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KMID : 0941820000100030111
Korean Journal of Clinical Pharmacy
2000 Volume.10 No. 3 p.111 ~ p.119
The Study of Different Regimens Prescribed for the Treatment of Peptic Ulcer Disease in a Community Hospital


Abstract
The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients (38.9%) had gastric ulcer (GU) alone, 6 patients (2.7%) had duodenal ulcer (DV) alone, 5 patients (2.2%) had gastroesophageal reflux disease (GERD) alone, 25 patients (11.1%) had both GU and DU, 88 patients (38.9%) had both GU and GERD, and 14 patients (6.2%) had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, 61.5%) and among the ages of 30 and 40 (62.4%). The average age of these patients was 41.3 years and there was no difference between the genders. 81.4% of these patients underwent CLO test to check for the existence of Helicobacter and 66.3% of these Patients showed the positive response. 65.6% of patients with GU and 80% of patients with DU showed the positive response and there was no difference between the genders (65.4%;vs.;67.6%). 184 patients (81.4%) were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients (20.65%) of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using H_2 receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately 20% of patients.
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