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BPJ 56 November 2013

Best Practice Journal

Assessing wheeze in pre-school children

Wheeze in children aged less than five years has many potential causes. Often it is regarded as the first sign of asthma, however, a substantial proportion of young children who wheeze will not go on to develop asthma. In infancy, bronchiolitis is the most likely cause of wheeze. As children get older, episodic viral wheeze becomes more common. Atopic wheeze is most likely in children with risk factors, such as a family history of asthma. By school-age, some of these children with wheeze will be diagnosed with asthma and others will have “grown out” of their symptoms. Therefore, rather than focusing on making a diagnosis when a young child presents with wheeze, it is more important to ensure the child receives appropriate management of their symptoms and that the parents receive education about their child’s treatment and advice about vaccinations, infection prevention and maintaining a smoke-free home. View Article

Risedronate now fully subsidised: What is its place in practice?

Risedronate has been fully subsided in New Zealand without restriction since 1 September, 2013. It is indicated for the treatment of osteoporosis and for the prevention of glucocorticoid-induced osteoporosis. Oral risedronate, taken once weekly, is likely to become the treatment of choice for patients with osteoporosis or at risk of osteoporotic fractures, due to its unrestricted subsidy access compared to alendonate or zoledronic acid and its superior efficacy and simpler dosing regimen compared to etidronate. View Article

Five tips for getting the most out of your Practice Management System

Your Practice Management System (PMS) is a powerful tool. When used well, consistently and linked to decision support software, it can enhance understanding of a practice population’s health and help to improve patient outcomes. Your PMS is also the best tool you have to help you meet the goals of the current PHO Performance Programme (PPP). View Article

Upfront - Sudden unexpected death in infancy: Where are we now?

The incidence of SUDI has declined significantly since public prevention campaigns began in New Zealand in the early 1990s. This success, however, masks several important factors. The first is that New Zealand still has one of the highest rates of SUDI in the developed world. The second is that the decline in infant mortality has not been equal among all New Zealanders. View Article

Prescribing update: Low dose isotretinoin for acne?

New evidence is increasingly suggesting that isotretinoin may be best prescribed using a lower daily dose, with the regimen tailored to the individual patient, the severity of their acne and their response to the medicine. View Article

Beating the blues

“Beating the Blues” is a web-based cognitive behavioural programme for people with symptoms of mild or mild-moderate depression, with good social support. View Article