Adherence Of Rheumatic Heart Disease Patients To Secondary Prophylaxis And Reasons For Poor Adherence At Jimma Medical Center | 105421
Journal of Cardiovascular Diseases & Diagnosis
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Background & Aim: Rheumatic Heart Disease (RHD) is the major long-term sequel of Acute Rheumatic Fever (ARF), which
involves the cardiac valves leading to stenosis or regurgitation with resultant hemodynamic disturbance. The incidence of ARF
and prevalence RHD in the sub-Saharan Africa including Ethiopia, are amongst the highest in the world. The main priority of
long-term management of ARF or RHD is to ensure that patients are adherent to the secondary prophylaxis which is monthly
benzathine penicillin injection to prevent recurrent attacks of ARF. The present study was aimed to assess the adherence rate
of RHD patients to secondary prophylaxis and reasons for poor adherence.
Method: A cross-sectional study was conducted among sampled 241 RHD patients having at least one year follow-up at cardiac
clinic of JMC who appointed every month to receive injections of antibiotic prophylaxis. The data was collected for 4 months
(from June 1-September 30, 2018 GC) by asking their follow-up status of last one year retrospectively and assessing related
variables by using face to face interview. After the data was collected using structured questionnaires, it was coded, entered
into Epi data and exported to SPSS for further analysis. The adherence rate of RHD patients was determined by frequency of
annual injections of prophylaxis.
Results: A total of 241 patients with RHD were interviewed, among those 224 (93.0%) were received the secondary prophylaxis
at least once within last one year, despite frequency differs while 17 (7.0%) of them didnā????t initiate the prophylaxis yet. The
adherence rate of the assessed RHD patients to secondary prophylaxis was 55.2% while the left 108 RHD patients (44.8%)
were generalized as non-adhered to the prophylaxis [can be who either donā????t start the prophylaxis 17 (7.0% ) or who missed
the prophylaxis more than three times annually 86 (35.6%)]. The main reasons to miss their prophylaxis among the 108 RHD
patients with poor adherence were lack of money 41 (38%), far distance from hospital 28 (26%), fear of medication side effects
and painful injection 25 (23%) and lack of knowledge about the disease and prevention 14 (13%).
Conclusion: RHD patients attending cardiac clinic of JMC had low adherence rate (44.8%) to the secondary prophylaxis due to
lack of money, far distance from the setup, painful injection especially among children and lack of awareness about the disease.
Wondu Reta has graduated from Jimma University, Institute of Health in BSc degree in Junior Anesthesiology Professional in June 2012 and Master’s degree in Medical Physiology in October 2017. He is currently serving at Jimma University, Institute of Health as Anesthesia Care Provider, Researcher and Lecturer of Medical Physiology and Anesthesiology.