Rheumatic fever recurrence prevention: A nurse‐led programme of 28‐day penicillin in an area of high endemnicity

Spinetto, Heather; Lennon, Diana; Horsburgh, Margaret

doi:10.1111/j.1440-1754.2010.01942.x

Cited by 53 publications

(43 citation statements)

References 24 publications

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“…High use rates were reported for a New Zealand secondary prophylaxis program that involved community-based nurses working with ethnically appropriate health workers who provided education, support, and transport. 59 Other studies have confirmed that the administration of secondary prophylaxis improves where clear responsibility is placed upon a particular staff member to actively follow-up clients who miss injections. 52 One study in central Australia investigated the novel concept of delivering secondary prophylaxis at times of the full moon.…”

Section: Clinical Practicementioning

confidence: 95%

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Rémond

Coyle

Mills

et al. 2016

Cardiology in Review

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Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are autoimmune conditions resulting from infection with group A streptococcus. Current management of these conditions includes secondary antibiotic prevention. This comprises regular 3 to 4 weekly long-acting intramuscular benzathine penicillin injections. Secondary antibiotic prevention aims to protect individuals against reinfection with group A streptococcus, thereby preventing recurrent ARF and the risk of further damage to the heart valves. However, utilization of benzathine penicillin can be poor leaving patients at risk of avoidable and progressive heart damage. This review utilizes the Chronic Care Model as a framework to discuss initiatives to enhance the delivery of secondary antibiotic prophylaxis for ARF and RHD. Results from the search strategy utilized revealed that there is limited pertinent published evidence. The evidence that is available suggests that register/recall systems, dedicated health teams for delivery of secondary antibiotic prophylaxis, education about ARF and RHD, linkages with the community (particularly between health services and schools), and strong staff-patient relationships may be important. However, it is difficult to generalize findings from individual studies to other settings and high quality studies are lacking. Although secondary antibiotic prophylaxis is an effective treatment for those with ARF or RHD, the difficulties in implementing effective programs that reduce the burden of ARF and RHD demonstrates the importance of ongoing work in developing and evaluating research translation initiatives.

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Section: Clinical Practicementioning

confidence: 95%

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Rémond

Coyle

Mills

et al. 2016

Cardiology in Review

View full text Add to dashboard Cite

show abstract

“…Secondary prophylaxis for rheumatic fever can be safely administered in schools and settings other than hospital and health centers with few incidents of lifethreatening allergic reactions reported. [26][27][28][29] Of 17 641 penicillin injections administered among 535 children diagnosed with rheumatic fever in Turkey, there were only 11 reported allergies of which one was confirmed as a penicillin allergy. According to Grayson et al, in the New Zealand health system, the delivery of rheumatic fever prophylaxis at the community level (school, work, home, and clinic) resulted in high rates of adherence.…”

Section: Thompson Et Al Low Adherence To Secondary Prophylaxis Amongmentioning

confidence: 99%

Low adherence to secondary prophylaxis among clients diagnosed with rheumatic fever, Jamaica

Thompson

Brown

Edwards

et al. 2014

Pathogens and Global Health

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Objectives:To determine the level of adherence and possible barriers to secondary prophylaxis among clients with rheumatic fever in Kingston, Jamaica. Methods: Cross-sectional survey of 39 clients diagnosed with rheumatic fever, receiving penicillin prophylaxis for more than a year using a 22-item self-administered questionnaire on adherence to secondary prophylaxis and knowledge of rheumatic fever. The patients' records were reviewed to determine the number of prophylaxis injections the patients received for the year 2010. Results: The majority of participants (74%) were females and 51% were adults. Only 48.7% had a high level of adherence. The majority (72%) had low knowledge levels regarding their illness, while only 5% had a high knowledge level score. Most clients (70%) strongly agreed that nurses and doctors encouraged them to take their prophylaxis. However, over 60% reported that they travelled long distances and or waited long periods to get their injections. One-third reported that they missed appointments because of fear of injections and having to take time off from work or school. Discussion: Clients attending the health centers studied had limited knowledge about rheumatic fever. Barriers to adherence included fear of the injections, long commutes, and long waiting periods at the facilities studied.

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“…In New Zealand, where RF is endemic among indigenous populations, penicillin every four weeks has dropped the ARF recurrence rate to 0.6/100 patient years 14 15. Compliance rates of >90% have been the norm.…”

Section: Discussionmentioning

confidence: 99%

“…Long-term compliance is reinforced at each follow-up. These programmes have been associated with reduced rates of ARF recurrences and high degrees of adherence to secondary prophylaxis regimens 14 15 17. These resources may not be available in countries with a low incidence of ARF.…”

Section: Discussionmentioning

confidence: 99%

Failure of oral penicillin as secondary prophylaxis for rheumatic heart disease: a lesson from a low-prevalence rheumatic fever region

et al. 2015

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Our patient is an 18-year-old Caucasian woman from the UK who developed severe mitral stenosis on a history of childhood acute rheumatic fever (ARF) and rheumatic heart disease (RHD). She had been reporting of her oral penicillin secondary prophylaxis regimen since diagnosis. At the age of 15 years, a new murmur was discovered during routine cardiac follow-up. An echocardiogram confirmed moderate-severe mitral stenosis. One year later, her exercise tolerance significantly deteriorated and she subsequently underwent balloon valvuloplasty of her mitral valve to good effect. Our case emphasises the evidence base supporting the use of monthly intramuscular penicillin injection to prevent ARF recurrence and RHD progression; it also emphasises the reduced efficacy of oral penicillin prophylaxis in this context. It particularly resonates with regions of low rheumatic fever endemicity. The long-term cardiac sequelae of ARF can be devastating; prescribing the most effective secondary prophylaxis regimen is essential.

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Rheumatic fever recurrence prevention: A nurse‐led programme of 28‐day penicillin in an area of high endemnicity

Cited by 53 publications

References 24 publications

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Low adherence to secondary prophylaxis among clients diagnosed with rheumatic fever, Jamaica

Failure of oral penicillin as secondary prophylaxis for rheumatic heart disease: a lesson from a low-prevalence rheumatic fever region

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