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Am J Public Health. 1980 November; 70(11): 1189–1193.
PMCID: PMC1619572

Two studies of compliance with daily prophylaxis in rheumatic fever patients in Iowa.


We determined the penicillin compliance rates in school year 1974-75 for 235 children with rheumatic fever through analysis of urine specimens collected at school. Patients relatively low on compliance during the first year of sampling were divided into two equal size groups for a second year sampling study. One-half (N = 44) of these second year study patients and their parents were readvised regarding the need for penicillin prophylaxis and one-half (N = 44) served as controls. We related eductional data, behavioral ratings, and family information to compliance rates in both study years. The overall compliance for the children during the initial sampling year was 64.6 per cent. Factors found to be significantly related to compliance in year one were: 1) male sex, 2) large sibship, 3) increased number of behavior problems, 4) relatively poor academic progress, 5) lower maternal educational level, and 6) recurrence of rheumatic fever. Compliance rates for reinforced patients did not differ significantly from controls during the second year sampling.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Gordis L, Markowitz M, Lilienfeld AM. Why patients don't follow medical advice: a study of children on long-term antistreptococcal prophylaxis. J Pediatr. 1969 Dec;75(6):957–968. [PubMed]
  • Markowitz M. Eradication of rheumatic fever: an unfulfilled hope. Circulation. 1970 Jun;41(6):1077–1084. [PubMed]
  • Markowitz M, Gordis L. A mail-in technique for detecting penicillin in urine: application to the study of maintenance of prophylaxis in rheumatic fever patients. Pediatrics. 1968 Jan;41(1):151–153. [PubMed]
  • PETERSON DR. Behavior problems of middle childhood. J Consult Psychol. 1961 Jun;25:205–209. [PubMed]
  • McKenney JM, Slining JM, Henderson HR, Devins D, Barr M. The effect of clinical pharmacy services on patients with essential hypertension. Circulation. 1973 Nov;48(5):1104–1111. [PubMed]

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