HC23010New Zealanders with low back pain seeking health care: a retrospective descriptive analysis of Accident Compensation Corporation-funded low back pain healthcare service usage

Julia Hill , Dylan Kay, Jacob Gordon, Imran Khan Niazi and Nicola Saywell

pp. 206-214

What is already known: Over 50% of people with LBP seek care. There is a global rise in LBP disability, often with inappropriate and unnecessary use of healthcare resources. What this study adds: In NZ, there are many services available for people with LBP and this study reports on the most used services and the associated costs for ACC-funded LBP health care.

HC23034Development and validation of PolyScan, an information technology triage tool for older adults with polypharmacy: a healthcare informatics study

Lisheng Liu , Rashmi Alate and Jeff Harrison

pp. 215-223

What is already known: Polypharmacy is common in older adults, and while not inherently unsafe, can be associated with increased adverse medicine events. There is a need for reliable and effective approaches to systematically triage those most at risk of adverse medicine events who may benefit from intervention. What this study adds: PolyScan is an information technology tool that has been developed and validated for New Zealand, based on an explicitly derived set of criteria. PolyScan can identify and triage older adults with polypharmacy in primary care who have been prescribed potentially inappropriate medicines.

HC23026Changing patterns of otitis media in the Waikato region during the COVID-19 pandemic

Andre Becker, Ha Nguyen , Michael Becker, Andrew Wood and Ross Lawrenson

pp. 224-229

Ear infections in children are commonly encountered by general practitioners (GP) and in some cases lead to a glue ear that requires the insertion of ventilation tubes. We compared the rate of ear infections between Māori and NZ European children in a rural general practice and linked this to the surgical intervention rates in Waikato Hospital before and during the COVID-19 pandemic. We found that the incidence of ear infection was similar for Māori and NZ European children, but Māori were more likely to be referred to specialist care and more likely to have insertion of ventilation tubes. Infection rates and surgical intervention fell during the COVID-19 pandemic.

HC23041Interventions to improve vaccine coverage of pregnant women in Aotearoa New Zealand

Flynn Macredie, Esther Willing , Pauline Dawson , Anna Howe and Amber Young

pp. 230-237

What is already known: Maternal immunisation against influenza and pertussis is suboptimal. Current strategies are inequitable, with mothers from Māori and Pacific backgrounds, and those from areas of high deprivation less likely to be vaccinated in pregnancy. What this study adds: Many strategies should be enlisted to improve coverage, including supporting a wider vaccination workforce, building on strategies used for the COVID-19 roll out, and supporting prioritisation of maternal vaccination by healthcare providers and hapū māmā. Building trusting relationships remains the mainstay of effective service provision.

HC23009New Zealand hospice staff perspectives on ‘Xcellent Gowns’ for big bodied palliative care patients: a qualitative study

Jazmin Phillips, Emily Wood, Tanya Loveard, Eileen McKinlay , Carol MacDonald, George Parker and Lesley Gray

pp. 238-245

What is already known: The one-size-fits-none design of most gowns is not fit for purpose and can negatively impact patient well-being and increase distress. The environment of ill-fitting patient wear and equipment can deliver micro-aggressions towards big bodied people. What this study adds: This qualitative study, the first in New Zealand, makes a valuable contribution to the limited research and discussion relating to end-of-life care for big bodied people and more generally to the role a patient’s gown plays in the quality of the patient care experience.

HC23022Physician and nurse practitioner perspectives of a modified Routine Opioid Outcome Monitoring (ROOM) Tool

Cynthia Lam, Patricia Marr, Kori Leblanc , Christine Papoushek, Debbie Kwan, Beth Sproule and Laura Murphy

pp. 246-252

What is already known: Interprofessional collaboration is an important component of providing optimal care to patients living with chronic pain. Community pharmacists are well positioned to support primary care providers in assessing safety and efficacy of opioid use by patients for chronic pain. What this study adds: The validated ROOM Tool guides community pharmacists to assist in screening, preventing, and reducing harms associated with opioid use. This research shares primary care provider perceptions of a combined communication and ROOM Tool, and highlights an opportunity for community pharmacists to more effectively collaborate with primary care providers when providing care for patients living with chronic pain.

HC23067Defining comprehensiveness in primary care: a scoping review

Derek Baughman , Rafay Nasir, Lynda Ngo and Andrew Bazemore

pp. 253-261

What is already known: Comprehensiveness is a well-established academic concept known as one of the foundations of effective primary care delivery, but its definition and interpretations vary across medical organizations and research groups. What this study adds: This scoping review organizes the known literature to unify a definition of comprehensiveness, generalizing the evidence-based, operationalizable concept for primary care leaders, researchers, and practitioners.

HC22127Imaging incidence and type in primary care patients with low back pain: a cross-sectional study on new referrals to an Australian specialist spinal surgical centre

Isaac J. Tennant , Yun-Hom Yau, Derek Yull, Peter Murphy and Ian R. Whittle

pp. 262-266

What is already known: Low back pain is a common presenting complaint to primary care, and frequently is investigated with imaging that does not conform to guideline recommendations. In Australia, general practitioner access to lumbar magnetic resonance imaging (MRI) is restricted, while subsidies are easier to access for spinal computed tomography (CT) and X-ray scan. What this study adds: This preliminary research contextualises the claims of spinal over-imaging by providing novel data, derived from new patient referrals from primary care to a specialist spinal surgical centre, which compares imaging guideline compliance levels by specific imaging indication. This study also found a high incidence of lumbar CT compared to lumbar MRI, despite guideline recommendations, validating recent statements released by the Australian Commission on Safety and Quality in Healthcare regarding expanding GP access to subsidised MRI and restricting CT access.

HC23006Nurse prescriber’s understanding of their antimicrobial stewardship role: a qualitative study

Anecita Gigi Lim, Dianne C. Marshall , Kenzie Roberts and Michelle L. L. Honey

pp. 274-280

What is already known: Registered nurses often demonstrate elements of antimicrobial stewardship across many healthcare settings and in their clinical work directly with patients. What this study adds: Registered nurse designated prescribers are engaging and using antimicrobial stewardship approaches when prescribing antibiotics. Further education about the appropriate use of antibiotics is recommended to enable nurses to reach their potential for full participation in antimicrobial stewardship.

HC23070Patient representation in New Zealand general practice and rural health case-based teaching: a quality improvement exercise

Jessica Gu, Jim Ross and Sharon Leitch

pp. 281-287

What is already known: A medical school curriculum that lacks diversity, inclusion and equity can increase student bias. This is detrimental in medical practice and may contribute to healthcare disparities. What this study adds: This research found a lack of diversity in the case-based teaching materials used in an undergraduate general practice education programme. This work provides impetus to drive the development of more representative cases that may improve cultural safety in medical education and the future health workforce.