Secondary prophylaxis among Indigenous Australians

This section focuses on BPG adherence amongst Indigenous Australians who were prescribed BPG on a 21-day or 28-day regimen in 2019. If a person had more than one notification (for example, of ARF and of RHD), they were included in the analysis only once. If a person was prescribed for less than the entire year, i.e. they were prescribed later in the year or if they finished their prescribed BPG, their prescribed doses are fewer to reflect that difference. Those on a different regimen or an alternative treatment (i.e. not BPG) were excluded.

There were 4,109 Aboriginal and Torres Strait Islander people eligible for inclusion in calculations about BPG delivery in 2019. They were located in Northern Territory (2,099), Queensland (1,244), Western Australia (629), and South Australia (137). Of these:

  • 19% (783 people) received 100% or more of their prescribed doses
  • 18% (755) received 80% to 99% of their prescribed doses
  • 29% (1,177) received 50% to 79% of their prescribed doses
  • 34% (1,394) received less than 50% of their prescribed doses, including 317 people who did not receive any doses.

The delivery of prophylaxis was similar in 2018 and 2019, despite more people being prescribed BPG in 2019. The proportion of people receiving at least 80% of their scheduled doses is used as an indicator of prophylactic delivery at a level which is likely to protect against ARF recurrences (RHD Australia 2012). Data from the Northern Territory have shown that there is very minimal benefit when adherence is lower than 40% (de Dassel et al. 2018). In 2019, 27% (1,117 people) of Indigenous Australians received fewer than 40% of their scheduled doses.

In 2019, 37% of Indigenous Australians (1,538 people) received at least 80% of doses. The proportion of people achieving at least 80% adherence in each jurisdiction was:

  • 59% in South Australia (81 people)
  • 48% in Northern Territory (1,013)
  • 26% in Queensland (317)
  • 20% in Western Australia (127).

Sex and age

In 2019, among Indigenous Australians prescribed prophylaxis:

  • adherence was better among females than males.
  • adherence was higher among people aged aged 0–14 years compared with other age groups (Figure 13).
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Historic adherence rate

Since 2016, the adherence level for Indigenous Australians has remained relatively stable with around 36% of people prescribed prophylaxis receiving at least 80% of their prescribed doses (Figure 14). However, there has been an increase in those receiving 100% of the prescribed doses (11% in 2016 to 19% in 2019) and a corresponding decrease in those with an 80–99% adherence level (25% and 18%, respectively). All other adherence levels have remained stable over the period.

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