Issue 277 - 25 May 2023

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)

He maungarongo ki ngā iwi: Envisioning a restorative health system in Aotearoa New Zealand
This framework, published by the Health Quality and Safety Commission, supports the health and disability sector to mitigate and respond to health care harm in Aotearoa New Zealand. Health care harm as defined in this framework can be a physical, psychological, social, spiritual injury or experience that occurs during the provision of care. In Aotearoa New Zealand, harm also occurs and endures due to the impacts of imperialism, colonisation and racism. In te ao Māori, harms are conceived as diminishing of the tapu and mana of people, their environments and their spiritual connection. The recommendations in the framework aim to enhance the overall health and wellbeing of consumers and providers of health care, while accounting for the unique features of the health system context.

Potentially inappropriate medications and potential prescribing omissions in hospitalised older adults in New Zealand: A retrospective study
Medication errors can have detrimental effects on patient outcomes, yet there are limited data on the prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among older adult inpatients in New Zealand (NZ). This study, published in the Australasian Journal of Ageing, investigated exposure to PIMs and PPOs in older adults in a New Zealand hospital. 
 

Cancer Services (International)

Strengthening cancer control in the South Pacific through coalition-building: a co-design framework
Cancer is a significant problem for the South Pacific region due to a range of complex health challenges. Currently gaps in diagnosis, treatment and palliative care are significant, and while governmental commitment is strong, economic constrains limit health system strengthening. Alliances have been successful in strengthening non-communicable disease and cancer control policy and services in resource constrained settings. This study, published in the Lancet Regional Health Western Pacific aims to create a Coalition Development Framework, and assess the use of the Framework in practice to co-design a South Pacific Coalition. 

Cardiovascular Disease and Diabetes (New Zealand)

Psychosocial well-being after stroke in Aotearoa New Zealand: a qualitative metasynthesis
Psychosocial well-being is key to living well after stroke, but often significantly affected by stroke. Existing understandings consider well-being comes from positive mood, social relationships, self-identity and engagement in meaningful activities. However, these understandings are socioculturally located and not necessarily universally applicable. This qualitative metasynthesis, published in Disability and Rehabilitation, examined how people experience well-being after a stroke in Aotearoa New Zealand. 

Adverse Clinical Outcomes Attributable to Socioeconomic and Ethnic Disparities Among People with Type 2 Diabetes in New Zealand Between 1994-2018: A Multiple Linked Cohort Study
This study, published in Clinical Epidemiology, aimed to examine the separate population-level contributions of the ethnic and socioeconomic disparities among people with type 2 diabetes mellitus (T2DM) and residence in New Zealand (NZ). 
 

Cardiovascular Disease and Diabetes (International)

Exploring quality improvement for diabetes care in First Nations communities in Canada: a multiple case study 
Indigenous peoples in Canada experience higher rates of diabetes and worse outcomes than non-Indigenous populations in Canada. Strategies are needed to address underlying health inequities and improve access to quality diabetes care. This study, published in BMC Health Services Research, explores two primary healthcare teams’ quality improvement process of developing and implementing strategies to improve the quality of diabetes care in First Nations communities in Canada.

Primary care management post Gestational Diabetes in Australia
Women with a history of gestational diabetes (GDM) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD). The aim of this retrospective study, published in the Internal Medicine Journal, assessed whether diabetes screening and CVD risk screening occurred in general practice amongst post-partum women with GDM. 

Primary Health Care (New Zealand)

Patterns of asthma medication use in New Zealand following publication of national asthma guidelines 
In June 2020, the New Zealand (NZ) adolescent and adult asthma guidelines recommended budesonide/formoterol, taken as maintenance and/or reliever therapy, as the preferred therapeutic approach. This study, published in the Journal of Allergy Clinical Immunology Practice, aimed to investigate whether these recommendations were associated with changes in clinical practice indicated by asthma medication use trends. 
 

Primary Health Care (International)

Remote care through telehealth for people with inflammatory bowel disease
People with inflammatory bowel disease (IBD) require intensive follow‐up with frequent consultations after diagnosis. IBD telehealth management includes consulting by phone, instant messenger, video, text message, or web‐based services. Telehealth can be beneficial for people with IBD, but may have its own set of challenges. This Cochrane Review aimed to identify the communication technologies used to achieve remote healthcare for people with inflammatory bowel disease and to assess their effectiveness.

Primary Mental Health (New Zealand)

Tracing the origins of midlife despair: association of psychopathology during adolescence with a syndrome of despair-related maladies at midlife.
Midlife adults are experiencing a crisis of deaths of despair (i.e. deaths from suicide, drug overdose, and alcohol-related liver disease). This study, published in Psychological Medicine, tested the hypothesis that a syndrome of despair-related maladies at midlife is preceded by psychopathology during adolescence. 
 

Increased Immunisation (New Zealand)

Need a flu jab? Let's try pharmacy: patient characteristics and experiences with pharmacy immunisation services
New Zealand pharmacists have been providing immunisation services since 2011. Literature from other developed countries reports the positive experience of people with community pharmacy immunisation services resulting in expansion of the scope of pharmacy practice. However, there is a dearth of such data in a New Zealand context. This study, published in the International Journal of Pharmacy Practice aimed to understand patients' experiences with pharmacy immunisation services in New Zealand. 
 

Increased Immunisation (International)

Complex intervention to promote human papillomavirus (HPV) vaccine uptake in school settings: A cluster-randomized trial.
Published in Preventive Medicine, this study aimed to evaluate a complex intervention to increase uptake of human papillomavirus (HPV) vaccination in Western and South Australian schools. 
 

Smoking Cessation (International)

Effectiveness of intensive stand-alone smoking cessation interventions for individuals with diabetes: A systematic review and intervention component analysis.
Tobacco smoking poses a significant threat to the health of individuals living with diabetes. Intensive stand-alone smoking cessation interventions, such as multiple or long (>20 minutes) behavioural support sessions focused solely on smoking cessation, with or without the use of pharmacotherapy, increase abstinence when compared to brief advice or usual care in the general population. However, there is limited evidence so far for recommending the use of such interventions amongst individuals with diabetes. This study, published in Tobacco Induced Diseases, aimed to assess the effectiveness of intensive stand-alone smoking cessation interventions for individuals living with diabetes and to identify their critical features. 

Nicotine receptor partial agonists for smoking cessation.
Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist). This Cochrane Review is an update of a review first published in 2007 to assess the effectiveness of nicotine receptor partial agonists, including varenicline and cytisine, for smoking cessation.

Key Ministry of Health Publications

Te Rau Ora Equity Review
Manatū Hauora – the Ministry of Health commissioned Te Rau Ora to carry out independent research into the August 2021 COVID-19 Delta outbreak health response, with a specific focus on how successful the response was in delivering equitable outcomes for Te Tiriti o Waitangi partners and whānau and Pacific community stakeholders and families. For this review, Te Rau Ora spoke to 14 whānau, 25 community stakeholders, and four mainstream health providers. The majority of those interviewed were Māori or Pacific people and eight had a disability or looked after someone who did. This research provides recommendations to reduce inequities associated with any future pandemics. Content warning: This report contains explicit language.
 

Ministry of Health Consultations & Events

Code of Practice for Dental Radiology ORS C4: For consultation
This document sets out proposed wording for a revised Code of Practice for Dental Radiology ORS C4 (the C4 Code) to be issued under the Radiation Safety Act 2016 (the Act). The survey at the end of the C4 Code contains questions that responders may wish to answer. The questions in the survey are provided as a guide only. This consultation closes on the 2nd of June 2023.

Health Sector Initiative

Free GP and nurse visits for rangatahi aged up to 24 years
Rangatahi (young people) in Hawke’s Bay aged between 14 and 24 years of age are being funded to see their GP or Registered Nurse for free, following repurposed funding being allocated. Te Whatu Ora in Hawke’s Bay today announced the funding package, secured for the next two years, which was offered to all general practices in Hawke’s Bay effective from 1 May, including co-payments for funded prescriptions.
 

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.