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Published: 10th November, 2023


In case you missed it: new and updated resources from bpacnz

Cervical cancer – early detection and referral: Cervical screening recommendations have been updated in this article to align with the HPV Primary Screening programme. HPV testing is now the primary cervical screening test in New Zealand, a move which is expected to improve cervical screening participation, promote equitable outcomes and further reduce the burden of cervical cancer over time.

Updated opioid report: Last year we published a report on national opioid use between 2017 and 2021; we have now updated this with dispensing data from 2022. A new-look interactive graph format allows comparison between New Zealand regions in 2020 and 2022, and the personalised data section has been updated to also include 2022 statistics. Have you looked at your 2022 data yet? If you are having trouble logging in, email:

Cough medicines: do they make a difference: Pharmacists and other staff working in community pharmacies are often tasked with guiding people who present with cough on appropriate management strategies. However, as there are a myriad of products available, with differing claims and extent of effectiveness, knowing which product(s) to recommend can sometimes be difficult.

#MedSafetyWeek 2023: 6th – 12th November

The eighth annual #MedSafetyWeek is being held this week. As reported in Bulletin 86, this initiative aims to raise awareness of adverse medicine reactions, with the theme this year being “Who can report?: How patients, doctors, pharmacists and other health professionals can contribute to pharmacovigilance”. In New Zealand, suspected adverse effects to medicines and vaccines can be reported to the Centre for Adverse Reactions Monitoring (CARM) or directly via your practice management software. How have you supported the initiative this #MedSafetyWeek?

World Antimicrobial Awareness Week: 18th – 24th November

World Antimicrobial Awareness Week is coming up, and like last year, the international theme is “Preventing antimicrobial resistance together”. Further information and resources for the global campaign from the World Health Organization are available here.

In New Zealand, along with raising awareness of antimicrobial resistance, prescribers are being encouraged to include a specific indication on their antibiotic prescriptions, e.g. flucloxacillin, 500 mg, four times daily, for five days, for cellulitis. Documenting the indication provides an opportunity for the prescriber, the pharmacist and other clinicians to consider the appropriateness of antibiotic use (including antibiotic selection, dose and duration of treatment), particularly if prescribing does not align with conventional guidance. It can also improve communication between healthcare professionals and reduce prescribing errors, with the overall goal of preventing inappropriate antimicrobial use.

Local resources for antibiotic awareness including posters and social media resources are available here.

November is Diabetes Action Month

This month is Diabetes Action Month, and the theme for 2023 is “Eyes on Diabetes”, which aims to raise patient awareness of eye health and how to protect their vision once a diagnosis of diabetes has been made. Diabetic retinopathy is a common microvascular complication of diabetes, and the risk of other eye conditions such as cataracts is also increased in people with diabetes.

Opportunistically ask patients with diabetes about any changes to their vision, and check as part of their annual diabetes review whether they are up to date with retinal photo-screening (occurs at least every two years). Also ensure that any pregnant women with pre-existing diabetes are scheduled to have, or have undergone, additional photo-screening in the first trimester.

bpacnz has published a suite of diabetes resources, including:

RNZCGP statement on medicinal cannabis prescribing

The Royal New Zealand College of General Practitioners (RNZCGP) has released a position statement on medicinal cannabis prescribing. In summary, the RNZCGP neither recommends nor encourages the use of medicinal cannabis products according to the current body of evidence. However, it is acknowledged that general practitioners may still choose to prescribe medicinal cannabis in certain situations after in-depth consultation with the patient and their wider care team about the risks and benefits of use. If such a decision is made, the RNZCGP states that medicinal cannabis products should only be considered when all first-line, conventional, evidence-based treatment options have been exhausted.

bpacnz, in conjunction with the Ministry of Health, has previously published an overview of medicinal cannabis for health practitioners - see: The RNZCGP position statement includes a quick reference summary of this resource. We have also published a medicinal cannabis guide for pharmacists, available at:

Immunisation Register transition date announced

The Aotearoa Immunisation Register (AIR) is replacing the National Immunisation Register (NIR) and the COVID-19 Immunisation Register (CIR) on the 25th November, 2023. From this date, all vaccinations will be recorded in either your PMS or the AIR vaccinator portal. The NIR and CIR will no longer be used to record vaccinations or to view a patient’s immunisation status or history.

General practices using a PMS connected to the NIR will continue to record vaccinations in their PMS. The PMS will connect to the AIR instead of the NIR after the transition date. Pharmacies will record vaccinations in the AIR vaccinator portal.

For further information, including how to sign up to use the AIR vaccinator portal, see:

MMR vaccination remains a priority

There have now been thirteen confirmed cases of measles in New Zealand in 2023. Healthcare professionals should remain alert for symptoms and signs of measles, particularly in patients who are not vaccinated or are immunocompromised, and especially if they have a recent history of overseas or domestic travel to locations of interest. Funding is available under certain circumstances, e.g. for close contacts who are requested by a Te Whatu Ora public health service to attend primary care for a measles test or consultation, check local HealthPathways or your PHO for details.

All suspected cases of measles must be notified to the local Medical Officer of Health.

MMR vaccination: Opportunistically check whether patients have received both doses of the MMR vaccine and offer vaccination where appropriate. Also ensure that patients with upcoming international travel are fully vaccinated with MMR.

MMR vaccination is funded for all children in New Zealand and anyone born from 1969 onwards who has not received two doses. Some people born overseas prior to 1969 are considered susceptible to MMR and so may be eligible for funded vaccination (click here for further information). N.B. MMR vaccination is contraindicated during pregnancy.

For further information on MMR, see:

Further resources for healthcare professionals are available from:

Medicine supply news: methylphenidate back in stock, metoprolol brand change

The following issues relating to medicine supply, of particular interest to primary care, have recently been announced. This information is also available in the New Zealand Formulary at the top of the individual monograph for any affected medicine and summarised here.

Proposal to fund testosterone gel

Pharmac has released a proposal to fund testosterone transdermal gel and to award Principal Supply Status to Testogel. Testosterone is currently approved for testosterone replacement in people with primary and secondary hypogonadism and for testosterone-based gender affirming hormone therapy, and is available in three formulations: injections, patches and capsules. The availability of testosterone gel will provide people who take testosterone with another option if other testosterone formulations are not suitable or appropriate. If the proposal is accepted, Testogel will be listed on the Pharmaceutical Schedule from 1st April, 2024 and funded without restriction. Submissions are due by 22nd November, 2023.

Read more about the proposal here

Pregnancy information updated in the NZF

In the November release of the NZF, pregnancy and breast-feeding advice sections in over 400 monographs have been reviewed and updated, where necessary, to align with updates to the Briggs Drugs in Pregnancy and Lactation summaries. Significant changes were made to the pregnancy advice in the clindamycin (systemic) monograph and to the breast-feeding advice in the misoprostol (gastrointestinal) monograph.

You can read about all the changes in the November release here. Also read about any significant changes to the NZF for Children (NZFC) here.

Annual report on abortion services published

Manatū Hauora, the Ministry of Health, has published Ratonga Whakatahe i Aotearoa | Abortion Services Aotearoa New Zealand: Annual Report 2023. In summary, access to abortion services increased overall in 2022, including for Māori and Pacific peoples, likely due to the establishment of the national telehealth early medical abortion (EMA) service (DECIDE), endorsement of EMA training for midwives and medicines for EMA now being available in the community. More EMAs were performed in 2022 than surgical abortions, which is the first year that this has been observed. Average gestation at the time of abortion also decreased across most ethnic groups compared to 2021. Read the full report here

The New Zealand College of Sexual and Reproductive Health (NZCSRH) has developed a series of four abortion theory training courses that are hosted on the bpacnz website. Click here to view the modules.

Paper of the Week: Colchicine for cardiovascular disease prevention

Colchicine has been a mainstay of treatment for joint pain since long before the modern era of medicine. It is most commonly used in the management of gout flares. However, as our understanding of disease pathophysiology has evolved, the potential applications for this medicine across a wider range of indications involving underlying inflammation has been considered, e.g. pericarditis.

There is growing evidence for clinical efficacy of colchicine in the prevention of cardiovascular disease (CVD). When balanced against the backdrop of increasing CVD deaths over the past few decades, this has led to some global regulatory agencies reconsidering its status. As outlined in a recent European Heart Journal review, the US Food and Drug Administration (FDA) has approved colchicine for reducing the risk of myocardial infarction, stroke, coronary revascularisation and cardiovascular death in adults with established atherosclerotic disease or who have multiple risk factors for CVD.

In New Zealand, the use of colchicine for the secondary prevention of CVD is not approved, nor is it common practice in primary care. As such, this announcement is likely to trigger some discussion and debate among clinicians. Do you think the current scope of evidence supports the use of colchicine for CVD prevention in specific patients, even if they don’t have gout? Would you be likely to alter your prescribing behaviour if similar changes in approval status and clinical guidelines were made here?

Bonaventura A, Abbate A. Colchicine for cardiovascular prevention: the dawn of a new era has finally come. European Heart Journal 2023;44:3303–4.

This Bulletin is supported by the South Link Education Trust

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