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

Chamberlain-Salaun, Jennifer, Mills, Jane, Kevat, Priya M., Rémond, Marc G.W., and Maguire, Graeme P. (2016) Sharing success - understanding barriers and enablers to secondary prophylaxis delivery for rheumatic fever and rheumatic heart disease. BMC Cardiovascular Disorders, 16. 166. pp. 1-10.

PDF (Published Version) - Published Version
Available under License Creative Commons Attribution.

Download (635kB) | Preview
View at Publisher Website:


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.

Item ID: 46105
Item Type: Article (Research - C1)
ISSN: 1471-2261
Keywords: rheumatic fever, rheumatic heart disease, secondary prophylaxis, benzathine penicillin, penicillin
Additional Information:

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Funders: Wilson HTM Foundation (WHTM), National Health and Medical Research Council of Australia (NHMRC), Victorian Government's Operational Infrastructure Support Program
Projects and Grants: WHTM HeartKids Australia Grants-in-Aid Program, NHMRC Practitioner Fellowship
Date Deposited: 19 Oct 2016 07:42
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450408 Aboriginal and Torres Strait Islander health promotion @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 50%
92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 50%
Downloads: Total: 1190
Last 12 Months: 47
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page