Ministry of Health Library Health Improvement and Innovation Digest

on 16 August

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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 172 - 16 August 2018

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

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)

Antibacterials dispensed in the community comprise 85%-95% of total human antibacterial consumption
Published in the Journal of Clinical Pharmacy and Therapeutics, the authors measured community and hospital antibacterial consumption in New Zealand during 2015, from both reimbursement and purchase data, and compared the New Zealand data with those reported from a large range of other nations during similar time periods. Their results suggest that improving antimicrobial stewardship in the community may provide greater overall benefits in combating antibacterial resistance than improving antimicrobial stewardship in hospitals.

Drug burden and its association with falls among older adults in New Zealand: A National Population Cross-Sectional Study
This study, published in Drugs & Aging, investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders.


Quality Improvement (International)

Patient and public engagement in research and health system decision making: A systematic review of evaluation tools
Patient and public engagement is growing, but evaluative efforts remain limited. Reviews looking at evaluation tools for patient engagement in individual decision making do exist, but no similar articles in research and health systems have been published. The objective of this research, published in Health Expectations, was to systematically review and appraise evaluation tools for patient and public engagement in research and health system decision making.

Comparing knowledge, accessibility, and use of evidence-based chronic disease prevention processes across four countries
Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of EBCDP worldwide. This study, published in Frontiers in Public Health, aimed to examine three contextual factors (knowledge, access, and use of chronic disease prevention processes) across four countries (Australia, Brazil, China and the United States).


Hospital Productivity (New Zealand)

Improving quality of clinical coding of post-partum haemorrhage: the process and its effects on reported incidence rates in a New Zealand hospital maternity service
The Waitemata District Health Board (DHB) aimed to investigate and improve the accuracy of its reporting of post-partum haemorrhage (PPH), to understand its true incidence. Published in the New Zealand Medical Journal, this quality improvement, multidisciplinary project illustrates the value of coding to a clinical service and the importance of clinical leadership and engagement in achieving successful and sustainable service redesign initiatives.


Shorter Waits for Cancer Treatment (International)

mHealth approaches in managing skin cancer: systematic review of evidence-based research using integrative mapping
mHealth, which encompasses mobile health technologies and interventions, is rapidly evolving in various medical specialties, and its impact is evident in oncology. In particular, mHealth has established itself as a prominent part of dermatology for cancer screening. The purpose of this systematic review, published in JMIR MHealth and UHealth, was to describe current trends in research addressing the integration of mHealth and its contributions across the skin cancer continuum


Shorter Stays In Emergency Departments (International)

Impact of the four-hour National Emergency Access Target on 30 day mortality, access block and chronic emergency department overcrowding in Australian emergency departments
Previous research has reported strong associations between emergency department overcrowding and mortality. In this longitudinal cohort study, published in Emergency Medicine Australasia, the authors assessed the effect of the Four-Hour Rule (4HR) intervention (Western Australia (WA) 2009), then nationally rolled out as the National Emergency Access Target (Australia 2012) policy, on mortality and patient flow.


Cardiovascular Disease and Diabetes (International)

Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force
Atrial fibrillation is the most common arrhythmia and increases the risk of stroke. The objective of this systematic review, published in JAMA, was to review the evidence on screening for nonvalvular atrial fibrillation with electrocardiography (ECG) and stroke prevention treatment


Primary Health Care (New Zealand)

Characteristics of a stratified random sample of New Zealand general practices
Practice size and location may affect the quality and safety of health care. Little is known about contemporary New Zealand general practice characteristics in terms of staffing, ownership and services. The aim of this records review study, published in the Journal of Primary Health Care, was to describe and compare the characteristics of small, medium and large general practices in rural and urban New Zealand.


Primary Health Care (International)

Ambulatory care sensitive chronic conditions: what can we learn from patients about the role of primary health care in preventing admissions?
Developing and targeting interventions to reduce hospital admissions for ambulatory care sensitive (ACS) chronic conditions for older people is a key focus for improvement of the health system. Published in the Australian Journal of Primary Health, this qualitative study collected the perspectives of 24 patients on factors that may have contributed to their unplanned ACS admissions.


Primary Mental Health (International)

Stigma in mental health at the macro and micro levels: implications for mental health consumers and professionals
Despite increasing mental health promotion and advocacy, stigma persists and poses a significant threat to the healthy functioning at the macro and micro-sociological levels. Stigma is gradually evolving with the incorporation of broader social contexts at the micro and macro levels in which individuals, institutions and larger cultural constructs shape and influence the perception of what is different and therefore stigmatized. This theoretical paper based on literature and published in the Community Mental Health Journal, underscores how mental health stigma discourages individuals from getting proper mental health treatment.

Efficacy of online lifestyle interventions targeting lifestyle behaviour change in depressed populations: A systematic review
This systematic review, published in the Australian & New Zealand Journal of Psychiatry, evaluates the existing evidence for the efficacy or effectiveness of lifestyle interventions for (1) individuals with depressive symptoms, (2) clinically depressed populations or discussing the outcomes of depression within a subset of a larger cohort delivered online or via smart phone.


Better Help for Smokers to Quit (New Zealand)

Reconceptualizing motivation for smoking cessation among people with rheumatoid arthritis as incentives and facilitators
Smokers with rheumatoid arthritis (RA) may have different motivations for, and barriers to, quitting. The focus of this study, published in Musculoskeletal Care, is to gain an understanding of the motivations of smokers and ex-smokers with RA, to help in the design and implementation of targeted smoking cessation interventions for people with RA that are not based solely on extrapolation from the general population or populations with other chronic illnesses.

Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations
By July 2018, five countries (Australia, France, the UK, New Zealand and Norway) had fully implemented plain (standardised) packaging. This study, published in Tobacco Control, used government documents to review the key legislative differences between these five countries to identify best practice measures and potential lacuna.


Better Help for Smokers to Quit (International)

Integrating smoking cessation care in alcohol and other drug treatment settings using an organisational change intervention: a systematic review
Organizational change interventions involve systems and cultural change within health‐care services to make smoking cessation care delivery part of usual treatment. Six strategies for organizational change have been proposed. This systematic review, published in Addiction, examined the evidence for organizational change interventions in the alcohol and other drug (AOD) setting on: (a) smoking cessation care; and (b) smoking cessation and cessation‐related outcomes.


Weight Management (New Zealand)

A taboo topic? How general practitioners talk about overweight and obesity in New Zealand
Research shows consistently low rates of weight management discussions between health professionals and patients, suggesting that health professionals may not be realising their full potential to address obesity. The aim of this study, published in the Journal of Primary Health Care, was to identify communication strategies used by General Practitioners (GPs) to open the topic of weight and weight management in routine consultations.


Weight Management (International)

Commissioning guidance for weight assessment and management in adults and children with severe complex obesity
Published in Obesity Reviews, this systematic review of 'what evidence exists for what should happen in/commissioning of: primary or secondary care weight assessment and management clinics in patients needing specialist care for severe and complex obesity?' used an accredited methodology to produce a model for organization of multidisciplinary team clinics that could be developed in every healthcare system, as an update to a previous review.

Metabolic syndrome and weight management programs in primary care: a comparison of three international healthcare systems
Lifestyle behaviours are contributing to the increasing incidence of chronic disease across all developed countries. Australia, Canada and the UK have had different approaches to the role of primary care in the prevention and management of lifestyle-related diseases. Both obesity and metabolic syndrome have been targeted by programs to reduce individual risk for chronic disease such as type 2 diabetes. Published in the Australian Journal of Primary Health, this study describes three interventions – for either obesity or metabolic syndrome – that have varying levels of involvement of GPs and other primary care professionals.


Childhood Obesity (International)

Effect of a behavioral intervention for underserved preschool-age children on change in body mass index: A randomized clinical trial
Prevention of obesity during childhood is critical for children in underserved populations, for whom obesity prevalence and risk of chronic disease are highest. Published in JAMA, the objective of this research was to test the effect of a multicomponent behavioral intervention on child body mass index growth trajectories over 36 months among preschool-age children at risk for obesity.

Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group randomized controlled trial on children's food, beverage, and calorie consumption among snacks served
Afterschool interventions have been found to improve the nutritional quality of snacks served. However, there is limited evidence on how these interventions affect children's snacking behaviors.  The aim of this study, published in the Journal of the Academy of Nutrition & Dietetics, was to determine the impact of an afterschool intervention focused at the school district, site, family, and child levels on dietary consumption of foods and beverages served at snack.

Early infant feeding of formula or solid foods and risk of childhood overweight or obesity in a socioeconomically disadvantaged region of Australia: a longitudinal cohort analysis
The timing of introduction of formula and solids may be associated with risk of childhood overweight or obesity, and this may vary by age at breastfeeding cessation during first year. Published in the International Journal of Environmental Research and Public Health, the authors included 346 infants from southwestern Sydney using the longitudinal study for Australian children (LSAC). The outcome risk of overweight or obesity was measured at every two-year interval of children aged 0 or 1 year at baseline until they reached age 10 or 11. Age at introduction to formula or solids was dichotomized at four months.

Effect of a responsive parenting educational intervention on childhood weight outcomes at 3 years of age: The INSIGHT randomized clinical trial
Rapid growth and elevated weight status in early childhood increase risk for later obesity, but interventions that improve growth trajectories are lacking.  The aim of this research, published in JAMA, was to examine effects of a responsive parenting intervention designed to promote developmentally appropriate, prompt, and contingent responses to a child’s needs on weight outcomes at 3 years.


Oral Health (International)

Bridging the dental-medical divide: Case studies integrating oral health care and primary health care
The National Academies of Sciences, Engineering, and Medicine commissioned an environmental scan describing the status of health care integration of oral health and primary care services. Published in the Journal of the American Dental Association, the authors conducted an environmental scan of US integration activities with publications from January 2000 through August 2017.


Key Ministry of Health Publications

New Zealand National Gambling Study: Wave 4 (2015), Report number 6
Prepared for the Ministry of Health, the National Gambling Study was designed as a prospective investigation to assess the incidence of problem and risky gambling in the New Zealand adult population, and other changes in gambling participation and gambling-related harm. These changes included increased and decreased gambling participation, decreased risky and problem gambling and relapse to at-risk and problem gambling.


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.


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