title: Low adherence to secondary prophylaxis among clients diagnosed with rheumatic fever, Jamaica.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.forename: Sheron Boswell
authors.initials: SB
authors.lastname: Thompson
authors.forename: Cerese Hepburn
authors.initials: CH
authors.lastname: Brown
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Edwards
authors.forename: Jascinth L M
authors.initials: JL
authors.lastname: Lindo
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007563:Jamaica; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010406:Penicillins / Q000627:therapeutic use*; D012213:Rheumatic Fever / Q000517:prevention & control* / Q000523:psychology; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins
keywords: Adherence,; Barriers,; Jamaica; Rheumatic fever,; Secondary Prophylaxis,
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