Rheumatic Fever in Children and Adolescents: A Long-term Epidemiologic Study of Subsequent Prophylaxis, Streptococcal Infections, and Clinical Sequelae: II. Maintenance and Preservation of the Population

Abstract

This report describes the paramedical methods used to preserve and maintain an outpatient population of 431 children and adolescents followed at monthly intervals for 5 to 6 years in an epidemiologic study of prophylaxis against rheumatic fever recurrences. The population was divided into 9 groups of patients who attended the same clinic session of each month. The 9 monthly sessions, held at places and times convenient for the patients, were expedited by advance planning of all procedures. Attendance figures showed that almost 70% of patients kept their specific scheduled appointment, and about 95% appeared for examination during each month. Of the original 431 patients, 351 (81%) were maintained throughout the entire 5 years of the prophylaxis investigation. Only 43 patients had to be dropped for lack of attendance. Although no comparable figures exist, this "preservation ratio" is unexpectedly high. It indicates the drgree of success that can be achieved by appropriate attention to the total needs of patients through integrated coordination of medical, nursing, social work, administrative, and other professional disciplines in a clinical epidemiologic investigation.