Impact of Clinical Pharmacist-led Intervention on Clinical Outcomes in Patients with Helicobacter pylori Infection
DOI:
https://doi.org/10.56056/392Keywords:
Clinical pharmacist intervention, Controlled trial, Helicobacter pylori infection, Medication adherenceAbstract
Background and objectives: Helicobacter pylori infection is prevalent and persistent in some cases. The rising incidence of drug resistance in this infection necessitates enhanced treatment methodologies. Our aim was to compare the efficacy of conventional therapy with that of a clinical pharmacist-led intervention for the management of Helicobacter pylori infection.
Methods: This randomized controlled trial included 100 therapy-naïve patients with confirmed Helicobacter pylori infection, recruited from an outpatient private clinic in Koye-Erbil, Iraq, between May and November 2023. Patients were randomly assigned to either the control group (receiving conventional therapy) or the intervention group (receiving additional clinical pharmacist-led interventions focused on personalized treatment plans, patient education, and adherence support). Treatment success was assessed using the Helicobacter pylori stool antigen test for follow up one-month post-treatment. Medication compliance was evaluated using the Morisky-Green scale.
Results: In this study, 54 (54.0) patients were female and 46 (46.0) patients were male. The intervention group showed a significantly higher rate of H. pylori eradication, with 42 (84%) patients testing negative in the second stool antigen test compared with 28 (56%) patients in the control group (p ? 0.002). Furthermore, medication compliance was significantly better in the intervention group of 36 (72%) patients compared to the control group of 18 (29%) patients (p < 0.013).
Conclusion: Clinical pharmacist interventions improve therapeutic outcomes and medication compliance in patients with Helicobacter pylori infection. Although integrating into peptic ulcer disease management teams enhances the treatment effectiveness.
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1. Hooi JK, Lai WY, Ng WK, Suen MM, Underwood FE, Tanyingoh D et al. Global Prevalence of Helicobacter pylori Infection: systematic review and meta-analysis. Gastroenterology. 2017 Aug;153(2):420-429. doi: 10.1053/j.gastro.2017.04.022/
2. de Brito BB, da Silva FAF, Soares AS, Pereira VA, Santos MLC, Sampaio MM et al. Pathogenesis and Clinical Management of Helicobacter pylori Gastric Infection. World J Gastroenterol. 2019 Oct 7;25(37):5578-5589. doi: 10.3748/wjg. v25.i37.5578/
3. Hu Y, Wan JH, Li XY, Zhu Y, Graham DY, Lu NH. Systematic review with Meta?analysis: the Global Recurrence Rate of Helicobacter pylori. Aliment Pharmacol Ther. 2017 Nov;46(9):773-779. doi: 10.1111/apt.14319/
4. Bhat S, Nunes D. Pharmacist-Managed Helicobacter pylori Treatment Service Within a Gastroenterology Clinic: Workflow and Real-World Experiences. Ann Pharmacother. 2022 Feb;56(2):162-169. doi: 10.1177/10600280211021501/
5. Nagy P, Johansson S, Molloy-Bland M. Systematic review of Time Trends in the Prevalence of Helicobacter pylori Infection in China and the USA. Gut pathogens.2016 Mar 15:8:8. doi: 10.1186/s13099-016-0091-7/
6. Peleteiro B, Bastos A, Ferro A, Lunet N. Prevalence of Helicobacter pylori Infection Worldwide: A Systematic review of Studies with National Noverage. Dig Dis Sci. 2014 Aug;59(8):1698-709. doi: 10.1007/s10620-014-3063-0/
7. McColl KE. Helicobacter pylori Infection. N Engl J Med. 2010 Apr 29;362(17):1597-604. doi: 10.1056/NEJMcp1001110/
8. Crowe SE. Helicobacter pylori Infection. N Engl J Med. 2019 Mar 21;380(12):1158-1165. doi: 10.1056/NEJMcp1710945/
9. Yokota SI, Konno M, Fujiwara SI, Toita N, Takahashi M, Yamamoto S et al. Intrafamilial, Preferentially Mother?to?child and Intraspousal, Helicobacter pylori Infection in Japan Determined by Mutilocus Sequence Typing and Random Amplified Polymorphic DNA Fingerprinting. Helicobacter. 2015 Oct;20(5):334-42. doi: 10.1111/hel.12217/
10. Malfertheiner P, Megraud F, O’Morain C, Bazzoli F, El-Omar E, Graham D et al. Current Concepts in the Management of Helicobacter pylori Infection: the Maastricht III Consensus Report. Gut. 2007 Jun;56(6):772-81. doi: 10.1136/gut.2006.101634/
11. Ford AC, Moayyedi P. Whom should we “test and treat” for Helicobacter pylori? BMJ. 2014 May 20:348: g3320. doi: 10.1136/bmj. g3320/
12. Nyssen OP, Vaira D, Tepes B, Kupcinskas L, Bordin D, Pérez-Aisa Á et al. Room for Improvement in the Treatment of Helicobacter pylori Infection: lessons from the European Registry on H. pylori Management (Hp-EuReg). J Clin Gastroenterol. 2022 Feb 1;56(2): e98-e108. doi: 10.1097/MCG.0000000000001482/
13. Savoldi A, Carrara E, Graham DY, Conti M, Tacconelli E. Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic review and Meta-analysis in World Health Organization Regions. Gastroenterology. 2018 Nov;155(5):1372-1382.e17. doi: 10.1053/j.gastro.2018.07.007. Epub 2018 Jul 7.
14. Suzuki S, Esaki M, Kusano C, Ikehara H, Gotoda T. Development of Helicobacter pylori Treatment: How do we Manage Antimicrobial Resistance World J Gastroenterol. 2019 Apr 28; 25(16): 1907–1912. doi: 10.3748/wjg. v25.i16.1907/
15. Al?Eidan F, McElnay JC, Scott MG, McConnell JB. Management of Helicobacter pylori Eradication–the Influence of Structured Counselling and Follow?up. Br J clin Pharmacol. 2002 Feb; 53(2): 163–171. doi: 10.1046/j.03065251.2001. 01531.x/
16. SekoT, Tachi T, Hatakeyama H, Noguchi Y, Teramachi H. Cost?effectiveness Analysis and Effectiveness of Pharmacist?managed Outpatient Clinics in Helicobacter pylori Eradication Therapy. Int J Clin Prac. 2019 Jun;73(6): e13349. doi: 10.1111/ijcp.13349/
17. Ravnan SL, Ravnan MC, Manzo BA. Developing and Implementing a Pharmacist-Managed, Telephone-based Helicobacter pylori Clinic. Am J health sys Pharm. 2002 Apr 15;59(8):725-7. doi: 10.1093/ajhp/59.8.725/
18. Bujanda L, Nyssen OP, Vaira D, Saracino IM, Fiorini G, Lerang F et al. Antibiotic Resistance Prevalence and Trends in Patients Infected with Helicobacter pylori in the Period 2013–2020: Results of the European Registry on H. pylori Management (Hp-EuReg). Antibiotics (Basel). 2021 Sep 1;10(9):1058. doi: 10.3390/antibiotics10091058/
19. Jearth V, Rath MM, Chatterjee A, Kale A, Panigrahi MK. Drug-Resistant Helicobacter pylori: Diagnosis and Evidence-Based Approach. Diagnostics (Basel). 2023 Sep 14;13(18):2944. doi: 10.3390/diagnostics13182944/
20. Alexander SM, Retnakumar RJ, Chouhan D, Devi TNB, Dharmaseelan S, Devadas K et al. Helicobacter pylori in Human Stomach: The Inconsistencies in Clinical Outcomes and the Probable Causes. Front microbiol. 2021 Aug 17:12:713955. doi: 10.3389/fmicb.2021.713955/
21. Malfertheiner P, Camargo MC, El-Omar E, Liou JM, Peek R, Schulz Ch et al. Helicobacter pylori Infection. Nat Rev Dis Primers. 2023 Apr 20;9(1):19. doi: 10.1038/s41572-023-00431-8/
22. Wang YZ, Chen J, Pei SQ, Wang C, Han G, Kan LD et al. Treatment Strategies and Pharmacist?led Medication Management for Helicobacter pylori Infection. Drug Dev Res. 2023 Apr;84(2):326-336. doi: 10.1002/ddr.22025/
23. Shoiab AA, Alsarhan A, Khashroum AO. Effect of Pharmacist Counseling on Patient Medication Compliance and Helicobacter Pylori Eradication Among Jordanian outpatients. Arq de Gastroenterol. 2023 Jan-Mar;60(1):74-83. doi: 10.1590/S0004-2803.202301000-10/
24. Elbehiry A, Marzouk E, Aldubaib M, Abalkhail A, Anagreyyah S, Anajirih N et al. Helicobacter pylori Infection: Current Status and Future Prospects on Diagnostic, Therapeutic and Control Challenges. Antibiotics. 2023; 12(2):191. https://doi.org/10.3390/antibiotics1202019/
25. Baryakova TH, Pogostin BH, Langer R, McHugh KJ. Overcoming Barriers to Patient Adherence: The Case for Developing Innovative Drug Delivery Systems. Nat Rev Drug Disco. 2023 May;22(5):387-409. doi: 10.1038/s41573-023-00670-0/
26. Weng A, Su X, Yang C, Zheng B, Zheng L, Jian C, et al. Telephone Follow-up by Clinical Pharmacists can Improve Treatment Outcomes in Patients with Peptic Ulcers: A Prospective Randomized Study. Medicine (Baltimore). 2022 Oct 21;101(42): e31150. doi: 10.1097/MD.0000000000031150/
27. Zhang Y, Yang H, Kong J, Liu L, Ran L, Zhang X et al. Impact of Interventions Targeting the Inappropriate use of Proton?pump Inhibitors by Clinical Pharmacists in a Hepatobiliary Surgery Department. J Clin Pharm Ther. 2021 Feb;46(1):149-157. doi: 10.1111/jcpt.13273/
28. Du Y, Li J, Wang X, Peng X, Wang X, He W et al. Impact of a Multifaceted Pharmacist-led Intervention on Antimicrobial Stewardship in a Gastroenterology ward: a Segmented Regression Analysis. Fron Pharmacol. 2020 Apr 15. doi: 10.3389/fphar.2020.00442/
29. Althomali A, Altowairqi A, Alghamdi A, Alotaibi M, Althubaiti A, Alqurashi A et al. Impact of Clinical Pharmacist Intervention on Clinical Outcomes in the Critical Care Unit, Taif City, Saudi Arabia: A Retrospective Study. Pharmacy (Basel). 2022 Aug 31;10(5):108. doi: 10.3390/pharmacy10050108/
30. Viktil KK, Blix HS. The Impact of Clinical Pharmacists on Drug?related Problems and Clinical Outcomes. Basic clin pharmacol toxicol. 2008 Mar;102(3):275-80. doi: 10.1111/j.1742-7843.2007. 00206.x/
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