Ministry of Health Library

Health Improvement and Innovation Digest

Issue 215 - 13 August 2020

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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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.

Health Equity (New Zealand)

Achieving physical health equity for people with experience of mental health and addiction issues
Te Pou has launched the 2020 Equally Well evidence update on the physical health of people with mental health conditions and/or addiction.

Quality Improvement (International)

Antimicrobial Stewardship Audit and Feedback rounds: moving beyond the restricted antibiotic list and the impact of electronic systems
Current methods of antimicrobial usage surveillance have limited efficacy in changing practice due to delayed reporting to clinicians and the inability to stratify by medical specialty. This study, published in the Internal Medicine Journal, was undertaken in a tertiary teaching hospital with a well‐established Antimicrobial Stewardship (AMS) programme and electronic medicines management (eMM) system in Sydney, Australia. The aim was to describe and analyse the implementation of a novel AMS audit and feedback method, in the context of an eMM system.

Hospital Productivity (New Zealand)

Evaluation of HealthPathways: an appraisal of usage, experiences and opinions of healthcare professionals in Australia and New Zealand
HealthPathways, pioneered in Canterbury, New Zealand, in 2008, is a web-based tool designed to promote health care integration and patient management in primary care and to reduce fragmentation in the delivery of health services. This cross-sectional study, published in the Australian Health Review, evaluated the utilisation and perceptions of this tool among health professionals in Australia and New Zealand.

Shorter Waits in Emergency Departments (International)

Interventions in overcrowding of emergency departments: an overview of systematic reviews
The objective of this study, published in Revista de saúde pública, was to present an overview of systematic reviews on throughput interventions to solve the overcrowding of emergency departments.

Cardiovascular Disease and Diabetes (New Zealand)

Exploring the role of goal setting in weight loss for adults recently diagnosed with pre-diabetes
The management of prediabetes in the community setting is a global priority. This study evaluated the feasibility of a 6-month multilevel practice nurse-led prediabetes dietary intervention which involved goal setting. The aim of this paper, published in BMC Nursing, was to explore the weight loss goals and strategies reported by participants to achieve their weight loss goals as recorded by practice nurses, and report on factors that influenced dietary behaviours.

Cardiovascular Disease and Diabetes (International)

What psychosocial interventions work to reduce hospital admissions in people with diabetes and elevated HbA1c: a systematic review of the evidence
Diabetes is a chronic condition that can lead to devastating complications if not managed effectively. Individuals with elevated HbA1c are at higher risk of developing complications resulting in diabetes‐related hospital admissions, an additional pressure and expense for healthcare systems.  This paper, published in Diabetic Medicine, aimed to systematically review evidence of the effectiveness of psychosocial interventions among individuals with elevated HbA1c, as indicated by hospital admissions.

Effectiveness of psychosocial interventions for the prevention and treatment of foot ulcers in people with diabetes: a systematic review
The aim of this review, published in Diabetic Medicine, was to identify and synthesize the evidence for the effectiveness of psychosocial interventions to promote the healing, and/or reduce the occurrence of, foot ulceration in people with diabetes.

Setting and techniques for monitoring blood pressure during pregnancy
Regular blood pressure (BP) measurement is crucial for the diagnosis and management of hypertensive disorders in pregnancy, such as pre‐eclampsia. BP can be measured in various settings, such as conventional clinics or self‐measurement at home, and with different techniques, such as using auscultatory or automated BP devices. It is important to understand the impact of different settings and techniques of BP measurement on important outcomes for pregnant women. The objective of this Cochrane Review was to assess the effects of setting and technique of BP measurement for diagnosing hypertensive disorders in pregnancy on subsequent maternal and perinatal outcomes, women's quality of life, or use of health service resources.

Primary Health Care (New Zealand)

Developing pharmacist‐facilitated medicines review services for community‐dwelling Māori older adults in New Zealand – A qualitative study exploring stakeholder views
Māori experience inequitable health outcomes compared to non‐Māori, across the spectrum of clinical care, including those relating to medicines. Internationally, pharmacist‐facilitated medicines review services have been shown to benefit older adults. Despite national policies calling for the increased implementation of these services, NZ data relating to them remain limited, and these services may increase disparities between Māori and non‐Māori. There are currently no medicines review services developed specifically for Māori older adults. The current study, published in Health & Social Care in the Community, aims to elicit stakeholder views of current and potential pharmacist services to help inform the development of a pharmacist‐facilitated medicines review service for community‐dwelling Māori older adults.

Primary Health Care (International)

Multimorbidity and consultation time: a systematic review
Multimorbidity is one of the major challenges health systems currently face. Management of time length of a medical consultation with a patient with MM is a matter of concern for doctors. This systematic review, published in BMC Family Practice, describes the impact of Multimorbidity on the average time of a medical consultation.

Primary care visits increase utilization of evidence-based preventative health measures
Primary care visits can serve many purposes and potentially influence health behaviors. Although previous studies suggest that increasing primary care provider numbers may be beneficial, the mechanism responsible for the association is unclear, and have not linked primary care access to specific preventative interventions. This study, published in BMC Family Practice, investigated the association between the number of times patients accessed their primary care provider team and the likelihood they received selected preventative health interventions.

Cost utility of a pharmacist-led minor ailment service compared with usual pharmacist care
A cluster randomised controlled trial (cRCT) performed from July 2018 to March 2019 demonstrated the clinical impact of a community pharmacist delivered minor ailment service (MAS) compared with usual pharmacist care (UC). MAS consisted of a technology-based face-to-face consultation delivered by trained community pharmacists. The consultation was guided by clinical pathways for assessment and management, and communication systems, collaboratively agreed with general practitioners. MAS pharmacists were trained and provided monthly practice support by a practice change facilitator. The objective of this study, published in Cost Effectiveness and Resource Allocation, was to assess the cost utility of MAS, compared to UC.

The Over 75 Service: Continuity of Integrated Care for Older People in a United Kingdom Primary Care Setting
Continuity of care is concerned with quality of care over a period of time. It describes a process by which service users and their families are co-operatively involved with health and social care professionals in managing their care needs. Continuity of care can be divided into informational, managerial and relational and has been associated with improved user- and service-related outcomes. To date, there have been few studies which examine how continuity of care is developed and maintained in integrated primary care systems. This paper, published in International Journal of Integrated Care, explores continuity of care in an integrated Over 75 Service for people living at home with complex health and social care needs.

What works in managing complex conditions in older people in primary and community care? A state‐of‐the‐art review
The number of older people living with complex health conditions is increasing, with the majority of these managed in primary and community settings. Many models of care have been developed to support them, however, there is mixed evidence on their value and they include multiple overlapping components. This paper, published in Health & Social Care in the Community, aimed to synthesise the evidence to learn what works for managing complex conditions in older people in primary and community care.

Increased Immunisation (International)

Does policy change to allow pharmacist provision of influenza vaccination increase population uptake? A systematic review
The aims of this study, published in the Australian Health Review, were to estimate the effect of pharmacists’ vaccinating for influenza on overall vaccination rates and to assess whether any effect differs for at-risk subgroups compared with the general population.

Childhood Obesity (International)

Effects of Lifestyle Modification Interventions to Prevent and Manage Child and Adolescent Obesity: A Systematic Review and Meta-Analysis
The objective of this review, published in Nutrients, was to assess the impact of lifestyle interventions (including dietary interventions, physical activity, behavioral therapy, or any combination of these interventions) to prevent and manage childhood and adolescent obesity.

Oral Health (New Zealand)

Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children
The objective of this article, published in JAMA Pediatrics, was to evaluate whether community water fluoridation is associated with the national rates of severe caries among 4-year-old children in New Zealand after accounting for key sociodemographic characteristics.

Disability Services (International)

Identifying and managing care for children with autism spectrum disorders in general practice: A systematic review and narrative synthesis
Many healthcare systems are organised such that General Practitioners (GPs) often have a key role in identifying autism spectrum disorders (hereafter collectively referred to as autism) in children. This review, published in Health & Social Care in the Community, explored what GPs know about autism and the factors that influence their ability to identify and manage care for their patients with autism in practice.

Eating well, living well and weight management: A co-produced semi-qualitative study of barriers and facilitators experienced by adults with intellectual disabilities
Adults with intellectual disabilities in England experience health inequalities. They are more likely than their non-disabled peers to be obese and at risk of serious medical conditions such as heart disease, stroke and type 2 diabetes. This semi-qualitative study, published in the Journal of Intellectual Disabilities, engaged adults with intellectual disabilities in a co-production process to explore their perceived barriers and facilitators to eating well, living well and weight management.

Key Ministry of Health Publications

Whakamaua: Māori Health Action Plan 2020-2025
As kaitiaki of the system, the Ministry of Health has an important leadership role to play in creating an environment that enables Māori to live healthier, happier lives. Whakamaua: Māori Health Action Plan 2020-2025 is the implementation plan for He Korowai Oranga, New Zealand’s Māori Health Strategy – it sets the government’s direction for Māori health advancement over the next five years.

Whatua: Engagement for the development the Māori Health Action Plan 2020-2025
This publication is a companion document to Whakamaua: Māori Health Action Plan 2020-2025. It provides a summary of the insights gathered during an extensive engagement process in 2019 to develop Whakamaua.

District Health Board Initiative

Let’s kōrero: Māori cultural safety sessions to benefit Hutt Valley DHB staff and patients
This month, Hutt Valley DHB Pou Tikanga Rawiri Hirini, launched the first module of the Te Kawa Whakaruruhau Māori cultural safety training programme for all Hutt Valley DHB staff.

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.