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Published: 3 June, 2022


B-QuiCK: a new online tool from bpacnz

We are pleased to announce the launch of our new online tool: B-QuiCK!  This tool, the name of which stands for bpacnz Quick Clinical Knowledge, provides short clinical summaries from some of the full articles available on our website. Relevant sections from these resources have been condensed into “notepad pages” or algorithms designed to offer rapid access to practical clinical information, such as what to ask, examine, investigate, prescribe and monitor when managing a condition.

Currently, all topics are initially displayed by default when you open the page. Topics can be filtered by category by clicking on the menu bar at the top. We will be regularly adding new topics to this resource with the aim of developing a comprehensive quick reference library for primary care clinicians. A future development will be to incorporate this tool directly into your practice management system.

N.B. A link to the full article is included at the end of each summary; it is strongly recommended to review the original resource at your convenience for full details of recommendations and evidence.

New article: Addressing heart failure in primary care

The incidence of heart failure is increasing in New Zealand, likely reflecting our ageing population as well as an increase in risk factors such as obesity, type 2 diabetes and ischaemic heart disease. Heart failure is also becoming more common in younger age groups, particularly among Māori and Pacific peoples. To help support primary healthcare professionals in managing patients with this complex clinical syndrome, we have developed a two-part series of articles:

We also outline the increasing evidence that supports sodium-glucose cotransporter-2 (SGLT-2) inhibitors as a candidate for the “cardio-protection toolbox”; this medicine class can improve prognostic outcomes in patients with heart failure, with or without diabetes. However, SGLT-2 inhibitors are currently only funded for patients with type 2 diabetes who meet the Special Authority criteria.

PHARMAC medicine supply issues

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

Potential interaction between levothyroxine and ciprofloxacin

A case report received by CARM describing a potential interaction between levothyroxine and ciprofloxacin was outlined in a recent Prescriber Update. Symptoms reported by the patient were fatigue, reduced heart rate and sensitivity to cold, i.e. features common in people with hypothyroidism. The patient improved after ciprofloxacin was discontinued and the dose of levothyroxine temporarily increased. There is a small amount of supporting evidence in the literature citing similar interactions. Ciprofloxacin is thought to potentially decrease the serum concentration of levothyroxine by limiting intestinal absorption when the medicines are used concomitantly.

It is recommended that if the two medicines are used together that:

  • Administration is separated by six hours
  • Patients are informed about the symptoms and signs that could occur
  • Thyroid function be monitored

Information in the data sheets for both medicines will be updated to reflect this potential interaction.

Access to funded treatments for relapsing remitting multiple sclerosis to be widened

Following a proposal in May, 2022, PHARMAC has announced that they are to fund treatment earlier for people with relapsing remitting multiple sclerosis. From 1 July, 2022, the Special Authority criteria for eight treatments (see below) for multiple sclerosis will be updated to include the 2017 McDonald criteria. This will allow people to access funded treatment for multiple sclerosis after only one clinical attack (also known as clinically isolated syndrome, CIS), and it is hoped this will bring New Zealand in line with international guidelines. Currently, people with multiple sclerosis must wait until they have had two clinical attacks before they can access funded treatment. Earlier access to funded treatment may delay transition from CIS to clinically definite multiple sclerosis, delay transition to secondary progressive multiple sclerosis, reduce the frequency of attacks and reduce brain atrophy.

Temporary top-up payments available to support MMR vaccination uptake

Immunisation coverage continues to be a key focus for the New Zealand health system, particularly given the lower rates consistently reported for Māori and Pacific peoples. The Ministry of Health has now established temporary top-up payment to help increase uptake of MMR vaccination, with a particular focus on these at-risk communities.

Sudden Unexpected Death in Infancy reports released

Sudden Unexpected Death in Infancy (SUDI) is the leading cause of preventable mortality in infants in New Zealand. In 2020, the Ministry of Health commissioned research to better understand the reasons behind SUDI rates and to identify potential improvements that could be made to the National SUDI Prevention Programme. Reports have now been released and can be found here.

For further information on the recommendations and data from main report, see:

Podcast of the Week: The Good GP – Assessing dementia in primary care

This week’s podcast is from The Good GP, an Australian podcast series intended to fit into the busy schedules of general practitioners. In a recent 30-minute episode, The Good GP interviews Dr Hilton Koppe, Dr Marita Long and Dr Steph Daly who are GPs and also podcasters from the “Dementia in Practice” training series. The focus is on the assessment of patients with dementia in primary care and it includes discussion of a diagnostic framework to simplify the process. If you find this interesting and helpful, and you are ready for more, there are another 18 short podcasts on the Dementia Training Australia website covering all aspects of caring for people for dementia in primary care.

Listen to the full Good GP podcast here.

This Bulletin is supported by the South Link Education Trust

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