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Published: 20 August, 2021


Primary care back to COVID-19 restrictions

The team here at bpacnz, several of whom also work in general practice, would like to acknowledge the efforts of all those who are working in primary care clinics, hospitals, pharmacies, vaccination and swabbing centres and other essential health services through this lockdown period. We have done this before, so "know the drill", however, there are some new challenges for primary care teams this time, including concerns about the increased risk of aerosol transmission with the more infectious Delta strain and balancing the need to both swab and vaccinate.

A reminder that resources for primary care from the Ministry of Health on managing suspected or confirmed COVID-19 cases can be found here.

Bowel cancer follow-up article now online

Following on from our 2020 article on investigating patients with features suggestive of bowel cancer, we have now published a second article in this series on the role of primary care in managing people who have been treated for bowel cancer. Follow-up and surveillance of people who have undergone curative treatment aims to improve outcomes through earlier detection of recurrence, which increases the chance that additional curative treatment can be offered. A number of different healthcare professionals may be involved in providing this follow-up and ensuring that the overall health needs of patients and their whānau/family are met.

A brief companion article discusses follow-up and surveillance for people with polyps and people with inflammatory bowel disease.

New statin to be funded for patients at high CVD risk

PHARMAC has announced that from 1 December, 2021, rosuvastatin will be funded with Special Authority Approval as a treatment for people with an increased risk of cardiovascular complications associated with high lipid levels. Māori and Pacific patients are specifically listed in the Special Authority criteria and can access funded treatment if they are “considered to be at high risk of cardiovascular disease” (CVD). Patients can also access funded treatment if they have a calculated five-year CVD risk of ≥15% and high lipid levels, despite treatment with atorvastatin and/or simvastatin. Any relevant practitioner can apply for the Special Authority funding.

Statins are the recommended first-line lipid-lowering medicine in New Zealand and international guidelines, with the decision to initiate depending on individual CVD risk, the potential benefit of treatment and the risk of adverse effects. Rosuvastatin is considered the most potent statin available and is associated with a comparable safety profile to other medicines in this class; conferring no greater risk of myopathy or serious renal injury when dosed appropriately.

For further information on prescribing statins, including dose equivalency, see:

Medsafe seeking feedback on dihydrocodeine

Last month (12th July, 2021) Medsafe issued a notice to the suppliers of dihydrocodeine (DHC) to provide evidence of the safety and effectiveness of this medicine. This is part of an overall review from Medsafe and the Medicines Adverse Reaction Committee (MARC) on the risks of misuse and dependence with opioids. As part of this review, Medsafe is seeking feedback from health care professionals and patients on the use of dihydrocodeine. This may include reports of adverse effects, risks and concerns, as well as benefits. Read more about this here, including how to submit a response.

Addressing COVID-19 vaccine hesitancy - new Goodfellow podcast

The team at the Goodfellow Unit have just released a new 30-minute podcast with Dr Nikki Turner from the Immunisation Advisory Centre, that discusses reasons and potential solutions for people with vaccine hesitancy. Note that the podcast was recorded prior to the current re-emergence of community transmission of COVID-19.

Paper of the week: five-minute concussion test

Doctors and researchers at the Children's Hospital of Philadelphia (CHOP) have spent many years developing and perfecting a clinical assessment tool for identifying concussion in children and adolescents: the visio-vestibular examination (VVE). It can be performed in under five minutes, in any setting, including virtually, by any health care professional or even a sports coach. Read an interview about the tool here with lead researcher Dr Daniel Corwin. This includes a link to the tool and instructional video.

This Bulletin is supported by the South Link Education Trust

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