Effects of New Media-Based Education on the Treatment of Helicobacter pylori Infection: Systematic Review and...

Helicobacter pylori (H. pylori) infection continues to pose a substantial global health burden. The eradication of H. pylori has been shown to substantially reduce the risk of gastric cancer. However, despite the availability of effective antimicrobial regimens, eradication rates remain suboptimal, largely due to poor patient adherence to treatment. The emergence of new media-based education (NME) offers an effective approach to enhancing patient understanding, engagement, and adherence, thereby improving the overall management of H. pylori treatment and follow-up care.

This meta-analysis aimed to assess the impact of NME interventions on H. pylori eradication rates, patient compliance, adverse events, and patient satisfaction.

We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to February 2025. Eligible studies included randomized controlled trials (RCTs) and retrospective cohort studies comparing NME (eg, mobile apps, SMS text messages, and WeChat) with conventional education in patients with H. pylori infection. Studies were required to report at least one of the following outcomes: eradication rate, patient compliance, adverse events, and patient satisfaction. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% CIs. Subgroup analyses were conducted based on intervention type, therapy regimen, regional socioeconomic status, age group, and WeChat communication format. Sensitivity analyses tested the robustness of the pooled results.

A total of 13 studies (n=11, 85% RCTs and n=2, 15% retrospective cohort studies) involving 2942 patients were included. Overall, NME significantly improved H. pylori eradication compared with conventional education (81.9% vs 67%; RR 1.22, 95% CI 1.11-1.33; P<.001). Subgroup analyses showed greater benefits in patients receiving quadruple therapy (P<.001), those aged ≤60 years (P=.03), populations from low- and middle-income countries (P<.001), and 14-day regimens (P<.001). Notably, WeChat-based interventions (P=.002), especially one-on-one education (P=.006), produced the most pronounced effects, whereas telephone- and messaging-based methods showed limited impact. Patient compliance was also significantly higher in the NME group (90.5% vs 73%; RR 1.27, 95% CI 1.15-1.40; P<.001), particularly among younger patients (P=.03) and in 14-day regimens (P<.001). In contrast, NME did not reduce adverse events (P=.23). Patient satisfaction, reported in 23% (3/13) of the studies, was consistently higher with NME (P<.001). Most RCTs (7/11, 64%) were judged to be at low risk of bias, and sensitivity analyses confirmed the robustness of all primary outcomes.

NME significantly enhances H. pylori eradication and patient compliance without increased adverse events. Personalized and interactive communication platforms, especially WeChat-based interventions, show substantial promise. These findings support the integration of tailored digital education into clinical practice, particularly in resource-limited or technology-adopting settings. Further high-quality RCTs are warranted to validate long-term efficacy and generalizability.

PROSPERO CRD42024517954; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024517954.