Ministry of Health Library

Health Improvement and Innovation Digest

Issue 174 - 13 September 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)

Opioid implementation package
The information in this implementation package, issued by the Health Quality & Safety Commission, is provided to assist health professionals with improving the safe use of opioids. The implementation package is based on the work undertaken through the Commission’s national formative opioid collaborative 2014–17 and the resultant How-to Guide.

Hospital Productivity (International)

Implementation and impact analysis of a transitional care pathway for patients presenting to the emergency department with cardiac-related complaints
Cardiac-related complaints are leading drivers of Emergency Department (ED) utilization. Although a large proportion of cardiac patients can be discharged with appropriate outpatient follow-up, inadequate care coordination often leads to high revisit rates or unnecessary admissions. The authors of this study, published in BMC Health Services Research, evaluated the impact of implementing a structured transitional care pathway enrolling low-risk cardiac patients on ED discharges, 30-day revisits and admissions, and institutional revenues.

Shorter stays in Emergency Departments (International)

Emergency department crowding: A systematic review of causes, consequences and solutions
The aim of this systematic review, published in PLOS ONE, was to critically analyse and summarise the findings of peer-reviewed research studies investigating the causes and consequences of, and solutions to, emergency department crowding.

Cardiovascular Disease and Diabetes (New Zealand)

Trends in the primary health care nursing workforce providing diabetes care in Auckland, New Zealand: A cross-sectional survey
This study, published in Primary Care Diabetes, aimed to describe trends from 2006–8 to 2016 in the demographic, education and work settings of the primary health care nursing workforce who provide diabetes care in the Auckland region.

Cardiovascular Disease and Diabetes (International)

The preferences of young adults with Type 1 diabetes at clinics using a discrete choice experiment approach: the D1 Now Study
Attending routine outpatient clinic appointments is a central self-management behaviour of individuals living with Type 1 diabetes. A large number of young adults with Type 1 diabetes disengage from diabetes services, which may contribute to poor psychosocial and diabetes outcomes. The aim of this study, published in Diabetic Medicine, is to elicit preferences from young adults with Type 1 diabetes regarding clinic-related services to inform service delivery.

Lifestyle advice and interventions for cardiovascular risk reduction: A systematic review of guidelines
Lifestyle factors are important in preventing cardiovascular disease (CVD) development. Published in the International Journal of Cardiology, the study’s authors aimed to systematically review guidelines on primary prevention of CVD and their recommendations on lifestyle advice or intervention, in order to guide primary prevention programs

Primary Health Care (New Zealand)

Older people's experiences of nurse–patient telephone communication in the primary healthcare setting
The aim of this qualitative exploratory study, published in the Journal of Advanced Nursing, was to determine which aspects of primary nurse–patient telephone communication are viewed positively or negatively in terms of meeting the older persons’ needs.

Healthcare-seeking behaviour of people with sexually transmitted infection symptoms attending a Sexual Health Clinic in New Zealand
Untreated sexually transmitted infections (STIs) can lead to serious health complications and may be transmitted to uninfected individuals. Therefore, the early detection and subsequent management of STIs is crucial to control efforts. This study, published in the New Zealand Medical Journal, sought to quantify time to presentation for STI testing in people with STI symptoms and assess whether delayed healthcare-seeking poses a transmission risk.

Improving healthcare through digital connection? Findings from a qualitative study about patient portals in New Zealand
Research has shown that patient portals can improve patient–provider communication and patient satisfaction. Yet few studies have examined patient portals in New Zealand. In this study, published in the Australian Journal of Primary Health, GPs from nine primary care practices were interviewed to ascertain how they thought patient portals influence the delivery of primary healthcare.

Primary Health Care (International)

Interventions to improve the appropriate use of polypharmacy for older people
The aim of this Cochrane Review was to find out which types of approaches can improve the use of suitable medicines in older people. Researchers collected and analysed all relevant studies to answer this question and included 32 trials in the review. This review examines studies in which healthcare professionals have taken action to make sure that older people are receiving the most effective and safest medicines for their illness.

Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis
This purpose of this study, published in Age and Ageing, was to summarise the (cost-) effectiveness of proactive, multidisciplinary, integrated care programmes for older people in Dutch primary care.

Pharmacist services for non‐hospitalised patients
Pharmacists deliver a wide range of services to patients. We need to know which pharmacist services are effective in helping patients to improve their health. This Cochrane Review included studies of pharmacist services for a wide range of conditions including high blood pressure and diabetes. The review measured the effect of these services on benefits (improved health outcomes) as well as harms (unplanned hospital admissions, adverse drug effects).

Impact of community pharmacist-provided preventive services on clinical, utilization, and economic outcomes: An umbrella review
Preventable diseases and late diagnosis of disease impose great clinical and economic burden for health care systems, especially in the current juncture of rising medical expenditures. Under these circumstances, community pharmacies have been identified as accessible venues to receive preventive services. This umbrella review, published in Preventive Medicine, aims to examine existing evidence on the impact of community pharmacist-provided preventive services on clinical, utilization, and economic outcomes in the United States (US).

Primary Mental Health (International)

Pathways to mental health services for young people: a systematic review
While early access to appropriate care can minimise the sequelae of mental illnesses, little is known about how youths come to access mental healthcare. This systematic review, published in Social Psychiatry and Psychiatric Epidemiology, aimed to synthesise literature on the pathways to care of youths across a range of mental health problems.

Coordinating Mental and Physical Health Care in Rural Australia: An Integrated Model for Primary Care Settings
The ‘GP Clinic’ provides primary health care to people using community mental health services in a small town in Australia. This article, published in the International Journal of Integrated Care, examined the factors that have driven successful integration in this rural location.

Better Help for smokers to Quit (International)

Efficacy of Pharmacotherapy for Smoking Cessation in Adolescent Smokers: A Meta-analysis of Randomized Controlled Trials
This study, published in Nicotine & Tobacco Research, aimed to evaluate the efficacy of pharmacotherapy for smoking cessation among adolescent smokers by using a meta-analysis of randomized controlled trials (RCTs).

Childhood Obesity (International)

The role and impact of community health workers in childhood obesity interventions: a systematic review and meta-analysis
One potential method for reducing childhood obesity disparities is to involve community health workers (frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served). The purpose of this systematic review and meta-analysis, published in Obesity Reviews, was to explore the role and effectiveness of community health workers in childhood obesity interventions.

Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review
Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study, published in Nutrients, examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices.

Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis
The growing body of research on weight-related interventions for youth has been summarized by several meta-analyses aiming to provide an overview of the effectiveness of interventions. Yet, the number of meta-analyses is expanding so quickly and overall results differ, making a comprehensive synopsis of the literature difficult. Published in Obesity Reviews, this meta-synthesis was conducted to draw informed conclusions about the state of the effectiveness of interventions targeting child and adolescent overweight.

Barriers and facilitators to health care professionals discussing child weight with parents: A meta-synthesis of qualitative studies
As parents play an important role in their children's weight-related behaviours, good communication between parents and health care professionals (HCPs) is essential. This systematic review, published in the British Journal of Health Psychology, provides a meta-synthesis of qualitative studies exploring the barriers and facilitators experienced by HCPs when discussing child weight with parents.

Oral Health (International)

Dental caries prevention strategies among children and adolescents with immigrant - or low socioeconomic backgrounds- do they work? A systematic review
This systematic review, published in BMC Oral Health, was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds

Key Ministry of Health Publications

Prescribing Controlled Drugs in Addiction Treatment 2018: Guidance for nurse practitioners, designated prescriber nurses and designated prescriber pharmacists
This document contains guidance to help addiction treatment services comply with section 24A of the Misuse of Drugs Act 1975 as it relates to nurse practitioners, designated prescriber nurses and designated prescriber pharmacists who are authorised to prescribe controlled drugs as a treatment for people dependent on controlled drugs.

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.