Issue 251 - 28 April 2022

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.

Health Equity (New Zealand)

"If we can just dream…" Māori talk about healthcare for bipolar disorder in New Zealand: A qualitative study privileging Indigenous voices on organisational transformation for health equity
This paper, published in the International Journal of Health Planning and Management, identifies barriers to equity and proposes changes to improve the organisation of healthcare in New Zealand for Māori with bipolar disorder (BD) and their families.

Co-design for indigenous and other children and young people from priority social groups: A systematic review
Co-design has increasingly been posited as a useful approach for Indigenous peoples and other social groups that experience inequities. However, the relatively rapid rise in co-design rhetoric has not necessarily been accompanied by increased understanding of whether co-design works for these social groups, and how equity is addressed. This systematic review, published in SSM - Population Health, aimed to identify the current state of co-design as theory and praxis within the context of health and/or disability related interventions or services, with a specific focus on equity considerations for Indigenous and other children and young people from priority social groups.

Trends in deprivation in hospitalisations of Indigenous children and young people in Aotearoa New Zealand 
The objective of this study, published in the Journal of Paediatrics and Child Health, was to examine the 20-year trends in socio-economic inequities in hospitalisations of Māori and non-Māori non-Pacific (NMNP) under-25-year olds in Aotearoa New Zealand.

Cardiovascular Disease and Diabetes (International)

A systematic review on assessment and management of preventive cardiovascular care in primary health for Aboriginal and Torres Strait Islander women and men
In promoting positive cardiovascular health for Aboriginal and Torres Strait Islander peoples, there is a need to ensure provision of high-quality risk assessment and management in primary healthcare settings. There is some evidence of gender gaps for Australian women in the provision of cardiovascular risk assessment and management; however, there is little understanding of whether these gaps are also present for Aboriginal and Torres Strait Islander women. This systematic review, published in the Australian Journal of Primary Health, was utilised to synthesise existing evidence on the provision of assessment and management against guideline-recommended care for Aboriginal and Torres Strait Islander women, and determine whether gender disparities in provision of care exist for this population.

Primary Health Care (New Zealand)

Investigating the effectiveness of virtual treatment via telephone triage in a New Zealand general practice
Telemedicine, including telephone triage, is increasingly being used in New Zealand general practices. Telephone triage involves diverting requests for same-day healthcare to a phone system where presenting complaints are explored only sufficiently to identify the most appropriate management. The aim of this study, published in the Journal of Primary Health Care, was to assess the rates of repeat triage among general practice patients treated virtually via phone and compare these with outcomes for patients who were dealt with in person.

Primary Health Care (International)

Delivery of supported self‐management in remote asthma reviews: A systematic rapid realist review
The COVID-19 pandemic forced health care systems globally to adapt quickly to remote modes of health care delivery, including for routine asthma reviews. A core component of asthma care is supporting self-management, a guideline-recommended intervention that reduces the risk of acute attacks, and improves asthma control and quality of life. This study, published in Health Expectations, aimed to explore context and mechanisms for the outcomes of clinical effectiveness, acceptability and safety of supported self-management delivery within remote asthma consultations.

Primary Mental Health (New Zealand)

Longitudinal Cohort Study of Depression and Anxiety Among Older Informal Caregivers Following the Initial COVID-19 Pandemic Response in Aotearoa New Zealand
The objective of this study, published in the Journal of Aging and Health, was to assess the impact of providing care and conditions of care on psychological wellbeing among older informal caregivers following the initial period of COVID-19 pandemic restrictions in Aotearoa New Zealand.

A community-based initiative to improve transgender mental health in Canterbury, New Zealand
The transgender community experiences high levels of mental distress. In the Canterbury region of New Zealand, transgender care was fragmented and there were gaps in service provision. This paper, published in the Journal of Primary Health Care, discussed the findings of a 2019 working group which was co-designed a model to coordinate and improve health care for the Canterbury transgender community. The aim was to co-design and implement a comprehensive system for transgender health care that filled any existing gaps.

Primary Mental Health (International)

The Impact of COVID on Adolescent Mental Health, Self-Harm and Suicide: How Can Primary Care Provider Respond? A Position Paper of the European Academy of Pediatrics
Adolescents aged 10 to 19 live a period of their life marked by opportunities and vulnerabilities during which the issue of mental health is of prime importance. Since several decades, and especially since the start of the COVID pandemic, mental health problems and disorders among adolescents have increased around the world. Depression, self-harm and suicidal behavior are common during this period of life, and pediatricians can play a pivotal role in identifying affected or vulnerable youngsters. This article describes risk factors for self-harm and suicidal behavior and reviews how primary care pediatricians and health professionals can respond to such situations. This scoping review, published in Frontiers in Pediatrics, is based on existing evidences as well as the authors clinical experience. It suggests concrete actions that can be taken to secure the life of at risk teenagers, and discusses how to organize the transfer to mental health professionals when needed.

Psychological treatments for depression and anxiety in dementia and mild cognitive impairment
Experiencing anxiety and depression is very common in people living with dementia and mild cognitive impairment (MCI). There is uncertainty about the best treatment approach. Drug treatments may be ineffective and associated with adverse effects. Guidelines recommend psychological treatments. This Cochrane Review investigated the effectiveness of different psychological treatment approaches.

Smoking Cessation (International)

Digital interventions for smoking abstinence: a systematic review and meta-analysis of randomized control trials
Technological advancements have improved patients' health and clinical care through digital interventions. This study, published in the Journal of Addictive Diseases, investigated the effects of digital interventions on smoking abstinence.

Mindfulness for smoking cessation
Mindfulness‐based smoking cessation interventions may aid smoking cessation by teaching individuals to pay attention to, and work mindfully with, negative affective states, cravings, and other symptoms of nicotine withdrawal. The objective of this Cochrane Review was to assess the efficacy of mindfulness‐based interventions for smoking cessation among people who smoke, and whether these interventions have an effect on mental health outcomes.

Weight Management (New Zealand)

Caregiver survey of preschool children with obesity referred to Whānau Pakari—a multidisciplinary healthy lifestyle intervention programme
The aim of this study, published in the New Zealand Medical Journal, was to examine caregiver perceptions relating to the acceptability of weight screening at New Zealand’s B4 School Check (B4SC), and the accessibility and acceptability of a healthy lifestyle programme (Whānau Pakari) for preschool children (Whānau Pakari preschool programme) identified with weight issues.

Testing the effectiveness of a novel, evidence-based weight management and lifestyle modification programme in primary care: the Healthy Weight Initiative
Primary care prevention strategies that support and provide tools for general practice have the potential to slow and reverse rates of overweight and obesity. The aim of this study, published in the Journal of Primary Health Care, was to test the effectiveness of a novel 12-week, online, structured, evidence-based weight management and lifestyle modification programme in general practices.

Weight Management (International)

Effect of High-Intensity Interval Training Combined with Fasting in the Treatment of Overweight and Obese Adults: A Systematic Review and Meta-Analysis
This systematic review and meta-analysis, published in the International Journal of Environmental Research and Public Health, was conducted to compare the effects of high-intensity interval training (HIIT) combined with fasting (HIIT + fasting) and other interventions (HIIT alone, fasting alone, or normal intervention) in adults with overweight and obesity on body composition.

Disability Services (International)

Interventions for health-related physical fitness and overweight and obesity in children with intellectual disability: Systematic review and meta-analysis
Poor health-related physical fitness (HRPF) and overweight and obesity are common health problems for children with intellectual disability. This study, published in Journal of Applied Research in Intellectual Disabilities, aimed to review existing lifestyle intervention studies, and identify effective strategies for this population.

Health and wellbeing outcomes and social prescribing pathways in community‐based support for autistic adults: A systematic mapping review of reviews
Adults on the autism spectrum are affected by health disparities which significantly reduce life expectancy and experience barriers to accessing healthcare. Social prescribing is a holistic approach that diverts patients from primary care to health-enhancing activities in communities. However, there has been a lack of research attention to how autistic people navigate the social prescribing pathway and the ability of these approaches to address existing disparities. This mapping review, published in Health & Social Care in the Community, aimed to synthesise features of non-medical, community-based interventions for autistic adults to assess their suitability for a social prescribing approach.

Key Ministry of Health Publications

Responding to Public Health Threats at New Zealand Air- and Seaports
These guidelines identify a range of border health and travel measures that could be used to prevent or respond to public health threats of international significance (including communicable diseases, such as novel influenza). The guidelines also outline the potential advantages and disadvantages of each measure. The guidelines have been developed to aid decision-making around implementing appropriate health measures at New Zealand air and sea ports.

Drug Checking Service Provider Licensing Handbook
This publication provides information and guidance about drug checking licensing for both potential and current providers. The handbook gives details on the application process, along with general information about the Drug Checking Licensing Scheme for drug checking service providers.

Ministry of Health Consultations & Events

Proposed addition to the schedule of the Medicines (Designated Pharmacist Prescribers) Regulations 2013
The oral antiviral medicines, Paxlovid and Lagevrio are used in the treatment of COVID-19 in adults, who do not require initiation of supplemental oxygen and are at increased risk of progression to hospitalisation or death. The medicine should be taken as soon as possible after a diagnosis of COVID-19 has been made and within five days of symptoms onset. Pharmacist prescribers are well positioned to ensure equitable and early access to COVID-19 treatments for their local communities. At the time of consultation, sotrovimab (Xevudy), etesevimab, ensovibep, cilgavimab, tixagevimab are section 29, or unapproved medicines. Current legislation does not authorise pharmacist prescribers to prescribe unapproved medicines and does allow the inclusion of unapproved medicines in these specified medicine schedules. Therefore these proposals are forward-looking to avoid barriers to accessing important medicines which may become available in New Zealand. You can submit your feedback on the proposed additions until 22 May 2022. 

District Health Board Initiative

Innovation led the way for Ethnic Care in the Community Hub
Hamilton Multicultural Services Trust found itself at the cutting edge of health care when its Settlement Centre became the Waikato’s COVID-19 Ethnic Care in the Community Hub. There were 10 COVID-19 Care in the Community Hubs proposed for Māori, and one for Pasifika and Ethnic communities combined, when the Trust, on behalf of the sector governance group, proposed a stand-alone hub for the region’s ethnic communities.

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.