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Rheumatic Heart Disease Australia

RHD Resouces

Medical guideline revised with culture at the centre of care


Medical guideline revised with culture at the centre of care

New medical guidelines released today place people with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) and their families and communities at the centre of care.

Rheumatic heart disease represents the greatest cardiovascular inequality between Indigenous and non-Indigenous Australians. From 2013 to 2017, 94 per cent of all new RHD cases were among Aboriginal and Torres Strait Islander people.

Published today by RHDAustralia, the new 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (3rd edition) recognises this disparity and highlights the need for health professionals to place people at the centre of care.

Vicki Wade, a respected Noongar woman with more than 30 years of experience working in cardiovascular health and RHDAustralia’s senior cultural advisor, was central in ensuring the new guideline addresses RHD as the leading cause of cardiovascular inequality and provides health professionals with a more holistic model of care.

“By refocusing on people with this disease, this guideline acknowledges Aboriginal and Torres Strait Islander peoples’ unique culture, and the social, economic and environmental circumstances in which they live,” said Ms Wade.

“The updated guideline identifies the systemic factors that drive disparities in best practice care delivery and offers culturally safe solutions. We have come a long way from the first edition, and this journey has culminated in an important balance between cultural and clinical competence.”

Ms Wade says the new guideline features case studies and the lived experiences of those with ARF and RHD to encourage clinicians to look beyond the biomedical context when delivering evidence-based care.

“By providing case studies and including the lived experiences of those with ARF and RHD we place the value of culture side-by-side with the biomedical model of health and lay the groundwork for a culturally responsive health system.”

Written by experts from across the country and developed in collaboration with key stakeholders and an Aboriginal and Torres Strait Islander advisory group, the 3rd edition will serve as the definitive guide to current ARF and RHD diagnosis and management in Australia.

Co-director of RHDAustralia Professor Anna Ralph says that since the last edition of the guideline was released in 2012 there have been many important changes to practice that need to be embraced.    

“We will work to support clinicians and control programs in understanding and responding to the changes. The great news is that for a subset of patients, 10 years of penicillin injections has now been dropped to five years, based on local data and international guidance,” said Professor Ralph.

“We’re so grateful to the many experts from around Australia and New Zealand who devoted their time to reviewing the latest evidence, synthesising concepts and workshopping new ideas that have now been incorporated.”

Based at Menzies School of Health Research, RHDAustralia supports the control of rheumatic heart disease in Australia and is funded under the Australian Government’s Rheumatic Fever Strategy.

RHDAustralia works alongside Aboriginal and Torres Strait Islander peoples, and other at-risk populations, to reduce acute rheumatic fever and rheumatic heart disease in Australia. We do this by developing and disseminating evidence-based resources to support health systems and health staff in their work, and by advocating and providing culturally appropriate educational resources for people with ARF/RHD and their families.

Contact: Sean Rung 
08 8946 8655