As part of our work in the national rheumatic fever prevention programme, NHC led a series of four pilot interventions to test whether they had an impact on antibiotic adherence. The trial was carried out in the South Auckland community during late 2014. A summary of the findings is included below.
The most effective intervention to improve antibiotic adherence was directly observed therapy (DOT), which significantly improved the number of children who successfully completed their 10 days of antibiotic treatment. To administer DOT in a school based clinic, an additional 127.9 minutes of nursing time per child was required.
Blister packs and daily text message reminders were well received in primary school students and their whānau but they did not help to improve antibiotic adherence and made no difference to the number of children successfully completing their antibiotic treatment.
Intramuscular (IM) bicillin was an acceptable treatment option to children and whānau in the South Auckland community. The majority of parents were happy with IM bicillin and would choose to have it again. Using a distraction device with lignocaine was an effective pain management strategy to manage pain associated with the injection. A number of children who received the IM bicillin were children with repeat sore throats and some of these children still had a GAS positive throat swab following the IM bicillin. There is some confusion in parents and nursing staff around the management of these children and clear guidelines are currently being established