Journal of the New Zealand Medical Association Vol 128 | No 1422 | 25 September 2015 Updated New Zealand health system cost estimates: further improvements in the age of ‘big data’ Trust, transparency: and why we need them both New Zealand’s growing thirst OBITUARY: Analysis of the Auckland 2014 for a sugar-sweetened measles outbreak indicates that beverage tax Sir Patrick William Eisdell Moore adolescents and young adults Rethinking the conceptual could benefit from catch-up toolkit of organ gifting (2 May 1930 – 7 March 2015) vaccination Publication Information published by the New Zealand Medical Association NZMA Chairman To contribute to the NZMJ, first read: Dr Stephen Child www.nzma.org.nz/journal/contribute NZMJ Editor Other enquiries to: Professor Frank Frizelle NZMA PO Box 156 NZMA Communications Manager The Terrace Sharon Cuzens Wellington 6140 Phone: (04) 472 4741 NZMJ Production Jeremiah Boniface © NZMA 2015 To subscribe to the NZMJ, email [email protected] Subscription to the New Zealand Medical Journal is free and automatic to NZMA members. 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Individual articles are available for purchase by emailing [email protected] NZMJ 25 September 2015, Vol 128 No 1422 ISSN 1175-8716 © NZMA 2 www.nzma.org.nz/journal CONTENTS EDITORIAL 53 7 Analysis of the Auckland 2014 Trust, transparency: and why we measles outbreak indicates that need them both adolescents and young adults Stephen Child, Sanji Gunasekara could benefit from catch-up vaccination 10 Gary Reynolds, Cassandra Dias, Simon Administrative health data in Thornley, Ronald King, Anne Morrison, New Zealand: we have come Angela Matson, Richard Hoskins so far; where are the next opportunities? VIEWPOINT Wing Cheuk Chan 63 ARTICLES Rethinking the conceptual toolkit of organ gifting 13 Rhonda M Shaw Updated New Zealand health system cost estimates from health CLINICAL CORRESPONDENCE events by sex, age and proximity 69 to death: further improvements Conjunctival squamous cell in the age of ‘big data’ carcinoma Tony Blakely, June Atkinson, Giorgi Ali Mahdavi Fard, Leili Pourafkari, Kvizhinadze, Nhung Nghiem, Heather Nader D Nader McLeod, Anna Davies, Nick Wilson 70 24 A case of perforated chronic Predictors of vitamin D status in idiopathic megacolon pregnant women in New Zealand Benjamin Cribb, Rukshan Ranjan, Alec J Ekeroma,Carlos A Camargo Jr, Nigel Henderson Robert Scragg, Clare Wall, Alistair Stewart, Ed Mitchell, Julian LETTERS Crane, Cameron C Grant 73 35 Out of touch? The shortcoming The community pharmacy-based of New Zealand’s amended Sale anticoagulation management and Supply of Alcohol Act (2012) service achieves a consistently high for the Rugby World Cup (2015) standard of anticoagulant care Benjamin Riordan, Tamlin Conner, Paul Harper, Ian McMichael, Dale Jayde Flett, Damian Scarf Griffiths, Joe Harper, Claire Hill 75 45 Accident Compensation Prevalence of human Corporation claim status and papillomaviruses in the mouths benefit type is associated with of New Zealand women low back pain outcomes Rebecca Lucas-Roxburgh, Jackie Jon Cornwall, Achim Elfering, Rebecca Benschop, Magdalena Dunowska, J Crawford, Markus Melloh Matthew Perrott NZMJ 25 September 2015, Vol 128 No 1422 ISSN 1175-8716 © NZMA 3 www.nzma.org.nz/journal CONTENTS 78 OBITUARY Fluoxetine-induced phenytoin 88 toxicity: a clinical reminder about Sir Patrick William Eisdell Moore the perils of polypharmacy Sean Lance, Ian Ternouth 80 92 New Zealand’s growing thirst for a Methuselah sugar-sweetened beverage tax Gerhard Sundborn, Simon Thornley, 93 Bodo Lang, Rob Beaglehole 100 years ago: Measles in adults Farquhar Matheson, M.R, Glasgow, 83 House Surgeon, Wellington Hospital Is our focus on pharmaceutical company influence too narrow? 95 Erratum 128:1421 Lance Gravatt 85 Comment on: Getting serious about protecting New Zealand children against unhealthy food marketing Katherine Rich NZMJ 25 September 2015, Vol 128 No 1422 ISSN 1175-8716 © NZMA 4 www.nzma.org.nz/journal SUMMARIES Predictors of vitamin D status in pregnant women in New Zealand Alec J Ekeroma, Carlos A Camargo Jr, Robert Scragg, Clare Wall, Alistair Stewart, Ed Mitchell, Julian Crane, Cameron C Grant New Zealand has a sun avoidance health policy and minimal dietary vitamin D fortification. Vitamin D deficiency was present in 109/259 (42%) of pregnant women in a south Auckland cohort. Of those enrolled in winter (June-August)/spring (September-November), vitamin D deficiency was present in 43% of European, 67% of Māori, 80% of Pacific and 59% of women of other ethnic groups. Supplementation for all pregnant women during winter/spring could be an appropriate intervention for prevention of vitamin D deficiency during pregnancy in New Zealand. The community pharmacy-based anticoagulation management service achieves a consistently high standard of anticoagulant care Paul Harper, Ian McMichael, Dale Griffiths, Joe Harper, Caire Hill People taking the blood thinning drug, warfarin, require regular blood tests to maintain safe control. In the past this service was provided by doctors using laboratory based blood tests. In 2012 a service was introduced to enable trained pharmacists to provide warfarin management through community pharmacies. Our audit confirms that pharmacists provide a safe, efficient and convenient service for patients and that the standard of anticoagulant control is above international recommendations and has remained high in spite of a five-fold increase in the number of patients using the service. Analysis of the Auckland 2014 measles outbreak indicates that adolescents and young adults could benefit from catch-up vaccination Gary Reynolds, Cassandra Dias, Simon Thornley, Ronald King, Anne Morrison, Angela Matson, Richard Hoskins A single child with measles at a high school would almost certainly cause a serious outbreak, because immunity in that age group is well below the national average. The rate of immunity in New Zealand is close to 95%, which suggests a high level of herd immunity, but the level of immunity among secondary school age children is between 65 per cent and 80 per cent. One of the reasons is that a controversial study linking the measles mumps and rubella vaccine to autism – later proven to be false - persuaded many parents not to vaccinate their children at that time. That means they remain vulnerable today, especially while gathered together at school. They would benefit greatly from national, targeted vaccination catch-up. NZMJ 25 September 2015, Vol 128 No 1422 ISSN 1175-8716 © NZMA 5 www.nzma.org.nz/journal SUMMARIES Updated New Zealand health system cost estimates from health events by sex, age and proximity to death: further improvements in the age of ‘big data’ Tony Blakely, June Atkinson, Giorgi Kvizhinadze, Nhung Nghiem, Heather McLeod, Anna Davies, Nick Wilson This study benefited from the relatively high quality and comprehensiveness of health cost data. It showed how widely this expenditure varied across the life course – with relatively more being spent in the last year of life (though this varied widely by age of death). This analysis has benefited from quality improvements in cost data and methods refinements but yet further improvements in coming years are likely. This is particularly so with access to additional data sources and with the move towards better integration of “big data” in the New Zealand health sector. Prevalence of human papillomaviruses in the mouths of New Zealand women Rebecca Lucas-Roxburgh, Jackie Benschop, Magdalena Dunowska, Matthew Robert Perrott Human papillomavirus (HPV) infection in the mouth is associated with an increased risk of developing HPV-positive head and neck cancer. This study of 234 young women found HPV in the mouths of 7 women. Of those positive for HPV, two were positive for an HPV type able to cause cancer. The other five women were positive for a non-cancer causing HPV. No asso- ciations were found between putative risk factors (smoking, alcohol consumption, and the number of sexual partners) and the presence of oral HPV infection. NZMJ 25 September 2015, Vol 128 No 1422 ISSN 1175-8716 © NZMA 6 www.nzma.org.nz/journal EDITORIAL Trust, transparency: and why we need them both Stephen Child, Sanji Gunasekara Perhaps the culture of accountability that we are relentlessly building