A Qualitative Examination of Secondary Prophylaxis in Rheumatic Heart
                        Disease: Factors Influencing Adherence to Secondary Prophylaxis in
                        Uganda

Huck, Daniel M; Nalubwama, Haddy; Longenecker, Chris T.; Frank, Scott; Okello, Emmy; Webel, Allison R.

doi:10.1016/j.gheart.2014.10.001

Cited by 36 publications

(38 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 Furthermore, different studies reported reasons for poor adherence were lack of money, far distance from hospital, fear of medication side effects and painful injection, lack of awareness of the importance of BPG, and non-availability of BPG. 15,24,25 On the contrary, the adherence rate of the present study (80.6%) was less than that of Indian and New Zealand studies which reported (89.6%) 26 and (92%) 27 respectively. Another prospective study conducted in India also showed the overall adherence rate of 93.6%.…”

Section: Discussioncontrasting

confidence: 94%

<p>Adherence to Benzathine Penicillin G Secondary Prophylaxis and Its Determinants in Patients with Rheumatic Heart Disease at a Cardiac Center of an Ethiopian Tertiary Care Teaching Hospital</p>

Mekonen

Yismaw

Abiye

et al. 2020

PPA

View full text Add to dashboard Cite

Purpose: Benzathine penicillin G (BPG) monthly administration is the most effective method for secondary prophylaxis against acute rheumatic fever (ARF). BPG's efficacy largely depends on adherence to treatment. This study was aimed at assessing adherence to BPG prophylaxis and its determinants among adult patients with rheumatic heart disease. Patients and Methods: An institutional cross-sectional study design was used. One hundred and forty-five patients receiving monthly BPG at the Adult Cardiac Clinic of Tikur Anbessa Specialized Hospital (TASH) were interviewed. Their 1-year BPG prophylaxis administration record was also reviewed. The rate of adherence to BPG injection was determined by calculating the percentage of the administered drug from the total expected doses. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) software version 25. Both descriptive and logistic regression analyses were computed to describe different variables and assess factors associated with adherence, respectively. A p-value <0.05 was used to declare association. Results: Among a total of 145 study participants involved, the majority (76.6%) of them had been receiving BPG for the last 10 years. The average adherence rate to monthly BPG injection was 80.60% with a range of 0% to 100%. However, only 101 (69.7%) of participants were taking ≥80% of their prescribed monthly BPG prophylaxis doses. Study participants with informal education 1.10 (0.023-46.96) and secondary school education 0.89 (0.10-8.11) were more and less likely to adhere to BPG injection, respectively, when compared with those who attended higher education programs. The regression analysis showed patients who were not admitted to the hospital (AOR: 26.22; CI: 2.55-269.70; p=0.006) and once admitted patients (AOR: 50.08; CI: 2.87-873.77; p=0.007) were more likely to adhere to their BPG injections than those admitted twice or more. The study participants who waited until the next appointment were also less adherent (AOR: 0.02; CI: 0.00-0.13; p=0.000) than those who went a few days later for receiving the missed/late dose. Conclusion: The adherence rate to BPG injection among RHD patients was found to be high (80.60%). Patients' admission status and their action on missed and/or late doses were found to be important determinants of adherence in this study.

show abstract

Section: Discussioncontrasting

confidence: 94%

<p>Adherence to Benzathine Penicillin G Secondary Prophylaxis and Its Determinants in Patients with Rheumatic Heart Disease at a Cardiac Center of an Ethiopian Tertiary Care Teaching Hospital</p>

Mekonen

Yismaw

Abiye

et al. 2020

PPA

View full text Add to dashboard Cite

show abstract

“…Secondary prevention with 4‐weekly BPG injections has been shown to prevent RHD progression and improve RHD outcomes in children with clinical RHD, but the efficacy of BPG in preventing progression among children with latent RHD is as of yet unclear. Previous studies have shown only 20%‐65% of people with clinical RHD received an adequate amount of prescribed injections to prevent further episodes of ARF . These numbers are consistent with the poor adherence that we observed in this study.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies have shown only 20%-65% of people with clinical RHD received an adequate amount of prescribed injections to prevent further episodes of ARF. [16][17][18][19][20] These numbers are consistent with the poor adherence that we observed in this study. Improving BPG adherence would likely improve outcomes in children with RHD and steps to improve adherence, such as ensuring access to BPG and syringes, should be implemented.…”

Section: Discussionsupporting

confidence: 90%

Two‐year evolution of latent rheumatic heart disease in Malawi

Sanyahumbi

Beaton

Guffey

et al. 2019

Congenital Heart Disease

View full text Add to dashboard Cite

Background In asymptomatic children, screening echocardiography has been used to attempt to diagnose rheumatic heart disease (RHD) at an early stage (latent RHD). World Heart Federation guidelines have standardized categorization of “definite,” “borderline,” or no RHD by echo findings. The progression of RHD diagnosed through echo screening is not known. In 2014, we screened 1450 schoolchildren in Malawi. Objective Our objective was to evaluate 2‐year RHD evolution among those diagnosed through screening. Methods Two‐year follow‐up echocardiograms of those diagnosed with latent RHD were read by a primary, secondary, then third reader if there was disagreement. Progression or regression of both definite and borderline groups were tabulated. Penicillin adherence, age, gender, number in home, and household income were compared between those with definite RHD who regressed to borderline and those that stayed definite. We utilized the local system used to track HIV defaulters in order to bring participants back into care. Comparisons were made using Fisher’s exact and Wilcoxon rank‐sum tests. Results Of the 39 with borderline RHD, 1 was lost to follow‐up (2.6%), 1 progressed to definite (2.6%), 19 remained borderline (48.7%), 17 (43.6%) regressed to normal, and 1 was reclassified as mitral valve prolapse (2.6%). Of the 11 with definite RHD, 6 (54.5%) remained definite, 4 regressed to borderline (36.4%), and 1 regressed to normal (9.1%). Two of 11 with definite RHD had penicillin adherence above 80% for the 2‐year follow‐up period. There were no differences in adherence, gender, age, household income, or number in household between those with definite RHD that regressed to borderline and those who did not (P > .19). Conclusions Borderlines had a very low progression rate to definite RHD. A strength of our study was a high retention rate (98%). Longer follow‐up is needed to determine expected disease evolution.

show abstract

“…It would be useful to repeat the present analysis in Fiji after the current interventions, ideally through routine programme data collection using the Web‐based register. Further qualitative investigation of the drivers of good and poor adherence will be valuable for targeting future adherence strategies . Advancements in therapy, such as a longer acting form of penicillin , could also improve adherence and disease control.…”

Section: Discussionmentioning

confidence: 99%

Adherence to secondary antibiotic prophylaxis for patients with rheumatic heart disease diagnosed through screening in Fiji

Engelman

Mataika

Kado

et al. 2016

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

A Qualitative Examination of Secondary Prophylaxis in Rheumatic Heart Disease: Factors Influencing Adherence to Secondary Prophylaxis in Uganda

Abstract: We identified key facilitators and barriers to secondary prophylaxis for RHD from the patient perspective framed within the socioecological model. Our findings provide direction for intervention development to improve national RHD secondary prophylaxis.

Cited by 36 publications

References 14 publications

<p>Adherence to Benzathine Penicillin G Secondary Prophylaxis and Its Determinants in Patients with Rheumatic Heart Disease at a Cardiac Center of an Ethiopian Tertiary Care Teaching Hospital</p>

<p>Adherence to Benzathine Penicillin G Secondary Prophylaxis and Its Determinants in Patients with Rheumatic Heart Disease at a Cardiac Center of an Ethiopian Tertiary Care Teaching Hospital</p>

Two‐year evolution of latent rheumatic heart disease in Malawi

Adherence to secondary antibiotic prophylaxis for patients with rheumatic heart disease diagnosed through screening in Fiji

Contact Info

Product

Resources

About