Issue 231 - 29 April 2021

Welcome to the fortnightly Health Improvement and Innovation 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.

Māori Innovation

Tino Rangatiratanga and Well-being: Māori Self Determination in the Face of Covid-19
This paper, published in Frontiers in Sociology, details some of the rapid Māori response to Covid-19 in Aotearoa New Zealand and argues the response can be understood as key examples of Māori exercising tino rangatiratanga (self-determination). 

Health Equity (New Zealand)

Equity in outcomes following major trauma among hospitalised patients
Equity in major trauma outcomes is the focus of this ninth Perioperative Mortality Review Committee (POMRC) report published by the Health Quality and Safety Commission. The POMRC has chosen to examine what factors impact on Māori and non-Māori mortality from major trauma.

Health Equity (International)

Structural Racism, Health Inequities, and the Two-Edged Sword of Data: Structural Problems Require Structural Solutions
Analysing the myriad ways in which structural racism systemically generates health inequities requires engaging with the profound challenges of conceptualizing, operationalising, and analysing the very data deployed. This essay, published in Frontiers in Public Health, calls attention to the two-edged sword of data at play, reflecting long histories of support of and opposition to white supremacy and scientific racism. As illustrated by both past and present examples, including COVID-19, at issue are both the non-use and problematic use of data on racialized groups.

Quality Improvement (New Zealand)

Shared goals of care principles for health service providers
The principles described in this document, published by the Health Quality and Safety Commission, outline what is required for health care providers to have shared goals of care discussions with adult patients and their whānau.

Quality Improvement (International)

The Effect of Antibiotic Restriction Programs on Prevalence of Antimicrobial Resistance: A Systematic Review and Meta-Analysis
In hospital settings, restriction of selected classes of antibiotics is usually believed to contribute to containment of resistance development. This systematic review and meta-analysis, published in Open Forum Infectious Diseases, assessed the effect of restricting the use of specific antibiotic classes on the prevalence of resistant bacterial pathogens.

Cancer Services (New Zealand)

Doing what it takes: a qualitative study of New Zealand carers’ experiences of giving home-based palliative care to loved ones
This study, published in the New Zealand Medical Journal, explored the views of New Zealand home carers providing home-based palliative.

How do colorectal cancer patients rate their GP: a mixed methods study
New Zealand has a high incidence of colorectal cancer (CRC) and low rates of early diagnosis. With screening not yet nationwide, the majority of CRC is diagnosed through general practice. A good patient-general practitioner (GP) relationship can facilitate prompt diagnosis, but when there is a breakdown in this relationship, delays can occur. Delayed diagnosis of CRC in NZ receives a disproportionally high number of complaints directed against GPs, suggesting deficits in the patient-GP connection. This study, published in BMC Family Practice, aimed to investigate patient-reported confidence and ratings of their GP following the diagnostic process. 

Cardiovascular Disease and Diabetes (International)

Effectiveness of Adherence Therapy in Adults with Type 2 Diabetes: A Systematic Review
Adherence therapy has been shown to be an effective adjunct treatment in long-term conditions including hypertension. The purpose of this study, published in the International Journal of Environmental Research and Public Health, was to review and critically appraise evidence on the effectiveness of adherence therapy as an intervention in adults with type 2 diabetes.

Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
Inappropriate polypharmacy is likely in older adults with chronic kidney disease owing to the considerable burden of comorbidities. This article, published in the International Journal of Environmental Research and Public Health, aimed to describe the impact of pharmacist-led geriatric medication management service on the quality of medication use. 

Primary Health Care (New Zealand)

Structured review of primary interventions to reduce group A streptococcal infections, acute rheumatic fever and rheumatic heart disease
Rheumatic heart disease (RHD) is a large, preventable, global public health burden. In New Zealand (NZ), acute rheumatic fever (ARF) and RHD rates are highest for Māori and Pacific children. This structured review, published in the Journal of Paediatrics and Child Health, explores the evidence for primary prevention interventions to diagnose and effectively treat group A Streptococcus (GAS) pharyngitis and skin infections to reduce rates of ARF and RHD.

Childhood asthma in New Zealand: the impact of on-going socioeconomic disadvantage (2010–2019)
The aim of this article, published in the New Zealand Medical Journal, was to document trends in number and cost of asthma hospital admissions and asthma prescriptions in children (0–14 years) from 2010–2019 in New Zealand. 

Primary Health Care (International)

Impact of Pharmacists’ Interventions and Patients’ Decision on Health Outcomes in Terms of Medication Adherence and Quality Use of Medicines among Patients Attending Community Pharmacies: A Systematic Review
Community pharmacists are responsible for providing the appropriate information on the use of medications to patients, which may enhance their medication adherence. The extent of control that patients have on their health care preferences creates many challenges for community pharmacists. This study, published in the International Journal of Environmental Research and Public Health, aimed to determine the impact of pharmacist interventions and patient decisions on health outcomes concerning medication adherence and the quality use of medicines among patients attending community pharmacies. 

Primary Mental Health (International)

Psychosocial interventions for self‐harm in adults
Self‐harm is a growing problem in most counties, often repeated, and associated with suicide. There has been a substantial increase in both the number of trials and therapeutic approaches of psychosocial interventions for self-harm in adults. This Cochrane Review updates a previous review on the role of psychosocial interventions in the treatment of self-harm in adults.

Discovering Common Elements of Empirically Supported Self-Help Interventions for Depression in Primary Care: a Systematic Review
Although the efficacy of self-help cognitive-behavioural therapy (CBT) for depression has been well established, its feasibility in primary care settings is limited because of time and resource constraints. The goal of this study, published in the Journal of General Internal Medicine, was to identify common elements of empirically supported self-help CBTs and frameworks for effective use in practice.

Approaches for discontinuation versus continuation of long‐term antidepressant use for depressive and anxiety disorders in adults
Depression and anxiety are the most frequent indication for which antidepressants are prescribed. Long‐term antidepressant use is driving much of the internationally observed rise in antidepressant consumption. The objective of this Cochrane Review was to assess the effectiveness and safety of approaches for discontinuation versus continuation of long‐term antidepressant use for depressive and anxiety disorders in adults.

Digital Health Interventions in Prevention, Relapse, and Therapy of Mild and Moderate Depression: Scoping Review
The purpose of this scoping review, published in JMIR Mental Health, was to give an overview of the digital health interventions used for depression. The main goal of this review was to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. 

Weight Management (International)

Intervention empowerment of families in preventing and controlling overweight and obesity in children: A systematic review
This study, published in Journal of Public Health Research, aimed to examine the literature analysing the effectiveness of family or parent empowerment interventions through health education.

The delivery of obesity interventions to children and adolescents with physical disabilities: a systematic review
The aim of this systematic review, published in the Journal of Public Health, was to examine the process and mechanisms of delivering obesity interventions to physically disabled children or adolescents.

Key Ministry of Health Publications

Proposals for a Smokefree Aotearoa 2025 Action Plan
The Proposals for a Smokefree Aotearoa 2025 Action Plan seeks comment on proposed actions to achieve the Smokefree 2025 goal, which will inform the development of the Smokefree Aotearoa 2025 Action Plan (the action plan). The closing date for submissions is 5.00 pm, Monday 31 May 2021.

Capping Problem Gambling in NZ: The effectiveness of local government policy interventions
This report analyses the impact of territorial authority electronic gaming machine policy on gambling harm in New Zealand.

New Zealand National Gambling Study: Correspondence between changes in gambling and gambling risk levels and health, quality of life, and health and social inequities
This study provides a statistical analysis of the four data collection years (2012 to 2015) of the National Gambling Study in order to assess how changes in gambling risk levels are associated with changes over time in health, wellbeing, disability, deprivation and social connectedness

District Health Board Initiative

Free pregnancy scans to improve equity and healthcare in the Eastern Bay
All ultrasound scans for pregnant women requested by a Lead Maternity Carer (LMC) in the Eastern Bay of Plenty are now fully funded by the Bay of Plenty District Health Board (BOPDHB). BOPDHB Population and Women’s Health Portfolio Manager Sarah Stevenson said the move improves access to routine scans which will also improve clinical outcomes and equity. 

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.