonio, Leja Marcis, Marcos-Pinto Ricardo, Simsek Cem, Papp Veronika, Rodríguez Blas Jg, Mejide Pilar P, Villarroya Ramón P, Alonso Mónica S, Cano-Català Anna, Megraud Francis, O'Morain Colm, Parra Pablo, Nyssen Olga P, Gisbert Javier P
Аннотация
AIM: To evaluate the reasons for and factors associated with non-retreatment after H. pylori eradication treatment failure.
METHODS: A multicenter, prospective registry (European registry on H. pylori management) was used to evaluate the decisions and outcomes of H. pylori management by European gastroenterologists. Patients with at least one eradication failure between 2013 and 2024 were included and classified into retreatment (control) and non-retreatment. The reasons for non-retreatment were categorized as medical- or patient-related. Multivariate logistic regression identified factors associated with non-retreatment from each perspective.
RESULTS: Of the 6904 patients with eradication failure, 950 (14%) were not retreated: 41% due to medical decisions, 50% due to patient decisions, and 9% due to other reasons. Frequent reasons for non-retreatment included previous poor tolerance, noncompliance, unclear indications, and multiple eradication attempts. From a medical perspective, non-retreatment was associated with age ≥ 71 years [odds ratio (OR) = 1.49; 95% confidence interval (CI): 1.04-2.13], previous noncompliance (OR = 4.27; 95%CI: 2.64-6.93), treatment discontinuation due to adverse events (OR = 2.06; 95%CI: 1.19-3.56), and number of previous attempts (OR range: 2.07-9.25). From the patient perspective, the associated factors included male sex (OR = 1.34; 95%CI: 1.10-1.63), two to four previous eradication attempts (OR range: 1.69-3.60) and previous noncompliance (OR = 10.04; 95%CI: 7.37-13.68).
CONCLUSION: Up to 14% of European patients are not retreated after H. pylori eradication failure. Key barriers include advanced age, previous noncompliance and prior eradication failures. The decision to avoid retreatment was often patient-driven, although medical reasons were also relevant, highlighting the importance of shared decision-making and improved patient education.