Ministry of Health Library

Health Improvement and Innovation Digest

Issue 135 - 2 February 2017

Welcome to the fortnightly Health Improvement and Innovation Digest (HIID). 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.

Quality Improvement (New Zealand)

National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study
Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study, published in Emergency Medicine Australasia, aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs.

Hospital Productivity (International)

The importance of healthcare managers’ organizational preconditions and support resources for their appraisal of planned change and its outcomes
Healthcare managers are expected to lead and manage planned organizational change intended to improve healthcare process quality. However, their complex working conditions offer limited decision control, and healthcare managers often feel ill prepared and inadequately supported to perform their duties. Healthcare managers have previously described their need for organizational support, but we lack knowledge of the preconditions and resources that help managers implement planned change. This study, published in the Journal of Hospital Administration, examined the importance of healthcare managers’ organisational preconditions and resources at five Swedish hospitals for their appraisal of planned change.

Shorter Waits for Cancer Treatment (New Zealand)

A cohort study of ethnic differences in use of adjuvant chemotherapy and radiation therapy for breast cancer in New Zealand
Ethnic and socioeconomic inequities in use of breast cancer adjuvant therapy are well documented in many countries including the USA, and are known to contribute to lower breast cancer survival among minority ethnic and socioeconomically deprived women. The authors of this study, published in BMC Health Services Research, investigated ethnic and socioeconomic inequities in use of adjuvant radiotherapy and chemotherapy in a cohort of women with invasive breast cancer in New Zealand.

More Heart and Diabetes Checks (International)

Are interventions to increase the uptake of screening for cardiovascular disease risk factors effective? A systematic review and meta-analysis
Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. The objective of this systematic review, published in BMC Family Practice, is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening.

The impact of Type 2 diabetes prevention programmes based on risk-identification and lifestyle intervention intensity strategies: a cost-effectiveness analysis
The objective of this study, published in Diabetic Medicine, was to develop a cost-effectiveness model to compare Type 2 diabetes prevention programmes targeting different at-risk population subgroups with a lifestyle intervention of varying intensity.

Primary Health Care (New Zealand)

Māori patients' experiences and perspectives of chronic kidney disease: a New Zealand qualitative interview study
The objective of this study, published in BMJ Open, was to explore and describe Māori patients' experiences and perspectives of chronic kidney disease (CKD), as these are largely unknown for indigenous groups with CKD.

Primary Health Care (International)

Reducing recurrence of bacterial skin infections in Aboriginal children in rural communities: new ways of thinking, new ways of working
Reports from health workers, school staff and community members in rural NSW suggested that bacterial skin infections are a significant health issue for Aboriginal children and their families, affecting quality of life and contributing to poor school attendance. Current NSW treatment guidelines do not incorporate important sociocultural factors or ways of living in Aboriginal communities. The aim of this qualitative study, published in the Australian Journal of Primary Health, was to gain a deeper understanding of the experience of parents and carers of Aboriginal children affected by skin infections and of other community members, health workers and school staff, and what actions have been considered successful or unsuccessful in reducing the recurrence of infection.

Effectiveness of medication review: a systematic review and meta-analysis of randomized controlled trials
Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged medication optimization interventions. Furthermore, most systematic reviews focused on specific patient groups (e.g. polypharmacy, elderly, hospitalized) and/or on specific outcome measures (e.g. hospital admissions and mortality). Therefore, the objective of this study, published in BMC Family Practice, is to assess the effectiveness of medication review as an isolated short-term intervention, irrespective of the patient population and the outcome measures used.

A systematic review of experiences of advanced practice nursing in general practice
Despite efforts to achieve conceptual clarity, advanced practice nursing continues to reside in a liminal space, unable to secure ongoing recognition as a viable means of healthcare delivery. This is particularly evident in general practice where advanced practice role development is more fluid and generally less supported by the hierarchical structures evident in the hospital system. This review, published in BMC Nursing, synthesises published qualitative studies reporting experiences of advanced practice nursing in general practice.

Primary Mental Health (New Zealand)

Changes in the age pattern of New Zealand suicide rates
Age patterns of suicide in both Australia and New Zealand have changed dramatically over the last 50 years. Fluctuations have been attributed to a complexity of factors. Changes within society and in availability of health and community services have doubtless affected suicide rates. The aim of this study, published in the New Zealand Medical Journal, was to examine changes in male and female suicide rates across the age range in New Zealand, comparing them to some of the changes recorded in Australia.

Increased Immunisation (International)

Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial
Improving provider recommendations is critical to addressing low human papillomavirus (HPV) vaccination coverage. The authors of this study, published in Pediatrics, sought to determine the effectiveness of training providers to improve their recommendations using either presumptive “announcements” or participatory “conversations.”

Better Help for smokers to Quit (International)

National guidelines for smoking cessation in primary care: a literature review and evidence analysis
National guidelines for smoking cessation in primary care can be effective in improving clinical practice. This study, published in NPJ Primary Care Respiratory Medicine, assessed which parties are involved in the development of such guidelines worldwide, which national guidelines address primary care, what recommendations are made for primary care settings, and how these recommendations correlate with each other and with current evidence.

Childhood Obesity (International)

The types and aspects of front-of-pack food labelling schemes preferred by adults and children
There is strong interest in front-of-pack labels (FoPLs) as a potential mechanism for improving diets, and therefore health, at the population level. The present study examined Australian consumers' preferences for different types and attributes of FoPLs to provide additional insights into optimal methods of presenting nutrition information on the front of food packets. Much research to date has focused on two main types of FoPLs - those expressing daily intake values for specific nutrients and those utilising 'traffic light' colour coding. This study, published in Appetite, extends this work by: (i) including the new Health Star Rating system recently introduced in Australia and New Zealand; (ii) allowing a large sample of consumers to self-nominate the evaluation criteria they consider to be most important in choosing between FoPLs; (iii) oversampling consumers of lower socioeconomic status; and (iv) including children, who consume and purchase food in their own right and also influence their parents' food purchase decisions.

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. The authors of this study, published in the Journal of Paediatrics and Child Health, conducted a systematic review and meta-analysis of prospective cohort studies to estimate the associations between sleep duration and obesity/body mass index (BMI) in children.

Oral Health (International)

Do children’s previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)?
Source: Oral health-related quality of life (OHRQoL) has been used to describe the consequences of oral health conditions and treatments in children. A better understanding of OHRQoL and its relationship with dental fear and previous dental experience is necessary to improve children’s oral health status. The aim of this study, published in BMC Oral Health, was to investigate the association of dental history and experience with dental fear and the OHRQoL of children aged 11 to 14 years.