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Published: 10 December, 2021


Contents

What’s the latest?

A new edition of Best Practice Journal (eBPJ) is now available online. In this third edition of eBPJ we take a closer look at the evidence for when and how gabapentinoids should be prescribed, update the management of urinary tract infections in adults and highlight MMR vaccination to ensure it also remains a priority in a COVID-19 dominated world. We also discuss the evidence for plant-based diets in children and take a fresh look at diagnosing and managing lactose intolerance. As usual, continuing professional development activities have been produced with this edition, including a quiz, a clinical audit and a peer group discussion. All articles are now also available to individually view and download on our website.

Coming soon: as part of our ongoing focus on cancer care with Te Aho o Te Kahu, the Cancer Control Agency, we will be publishing a series on early identification of melanoma, including guidance on dermatoscopy, and post-treatment follow-up and surveillance. We will also be shortly publishing the first of our series of resources on prescribing medicinal cannabis, in conjunction with the Ministry of Health.


IMAC clarifies aspects of AstraZeneca vaccine use

The Immunisation Advisory Centre (IMAC) has provided some updated information on certain aspects of the AstraZeneca vaccine. The AstraZeneca vaccine is available for people aged over 18 years who are unable to, or do not want to, have the Pfizer vaccine. It is only available at certain vaccination sites which can be identified on the Book my vaccine website.

IMAC advise that:

  • Vaccination with the AstraZeneca vaccine requires written consent. A Ministry of Health-developed consent form for any COVID-19 vaccine is available here.
  • A prescription is required if the AstraZeneca vaccine is given as part of a mixed schedule* with other COVID-19 vaccines, e.g. given after a first or second dose of Pfizer vaccine, because this reflects off-label use. Some vaccination clinics may be able to provide a prescription and consent on-site, but some people may need to see their General Practitioner or Nurse Practitioner to request these.
  • A prescription is not required for the Pfizer vaccine if it is used after the AstraZeneca vaccine (or any other COVID-19 vaccine)

*A “mixed schedule” refers to anyone requesting an AstraZeneca vaccination for a second or booster dose when the previous dose(s) administered were not the AstraZeneca vaccine.


Cancer Society SunSmart website launch

The Cancer Society of New Zealand has partnered with Te Hiringa Hauora/Health Promotion Agency to take over the delivery of www.sunsmart.org.nz and associated campaigns. The new look website launched on 1 December, 2021, and includes patient information and resources on how to check for and detect skin cancers and how to be SunSmart, along with a training module for nurses.


Reminder about nitrofurantoin

Modified release (MR) nitrofurantoin 100 mg capsules (Macrobid) have been fully funded on prescription since March, 2021. The standard dose of Macrobid for urinary tract infection (UTI) is 100 mg MR, twice daily. As previously reported, most recently in Issue 27, this medicine should be prescribed by brand name so it is not confused with the 50 mg or 100 mg immediate release (IR) formulations (Nifuran), which are prescribed four times daily for UTI. It is also important to ensure that any personalised prescribing "shortcuts" are updated to avoid inadvertent errors, e.g. prescribing Nifuran 100 mg IR, twice daily instead of Macrobid 100 mg MR, twice daily. Pharmacists should also query any nitrofurantoin prescriptions they receive that are not a standard dose, to ensure that this was intentional.


Invitation to join new Public Health group

The Public Health Observatory New Zealand (PHONZ) has been established to provide a forum for people interested in public health intelligence to collaborate, exchange ideas, and meet other people locally, nationally and internationally with similar interests and passions. It will be a repository for news, data, analytical tools, information about public health intelligence and provide workforce development opportunities. Further information is available on the EHINZ website (this is an interim home while a dedicated website is under development). To sign up, click here.


New Zealand Formulary updates for December

Changes to the NZF in the December, 2021, release include updated monographs for rosuvastatin*, levetiracetam and the mRNA COVID-19 vaccines. The New Zealand Formulary for Children (NZFC) includes new monographs for clopidogrel and fosfomycin for multi-resistant urinary tract infection. Patient information leaflets on NZFC for ibuprofen and macrogol have been updated.

*Watch out for an upcoming article by bpacnz on rosuvastatin, the Special Authority criteria and its place in treatment


PHARMAC medicine funding and supply issues

The following issues relating to medicine funding and supply have recently been announced by PHARMAC


Paper of the Week: Smokefree Aotearoa 2025 Action Plan

The Ministry of Health has just released their latest iteration of the plan to ultimately eliminate smoking, and therefore smoking-related morbidity and mortality, from New Zealand. The plan contains several bold interventions designed to collectively move the country towards the goal of being smokefree by 2025. Many aspects of the framework are related to policy and public health measures, but primary care health professionals have an important role in helping individuals to quit smoking and remain smokefree.

The three key outcomes of the Action Plan are:

  • Eliminate inequities in smoking rates and smoking-related illness
  • Ensure young people never start smoking
  • Increase the number of people who successfully quit smoking

Read more about the Action Plan here


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