Ministry of Health Library

Health Improvement and Innovation Digest

Issue 196 - 1 August 2019

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@health.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)

Medication safety, prescribing and the medicines management process in mental health
Therapeutic interventions for mental health consumers frequently include medication, often in combination with psychosocial treatment. However, adverse drug events (ADEs) associated with medicines used in mental health do occur and some of these cause serious morbidity and mortality. The Health Quality & Safety Commission has reviewed what is known about medication safety within mental health. The review covered all aspects of medicines management: prescribing, dispensing, administration, monitoring, transitions in care and adherence. It considered evidence that adverse events occur, along with prevention strategies that have been tested.

Hospital Productivity (International)

Pay for performance for hospitals
Pay‐for‐Performance (P4P) is a payment model that rewards health care providers for meeting pre‐defined targets for quality indicators or efficacy parameters to increase the quality or efficacy of care. The objective of this study, published in the Cochrane Database of Systematic Reviews, was to assess the impact of P4P for in‐hospital delivered health care on the quality of care, resource use and equity.

Shorter Stays In Emergency Departments (International)

What is full capacity protocol, and how is it implemented successfully?
Full capacity protocol (FCP) is an internationally recognized intervention designed to address emergency department (ED) crowding. Despite FCP international recognition and positive effects on hospital performance measures, many hospitals, even the most crowded ones, have not implemented FCP. Published in Implementation Science, this study was conducted to identify the core components of FCP, explore the key barriers and facilitators associated with the FCP implementation, and provide practical recommendations on how to overcome those barriers.

Reducing repeat paediatric emergency department attendance for non-urgent care: a systematic review of the effectiveness of interventions
Non-urgent paediatric ED (PED) visits appear to contribute a large portion to the growing use of EDs globally. Several interventions have tried to curb repeated non-urgent attendances, but no systematic review of their effectiveness exists. This review, published in Emergency Medicine Journal, examines the effectiveness of interventions designed to reduce subsequent non-urgent PED visits after a non-urgent attendance.

Cardiovascular Disease and Diabetes (International)

Women's views on screening for Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for increasing uptake
Many women do not attend recommended glucose testing following a pregnancy affected by gestational diabetes (GDM). Published in Diabetic Medicine, this study aimed to synthesize the literature regarding the views and experiences of women with a history of GDM on postpartum glucose testing, focusing on barriers and facilitators to attendance.

Medication management support in diabetes: a systematic assessment of diabetes self-management apps
Smartphone apps are becoming increasingly popular for supporting diabetes self-management. A key aspect of diabetes self-management is appropriate medication-taking. This study, published in BMC Medicine, aims to systematically assess and characterise the medication management features in diabetes self-management apps and their congruence with best-practice evidence-based criteria.

Effects of a Mediterranean eating plan on the need for glucose-lowering medications in participants with Type 2 diabetes: a subgroup analysis of the PREDIMED Trial
Published in Diabetes Care, the objective of this study was to examine the effects of two Mediterranean eating plans (Med-EatPlans) versus a low-fat eating plan on the need for glucose-lowering medications.

Primary Health Care (New Zealand)

Pharmacist integration into general practice in New Zealand
Pharmacist integration into general practice is gaining momentum internationally, with benefits noted in reducing medication errors, improving chronic disease management and alleviating general practitioner workforce shortages. This study, published in the Journal of Primary Health Care, characterised the current landscape of pharmacist integration into general practice in New Zealand.

Establishing the nurse practitioner workforce in rural New Zealand: barriers and facilitators
The health sector is facing considerable challenges to meet the health needs of rural communities. Nurse practitioners (NPs) deliver primary health care (PHC) services similar to general practitioner (GP) services, within a health equity and social justice paradigm. Despite GP workforce deficits, New Zealand has been slow to effectively utilise NPs. From a larger study exploring the establishment of NP services, this paper, published in the Journal of Primary Health Care, reports on the barriers and facilitators to becoming a NP in rural PHC.

Facilitating equitable prevention and management of gout for Māori in Northland, New Zealand, through a collaborative primary care approach
The Gout Stop Programme was developed for primary care in Northland, New Zealand, to address inequitable health outcomes for Māori and Pacific people with gout. The aim of the programme was to make it easier for clinicians to prescribe urate-lowering treatment, facilitate patient adherence through education and support, and reduce barriers to gout prevention and long-term management.This study, published in the Journal of Primary Health Care, is an open evaluation based on the collection of data from patients enrolled in the programme and prescribed the treatment protocol.

Primary Health Care (International)

Cost-effectiveness and budget impact of the management of uncomplicated urinary tract infection by community pharmacists
Urinary tract infections (UTI) are one of the most common infections treated in primary care and the emergency department. The RxOUTMAP study demonstrated that management of uncomplicated UTI by community pharmacists resulted in high clinical cure rates similar to those reported in the literature and a high degree of patient satisfaction. The objective of this study, published in BMC Health Services Research, was to assess the cost-effectiveness and budget impact of community pharmacist-initiated compared to family or emergency physician-initiated management of uncomplicated UTI.

Role of advanced practitioners in primary care – a literature review
Pressures on primary care services are making it more difficult for patients to access to GP consultations. This literature review, published in the Nursing Times, explored the role of advanced clinical practitioners in primary care to determine whether they could support over-stretched general practice teams.

Primary Mental Health (New Zealand)

Systematic review of addiction recovery mutual support groups and Indigenous people of Australia, New Zealand, Canada, the United States of America and Hawaii
Addictions contribute significantly to the overall disease burden for Indigenous peoples of colonised countries. Mutual support groups are one of the most common addiction recovery resources, however their effectiveness for Indigenous peoples is unclear. This study, published in Addictive Behaviors, reviewed studies on addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii.

Antenatal depression symptoms in Pacific women: evidence from Growing Up in New Zealand
Pacific women in New Zealand have higher rates of antenatal depression than women from other ethnic groups. The aim of this study, published in the Journal of Primary Health Care, was to identify factors that are significantly associated with depression symptoms in pregnant Pacific women living in New Zealand.

Primary Mental Health (International)

Five-year outcomes of behavioral health integration in pediatric primary care
In the context of protracted shortages of pediatric behavioral health (BH) specialists, BH integration in pediatric primary care can increase access to BH services. The objectives of this study, published in Pediatrics, were to assess the structure and process of pediatric BH integration and outcomes in patient experience (access and quality), cost, and provider satisfaction.

Increased Immunisation (International)

Implementing evidence-based strategies to improve HPV vaccine delivery
High-quality evidence indicates that intervening with health care providers improves human papillomavirus (HPV) vaccine delivery. However, scaling up evidence-based strategies in real-world clinical practice remains challenging. This study, published in Pediatrics, sought to improve the reach and impact of strategies for HPV vaccination quality improvement (QI) through local adaptation and implementation in a large, not-for-profit health care system.

Better Help for Smokers to Quit (International)

Incentives for smoking cessation
Financial incentives, monetary or vouchers, are widely used in an attempt to precipitate, reinforce and sustain behaviour change, including smoking cessation. They have been used in workplaces, in clinics and hospitals, and within community programmes. The objective of this study, published in the Cochrane Database of Systematic Reviews, was to determine the long‐term effect of incentives and contingency management programmes for smoking cessation.

Models for pharmacist-delivered tobacco cessation services: a systematic review
The objective of this study, published in the Journal of the American Pharmacists Association, was to summarise delivery models of pharmacist-led tobacco cessation services.

Childhood Obesity (International)

The effectiveness of physical activity Interventions for low-income and ethnic minority children and youths: a meta-analysis
Children and youths from low-income families and certain ethnic minority groups show high levels of risk and vulnerability to physical inactivity. The aim of this review, published in the Journal of Physical Activity and Health, was to examine the effectiveness of interventions to increase physical activity (PA) in children and youths from low-income and ethnic minority (LIEM) families.

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.