Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Achieving health equity in Aotearoa New Zealand: the contribution of medicines optimisation

Leanne Te Karu 1 , Linda Bryant 1 , Matire Harwood 2 , Bruce Arroll 1
+ Author Affiliations
- Author Affiliations

1 Department of General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand

2 Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences University of Auckland, Auckland, New Zealand

Correspondence to: Leanne Te Karu, Department of General Practice and Primary Healthcare, University of Auckland, Tamaki Campus Gate 1, 261 Morrin Rd, St Johns, Auckland 1072, New Zealand. Email: ltekaru@xtra.co.nz

Journal of Primary Health Care 10(1) 11-15 https://doi.org/10.1071/HC17067
Published: 29 March 2018

Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

This paper aims to consider the various parts of what is required to achieve the best possible health outcomes from medicines in partnership with the person for whom they are prescribed. Specifically, it looks to highlight the process from an Indigenous view with respect to Māori in Aotearoa New Zealand, and claims a multi-dimensional approach is imperative. Attaining optimal use of medicines is necessary to help achieve health equity. There is an urgent need to understand and investigate models of care that achieve this optimal state.


References

[1]  Anderson I, Robson B, Connolly M, et al. Indigenous and tribal peoples’ health. (The Lancet – Lowitja Institute Global Collaboration): a population study. Lancet. 2016; 388 131–57.
Indigenous and tribal peoples’ health. (The Lancet – Lowitja Institute Global Collaboration): a population study.CrossRef |

[2]  United Nations Inter-Agency Support Group on Indigenous Peoples’ Issues. The Health of Indigenous Peoples 2014. Geneva: United Nations; 2014. [cited 2017 January 10]. Available from: http://www.un.org/en/ga/president/68/pdf/wcip/IASG%20Thematic%20Paper%20- %20Health%20-%20rev1.pdf

[3]  Cobo M. Study of the Problem of Discrimination against Indigenous Populations: Final report. City: United Nations; 1981. p. 10.

[4]  Anaya SJ. Indigenous Peoples in International Law, 2nd edn. Dunedin: Otago University Press; 2004.

[5]  Robson B, Harris R. Hauora: Maori standards of health IV: a study of the years 2000–2005. Wellington: Te Rōpū Rangahau Hauora a Eru Pōmare; 2007.

[6]  Ministry of Health. Tatau Kahukura: Māori Health Chart Book 2015, 3rd edn. Wellington: Ministry of Health; 2015.

[7]  New Zealand Government. Health Practitioners Competence Assurance Act 2003, Section 118 (i). Wellington: New Zealand Government; 2003.

[8]  Baumhäkel M, Muller U, Bohm M. Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study. Eur J Heart Fail. 2009; 11 299–303.
Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study.CrossRef |

[9]  Tsugawa Y, Jena AB, Figueroa JF, et al. Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians. JAMA Intern Med. 2017; 177 206–13.
Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians.CrossRef |

[10]  de Vries TPGM, Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing. Geneva: World Health Organization; 2004: p 142. [cited 2017 January 15]. Available from: http://apps.who.int/medicinedocs/pdf/whozip23e/whozip23e.pdf.

[11]  Yudkin JS, Kavanagh J, McCormack JP. Guidelines for treating risk factors should include tools for shared decision making. BMJ. 2016; 353 i3147

[12]  Maxwell S. Good prescribing: better systems and prescribers needed. CMAJ. 2010; 182 540–1.
Good prescribing: better systems and prescribers needed.CrossRef |

[13]  Bolland MJ, Grey A, Reid IR. Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis? Climacteric. 2015; 18 22–31.
Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis?CrossRef |

[14]  Nicholson T. Complementary and alternative medicines (including traditional Maori treatments) used by presenters to an emergency department in New Zealand: a survey of prevalence and toxicity. N Z Med J. 2006; 119 U1954.

[15]  Pharmaceutical Management Agency. [cited 2016 November 17]. Available from: https://www.pharmac.govt.nz

[16]  Norris P, Horsburgh S, Cumming J, Tordoff J. Prescription charge increases in New Zealand penalise the poor and sick. J Prim Health Care. 2014; 6 4–5.

[17]  Horsburgh S, Norris P. Ethnicity and access to prescription medicines. N Z Med J. 2013; 126 7–11.

[18]  Norris P, Tordoff J, McIntosh B, et al. Impact of prescription charges on people living in poverty: a qualitative study. Res Social Adm Pharm. 2016; 12 893–902.
Impact of prescription charges on people living in poverty: a qualitative study.CrossRef |

[19]  Jatrana S, Crampton P, Norris P. Ethnic differences in access to prescription medication because of cost in New Zealand. J Epidemiol Community Health. 2011; 65 454–60.
Ethnic differences in access to prescription medication because of cost in New Zealand.CrossRef |

[20]  Gillies TD, Tomlin AM, Dovey SM, Tilyard MW. Ethnic disparities in asthma treatment and outcomes in children aged under 15 years in New Zealand: analysis of national databases. Prim Care Respir J. 2013; 22 312–8.
Ethnic disparities in asthma treatment and outcomes in children aged under 15 years in New Zealand: analysis of national databases.CrossRef |

[21]  Seneviratne S, Campbell I, Scott N, et al. Ethnic differences in timely adjuvant chemotherapy and radiation therapy for breast cancer in New Zealand: a cohort study. BMC Cancer. 2014; 14 839
Ethnic differences in timely adjuvant chemotherapy and radiation therapy for breast cancer in New Zealand: a cohort study.CrossRef |

[22]  Metcalfe S, Laking G, Arnold J. Variation in the use of medicines by ethnicity during 2006/07 in New Zealand: a preliminary analysis. N Z Med J. 2013; 126 14–41.

[23]  Ingrasciotta Y, Sultana J, Giorgianni F, et al. Association of individual non-steroidal anti-inflammatory drugs and chronic kidney disease: a population-based case control study. PLoS One 2015; 10 e0122899
Association of individual non-steroidal anti-inflammatory drugs and chronic kidney disease: a population-based case control study.CrossRef |

[24]  Pirlamarla P, Bond RM. FDA labeling of NSAIDs: review of nonsteroidal anti-inflammatory drugs in cardiovascular disease. Trends Cardiovasc Med. 2016; 26 675–80.
FDA labeling of NSAIDs: review of nonsteroidal anti-inflammatory drugs in cardiovascular disease.CrossRef |

[25]  Cram F, Smith L, Johnstone W. Mapping the themes of Maori talk about health. N Z Med J. 2003; 116 1–17.

[26]  Bassett-Clarke D, Krass I, Bajorek B. Ethnic differences of medicines-taking in older adults: a cross cultural study in New Zealand. Int J Pharm Pract. 2012; 20 90–8.
Ethnic differences of medicines-taking in older adults: a cross cultural study in New Zealand.CrossRef |

[27]  Gu Y, Warren J, Kennelly J, et al. Cardiovascular disease risk management for Maori in New Zealand general practice. J Prim Health Care. 2014; 6 286–94.

[28]  Kidd J, Gibbons V, Lawrenson R, Johnstone W. A whanau ora approach to health care for Māori. J Prim Health Care. 2010; 2 163–4.

[29]  Capstick S, Norris P, Sopoaga F, Tobata W. Relationships between health and culture in Polynesia – A review. Soc Sci Med. 2009; 68 1341–8.
Relationships between health and culture in Polynesia – A review.CrossRef |

[30]  Raval M, Goodyear-Smith F, Wells S. The effect of ethnicity on different ways of expressing cardiovascular treatment benefits and patient decision-making. J Prim Health Care. 2015; 7 24–33.

[31]  Crengle S, Lay-Yee R, Davis P, Pearson J. A comparison of Māori and Non-Māori patient visits to doctors: The National Primary Medical Care Survey (NatMedCa): 2001/02. Report 6. Wellington: Ministry of Health; 2005.

[32]  Jansen P, Bacal K, Buetow S. A comparison of Maori and non-Maori experiences of general practice. N Z Med J. 2011; 124 24–9.

[33]  Crengle S, Smylie J, Kelaher M, et al. Cardiovascular disease medication health literacy among Indigenous peoples: design and protocol of an intervention trial in Indigenous primary care services. BMC Public Health. 2014; 14 714
Cardiovascular disease medication health literacy among Indigenous peoples: design and protocol of an intervention trial in Indigenous primary care services.CrossRef |

[34]  Harwood M. Rehabilitation and indigenous peoples: the Māori experience. Disabil Rehabil. 2010; 32 972–7.
Rehabilitation and indigenous peoples: the Māori experience.CrossRef |

[35]  Hotu C, Bagg W, Collins J, et al. A community-based model of care improves blood pressure control and delays progression of proteinuria, left ventricular hypertrophy and diastolic dysfunction in Māori and Pacific patients with type 2 diabetes and chronic kidney disease: a randomized controlled trial. Nephrol Dial Transplant. 2010; 25 3260–6.
A community-based model of care improves blood pressure control and delays progression of proteinuria, left ventricular hypertrophy and diastolic dysfunction in Māori and Pacific patients with type 2 diabetes and chronic kidney disease: a randomized controlled trial.CrossRef |

[36]  Ratima MM, Fox C, Fox B, et al. Long-term benefits for Maori of an asthma self-management program in a Maori community which takes a partnership approach. Aust N Z J Public Health. 1999; 23 601–5.
Long-term benefits for Maori of an asthma self-management program in a Maori community which takes a partnership approach.CrossRef | 1:STN:280:DC%2BD3c7gs1Wjtg%3D%3D&md5=e4913d866a304a7490a16f82767e4bd0CAS |

[37]  Jones RG, Trivedi A, Ayanian J. Factors influencing the effectiveness of interventions to reduce racial and ethnic disparities in health care. Soc Sci Med. 2010; 70 337–41.
Factors influencing the effectiveness of interventions to reduce racial and ethnic disparities in health care.CrossRef |

[38]  Scott N. A Maori cultural reluctance to present for care, or a systems and quality failure? How we pose the issue, informs our solutions. N Z Med J. 2014; 127 8–11.

[39]  Sheridan NF, Kenealy TW, Connolly MJ, et al. Health equity in the New Zealand health care system: a national survey. Int J Equity Health. 2011; 10 45
Health equity in the New Zealand health care system: a national survey.CrossRef |

[40]  Chin MH, Clarke AR, Nocon RS, et al. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J Gen Intern Med. 2012; 27 992–1000.
A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care.CrossRef |

[41]  Ministry of Health. Equity of Health Care for Māori: A framework. Wellington: Ministry of Health; 2014.


Full Text PDF (736 KB) Export Citation