The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease.

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Abstrakt

Tytuł:: The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease.
Autorzy:: Ralph AP; Menzies School of Health Research, Darwin, NT.
Noonan S; RHDAustralia, Darwin, NT.
Wade V; RHDAustralia, Darwin, NT.
Currie BJ; Menzies School of Health Research, Darwin, NT.; Royal Darwin Hospital, Darwin, NT.
Źródło:: The Medical journal of Australia [Med J Aust] 2021 Mar; Vol. 214 (5), pp. 220-227. Date of Electronic Publication: 2020 Nov 15.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't; Review
Język:: English
Imprint Name(s):: Publication: : Pyrmont, NSW : Australasian Medical Publishing Co.
Original Publication: Sydney : Australasian Medical Pub. Co.
MeSH Terms:: Rheumatic Fever/*diagnosis
Rheumatic Fever/*therapy
Rheumatic Heart Disease/*diagnosis
Rheumatic Heart Disease/*therapy
Australia ; Diagnosis, Differential ; Evidence-Based Medicine ; Humans ; Native Hawaiian or Other Pacific Islander ; Practice Guidelines as Topic ; Primary Prevention ; Rheumatic Fever/prevention & control ; Rheumatic Heart Disease/prevention & control ; Secondary Prevention
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Grant Information:: National Heart Foundation of Australia; 1142011 National Health and Medical Research Council
Contributed Indexing:: Keywords: Autoimmune diseases; Guidelines as topic; Rheumatic heart disease; Streptococcus
Entry Date(s):: Date Created: 20201115 Date Completed: 20210323 Latest Revision: 20211204
Update Code:: 20240105
DOI:: 10.5694/mja2.50851
PMID:: 33190309
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Introduction: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) cause significant morbidity and premature mortality among Australian Aboriginal and Torres Strait Islander peoples. RHDAustralia has produced a fully updated clinical guideline in response to new knowledge gained since the 2012 edition. The guideline aligns with major international ARF and RHD practice guidelines from the American Heart Association and World Heart Federation to ensure best practice. The GRADE system was used to assess the quality and strength of evidence where appropriate.
Main Recommendations: The 2020 Australian guideline details best practice care for people with or at risk of ARF and RHD. It provides up-to-date guidance on primordial, primary and secondary prevention, diagnosis and management, preconception and perinatal management of women with RHD, culturally safe practice, provision of a trained and supported Aboriginal and Torres Strait Islander workforce, disease burden, RHD screening, control programs and new technologies.
Changes in Management as a Result of the Guideline: Key changes include updating of ARF and RHD diagnostic criteria; change in secondary prophylaxis duration; improved pain management for intramuscular injections; and changes to antibiotic regimens for primary prevention. Other changes include an emphasis on provision of culturally appropriate care; updated burden of disease data using linked register and hospitalisations data; primordial prevention strategies to reduce streptococcal infection addressing household overcrowding and personal hygiene; recommendations for population-based echocardiographic screening for RHD in select populations; expanded management guidance for women with RHD or ARF to cover contraception, antenatal, delivery and postnatal care, and to stratify pregnancy risks according to RHD severity; and a priority classification system for presence and severity of RHD to align with appropriate timing of follow-up.
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