Connections Reduce Rheumatic Heart Disease-Related Mortality in Western Australia: A Mixed Methods Study.
Virginia DeCourcy, Daniel Hunt, Ingrid Stacey and 5 others
PMID 40062424WHAT IT FOUND
Most deaths among WA RHD register patients under 65 were Aboriginal and remote.
Register data showed low BPG adherence and delayed echo and specialist review. Interviews described access and cultural barriers, with trusting relationships and community-controlled services seen as key.
Key findings
01Among 820 analysed WA Register patients under 65, 60 died during 2012 to 2021, and 59 were Aboriginal or Torres Strait Islander.
02In the deceased group, 73% had severe RHD at the most recent echocardiogram, but only 23% of those with severe RHD had an echocardiogram within 6 months before study exit, and one quarter had specialist review within 6 months before death.
03All nine interviewees mentioned transient workforce impacts, and several said new or shorter-term staff struggled to recognise RHD.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The register is filled in manually and depends on clinicians notifying cases, so it probably misses some RHD cases and deaths. The register is better at finding younger, Aboriginal and northern residents, and was managed from the Kimberley for part of the period, so these groups may be overrepresented. Only nine stakeholders were interviewed, because WA has few RHD stakeholders, so other views may be missing. The quantitative analysis was descriptive and made no formal comparisons, so it cannot show which factors caused death. For most deaths, the cause was unknown in the register, so the proportion directly caused by RHD is uncertain. Regional subgroup patterns were based on small numbers.
Declared interests
The lead author received a scholarship funded by WA Country Health Service. The ABS data extract fee was jointly funded by the University of Western Australia and WA Country Health Service. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the title as proof that relationships reduce RHD mortality. This study did not test an intervention and made no formal comparisons between the deceased and prevalent groups. It describes register patterns and stakeholder views.