Elimination of hepatitis C virus (HCV) is possible with publicly funded, highly effective and well-tolerated oral treatment. However, most people with chronic HCV are asymptomatic and remain undiagnosed until complications develop. Furthermore, HCV testing and treatment inequities remain for Māori. The addition of HCV testing to blood sampling for other indications in widely accessed settings to augment current screening strategies warrants further investigation. We analysed national and regional data to compare attenders at community laboratories and hospital emergency departments (EDs), and Northern Region data from ED attenders to determine the proportion who had blood sampling. National data (July 2023-June 2024) and Northern Region data (November 2024) were extracted for people aged ≥20years. Among 2,586,051 adult attenders at either setting, most (75%) attended community laboratories only, 8% attended EDs only, and 17% attended both (dual attenders). Although Māori represented a higher proportion of ED attenders than community laboratory attenders (22% vs 11%), the number of Māori attenders was 4.4 times greater for community laboratories vs EDs (203,585 vs 46,009). Of community laboratory attenders, 53% (n=1,013,690) were aged 40-69years, the age group with the highest HCV prevalence. Among 28,396 ED attenders in the Northern Region, 77% had a blood test at that visit. These findings suggest that HCV screening at community laboratories could test more people, including Māori, than screening at EDs. However, the ED setting could capture people who may not engage with other health services, an important group for targeted outreach.

AI scribes have had a rapid uptake in primary care across New Zealand (NZ). The benefits of this new technology must be weighed against the potential risks they may pose. This study provides a snapshot of AI scribes use in primary care to generate clinical notes. We aimed to understand emerging provider experiences, identify perceived clinical benefits and concerns, and flag potential ethical and legal issues as a basis for future research and policy development. GPs and health providers working in primary care across NZ were invited to participate in an anonymous survey about their experience with AI scribes (February-March 2024). One hundred and ninety-seven respondents completed the survey, 88% (n=164) of whom were GPs. Of these, 40% (n=70) had experience with AI scribes. Reported benefits included: reduced multitasking (n=46), saved time (n=43), and improved rapport with patients (n=43). Key concerns included: compliance with NZ legal and ethical frameworks (n=108), data security (n=98), errors or omissions (n=93), and data leaving New Zealand (n=91). Only 66% (n=41) had read the terms and conditionss of the AI scribe tool, and 59% (n=35) reported seeking patient consent. Most (80%, n=50) found AI scribes helpful or very helpful, and 56% (n=35) said the tool changed consultation dynamics. While there is strong uptake and enthusiasm for AI scribes in primary care in NZ, critical issues remain around legal and ethical oversight, patient consent, data security, and the broader impact on clinician-patient interactions. Health providers need clearer guidance and regulatory support for safe, ethical, and legal use of AI tools.

Osteoarthritis (OA) affects one in ten adults in Aotearoa New Zealand, yet care remains fragmented and under-prioritised. The 2025 Aotearoa Osteoarthritis Summit explored re-framing OA through a lifespan, equity-focused lens. Summit attendees contribution to a collaborative workshop at the event highlighted misconceptions, harmful "wear and tear" narratives, and inconsistent information. Attendees called for empowering, strengths-based messaging, culturally responsive care, and early, lifelong joint-health strategies. Recommendations included myth-busting, accessible education, community support, and integrated non-surgical management. Equity for Māori, Pasifika, rural, and low-income communities was emphasised. Changing the OA narrative requires collaboration, consistent messaging, and scalable frameworks to improve outcomes nationwide.

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity globally and a significant contributor to health inequities for Pacific peoples in Aotearoa New Zealand. Addressing these inequities requires a multidisciplinary approach, where community pharmacists (CPs) have the potential to play a critical role. CPs' accessibility, medication expertise, and ability to engage with underserved populations position them uniquely within the healthcare system. However, their contribution to equitable heart health outcomes remains underexplored. The aim was to explore the experiences and views of general practitioners (GPs) on CPs' roles in supporting heart health equity for Pacific peoples and to examine how GPs currently work with CPs. This research employed interpretive description with Pacific principles, and semi-structured interviews with GPs were conducted. Analysis was conducted using template analysis and the Lili Health Model data interpretation tool. Nine interviews were conducted, from which five themes were generated: (1) Optimising CPs' roles beyond supporting GPs, (2) GPs and Pacific peoples' ability to engage with CPs, (3) Increasing Pacific representation and cultural responsiveness, (4) (Mis)perceptions of pharmacy, and (5) Control in a constrained healthcare system. Interviewed GPs believed that CPs play a pivotal role in addressing heart health equity for Pacific peoples. This role could be enhanced by expanding CPs' clinical responsibilities, enhancing cultural safety, increasing the number of Pacific pharmacy staff, and addressing systemic barriers.

In New Zealand, lower immunisation coverage is seen among those of Māori and Pacific ethnicity, as well as in communities with higher levels of socioeconomic deprivation. However, the impact of rurality on routine childhood immunisations has been incompletely investigated. This study aims to measure the effect of rurality on second-dose measles-mumps-rubella vaccination (MMR2) within the Taranaki region. This was a retrospective observational study using routinely collected health data. Participants were born in 2019, 2020, or 2021 and lived in the Taranaki region at age 24months. Rurality was determined using the Geographic Classification for Health (GCH). The percentage of MMR2 coverage was calculated for each rurality grouping, and logistic regression was used to adjust for confounders. A total of 4596 participants were enrolled across three GCH levels. MMR2 coverage rates were 56.2% in the most rural group (R2+3), compared to 63.0% in R1 (Rural 1) and 62.3% in U2 (Urban 2). Adjusting for ethnicity and socioeconomic deprivation produced odds ratios (ORs) of 1.33 for R1 participants and 1.18 for U2 participants, compared to R2+3. It was also shown that Māori had lower immunisation coverage than non-Māori at every GCH classification. Children living in more rural areas had lower rates of MMR2 coverage at age 24months. This may reflect inequitable impacts of the COVID-19 pandemic or uneven rollout of the 2020 changes to the National Immunisation Schedule.

Type 2 diabetes mellitus is a major health burden in Fiji (19.3% prevalence). Evidence suggests increased physical activity improves glycaemic control and health outcomes; however, this remains unstudied in Fiji's population. This study aimed to assess physical activity levels and explore its relationship with glycaemic control among diabetic patients. A quantitative, cross-sectional pilot study was conducted at Samabula Health Center, Fiji, from September to November 2022 using convenience sampling for 174 adults with diabetes. The International Physical Activity Questionnaire, short form, assessed physical activity, whereas capillary fasting and random blood sugar assessed glycaemic control targets. Logistic regression analysed associations. The study found 64% of participants were physically inactive, with females significantly less active than males (odds ratio (OR)=0.49, 95% confidence interval (CI)=0.25-0.98). Poor glycaemic control was common (75%), although adherence to lifestyle and pharmacological management plans were significantly associated with good control (OR=2.37, 95% CI: 1.05-5.37). Increased physical activity levels were not significantly associated with meeting glycaemic control targets. Despite clinic attendance, patients with diabetes remained inactive, had poor glycaemic control and were non-adherent to lifestyle and drug treatment. Contradicting previous evidence, physical activity was not associated with meeting glycaemic control targets, possibly reflecting point-of-care glucose variability compared to the gold-standard glycated hemoglobin measure (HbA1c), and cross-sectional study design limiting causal interpretation. Future research should investigate glycaemic control and physical activity barriers, especially among women, physician practices and test culturally adapted interventions. Fiji's National Wellness Policy and Non-Communicable Disease (NCD) Strategic Plan must consider strengthening diabetes management guidelines, clinician training and patient support to address systemic gaps.

Antibiotic misuse and overuse, among other factors, are the main drivers of increased antimicrobial resistance. Although cefalexin is generally recommended as a second-line agent, recent trends in Aotearoa New Zealand (NZ) indicate increased community use, highlighting the need for closer scrutiny. This preliminary study aimed to assess the appropriateness and guideline compliance of cefalexin prescribing. We conducted a cross-sectional study reviewing all cefalexin prescriptions issued at a single urban medical centre in Ōtautahi Christchurch, NZ, during July-August 2023. Retrieved prescriptions were assessed for guideline compliance and clinical appropriateness using a modified audit survey based on national and regional guidelines. We identified 27 cefalexin prescriptions provided to 25 patients (16 female, 20 NZ European; median age 48.9years, IQR 49.7). Soft tissue (n=11, 42.3%) and genito-urinary infections (n=10, 38.5%) were the most common indications. Of the assessable prescriptions (n=26), 14 (53.8%) were guideline compliant, and 15 (57.7%) were clinically appropriate. Indications were documented in 22 cases (84.6%) - 6 on the prescription and 19 in the clinical record. This exploratory study identifies areas for targeted antimicrobial stewardship interventions in general practice to promote improved prescribing practices. A larger multicentre study is planned to further investigate prescribing patterns and appropriateness.

Despite the large volume of health and administrative data collected every day in primary care, little is available for research in Aotearoa New Zealand (NZ). The Southern Primary Care Research Network (PCRN) was developed to enable access to primary care data through the establishment of a regional research database, and to create the supportive governance and infrastructure necessary for enabling a broader programme of research. This includes, but is not limited to, studies utilising linked data. This paper describes the formation of the Southern PCRN and the research undertaken so far. It aims to raise awareness about the Southern PCRN, the types of data available, and caveats associated with using primary care data for research. Research networks require organisational coherence for governance and oversight. Various linked groups take on different roles in the Southern PCRN and are described. Foundational research projects are described, including three data linkage projects, a scoping review, research prioritisation exercises, and the development of an ethical framework for data use. Securing ongoing funding will improve the capacity of the network to undertake primary care research and facilitate the unification of regional primary care networks to establish a national primary care research network. Strategic investment in primary care research infrastructure is essential for NZ to fully realise the potential of routinely collected health data to inform equitable service delivery, policy, and innovation in population health. Establishing a regional primary care research network is demonstrably feasible.

Introduction People are precluded from enrolling in primary health care at a general practice if it has 'Closed Books'. This creates barriers to accessing health care. Aim To examine which Health Districts had the greatest number and proportion of general practices with Closed Books and how this has changed since 2022. Methods Maps were used to display the distribution of Closed Books general practices and tables were used to compare changes in Health Districts over time. Results There were 373 (36%) general practices that had Closed Books in September 2024. Canterbury (n = 56), Southern (37) and Northland (32) Health Districts had the greatest number of Closed Books general practices, while Hutt Valley (73%), Lakes (70%) and Wairarapa (67%) Health Districts had the greatest percentage of general practices with Closed Books. Discussion The problem of Closed Books was felt across the country but has a larger impact in the middle-lower North Island and an increase in impact in Northland and the lower South Island. Improvements have been seen in the worst hit areas since 2022 but, overall, the percentage of general practices with Closed Books has not improved.