Reasons for lack of awareness regarding rheumatic heart disease among hospitalized patients at a cardiac tertiary care setting - Who to blame, the patient or the practitioner?

Objective: To assess patient and physician related factors affecting awareness about rheumatic heart disease among hospitalized patients. Methodology: This cross-sectional study was conducted in the adult cardiology unit at the National Institute of Cardiovascular Diseases, Karachi, Pakistan. The sampling technique was non -probability, consecutive sampling. Patients with rheumatic heart disease of age group between 18 to 60 years were included. All information was recorded using a structured questionnaire. Collected data was entered and analyzed using SPSS 19. Results: A total of 502 patients were enrolled with almost equal number of male and female patients. Mean age was 37.3 +/- 10.9 years. Majority had received primary school education or above. Forty percent patients were not aware of rheumatic valvular heart disease as their diagnosis. Less than half of patients knew childhood fever and sore throat. 72.6% patients were not aware of prophylactic treatment for the disease. There was a late referral to a cardiologist by the general medical practitioner. Conclusion: There was a very high incidence of lack of awareness regarding rheumatic heart disease among affected patients. Moreover, there was a high incidence of inadequate physician -patient counseling about the disease and late referral to cardiologist. To eradicate the scourge of rheumatic heart disease, there needs to be greater physician -patient engagement for improving awareness.