A Real-World Analysis of Treatment Patterns and Clinical Characteristics Among Patients with COPD Who Initiated Multiple-Inhaler Triple Therapy in New Zealand.

Purpose: Real-world data on maintenance treatment and prescription patterns provide insights into healthcare management among patients with chronic obstructive pulmonary disease (COPD), which benefits our understanding of current COPD treatment patterns in New Zealand.

Methods: We retrospectively analyzed real-world data from the HealthStat general practice database to evaluate treatment patterns among patients with COPD in New Zealand who initiated multiple-inhaler triple therapy (MITT): inhaled corticosteroid (ICS) + long-acting muscarinic antagonist + long-acting β-agonist (LABA). Our main objective described treatment patterns (class, duration, modification, persistence, and adherence) and characteristics of patients with COPD initiating MITT between 1 May 2016 and 30 April 2017, with 12-months' follow-up.

Burden of illness in blood eosinophilic phenotype COPD patients in New Zealand.

Background: Real-world data on eosinophilic chronic obstructive pulmonary disease (COPD)'s clinical burden, in exacerbating/stable states, and the stability of blood eosinophil count (BEC) measurements are limited. We described measured BEC distributions among general practice COPD patients in New Zealand (NZ).

Methods: This retrospective cohort study utilized the NZ-HealthStat primary care database.

Long-Acting Bronchodilator Use in Chronic Obstructive Pulmonary Disease in Primary Care in New Zealand: A Retrospective Study of Treatment Patterns and Evolution Using the HealthStat Database.

Purpose: Long-acting bronchodilator (LABD) use is the mainstay of pharmacologic treatment for chronic obstructive pulmonary disease (COPD). Few studies describe evolving patterns of LABD use in the setting of changing inhaler availability and updated clinical guidelines.

Methods: A retrospective cohort study in New Zealand using the HealthStat general practice database (01/2014 to 04/2018).

Dentition and nutritional status of aged New Zealanders living in aged residential care.

Background: Previous studies of the nutritional status of older individuals have used measures such as plasma vitamin and mineral levels, which can be difficult to interpret. The relationship between nutrition and dentition has been limited to studying exposures such as the number of posterior occluding pairs of teeth, edentulousness, and the number of natural teeth.

Objectives: To investigate the association between dentition status and nutritional status in a national survey of older New Zealanders living in aged residential care facilities.

Characterization and burden of severe eosinophilic asthma in New Zealand: Results from the HealthStat Database.

Background: This retrospective cohort study aimed to characterize epidemiology, medication use and healthcare resource utilization (HCRU) of patients diagnosed with severe eosinophilic asthma (SEA) compared to other patients with asthma in New Zealand.

Methods: Adult patients with asthma with no concurrent diagnosis of Chronic Obstructive Lung Disease (COPD) were identified from the HealthStat primary care database and the National Minimum Dataset using asthma diagnosis, hospital codes and prescriptions. Patients with SEA were identified using a 1-year baseline period (2011) and were those with: inhaled corticosteroid prescription above medium dose (including high dose) plus controller medication, ≥2 exacerbations, and eosinophils ≥300 cells/μl (or ≥150 in 6 weeks prior to index date); patients were followed for 1 year (2012).

Risk Factors for Acute Rheumatic Fever: Literature Review and Protocol for a Case-Control Study in New Zealand.

Acute rheumatic fever (ARF) and its sequela, rheumatic heart disease (RHD), have largely disappeared from high-income countries. However, in New Zealand (NZ), rates remain unacceptably high in indigenous Māori and Pacific populations. The goal of this study is to identify potentially modifiable risk factors for ARF to support effective disease prevention policies and programmes.

The residual dentition among New Zealanders in aged residential care.

Background: Descriptions of the older population's dentition status are usually limited to indicators such as the edentulous proportion, the mean number of restored and missing teeth, and the proportion with a functional dentition, with very few reports describing in detail the nature of the residual dentition.

Objectives: This study described the residual dentition among older New Zealanders living in residential aged care facilities.

Material And Methods: Using national data from the Older People's Oral Health Survey, we determined the residual dentition arrangement and Kennedy classification for each dental arch.

Oral status, cognitive function and dependency among New Zealand nursing home residents.

Objectives: To investigate clinical oral disease and its association with cognitive function and dependency among older New Zealanders in residential aged care.

Material And Methods: National survey of oral health in aged residential care throughout New Zealand. We classified residents into 1 of 3 levels of care: "low dependency care (or assisted living)"; "high dependency care"; or "specialist dementia care/psychogeriatric care.

The incidence of acute otitis media in New Zealand children under five years of age in the primary care setting.

Introduction: Acute otitis media (AOM) is a common childhood infection. Baseline data are required to evaluate potential changes in the epidemiology of AOM with new public health measures.

Aim: To estimate the incidence of AOM in children under five years of age in primary care in New Zealand.

Potential unmet need for gout diagnosis and treatment: capture-recapture analysis of a national administrative dataset.

Objective: To estimate the degree of undercount of people diagnosed with gout in administrative datasets using capture-recapture methods.

Methods: Hospitalization and drug dispensing claims (allopurinol or colchicine) data for all Aotearoa New Zealand were used to estimate the prevalence of gout in 2009 (n = 4 295 296). As a comparison, we calculated gout prevalence using a large primary care dataset using general practitioner diagnosis and prescribing records (n = 555 313).

National prevalence of gout derived from administrative health data in Aotearoa New Zealand.

Objective: Previous small studies in Aotearoa New Zealand have indicated a high prevalence of gout. This study sought to determine the prevalence of gout in the entire Aotearoa New Zealand population using national-level health data sets.

Methods: We used hospitalization and drug dispensing claims for allopurinol and colchicine for the entire Aotearoa New Zealand population from the Aotearoa New Zealand Health Tracker (ANZHT) to estimate the prevalence of gout in 2009, stratified by age, gender, ethnicity and socio-economic status (n = 4 295 296).

Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?

Background: In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates.

Teenage use of GP care for moderate to severe asthma in Auckland, New Zealand.

Objectives: To describe and understand teenagers' frequency of attendance for General Practitioner (GP) care of moderate to severe asthma in the Auckland region.

Methods: Ten Auckland schools identified 510 children aged 13-14 years with breathing problems, who were invited to complete a screening questionnaire. 271 children participated, of whom 114 had moderate to severe asthma.

Attendance for general practitioner asthma care by children with moderate to severe asthma in Auckland, New Zealand.

Attendance for general practitioner (GP) care of childhood asthma varies widely in New Zealand (NZ). There is little current research to account for the variations, although groups such as Māori and Pacific peoples have traditionally faced barriers to accessing GP care. This paper aims to describe and account for attendance levels for GP asthma care among 6-9 year-olds with moderate to severe asthma in Auckland, NZ.

GP care for moderate to severe asthma in children: what do infrequently attending mothers disagree with and why?

Objectives: Our aim was to identify and account for areas of disagreement with GP care for moderate to severe child asthma among mothers who infrequently use this care. Identifying and understanding these areas of disagreement has the potential to improve child access to GP care.

Methods: This qualitative study in Auckland, New Zealand, used a general inductive approach to analyse 23 semi-structured, personal interviews during March-October 2001 with samples of 11 mothers of children with moderate to severe asthma, and 12 medical providers (10 in general practice and two in hospital emergency departments).

General practitioners' assessments of the primary care caseload in Middlemore Hospital Emergency Department.

Aim: To estimate the proportion of Middlemore Hospital Emergency Department (ED) attendances that GPs thought could be handled in primary care.

Methods: A retrospective review of 300 randomly selected discharge summaries of non-admitted patients by 12 GPs.

Results: Data were available from 278 discharges.

Establishing a Maori case management clinic.

Aims: The Maori Case Management Clinic Project aims to improve Maori health outcomes by establishing low cost, high quality, culturally appropriate primary care facilities in targeted areas, with a focus on the management of chronic illness. Further, the project aims to evaluate this 'by Maori for Maori' model of community healthcare delivery.

Methods: Working in partnership with local Maori health providers, we analysed the available health utilisation and demographic data to choose the three best sites to establish new primary care facilities.

The development and implementation of the Chronic Care Management Programme in Counties Manukau.

Aims: To develop an effective and efficient process for the seamless delivery of care for targeted patients with specific chronic diseases. To reduce inexplicable variation and maximise use of available resources by implementing evidence-based care processes. To develop a programme that is acceptable and applicable to the Counties Manukau region.

Primary options for acute care: general practitioners using their skills to manage "avoidable admission" patients in the community.

Aim: To enroll 600 primary care "avoidable admission" patients in a programme that utilised general practitioners to manage those patients in the community.

Methods: The Primary Options for Acute Care (POAC) programme ran from 26 February to 31 December 2001. Using networks already established, primary care teams were invited to manage patients using any resources they required, up to a cost of approximately $266 per patient.

Integrating healthcare: the Counties Manukau experience.

In 1998, Counties Manukau District Health Board (CMDHB) was experiencing rapidly increasing demands on its secondary services. It was finding it increasingly difficult to meet the health needs of its relatively deprived population. There was widespread evidence of "systems failure", with poor coordination of primary and secondary services.

How much variation in clinical activity is there between general practitioners? A multi-level analysis of decision-making in primary care.

Objectives: There is considerable policy interest in medical practice variation (MPV). Although the extent of MPV has been quantified for secondary care, this has not been investigated adequately in general practice. Technical obstacles to such analyses have been presented by the reliance on ecological small area variation (SAV) data, the binary nature of many clinical outcomes in primary care and by diagnostic variability.

Integrated disease management pilot for diabetes.

A New Zealand diabetes program integrates management systems for hospitals and physician practices through a shared integrated care server (ICS), which supports collaborative patient management, virtual consults, and clinical feedback.

Reasons for poor understanding of when and how to access GP care for childhood asthma in Auckland, New Zealand.

Background: Attempts to explain why some patients lack the understanding needed to access GP care for childhood asthma are uncommon and have tended to be based on reported statistical associations.

Objectives: The aims of this study were to describe and account for poor patient understanding of when and how to access GP care for childhood asthma in Auckland, New Zealand.

Methods: A general inductive approach was used to analyse 29 semi-structured, personal interviews, during March-May 2001, with Auckland key informants selected through maximum variation sampling.

Quality of care indicators for population-based primary care in New Zealand.

Aim: To develop a set of non-invasive, evidence-based, population-based quality of care indicators for primary care in New Zealand and to test their feasibility.

Methods: New Zealand, British and Australian publications were reviewed and a set of quality of care indicators was constructed. These were trialed on data collected from seventeen fully computerised practices from the FirstHealth network of general practices.