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BPJ 39 October 2011

Best Practice Journal

The use of antithrombotic medicines in general practice: a consensus statement

In July 2011, a consensus forum was held in Wellington to discuss the use of antithrombotic medicines in general practice. This was attended by representatives from primary care, secondary care, bpacnz, PHARMAC and the New Zealand Guidelines Group. View Article

Management of atrial fibrillation in general practice

Atrial fibrillation (AF) is often an incidental finding during a routine medical assessment. The diagnosis of AF can be confirmed with an ECG. Symptom management focuses on either rate or rhythm control using medicines such as beta-blockers, calcium channel blockers, digoxin and amiodarone. Patients who require rhythm control should be referred to a cardiologist. The need for antithrombotic treatment is determined after an assessment of stroke and bleeding risk. View Article

Transient ischaemic attack: shoot first ask questions later

A transient ischaemic attack (TIA) is a medical emergency due to the high risk that stroke will occur within the next 48 hours. True TIA symptoms should resolve within one hour. Once symptoms are resolved, patients should immediately be given aspirin, a statin and an antihypertensive medicine (if there are no contraindications). Patients should have their risk of stroke assessed and be referred appropriately for investigation and treatment. View Article

Medical management of stable angina pectoris

Patients presenting with symptoms consistent with angina is a common occurrence in general practice. Angina is formally diagnosed after referral to secondary care for stress testing and further assessment. Revascularisation and pharmacological treatment are used for symptom relief. Minimising the risks of future cardiovascular events is an important aspect of the treatment of stable angina. View Article

Diabetes follow-up: what are the PHO Performance Programme indicators and how are they best achieved?

The purpose of the PHO Performance Programme is to improve health and reduce disparities among people using primary healthcare services in New Zealand, through the implementation of key indicators. The PHO performance indicator and target for diabetes follow-up is for 80% of enrolled patients expected to have diabetes to have had an annual diabetes review. View Article

Upfront: Infant mental health and child protection

The third article in our series on vulnerable children and young people in New Zealand. This article aims to provide primary care professionals with an understanding of infant mental health, with particular reference to the needs of very young children who may come to the attention of Child Youth and Family View Article

News in brief: HbA1c reporting and diabetes resources

As of 1 October 2011, laboratories are reporting HbA1c results in millimoles per mole (mmol/mol) only. For the preceding two years, results have been reported in both percentages (%) and mmol/mol to allow time for both practitioners and patients to become familiar with the mmol/mol system. View Article