At the present time, the therapy of most diseases requires special attention not only from the treating physician, but also from the patient. In turn, in the treatment of children, the monitoring of compliance with the treatment is carried out not by the patient, but by his parents who control the regimen of taking medications. The aim of the study was to determine the efficiency of traditional anti-H. pylori regimen in the treatment of chronic gastroduodenal pathology in children with various level of parental compliance. 80 children of school age suffering from peptic ulcer disease duodenal ulcer associated with H. pylori from families with different levels of parental compliance were examined. The traditional anti-H. pylori therapy scheme containing omeprazole, clarithromycin lasting 14 days was prescribed for all children with chronic gastroduodenal pathology. It is established that strict adherence to the regimen and duration of administration of prescribed drugs allows achieving a high level of eradication of H. pylori even with the use of the traditional anti-Helicobacter pylori. Conducting a “compliance training” before starting therapy is an important factor that increases the level of parental compliance in patients with inflammatory-destructive diseases of the stomach and duodenum. Establishment of interpersonal relationships in the “doctor-patient-parent” system, working with parents, aimed at explaining the essence of the disease, the consequences of the disease, treatment tactics are an important stage in the therapy of a sick child.
Introduction: The article focuses on the studies which point to particular difficulties in achieving compliance in pediatrics. A dangerous trend to escalate the number and doses of antibiotics in anti- Helicobacter pylori (HP) schemes, the dosage frequency and course duration of eradication therapy considerably complicates a patient’s compliance to the treatment and contributes to a further growth of HP antibiotic resistance. In the treatment of children, the control of the outpatient therapy largely depends on the patient’s parents. Materials and methods: At the first stage of the study, 103 children with chronic gastroduodenal pathology associated with HP were examined. Diagnosis of the disease was based on the study of complaints, the anamnesis data, and the results of the endoscopic examination. All the patients underwent a course of anti-HP therapy in the outpatient setting. A degree of parental compliance to their child’s therapy was determined in by a questionnaire, which had been developed by us, the families of the children suffering from chronic gastroduodenal pathology. At the second stage, 80 children suffering from peptic ulcer associated with HP were examined. HP was eradicated in the outpatients of both groups, using an anti-HP regimen: omeprazole, clarithromycin, and amoxicillin administered for 14 days. The influence of the measures to improve parental compliance carried out in tandem “doctor – pharmacist” in the families with children suffering from chronic gastroduodenal pathology was studied. Results and discussion: A decrease in parental compliance was observed in more than 2/3 of the families with children suffering from chronic gastroduodenal pathology, associated with HP infection. A higher level of parental compliance was established in the families of children after the ”compliance training”. In the patients of this group, eradication of HP was achieved in 87.5% cases by using a traditional scheme: omeprazole, clarithromycin, and amoxicillin administered for 14 days. Conclusion: It can be concluded that the level of parental compliance to an anti-HP therapy for their children is insufficient. In turn, conducting a “compliance training” in the tandem of ”doctor – pharmacist” before starting the therapy is an important factor in increasing the level of parental compliance, which is reflected in increasing the effectiveness of the treatment. Strict adherence to the regimen and duration of administration of the prescribed drugs in children with ulcer allows achieving a high level of HP eradication – 95.2 %, even when using the traditional anti-HP regimen. The eradication was achieved in 56.5 % of the children with partial parental compliance, and only in 6.7 % of the children with non-compliant parents.
The effectiveness of the treatment of chronic gastroduodenal pathology associated with Helicobacter pylori infection consists not only in the successful eradication of the pathogenic microorganism, but also in eliminating dyspeptic and abdominal pain syndrome, as the main clinical criteria for this pathology. Among the main reasons that affect the successful outcome of therapy, it can be distinguished strict adherence to the prescribed drug regimens. The aim of the work was to assess the effect of parental adherence to their child suffering from chronic gastroduodenal pathology, treatment on the patient's quality of life. 80 children of high school age suffering from chronic gastroduodenal pathology associated with Helicobacter pylori were examined. Anti-Helicobacter therapy using clarithromycin, amoxicillin, omeprazole for 14 days was held in all patients. The training of parental compliance in relation to ongoing therapy for their child was conducted before therapy in patients of the comparison group. The special questionnaire developed by us was used to assess the level of parental compliance. In addition, in all patients, the quality of life indices were studied using the SF-36 questionnaire at baseline and one month after the start of therapy. It was revealed that in children with chronic gastroduodenal pathology the initial indicators on all scales of quality of life were significantly lower compared to the children of the control group. It was found that the greater compliance of parents to their child's prescribed therapy leads not only to the successful eradication of Helicobacter pylori infection, but also to positive dynamics, both physical and psychological aspects of health.
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