Download the full-sized PDF of Adherence and barriers to H. pylori treatment in Arctic Canada.Download the full-sized PDF



Permanent link (DOI):


Export to: EndNote  |  Zotero  |  Mendeley


This file is in the following communities:

CANHelp Working Group


This file is in the following collections:

Journal Articles (CANHelp Working Group)

Adherence and barriers to H. pylori treatment in Arctic Canada. Open Access


Author or creator
Lefebvre, M.
Chang, H.J.
Morse, A.
van Zanten, S.V.
Goodman, K.J.
Additional contributors
circumpolar regions
Aboriginal health
Helicobacter pylori
peptic ulcers
Type of item
Journal Article (Published)
Introduction. Helicobacter pylori infection is an emerging health concern to some northern Canadian Aboriginal communities and their clinicians. Clinicians in the north perceive H. pylori infection to be a major clinical problem because they find H. pylori infection in many patients evaluated for common stomach complaints, leading to frequent demand for treatment, which often fails. Moreover, public health authorities identified the need for information to develop locally appropriate H. pylori control strategies. We described adherence and identified barriers to completing treatment among H. pylori-positive participants in a community-based project inspired by local concerns about H. pylori infection risks. Methods. In 2008, 110 H. pylori-positive participants (diagnosed by a breath test, histopathology and/or culture) of the Aklavik H. pylori project were randomised to standard-of-care or sequential treatment. We ascertained adherence by interviewing participants using a structured questionnaire. We estimated adherence frequencies as the proportion of participants who reported taking either 100% of doses (perfect adherence) or ≥80% of doses (good adherence). To compare the proportion with perfect or good adherence in subgroups, we report proportion differences and 95% confidence intervals (CI). Results. Of 87 participants who were interviewed, 64% reported perfect adherence and 80% reported good adherence. We observed more frequent perfect adherence for: standard therapy (67%) versus sequential (62%); males (76%) versus females (52%); participants 40–77 years (79%) versus 17–39 (50%). Proportion differences were 5% (CI: −15, 25) for standard versus sequential therapy; 23% (CI: 4, 43) for male versus female; and 29% (CI: 10, 48) for 40–77 versus 15–39 years for perfect adherence. Of the 29 participants who reported poor adherence (<80% of doses taken), the following barriers to treatment were reported: changed mind about taking treatment (24%), consumption of alcoholic beverages (18%), nausea (18%), forgetfulness (12%), stomach pain (12%), difficulty in swallowing pills (6%), no reason (6%) or bad taste of the pills (6%). Conclusion. This analysis suggests that adherence to treatment for eliminating H. pyori infection may vary by regimen and may be influenced by socio-demographic factors. These findings add to the small body of evidence pertaining to adherence to H. pylori treatment in Arctic Aboriginal communities. On-going research in additional northern Canadian communities will accumulate data for developing recommendations to improve adherence for treatment to eliminate H. pylori infection.
Date created
License information
Creative Commons Attribution-Non-Commercial 3.0 Unported

Citation for previous publication
Lefebvre M, Chang HJ, Morse A, van Zanten SV, Goodman KJ, CANHelp Working Group. Adherence and barriers to H. pylori treatment in Arctic Canada. Int J Circumpolar Health. 2014, 73: 22791.

Link to related item

File Details

Date Uploaded
Date Modified
Audit Status
Audits have not yet been run on this file.
File format: pdf (Portable Document Format)
Mime type: application/pdf
File size: 567913
Last modified: 2015:10:12 11:26:21-06:00
Filename: IJCH_73_2014.pdf
Original checksum: 23b5ecc6fbbd7d28cbb33b7787c52f31
Well formed: false
Valid: false
Status message: Unexpected error in findFonts java.lang.ClassCastException: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject cannot be cast to edu.harvard.hul.ois.jhove.module.pdf.PdfDictionary offset=3736
Page count: 8
Activity of users you follow
User Activity Date