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Published: 18 August, 2022


In case you missed it: Latest from bpacnz

We regularly add new content to our website – check out the latest articles on our home page reel or search for something specific. Here are some of our most recently published resources:

COVID-19 public health requirements dropped: what does this mean for practices?

As you will be aware, the Government has announced that all COVID-19 public health requirements have been removed. As of Tuesday, 15th August, 2023, there is no longer a requirement for people to wear face masks when visiting a health care facility. Seven-day mandatory isolation periods have also been removed, it is, however, recommended that people who test positive for COVID-19 (or have flu-like symptoms) remain at home for five days. It has been reported that the changes have been made in response to lower COVID-19 rates and reducing pressure on the health care system after passing the expected peak of winter-illnesses. Many practices are still likely to be experiencing a significant respiratory related workload.

The importance of mask wearing to reduce the spread of all respiratory illnesses is acknowledged in the Beehive media release and it is expected that many primary care clinics will continue to recommend the use of face masks as part of their own health and safety policy, e.g. for patients with respiratory symptoms. Several strategies introduced during the pandemic remain part of everyday practice for many, e.g. red-streaming, phone triage and altered cleaning procedures. The RNZCGP has updated its COVID-19 advice, which can be read here and this may assist individual practices with their infection control policies to continue to protect patients and staff.

For a downloadable patient information sheet for managing COVID-19 symptoms or a seasonal viral illness at home, click here

N.B. Te Whatu Ora recently announced it is ceasing funding for personal protective equipment (PPE) for health and disability service providers on a product-by-product basis. The estimated last month of supply for isolation gowns, nitrile gloves and alcohol-based disinfectant wipes is September, 2023 and the last month of supply for medical masks (Type II R) is October, 2023.

South GP CME 2023: a report from the field

It was great to see so many of our readers at the South GP CME conference in Christchurch last weekend. There was an overwhelming amount of information to take in and it was difficult at times to choose which session to attend out of the interesting topics on offer.

We appreciated receiving feedback at the conference. Of course, you can send us feedback about our resources at any time – email:

If you have any technical questions, e.g. about your log-in details or accessing our website, email:

Daffodil day next Friday

Next Friday (25th August, 2023) is the annual Cancer Society Daffodil Day fundraiser. Money raised in the appeal will contribute towards cancer care for patients and their whānau through the Cancer Society education and awareness programmes and cancer research efforts.

The bpacnz website has a dedicated section for resources supporting cancer care in New Zealand. We have recently published a series on early detection and follow-up of gynaecological cancers, supported by Te Aho o Te Kahu, Cancer Control Agency. Click here for further resources on bowel, lung and prostate cancer, melanoma and cancer cachexia.

2023 European Society of Hypertension guidelines now available

New ESH hypertension guidelines have been released, providing clinicians with further direction when treating patients with hypertension. The 2023 update largely reflects the recommendations established in the previous version of the guideline (2018) and endorses several key changes to the way we approach management. This includes making antihypertensive prescribing decisions according to both blood pressure (BP) and CVD risk in combination (unless BP is significantly elevated) and prescribing two low-dose antihypertensives as a starting point for most patients requiring pharmacological treatment.

In addition, the 2023 ESH guidelines propose a revised set of recommendations for blood pressure targets (140/80 mmHg for most; 130/80 mmHg for some). This adds to the growing pool of international guideline-suggested targets; the “bottom-line” is that individualisation is key, and the most important step is identifying hypertension in the first place, initiating treatment and supporting patients to adhere to their treatment and make appropriate lifestyle changes.

To access the 2023 ESH hypertension guidelines, click here

For further information on diagnosing and managing hypertension in primary care, see:

The goldilocks approach to measuring blood pressure

Most health professionals know that incorrectly sized cuffs can lead to inaccurate blood pressure measurements and the potential for misdiagnosis. A recent study published in JAMA Internal Medicine shows us exactly how inaccurate “mis-cuffing” can be, and that measurement errors are potentially bigger than anticipated. As highlighted in a Medscape commentary, the goldilocks approach of having several cuff sizes to choose from, and selecting the one that is “just right”, remains as important as ever when measuring blood pressure.

Folic acid fortification of flour now in effect

As reported in Bulletin 77, as of 14th August, 2023, all non-organic bread-making wheat flour produced or sold in New Zealand must now be fortified with folic acid. A reminder that folic acid supplementation for women planning a pregnancy, or who are pregnant, is still necessary even if folic acid fortified bread is consumed; the standard dose is 800 micrograms but people at higher risk require 5 mg.

Clozapine survey 2023

Clozapine can be an effective treatment for some patients with schizophrenia, however, it is associated with a number of significant adverse effects that necessitate close monitoring and co-ordinated care between the patient, caregivers, mental health and primary care teams.

Following recommendations by the Medicines Adverse Reactions Committee, Medsafe is conducting a survey to better understand the impacts of clozapine on patients. This may include difficulties in managing risks associated with taking clozapine and adverse effects. The survey is open to healthcare professionals, as well as patients who are prescribed clozapine and family/whānau/carers who support them. The survey closes on 6th October, 2023.

To refresh your knowledge on the safe prescribing of clozapine, see:

ACC invoicing webinar available

As reported in Bulletin 79, ACC recently hosted a webinar to explain the process and codes for invoicing under Cost of Treatment Regulations for medical practitioners, nurse practitioners, nurses, practice managers, practice administrators or anyone else involved in invoicing ACC. If you missed it, you can view a recording of the webinar here.

Paper of the Week: Preventing dementia in primary care

Dementia is an increasing health issue in New Zealand’s ageing population. According to the Dementia Economic Impact Report, approximately 1% of the population live with some form of dementia as of 2020 and this is projected to increase to nearly 3% by 2050, including 10% of the population aged over 65 years. Rates of dementia in Māori, Pacific or Asian people are projected to triple in that period. These groups are also considerably more likely to develop dementia before the age of 65 years compared with New Zealand Europeans.

In 2020, the Lancet Commission identified twelve modifiable risk factors for the development of dementia; these are associated with to up 40% of dementia cases. Risk factors include poor education, hearing loss, traumatic brain injury, hypertension, excessive alcohol consumption, obesity, smoking, depression, social isolation, physical inactivity, air pollution, and diabetes. Given that many of these risk factors are already addressed when managing other conditions in primary care, incorporating a dementia prevention element has been proposed as a possible factor to boost the uptake and adherence to effective lifestyle messaging.

A qualitative study published in the British Journal of General Practice interviewed a small group of United Kingdom based general practitioners to assess their understanding on modifiable dementia risk factors and how these are communicated to patients. It may be surprising for some readers that screening for dementia and preventative education was not prominent in their practice. New Zealand primary care clinicians may want to consider whether the associated themes and conclusions drawn are applicable to their own practice.

Jones D, Drewery R, Windle K, et al. Dementia prevention and the GP’s role: a qualitative interview study. Br J Gen Pract 2023;0103. doi:10.3399/BJGP.2023.0103

For further information on the recognising and managing early dementia in primary care, see:

If podcasts are more your thing, Australian-based general practice dementia resources, training and education support can be found here

This Bulletin is supported by the South Link Education Trust

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