Secondary Prophylaxis Among First Nations People With Acute Rheumatic Fever in Australia: An Integrative Review.
Kerissa Govender, Amanda Müller
PMID 37572036WHAT IT FOUND
Secondary prophylaxis injections for First Nations people in Australia with acute rheumatic fever were often not received because of painful injections, duplicate recall systems, inconvenient clinic locations, limited family support, poor understanding, and weak patient and clinician relationships.
Key findings
01Eight included studies yielded six recurring barriers to secondary prophylaxis: databases and recall systems, patient and family characteristics, service location, injection pain, education, and patient and clinician relationships.
02Painful benzathine penicillin injections, inconsistent pain-reduction strategies, and carers' distress were barriers, and clinicians who saw patients in pain were reluctant to administer them.
03Text-message recall, improved scheduling, family meetings, and community or home visits were reported as supports for secondary prophylaxis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only eight included studies were analysed, so the themes may not cover all barriers. The search was limited to PubMed, CINAHL, ProQuest, and Wiley Online Library, articles from 2011 to 2021, Australian First Nations studies, and peer-reviewed primary research. No statistical meta-analysis was done because the number of included articles was low. The review did not include a First Nations consultant, despite attempts to secure input. Terminology for First Nations people varied in the literature, so some relevant terms may have been missed. The review reports barriers and supports, not tested interventions that improve adherence.
The easy way to misread this
Do not read the reported supports as proven fixes. The review identifies barriers and reports what included studies observed; it did not test whether these actions increase secondary prophylaxis.