Jones Benjamin, Turner Angus W, Marangou James, Yan Jennifer, Burgess Paul, Kaethner Alex, Howard Natasha, English Mike, Nagraj Shobhana, Francis Joshua R
MD, MHLM, Health Systems Collaborative, University of Oxford, Oxford, UK; Honorary Research Fellow, Menzies School of Health Research, Darwin, NT.
MBBS (Hons), MSc (Oxon), FRANZCO, Associate Professor, Centre for Ophthalmology @ Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, WA.
Aust J Gen Pract. 2025 Jan-Feb;54(1-2):75-79. doi: 10.31128/AJGP-05-24-7294.
Australia has some communities with the highest rates of rheumatic heart disease (RHD) in the world. Echocardiographic detection of RHD through active case finding has been proposed for early detection. Lessons can be learnt from the implementation of a similar program - diabetic retinopathy screening. The aim of this paper is to identify transferable lessons from the implementation of diabetic retinopathy screening that could be applied to RHD echocardiographic detection.
This paper presents a narrative review and expert recommendations.
Transferable lessons from the implementation of diabetic retinopathy screening include training local staff regularly with formal certification; supplementary health promotion; program champions; general practitioner involvement; informing all staff at clinics; creating separate Medicare Benefits Schedule items for acquisition and interpretation; using echocardiography for detection and monitoring of RHD; establishing referral pathways and communication channels; local community involvement in implementation planning; and developing an adaptable program.
Implementing programs successfully and sustainably in remote communities is known to be challenging. These transferable lessons from the implementation of diabetic retinopathy screening might assist in the planning of an RHD detection program.
澳大利亚部分社区的风湿性心脏病（RHD）发病率位居世界前列。有人提议通过主动病例发现，利用超声心动图检测RHD以实现早期发现。可从实施类似项目——糖尿病视网膜病变筛查中吸取经验教训。本文旨在确定糖尿病视网膜病变筛查实施过程中可应用于RHD超声心动图检测的可借鉴经验。
本文进行了叙述性综述并给出专家建议。
糖尿病视网膜病变筛查实施过程中的可借鉴经验包括定期对当地工作人员进行正规认证培训；辅助性健康促进；项目倡导者；全科医生参与；告知诊所所有工作人员；为采集和解读设立单独的医疗保险福利计划项目；使用超声心动图检测和监测RHD；建立转诊途径和沟通渠道；当地社区参与实施规划；以及制定适应性项目。
在偏远社区成功且可持续地实施项目具有挑战性。糖尿病视网膜病变筛查实施过程中的这些可借鉴经验可能有助于RHD检测项目的规划。
