The Lancet Regional Health: Western Pacific最新文献

{"title":"Care provided to women during and after a pregnancy complicated by hyperglycaemia: the impacts of a multi-component health systems intervention","authors":"Diana MacKay ,&nbsp;Jacqueline A. Boyle ,&nbsp;Sandra Campbell ,&nbsp;Natasha Freeman ,&nbsp;Anna McLean ,&nbsp;Denella Hampton ,&nbsp;Cherie Whitbread ,&nbsp;Paula Van Dokkum ,&nbsp;Kirby Murtha ,&nbsp;Christine Connors ,&nbsp;Elizabeth Moore ,&nbsp;Ashim Sinha ,&nbsp;Yvonne Cadet-James ,&nbsp;Sharni Cardona ,&nbsp;Jeremy Oats ,&nbsp;H David McIntyre ,&nbsp;Anthony J. Hanley ,&nbsp;Alex Brown ,&nbsp;Jonathan E. Shaw ,&nbsp;Renae Kirkham ,&nbsp;Louise Maple-Brown","doi":"10.1016/j.lanwpc.2025.101514","DOIUrl":"10.1016/j.lanwpc.2025.101514","url":null,"abstract":"<div><h3>Background</h3><div>Aboriginal and Torres Strait Islander women experience a disproportionate burden of hyperglycaemia in pregnancy. A multi-component health systems intervention aiming to improve antenatal and postpartum care was implemented across Australia’s Northern Territory (NT) and Far North Queensland (FNQ) between 2016 and 2019. Components included clinician education, improving recall systems, enhancing policies and guidelines, and embedding Diabetes in Pregnancy (DIP) Clinical Registers in systems of care. This program was evaluated to determine impacts on clinical practice and maternal health.</div></div><div><h3>Methods</h3><div>Data for women with hyperglycaemia in pregnancy from primary care clinical records and the DIP Clinical Registers were analysed to assess changes in: antenatal and postpartum diabetes testing; HbA1c/glucose levels; medication use; weight checks performed, weight and body mass index; and postpartum contraception, smoking and breastfeeding.</div></div><div><h3>Findings</h3><div>Clinical practice in the NT improved, including increased uptake of the recommended first trimester 75 g oral glucose tolerance test among women with hyperglycaemia risk factors (Aboriginal and Torres Strait Islander women 11.7% to 26.5%, p &lt; 0.001; non-Indigenous women 6.2% to 19.3%, p &lt; 0.001). In the NT, postpartum diabetes monitoring (56% to 68%, p = 0.039) and contraceptive use (41% to 60%, p = 0.001) increased among Aboriginal and Torres Strait Islander women. In FNQ, postpartum glucose monitoring increased among women with T2D (26% to 68% Aboriginal and Torres Strait Islander, p = 0.002; 50% to 100% non-Indigenous, p = 0.008), although there were no improvements in antenatal care indicators.</div></div><div><h3>Interpretation</h3><div>Aspects of care for women with hyperglycaemia in pregnancy improved in the NT and FNQ following a multi-component health systems intervention.</div></div><div><h3>Funding</h3><div>This study is funded by the <span>Australian National Health and Medical Research Council</span> (NHMRC) <span>Global Alliance for Chronic Diseases</span> Grant <span><span>1092968</span></span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101514"},"PeriodicalIF":7.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulse oscillometry-derived equation for prediction of abnormal FEV1/FVC ratio for COPD screening in Chinese population: a multicenter cross-sectional study","authors":"Meishan Liu ,&nbsp;Xin Yao ,&nbsp;Yiwei Shi ,&nbsp;Huiguo Liu ,&nbsp;Liang Chen ,&nbsp;Yong Lu ,&nbsp;Chunmei Zhang ,&nbsp;Xinran Zhang ,&nbsp;Lirong Liang ,&nbsp;Xiaohong Chang ,&nbsp;Li An ,&nbsp;Kian Fan Chung ,&nbsp;Janwillem W.H. Kocks ,&nbsp;Kewu Huang","doi":"10.1016/j.lanwpc.2025.101501","DOIUrl":"10.1016/j.lanwpc.2025.101501","url":null,"abstract":"<div><h3>Background</h3><div>The diagnosis of chronic obstructive pulmonary disease (COPD) is based on spirometry that requires a forced expiratory manoeuvre, which is laborious and difficult for mass screening. Impulse oscillometry (IOS) is easier than spirometry and performed with tidal breathing. We sought to develop an equation for predicting forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) and screening COPD using IOS parameters.</div></div><div><h3>Methods</h3><div>Data from patients who simultaneously underwent spirometry and IOS were obtained from databases at five tertiary hospitals in China. Multivariable linear regression analysis was used to develop a predictive model for pre-bronchodilator (BD) FEV₁/FVC. Model performance was analyzed against spirometric criteria of airflow obstruction (AO, defined as pre-BD FEV₁/FVC &lt; 0.7) and COPD (post-BD FEV₁/FVC &lt; 0.7).</div></div><div><h3>Findings</h3><div>Using 15,113 patients and externally validated with 9586 patients, the model estimated FEV₁/FVC ratio could identified AO and spirometry-defined COPD in internal (AUC = 0.822 and 0.849, respectively) and external (AUC = 0.790 and 0.828, respectively) validation. A clinical algorithm was constructed to classify patients into three different groups: estimated FEV₁/FVC &lt; 0.7: likely COPD; estimated FEV₁/FVC ≥ 0.7 and ≤0.73: suspicious for COPD; estimated FEV₁/FVC &gt; 0.73: unlikely COPD. The sensitivity and specificity for detecting spirometry-defined COPD were 88.0% and 77.0%, respectively, while the negative predictive value ranged from 93.7% to 98.6% and positive predictive value ranged from 26.5% to 62.1% across different COPD prevalence groups in the Chinese population.</div></div><div><h3>Interpretation</h3><div>This equation could be useful to screen for COPD particularly in community and primary care settings.</div></div><div><h3>Funding</h3><div>The Financial Budgeting Project of <span>Beijing Institute of Respiratory Medicine</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101501"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers to primary care research in Japan: a call to action","authors":"Thomas Rouyard ,&nbsp;Emilie Yoda ,&nbsp;Ryota Nakamura ,&nbsp;Michiko Moriyama ,&nbsp;Masako Ii ,&nbsp;Maham Stanyon ,&nbsp;Mei Endo ,&nbsp;Koki Nakamura ,&nbsp;Satoshi Kanke ,&nbsp;Ryuki Kassai","doi":"10.1016/j.lanwpc.2025.101523","DOIUrl":"10.1016/j.lanwpc.2025.101523","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101523"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the technical feasibility of serological testing and treatment for Plasmodium vivax in mobile at-risk of malaria Cambodian populations","authors":"Costanza Tacoli ,&nbsp;Sopheany Thin ,&nbsp;Malen Ea ,&nbsp;Nimol Khim ,&nbsp;Agnes Orban ,&nbsp;Dysoley Lek ,&nbsp;Rhea J. Longley ,&nbsp;Michael White ,&nbsp;Leanne J. Robinson ,&nbsp;Benoit Witkowski ,&nbsp;Ivo Mueller ,&nbsp;Jean Popovici","doi":"10.1016/j.lanwpc.2025.101518","DOIUrl":"10.1016/j.lanwpc.2025.101518","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Cambodia is targeting malaria elimination by 2025, aligning with the WHO's Mekong Malaria Elimination program. While elimination of &lt;em&gt;Plasmodium falciparum&lt;/em&gt; is nearly achieved, &lt;em&gt;Plasmodium vivax&lt;/em&gt; elimination presents challenges inherent to this species due to the occurrence of dormant parasite stages, known as hypnozoites. A new approach has been proposed to serologically identify individuals likely carrying hypnozoites that should receive appropriate antimalarial treatment: &lt;em&gt;P. vivax&lt;/em&gt; serological testing and treatment (PvSeroTAT). This study aims to determine the technical feasibility of a PvSeroTAT approach in malaria endemic communities with highly mobile populations in Eastern Cambodia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;From October 24th 2021 to February 26th 2023, two successive rounds of PvSeroTAT were conducted in adult and adolescent males in three villages of Mondolkiri, Eastern Cambodia. At each round, capillary blood samples were collected from consenting participants to be used for &lt;em&gt;P. vivax&lt;/em&gt; serology and G6PD activity determination. Seropositive participants, who were G6PD normal, were then recontacted to be provided an anti-hypnozoite primaquine regimen following Cambodian treatment guidelines (0.25 mg/kg for 14 days). Cross-sectional surveys to evaluate &lt;em&gt;P. vivax&lt;/em&gt; prevalence were conducted before, during and after the PvSeroTAT interventions in the same three villages and in three additional neighboring control villages where interventions were not implemented.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Participation was high, with 96% (456/477) of eligible individuals enrolled in at least one round of PvSeroTAT. However, only 63% of participants enrolled in the first PvSeroTAT round agreed to participate in the second round. In the first and second round of PvSeroTAT, 31% (101/327) and 30% (98/334) of enrolled participants, respectively, were seropositive and among those, 82% (163/199) were eligible for primaquine treatment. All 163 seropositive eligible individuals could be recontacted and offered a primaquine treatment, this occurred within 10 days for 96% of individuals (157/163). &lt;em&gt;P. vivax&lt;/em&gt; prevalence decreased in all villages, including the control ones, after the first round of PvSeroTAT from 7.7% to 2.7% overall.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The participation rates and overall technical feasibility of PvSeroTAT in highly mobile individuals living within communities in malaria endemic areas of Cambodia were very promising. PvSeroTAT with a lab-based assay is feasible in Cambodia even if it is logistically more challenging than using point-of-care assays. Further studies to understand community perspectives about test and treat approaches in the absence of clinical symptoms will be important for the development of tailored community education and awareness material to improve participation in multiple rounds of test and treat interventions.&lt;/di","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101518"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing socioeconomic disparities in emerging hybrid food environments: a cross-sectional analysis of the DIGIFOOD dashboard","authors":"Si Si Jia ,&nbsp;Katherine B. Owen ,&nbsp;Philayrath Phongsavan ,&nbsp;Margaret Allman-Farinelli ,&nbsp;Alice A. Gibson ,&nbsp;Stephanie R. Partridge","doi":"10.1016/j.lanwpc.2025.101504","DOIUrl":"10.1016/j.lanwpc.2025.101504","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101504"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short term safety profile of respiratory syncytial virus vaccine in adults aged ≥ 60 years in Australia","authors":"Thuy Nguyen ,&nbsp;Lucy Dawes ,&nbsp;Yuanfei Anny Huang ,&nbsp;Evelyn Tay ,&nbsp;Michael Dymock ,&nbsp;Megan O'Moore ,&nbsp;Clare King ,&nbsp;Kristine Macartney ,&nbsp;Nicholas Wood ,&nbsp;Lucy Deng","doi":"10.1016/j.lanwpc.2025.101506","DOIUrl":"10.1016/j.lanwpc.2025.101506","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101506"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-sex-specific burden of urological cancers attributable to risk factors in China and its provinces, 1990–2021, and forecasts with scenarios simulation: a systematic analysis for the Global Burden of Disease Study 2021","authors":"Mingyang Xue ,&nbsp;Weiheng Guo ,&nbsp;Yundong Zhou ,&nbsp;Jialin Meng ,&nbsp;Yong Xi ,&nbsp;Liming Pan ,&nbsp;Yanfang Ye ,&nbsp;You Zeng ,&nbsp;Zhifei Che ,&nbsp;Liang Zhang ,&nbsp;Pengpeng Ye ,&nbsp;João Conde ,&nbsp;Queran Lin ,&nbsp;Wenyi Jin ,&nbsp;GBD 2021 China Urological Cancers Burden and Forecasting Collaborators","doi":"10.1016/j.lanwpc.2025.101517","DOIUrl":"10.1016/j.lanwpc.2025.101517","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;As global aging intensifies, urological cancers pose increasing health and economic burdens. In China, home to one-fifth of the world's population, monitoring the distribution and determinants of these cancers and simulating the effects of health interventions are crucial for global and national health.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;With Global Burden of Disease (GBD) China database, the present study analyzed age-sex-specific patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) in China and its 34 provinces as well as the association between gross domestic product per capita (GDPPC) and these patterns. Importantly, a multi-attentive deep learning pipeline (iTransformer) was pioneered to model the spatiotemporal patterns of urological cancers, risk factors, GDPPC, and population, to provide age-sex-location-specific long-term forecasts of urological cancer burdens, and to investigate the impacts of risk-factor-directed interventions on their future burdens.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;From 1990 to 2021, the incidence and prevalence of urological cancers in China has increased, leading to 266,887 new cases (95% confidence interval: 205,304–346,033) and 159,506,067 (12,236,0000–207,447,070) cases in 2021, driven primarily by males aged 55+ years. In 2021, Taiwan, Beijing, and Zhejiang had the highest age-standardized incidence rate (ASIR) and age-standardized prevalence rates of urological cancer in China, highlighting significant regional disparities in the disease burden. Conversely, the national age-standardized mortality rate (ASMR) has declined from 6.5 (5.1–7.8) per 100,000 population in 1990 to 5.6 (4.4–7.2) in 2021, notably in Jilin [−166.7% (−237 to −64.6)], Tibet [−135.4% (−229.1 to 4.4)], and Heilongjiang [−118.5% (−206.5 to −4.6)]. Specifically, the national ASMR for bladder and testicular cancers reduced by −32.1% (−47.9 to 1.9) and −31.1% (−50.2 to 7.2), respectively, whereas prostate and kidney cancers rose by 7.9% (−18.4 to 43.6) and 9.2% (−12.2 to 36.5). Age-standardized DALYs, YLDs, and YLLs for urological cancers were consistent with ASMR. Males suffered higher burdens of urological cancers than females in all populations, except those aged &lt;5 years. Regionally and provincially, high GDPPC provinces have the highest burden of prostate cancer, while the main burden in other provinces is bladder cancer. The main risk factors for urological cancers in 2021 are smoking [accounting for 55.1% (42.7–67.4)], high body mass index [13.9% (5.3–22.4)], and high fasting glycemic index [5.9% (−0.8 to 13.4)] for both males and females, with smoking remarkably affecting males and high body mass index affecting females. Between 2022 and 2040, the ASIR of urological cancers increased from 10.09 (9.19–10.99) to 14.42 (14.30–14.54), despite their ASMR decreasing. Notably, prostate cancer surpassed bladde","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101517"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing for the next pandemic: insights from Aotearoa New Zealand’s Covid-19 response","authors":"Nigel P. French ,&nbsp;Howard Maxwell ,&nbsp;Michael G. Baker ,&nbsp;Fiona Callaghan ,&nbsp;Kristin Dyet ,&nbsp;Jemma L. Geoghegan ,&nbsp;David T.S. Hayman ,&nbsp;Q. Sue Huang ,&nbsp;Amanda Kvalsvig ,&nbsp;Euan Russell ,&nbsp;Pippa Scott ,&nbsp;Te Pora Thompson ,&nbsp;Michael J. Plank","doi":"10.1016/j.lanwpc.2025.101525","DOIUrl":"10.1016/j.lanwpc.2025.101525","url":null,"abstract":"<div><div>In 2020 Aotearoa New Zealand, like many other countries, faced the coronavirus pandemic armed with an influenza-based pandemic plan. The country adapted rapidly to mount a highly strategic and effective elimination response to the SARS-CoV-2 pandemic. However, implementation was hampered by gaps in pandemic preparedness. These gaps undermined effectiveness of the response and exacerbated inequitable impacts of both Covid-19 disease and control measures. Our review examines the Covid-19 response, reflecting on strengths, limitations and implications for pandemic planning. We identify three key areas for improvement: 1) development of a systematised procedure for risk assessment of a new pandemic pathogen; 2) investment in essential capabilities during inter-pandemic periods; and 3) building equity into all stages of the response. We present a typology of potential pathogens and scenarios and describe the evidence assessment process and core capabilities required for countries to respond fluidly, equitably, and effectively to a rapidly emerging pandemic threat.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101525"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FURLONG study: reply on the patient reported outcome measures and thresholds","authors":"Ahu Alanya ,&nbsp;Corneel Coens ,&nbsp;Dagmara Kuliś ,&nbsp;Jaap Reijneveld","doi":"10.1016/j.lanwpc.2025.101521","DOIUrl":"10.1016/j.lanwpc.2025.101521","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101521"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the gaps in cardiovascular disease risk assessment and management in primary care for Māori and Pacific peoples in Aotearoa New Zealand— a systematic review","authors":"Annaliese Wheeler ,&nbsp;Jamie-Lee Rahiri ,&nbsp;Rochelle Ellison-Lupena ,&nbsp;Sandra Hanchard ,&nbsp;Karen Marie Brewer ,&nbsp;Janine Paynter ,&nbsp;Julie Winter-Smith ,&nbsp;Vanessa Selak ,&nbsp;Shanthi Ameratunga ,&nbsp;Corina Grey ,&nbsp;Matire Harwood","doi":"10.1016/j.lanwpc.2025.101511","DOIUrl":"10.1016/j.lanwpc.2025.101511","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Māori and Pacific peoples carry the highest burden of cardiovascular disease in New Zealand (NZ). This systematic review aimed to determine access to evidence-based cardiovascular disease risk assessment (CVDRA) and management in primary care for Māori and Pacific peoples compared with other ethnicities in NZ, as well as factors contributing to reduced access.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this systematic review with a narrative synthesis, keywords related to Māori and Pacific peoples, cardiovascular disease, and primary care were used to search MEDLINE (OVID), EMBASE, Scopus, CINAHL, NZresearch.org, National Library Catalogue (Te Puna), Index New Zealand (INNZ), and Australia/New Zealand Reference Centre, grey literature and hand search sources from 1 January 2000 to 31 December 2024. Two reviewers screened texts and three reviewers extracted data and assessed quality. High quality was defined using Western (Mixed Methods Appraisal Tool, MMAT, ≥80% compliance) and Indigenous (CONSolIDated critERtia for strengthening the reporting of health research involving Indigenous Peoples, CONSIDER) research tools. The protocol for this systematic review was registered at: &lt;span&gt;&lt;span&gt;https://doi.org/10.17605/OSF.IO/VUDE9&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 2765 texts were identified of which 69 were included. This review identified inadequate levels of CVDRA in Māori and Pacific peoples when measured against the 90% national target. While the provision of primary prevention medications was higher (antihypertensives) or similar (lipid-lowering) compared to that for other ethnic groups, adherence was lower for Māori and Pacific peoples compared to other groups. Māori and Pacific peoples were less likely than others to receive antiplatelets and lipid-lowering therapy for secondary prevention. Evidence for antihypertensives in secondary prevention and combination therapy (in primary or secondary prevention) was mixed. Māori and Pacific peoples experienced reduced access to revascularisation compared with other ethnic groups, an inequity that persisted over time. Factors contributing to CVDRA and management were provision of adequate health literacy, relationships with providers and whānau, access to care, and cultural safety. While 64% of studies were ≥80% compliant with the MMAT, suggesting high quality from a Western research perspective, 71% of studies had an adapted CONSIDER score ≤2, suggesting low quality from an Indigenous perspective. The CONSIDER domains with the highest levels of reporting were Prioritisation, and Analysis and interpretation, while Capacity and Dissemination were the least reported domains. Qualitative studies had generally higher levels of CONSIDER reporting than mixed methods and quantitative studies. Kaupapa Māori Research was of the highest quality, followed by studies focused on Māori and/or Pacific peoples, while studies not focused on Mā","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101511"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}