Ministry of Health Library

Health Improvement and Innovation Digest

Issue 156 - 23 November 2017

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@moh.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 (International)

A meta-ethnography of the facilitators and barriers to successful implementation of patient complaints processes in health-care settings
The objective of this study, published in Health Expectations, was to synthesize experiences of the patient complaints process for patients and health-care professionals to identify facilitators and barriers in the successful implementation of patient complaints processes.

Shorter Waits for Cancer Treatment (New Zealand)

Adherence to Adjuvant Endocrine Therapy in Christchurch Women with Early Breast Cancer
The aim of this study, published in Clinical Oncology, was to assess adherence to adjuvant endocrine therapy by a real-world cohort of women in Christchurch and to determine any associated factors.

Shorter Waits for Cancer Treatment (International)

Coordination of radiologic and clinical care reduces the wait time to breast cancer diagnosis
In 2009, a Rapid Access Breast Clinic (RABC) was opened at an urban hospital. Compared with the traditional system, the navigated care through the clinic was associated with a significantly shorter time to surgical consultation. Since 2009, many radiology facilities have introduced facilitated-care pathways for patients with breast pathology. The objective of this study, published in Current Oncology, was to determine if that change in diagnostic imaging pathways had eliminated the advantage in time to care previously shown for the RABC.

Integrated Care Planning for Cancer Patients: A Scoping Review
There has been a growing emphasis on the use of integrated care plans to deliver cancer care. This review, published in the International Journal of Integrated Care, explores how integrated care plans for cancer patients are developed including featured core activities, facilitators for uptake and indicators for assessing impact.

Shorter Stays In Emergency Departments (New Zealand)

Emergency Physician Screening and Management of Trauma Patients with Alcohol Involvement
Alcohol screening and brief intervention (SBI) in trauma patients has been reported in literature to be effective in changing harmful drinking patterns and injury recurrence. Despite good evidence that SBI can benefit patients and provide a more holistic care, it is not routinely implemented in acute medical settings in Australia, in particular emergency departments (EDs). This paper, published in the Journal of Emergencies, Trauma and Shock, aims to assess the knowledge, confidence, and practice of alcohol SBI in trauma patients by emergency physicians throughout Australia and New Zealand through an online survey.

Shorter Stays In Emergency Departments (International)

Who breaches the four-hour emergency department wait time target? A retrospective analysis of 374,000 emergency department attendances between 2008 and 2013 at a type 1 emergency department in England
The four-hour target is a key hospital emergency department performance indicator in England and one that drives the physical and organisational design of the ED. Some studies have identified time of presentation as a key factor affecting waiting times. Few studies have investigated other determinants of breaching the four-hour target. Therefore, the objective of this study, published in BMC Emergency Medicine, was to describe patterns of emergency department breaches of the four-hour wait time target and identify patients at highest risk of breaching.

Cardiovascular Disease and Diabetes (New Zealand)

Dispensing patterns for antidiabetic agents in New Zealand: are the guidelines being followed?
Type 2 diabetes mellitus (T2DM) is a significant public health issue in New Zealand. Effective management and glycaemic control is critical for reducing diabetes-related complications. Treatment guidelines are well established in New Zealand. Using dispensing data as a proxy for prescribing data, this paper, published in the New Zealand Medical Journal, aims to describe the pattern of first- and second-line antidiabetic agent (AA) dispensing for T2DM in New Zealand and assess adherence with treatment guidelines.

Cardiovascular Disease and Diabetes (International)

Combined diet and exercise interventions for preventing gestational diabetes mellitus
Gestational diabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their infants in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions. The objective of this Cochrane Review was to assess the effects of diet interventions in combination with exercise interventions for pregnant women for preventing GDM, and associated adverse health consequences for the mother and her infant/child.

Primary Health Care (New Zealand)

Implementing non-invasive prenatal testing into publicly funded antenatal screening services for Down syndrome and other conditions in Aotearoa New Zealand
Non-invasive prenatal testing (NIPT) is a relatively new screen for congenital conditions – specifically, common fetal aneuploidies including Down Syndrome. The test is based on isolating freely circulating fragments of fetal-placental DNA that is present in the mother’s blood. NIPT has a superior clinical performance compared to current screening, and has been available privately in Aotearoa New Zealand for the last 4 years. The proposed implementation of NIPT as a publicly funded service may widen the inequity in access to optional antenatal screening that already exists in this country. This paper, published in BMC Pregnancy Childbirth, discusses precautions that can be taken at the health system, organisation, and personnel levels to ensure that access to NIPT is equitable, that services are culturally responsive, and women’s informed choice is promoted and protected.

Unplanned pregnancies in New Zealand
Unplanned pregnancies can bring risk. It is important to have an accurate count of unplanned pregnancies, but to date there is no precise number for New Zealand or Australia. This analysis, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, estimates the number and proportion of pregnancies in New Zealand that are unplanned.

Evaluation of a sudden unexpected death in infancy intervention programme aimed at improving parental awareness of risk factors and protective infant care practices
Sudden unexpected death in infancy (SUDI) rates for Māori and Pacific infants remain higher than for other ethnic groups in New Zealand and bed-sharing is a major risk factor when there is smoking exposure in pregnancy. This study, published in the Journal of Paediatrics and Child Health, evaluated a programme for improving parental awareness of risk factors for SUDI and improving infant care practices.

Whānau perceptions and experiences of acute rheumatic fever diagnosis for Māori in Northland, New Zealand
In New Zealand, acute rheumatic fever (ARF) remains a significant health problem with persistent ethnic inequities. Māori children 5-15 years of age in Northland have some of the highest ARF rates nationally. This study, published in the New Zealand Medical Journal,  explored Māori whānau experiences of ARF, including pathways to primary healthcare and barriers and facilitators for diagnosis of ARF.

Face-to-face versus telephone delivery of the Green Prescription for Māori and New Zealand Europeans with type-2 diabetes mellitus: influence on participation and health outcomes
In New Zealand, the proportion of Māori who participate in the national Green Prescription lifestyle programme is lower than for New Zealand Europeans. This study, published in the New Zealand Medical Journal, compared the uptake and effectiveness of two modes of Green Prescription delivery: face-to-face and telephone among both Māori and New Zealand Europeans.

Primary Mental Health (New Zealand)

Integrated (one-stop shop) youth health care: best available evidence and future directions
Although mental health problems represent the largest burden of disease in young people, access to mental health care has been poor for this group. Integrated youth health care services have been proposed as an innovative solution. Integrated care joins up physical health, mental health and social care services, ideally in one location, so that a young person receives holistic care in a coordinated way. It can be implemented in a range of ways. This paper, published in the Medical Journal of Australia, reviews the available literature and identified a range of studies reporting the results of evaluation research into integrated care services.

Primary Mental Health (International)

Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis
Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. This study, published in Clinical Psychology Review, sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms.

Effectiveness of Online Collaborative Care for Treating Mood and Anxiety Disorders in Primary Care: A Randomized Clinical Trial
Collaborative care for depression and anxiety is superior to usual care from primary care physicians for these conditions; however, challenges limit its provision in routine practice and at scale. Advances in technology may overcome these barriers but have yet to be tested. The objective of this study, published in JAMA Psychiatry  was to examine the effectiveness of combining an internet support group (ISG) with an online computerized cognitive behavioural therapy (CCBT) provided via a collaborative care program for treating depression and anxiety vs CCBT alone and whether providing CCBT in this manner is more effective than usual care.

Increased Immunisation (New Zealand)

Bad news: The influence of news coverage and Google searches on Gardasil adverse event reporting
Human papilloma virus vaccines are a safe and effective tool for reducing HPV infections that can cause cervical cancer. However, uptake of these vaccines has been suboptimal, with many people holding negative beliefs and misconceptions. Such beliefs have been linked with the experience of unpleasant side effects following medical treatment, and media coverage may heighten such concerns. This study, published in Vaccine, sought to assess the influence of news coverage (number of news articles per month) on adverse event reporting in response to Gardasil vaccination in New Zealand over a 7.5-year period, and whether the influence of news coverage was mediated by internet search activity (Google search volumes).

Better Help for smokers to Quit (New Zealand)

Establishing Smoke-Free Homes in the Indigenous Populations of Australia, New Zealand, Canada and the United States: A Systematic Literature Review
A smoke-free home can have multiple benefits by reducing exposure to secondhand smoke (SHS), supporting quit attempts among active smokers, and discouraging adolescents from taking up smoking. The aim of this review, published in the International Journal of Environmental Research and Public Health, was to summarize the literature on the establishment of smoke-free homes in Indigenous populations and identify the supporting influences and barriers, using the Social Cognitive Theory lens.

Weight Management (New Zealand)

Kids in space: Measuring children's residential neighborhoods and other destinations using activity space GPS and wearable camera data
Defining the boundary of children's 'neighbourhoods' has important implications for understanding the contextual influences on child health. Additionally, insight into activities that occur outside people's neighbourhoods may indicate exposures that place-based studies cannot detect. This study, published in Social Science & Medicine, aimed to extend current neighbourhood research, using data from wearable cameras and GPS devices that were worn over several days in an urban setting; define the boundary of children's neighbourhoods by using leisure time activity space data; and determine the destinations visited by children in their leisure time, outside their neighbourhoods.

Weight Management (International)

The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area
The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. This study, published in the International Journal of Environmental Research and Public Health, evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention.

Childhood Obesity (International)

The Need for Early Referral: Characteristics of Children and Adolescents Who Are Overweight and Obese Attending a Multidisciplinary Weight Management Service
There is a need to examine the issue of childhood obesity from a systems perspective. This study, published in Children, aimed to describe the baseline characteristics of children attending pediatric multidisciplinary weight management services and understand how this information will inform future service delivery.

Sleep duration and obesity in children: A systematic review and meta-analysis of prospective cohort studies
Childhood obesity is a major public problem worldwide, and sleep duration may be associated with childhood obesity. This systematic review and meta-analysis of prospective cohort studies, published in the Journal of Paediatrics and Child Health, was conducted to estimate the associations between sleep duration and obesity/body mass index (BMI) in children.

A mHealth randomized controlled trial to reduce sugar-sweetened beverage intake in preschool-aged children
Sugar-sweetened beverages and maternal weight are strong drivers of child obesity, but few studies have targeted these risk factors as an obesity prevention strategy in children. The objective of this study, published in Pediatric Obesity, was to test the efficacy of a smartphone-delivered intervention to reduce parent-provided sugar-sweetened beverage and juice (SSB/juice) consumption among children ages 3-5 and maternal weight.

Food parenting and child snacking: a systematic review
While the role of parenting in children's eating behaviours has been studied extensively, less attention has been given to its potential association with children's snacking habits. This objective of this systematic review, published in the International Journal of Behavioral Nutrition and Physical Activity, was to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals.

Māori Innovation

Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research
Excellent health research is essential for good health outcomes, services and systems. Health research should also build towards equity and in doing so ensure that no one is left behind. As recipients of government funding, researchers are increasingly required to demonstrate an understanding of their delegated responsibilities to undertake research that has the potential to address Māori health needs and priorities. These requirements form the basis of responsiveness to Māori in health research, and several research institutions have implemented systems to support their organisational approach to this endeavour. However, many health researchers have a narrow view of responsiveness to Māori and how it might be relevant to their work. In this viewpoint paper, published in the New Zealand Medical Journal, the authors provide an overview of existing frameworks that can be used to develop thinking and positioning in relation to the Treaty of Waitangi and responsiveness to Māori.

Key Ministry of Health Publications

Tier 1 statistics 2016/17: New Zealand Health Survey
These tables cover the most important statistics (Tier 1) from the 2016/17 New Zealand Health Survey. The statistics included are: self-rated health, smoking (current), past-year drinking, hazardous drinking, obesity, mental health status (psychological distress), unmet need for GP due to cost, and unfilled prescription due to cost.

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.