Ministry of Health Library

Health Improvement and Innovation Digest

Issue 152 - 28 September 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.

Shorter Waits for Cancer Treatment (International)

Prognostic consequences of implementing cancer patient pathways in Denmark: a comparative cohort study of symptomatic cancer patients in primary care
Cancer Patient Pathways (CPPs) were introduced in 2000-2015 in several European countries, including Denmark, to reduce the time to diagnosis and treatment initiation and ultimately improve patient survival. Yet, the prognostic consequences of implementing CPPs remain unknown for symptomatic cancer patients diagnosed through primary care. The study, published in BMC Cancer, aimed to compare survival and mortality among symptomatic patients diagnosed through a primary care route before, during and after the CPP implementation in Denmark.

Association between the time to surgery and survival among patients with colon cancer: A population-based study
Factors associated with time-to-surgery and survival in colon cancer has not been well studied. Cancer Care Ontario recommends surgery within 42 days of diagnosis and that 90% of patients meet this benchmark. This study, published in the European Journal of Surgical Oncology, describe factors associated with time-to-surgery and survival in routine clinical practice.

Shorter Stays In Emergency Departments (International)

Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED: A prospective randomized controlled study
Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study, published in Applied Clinical Informatics, was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time.

More Heart and Diabetes Checks (International)

Effectiveness of Pharmacist Interventions on Cardiovascular Risk in Patients With CKD: A Subgroup Analysis of the Randomized Controlled RxEACH Trial
Affecting a substantial proportion of adults, chronic kidney disease (CKD) is considered a major risk factor for cardiovascular (CV) events. This study, published in the American Journal of Kidney Diseases, explores the effectiveness of pharmacist interventions on cardiovascular risk in patients with CKD.

Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis
Self-monitoring of blood pressure (BP) appears to reduce BP in hypertension but important questions remain regarding effective implementation and which groups may benefit most. This individual patient data (IPD) meta-analysis, published in PLOS Medicine, was performed to better understand the effectiveness of BP self-monitoring to lower BP and control hypertension.

Primary Health Care (International)

An after hours gp clinic in regional Australia: appropriateness of presentations and impact on local emergency department presentations
After hours general practice clinics provide medical attention for clients with non-emergency situations but are seeking immediate treatment and unable to wait for a general practitioner during routine opening hours. Evidence on the impact that after hours clinics have on emergency department presentations is equivocal. This study, published in BMC Family Practice, explored outcomes of the Bathurst After Hours General Practice Clinic (BAHGPC).

Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners
The integration of community pharmacy services (CPSs) into primary care practice can be enhanced by assessing (and further addressing) the elements that enable (ie, facilitators) or hinder (ie, barriers) the implementation of such CPSs. These elements have been widely researched from the perspective of pharmacists but not from the perspectives of other stakeholders who can interact with and influence the implementation of CPSs. The aim of this study, published in BMJ Open, was to synthesise the literature on patients’, general practitioners’ (GPs) and nurses’ perspectives of CPSs to identify barriers and facilitators to their implementation in Australia.

Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews
This Cochrane Review aimed to summarise all evidence from systematic reviews on strategies directed at doctors to reduce the antibiotic prescriptions they give to patients with acute respiratory infections (ear, nose, throat or chest infections).

Primary Mental Health (New Zealand)

Pacific Islands Families (PIF) Study: housing and psychological distress among Pacific mothers
This study, published in the Australian and New Zealand Journal of Public Health, examined maternal reports, in a sample of Pacific mothers living in New Zealand, about seven specific major housing problems (too small, difficult to get to from the street, in poor condition, damp, cold, presence of pests, too expensive); and associations between these housing problems and maternal psychological distress, adjusting for some maternal sociodemographic characteristics.

Green Space and Depression during Pregnancy: Results from the Growing Up in New Zealand Study
Antenatal depression is an important contributor to poor maternal health experienced by some women. This study, published in the International Journal of Environmental Research and Public Health, aimed to determine whether exposure to green space during pregnancy is associated with less depression, and whether this association is moderated by relevant factors, such as age, education, self-identified ethnicity, physical activity, residential rurality, and socioeconomic status.

Increased Immunisation (New Zealand)

Vaccine Education During Pregnancy and Timeliness of Infant Immunization
Pregnant women routinely receive information in support of or opposing infant immunization. This study, published in Pediatrics, aimed to describe immunisation information sources of future mothers' and determine if receiving immunisation information is associated with infant immunisation timeliness.

Increased Immunisation (International)

Knowledge, attitudes and opinions towards measles and the MMR vaccine across two NSW cohorts
Although the number of national measles cases has greatly decreased since 1980s, there has been resurgence in disease incidence in recent years. While parental knowledge and attitudes toward both disease and vaccinations are known to influence vaccine uptake, the contribution of these factors toward vaccination rates in NSW populations has not been studied. The aim of this study, published in the Australian and New Zealand Journal of Public Health, was to investigate the knowledge and opinions on measles and MMR vaccine in NSW Central and North Coast regions.

Better Help for smokers to Quit (International)

Healthcare financing systems for increasing the use of tobacco dependence treatment
Interventions that reduce or cover the costs of smoking cessation medication and behavioural support could help smokers quit. This Cochrane Review explored the evidence about the effects of financial interventions directed at smokers and healthcare providers on medication use, quit attempts and successful quitting.

Pharmacotherapy for smoking cessation: effects by subgroup defined by genetically informed biomarkers
Smoking cessation therapies are not effective for all smokers, and researchers are interested in identifying those subgroups of individuals (e.g. based on genotype) who respond best to specific treatments. The objective of this Cochrane Review was to assess whether quit rates vary by genetically informed biomarkers within pharmacotherapy treatment arms and as compared with placebo.

Weight Management (New Zealand)

Energy drink consumption among New Zealand adolescents: Associations with mental health, health risk behaviours and body size
With the increase in popularity of energy drinks come multiple concerns about the associated health indicators of young people. The current study, published in the Journal of Paediatrics and Child Health, aims to describe the frequency of consumption of energy drinks in a nationally representative sample of adolescents and to explore the relationship between energy drink consumption and health risk behaviours, body size and mental health.

Relationships between sleep duration, physical activity and body mass index in young New Zealanders: An isotemporal substitution analysis
The evidence regarding the unique effect of sedentary behaviour on obesity among children is unclear. Moreover, the effect of substituting sedentary behaviour with physical activity of different intensities on the body composition of children has received limited empirical study. The objective of this study, published in PLOS One, was to examine the mathematical effects on Body Mass Index (BMI) of substituting sedentary behaviours with physical activities of different intensities on children and youth aged 5-14 years old in New Zealand.

Weight Management (International)

Cost-effectiveness of Family-Based Obesity Treatment
This study, published in Pediatrics, translated family-based behavioral treatment (FBT) to treat children with overweight and obesity and their parents in the patient-centered medical home.

Childhood Obesity (New Zealand)

Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand
Paediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. In this study, published in the Australian and New Zealand Journal of Public Health, the authors used a novel solution-focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non-obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13–17) living in socioeconomically deprived neighbourhoods.

Gene-by-environment interactions of the CLOCK, PEMT, and GHRELIN loci with average sleep duration in relation to obesity traits using a cohort of 643 New Zealand European children
Modern technology may have desensitised the 'biological clock' to environmental cues, disrupting the appropriate co-ordination of metabolic processes. Susceptibility to misalignment of circadian rhythms may be partly genetically influenced and effects on sleep quality and duration could predispose to poorer health outcomes. Shorter sleep duration is associated with obesity traits, which are brought on by an increased opportunity to eat and/or a shift of hormonal profile promoting hunger. This study, published in Sleep Medicine, hypothesised that increased sleep duration will offset susceptible genetic effects, resulting in reduced obesity risk.

Oral Health (International)

The cost-effectiveness of oral health interventions: A systematic review of cost-utility analyses
The objective of this study, published in Community Dentistry and Oral Epidemiology, was to assess the usage of cost-utility analysis (CUA) in oral health interventions and to evaluate the methods used and the reporting quality of CUA in publications on oral health interventions.

Key Ministry of Health Publications

Interim Evaluation Report: Healthy Families NZ
In 2015 the Ministry of Health contracted an evaluation of Healthy Families NZ to Massey University to follow the progress of Healthy Families NZ’s innovative dynamic systems approach to preventing chronic disease. This Healthy Families NZ Interim Evaluation report shows that the initiative has been established with integrity to its intention and purpose and is a promising approach to prevention of chronic disease. The report also identifies enabling and supporting Māori leadership as an integral part of the Healthy Families NZ approach and one of eight emerging themes and lessons that are addressed in the report.

Health Promoting Schools: Impact on Targeted Student Outcomes
Health Promoting Schools (or HPS) is a school community focused national service funded by the Ministry of Health in New Zealand to help schools assess and address the health and wellbeing requirements of their students to advance student learning and achievement outcomes. This report assesses how successful the Health Promoting Schools service has been across schools in New Zealand.

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.