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Issue

Vol 131 No 1480: 17 August 2018

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Issue Summary

SUMMARY

An audit of regular medication compliance prior to presentation for elective surgery

Daniel Wood, Nicholas Lightfoot

An audit was conducted looking at whether people coming in for planned surgery had not taken some of their usual medications and why. Some medications should be stopped but it is better if certain others like heart medication are taken to help prevent problems arising at the time of surgery. We found many people missed some or all of their medications and this was mostly due to them not understanding the instructions they were given before surgery. There are methods of improving the communication (verbal and written) of instructions given to patients to help people take the medications they should be taking. Improving the way we do this should help prevent some avoidable complications during and after surgery.

SUMMARY

A media content analysis of New Zealand s district health board Population-Based Funding Formula

Aaron N Chester, Erin C Penno, Robin DC Gauld

The findings suggest general discontent with the PBFF model across the DHB sector and a sense that the PBFF has failed to address various challenges facing DHBs. The geographic imbalance in reporting volume suggests that frustration with the PBFF is particularly keenly felt in the South Island. Although the PBFF is a lightning rod for frustrations over limited health funding, the findings point to the need to improve transparency and dialogue around the formula and to monitor of the impact of PBFF allocations throughout the country.

SUMMARY

Psychogeriatric day hospital reduces depression and anxiety symptoms and improves quality of life

Petra Ann Hoggarth

Day hospitals are outpatient clinics where groups of patients attend for several hours and receive comprehensive treatment from an interdisciplinary team of health professionals. Only one psychogeriatric day hospital exists in New Zealand, at the Canterbury District Health Board. Self-report measures of depression, anxiety, and life satisfaction and quality were completed at intake and discharge in a sample of 185 older adults attending he day hospital. Statistically and clinically significant improvements were found on all measures. This is the first step in demonstrating that New Zealand psychogeriatric day hospitals may be an effective way of treating older adults. This is an important consideration given the increased need for effective and efficient mental health services for the burgeoning older adult population.

SUMMARY

Ethnic disparities in community antibacterial dispensing in New Zealand, 2015

Naomi Whyler, Andrew Tomlin, Murray Tilyard, Mark Thomas

Compared with many other countries, the level of antibiotic consumption by people in the community in New Zealand is very high, encouraging the spread of antibiotic resistant bacteria in New Zealand, and threatening the effectiveness of many antibiotic medicines in the coming years. One of the goals of the Antimicrobial Resistance Action Plan, developed by the NZ Ministry of Health, is to optimise the use of antimicrobial medicines in human health by encouraging appropriate antbiotic prescribing and discouraging inappropriate prescribing. However, there are large differences between the ethnic groups in New Zealand with regard to the rates of various infectious diseases, including rheumatic fever, pneumonia, and skin infections, and interventions to improve antibiotic prescribing need to take account of these ethnic differences in the rates of infectious diseases. This study has shown that Pacific and Maori people, who have very much higher rates of many infectious diseases, have only moderately higher rates of dispensing of antibiotics, when compared with people of European, Middle Eastern, Latin American or African, or Asian ethnicity. General practitioners and other health care workers caring for patients in the community need to reduce antibiotic prescribing for all population groups, but particularly for those groups with lower rates of serious infectious diseases.

SUMMARY

A multicentre, benchmarking study of rectal cancer management in provincial New Zealand hospitals

Michael J O Grady, Josephine O Grady, Rebecca Shine, Gerard Bonnet, Tim Eglinton

This study compared patients who received care for their rectal cancer in provincial verses main centre hospitals. It shows that patients who receive treatment for rectal cancer in provincial hospitals achieve similar results to those in the main centres. This is important because some international studies have shown inferior outcomes in smaller hospitals.

SUMMARY

Antipsychotic prescribing in New Zealand between 2008 and 2015

Sam Wilkinson, Roger T Mulder

We looked at antipsychotic prescribing for the whole population of New Zealand using Ministry of Health data. Antipsychotic prescribing rose by 49% over the years 2008 to 2015. Most of this change was in prescribing atypical antipsychotics. Young Maori males and older European females were most likely to receive antipsychotics.

SUMMARY

First, do no harmony: an examination of attitudes to music played in operating theatres

Anantha Narayanan, Andrew R Gray

Music is commonly played in operating theatres worldwide. This paper examines the use of and perceptions towards music being played during operations, by operating theatre staff. 72% of respondents liked it or did not mind music being played. We found that easy listening was the most frequently played, and most frequently preferred. Music was preferable for familiar, non-urgent procedures, at a low to medium volume from a CD or MP3. Surgeons were the group of staff most empowered to choose the music. While most respondents felt music improved calmness, mood, team and surgical performance, most felt it worsened communication and is distracting during crises.

SUMMARY

Genomic medicine must reduce, not compound, health inequities: the case for hauora-enhancing genomic resources for New Zealand

Stephen P Robertson, Jennie Harr Hindmarsh, Sarah Berry, Vicky A Cameron, Murray P Cox, Ofa Dewes, Robert N Doughty, George Gray, Jessie C Jacobsen, Albert Laurence, Elizabeth Matisoo-Smith, Susan Morton, Andrew N Shelling, Dianne Sika-Paotonu, Anna Rolleston, Jonathan R Skinner, Russell G Snell, Andrew Sporle, Cristin Print, Tony R Merriman, Maui Hudson, Philip Wilcox

The genomes of people living in Aotearoa are derived from populations that have disparate and distinct ancestries. As genomic medicine increases in its reach and significance, the accurate and equitable interpretation of genetic variation in the healthcare context is critical. Misinterpretation or inaccurate analysis of genetic data by using datasets mismatched to the populations being studied or served has contributed to disparities in health outcomes elsewhere, such in the US and Canada. We suggest that this will become a significant problem in Aotearoa unless an appropriate and relevant understanding of our genomic diversity is established. Aotearoa New Zealand needs to assemble a genomic resource for use in healthcare settings to aid in the accurate interpretation of genomic data for all New Zealanders, most especially for Mori and Pacific peoples.

SUMMARY

What keeps Northland general practitioners working in Northland?

Tanya Quin, Kyle Eggleton

In response to understanding Northlands GP workforce issues, this paper used face-to-face interviews with Northland GPs to explore why Northland GPs work in Northland. To answer this question the interview information was grouped together to find common reasons. Developing a personal connection to the region explained why Northland GPs work in Northland. This paper explores that connection.

ALL ARTICLES
SUMMARY

An audit of regular medication compliance prior to presentation for elective surgery

Daniel Wood, Nicholas Lightfoot

A new report on the effects of a policy used to restrict access to elective inguinal hernia surgery

Philip Bagshaw

Redundant laparoscopic adjustable gastric band tubing causing internal hernia and small bowel obstruction

Erika Fernandes, James Tan, Glenn Farrant, Karl Kodeda

Is there a place for day hospitals in older persons mental health care?

Matthew Croucher

A media content analysis of New Zealand s district health board Population-Based Funding Formula

Aaron N Chester, Erin C Penno, Robin DC Gauld

Five-year risk of stroke after TIA or minor ischemic stroke

Psychogeriatric day hospital reduces depression and anxiety symptoms and improves quality of life

Petra Ann Hoggarth

Provincial or Tertiary Surgical Treatment for Rectal Cancer in New Zealand?

Ian Bissett

A multicentre, benchmarking study of rectal cancer management in provincial New Zealand hospitals

Michael J O Grady, Josephine O Grady, Rebecca Shine, Gerard Bonnet, Tim Eglinton

Antipsychotic prescribing in New Zealand between 2008 and 2015

Sam Wilkinson, Roger T Mulder

First, do no harmony: an examination of attitudes to music played in operating theatres

Anantha Narayanan, Andrew R Gray

A Case of Adherent Meckel’s Diverticulum Causing Fatal Strangulation

By E. H. WILKINS, M.B.

A genome project for Māori and Pasifika: charting a path to equity in genomic medicine for Aotearoa

Martin A Kennedy

Genomic medicine must reduce, not compound, health inequities: the case for hauora-enhancing genomic resources for New Zealand

Stephen P Robertson, Jennie Harr Hindmarsh, Sarah Berry, Vicky A Cameron, Murray P Cox, Ofa Dewes, Robert N Doughty, George Gray, Jessie C Jacobsen, Albert Laurence, Elizabeth Matisoo-Smith, Susan Morton, Andrew N Shelling, Dianne Sika-Paotonu, Anna Rolleston, Jonathan R Skinner, Russell G Snell, Andrew Sporle, Cristin Print, Tony R Merriman, Maui Hudson, Philip Wilcox

What keeps Northland general practitioners working in Northland?

Tanya Quin, Kyle Eggleton

Ethnic disparities in community antibacterial dispensing in New Zealand, 2015

Naomi Whyler, Andrew Tomlin, Murray Tilyard, Mark Thomas

SUMMARY

An audit of regular medication compliance prior to presentation for elective surgery

Daniel Wood, Nicholas Lightfoot

An audit was conducted looking at whether people coming in for planned surgery had not taken some of their usual medications and why. Some medications should be stopped but it is better if certain others like heart medication are taken to help prevent problems arising at the time of surgery. We found many people missed some or all of their medications and this was mostly due to them not understanding the instructions they were given before surgery. There are methods of improving the communication (verbal and written) of instructions given to patients to help people take the medications they should be taking. Improving the way we do this should help prevent some avoidable complications during and after surgery.

SUMMARY

A media content analysis of New Zealand s district health board Population-Based Funding Formula

Aaron N Chester, Erin C Penno, Robin DC Gauld

The findings suggest general discontent with the PBFF model across the DHB sector and a sense that the PBFF has failed to address various challenges facing DHBs. The geographic imbalance in reporting volume suggests that frustration with the PBFF is particularly keenly felt in the South Island. Although the PBFF is a lightning rod for frustrations over limited health funding, the findings point to the need to improve transparency and dialogue around the formula and to monitor of the impact of PBFF allocations throughout the country.

SUMMARY

Psychogeriatric day hospital reduces depression and anxiety symptoms and improves quality of life

Petra Ann Hoggarth

Day hospitals are outpatient clinics where groups of patients attend for several hours and receive comprehensive treatment from an interdisciplinary team of health professionals. Only one psychogeriatric day hospital exists in New Zealand, at the Canterbury District Health Board. Self-report measures of depression, anxiety, and life satisfaction and quality were completed at intake and discharge in a sample of 185 older adults attending he day hospital. Statistically and clinically significant improvements were found on all measures. This is the first step in demonstrating that New Zealand psychogeriatric day hospitals may be an effective way of treating older adults. This is an important consideration given the increased need for effective and efficient mental health services for the burgeoning older adult population.

SUMMARY

A multicentre, benchmarking study of rectal cancer management in provincial New Zealand hospitals

Michael J O Grady, Josephine O Grady, Rebecca Shine, Gerard Bonnet, Tim Eglinton

This study compared patients who received care for their rectal cancer in provincial verses main centre hospitals. It shows that patients who receive treatment for rectal cancer in provincial hospitals achieve similar results to those in the main centres. This is important because some international studies have shown inferior outcomes in smaller hospitals.

SUMMARY

Antipsychotic prescribing in New Zealand between 2008 and 2015

Sam Wilkinson, Roger T Mulder

We looked at antipsychotic prescribing for the whole population of New Zealand using Ministry of Health data. Antipsychotic prescribing rose by 49% over the years 2008 to 2015. Most of this change was in prescribing atypical antipsychotics. Young Maori males and older European females were most likely to receive antipsychotics.

SUMMARY

First, do no harmony: an examination of attitudes to music played in operating theatres

Anantha Narayanan, Andrew R Gray

Music is commonly played in operating theatres worldwide. This paper examines the use of and perceptions towards music being played during operations, by operating theatre staff. 72% of respondents liked it or did not mind music being played. We found that easy listening was the most frequently played, and most frequently preferred. Music was preferable for familiar, non-urgent procedures, at a low to medium volume from a CD or MP3. Surgeons were the group of staff most empowered to choose the music. While most respondents felt music improved calmness, mood, team and surgical performance, most felt it worsened communication and is distracting during crises.

SUMMARY

Genomic medicine must reduce, not compound, health inequities: the case for hauora-enhancing genomic resources for New Zealand

Stephen P Robertson, Jennie Harr Hindmarsh, Sarah Berry, Vicky A Cameron, Murray P Cox, Ofa Dewes, Robert N Doughty, George Gray, Jessie C Jacobsen, Albert Laurence, Elizabeth Matisoo-Smith, Susan Morton, Andrew N Shelling, Dianne Sika-Paotonu, Anna Rolleston, Jonathan R Skinner, Russell G Snell, Andrew Sporle, Cristin Print, Tony R Merriman, Maui Hudson, Philip Wilcox

The genomes of people living in Aotearoa are derived from populations that have disparate and distinct ancestries. As genomic medicine increases in its reach and significance, the accurate and equitable interpretation of genetic variation in the healthcare context is critical. Misinterpretation or inaccurate analysis of genetic data by using datasets mismatched to the populations being studied or served has contributed to disparities in health outcomes elsewhere, such in the US and Canada. We suggest that this will become a significant problem in Aotearoa unless an appropriate and relevant understanding of our genomic diversity is established. Aotearoa New Zealand needs to assemble a genomic resource for use in healthcare settings to aid in the accurate interpretation of genomic data for all New Zealanders, most especially for Mori and Pacific peoples.

SUMMARY

What keeps Northland general practitioners working in Northland?

Tanya Quin, Kyle Eggleton

In response to understanding Northlands GP workforce issues, this paper used face-to-face interviews with Northland GPs to explore why Northland GPs work in Northland. To answer this question the interview information was grouped together to find common reasons. Developing a personal connection to the region explained why Northland GPs work in Northland. This paper explores that connection.

SUMMARY

Ethnic disparities in community antibacterial dispensing in New Zealand, 2015

Naomi Whyler, Andrew Tomlin, Murray Tilyard, Mark Thomas

Compared with many other countries, the level of antibiotic consumption by people in the community in New Zealand is very high, encouraging the spread of antibiotic resistant bacteria in New Zealand, and threatening the effectiveness of many antibiotic medicines in the coming years. One of the goals of the Antimicrobial Resistance Action Plan, developed by the NZ Ministry of Health, is to optimise the use of antimicrobial medicines in human health by encouraging appropriate antbiotic prescribing and discouraging inappropriate prescribing. However, there are large differences between the ethnic groups in New Zealand with regard to the rates of various infectious diseases, including rheumatic fever, pneumonia, and skin infections, and interventions to improve antibiotic prescribing need to take account of these ethnic differences in the rates of infectious diseases. This study has shown that Pacific and Maori people, who have very much higher rates of many infectious diseases, have only moderately higher rates of dispensing of antibiotics, when compared with people of European, Middle Eastern, Latin American or African, or Asian ethnicity. General practitioners and other health care workers caring for patients in the community need to reduce antibiotic prescribing for all population groups, but particularly for those groups with lower rates of serious infectious diseases.

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