Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study
Abstract Background Despite an overt commitment to equity, health inequities are evident throughout Aotearoa New Zealand. A general practice electronic alert system was developed to notify clinicians about their patient’s risk of harm due to their pre-existing medical conditions or current medicatio...
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | International Journal for Equity in Health |
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| Online Access: | https://doi.org/10.1186/s12939-021-01461-y |
| _version_ | 1830302649139855360 |
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| author | Sharon Leitch Jiaxu Zeng Alesha Smith Tim Stokes |
| author_facet | Sharon Leitch Jiaxu Zeng Alesha Smith Tim Stokes |
| author_sort | Sharon Leitch |
| collection | DOAJ |
| description | Abstract Background Despite an overt commitment to equity, health inequities are evident throughout Aotearoa New Zealand. A general practice electronic alert system was developed to notify clinicians about their patient’s risk of harm due to their pre-existing medical conditions or current medication. We aimed to determine whether there were any disparities in clinician action taken on the alert based on patient ethnicity or other demographic factors. Methods Sixty-six New Zealand general practices from throughout New Zealand participated. Data were available for 1611 alerts detected for 1582 patients between 1 and 2018 and 1 July 2019. The primary outcome was whether action was taken following an alert or not. Logistic regression was used to assess if patients of one ethnicity group were more or less likely to have action taken. Potential confounders considered in the analyses include patient age, gender, ethnicity, socio-economic deprivation, number of long term diagnoses and number of long term medications. Results No evidence of a difference was found in the odds of having action taken amongst ethnicity groups, however the estimated odds for Māori and Pasifika patients were lower compared to the European group (Māori OR 0.88, 95 %CI 0.63–1.22; Pasifika OR 0.88, 95 %CI 0.52–1.49). Females had significantly lower odds of having action taken compared to males (OR 0.76, 95 %CI 0.59–0.96). Conclusions This analysis of data arising from a general practice electronic alert system in New Zealand found clinicians typically took action on those alerts. However, clinicians appear to take less action for women and Māori and Pasifika patients. Use of a targeted alert system has the potential to mitigate risk from medication-related harm. Recognising clinician biases may improve the equitability of health care provision. |
| first_indexed | 2024-12-19T09:10:05Z |
| format | Article |
| id | doaj.art-a7367f71577442b881a2ab25e02d9e18 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-19T09:10:05Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-a7367f71577442b881a2ab25e02d9e182022-12-21T20:28:14ZengBMCInternational Journal for Equity in Health1475-92762021-05-012011810.1186/s12939-021-01461-yMedication risk management and health equity in New Zealand general practice: a retrospective cross-sectional studySharon Leitch0Jiaxu Zeng1Alesha Smith2Tim Stokes3Department of General Practice and Rural Health, Otago Medical School – Dunedin Campus, University of OtagoDepartment of Preventive and Social Medicine, Otago Medical School – Dunedin Campus, University of OtagoSchool of Pharmacy, University of OtagoDepartment of General Practice and Rural Health, Otago Medical School – Dunedin Campus, University of OtagoAbstract Background Despite an overt commitment to equity, health inequities are evident throughout Aotearoa New Zealand. A general practice electronic alert system was developed to notify clinicians about their patient’s risk of harm due to their pre-existing medical conditions or current medication. We aimed to determine whether there were any disparities in clinician action taken on the alert based on patient ethnicity or other demographic factors. Methods Sixty-six New Zealand general practices from throughout New Zealand participated. Data were available for 1611 alerts detected for 1582 patients between 1 and 2018 and 1 July 2019. The primary outcome was whether action was taken following an alert or not. Logistic regression was used to assess if patients of one ethnicity group were more or less likely to have action taken. Potential confounders considered in the analyses include patient age, gender, ethnicity, socio-economic deprivation, number of long term diagnoses and number of long term medications. Results No evidence of a difference was found in the odds of having action taken amongst ethnicity groups, however the estimated odds for Māori and Pasifika patients were lower compared to the European group (Māori OR 0.88, 95 %CI 0.63–1.22; Pasifika OR 0.88, 95 %CI 0.52–1.49). Females had significantly lower odds of having action taken compared to males (OR 0.76, 95 %CI 0.59–0.96). Conclusions This analysis of data arising from a general practice electronic alert system in New Zealand found clinicians typically took action on those alerts. However, clinicians appear to take less action for women and Māori and Pasifika patients. Use of a targeted alert system has the potential to mitigate risk from medication-related harm. Recognising clinician biases may improve the equitability of health care provision.https://doi.org/10.1186/s12939-021-01461-yEthnicityEquityDecision supportGeneral practiceHarm |
| spellingShingle | Sharon Leitch Jiaxu Zeng Alesha Smith Tim Stokes Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study International Journal for Equity in Health Ethnicity Equity Decision support General practice Harm |
| title | Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study |
| title_full | Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study |
| title_fullStr | Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study |
| title_full_unstemmed | Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study |
| title_short | Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study |
| title_sort | medication risk management and health equity in new zealand general practice a retrospective cross sectional study |
| topic | Ethnicity Equity Decision support General practice Harm |
| url | https://doi.org/10.1186/s12939-021-01461-y |
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