A qualitative examination of secondary prophylaxis in rheumatic heart disease: factors influencing adherence to secondary prophylaxis in Uganda

Global Heart
Daniel M HuckAllison R Webel

Abstract

Rheumatic heart disease (RHD) is the most common cause of heart disease among Ugandans age 15 to 49 years. Secondary prophylaxis with monthly injection of benzathine penicillin is effective in preventing recurrence of acute rheumatic fever and worsening of RHD, but adherence rates are poor in Uganda. This study sought to identify health behaviors, attitudes, and health care system factors that influence adherence to RHD secondary prophylaxis. We conducted 5 structured focus groups with 36 participants on monthly penicillin injections for RHD in Kamplala, Uganda. Transcripts were analyzed using qualitative description analysis and health behavior models. Most participants were female (64%), from an urban area (81%), and had family income less than US$1 daily (69%). Ages ranged from 14 to 58 years. Median prophylaxis duration was 1.42 years and 58% were adherent (≥80% of injections). Key facilitators include perceived worsening of disease with missing injections, personal motivation, a reminder system for injections, supportive family and friends, and a positive relationship with health care providers. Barriers to adherence include lack of resources for transportation and medications, fear of injection pain, poor patient-provider...Continue Reading

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Citations

Nov 19, 2017·International Journal for Equity in Health·Hilary BarkerKeri Bolton Oetzel
Mar 11, 2015·Global Heart·Uchechukwu K A SampsonJagat Narula
Apr 25, 2018·Global Heart·Christopher T LongeneckerMarco A Costa
Oct 30, 2016·Tropical Medicine & International Health : TM & IH·Daniel EngelmanAndrew C Steer
Jul 5, 2017·Transactions of the Royal Society of Tropical Medicine and Hygiene·Daniel EngelmanAndrew C Steer
Nov 24, 2017·Australian and New Zealand Journal of Public Health·Alice G MitchellAnna P Ralph
Feb 2, 2019·Congenital Heart Disease·Amy SanyahumbiPeter N Kazembe
Aug 24, 2021·Expert Review of Cardiovascular Therapy·Sarah R de LoizagaMaria Carmo Pereira Nunes
Oct 3, 2021·Current Cardiology Reports·Joselyn RwebemberaBruno R Nascimento
Oct 3, 2021·Global Health Research and Policy·Jeffrey G EdwardsAndrew Y Chang
Dec 5, 2020·The Journal of the Association of Nurses in AIDS Care : JANAC·Chelsea H WrightAllison Webel
Mar 30, 2018·American Journal of Infection Control·Shuangmei TongJing Tang

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