Asthma and Respiratory Foundation NZ child and adolescent asthma guidelines: a quick reference guide.

The purpose of the New Zealand Child and adolescent asthma guidelines: a quick reference guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment and management of asthma in children and adolescents in New Zealand, with the aim of improving outcomes and reducing inequities. The intended users are health professionals responsible for delivering asthma care in the community and hospital emergency department settings, and those responsible for the training of such health professionals.

Cardiovascular risk management at a Maori-led Primary Health Organisation--findings from a cross-sectional audit.

AIM: To examine the cardiovascular disease (CVD) risk profile and management for the first 12 months of an electronic risk assessment program at Tamaki Healthcare, Auckland. METHODS: An audit of risk assessment and medication data supplemented by a manual case record review. RESULTS: 1522 people were screened representing around 15.5% of the eligible population. Of the 1420 people with data available, 248 (17.5%) had a calculated 5-year CVD risk > or = 15% and another 177 (12.5%) had previous CVD. Maori were significantly more likely to be at high CVD risk than non-Maori (OR 2.07 (1.51-2.84); p<0.001). For Pacific peoples (mostly of Samoan, Tongan, Niuean, Fijian, or Cook Islands origin) there was no increased likelihood of high CVD risk. Medication data were available for 399 (95.5%) people at high CVD risk. Prescribing rates for this group were 78.1% for blood pressure lowering, 71.9% for lipid-lowering, 65.3% for anti-platelet ,and 50.3% for all three therapies. Whilst this group may represent the better end of the management spectrum, success in achieving treatment targets was modest. For 451 people with either diabetes or established CVD, 65.9% and 66.1% were not meeting blood pressure and lipid management recommendations respectively. There were very few disparities in prescribing rates and attainment of target levels by ethnic group. CONCLUSION: This study has shown that a primary care electronic risk assessment program can be rapidly implemented within 12 months. Although the sample may not be representative due to a small proportion screened so far, major disparities in risk factor prevalence rates were found- particularly for Maori. Furthermore, substantial guideline-practice gaps were encountered in the appropriate prescribing of cardiovascular medicines and attainment of recommended targets. Several Tamaki Healthcare initiatives to address these findings are discussed.