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Published: 23 September, 2022


Contents

Update from the National Cervical Screening Programme

September is Cervical Screening Awareness Month, so we have taken this opportunity to share a brief update from the National Cervical Screening Programme Team.

From July, 2023, the primary method for cervical screening will test for human papillomavirus (HPV), the cause of over 95% of cervical cancers. Self-testing will be an option for everyone.

Participants can choose how to have their screening test performed - they can opt for:

  • Self-testing using a swab, in a location of their choice (including at home)
  • A clinician to take the HPV test using a swab
  • A clinician to take a liquid-based cytology sample (using a speculum) which can be used for HPV testing, and cytology if required

Clinical oversight is required in order to explain the test, manage results and arrange follow up.

In the meantime, the key message is “keep screening”. We don’t want anyone holding off on screening until HPV Primary Screening becomes available next year because the time lag will make a difference for some people - cytology screening needs to continue while we prepare for the new programme.

If you have any questions about the HPV Primary Screening Project, or wish to sign up to the National Cervical Screening Programme Sector Update newsletters, please contact us at: hpvscreen@health.govt.nz


Funding restrictions removed from progesterone

From 1 December, 2022, prescribing restrictions will be removed from oral progesterone, allowing it to be prescribed fully funded to any patient who requires this treatment.

Progesterone 100 mg oral capsules (Utrogestan) are approved for use in combination with oestrogen for menopausal hormone therapy in post-menopausal females with an intact uterus. Other uses include prevention of pre-term labour (unapproved indication) - see New Zealand Formulary for details on dosing.

Progesterone oral capsules are currently only funded with Special Authority approval for prevention of pre-term labour in patients who meet the criteria. This change in access will increase the options for women requiring a progestogen as part of their menopausal hormone therapy (MHT).

Read more about the decision and consultation process here.


Potential new treatment for inflammatory bowel disease

Pharmac is seeking feedback on a proposal to fund a new treatment for people with ulcerative colitis or Crohn’s disease: vedolizumab. Submissions are due by 5 October.

N.B. This consultation also includes a proposal to fund brentuximab vedotin for the treatment of patients with Hodgkin and anaplastic large-cell lymphoma.


New long COVID guidelines published

Manatū Hauora, The Ministry of Health, has published a “living document” providing clinical guidelines on the rehabilitation of people with long COVID. It includes a case definition and diagnostic criteria, symptoms and clinical management by body system. It is intended that guidance will be updated as further evidence evolves on managing long COVID. COVID-19 has disproportionately affected Māori and Pacific peoples, therefore future iterations of the guide will further build on holistic models of care and resources to support people with long COVID and their whānau equitably in the community.


Safety report on COVID-19 vaccines

Since March, 2021, Medsafe has been publishing data on adverse event reports and other safety monitoring for COVID-19 vaccination. Reports are now published two-monthly and the latest report for accumulated data up until the end of August, 2022 is now available.

It is important to note that these reports of adverse events following immunisation have been made by members of the public and health professionals, and have not been verified as being caused by, or associated with, COVID-19 vaccination.

Read the full report for data up to 31 August, 2022 here. An index page for all safety reports is available here.

Also see the Medsafe alert about myocarditis and pericarditis with Nuvaxovid, as reported in Bulletin 58


Community pharmacies can now offer Boostrix vaccine

As of 1 September, community pharmacies are able to offer Boostrix vaccine (diphtheria, tetanus and pertussis) to eligible patients at no cost. A list of eligibility criteria for funded vaccination can be found here. N.B. The current medicines classification of Boostrix means that it can only be administered by authorised pharmacist vaccinators to people aged 18 years or older or to pregnant females aged 13 years or older.

Pharmacies who choose to offer Boostrix will record administrations of vaccines in the National Immunisation Register. Pharmacists are encouraged to check with a patient’s general practice if their immunisation record of previous Boostrix/Tdap vaccination is unknown.

The Immunisation Advisory Centre ran a webinar earlier this week, covering questions about Boostrix, Nuvaxovid and more: the webinar replay is available here.


Paper of the Week: A walk in the park – how the great outdoors improves mental health

A recently published paper in Molecular Psychiatry (a Nature portfolio journal) examined the effect of natural versus urban environments on stress-related brain mechanisms. Study participants undertook a one hour walk in either a busy street or forest setting. Brain activation was assessed with psychometric tasks before and after the walks. It was found that participants had decreased amygdala activation after their nature walk, i.e. reduced stress levels, but amygdala activation remained the same with the urban walk.

Exercise is an important aspect of lifestyle measures for improving mental health. Next time you recommend that a patient takes a walk, suggest that they go further afield than their city block.


This Bulletin is supported by the South Link Education Trust

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