Analysis of medical compliance in gastro-oesophageal reflux disease patients referred to pre-surgical examination.

BACKGROUND: Despite potential of modern pharmacotherapy to control gastro-oesophageal reflux disease and also to improve patients' quality of life, an efficient long-term management always depends on patients compliance with medication. AIMS: To evaluate and analyse potential aspects of compliance or non-compliance with medical and clinical prescriptions in a selected group of gastro-oesophageal reflux disease patients referred to pre-surgical examination because of persistent or recurrent symptoms. PATIENTS: A total of 182 gastro-oesophageal reflux disease patients have been divided by patient rating to 3 different subgroups: group 1/TC consisted of patients who subjectively stated to be totally compliant (n=71; 39%); group 2/PC of patients with partial compliance (n=65; 36%), and group 3/NC consisted of patients with non-compliance (n=46; 25%) in relation to the prescriptions of their doctor taking care of their treatment.
METHODS: All patients have been asked for potential aspects of compliance or non-compliance. The following aspects have been analysed: understandable medical prescription, information about gastro-oesophageal reflux disease, subjective severity of gastro-oesophageal reflux disease-related symptoms, severity of disease, side-effects of medication, general rejection of medication, multi-medication, patient age and sex, quality of life, and a specific construct of personality (health locus of control).
RESULTS: Significant differences could be calculated between patients' age and gender showing that female and elderly patients are more compliant with medication. Group 1/TC patients suffered from a significantly longer period of symptoms and received medication for a longer period when compared to the other groups. Quality of life was impaired in all patients but patients in group 3/NC had a significantly better quality of life than patients in group 1/TC. The leading aspects for total compliance were: an understandable medical prescription (95%), high severity of perceived symptoms (76%) and of disease (88%). The major factors in group 2/PC patients have been unclear information about gastro-oesophageal reflux disease (41%), mild severity of perceived symptoms (59%), low severity of disease (30%), and a general rejection of medical treatment (21%). General rejection of drug treatment has been the major factor in group 3/NC patients (80%) which can be viewed in relation to patients' personality
CONCLUSION: Compliance or non-compliance in this selected group of patients depended on several factors such as information, subjective severity of symptoms, severity of disease but, in addition, on patients' personality Therefore, new strategies for compliance with long-term treatment in gastro-oesophageal reflux disease patients should be discussed.