Issue 170 - 5 July 2018

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email library@moh.govt.nz

Article access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Quality Improvement (New Zealand)

A Window on the Quality of New Zealand’s Health Care 2018
This year’s edition of the Health Quality & Safety Commission’s A Window on the Quality of New Zealand’s Health Care ‘shines the light’ beyond ultimate outcomes to look at where the system is performing less well and where possible system weaknesses may put future performance at risk. ‘Shining the light’ aims to start the thinking and discussion needed to lead to change.

Shorter Waits for Cancer Treatments (New Zealand)

Faster Cancer Treatment pathway in gynaecological malignancy: a repeat clinical audit
Published in the New Zealand Medical Journal, this clinical audit aimed to review the Faster Cancer Tract pathway in Northland patients with gynaecological cancers to evaluate whether there has been an improvement since the previous audit in 2014-2015.

Shorter Waits for Cancer Treatment (International)

Economic evaluation of patient navigation programs in colorectal cancer care, a systematic review
Patient navigation has expanded as a promising approach to improve cancer care coordination and patient adherence. This paper, published in Health Economics Review, addresses the need to identify the evidence on the economic impact of patient navigation in colorectal cancer, following the Health Economic Evaluation Publication Guidelines.

Cardiovascular Disease and Diabetes (New Zealand)

Projected stroke volumes to provide a 10-year direction for New Zealand stroke services
Stroke incidence and mortality are declining due to effective public health initatives and modern healthcare advances. However, due to population growth and ageing, the burden of stroke continues to rise worldwide. Published in the New Zealand Medical Journal, this paper aims to provide stroke volume projections for the next 1-2 decades and explores potential solutions to anticipated challenges.

Cardiovascular Disease and Diabetes (International)

Global Diabetes Prevention Interventions: A Systematic Review and Network Meta-analysis of the Real-World Impact on Incidence, Weight, and Glucose
Understanding the real-world impacts of lifestyle modification (LSM) for diabetes prevention is imperative to inform resource allocation. The purpose of this study, published in Diabetes Care, was to synthetize global evidence on the impact of LSM strategies on diabetes incidence and risk factors in one parsimonious model.

Long-term Outcomes of Lifestyle Intervention to Prevent Diabetes in American Indian and Alaska Native Communities: The Special Diabetes Program for Indians Diabetes Prevention Program
Evidence for long-term translational effectiveness of lifestyle interventions in minority populations is scarce. Published in Diabetes Care, this article reports long-term outcomes, for up to 10 years, of such an intervention to prevent diabetes in American Indian and Alaska Native (AI/AN) communities.

Primary Health Care (International)

Using information communication technology in models of integrated community-based primary health care: learning from the iCOACH case studies
Information communication technology (ICT) is a critical enabler of integrated models of community-based primary health care; however, little is known about how existing technologies have been used to support new models of integrated care. Published in Implementation Science, this article draws on data from an international study of integrated models, exploring how ICT is used to support activities of integrated care and the organizational and environmental barriers and enablers to its adoption.

Developing a measure of polypharmacy appropriateness in primary care: systematic review and expert consensus study
Polypharmacy is an increasing challenge for primary care. Although sometimes clinically justified, polypharmacy can be inappropriate, leading to undesirable outcomes. Optimising care for polypharmacy necessitates effective targeting and monitoring of interventions.  Published in BMC Medicine, the aim of this study was to identify what experts consider to be the key elements of a measure of prescribing appropriateness in the context of polypharmacy.

What is the overall impact or effectiveness of visiting primary health care services in rural and remote communities in high-income countries? A systematic review
Visiting services address the problem of workforce deficit and access to effective primary health care services in isolated remote and rural locations. Little is known about their impact or effectiveness and thereby the extent to which they are helping to reduce the disparity in access and health outcomes between people living in remote areas compared with people living in urban regions of Australia. The objective of this study, published in BMC Health Services Research, was to answer the question “What is the impact or effectiveness when different types of primary health care services visit, rather than reside in, rural and remote communities?"

Primary Mental Health (International)

Factors contributing to the recognition of anxiety and depression in general practice
Adequate recognition of anxiety and depression by general practitioners (GPs) can be improved. Research on factors that are associated with recognition is limited and shows mixed results. Published in BMC Family Practice, the aim of this study was to explore which patient and GP characteristics are associated with recognition of anxiety and depression.

Treatment for Alcohol Dependence in Primary Care Compared to Outpatient Specialist Treatment—A Randomized Controlled Trial
Published in Alcohol and Alcoholism, the aim of this study was to investigate if treatment for alcohol dependence in primary care is as effective as specialist addiction care.

Better Help for Smokers to Quit (New Zealand)

A national quitline service and its promotion in the mass media: modelling the health gain, health equity and cost–utility
Mass media campaigns and quitlines are both important distinct components of tobacco control programmes around the world. But when used as an integrated package, the effectiveness and cost-effectiveness are not well described. Published in Tobacco Control, this study aimed to estimate the health gain, health equity impacts and cost–utility of the package of a national quitline service and its promotion in the mass media.

Better Help for Smokers to Quit (International)

Smoking Cessation for Smokers Not Ready to Quit: Meta-analysis and Cost-effectiveness Analysis
Published in the American Journal of Preventive Medicine, the aim of this study was to provide a systematic review and cost-effectiveness analysis on smoking interventions targeting smokers not ready to quit.

Are digital interventions for smoking cessation in pregnancy effective? A systematic review and meta-analysis
Smoking in pregnancy remains a global public health issue due to foetal health risks and potential maternal complications. Published in Health Psychology Review, the aims of this systematic review and meta-analysis were to explore: (1) whether digital interventions for pregnancy smoking cessation are effective, (2) the impact of intervention platform on smoking cessation, (3) the associations between specific Behaviour Change Techniques (BCTs) delivered within interventions and smoking cessation, and (4) the association between the total number of BCTs delivered and smoking cessation.

Weight Management (International)

Five A’s counseling in weight management of obese patients in primary care: a cluster-randomized controlled trial (INTERACT)
Originating from smoking cessation, a tool called the 5As for obesity management has been drafted and adapted by the Canadian Obesity Network (CON) to improve weight counseling and provider-patient-interaction. This paper, published in BMC Family Practice, describes the rationale and design of the INTERACT study. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed specifically at general practitioners (GPs).

Childhood Obesity (New Zealand)

Economic evaluation of a multi-disciplinary community-based intervention programme for New Zealand children and adolescents with obesity
Published in Obesity Research & Clinical Practice, the purpose of this study was to determine whether Whānau Pakari, a home-based, 12-month multi-disciplinary child obesity intervention programme was cost-effective when compared with the prior conventional hospital-based model of care.

Childhood Obesity (International)

Helping With Meal Preparation and Children’s Dietary Intake: A Literature Review
Most children and adolescents do not meet dietary recommendations that may result in poor diets contributing to obesity. This systematic literature review, published in the Journal of School Nursing, was conducted to examine associations between helping with meal preparation at home and dietary quality, intake of specific foods, and/or dietary-related perceptions among youth.

Oral Health (International)

Randomised controlled trial on differential learning of toothbrushing in 6- to 9-year-old children
Published in Clinical Oral Investigations, this study aimed to evaluate the effect of differential learning of toothbrushing compared to habitual toothbrushing and instruction/demonstration of toothbrushing on plaque reduction and gingival inflammation of primary school children.

Key Ministry of Health Publications

Top Tips for Improving Your Acute Demand Management
It is important that acute care services identify new ways of working to manage these greater demands effectively. We need to strengthen our ability to manage acute demand and deliver more planned care in the community, rather than unplanned care in hospitals. This Ministry of Health document is designed to identify gaps in local acute service delivery. It provides tips to implement strategies for teams, departments and organisations wanting to see improved practice and improved health outcomes for their patients.

The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.