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Sharing success - understanding barriers and enablers to secondary prophylaxis delivery for rheumatic fever and rheumatic heart disease

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journal contribution
posted on 17.01.2021, 23:33 by J Chamberlain-Salaun, Jane MillsJane Mills, PM Kevat, MGW Rémond, GP Maguire
© 2016 The Author(s). 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.


This study was supported by: the HeartKids Australia Grants-In-Aid Program supported by the Wilson HTM Foundation; the National Health and Medical Research Council (NHMRC) Centres for Research Excellence to Reduce Inequality in Heart Disease and END RHD; and the Victorian Government's Operational Infrastructure Support Program. Graeme Maguire is supported by an NHMRC Practitioner Fellowship. The funding bodies had no role in the design of the study, collection, analysis and interpretation of data, or in writing the manuscript.


Publication Date



BMC Cardiovascular Disorders





Article Number

ARTN 166







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