Evaluation of a nurse-led intervention to improve adherence to secondary prevention of rheumatic heart disease

Abstract

Background/Aims Rheumatic heart disease is a major health concern in India. Secondary prevention following acute rheumatic fever can prevent disease escalation, but adherence rates are often low. This study evaluated whether a nurse-led intervention could effectively increase adherence rates to secondary prevention and reduce rheumatic symptoms in this patient group. Methods A total of 60 patients were randomly assigned to either an intervention or control group. The control group received standard treatment, while the intervention group received a 25-minute education session with a nurse, along with text message or phone call reminders before they were due for treatment. Participants also completed a rheumatic morbidity index scale survey over 12 months to record their symptoms. A two-way sample t-test was used to compare adherence rates and symptom incidence in both groups. Results Patients in the intervention group had significantly better adherence rates to their medication, receiving 11–17 of the total 18 injections over the 12-month period, compared to 6–12 in the control group. They were also less likely to experience symptoms of rheumatic heart disease or require emergency hospitalisation. Conclusions A nurse-led intervention is an effective method of reducing pressure on hospital services and increasing treatment adherence among patients receiving secondary prevention treatment for rheumatic heart disease.