The quality of management of rheumatic fever/ heart disease in the Kimberley.

OBJECTIVE

To evaluate the quality of management of Kimberley patients with rheumatic fever (RF) and rheumatic heart disease (RHD).

METHODS

A retrospective analysis of medical records for 215 residents of the Kimberley region of Western Australia, diagnosed with RF or RHD during the years 1982 to 1996.

RESULTS

Among patients prescribed intramuscular penicillin for secondary prophylaxis, 67% of prescribed doses were given, with individuals receiving 8-100% of doses prescribed. Of patients recommended visiting specialist or echocardiographic review, 78% and 64% attended respectively. Only 34% of patients with RHD in 1996 were recommended dental review in 1996 or 1997. Appropriate blood testing occurred in 34% of the months in which people had anticoagulant prescribed.

CONCLUSIONS

A clinical audit can be used to evaluate the management received by this population and hence identify areas to improve management. We found much room for improvement if optimal clinical outcomes are to be obtained.