Clinical Matters Newsletter - May 2021 21 May 2021

Welcome to the May 2021 Edition of Clinical Matters!

In this issue...

Hepatitis C Update

The highly-effective hepatitis C drug Maviret was released in NZ in 2019. This drug offers a very high cure rate for people with hepatitis C. The Midland Hepatitis C service is now calling on GPs to help identify more people with hepatitis C.

See here for contact details and an update on how to refer to the Midland Hepatitis C service.

Updated Polyp Surveillance Guidelines

Please click here for a recent update (2020) on surveillance of polyps. In a nutshell, this is what it now looks like:

Updated Guidelines on COVID Vaccination for Cancer Patients

Please click here to read the Updated Guidelines on Covid Vaccination for Cancer Patients.

Now Live: Tautoko Mai Sexual Harm Support Service Electronic Referral

The Tautoko Mai Sexual Harm Support Service now has an electronic form available via Best Practice.
 
The service is available to any person and their family who has been sexually harmed. This is a very broad term and encompasses a continuum of harm from emotional through to physical rape. The harm is defined by the person experiencing it.
 
They provide FREE crisis counselling and social work services, medical services (forensics, consultations and paediatric clinics), longer term ACC therapy, and prevention and training in the area of sexual violence.

They provide a 24/7 service and have staff on call after hours to take phone call referrals and answer queries.
 
PLEASE NOTE: If the assault has occurred within the last seven days please telephone the team on 0800 227 233 as well as making the referral as timing of forensic exams can be critical.

Empagliflozin: Do you Feel Confident Prescribing This Newly Funded Oral Hypoglycaemic Medication?

You are probably aware of the newly funded SGLT2 inhibitor empagliflozin – but are you aware of:

• The additional benefits of prescribing it to patients with diabetic renal disease, heart failure or cardiovascular disease?
• The Special Authority criteria?
• Where it fits with other, established treatments?
• Rare side effects such as atypical normoglycaemic diabetic ketoacidosis, or Fournier’s gangrene?

 
The New Zealand Society for the Study of Diabetes has created a new treatment algorithm for the treatment of type 2 diabetes mellitus – you can find it here.
 
There is also a comprehensive section on SGLT2 inhibitors including what to tell your patients – you can find it here.

Post-Menopausal Bleeding - New Dual Gynaecology/Radiology Electronic Referral Form Available

Referrals to the gynaecology team for post-menopausal bleeding always need to be paired with a pelvic ultrasound to assess endometrial thickness, historically necessitating the completion of two separate electronic referral forms.
 
However, this is no longer the case as a new Best Practice form has been created specifically for post-menopausal bleeding. This has the facility to generate a radiology request for ultrasound as part of the gynaecology referral.
 
Please contact the GP Liaison team with any queries at baynav@bopdhb.govt.nz.

Please Check Grading Letters for Custom Messages from SMOs

With the advent of eTriage at BOPDHB, hospital specialists can now add custom messages to their grading outcomes. These are printed below the grading decision and may contain vital information. Please make sure you check for these messages before filing grading letters.

National Bowel Screening Programme Session

• Understand the importance and impact of bowel screening
• Know the eligibility criteria and processes required and the role of General Practice
• Understand the impact of bowel screening on Māori health and the potential for reducing Māori health inequities

Midland HealthPathways Update

New pathways for GPs on HealthPathways
The following pathways are now live on our HealthPathways site for you to use:

• Insulin for Type 2 Diabetes
• Non-insulin Diabetes Medications
• Pre-pregnancy Diabetes Planning

And remember there is up-to-date information on all matters Covid-19 for primary care on Health Pathways, including national as well as local information.

HealthPathways is a collection of management guidelines specifically tailored to primary care.  Our GP Liaison team is in the process of 'localising' these pathways to the Bay of Plenty, i.e, making them relevant to GPs and other primary care providers specifically in the Bay of Plenty.  You'll find valuable pointers on history, examination, treatment and of course when and how to refer patients on to other services.  These pathways will, over time, be replacing the Bay Navigator pathways

Dr Chris Tofield, Dr Dan Jackson, and Dr Paula Taylor

Click here to email the Bay Navigator team