Published: 7 August, 2020


Medsafe monitoring Smith BioMed Rapid Pregnancy Tests

Medsafe has received reports about the Smith BioMed Rapid Pregnancy Test (also known as the Yes! Cassette Pregnancy Test Kits) showing false positive and inconclusive results. The results present as faint lines. Medsafe has asked healthcare professionals to report any problems with these test kits.

Mini-ACE replaces MoCA as the recommended cognitive screening test

The Cognitive Impairment Assessment Review (CIAR) Working Group have prepared a report on the preferred test for assessing cognitive decline in New Zealand. The Mini-Addenbrooke’s Cognitive Examination (Mini-ACE or M-ACE) is now recommended as the preferred screening tool. Online training and access to the test is available at www.nzdementia.org/mini-ace and from 1 September, 2020, Mini-ACE will be incorporated into the cognitive impairment pathway on HealthPathways. From 1 September, 2019, it has been mandatory to have completed a training and certification programme from the MoCA institute and after 1 September, 2020, access to the test will be restricted to officially certified users.

Norimin and Brevinor-1 28 day temporarily out of stock

Norimin out of stock: The supplier of Norimin 28, a combined oral contraceptive (COC), has advised that stock has now run out, but supply should be restored by mid-October, 2020. An alternative product, Necon, has been listed on the Pharmaceutical Schedule. Necon contains the same active ingredients as Norimin (norethisterone 500 micrograms with ethinyloestradiol 35 micrograms) but has different packaging and product information to Norimin. Medsafe have given a time limited, conditional approval for Necon for use during the out of stock period.

Ensure patients switching brands understand the seven-day rule to maintain effective contraception due to possible bioequivalence differences.

Information for community pharmacists: Necon can be substituted for Norimin if patients have any repeat prescriptions owing.

For further information on these changes, see: https://www.pharmac.govt.nz/information-for/enquiries/oral-contraceptives-supply-updates/ethinyloestradiol-35mcg-with-norethisterone-500mcg-norimin/

Shortage of Brevinor-1 28 day tablets: The supplier has advised that stock of Brevinor-1 28 day (Brevinor 1/28), a combined oral contraceptive (norethisterone 1mg + ethinyloestradiol 35 micrograms), will run out in August, 2020; more stock is expected to arrive in New Zealand by mid-October 2020. The supplier has been unable to source an alternative brand that is chemically equivalent, therefore, patients taking Brevinor 1/28 will need to switch to another contraceptive.

For further information, see: https://www.pharmac.govt.nz/information-for/enquiries/oral-contraceptives-supply-updates/brevinor28/

For further information on selecting a contraceptive, see: www.bpac.org.nz/2019/contraception/options.aspx

Reminder: Brevinor 21 day and Brevinor-1 21 day were delisted on 1 July, 2020; Marvelon has been discontinued and stocks are depleted; a delisting date will be announced soon.

Rivaroxaban dosing with renal impairment altered

The NZF have updated rivaroxaban dosing recommendations in people with renal impairment following an update to the manufacturer’s data sheet. It can now be prescribed with caution to people with creatinine clearance of 15-29 mL/min. Previously, it was recommended that rivaroxaban be avoided in people with creatinine clearance 15–29 mL/minute who were taking this medicine for prevention of stroke and systemic embolism in atrial fibrillation or for the prevention and treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE).

For updated dosing recommendations and further information on prescribing rivaroxaban, see: https://bpac.org.nz/2018/rivaroxaban.aspx

Paper of the week: Cognitive behavioural therapy delivered electronically may be more effective than face-to-face consultations for patients with depression

Difficulty accessing face-to-face psychological therapy, e.g. cognitive behavioural therapy (CBT), is a problem in many countries including New Zealand, due to factors such as resource limitation, long waiting times, cost and geographical limitations. Increasing provision of electronically delivered resources, e.g. cognitive behavioural therapy (eCBT) has the potential to reduce barriers to access and increase adherence to treatment.

A systematic review and meta-analysis that included 17 studies (eight from the United States, three from Australia and the remainder from Europe) found that eCBT was more effective at reducing depression severity than face-to-face CBT. There was no significant difference in patient satisfaction between the two types of intervention. The review also looked at other outcomes including quality of life and global [overall] functionality but the results did not show any statistically significant differences.


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