| BackgroundHelicobacter pylori(H.pylori)infections are of serious concern due to the associated risk of gastric cancer.However,many patients have poor medication and therapy compliance,which makes it difficult to eradicate their infections.The effect of strengthening patient education interventions on eradication rate and medication compliance is unclear.As such,this study conducted a meta-analysis to clarify the effects of enhanced patient education programmes for H.pylori.AimThe aim of the study was to evaluate the efficacy of enhanced patient education on H.pylori eradication,and the potential impact on patient compliance,adverse reactions during medication,relief of clinical symptoms after treatment and patient satisfaction,in order to provide evidence-based medicine for clinical practice.MethodsWe searched PubMed,Embase,Web of Science,and Cochrane Library in total,and further traced the literature that met the inclusion criteria,and browsed all references.The search time was until July 2021.Two researchers independently conducted literature search,quality evaluation and information extraction of included study.All included studies were randomized controlled trials(RCTs).The primary outcome was the H.pylori eradication rate,and secondary outcomes included the incidence of adverse reactions,treatment compliance,clinical symptom relief after treatment and patient satisfaction.We used the fixed or random effects model to pool the risk ratio(RR),with 95%confidence interval.The heterogeneity among included studies is expressed by I2.If I2<50%,it means that the heterogeneity is acceptable and a fixed effect model is used;if I2>50%,it means that there is heterogeneity and a random effects model was used.Descriptive analysis was performed if there were too few data for combined analysis.P<0.05 indicated that the difference was statistically significant.Publication bias,sensitivity analysis and subgroup analysis were assessed using RevMan and STATA software.ResultsOur search returned seven relevant studies across a total of 1,433 patients.The experimental group adopted intensive education,and the control group adopted routine patient education.Meta-analysis results showed that:Compared with controls,enhanced patient education was significantly associated with improved H.pylori eradication rates(RR=1.16,95%CI:1.04-1.29,P=0.006)and patient compliance(RR=1.48,95%CI:1.14-1.93,P=0.003).In terms of adverse reactions,there was no significant difference between the two groups(RR=0.88,95%CI:0.67-1.16,P=0.35).A subgroup analysis showed that enhanced patient education benefits were consistent across patients with different eradication programmes(P<0.05).Compared with other education methods,WeChat education improved the H.pylori eradication rate of patients(RR=1.24,95%CI:1.03-1.50,P=0.02).The frequent intervention group had a certain influence on the H.pylori eradication rate compared with the infrequent intervention group(RR=1.15,95%CI:1.01-1.30,P=0.03).In terms of compliance,the compliance of frequent intervention group was higher than that of infrequent intervention group(RR=1.32,95%CI:1.02-1.71,P=0.04).In terms of adverse reactions,enhanced education had no effect on various adverse reactions and patient withdrawal rates.Conclusion1.Enhanced educational interventions have positive effects on both the H.pylori eradication rate and adherence among infected patients.2.The intervention frequency of educational interventions has a certain impact on H.pylori eradication rates and patient adherence.3.Strengthening education has no effect on the incidence of adverse reactions and withdrawal rate of patients.4.Enhanced education may constitute promising complements to clinical treatment regimens. |
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