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Adherence to Secondary Prophylaxis for Acute Rheumatic Fever and Rheumatic Heart Disease: A Systematic Review.

Priya M Kevat1,2, Benjamin M Reeves2,3, Alan R Ruben4

  • 1Royal Children's Hospital, Melbourne, Victoria, Australia.

Current Cardiology Reviews
|January 18, 2017
PubMed
Summary

Adherence to benzathine penicillin G (BPG) injections for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) is crucial but challenging. Understanding patient and healthcare factors can improve secondary prophylaxis delivery.

Keywords:
Acute rheumatic feveradherencebenzathine benzylpenicillinbenzathine penicillincompliancepenicillin G benzathinerheumatic heart diseasesecondary prophylaxis.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Secondary prophylaxis with benzathine penicillin G (BPG) is vital for preventing ARF and RHD complications.
  • Poor adherence to BPG injections poses a significant challenge to ARF/RHD control programs globally.

Purpose of the Study:

  • To systematically review adherence rates to secondary prophylaxis for ARF and RHD.
  • To identify factors influencing adherence worldwide to improve service delivery.

Main Methods:

  • Systematic literature review of primary studies published in English (1994-2014).
  • Searched MEDLINE and reference lists of eligible articles.
  • Assessed methodological quality of included studies.

Main Results:

  • Twenty studies were included, reporting varied global adherence rates to BPG prophylaxis.
  • Identified demographic, clinical, socio-cultural, and healthcare factors associated with adherence.

Conclusions:

  • Insights into adherence factors can enhance secondary prophylaxis delivery for ARF/RHD.
  • Strategies include active recall systems, holistic care, community health worker involvement, and health education.