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. 2024 May 20;8(1):e002450.
doi: 10.1136/bmjpo-2023-002450.

Patient preferences for prophylactic regimens requiring regular injections in children and adolescents: a systematic review and thematic analysis

Jana Ilievski  1 , Olivia Mirams  2 , Rebecca Trowman  3 , Renae K Barr  2 , Laurens Manning  4   5
Affiliations

Patient preferences for prophylactic regimens requiring regular injections in children and adolescents: a systematic review and thematic analysis

Jana Ilievski et al. BMJ Paediatr Open. .

Abstract

Background: At present, limited literature exists exploring patient preferences for prophylactic treatment of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Given low treatment completion rates to this treatment in Australia, where the burden of disease predominantly affects Aboriginal and Torres Strait Islander people, an improved understanding of factors driving patient preference is required to improve outcomes. Due to limited available literature, this review sought to explore treatment preferences for conditions for which the findings might be generalisable to the ARF/RHD context.

Objective: Explore treatment preferences of patients, parents/caregivers and healthcare providers towards regular injection regimens in paediatric and adolescent populations for any chronic condition. Findings will be applied to the development of benzathine penicillin G (BPG) prophylactic regimens that are informed by treatment preferences of patients and their caregivers. This in turn should contribute to optimisation of successful BPG delivery.

Methods: A systematic review of databases (Medline, Embase and Global Health) was conducted using a search strategy developed with expert librarian input. Studies were selected using a two-stage process: (1) title and abstract screen and (2) full text review. Data were extracted using a reviewer-developed template and appraised using the JBI Critical Appraisal tool. Data were synthesised according to a thematic analytical framework.

Results: 1725 papers were identified by the database search, conducted between 12 February 2022 and 8 April 2022, and 25 were included in the review. Line-by-line coding to search for concepts generated 20 descriptive themes. From these, five overarching analytical themes were derived inductively: (1) ease of use, (2) tolerability of injection, (3) impact on daily life, (4) patient/caregiver agency and (5) home/healthcare interface.

Conclusions: The findings of this review may be used to inform the development of preference-led regular injection regimens for paediatric and adolescent patient cohorts-specifically for BPG administration in ARF/RHD secondary prophylaxis.

Trial registration number: Patient, parent and health personnel preferences towards regular injection regimes in paediatric and adolescent populations-a protocol for a systematic review. PROSPERO 2021 CRD42021284375. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021284375.

Keywords: Adolescent Health; Cardiology; Therapeutics.

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Conflict of interest statement

Competing interests: This review was completed as part of the MD Scholarly Activity programme at the University of Western Australia (UWA) Medical School. Telethon Kids Institute and UWA Medical School provided support for the work reported in the submitted manuscript.

Figures

Figure 1
Figure 1
PRISMA flow diagram of eligible studies available for data synthesis.
Figure 2
Figure 2
Depiction of the data synthesis process, identified descriptive subthemes corresponding to overarching analytical themes.
See this image and copyright information in PMC

References

    1. Wyber R, Noonan K, Halkon C, et al. . Ending rheumatic heart disease in Australia: the evidence for a new approach. Med J Aust 2020;213 Suppl 10:S3–31. 10.5694/mja2.50853 - DOI - PubMed
    1. RHD Australia . Administering BPG [Internet]. 2017. Available: https://www.rhdaustralia.org.au/system/files/fileuploads/bicillin_dvd_bo...
    1. Beaton A, Okello E, Engelman D, et al. . Determining the impact of Benzathine penicillin G prophylaxis in children with latent rheumatic heart disease (GOAL trial): study protocol for a randomized controlled trial. Am Heart J 2019;215:95–105. 10.1016/j.ahj.2019.06.001 - DOI - PubMed
    1. Kevat PM, Gunnarsson R, Reeves BM, et al. . Adherence rates and risk factors for suboptimal adherence to secondary prophylaxis for rheumatic fever. J Paediatr Child Health 2021;57:419–24. 10.1111/jpc.15239 - DOI - PMC - PubMed
    1. Russo S, Jongerius C, Faccio F, et al. . Understanding patients' preferences: a systematic review of psychological instruments used in patients' preference and decision studies. Value Health 2019;22:491–501. 10.1016/j.jval.2018.12.007 - DOI - PubMed

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