Clinical Matters Newsletter August 2024 23 Aug 2024
Check out the latest clinical matters news in the August 2024 edition.
In this issue:
- Medicines update - OxyNorm has been discontinued
- Direct acting oral anticoagulants and potential for patients to experience mood changes
- Methylphenidate ER brands supply issues
- Changes to the status of invasive group A streptococcal infection (iGAS)
- Musculoskeletal Pathway National Rollout
- New format for sleep clinic letters
- New and updated Community HealthPathways
Medicines update - OxyNorm has been discontinued
Direct acting oral anticoagulants and potential for patients to experience mood changes
Medsafe is reviewing the risk of mood changes in individuals taking direct acting oral anticoagulant medicines. For more information, refer to Medsafe article https://www.medsafe.govt.nz/safety/Alerts/Direct_acting_oral_anticoagulants_and_mood_changes.asp
Monitoring closes February 2025
Methylphenidate ER brands supply issues
Pharmac has expected simultaneous supply outages for both methylphenidate ER brands. For more information including links to clinical guidance go to:
- Pharmac Medicine Notices https://pharmac.govt.nz
Changes to the status of invasive group A streptococcal infection (iGAS)
Kia ora koutou,
This email is to inform you about upcoming changes to the status of invasive group A streptococcal infection (iGAS).
On 5 August 2024, Cabinet approved adding iGAS to the list of notifiable infectious diseases under the Health Act 1956. Making iGAS notifiable creates new legal obligations on organisations that detect iGAS cases, or suspected cases, to report them to the relevant health authorities. These obligations will come into force from 1 October 2024.
While we already have well-established health measures in place for detecting, managing and treating iGAS in New Zealand, making iGAS notifiable will enhance the health system’s ability to monitor the disease and help develop more effective interventions and policies for reducing its impact on people’s health.
The Ministry of Health considers many factors in deciding whether to add a disease to “notifiable” list. These include:
- Severity of the disease
- How easily and quickly the disease can spread from person to person
- The quality and timeliness of existing data reporting about the disease
- The ability of the health system to intervene effectively based on notifications about the disease.
Health New Zealand is currently working on updating its guidance on how to report iGAS if detected as part of broader review on Communicable Disease Manual chapter on iGAS. These will be finalised before the notification comes into force and further details on implementing the notification changes will be communicated close to the time.
More information about iGAS, including causes and symptoms, can be found here.
Ngā mihi nui,
Office of the Deputy-Director General Clinical, Community & Mental Health
Te Pou Whakakaka
Manatū Hauora, 133 Molesworth Street Thorndon,
Wellington 6011
Musculoskeletal Pathway National Rollout
Please find attached a memo about the Musculoskeletal Pathway National Rollout.
Within the BOP, please continue to refer via the orthopaedic or COTS BPAC forms. Changes are in progress at Hauora a Toi BOP to enable first assessment, improve access, remove duplication and speed up care delivery.
New format for sleep clinic letters
We wish to advise that the sleep team have changed the way patient sleep assessments of obstructive sleep apnoea are documented at Hauora a Toi Bay of Plenty Health NZ. This has been in collaboration with the Te Manawa Taki (Midland) region, aiming to incorporate the documentation of assessments into a patient’s electronic clinical record.
Sleep assessments involve multiple patient visits across several specific clinics, meeting with various members of the sleep team. Formerly, each visit, test, or phone call generated a piece of paper which were manually scanned and added to the medical record as individual entries; all information was then transcribed into a clinic letter of several pages.
The new electronic sleep assessment form is held within the patient electronic record or Regional Clinical Portal (RCP aka Eclair). This living document is secure and audited and accessible for all members working within the hospital clinical system. Patients can be tracked using a dashboard, through their series of appointments, aiming to reduce delays between each appointment or step.
At the end of the assessment process, the completed final document is available for viewing on RCP. All the collated patient assessment notes, reports, questionnaires, diagnosis, and plan are available as a single document for hospital and community medical professionals. This has been a monumental shift in the way we work day-to-day. We are finding great gains each day, while also realising some shortcomings.
One area we have appreciated feedback is regarding the length and complexity of the finalised sleep assessment document. Much like the old clinic letters, the electronic sleep assessment form has subheadings, you can scroll to the Diagnosis > Plan > Important information for GP sections to view the most important outcomes for the patient.
Some small changes to these sections will occur at the end of August to reduce their complexity. We are also consulting with the regional Te Manawa Taki team on more substantial improvements to deliver targeted information to GPs.
We are always open to further feedback, you can reach us at sleep@bopdhb.govt.nz.
The Sleep Team
Hauora a Toi Bay of Plenty - Health New Zealand
New and updated Community HealthPathways
Go to HealthPathways Midland https://midland.communityhealthpathways.org
- Eczema (dermatitis) in adults
- Malaria
- Planning immunisation catch ups
- Managing swallowing difficulties
- Skin infections in children
- Cellulitis in children
- Recurrent staphylococcal infection
- Fitness to drive
- BCG vaccination
- Sexual assault