Project Details

Case Managers and Peer Support Groups (CAMPS) for Prophylaxis Adherence in Rheumatic Heart Disease

Sarah de Loizaga, MD

Summary

BACKGROUND: Rheumatic heart disease (RHD) is a chronic valvular heart disease due to untreated, recurrent Streptococcus pyogenes infection. More than 40 million people are estimated to live with RHD and 306,000 die from RHD annually. Late diagnosis of RHD is associated with high mortality at a young age, in part due to the missed opportunity to benefit from secondary antibiotic prophylaxis (SAP). GAP: Despite low adherence to RHD secondary prophylaxis globally, there is a dearth of research into pragmatic, scalable approaches to improve adherence. A recent randomized controlled trial (GOAL) achieved high adherence under trial conditions, providing a potentially scalable intervention, but it is unknown which components had the greatest effect and if these approaches would result in high adherence when integrated into routine care. HYPOTHESIS: Peer group + case manager strategies integrated into routine care will improve adherence and patient reported outcomes as compared to usual care. METHODS: CAMPS will be a pragmatic randomized trial of two support strategies for RHD secondary antibiotic prophylaxis: (1) usual care and (2) peer group + case manager strategy. The study will examine 1-year BPG adherence rates and patient reported outcomes such as treatment satisfaction and health-related quality of life. Participants will be children ages 5-17 years from the Tororo District in Eastern Uganda newly diagnosed with latent RHD. RESULTS: Pending. IMPACT: Achieving at least 80% adherence to secondary prophylaxis is critical in the management of RHD and if successful CAMPS could provide a model for improving outcomes for children impacted by RHD in Uganda and around the world.