Secondary Prophylaxis Among First Nations People With Acute Rheumatic Fever in Australia: An Integrative Review

Abstract

Introduction: The prevalence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) among Australia’s First Nations populations are some of the highest in the world, accounting for 95% of the 2,244 ARF notifications between 2015 and 2019 in Australia. A key issue in treating ARF is long-term secondary prophylaxis, yet only one in five patients received treatment in 2019. This review identifies barriers to secondary prophylaxis of ARF in Australia’s First Nations people. Methods: An integrative review was undertaken utilizing PubMed, CINAHL, ProQuest, and Wiley Online. Joanna Briggs Institute critical appraisal tools were used, followed by thematic analysis. Results: The key themes uncovered included: issues with database and recall systems, patient/family characteristics, service delivery location and site, pain of injection, education (including language barriers), and patient-clinician relationship. Conclusions: A national RHD register, change in operation model, improved pain management, improved education, and need for consistent personnel is suggested.