Watch or listen to the May 2023 clinical update from Dr Jo Scott-Jones joined by Dr Dave Maplesden, Pinnacle GP liaison in this 42 minute podcast/video. (Written version below.)
Clinical snippets are now available as a podcast! Search on your favourite podcast platform for The New Zealand General Practice Podcast to listen, or click here to listen on Anchor.
GP Research Review issue 2 2023 comments on the USANZ position statement on PSA testing. This position statement serves as an interim document for the optimised use of PSA testing in Australia and New Zealand until current guidelines on PSA testing are updated. The USANZ New Zealand section is working on new PSA guidelines to be released later this year as the 2015 guidance is now outdated and inconsistent with contemporary clinical practice.
Recommendations include:
Issue 3 of GP Research Review looked at a recent article published in the Journal of Primary Health Care with a focus on polypharmacy.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published updated guidelines on chronic obstructive pulmonary disease (COPD). The guidelines include several important changes, particularly concerning the use of long-acting bronchodilators in treatment.
Medsafe have put out a further alert regarding use of topiramate in pregnancy and women of childbearing age. Congenital malformations and neurodevelopmental disorders have been reported in children following in utero topiramate exposure.
Advice to health professionals includes the following.
(i) Pharmac has announced the General Rules of the Pharmaceutical Schedule will be amended from 1 June 2023 to allow three months of the stimulant/ADHD treatments, methylphenidate and dexamfetamine, to be funded when prescribed electronically. While the Regulations allow electronic prescriptions for methylphenidate and dexamfetamine to be issued for three months at a time instead of one month, the frequency of dispensing for these medicines remains monthly.
(ii) The RANZCP has a statement on guidance for the use of stimulant medications in adults (2015) which includes: Specific caution, including appropriate monitoring, is required in the consideration of stimulant prescription to persons who have a history of substance abuse or dependence… Clinicians should assess and monitor the risk associated with stimulant prescription in adults with a history of hypertension, cardiovascular or cerebrovascular disorders. A baseline electrocardiogram (ECG) should be performed if there is a family history of serious cardiac disease or sudden death in young family members, or abnormal finding on cardiac examination. The patient’s blood pressure should be regularly monitored during the course of treatment with stimulant medication.
(iii) New Zealand Formulary includes the following screening and monitoring advice for methylphenidat.
Pre-treatment screening
Monitoring requirements
Kathy joined Pinnacle earlier this month as clinical diabetes specialist for Waikato, replacing the role previously held by Anne Waterman.
Read moreThere is a New Zealand-wide shortage of extended-release methylphenidate, both Concerta and Methylphenidate ER - Teva brands.
Read moreThis programme provides funding for Aclasta infusions for eligible patients. The infusion is to be provided in the community by the patient’s general practice.
View detailsA guide for clinical management of type 2 diabetes, to support nurses at all levels to develop their knowledge and clinical reasoning in diabetes care.