Adherence to secondary prevention of rheumatic fever and rheumatic heart disease in young people: an 11-year retrospective study

Liaw, Joshua, Gorton, Susan, Heal, Clare, and White, Andrew (2022) Adherence to secondary prevention of rheumatic fever and rheumatic heart disease in young people: an 11-year retrospective study. Australian and New Zealand Journal of Public Health, 46 (6). pp. 758-763.

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Objectives: To evaluate the secondary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in the Townsville region, Australia.

Methods: Adherence to benzathine benzylpenicillin G (BPG) was determined for 196 children and young adults aged under 22 years between January 2009 and December 2019, and factors associated with BPG adherence were analysed. Secondary outcomes included attendance at specialist reviews and echocardiograms.

Results: Adequate adherence (80%) to regular BPG injections was met by 51.1% of the cohort. Adequate BPG adherence more likely occurred for those that attended the Paediatric Outreach Clinic (OR4.15, 95%CI:2.13-8.05) or a school delivery program (OR1.87, 95%CI:1.11-3.45). People with moderate/severe RHD had greater BPG adherence (OR1.76,95%CI:1.00-3.10). People in rural/remote areas were less likely to have adequate BPG adherence compared to urban counterparts (OR0.31, 95%CI:0.15-0.65). Adherence to echocardiography was 66% and specialist review attendance was 12.5–50%.

Conclusion: Half of the cohort in the Townsville region received adequate BPG prophylaxis to prevent ARF/RHD. Although rates were relatively higher than those reported in other Australian regions, health delivery goals should be close to 100%. Low attendance at specialist services was reported.

Implication for public health: Delivery models with dedicated services, case management and family support could improve BPG adherence in individuals with ARF/RHD. Further resources in rural and remote areas are needed.

Item ID: 74421
Item Type: Article (Research - C1)
ISSN: 1753-6405
Keywords: adolescent, rheumatic fever, rheumatic heart disease, Penicillin G Benzathine, treatment adherence and compliance, medication adherence, antibiotic prophylaxis, secondary prevention
Copyright Information: © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Date Deposited: 08 Jun 2022 07:31
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 70%
42 HEALTH SCIENCES > 4206 Public health > 420605 Preventative health care @ 30%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 70%
20 HEALTH > 2004 Public health (excl. specific population health) > 200412 Preventive medicine @ 30%
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