The Contribution of Psychosocial Factors to the Effectiveness of Therapy in Patients with Chronic Gastritis Associated with Helicobacter Pylori

Aim. To assess the role of psychosocial factors in the formation of adherence in patients with chronic gastritis associated with Helicobacter pylori. Design. Prospective study. Materials and methods. A survey of 302 patients with chronic gastritis was conducted, which were divided into four groups. Group 1 included 96 patients with chronic gastritis associated with H. pylori, group 2 included 110 people with chronic gastritis not associated with H. pylori (the etiology of gastritis is different), and was used as a comparison group to assess psychosocial factors. Patients in groups 1 and 2 followed the doctor's recommendations in full. Group 3 consisted of 36 patients with chronic gastritis associated with H. pylori who refused to perform medical procedures, a group of 4-60 patients with chronic gastritis associated with H. pylori, who partially followed the doctor's recommendations. The patients underwent clinical and instrumental examination (fibrogastroduodenoscopy and biopsy of the gastric mucosa) upon admission to the study and one year later. The presence of H. pylori was detected using a rapid urease test and the method of determining the antigen of H. pylori in feces. H. pylori eradication therapy was prescribed according to the clinical recommendations of the Russian Gastroenterological Association and the RANDO Endoscopic Society Association for the diagnosis and treatment of gastritis and duodenitis (2021). The patients' adherence to treatment was determined by the Davydov Compliance Level questionnaire. To assess the level of empathy, we used The Consultation and Relational Empathy Measure (CARE Measure) questionnaire, which allows us to identify the degree of empathy that has arisen between a doctor and a patient. The anxiety levels of the patients were determined using the Spielberger — Khanin questionnaire, and the assessment of personal response to the disease was based on the questionnaire for diagnosing the type of attitude to the disease (TOBOL). The search for correlations of indicators was carried out using correlation analysis, Spearman correlation coefficients were calculated. Results. The maximum result of H. pylori eradication was observed in patients with high rates of adherence to treatment according to the Davydov questionnaire and empathy according to the CARE Measure questionnaire. According to the data obtained, the significant factors associated with the highest level of patient compliance are higher rates of personal and situational anxiety according to Spielberger and anxiety score on the HADS scale. Conclusion. In the course of treatment and follow-up of patients with chronic gastritis, in order to assess and predict the degree of adherence to treatment, it is advisable to include in a set of measures to identify the level of compliance (according to the Davydov questionnaire), the level of empathy (according to the CARE Measure questionnaire) and the type of attitude towards the disease (according to the TOBOL questionnaire). Keywords: chronic gastritis, Helicobacter pylori, compliance, empathy, anxiety.