Comparison of follow-up methods on compliance and prognosis of non-selective beta blockers for prevention of esophagogastric variceal bleeding / 中华消化内镜杂志

ABSTRACT

Objective:To compare the different follow-up methods on compliance and prognosis of non-selective beta blockers (NSBBs) for out-patients with secondary prevention of esophagogastric variceal bleeding (EGVB).Methods:A total of 72 patients with portal hypertension and esophageal gastric varices (EGV), who were admitted to the department of gastroenterology, Renmin Hospital of Wuhan University from July 2018 to April 2019 were randomly included in the traditional outpatient follow-up group (group A, 24), remote platform follow-up group (group B, 23) and combined follow-up group (group C, 25) according to the random number table. The patient′s medication compliance, heart rate response, condition change and treatment were recorded. NSBBs medication compliance, influencing factors and prognosis of patients in different groups were analyzed.Results:Forty (40/72, 55.6%) patients had good compliance with NSBBs, among which 34 (34/40, 85.0%) achieved heart rate response. The medication compliance of the group B (15/23, 65.2%) and the group C (17/25, 68.0%) was higher than that of the group A (8/24, 33.3%; χ2=4.778, P=0.029; χ2=5.889, P=0.015, respectively). There was no significant difference in the medication compliance between the group B and the group C ( χ2=0.042, P=0.838). In the group A, the subgroup of good compliance had higher proportion of local patients than that of poor compliance subgroup [7/8 VS 37.5% (6/16), P=0.033]. Patients with good drug compliance had higher proportion of gastroscopy review than that of poor compliance patients [75.0% (30/40) VS 21.9% (7/32), χ2=20.085, P<0.001] and less patients with EGVB [5.0% (2/40) VS 21.9% (7/32), P=0.073]. Conclusion:Patients with portal hypertension and EGV have poor compliance with NSBBs. Remote platform follow-up is a better way to improve compliance of drug prevention. Patients with good NSBBs compliance have a higher compliance of gastroscopy review. The risk assessment of variceal bleeding and endoscopic sequential therapy based on the results of gastroscopy review are expected to reduce the risk of EGVB.