Sharing Success - Understanding Barriers and Enablers to Secondary Prophylaxis Delivery for Rheumatic Fever and Rheumatic Heart Disease

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2016 Sep 2

PMID 27581750

Citations 15

Authors

Jennifer Chamberlain-Salaun

Jane Mills

Priya M Kevat

Marc G W Remond

Graeme P Maguire

Affiliations

Soon will be listed here.

Abstract

Background: Rheumatic fever (RF) and rheumatic heart disease (RHD) cause considerable morbidity and mortality amongst Australian Aboriginal and Torres Strait Islander populations. Secondary antibiotic prophylaxis in the form of 4-weekly benzathine penicillin injections is the mainstay of control programs. Evidence suggests, however, that delivery rates of such prophylaxis are poor.

Methods: This qualitative study used semi-structured interviews with patients, parents/care givers and health professionals, to explore the enablers of and barriers to the uptake of secondary prophylaxis. Data from participant interviews (with 11 patients/carers and 11 health practitioners) conducted in four far north Queensland sites were analyzed using the method of constant comparative analysis.

Results: Deficits in registration and recall systems and pain attributed to injections were identified as barriers to secondary prophylaxis uptake. There were also varying perceptions regarding responsibility for ensuring injection delivery. Enablers of secondary prophylaxis uptake included positive patient-healthcare provider relationships, supporting patient autonomy, education of patients, care givers and healthcare providers, and community-based service delivery.

Conclusion: The study findings provide insights that may facilitate enhancement of secondary prophylaxis delivery systems and thereby improve uptake of secondary prophylaxis for RF/RHD.

Citing Articles

Acceptability and Implementation Challenges of Benzathine Penicillin G Secondary Prophylaxis for Rheumatic Heart Disease in Ethiopia: A Qualitative Study.

Birru E, Batty K, Manning L, Enkel S, Moore B Glob Heart. 2025; 20(1):8.

PMID: 39896316 PMC: 11784522. DOI: 10.5334/gh.1393.

User-Centered Design to Develop Automated Short Message Service Messaging for Patient Support of Rheumatic Heart Disease Secondary Antibiotic Prophylaxis.

Fall N, Odong F, Thembo J, Pulle J, Hoekzema J, Rwebembera J J Am Heart Assoc. 2024; 13(2):e031252.

PMID: 38226514 PMC: 10926829. DOI: 10.1161/JAHA.123.031252.

Health System Enablers and Barriers to Continuity of Care for First Nations Peoples Living with Chronic Disease.

Pinero de Plaza M, Gebremichael L, Brown S, Wu C, Clark R, McBride K Int J Integr Care. 2023; 23(4):17.

PMID: 38107834 PMC: 10723014. DOI: 10.5334/ijic.7643.

Detection and management of latent rheumatic heart disease: a narrative review.

Lamichhane P, Patel F, Al Mefleh R, Mohamed Gasimelseed S, Ala A, Gawad G Ann Med Surg (Lond). 2023; 85(12):6048-6056.

PMID: 38098553 PMC: 10718380. DOI: 10.1097/MS9.0000000000001402.

Development and User Testing of a Dynamic Tool for Rheumatic Heart Disease Management.

de Loizaga S, Pulle J, Rwebembera J, Abrams J, Atala J, Chesnut E Appl Clin Inform. 2023; 14(5):866-877.

PMID: 37914157 PMC: 10620041. DOI: 10.1055/s-0043-1774812.

References

. Allergic reactions to long-term benzathine penicillin prophylaxis for rheumatic fever. International Rheumatic Fever Study Group. Lancet. 1991; 337(8753):1308-10. View

Remond M, Severin K, Hodder Y, Martin J, Nelson C, Atkinson D . Variability in disease burden and management of rheumatic fever and rheumatic heart disease in two regions of tropical Australia. Intern Med J. 2012; 43(4):386-93. DOI: 10.1111/j.1445-5994.2012.02838.x. View

Weinstein P, Raadal M, Naidu S, Yoshida T, Kvale G, Milgrom P . A videotaped intervention to enhance child control and reduce anxiety of the pain of dental injections. Eur J Paediatr Dent. 2004; 4(4):181-5. View

Jacobson Vann J, Szilagyi P . Patient reminder and patient recall systems to improve immunization rates. Cochrane Database Syst Rev. 2005; (3):CD003941. PMC: 6485483. DOI: 10.1002/14651858.CD003941.pub2. View

Carapetis J, Currie B . Mortality due to acute rheumatic fever and rheumatic heart disease in the Northern Territory: a preventable cause of death in aboriginal people. Aust N Z J Public Health. 1999; 23(2):159-63. DOI: 10.1111/j.1467-842x.1999.tb01227.x. View

Carapetis J, Kilburn C, MacDonald K, Walker A, Currie B . Ten-year follow up of a cohort with rheumatic heart disease (RHD). Aust N Z J Med. 1998; 27(6):691-7. DOI: 10.1111/j.1445-5994.1997.tb01000.x. View

Manyemba J, Mayosi B . Penicillin for secondary prevention of rheumatic fever. Cochrane Database Syst Rev. 2002; (3):CD002227. PMC: 7017848. DOI: 10.1002/14651858.CD002227. View

White H, Walsh W, Brown A, Riddell T, Tonkin A, Jeremy R . Rheumatic heart disease in indigenous populations. Heart Lung Circ. 2010; 19(5-6):273-81. DOI: 10.1016/j.hlc.2010.02.019. View

Russell K, Nicholson R, Naidu R . Reducing the pain of intramuscular benzathine penicillin injections in the rheumatic fever population of Counties Manukau District Health Board. J Paediatr Child Health. 2013; 50(2):112-7. DOI: 10.1111/jpc.12400. View

10.

Remond M, Coyle M, Mills J, Maguire G . Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease: A Literature Review with a Global Perspective. Cardiol Rev. 2015; 24(2):94-8. DOI: 10.1097/CRD.0000000000000065. View

11.

Amir J, Ginat S, Cohen Y, Marcus T, Keller N, Varsano I . Lidocaine as a diluent for administration of benzathine penicillin G. Pediatr Infect Dis J. 1998; 17(10):890-3. DOI: 10.1097/00006454-199810000-00008. View

12.

Carapetis J, Steer A, Mulholland E, Weber M . The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005; 5(11):685-94. DOI: 10.1016/S1473-3099(05)70267-X. View

13.

. Rheumatic fever and rheumatic heart disease. World Health Organ Tech Rep Ser. 2004; 923:1-122, back cover. View

14.

Heckathorn D . SNOWBALL VERSUS RESPONDENT-DRIVEN SAMPLING. Sociol Methodol. 2012; 41(1):355-366. PMC: 3250988. DOI: 10.1111/j.1467-9531.2011.01244.x. View

15.

Carapetis J, Wolff D, Currie B . Acute rheumatic fever and rheumatic heart disease in the top end of Australia's Northern Territory. Med J Aust. 1996; 164(3):146-9. DOI: 10.5694/j.1326-5377.1996.tb122012.x. View

16.

Meira Z, Goulart E, Colosimo E, Mota C . Long term follow up of rheumatic fever and predictors of severe rheumatic valvar disease in Brazilian children and adolescents. Heart. 2005; 91(8):1019-22. PMC: 1769032. DOI: 10.1136/hrt.2004.042762. View

17.

Remond M, Wheaton G, Walsh W, Prior D, Maguire G . Acute rheumatic fever and rheumatic heart disease--priorities in prevention, diagnosis and management. A report of the CSANZ Indigenous Cardiovascular Health Conference, Alice Springs 2011. Heart Lung Circ. 2012; 21(10):632-8. DOI: 10.1016/j.hlc.2012.05.006. View

18.

Eissa S, Lee R, Binns P, Garstone G, McDonald M . Assessment of a register-based rheumatic heart disease secondary prevention program in an Australian Aboriginal community. Aust N Z J Public Health. 2005; 29(6):521-5. DOI: 10.1111/j.1467-842x.2005.tb00243.x. View

19.

Harrington Z, Thomas D, Currie B, Bulkanhawuy J . Challenging perceptions of non-compliance with rheumatic fever prophylaxis in a remote Aboriginal community. Med J Aust. 2006; 184(10):514-7. DOI: 10.5694/j.1326-5377.2006.tb00347.x. View

20.

Wagner E, Austin B, Davis C, Hindmarsh M, Schaefer J, Bonomi A . Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2002; 20(6):64-78. DOI: 10.1377/hlthaff.20.6.64. View