Evidence map›Paper›PMID 30018166›Full record

Trial reportJournal of the American Heart Association2018

Qualitative Evaluation of a Complex Intervention to Improve Rheumatic Heart Disease Secondary Prophylaxis.

Clancy Read, Alison G Mitchell, Jessica L de Dassel, Clair Scrine, David Hendrickx, Ross S Bailie, Vanessa Johnston, Graeme P Maguire, Rosalie Schultz, Jonathan R Carapetis and 1 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Review
  7. Review
  8. Article
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  11. Article
  12. Review
  13. The Global Impact of Rheumatic Heart Disease.Current cardiology reports · 2021
    Review
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  15. Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 1 country.

Clancy ReadTelethon Kids Institute, University of Western Australia, Western Australia, Australia.
Alison G MitchellCharles Darwin University, Darwin, Northern Territory, Australia.
Jessica L de DasselCharles Darwin University, Darwin, Northern Territory, Australia.
Clair ScrineTelethon Kids Institute, University of Western Australia, Western Australia, Australia.
David HendrickxTelethon Kids Institute, University of Western Australia, Western Australia, Australia.
Ross S BailieUniversity of Sydney University Centre for Rural Health, Lismore, New South Wales, Australia.
Vanessa JohnstonMenzies School of Health Research, Darwin, Northern Territory, Australia.
Graeme P MaguireBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Rosalie SchultzCentre For Remote Health, Alice Springs, Northern Territory, Australia.
Jonathan R CarapetisTelethon Kids Institute, University of Western Australia, Western Australia, Australia.
Anna P RalphCharles Darwin University, Darwin, Northern Territory, Australia anna.ralph@menzies.edu.au.
Charles Darwin University · AUMenzies School of Health Research · AUThe Kids Research Institute Australia · AUBaker Heart and Diabetes Institute · AUCentre for Remote Health · AULismore Base Hospital · AUPrincess Margaret Hospital for Children · AUUniversity of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRheumatic heart disease is a high-burden condition in Australian Aboriginal communities. We evaluated a stepped-wedge, community, randomized trial at 10 Aboriginal communities from 2013 to 2015. A multifaceted intervention was implemented using quality improvement and chronic care model approaches to improve delivery of penicillin prophylaxis for rheumatic heart disease. The trial did not improve penicillin adherence. This mixed-methods evaluation, designed a priori METHODS AND

resultsAn evaluation framework was developed to measure the success of project implementation and of the underlying program theory. The program theory posited that penicillin delivery would be improved through activities implemented at clinics that addressed elements of the chronic care model. Qualitative data were derived from interviews with health-center staff, informants, and clients; participant observation; and project officer reports. Quantitative data comprised numbers and types of "action items," which were developed by participating clinic staff with project officers to improve delivery of penicillin injections. Interview data from 121 health-center staff, 22 informants, and 72 clients revealed barriers to achieving the trial's aims, including project-level factors (short trial duration), implementation factors (types of activities implemented), and contextual factors (high staff turnover and the complex sociocultural environment). Insufficient actions were implemented addressing "self-management support" and "community linkage" streams of the chronic care model. Increased momentum was evident in later stages of the study.

conclusionsThe program theory underpinning the study was sound. The limited impact made by the study on adherence was attributable to complex implementation challenges.

Indexed as

Patient ComplianceAdolescentAdultAnti-Bacterial AgentsChildChild, PreschoolFemaleHumansIncidenceMaleNorthern TerritoryPenicillinsQuality ImprovementRheumatic Heart DiseaseSecondary PreventionYoung AdultAnti-Bacterial AgentsPenicillinsacute rheumatic feveradherencechronic diseasequality improvementrheumatic heart diseasesystems of care

Identifiers

PMID30018166
PMCPMC6064865
OpenAlexW2884197641

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.