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BPJ 47 October 2012

Best Practice Journal

Managing medicines in older people

It is increasingly recognised that health care for older people is improved when one prescriber takes responsibility for all of a patient's medicines. Multiple prescribers are associated with increasing polypharmacy, and are also an independent risk factor for adverse drug reactions in older populations. By asking specific questions in consultations and using validated tools to eliminate unnecessary medicines, clinicians can further improve prescribing to older people with complex co-morbidities. View Article

Managing breathlessness in palliative care

Breathlessness is a complex and subjective symptom that is commonly experienced by people who are nearing the end of life. Once reversible causes have been addressed, management focuses on non-pharmacological interventions, aimed at increasing comfort. Pharmacological options include low dose morphine, and if appropriate, benzodiazepines or oxygen treatment (if hypoxaemic). The effectiveness of treatments will vary between patients, so a flexible approach to management is required. View Article

Silencing tinnitus

Tinnitus is the perception of sound within the ear or head, without a corresponding external stimulus for that sound. It is a common, but frustrating problem for both patients and clinicians, as in many cases the cause cannot be identified and there is no single effective treatment. Most treatments aim to help patients habituate to the tinnitus. It is important to identify people who are hearing genuine sounds generated within the body (objective tinnitus) or have some other underlying treatable condition. View Article

Care pathways for long-term conditions: Using type 2 diabetes as an example

A care pathway is a tool that enables practitioners to provide better health care and better patient outcomes at a lower cost. A diabetes care pathway helps guide decisions and timing for diagnosis, interventions, appropriate follow-up, escalation of treatment and referral to secondary care. This introduction to care pathways places the concept of a pathway in the context of managing long-term conditions, and highlights the difference between a care pathway and a care plan. View Article

News and updates

New national genetic service launched View Article

Appropriate use of tetracyclines

What are tetracyclines and how do they work? | Which infections should tetracyclines be used for? | First-line indications for tetracyclines | Second-line indications for tetracyclines | Prescribing notes for tetracyclines | Adverse effects associated with tetracyclines View Article

Using the New Zealand Formulary

Locating product and funding information View Article