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Rheumatic Heart Disease Australia

Aoife and Jules Milikapiti preschool

In Context

RHDAustralia works in the context of relevant policy, research and practice developments both in Australia and internationally. We do this by working with affiliated organisations, researchers and clinicians to ensure our work is informed and guided by current thinking and research in the field.

This means a knowledge and awareness of:

  • The policy context in which rheumatic heart disease control in Australia operates
  • Current research findings and opportunities to translate these into practice
  • Global experience and best practice recommendations for control of rheumatic heart disease
  • Primary health care systems and chronic care models applicable in the context of acute rheumatic fever and rheumatic heart disease

RHDAustralia contributes to the development and progression of an improved model of care to address the burden of acute rheumatic fever and rheumatic heart disease in Australia through coordination of state and national forums to share and progress knowledge and evidence-based best practice.

Key policy documents and statements which guide our work are provided below. You can also download key reports produced by RHDAustralia.


Key Policy Documents

Better Cardiac Care for Aboriginal and Torres Strait Islander people

Better Cardiac Care for Aboriginal and Torres Strait Islander People, a project supported by the Australian Health Ministers’ Advisory Council, aims to reduce mortality and morbidity from cardiac conditions by increasing access to services, better managing risk factors and treatment, and by improving the coordination of care. The Better Cardiac Care for Aboriginal and Torres Strait Islander People Forum was held in March 2014. The (unpublished) post-forum report identified five priority areas for intervention and associated actions that health services should undertake to improve cardiac care for Aboriginal and Torres Strait Islander people. Rheumatic heart disease (strengthen the diagnosis, notification and follow-up of rheumatic heart disease) was one of these priority areas. The forum also developed a set of 21 Better cardiac care measures that were designed to ensure implementation and ongoing monitoring of these actions. The Australian Institute of Health and Welfare (AIHW) was funded to prepare the first report on these 21 measures, which was released in August 2015.

UPDATE: 2016 Report Available Below

This is the second national report on the 21 Better Cardiac Care measures for Aboriginal and Torres Strait Islander people, with updated data available to report on eleven measures. For some of the measures, a better or similar rate for Indigenous Australians compared with non-Indigenous Australians was apparent, while on other measures, higher rates of ill health and death from cardiac conditions and lower rates of in-hospital treatment services among Indigenous Australians were evident. A number of measures suggested improvements for Indigenous Australians over time; examples include a decline in the death rate due to cardiac conditions and an increase in the proportion who received an MBS health assessment.

Essential service standards for equitable national cardiovascular care for Aboriginal and Torres Strait Islander people (ESSENCE)

The Essential service standards for equitable national cardiovascular care for Aboriginal and Torres Strait Islander people (ESSENCE) project, led by the South Australian Health and Medical Research Institute, has produced standards on the essential services and care for Aboriginal and Torres Strait Islander people with cardiovascular disease.

These standards represent the best available evidence and expert consensus on the essential services and care for Aboriginal and Torres Strait Islander people with cardiovascular disease. They articulate what elements of care are necessary to reduce disparity in access and outcomes for five critical cardiovascular conditions: Coronary Heart Disease; Chronic Heart Failure; Stroke; Rheumatic Heart Disease; and Hypertension, the leading causes of death and disability within the Australian population.

Some of the measures for these standards overlap with the Better cardiac care measures.

The 5x5 path towards Rheumatic Heart Disease control: outcomes from the Third Rheumatic Heart Disease Forum

The Third Global Rheumatic Heart Disease Forum (RHD forum) was held on May 5th at the 2014 World Congress of Cardiology in Melbourne, Australia. Hosted by RHDAustralia, RhEACH and the World Heart Federation the forum brought together over 167 participants from 33 countries, representing all the major continents. It was the largest gathering to date of the growing global movement to address the challenge of rheumatic heart disease (RHD).

The 5x5 path towards Rheumatic Heart Disease control: outcomes from the Third Rheumatic Heart Disease Forum, outlines discussions which occurred at the Third Global RHD Forum, and summarizes the action plan for a Roadmap for RHD Control emanating from the forum. Please note this is not an open source publication. 

Aboriginal and Torres Strait Islander Health Performance Framework

The Aboriginal and Torres Strait Islander Health Performance Framework monitors progress in Indigenous Australian health outcomes, health system performance and broader determinants of health. It was developed to support a comprehensive and coordinated effort across and beyond the health sector to address the complex and interrelated factors that contribute to health outcomes experienced by Aboriginal and Torres Strait Islander Australians.

The biennial report Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report: detailed analyses is the authoritative evidence base for Aboriginal and Torres Strait Islander health policy and is well recognised for its innovative approach to combining evidence from national data collections and research literature with policy analysis. The HPF report presents a high level summary of data and policy analysis for 68 performance measures across three tiers of health status and outcomes, determinants of health, including socioeconomic and behavioural factors, and health system performance.

Content is developed and coordinated by the Department of the Prime Minister and Cabinet in consultation with the Department of Health. For each HFP report, the Australian Institute of Health and Welfare (AIHW) has published detailed analyses of the data prepared for each measure.

Section 1.06: Acute rheumatic fever and rheumatic heart disease provides a detailed analysis of the incidence and prevalence of acute rheumatic fever and rheumatic heart disease among Aboriginal and Torres Strait Islander people.

 

Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease

In the 21st century, rheumatic fever (RF) and rheumatic heart disease (RHD) are neglected diseases of marginalized communities. Globally, RHD remains the most-common cardiovascular disease in young people aged <25 years. Although RF and RHD have been almost eradicated in areas with established economies, migration from low-income to high-income settings might be responsible for a new burden of RHD in high-income countries. The World Heart Federation (WHF) and its Working Group on RF and RHD unites global experts, combines their experience and enthusiasm, and provides a platform for RHD control. The Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease is a declaration of the WHF institutional strategic goal—a 25% reduction in premature deaths from RF and RHD among individuals aged <25 years by the year 2025. The position statement affirms WHF commitments to five key strategic targets: comprehensive register-based control programmes, global access to benzathine penicillin G, identification and development of public figures as 'RHD champions', expansion of RHD training hubs, and support for vaccine development.

The paper also reviews existing barriers to RF and RHD control and identifies the actions required to change the trajectory of control for these diseases. This approach provides the foundation for governments, civil society, patient advocates, clinicians, researchers, and funding agencies to develop partnerships and unify global efforts to control RF and RHD. The WHF plans to expand this position statement to an operational plan that will be founded on science, research, and quantifiable progress indicators to impact positively on the millions of people who are affected by RHD and its long-term sequelae.

Northern Territory chronic conditions prevention and management strategy 2010-2020

The approach to chronic conditions described in the Northern Territory chronic conditions prevention and management strategy 2010-2020 can be applied to all chronic conditions, however 7 specific conditions are prioritised because they cause the greatest burden of disease in the NT; are preventable; share common risk factors; have complex causes; have a gradual onset but are long term and persistent; occur across the life cycle although they become more prevalent with older age; and are usually not immediately life threatening but can compromise quality of life through physical limitations and disability.

These conditions, which include rheumatic heart disease, are commonly associated with the social determinants of health and contribute significantly to the gap in life expectancy between Aboriginal and non-Aboriginal people


RHD Australia Reports

RHDAustralia Colloquium | Sydney, NSW, May 2015

The Colloquium brought together stakeholders from policy, clinical practice and research to discuss the development of a framework for a patient-centred model of care for acute rheumatic fever and rheumatic heart disease in the Australian context.

The Colloquium included an assessment of the current national and jurisdictional policy environments; an analysis of gaps within service delivery; and a review of international experience and recommendations for the control of rheumatic heart disease. Outcomes from the day will inform recommendations for potential reorientation of health services and systemic changes to improve outcomes for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) patients and to reduce the incidence of ARF/RHD.

The Colloquium discussion enabled a consensus view in the identification of six national priorities for ARF and RHD prevention and management in Australia, and demonstrated how collaboration may proceed to influence national policy. The ARF/RHD Colloquium was the first of its kind in Australia, and provided a valuable opportunity to build relationships with and amongst key stakeholders, to identify current issues and gaps in service delivery, and to prioritise further action required to address these gaps.

RHDAustralia will undertake further work to progress these recommendations as a priority during the National Coordinating Unit’s current funding agreement with the Commonwealth 2015-2017.

Colloquim Participant Report »

Nurse Practitioner Framework

The framework presents a case for a nurse practitioner role in the prevention and management of acute rheumatic fever and rheumatic heart disease.

The majority of acute rheumatic fever and rheumatic heart disease patients in Australia are Aboriginal and Torres Strait Islander people living in remote and rural areas where remoteness; transient population; poor living and education standards; high health practitioner turnover; and limited knowledge of the disease all contribute to delays and deficiencies in health service delivery and, ultimately, to the burden of disease.

The framework demonstrates how a nurse practitioner could play a pivotal role in building the capacity of the health service to provide a more systematic, timely and coordinated approach to addressing service gaps and improving outcomes in the management of acute rheumatic fever and rheumatic heart disease.

Framework for a Nurse Practitioner Role in ARF and Heart Disease »

Series of National Guidelines (SoNGs): Public Health Management of ARF/RHD

The Series of National Guidelines (SoNGs) have been developed in consultation with the Communicable Diseases Network Australia (CDNA) and endorsed by the Australian Health Protection Principal Committee (AHPPC). Their purpose is to provide nationally consistent advice and guidance to public health units in responding to a notifiable disease event. These guidelines capture the knowledge of experienced professionals, built on past research efforts, and provide advice on best practice based upon the best available evidence at the time of completion.

RHDAustralia has led the development of National Guideline for the public health management of acute rheumatic fever and rheumatic heart disease. The guideline is in final stages of consultation before submission to CDNA in early 2016.