Adherence to non-selective beta blockers for prevention of variceal bleeding in cirrhotic patients

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dc.contributor.authorAn, Yang
dc.contributor.authorXu, Xiangbo
dc.contributor.authorRen, Tianshu
dc.contributor.authorTong, Zhenhua
dc.contributor.authorRomeiro, Fernando Gomes [UNESP]
dc.contributor.authorMancuso, Andrea
dc.contributor.authorGuo, Xiaozhong
dc.contributor.authorQi, Xingshun
dc.contributor.institutionGeneral Hospital of Northern Theater Command
dc.contributor.institutionShenyang Pharmaceutical University
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionDi Cristina-Benfratelli
dc.date.accessioned2022-04-29T08:35:41Z
dc.date.available2022-04-29T08:35:41Z
dc.date.issued2021-01-01
dc.description.abstractBackground and Aim: Long-term use of non-selective beta blockers (NSBBs) is essential for the prevention of esophageal variceal bleeding in liver cirrhosis but may impair the patient’s adherence. The present study aimed to investigate the adherence to NSBBs to prevent variceal bleeding in cirrhotic patients. Methods: All patients who had an indication of NSBBs for the prophylaxis of variceal bleeding between February 2018 and June 2019 were screened. Clinical pharmacists gave pre-medication education and recorded the adherence to NSBBs during the patients’ hospi-talizations. Factors associated with poor adherence were evaluated by univariate logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. The relationship between poor adherence during follow-up and variceal bleeding after discharge was also evaluated. Results: Overall, 108 patients were screened, of whom 12 were intolerant to NSBBs. Among the 96 remaining patients who could take NSBBs, the average change of heart rate after NSBBs was −10.49 b.p.m. Twenty-two (22.9%) patients had poor adherence to NSBBs due to their refusal to take NSBBs (n = 2), complete forgetfulness to take NSBBs (n = 10), and refusal or forgetfulness to monitor heart rate (n = 10). Univariate logistic regression analysis demonstrated that only older age was significantly associated with poor adherence (OR: 1.065, 95% CI: 1.019–1.114, P = 0.005). Patients with poor adherence during follow-up were more likely to develop variceal bleeding after discharge. Conclusion: A significant proportion of cirrhotic patients had poor adherence to NSBBs during their hospitalizations. Further studies should explore how to improve the patient’s adherence to NSBBs.en
dc.description.affiliationLiver Cirrhosis Study Group Department of Gastroenterology General Hospital of Northern Theater Command
dc.description.affiliationPostgraduate College Shenyang Pharmaceutical University
dc.description.affiliationDepartment of Pharmacy General Hospital of Northern Theater Command
dc.description.affiliationSection of Medical Service General Hospital of Northern Theater Command
dc.description.affiliationDepartment of Internal Medicine Botucatu Medical School UNESP – Univ Estadual Paulista, Av. Prof. Mário Rubens Guimarães Montenegro, s/n Distrito de Rubião Jr
dc.description.affiliationMedicina Interna 1 ARNAS-Civico Di Cristina-Benfratelli
dc.description.affiliationUnespDepartment of Internal Medicine Botucatu Medical School UNESP – Univ Estadual Paulista, Av. Prof. Mário Rubens Guimarães Montenegro, s/n Distrito de Rubião Jr
dc.format.extent6713-6724
dc.identifierhttp://dx.doi.org/10.2147/IJGM.S326192
dc.identifier.citationInternational Journal of General Medicine, v. 14, p. 6713-6724.
dc.identifier.doi10.2147/IJGM.S326192
dc.identifier.issn1178-7074
dc.identifier.scopus2-s2.0-85117717002
dc.identifier.urihttp://hdl.handle.net/11449/229770
dc.language.isoeng
dc.relation.ispartofInternational Journal of General Medicine
dc.sourceScopus
dc.subjectAdherence
dc.subjectEsophageal varices
dc.subjectLiver cirrhosis
dc.subjectNon-selective beta blockers
dc.subjectRisk factors
dc.titleAdherence to non-selective beta blockers for prevention of variceal bleeding in cirrhotic patientsen
dc.typeArtigo

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