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.