Issue 309 - 19 September 2024

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 Health NZ district 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)

Barriers for bariatric surgery in provincial New Zealand: a qualitative analysis
Bariatric surgery is the most effective treatment for people with obesity. It has been shown that there's is a complex psychosocial overlay in the pathophysiology and treatment, which requires specific consideration when delivering care. This study, published in the ANZ Journal of Surgery, explored the barriers to bariatric surgery in provincial New Zealand.

E kaua e hoki i te waewae tūtuki, ā, apā anō hei te ūpoko pakaru - a systematic review of neurosurgical disease and care for Māori in New Zealand
The aim of this study, published in ANZ Journal of Surgery, was to assess neurosurgical disease incidence and perioperative outcomes for Māori at any point from referral through to the postoperative period.

Nutrition & Physical Activity (International)

Family meals on prescription as treatment for childhood obesity-a randomized controlled trial
The aim of this study, published in the European Journal of Pediatrics, was to evaluate the effects and tolerability of Family Meals on Prescription, a 3-month intensive dietary intervention with a participatory approach on body mass index (BMI) and metabolic health in children living with obesity.

Quality Improvement (New Zealand)

A quality improvement project: Rapid Access Hysteroscopy Clinics with nurse pre-procedural telephone support in the outpatient setting
Endometrial cancer (EC) is increasing in incidence in women across Aotearoa New Zealand as risk factors such as obesity and diabetes become more prevalent. This article, published in The New Zealand Medical Journal, discusses a Rapid Access Clinic (RAC) for hysteroscopy and how it was implemented at Te Whatu Ora Counties Manukau District to increase early detection of EC.

Cancer Services (New Zealand)

Faecal immunochemical test (FIT) based prioritisation of new patient symptomatic cases referred for colorectal investigation
Quantitative faecal haemoglobin (fHb) measurement by faecal immunochemical test (FIT) is a powerful biomarker for colorectal cancer (CRC) and is incorporated in referral, prioritisation and triage protocols for symptomatic cases in other countries. This article, published in The New Zealand Medical Journal, reports on the use of FIT to prioritise new patient symptomatic cases referred for colorectal investigation.

Cancer Services (International)

Which social determinants of health have the highest impact in community oncology to advance patient care equity and improve health outcomes? A scoping review
The aim of this review, published in Cancer Medicine, was to better understand the Social Determinants of Health (SDOH)-health equity landscape within a community oncology setting.

Interventions to promote colorectal cancer screening among people with a family history of colorectal cancer: A scoping review
The global incidence of colorectal cancer (CRC) is rising, with people having a family history of CRC (PFH-CRC) facing double the risk compared to the average-risk population. Despite this, CRC screening uptake among PFH-CRC remains low. There is a lack of systematic mapping of interventions promoting CRC screening in this high-risk population. This scoping review, published in Preventive Medicine, aimed to identify the types of interventions targeting PFH-CRC, their effectiveness in increasing CRC screening uptake, and the elements associated with the outcomes.

Emergency Department Services (New Zealand)

Redirection of low-acuity emergency department patients to nearby medical clinics using an electronic medical support system: effects on emergency department performance indicators
Overcrowded emergency departments (EDs) are associated with higher morbidity and mortality and suboptimal quality-of-care. Most ED flow management strategies focus on early identification and redirection of low-acuity patients to primary care settings. This article, published in BMC Emergency Medicine, was to assess the impact of redirecting low-acuity ED patients to medical clinics using an electronic clinical decision support system on four ED performance indicators.

Cardiovascular Disease and Diabetes (International)

Impact of Interventions on Medication Adherence in Patients With Coexisting Diabetes and Hypertension
The coexistence of diabetes and hypertension is prevalent due to shared risk factors. Pharmacological treatment has been reported to be effective in managing both conditions. However, treatment effectiveness depends on the extent to which a patient adheres to their treatment. Poor adherence to long‐term treatment for chronic diseases is a growing global problem of significant magnitude. Several interventions have been developed to help improve medication adherence in patients with coexisting diabetes and hypertension. This review, published in Health Expectations, aimed to determine the characteristics of these interventions and their impact on medication adherence.

Primary Health Care (International)

How effective are allied health group interventions for the management of adults with long-term conditions? An umbrella review of systematic reviews and its applicability to the Australian primary health system
Group allied health interventions for people with chronic conditions may be a solution to increasing access to allied health in primary care. This umbrella review, published in BMC Primary Care, aimed to determine the effectiveness of allied health group interventions to improve health-related outcomes for adults with chronic conditions and the applicability of the findings to the Australian primary health care context.

Primary Mental Health (New Zealand)

Text2whaiora after a suicide attempt: Text message design alongside people with lived experience
People with lived experience have had limited opportunities to meaningfully contribute to the design of caring contacts interventions. The objective of this study, published in PLOS One, was to co-design text messages with peer support specialist staff to determine optimal language and delivery, within a cultural context.

Primary Mental Health (International)

Discharge from secondary care services to primary care for adults with serious mental illness: a scoping review
Effective transitions of patients from Secondary Care Services (SCSs) to primary care are necessary for optimisation of resources and care. Factors that enable or restrict smooth transitions of individuals with Serious Mental Illness (SMI) to primary care from SCSs have not been comprehensively synthesised. A scoping review, published in BMC Psychiatry, was conducted to answer the questions "What are the barriers and facilitators to discharge from SCSs to primary care for adults with SMI?" and "What programs have been developed to support these transitions?".

Oral Health (International)

Effects of oral health interventions on cognition of people with dementia: a systematic review with meta-analysis
Increasing studies have shown that poor oral health contributes to the progression of dementia. It is meaningful to find out the role of oral health interventions in maintaining people’s cognition levels and delaying the progression of dementia. This review, published in BMC Oral Health, aimed to summarise the present evidence on the effect of oral health interventions on the cognition change of people with dementia.

Disability Services (New Zealand)

Low-intensity parent- and clinician-delivered support for young autistic children in Aotearoa New Zealand: a randomised controlled trial
Aotearoa New Zealand does not provide publicly-funded intensive autism support. While parent-mediated supports are promising, children and families may also benefit from direct clinician support. This study, published in The Lancet Regional Health: Western Pacific, tested the efficacy of a low-intensity programme involving parent- and clinician-delivered support for autistic children.

Key Ministry of Health Publications

COVID-19’s role in shaping reactions to public health advice and New Zealanders’ preferences for handling a new pandemic
This report, commissioned by the Public Health Agency, within the Ministry of Health, outlines the results of a quantitative survey aiming to quantify the impact of barriers and other factors on adherence to public health measures.

Measuring Public Health Behaviours and Intentions – Wave Two
This report, commissioned by the Public Health Agency, within the Ministry of Health, is the second report based on repeat surveys. The report will help enhance the Ministry's understanding of people’s attitudes to public health measures and provides ideas on how to communicate important public health information and support people taking protective and preventative measures.

Te Weu me Te Wai: Research into the health and wellbeing impacts of adverse weather conditions
In 2023 a series of extreme weather events occurred, including Cyclone Gabrielle on 13 February. The Ministry of Health (the Ministry) commissioned research Te Weu me Te Wai – Research into health and wellbeing impacts of adverse weather conditions to understand how health and the health system was impacted by these events.

Ministry of Health Consultations & Events

Safe Areas - One year survey
The Ministry is conducting a survey to understand provider experiences and observations following the establishment of a Safe Area around their facility. The information gathered from this survey will contribute to a review of the effectiveness of Safe Areas surrounding abortion services in Aotearoa New Zealand. This survey closes on the 30th of September.

Public consultation for the review of the End of Life Choice Act (2019)
The End of Life Choice Act 2019 (the Act) is the law that makes assisted dying legal in New Zealand. It came into force on 7 November 2021. The Act is administered by the Ministry of Health | Manatū Hauora, and the Assisted Dying Service is delivered by Health New Zealand | Te Whatu Ora.  The Act sets out the legal framework for assisted dying, including eligibility criteria, processes, safeguards to protect patients and practitioners, and the establishment of administrative bodies to oversee and monitor the provision of assisted dying. This consultation is open until 26 September 2024.

Health Sector Initiative

Holistic Pacific health provider now delivering specialist maternity care 
The holistic Pacific healthcare provider began its specialist ‘early years’ journey in December and has worked to overcome some challenges along the way.

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.