Ocular Antibiotic Utilisation across Aotearoa/New Zealand.

Ocular antibiotics are integral to the prevention and treatment of bacterial ocular infections. This study aimed to describe their utilisation across New Zealand according to patient and healthcare factors. Every subsidy-eligible community dispensing of ocular chloramphenicol, fusidic acid and ciprofloxacin in New Zealand, between 2010 and 2019, was included in this analysis.

Societal burden of work on injury deaths in New Zealand, 2005-14: An observational study.

Background: Work poses increased risk of injury not only for workers but also for the public, yet the broader impact of work-related injury is not quantified. This study, utilising population data from New Zealand, estimates the societal burden of work-related fatal injury (WRFI) by including bystanders and commuters.

Methods: This observational study selected deaths due to unintentional injury, in persons aged 0-84 years using International Classification of Disease external cause codes, matched to coronial records, and reviewed for work-relatedness.

Impact of removing prescription co-payments on the use of costly health services: a pragmatic randomised controlled trial.

Objectives: To determine whether exempting people (with high health needs and living in areas of high deprivation) from a $5 prescription charge reduces hospital use.

Design: Two-group parallel prospective randomised controlled trial.

Setting: People living in the community in various regions of New Zealand.

Impact of legislative reform on worker fatalities in New Zealand workplaces: a 30-year retrospective population-level analysis.

Objectives: To determine the impact of major legislative changes to New Zealand's Occupational Health and Safety (OHS) legislation with the adoption of the Robens model as a means to control occupational risks on the burden and risk of work-related fatal injury (WRFI).

Methods: Population-based comparison of WRFI to workers aged 15-84 years occurring during three periods: before (pre:1985-1992), after legislative reform (post-1:1993-2002) and after subsequent amendment (post-2:2003-2014). Annual age-industry standardised rates were calculated with 95% CI.

Treatment pathways in people with type 2 diabetes mellitus: a nationwide cohort study of new users of metformin monotherapy in New Zealand.

Objectives: The aims of this study were to describe the following: (1) the time to change of therapy in patients with type 2 diabetes who had initiated metformin monotherapy as first-line treatment and (2) the sequence in which subsequent therapeutic regimens were introduced.

Design: Cohort study.

Setting: National study based on linked data from the New Zealand Ministry of Health's National Collections of health and pharmaceutical dispensing data.

Impact of removing prescription charges on health outcomes: protocol for a randomised controlled trial.

Introduction: Prescription charges prevent many people from accessing the medicines they need to maintain or improve their health. In New Zealand, where most people pay $5 per prescription item, Māori and Pacific peoples, those living in most deprived areas and those with chronic health conditions are the most likely to report that cost prevents them from accessing medicines.

Methods And Analysis: This randomised controlled trial (RCT) will evaluate the effect of removing prescription charges on health outcomes and healthcare utilisation patterns of people with low income and high health needs.

Dual versus single long-acting bronchodilator use could raise acute coronary syndrome risk by over 50%: A population-based nested case-control study.

Background: Coronary heart disease occurs more frequently among patients with chronic obstructive pulmonary disease (COPD) compared to those without COPD. While some research suggests that long-acting bronchodilators might confer an additional risk of acute coronary syndrome (ACS), information from real-world clinical practice about the cardiovascular impact of using two versus one long-acting bronchodilator for COPD is limited. We undertook a population-based nested case-control study to estimate the risk of ACS in users of both a long-acting muscarinic antagonist (LAMA) and a long-acting beta2-agonist (LABA) relative to users of a LAMA.

Antidepressant dispensing before, during, and after pregnancy in New Zealand, 2005-2014.

Background: Depression during pregnancy is associated with a number of negative impacts on maternal and infant health, therefore good control of depression in pregnant women is crucial. There is a lack of population-level information about patterns of antidepressant use during pregnancy in New Zealand.

Aim: To describe antidepressant dispensing patterns before, during, and after pregnancy in New Zealand, 2005-2014.

Patterns of metformin monotherapy discontinuation and reinitiation in people with type 2 diabetes mellitus in New Zealand.

Aim: To describe the patterns of discontinuation and reinitiation in new users of metformin monotherapy in New Zealand, overall and according to person- and healthcare-related factors.

Materials And Methods: We created a cohort (n = 85,066) of all patients in New Zealand with type 2 diabetes mellitus who initiated metformin monotherapy between 1 January 2006 and 30 September 2014 from the national data collections, and followed them until the earlier of their death or 31 December 2015. Discontinuation was defined as a gap in possession of metformin monotherapy of ≥90 days.

Is the use of two versus one long-acting bronchodilator by patients with COPD associated with a higher risk of acute coronary syndrome in real-world clinical practice?

Background: Cardiovascular comorbidity is common among patients with chronic obstructive pulmonary disease (COPD) and there is concern that long-acting bronchodilators (long-acting muscarinic antagonists (LAMAs) and long-acting beta agonists (LABAs)) may further increase the risk of acute coronary events. Information about the impact of treatment intensification on acute coronary syndrome (ACS) risk in real-world settings is limited. We undertook a nationwide nested case-control study to estimate the risk of ACS in users of both a LAMA and a LABA relative to users of a LAMA.

Statin adherence is lower in primary than secondary prevention: A national follow-up study of new users.

Background: Maintaining adherence to statins reduces the risk of an initial cardiovascular disease (CVD) event in high-risk individuals (primary prevention) and additional CVD events following the first event (secondary prevention). The effectiveness of statin therapy is limited by the level of adherence maintained by the patient. We undertook a nationwide study to compare adherence and discontinuation in primary and secondary prevention patients.

Decade of variable progress: trends in fatal injury in workers in New Zealand from a national observational study.

Introduction: Analyses of secular trends in work-related fatal injury in New Zealand have previously only considered the total working population, potentially hiding trends for important subgroups of workers. This paper examines trends in work-related fatalities in worker subgroups between 2005 and 2014 to indicate where workplace safety action should be prioritised.

Methods: A dataset of fatally injured workers was created; all persons aged 15-84 years, fatally injured in the period 2005-2014, were identified from mortality records, linked to coronial records which were then reviewed for work relatedness.

Did healthcare professional perspectives on the quality and safety environment in New Zealand public hospitals change from 2012 to 2017?

Purpose: The work environment is known to influence professional attitudes toward quality and safety. This study sought to measure these attitudes amongst health professionals working in New Zealand District Health Boards (DHBs), initially in 2012 and again in 2017.

Design/methodology/approach: Three questions were included in a national New Zealand health professional workforce survey conducted in 2012 and again in 2017.

Patterns of prescription medicine dispensing before and during pregnancy in New Zealand, 2005-2015.

Objective: To describe prescription medicine dispensing before and during pregnancy in New Zealand, 2005-2015.

Methods: Members of the New Zealand Pregnancy Cohort were linked with their dispensing records in a national database of prescription products dispensed from community pharmacies. We identified the proportion of pregnancies during which at least one prescription medicine was dispensed, the number of different medicines used and the most commonly dispensed medicine groups both during pregnancy and in the 270 days before conception.

Prescription medicines with potential for foetal harm: dispensing before and during pregnancy in New Zealand, 2005-2015.

Purpose: This study describes dispensing of potentially teratogenic prescription medicines before and during pregnancy in New Zealand over the period 2005-2015.

Methods: Records in a national dispensing database were linked with the members of the New Zealand Pregnancy Cohort to determine the proportion of pregnancies with at least one dispensing of a Category D or X medicine, using the Australian pregnancy risk categorisation system. Exposure was examined from 270 days prior to conception through to the end of pregnancy.

Decade of fatal injuries in workers in New Zealand: insights from a comprehensive national observational study.

Introduction: Current priorities and strategies to prevent work-related fatal injury (WRFI) in New Zealand (NZ) are based on incomplete data capture. This paper provides an overview of key results from a comprehensive 10-year NZ study of worker fatalities using coronial records.

Methods: A data set of workers, aged 15-84 years at the time of death who died in the period 2005-2014, was created using coronial records.

Has the clinical governance development agenda stalled? Perceptions of New Zealand medical professionals in 2012 and 2017.

Clinical governance is a key policy and organisational foundation for health care quality improvement. This study sought to measure progress with clinical governance development from the perspective of practicing medical professionals in the New Zealand public health system. A short fixed-response survey, with questions derived from a government policy statement, was sent in 2012 and 2017 to all registered medical professionals in ongoing employment in New Zealand's public health system.

Adherence to metformin monotherapy in people with type 2 diabetes mellitus in New Zealand.

Aim: To describe adherence to metformin monotherapy in New Zealanders with type 2 diabetes mellitus (T2DM) initiating pharmacological treatment for the first time.

Methods: We created a cohort of all New Zealanders with T2DM commencing metformin monotherapy between 1 January 2006 and 30 September 2014 using national data collections and followed them until the end of 2015. We obtained data on person- and health-related characteristics at metformin initiation from these collections and calculated medication possession ratios from pharmacy dispensing data.

Identifying opportunities to prevent work-related fatal injury in New Zealand using 40 years of coronial records: protocol for a retrospective case review study.

Background: Improving New Zealand's poor workplace safety record has become a high priority following high profile workplace fatal incidents in 2010 and 2014. Existing routine official data are unable to reliably inform occupational safety policy and action in New Zealand. This case review study will examine work-related fatal injury (WRFI) to: i) determine their burden, rates and distribution; ii) identify high-risk groups, causes and circumstances; iii) analyse secular trends, and iv) examine the impact of historic occupational safety legislative reform.

Generation of a pregnancy cohort for medicine utilisation and medicine safety studies in New Zealand.

Purpose: The aim of this study was to use national health databases to assemble a pregnancy cohort for undertaking medicine utilisation and safety studies in New Zealand.

Method: Pregnancies conceived between January 2005 and March 2015 were identified in the National Maternity Collection, the National Minimum Dataset, the Mortality Collection, and the Laboratory Claims Collection. Pregnancy start and end dates were calculated and used in conjunction with the National Health Index number to merge the records from the four collections to create the New Zealand Pregnancy Cohort.

Patterns of use of long-acting bronchodilators in patients with COPD: A nationwide follow-up study of new users in New Zealand.

Background And Objective: While several studies have found that prescribing practices do not conform to chronic obstructive pulmonary disease (COPD) treatment guidelines, none have examined longitudinal patterns of use of long-acting beta -agonist (LABA) and long-acting muscarinic antagonist (LAMA) therapy across an entire country. We undertook a nationwide follow-up study to describe treatment patterns in new users of long-acting bronchodilators.

Methods: National health and pharmaceutical dispensing data were used to identify patients aged ≥45 years who initiated LABA and/or LAMA therapy for COPD between 1 February 2006 and 31 December 2013.

Do different approaches to clinical governance development and implementation make a difference? Findings from Ireland and New Zealand.

Purpose Clinical governance (CG) is an important foundation for a high-performing health care system, with many countries supporting its development. CG policy may be developed and implemented nationally, or devolved to a local level, with implications for the overall approach to implementation and policy uptake. However, it is not known whether one of these two approaches is more effective.