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Otago Medical School staff profiles

Professor Les Toop

PositionProfessor
DepartmentDepartment of General Practice (Christchurch)
QualificationsMD (Brist) MRCGP FRNZCGP
Research summaryGeneral Practice

Research

Les is involved in General Practice education and research at all levels. Les has been in part-time urban general practice in Christchurch for 29 years. He is actively involved both in multidisciplinary clinical research and in health system redesign and is a long term advocate for the promotion of rational, effective and patient-centred care, delivered though strong interdisciplinary teamwork.

Les has been a vocal critic of misleading marketing, instead promoting access to evidence informed, independent health information for all. He provides clinical and academic advice to the emerging national integration framework and has sat on many government advisory committees over two decades. He is currently on the medicines classification committee and on the GPNZ national executive.

Les is Chair of the Pegasus Health Charitable group of companies, one of the largest New Zealand primary health network organisations. He was involved in setting and leading its unique interdisciplinary continuing education programme which has been running successfully for more than two decades and currently expanding throughout the country. He also sits on the alliance leadership team of the multi award winning Canterbury Clinical Network which recently was awarded the Prime Ministers supreme award for public service.

Les has had long involvement with the RNZCGP, sat on its national council for twenty some years and currently chairs its Research and Education Trust.

Publications

Malihi, Z., Lawes, C. M. M., Wu, Z., Huang, Y., Waayer, D., Toop, L., … Scragg, R. (2019). Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: Results from a randomized controlled trial. American Journal of Clinical Nutrition. Advance online publication. doi: 10.1093/ajcn/nqy378

Townsend, P., Toop, L., Aish, H., Jordan, L., & Cullen, F. (2019). Response to 'Elephants in the room" editorial, 1 February 2019. New Zealand Medical Journal, 132(1495), 86-87. Retrieved from http://www.nzma.org.nz/journal

Malihi, Z., Lawes, C. M. M., Wu, Z., Huang, Y., Waayer, D., Toop, L., … Scragg, R. (2018). Monthly high-dose vitamin D3 supplementation and self-reported adverse events in a 4-year randomized controlled trial. Clinical Nutrition. Advance online publication. doi: 10.1016/j.clnu.2018.07.034

Wu, Z., Camargo, Jr, C. A., Khaw, K.-T., Waayer, D., Lawes, C. M. M., Toop, L., & Scragg, R. (2018). Effects of vitamin D supplementation on adherence and persistence with long-term statin therapy: Secondary analysis from the randomized, double-blind, placebo-controlled ViDA study. Atherosclerosis. Advance online publication. doi: 10.1016/j.atherosclerosis.2018.04.009

Win, S. S., Camargo, Jr, C. A., Khaw, K.-T., Lawes, C. M. M., Sluyter, J., Waayer, D., Toop, L., & Scragg, R. (2018). Cross-sectional associations of vitamin D status with asthma prevalence, exacerbations, and control in New Zealand adults. Journal of Steroid Biochemistry & Molecular Biology. Advance online publication. doi: 10.1016/j.jsbmb.2018.11.016

Chapter in Book - Research

Mintzes, B., Toop, L., & Mangin, D. (2009). Promotion to consumers: Responding to patient requests for advertised medicines. In B. Mintzes, D. Mangin & L. Hayes (Eds.), Understanding and responding to pharmaceutical promotion: A practical guide [Working draft for pilot field testing]. (pp. 81-104). World Health Organization & Health Action International. Retrieved from http://www.haiweb.org/11062009/drug-promotion-manual-CAP-3-090610.pdf

Toop, L. J. (1998). Patient Centred Primary Care. In Core Values in Primary Care. London: BMJ Books.

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Chapter in Book - Other

Toop, L. (2013). Public Health and General Practice. In P. Joyce, G. Nicholls, K. Thomas & T. Wilkinson (Eds.), The Christchurch experience: 40 years of research and teaching. (pp. 53-55). Christchurch, New Zealand: University of Otago.

Toop, L., & Mangin, D. (2013). Marketing of pharmaceuticals. In P. Joyce, G. Nicholls, K. Thomas & T. Wilkinson (Eds.), The Christchurch experience: 40 years of research and teaching. (pp. 177-182). Christchurch, New Zealand: University of Otago.

Toop, L. (2004). Principles of drug prescribing. In Volume 1: Principles and concepts: Oxford textbook of primary medical care. (pp. 242-245). Oxford University Press.

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Journal - Research Article

Malihi, Z., Lawes, C. M. M., Wu, Z., Huang, Y., Waayer, D., Toop, L., … Scragg, R. (2019). Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: Results from a randomized controlled trial. American Journal of Clinical Nutrition. Advance online publication. doi: 10.1093/ajcn/nqy378

Malihi, Z., Lawes, C. M. M., Wu, Z., Huang, Y., Waayer, D., Toop, L., … Scragg, R. (2018). Monthly high-dose vitamin D3 supplementation and self-reported adverse events in a 4-year randomized controlled trial. Clinical Nutrition. Advance online publication. doi: 10.1016/j.clnu.2018.07.034

Win, S. S., Camargo, Jr, C. A., Khaw, K.-T., Lawes, C. M. M., Sluyter, J., Waayer, D., Toop, L., & Scragg, R. (2018). Cross-sectional associations of vitamin D status with asthma prevalence, exacerbations, and control in New Zealand adults. Journal of Steroid Biochemistry & Molecular Biology. Advance online publication. doi: 10.1016/j.jsbmb.2018.11.016

Wu, Z., Camargo, Jr, C. A., Khaw, K.-T., Waayer, D., Lawes, C. M. M., Toop, L., & Scragg, R. (2018). Effects of vitamin D supplementation on adherence and persistence with long-term statin therapy: Secondary analysis from the randomized, double-blind, placebo-controlled ViDA study. Atherosclerosis. Advance online publication. doi: 10.1016/j.atherosclerosis.2018.04.009

Scragg, R., Khaw, K.-T., Toop, L., Sluyter, J., Lawes, C. M. M., Waayer, D., … Camargo, Jr, C. A. (2018). Monthly high-dose vitamin D supplementation and cancer risk: A post hoc analysis of the Vitamin D Assessment Randomized Clinical Trial. JAMA Oncology. Advance online publication. doi: 10.1001/jamaoncol.2018.2178

Wu, Z., Camargo, Jr, C. A., Sluyter, J. D., Khaw, K.-T., Malihi, Z., Waayer, D., Toop, L., … Scragg, R. (2018). Association between serum 25-hydroxyvitamin D levels and self-reported chronic pain in older adults: A cross-sectional analysis from the ViDA study. Journal of Steroid Biochemistry & Molecular Biology. Advance online publication. doi: 10.1016/j.jsbmb.2018.11.018

Wu, Z., Camargo, Jr, C. A., Malihi, Z., Bartley, J., Waayer, D., Lawes, C. M. M., Toop, L., … Scragg, R. (2018). Monthly vitamin D supplementation, pain, and pattern of analgesic prescription: Secondary analysis from the randomized, double-blind, placebo-controlled Vitamin D Assessment study. Pain, 159(6), 1074-1082. doi: 10.1097/j.pain.0000000000001189

Sluyter, J. D., Camargo, Jr, C. A., Waayer, D., Lawes, C. M. M., Toop, L., Khaw, K. T., & Scragg, R. (2017). Effect of monthly, high-dose, long-term vitamin D on lung function: A randomized controlled trial. Nutrients, 9(12), 1353. doi: 10.3390/nu9121353

Khaw, K.-T., Stewart, A. W., Waayer, D., Lawes, C. M. M., Toop, L., Camargo, Jr, C. A., & Scragg, R. (2017). Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: Secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial. Lancet Diabetes & Endocrinology, 5(6), 438-447. doi: 10.1016/S2213-8587(17)30103-1

Scragg, R., Stewart, A. W., Waayer, D., Lawes, C. M. M., Toop, L., Sluyter, J., … Camargo, Jr, C. A. (2017). Effect of monthly high-dose vitamin D supplementation on cardiovascular disease in the Vitamin D Assessment Study: A randomized clinical trial. JAMA Cardiology, 2(6), 608-616. doi: 10.1001/jamacardio.2017.0175

Bagshaw, P., Bagshaw, S., Frampton, C., Gauld, R., Green, T., Harris, C., Hornblow, A., Hudson, B., … Toop, L. (2017). Pilot study of methods for assessing unmet secondary health care need in New Zealand. New Zealand Medical Journal, 130(1452), 23-38. Retrieved from https://www.nzma.org.nz/journal

Sluyter, J. D., Camargo, Jr, C. A., Stewart, A. W., Waayer, D., Lawes, C. M. M., Toop, L., … Scragg, R. (2017). Effect of monthly, high-dose, long-term vitamin D supplementation on central blood pressure parameters: A randomised controlled trial substudy. Journal of the American Heart Association, 6, e006802. doi: 10.1161/JAHA.117.006802

Scragg, R., Waayer, D., Stewart, A. W., Lawes, C. M. M., Toop, L., Murphy, J., … Camargo, Jr, C. A. (2015). The Vitamin D Assessment (ViDA) Study: Design of a randomized controlled trial of vitamin D supplementation for the prevention of cardiovascular disease, acute respiratory infection, falls and non-vertebral fractures. Journal of Steroid Biochemistry & Molecular Biology, 164, 318-325. doi: 10.1016/j.jsbmb.2015.09.010

Hudson, B., Toop, L., Mangin, D., Brunton, C., Jennings, L., & Fletcher, L. (2013). Pandemic influenza A(H1N1)pdm09: Risk of infection in primary healthcare workers. British Journal of General Practice, 63(611), e416-e422. doi: 10.3399/bjgp13X668212

Mangin, D., Murdoch, D., Wells, J. E., Coughlan, E., Bagshaw, S., Corwin, P., Chambers, S., & Toop, L. (2012). Chlamydia trachomatis testing sensitivity in midstream compared with first-void urine specimens. Annals of Family Medicine, 10(1), 50-53. doi: 10.1370/afm.1323

Toop, L. (2011). 1998 vision for year 2003 for members of Pegasus Medical Group. Journal of Primary Health Care, 3(1), 79-81.

Hudson, B., Toop, L., Mangin, D., & Pearson, J. (2011). Risk communication methods in hip fracture prevention: A randomised trial in primary care. British Journal of General Practice, 61(589), e469-e476. doi: 10.3399/bjgp11X588439

Vitry, A., Lexchin, J., Sasich, L., Dupin-Spriet, T., Reed, T., Bertele, V., … Toop, L., & Hurley, E. (2008). Provision of information on regulatory authorities' websites. Internal Medicine Journal, 38(7), 559-567.

Richards, D. A., Toop, L. J., Epton, M. J., McGeoch, G. R. B., Town, G. I., Wynn-Thomas, S. M. H., Dawson, R. D., Hlavac, M. C., Werno, A. M., & Abernethy, P. D. (2005). Home management of mild to moderately severe community-acquired pneumonia: A randomised controlled trial. Medical Journal of Australia, 183(5), 235-238.

Corwin, P., Toop, L., McGeoch, G., Than, M., Wynn-Thomas, S., Wells, J. E., Dawson, R., … Pithie, A., Chambers, S., Fletcher, L., & Richards, D. (2005). Randomised controlled trial of intravenous antibiotic treatment for cellulitis at home compared with hospital. British Medical Journal, 330(7483). Retrieved from http://www.bmj.com/cgi/reprint/330/7483/129

Richards, D., Toop, L., Chambers, S., & Fletcher, L. (2005). Response to antibiotics of women with symptoms of urinary tract infection but negative dipstick urine test results: Double blind randomised controlled trial. British Medical Journal, 331(7509). Retrieved from http://bmj.bmjjournals.com/cgi/content/abstract/331/7509/143

Mangin, D., Toop, L., Chambers, S., Ikram, R., & Harris, B. (2005). Increased rates of trimethoprim resistance in uncomplicated urinary tract infection: Cause for concern? New Zealand Medical Journal, 118(1225). Retrieved from http://journal.nzma.org.nz/journal/118-1225/1726/content.pdf

Richards, D. A., Toop, L. J., & Graham, P. J. (2003). Do clinical practice education groups result in sustained change in GP prescribing? Family Practice, 20(2), 199-206.

Botting, C., Sutherland, M., Wells, E., Town, I., Sainsbury, R., & Toop, L. (2003). The use of inhaled and related respiratory medications in Christchurch rest homes. New Zealand Medical Journal, 116(1187). Retrieved from http://journal.nzma.org.nz/journal/116-1187/709/content.pdf

Richards, D., Toop, L., Brockway, K., Graham, S., McSweeney, B., MacLean, D., … Parsons, A. (2003). Improving the effectiveness of smoking cessation in primary care: Lessons learned. New Zealand Medical Journal, 116(1173). Retrieved from http://journal.nzma.org.nz/journal/116-1173/417/content.pdf

Richardson, A. K., Sutherland, M. G., Wells, J. E., Toop, L. J., & Plumridge, E. W. (2002). Factors affecting general practitioner involvement in a randomised controlled trial in primary care. New Zealand Medical Journal, 115, 153-155.

Richards, D. A., Toop, L. J., Chambers, S., Sutherland, M. G., Harris, B., Ikram, R., … Peddie, B. A. (2002). Antibiotic resistance in uncomplicated urinary tract infection: Problems with interpreting cumulative resistance rates from local community laboratories. New Zealand Medical Journal, 115(1146), 12-14.

McGeoch, G. R. B., Lainchbury, J. G., Town, G. I., Toop, L. J., Espiner, E. A., & Richards, A. M. (2002). Plasma brain natriuretic peptide after long-term treatment for heart failure in general practice. European Journal of Heart Failure, 4(4), 479-483.

Williams, D., Barnett, P. S., & Toop, L. J. (1999). Preventive care in Canterbury general practice. New Zealand Medical Journal, 112(1088), 183-186.

Toop, L. J. (1998). Patient centred primary care. British Medical Journal, 316, 1882-1883.

Toop, L. J. (1998). Making practice nurse collaboration a reality. New Zealand Family Physician, 25(2), 35-36.

Watson, P. B., Town, G. I., Holbrook, N., Dwan, C., Toop, L. J., & Drennan, C. J. (1997). Evaluation of a self-management plan for chronic obstructive pulmonary disease. European Respiratory Journal, 10(6), 1267-1271.

Harre, E., Price, P. D., Ayrey, R. B., Toop, L. J., Martin, I. R., & Town, G. I. (1997). Respiratory effects of air pollution in chronic obstructive pulmonary disease: a three month prospective study. Thorax, 52(12), 1040-1044.

Toop, L. J., & Hodges, I. D. (1996). Primary care teamwork in the Christchurch area: Part 1: Health professionals actual and preferred levels of interdisciplinary contact and collaboration. New Zealand Family Physician, 23(6), 42-49.

Toop, L. J. (1996). Whose responsibility is it to manage pharmaceuticals? New Zealand Family Physician, 23, 17-19.

Toop, L. J., Nuthall, J. J., & Hodges, I. D. (1996). Primary care teamwork in the Christchurch area: Part 2: Barriers to greater collaboration. New Zealand Family Physician, 23(6), 51-59.

Gillies, J. D., Barry, D. M. J., Crane, J., Jones, D. T., MacLennan, L., Reid, J. J., Toop, L. J., & Pearce, N. E. M. (1996). A community trial of a written self management plan for children with asthma. New Zealand Medical Journal, 109, 30-33.

Town, G. I., Hodges, I. D., Wilkie, A. T., Toop, L. J., Graham, P. J. M., & Drennan, D. J. (1995). A community promotion of asthma self management in New Zealand. Patient Education & Counseling, 26, 219-224.

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Journal - Research Other

Townsend, P., Toop, L., Aish, H., Jordan, L., & Cullen, F. (2019). Response to 'Elephants in the room" editorial, 1 February 2019. New Zealand Medical Journal, 132(1495), 86-87. Retrieved from http://www.nzma.org.nz/journal

Toop, L. (2017). Steps towards more integrated care in New Zealand: A general practice perspective. BJGP Open, 1(1), 0845. doi: 10.3399/bjgpopen17X100845

Swinburn, B., Vandevijvere, S., on behalf of submitting health professors, including Hornblow, A., Taylor, B., Drummond, B., Murdoch, D., Mangin, D., Sarfati, D., Sellman, D., Sopoaga, F., Thomson, G., Abel, G., Hoek, J., Connor, J., Krebs, J., Mann, J., McCall, J., Broughton, J., Toop, L., Signal, L., Beckert, L., Farella, M., Baker, M., Keall, M., Skeaff, M., Thomson, M., Wilson, N., Chandler, N., Priest, P., Brunton, P., Crampton, P., Gendall, P., Howden-Chapman, P., Taylor, R., Edwards, R., Gauld, R., McGee, R., Mulder, R., Derrett, S., Hales, S., Pullon, S., & Blakely, T. (2017). Proposed new industry code on unhealthy food marketing to children and young people: Will it make a difference? New Zealand Medical Journal, 130(1450), 94-101. Retrieved from http://www.nzma.org.nz/journal

Mulder, R., Rucklidge, J. J., & Toop, L. (2016). Restoring Study 329: Paroxetine neither effective nor safe for adolescents. Australian & New Zealand Journal of Psychiatry, 50(9), 922-923. doi: 10.1177/0004867416657412

Toop, L., & Mangin, D. (2015). The art and science of marketing medications. New Zealand Medical Journal, 128(1421). Retrieved from https://www.nzma.org.nz/journal

Hudson, B., Williman, J. A., Stamp, L. K., Alchin, J. S., Hooper, G. J., Mangin, D., Thompson, B. F., & Toop, L. (2015). Nortriptyline in knee osteoarthritis (NortIKA Study): Study protocol for a randomised controlled trial. Trials, 16, 448. doi: 10.1186/s13063-015-0961-1

Toop, L., & Jackson, C. (2015). Patient co-payment for general practice services: Slippery slope or a survival imperative for the NHS? British Journal of General Practice, 65(635), 276-277. doi: 10.3399/bjgp15X685105

Mangin, D., Hudson, B., & Toop, L. (2012). Direct-to-consumer genetic testing: Letting the genie out of the bottle? New Zealand Medical Journal, 125(1364). Retrieved from http://www.nzma.org.nz/journal

Hudson, B., Alderton, A., Doocey, C., Nicholson, D., Toop, L., & Day, A. S. (2012). Crying and spilling: Time to stop the overmedicalisation of normal infant behaviour. New Zealand Medical Journal, 125(1367). Retrieved from http://www.nzma.org.nz/journal

Toop, L. (2011). The QOF, NICE, and depression: A clumsy mechanism that undermines clinical judgment [Editorial]. British Journal of General Practice, 61(588), 432-433. doi: 10.3399/bjgp11X582994

Heath, I., Mangin, D., Toop, L., & Brodersen, J. (2011). The future of national health systems [Editorial]. British Journal of General Practice, 61(586), 319-320. doi: 10.3399/bjgp11X572292

Toop, L., & Mangin (Richards), D. (2009). [Commentary to A dipstick clinical prediction rule modestly improved diagnostic precision in women with suspected urinary tract infection]. Evidence-Based Medicine, 14(5), 155. doi: 10.1136/ebm.14.5.155

Toop, L. (2009). A polypill is the solution to the pharmacological management of cardiovascular risk: The 'no' case. Journal of Primary Health Care, 1(3), 234-236. [Commentary].

Mangin, D., & Toop, L. (2007). The quality and outcomes framework: What have you done to yourselves? [Editorial]. British Journal of General Practice, 57(539), 435-437.

Mangin, D., & Toop, L. (2007). Urinary tract infection in primary care. BMJ, 334, 597-598. doi: 10.1136/bmj.39148.403206.80

Toop, L., & Mangin, D. (2007). Industry funded patient information and the slippery slope to New Zealand. BMJ, 335, 694-695. doi: 10.1136/bmj.39346.525764.AD

Toop, L., Richards, D., & Dowell, T. (2005). Response to Maubach and Hoek's paper on GP attitudes to DTCA [Letter]. New Zealand Medical Journal, 118(1217). Retrieved from http://journal.nzma.org.nz/journal/118-1217/1543/content.pdf

Mansfield, P. R., Mintzes, B., Richards, D., & Toop, L. (2005). Direct to consumer advertising: Is at the crossroads of competing pressures from industry and health needs [Editorial]. BMJ, 330(7481), 5-6. doi: 10.1136/bmj.330.7481.5

Toop, L., & Richards, D. (2004). Physicians' negative views of direct-to-consumer advertising (DTCA): The international evidence grows [Editorial]. New Zealand Medical Journal, 117(1195). Retrieved from http://journal.nzma.org.nz/journal/117-1195/905/content.pdf

Toop, L. J., Richards, D. A., & Dowell, A. C. (2003). The leadership role of general practice in public health: Advocating a ban of direct-to-consumer advertising of prescription drugs in New Zealand. 'Possums in the headlights?'. British Journal of General Practice, 53(489), 342-345.

Toop, L. J., & Richards, D. A. (2002). DTCA in New Zealand: The challenge of finding an acceptable balance. British Journal of General Practice, 52(477), 341.

Nicholls, G., Bagshaw, P., Begg, E., Moller, P., Toop, L., & Winterbourn, C. (2000). Malpractice and our responses [Editorial]. New Zealand Medical Journal, 113(345).

Nicholls, G., Bagshaw, P., Begg, E., Moller, P., Toop, L., & Winterbourn, C. (2000). The case for doubling investment in biomedical research [Editorial]. New Zealand Medical Journal, 113(389).

Nicholls, G., Bagshaw, P., Begg, E., Moller, P., Toop, L., & Winterbourn, C. (2000). Medical training in crisis. New Zealand Medical Journal, 113(155).

Nicholls, G., Bagshaw, P., Begg, E., Moller, P., Toop, L., & Winterbourn, C. (2000). Patients, professionalism and politics: A new beginning [Editorial]. New Zealand Medical Journal, 113(23).

Nicholls, G., Bagshaw, P., Begg, E., Moller, P., Toop, L., & Winterbourn, C. (2000). Everything is new! [Editorial]. New Zealand Medical Journal, 113(1).

Nicholls, M. G., Bagshaw, P., Begg, E. J., Moller, P. W., Toop, L., & Winterbourn, C. (2000). Getting health back on track [Editorial]. New Zealand Medical Journal, 113(369).

Nicholls, G., Bagshaw, P., Begg, E., Moller, P., Toop, L., & Winterbourn, C. (1999). [Editorial The Journal: Into the new millenium]. New Zealand Medical Journal, 112, 415.

Asher, M. I., Toop, L., Mitchell, E. A., and Ad Hoc Paediatric Group, including Pattemore, P., MacKay, R., Shaw, R., & Stanley, T. (1994). Asthma in children: Consensus on preventive management in New Zealand. New Zealand Medical Journal, 107(974), 108-110.

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