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Published: 11 March, 2022


Contents

COVID Care app is here

As many of you would have seen, the Bpac Covid Care app is now live; we have had a great response so far. Bpac Covid Care is a decision support and management application integrated with MedTech Evolution and Medtech 32, that combines the most up to date guidance, clinical pathways and bestpractice decision support capability to help general practice safely triage and monitor patients with COVID-19 at home. It is provided to you free-of-charge by the South Link Education Trust and Bpac, supported by Medtech Global, as part of our ongoing commitment and service to general practice.

Covid Care makes managing your patients with COVID-19 easier by:

  • Integrating relevant patient demographics, long term conditions and prescribed medicines from the PMS
  • Using decision support to provide best practice recommendations based on the patient’s symptoms and signs
  • Automatically generating recalls based on the patient’s risk categorisation within your Medtech Recalls Contact list
  • Providing data within an individual PMS, that can then be used for claiming purposes

COVID Care is available now in your Medtech bestpractice dashboard. For further information about the app, including a link to an instructional video, see: https://bpac.org.nz/2022/covidcare.aspx


Patient information on managing COVID-19 at home

To support the COVID Care app, we have developed a patient resource on managing at home with COVID-19. This can be downloaded and emailed or printed, or a link sent via text message, for the patient or caregivers.


Third and fourth doses of COVID-19 vaccine for people with severe immunocompromise

Primary course: The COVID-19 Vaccine Technical Advisory Group recommend that people aged ≥ 12 years with severe immunocompromise receive a third primary dose of the Pfizer COVID-19 vaccine. The third primary dose should be administered at least eight weeks, but no more than three months, after the second dose*. If there are current or planned immunosuppressive treatments, the third dose should be delayed until two weeks after the period of immunosuppression, in addition to the period of clearance of the therapeutic agent.

Booster doses for ≥ 18s: A schedule of a primary course of three doses and a booster dose is recommended for people with severe immunocompromise aged ≥ 18 years. A booster dose is ideally given six months after the third primary dose but may be given from three months. Booster doses are not currently approved for use in people aged < 18 years.

N.B. The recommended regimen of three primary doses plus a booster (i.e. a series of four doses) is not approved, so either the third primary dose or the fourth dose (if the third primary dose is regarded at the time as a booster*) needs to be prescribed. If the third dose is entered into CIR as their booster, the fourth dose should be recorded as an additional vaccine in the primary/standard case schedule.

* If the third primary dose is given more than three months after the second dose, it has essentially become a booster dose, i.e. not part of the primary course. IMAC supports that a fourth dose can still be given three months later, ideally at six months.

For further information on third primary doses, see: https://covid.immune.org.nz/covid-19-vaccines-nz/getting-vaccinated/boosters-and-third-primary-dose-information


Novavax is now available

Novavax (Nuvaxovid), a recombinant protein vaccine against COVID-19, is now available in New Zealand for people aged 18 years and older who wish to use an alternative COVID-19 vaccine. The Pfizer COVID-19 vaccine remains the recommended vaccine for most people.


Opioid consumer information leaflet

As part of an ongoing effort to minimise opioid misuse and dependence in New Zealand, Medsafe has published a consumer information leaflet on the risks associated with opioid medicines; available here to view, download and print.

In June, 2021, the Medicines Adverse Reaction Committee (MARC) recommended that Medsafe develop a consumer information leaflet to highlight the risks of opioid medicines following global concerns over opioid misuse and dependence. Read here to find out what other recommendations were made.


Brief update on influenza vaccines

The influenza vaccination programme is expected to commence from 1 April, 2022. PHARMAC has issued a proposal to extend funded vaccinations to include Māori and Pacific peoples aged between 55 and 64 years. The supplier of influenza vaccinations for 2022, Seqirus, has advised that the purchase cost to vaccinators will increase by $2 per dose; this cost will be fully reimbursed when vaccinating eligible people, however, the cost may need to be passed on to people who self-fund their vaccination.

IMAC has a dedicated website for health professionals to keep up to date with the latest information about the 2022 Influenza Immunisation Programme: www.influenza.org.nz


New Zealand Formulary updates for March

Significant changes to the NZF in the March, 2022, release include:

  • Updated dosing of misoprostol to reflect use for medical termination of pregnancy
  • New information on therapeutic drug monitoring has been added to the monograph for sodium valproate
  • Severe Cutaneous Adverse Reactions (SCARs) has been added to the adverse effects of omeprazole
  • Updated dosing regimen for bendroflumethiazide

PHARMAC medicine supply issues

The NZF contains up to date information about medicine supply issues. The following issues relating to medicine supply have recently been announced by PHARMAC


Paper of the Week: Statin intolerance

Statin discontinuation due to intolerance is an important clinical challenge in primary care, and is associated with an increased risk of cardiovascular events. A meta-analysis recently published in the European Heart Journal (176 studies, including over four million patients), found that the overall prevalence of statin intolerance is low, and might often be over-estimated. The authors identified possible risk factors that influence the risk of statin intolerance.

For further information on prescribing statins, including managing adverse effects, see: https://bpac.org.nz/2021/statins.aspx


If you have any information you would like us to add to our next bulletin, please email: editor@bpac.org.nz

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