Comparative analysis of international and Malaysia approaches to the treatment of patients with chronic gastritis from the point of view of evidence-based medicine.

Authors

DOI:

https://doi.org/10.58676/sjmas.v2i8.86

Keywords:

Chronic gastritis, Evidence-based medicine, Helicobacter pylori* treatment, Malaysia healthcare system, Antibiotic resistance

Abstract

Background: Chronic gastritis, often resulting from *Helicobacter pylori* infection, is a widespread gastrointestinal disorder. The condition requires evidence-based treatment approaches to ensure effective management and improved patient outcomes. This study conducts a comparative analysis of the treatment approaches for chronic gastritis in Malaysia and internationally, focusing on adherence to evidence-based medicine (EBM) practices. Understanding the similarities and differences in these approaches is critical for enhancing Malaysia's healthcare strategies.

Methods and Materials: The study employed a systematic review of relevant literature sourced from global medical databases, including PubMed, Embase, and Cochrane Library. The review focused on therapeutic options, diagnostic standards, and evidence-based protocols for managing chronic gastritis, with emphasis on both international and Malaysian healthcare systems. Studies included in the review primarily focused on adult patients diagnosed with chronic gastritis and treated using evidence-based methodologies.

Results: The analysis revealed significant parallels in the treatment protocols between Malaysia and international guidelines, particularly in the use of proton pump inhibitors (PPIs) and antibiotic regimens for *H. pylori* eradication. However, differences emerged in the implementation of advanced diagnostic tools, accessibility of healthcare services, and the influence of local antibiotic resistance patterns. While Malaysia follows global best practices, rural-urban healthcare disparities impact the consistency of treatment delivery and patient outcomes.

Conclusion: Both international and Malaysian approaches to chronic gastritis prioritize evidence-based medicine. The findings suggest that Malaysia effectively adapts international guidelines to its local healthcare context, though improvements are needed in addressing healthcare accessibility and antibiotic resistance. Enhanced implementation of EBM practices, particularly in rural areas, and personalization of treatment based on resistance patterns, could further optimize patient outcomes in Malaysia.

References

Gastritis. (n.d.). MUSC Health | Charleston SC. https://muschealth.org/medical-services/ddc/patients/digestive- diseases/stomach-and- duodenum/gastritis#:~:text=Chronic%20gastritis%20is%20a%20conditio n,due%20to%20vitamin%20B12%20deficiency.

Malfertheiner, P., Megraud, F., O'Morain, C. A., et al. (2017). Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut, 66(1), 6-30. Retrieved from https://gut.bmj.com/content/66/1/6

Laine L, Takeuchi K, Tarnawski A. Gastric mucosal defense and cytoprotection: bench to bedside. Gastroenterology. 2010;135(1):41-60

Mayo Clinic. (n.d.). Endoscopy. Retrieved from https://www.mayoclinic.org/tests-procedures/endoscopy/about/pac- 20395197

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (n.d.). Upper GI Endoscopy. Retrieved from https://www.niddk.nih.gov/health-information/diagnostic-tests/upper-gi- endoscopy

American College of Gastroenterology. (2017). H. pylori and Testing. Retrieved from https://gi.org/topics/helicobacter-pylori-and-testing/

National Institutes of Health (NIH). (n.d.). Helicobacter Pylori Tests. Retrieved from https://medlineplus.gov/lab-tests/helicobacter-pylori-tests/

American College of Gastroenterology. (n.d.). Clinical Guidelines. Retrieved from https://gi.org/clinical-guidelines/

European Helicobacter and Microbiota Study Group. (n.d.). EHMSG Guidelines. Retrieved from https://www.helicobacter.org/guidelines

Ministry of Health Malaysia. (2020). Health Facts 2020. Retrieved from

http://www.moh.gov.my/moh/resources/Penerbitan/Penerbitan%20Utama

/Health%20Fact/HEALTH_FACTS_2020.pdf

World Health Organization. (2019). Primary health care systems (PRIMASYS): Case study from Malaysia. Retrieved from https://www.who.int/docs/default-source/primary-health-care- conference/Malaysia.pd

Ministry of Health Malaysia. (2019). Clinical Practice Guidelines. Retrieved from http://www.moh.gov.my/index.php/pages/view/clinical- practice-guidelines

Lee, Y. Y., & Mahadeva, S. (2017). Gastroesophageal Reflux Disease in Asia: A Systematic Review on the Time Trends. Journal of Neurogastroenterology and Motility, 23(3), 341-350.

Malaysian Healthcare Performance Unit. (2021). National Healthcare Establishment & Workforce Statistics (Primary Care) 2018-2019. Retrieved from http://www.moh.gov.my/moh/resources/NHEWS_2018- 2019_(1)_Feb_2021.pdf

Wong, L. P., & Sam, I. C. (2010). Current issues in the management of infectious diseases in Malaysia. Asia Pacific Family Medicine, 9, 11.

Malfertheiner, P., Megraud, F., O'Morain, C. A., et al. (2017). Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut, 66(1), 6-30. Retrieved from https://gut.bmj.com/content/66/1/6

Chey, W. D., Leontiadis, G. I., Howden, C. W., & Moss, S. F. (2017). ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American Journal of Gastroenterology, 112(2), 212-239. Retrieved from https://journals.lww.com/ajg/Fulltext/2017/02000/ACG_Clinical_Guideli ne Treatment_of_Helicobacter.12.asp.

Thung, I., Aramin, H., Vavinskaya, V., et al. (2016). Review article: the global emergence of Helicobacter pylori antibiotic resistance.

Alimentary Pharmacology & Therapeutics, 43(4), 514-533. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/apt.13497

Gisbert, J. P., & Calvet, X. (2011). Review article: rifabutin in the treatment of refractory Helicobacter pylori infection. Alimentary Pharmacology & Therapeutics, 33(4), 527-534. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04549.x

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2020). Helicobacter pylori and Peptic Ulcer Disease. Retrieved from https://www.niddk.nih.gov/health-information/digestive- diseases/peptic-ulcer/causes-helicobacter-pylori

Ministry of Health Malaysia. (2019). Clinical Practice Guidelines: Management of Helicobacter pylori Infection. Retrieved from [MOH](http://www.moh.gov.my/index.php/pages/view/clinical-practice- guidelines)

Goh, K. L., & Navaratnam, P. (2011). High Helicobacter pylori resistance to metronidazole and clarithromycin in Malaysia. Journal of Gastroenterology and Hepatology, 26(1), 37-41. Retrieved from [Wiley Online Library](https://onlinelibrary.wiley.com/doi/10.1111/j.1440- 1746.2010.06450.x)

Ministry of Health Malaysia (2020). National Antibiotic Guideline 2019. Retrieved from [MOH](http://www.pharmacy.gov.my/v2/sites/default/files/document- upload/national-antibiotic-guideline-2019-v2.pdf)

Thung, I., Aramin, H., Vavinskaya, V., et al. (2016). Review article: the global emergence of Helicobacter pylori antibiotic resistance. Alimentary Pharmacology & Therapeutics, 43(4), 514-533. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/apt.13497

Gisbert, J. P., & Calvet, X. (2011). Review article: rifabutin in the treatment of refractory Helicobacter pylori infection. Alimentary Pharmacology & Therapeutics, 33(4), 527-534. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04549.x

World Health Organization. (2018). World Health Statistics 2018: Monitoring Health for the SDGs, Sustainable Development Goals. Retrieved from https://www.who.int/gho/publications/world_health_statistics/2018/en/

Ministry of Health Malaysia. (2019). Health Facts 2019. Retrieved from http://www.moh.gov.my/moh/resources/Penerbitan/Penerbitan%20Utama

/Health%20Fact/Health%20Facts%202019_Booklet.pdf

Jaafar, S., Noh, K. M., Muttalib, K. A., et al. (2013). Malaysia Health System Review. Health Systems in Transition, 3(1), 1-103. Retrieved from https://apps.who.int/iris/handle/10665/206911

Cheah, J. C. H., & Tay, T. K. (2020). Equity and access to healthcare: Addressing the needs of rural and remote populations. Journal of Global Health Reports, 4, e2020018. Retrieved from https://www.joghr.org/article/12693-equity-and-access-to-healthcare- addressing-the-needs-of-rural-and-remote-populations

Wong, J. E., & Sam, I. C. (2010). Healthcare infrastructure and facilities in Malaysia. Asia Pacific Family Medicine, 9(1), 1-4. Retrieved from https://apfmj.biomedcentral.com/articles/10.1186/1447-056X-9-1

Published

2024-10-13

How to Cite

Hui Yee, L., Ghassan, S., & Tzenios, N. (2024). Comparative analysis of international and Malaysia approaches to the treatment of patients with chronic gastritis from the point of view of evidence-based medicine. Special Journal of the Medical Academy and Other Life Sciences., 2(8). https://doi.org/10.58676/sjmas.v2i8.86