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Published: 14 May, 2021


eBPJ articles now online

All of the articles from our most recent edition of eBPJ are now loaded on our website as individual resources. You can read the articles on your desktop or mobile device, make a new comment or join a discussion thread and download or save as a pdf version. To check out all our new arrivals, click here.

Antidepressants article revised

We have completed a revision of our 2017 article on the role of medicines in the management of depression in primary care. Non-pharmacological interventions are the mainstay of treatment for patients with depression. The addition of pharmacological treatment is usually appropriate for patients with moderate to severe depression or if other interventions have been inadequate. We offer guidance on how to select from the range of funded antidepressant medicines, depending on the patient's specific needs.

As with all our revised articles, this article contains a box at the beginning to highlight key information that has been updated.

No new patients on cilazapril

A reminder that, as of 1 May, no new patients should be prescribed cilazapril and all existing patients who remain on cilazapril require their prescription to be endorsed. If a clinician has not endorsed the prescription, pharmacists are able to annotate the prescription provided there is a record of a recent prescription for that patient. See more information from PHARMAC here.

We have revised our article "Prescribing ACE inhibitors: time to reconsider old habits" to reflect these changes, and updated guidance on selecting an appropriate alternative. ARBs are now recommended as a first-line alternative to ACE inhibitors for many indications and are significantly less likely to cause cough.

Latest medicine supply issues

The following medicine supply issues have been advised by PHARMAC:

  • All formulations of cetomacrogol with glycerol cream are out of stock due to shipping delays. An alternative product (Pharmacy Health sorbolene with glycerin, 500 ml) is listed from 10 May, 2021
  • From June, 2021 to mid-2022, flumetasone pivalate (Locorten-Vioform) ear drops will be out of stock due to problems with the active ingredients. PHARMAC advises that Triamcinolone acetonide with gramicidin, neomycin and nystatin (Kenacomb brand) ear drops are a suitable alternative.
  • Salbutamol with ipratropium bromide (Duolin) inhalers remain out of stock. Although there have been batches of Duolin recently manufactured, there are quality control issues at the point of manufacture in India. Patients have been advised to use two inhalers (salbutamol and ipratropium) and the existing pharmacy co-payment charge for ipratropium will continue to be waived until 30 June, 2021, i.e. patients are charged one co-payment only.

More than just a jab: findings from the Māori Influenza Vaccination Programme

In 2020, as part of the COVID-19 Māori health response, a programme was implemented that focused on addressing barriers and improving influenza vaccination rates among Māori. The programme was successful in its objectives and provides a model for organisational change. A report outlining the programme and its findings is now available on the Ministry of Health website.

Paper of the week: New NICE guideline on atrial fibrillation

The National Institute for Health and Care Excellence (NICE) has just published a new guideline on the diagnosis and management of atrial fibrillation (AF). This is an update of the 2014 NICE guideline and addresses a number of areas where new evidence had become available, such as a new tool for assessing bleeding risk.

It is uncertain at this stage how these recommendations might affect clinical practice guidelines in New Zealand. We will assess any implications and provide further comment in our freely available Primary Care Update series topic on AF.

This Bulletin is supported by the South Link Education Trust

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