Sharon Leitch

University of Otago · Department of General Practice & Rural Health

Background Patient medication knowledge and health literacy affect patient safety. Taking angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin II receptor blockers (ARBs), with diuretics and non-steroidal anti-inflammatory medications (NSAIDs) is nephrotoxic. Patients may not know of this risk. An eHealth information package was develope...

Introduction The University of Otago School of Pharmacy Clinic (the Clinic) is a campus-based non-dispensing clinic that offers consultation-based medicines optimisation services to patients. Aim This project aims to understand the experiences and opinions of healthcare providers who have referred patients to the School of Pharmacy Clinic, specific...

Introduction Healthcare inequity disproportionately affects minority populations in Aotearoa New Zealand. Healthcare providers may contribute to inequity due to their biases. Medical education can unintentionally promote biases by reinforcing stereotypes or limiting exposure to diversity. Teaching staff from the Department of General Practice and R...

The aim of this study was to describe the epidemiology in children of harms detectable from general practice records, and to identify risk factors. The SHARP study examined 9076 patient records from 44 general practices in New Zealand, with an enrolled population of 210,559 patients. "Harm" was defined as disease, injury, disability, suffering, and...

Introduction Developments in Artificial Intelligence (AI) are adopted widely in healthcare. However, the introduction and use of AI may come with biases and disparities, resulting in concerns about healthcare access and outcomes for underrepresented indigenous populations. In New Zealand, Māori experience significant inequities in health compared t...

This study employs machine learning using electronic general practice records to enhance patient safety in New Zealand. Objectives include identifying healthcare harm, harm severity and preventability. This research uses existing data and knowledge from an extensive retrospective review of general practice records. Three years of records were obtai...

Objectives To determine the epidemiology of healthcare harm observable in general practice records. Design Retrospective cohort records review study. Setting 72 general practice clinics were randomly selected from all 988 New Zealand clinics stratified by rurality and size; 44 clinics consented to participate. Participants 9076 patient records w...

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...

Background The extent of medication-related harm in general practice is unknown. Aim To identify and describe all medication-related harm in electronic general practice records. The secondary aim was to investigate factors potentially associated with medication-related harm. Design and setting Retrospective cohort records review study in 44 rando...

BACKGROUND Non-steroidal anti-inflammatory drugs (NSAIDs) are a common cause of renal damage, especially when taken together with angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin II receptor blockers (ARBs) plus a diuretic – a combination known as the “triple whammy”. New Zealand patients are at high risk of the “triple whammy” becau...

Background Non-steroidal anti-inflammatory drugs (NSAIDs) are a common cause of renal damage, especially when taken together with angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin II receptor blockers (ARBs) plus a diuretic — a combination known as the “triple whammy.” New Zealand patients are at high risk of the “triple whammy” becau...

Background Centenarians escapers are those who reached 100 years of age without the diagnosis of any of the common age-related diseases and exploring their characteristics will inform about successful ageing. No previous study has examined centenarians free of common chronic diseases amongst New Zealand centenarians.Methods Retrospective observatio...

Background Communicating risks of medication harm and obtaining informed consent is difficult due to structural barriers, language and cultural practices, bias and a lack of resources appropriately tailored for the health literacy of most patients. A decision support tool was proposed to alert prescribers of risk and provide tailored information fo...

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...

An association between fatigue and depression was reported for older adults. We examined the association between fatigue, sleep and depression from interRAI-HC assessments of community dwelling older people (65+ years). Interview data from 5,950 participants who completed their first interRAI-HC assessment was analysed (mean age, 81.3 ± 7.1 years;...

Objectives: A recent North American study reported seasonal differences in cognitive functioning in older adults. We assessed seasonality of cognitive functioning in a large data set of older adults in New Zealand. Methods: The International Residential Assessment Instrument-Home Care (interRAI-HC) data set was analysed using a non-parametric me...

General practitioners are increasingly approached to participate in research and share de-identified patient information. Research using electronic health records has considerable potential for improving the quality and safety of patient care. Obtaining individual patient consent for the use of the information is usually not feasible. In this artic...

Objectives: To determine how often general practitioners (GPs) and pharmacists recommend patients obtain information about their medicines via websites and to explore factors that might improve the delivery of written information about medicines to patients. Design: Cross-sectional surveys. Setting: GPs and community pharmacists in New Zealand pr...

Importance Loneliness is associated with reduced health-related quality of life and increased morbidity and mortality and typically worsens with aging. Objectives To evaluate associations between demographic and psychosocial variables and loneliness, examine any age-specific associations, and compare centenarians (aged ≥100 years) with elderly peo...

Objectives Hoarding disorder (HD) is prevalent in older adults and contributes to morbidity and mortality. We attempted to estimate rates of hoarding amongst the elderly using the international Residential Assessment Instrument – Home Care (interRAI-HC). Setting The interRAI is a mandatory prerequisite in New Zealand (NZ) for government-funded com...

Background: Prescribers and pharmacists have a duty of care to ensure patients are adequately informed about their medicines. A recent review determined what information (or counselling points) patients themselves consider important to know about their medicines. Ensuring patients receive the information they want to know about their medicines is i...

Background: Medicine information leaflets benefit patients by emphasising important information, reducing the need to recall verbal information, and by filling the gaps of insufficient verbal information provided at point-of-care. In New Zealand, providing leaflets is not compulsory and may not be common practice. If leaflets are disliked by health...

INTRODUCTION: Practice size and location may affect the quality and safety of health care. Little is known about contemporary New Zealand general practice characteristics in terms of staffing, ownership and services. AIM: To describe and compare the characteristics of small, medium and large general practices in rural and urban New Zealand. METHODS...

Background Providing verbal medicines information to patients may be insufficient. Providing medicine information leaflets could support verbal information, however New Zealand health professionals’ opinions or use of leaflets is unknown. Objective To examine self-reported provision and health professionals’ views about medicine information leaflet...

Background Discussing medicines with patients is the responsibility of prescribers and pharmacists. However, it is not well known whether patients are given the information they want or whether information provision continues when medicines are taken long-term. Objective To determine how often general practitioners (GPs) and pharmacists provide ve...

Background: Safety incidents in a primary care setting occur in approximately 2.2% of patient contacts, and 1 in 4 of these incidents have effects on patients, with hospital admission in approximately 3% of incidents (1). Available data indicate that, in pediatric patients, vaccines and medicines are the leading source of harm. Children are at part...

Background Knowing where and why harm occurs in general practice will assist patients, doctors, and others in making informed decisions about the risks and benefits of treatment options. Research to date has been unable to verify the safety of primary health care and epidemiological research about patient harms in general practice is now a top prio...

We know for sure that healthcare does good things for a lot of people and that for some, it harms—sometimes concurrently with providing benefits. Quite likely doctors have known this for millennia, inspiring the caution in the Hippocratic oath to ‘first do no harm’. Clinically grounded medical researchers know that medicine is complicated and that...

Practice Based Research Networks (PBRNs) are groups of general practices collaborating to produce research. Contemporary New Zealand health information technology systems are ideal for electronic data extraction for PBRN research. Stakeholders have a valuable, but typically underutilised, part to play in research. Development of an e-participation...

A majority of adults have sub-optimal vitamin D levels in the winter in southern New Zealand. This is associated with an increased risk of falls and fragility fractures in the elderly, with long-term adverse outcomes likely. Vitamin D supplementation decreases the risks of both falls and fractures. An intervention was undertaken by a small urban ge...

By the time medical students graduate many wish to work part-time while accommodating other lifestyle interests. To review flexibility of medical registration requirements for provisional registrants in New Zealand, Australia, the United Kingdom, Ireland and Canada. Internet-based review of registration bodies of each country, and each state or pro...