16 DECEMBER 2015
CLINICAL DECISION RULES TO DECREASE UNNECESSARY USE OF MEDICAL IMAGING
The Royal Australian and New Zealand College of Radiologists (RANZCR) have taken the next step in support of their Choosing Wisely Australia® recommendations.
RANZCR Dean, Faculty of Clinical Radiology, Dr Greg Slater says the RANZCR clinical decision rules (CDRs) for the Choosing Wisely initiative will help clinicians with their decision making when they are considering a referral for imaging.
“The RANZCR Choosing Wisely Australia Recommendations and Clinical Decision Rules booklet and app for iOS supplement our six Choosing Wisely recommendations and support their implementation at the point of care. They contain the additional information required to inform dialogue between clinical radiologists and referring practitioners and their patients.
“The detailed, evidence-based guidance further progresses our strong commitment to the Choosing Wisely Australia initiative.The app is an innovative tool, providing easy access to the CDRs for clinicians via their smart phones.
“RANZCR is proud to have been one of the inaugural medical colleges to release recommendations through the Choosing Wisely Australia campaign. We encourage other colleges, societies and associations to get involved and take a lead on identifying tests, treatments and procedures that confer little or no health benefit to patients.”
CDRs help clinicians use evidence-based strategies to stratify patients into higher and lower risk for a given clinical condition, and this stratification helps to determine whether or not they would benefit from medical imaging.
The RANZCR Choosing Wisely CDRs focus on imaging for the following conditions:
- suspected lower limb deep vein thrombosis (DVT)
- suspected pulmonary embolism in pregnant and non-pregnant patients
- acute low back pain
- adult and paediatric ankle, cervical spine and head trauma.
Point of care decision aids are included in the booklet that will assist the clinician in quickly and efficiently applying the rules for the particular condition.
RANZCR’s Choosing Wisely Australia recommendations on imaging aim to achieve more appropriate health care, with less waste of healthcare resources on unnecessary diagnostic testing.
The RANZCR Choosing Wisely Australia Recommendations and Clinical Decision Rules booklet and app are available on the Choosing Wisely Australia website.
15 DECEMBER 2015
SEEK ADVICE ABOUT CHANGES TO COMMON OVER-THE-COUNTER MEDICINES AHEAD OF THE HOLIDAYS
NPS MedicineWise is encouraging people who are prescribed over-the-counter medicines to talk to their pharmacists and doctors about how the removal of some over-the-counter medicines from the Pharmaceutical Benefits Scheme (PBS) could affect them.
From 1 January 2016, 17 common medicines that are readily available over-the-counter and also through prescription will have their PBS listing altered or removed.
The listing changes will affect medicines used to treat a range of conditions, such as blood clot prevention, osteoarthritis-related pain, heartburn and reflux, eye infection, itchy skin and iron deficiency anaemia.
Some of the common over-the-counter medicines affected by the changes are:
* Astrix (aspirin)
* Spren 100 (aspirin)
* Panamax (paracetamol in 500mg tablet, 100ml liquid and 200 ml liquid)
* Panadol Osteo (paracetamol; 665g modified release tablets)
* Chlorsig eye drops (0.5%) and ointment (1%)
* Dulcolax suppositories (10 mg)
* Gaviscon P and Mylanta P.
The changes mean anyone currently prescribed any of these medicines by a doctor can no longer have a PBS script written for them and they cannot be purchased at a PBS-subsided price—the changes may also affect a patient’s PBS safety net threshold.
Dr Lynn Weekes, CEO of NPS MedicineWise says, “If you or someone you care about takes one of these over-the-counter medicines on medical advice, it is best to speak with your pharmacist or your prescribers as soon as possible so you know how the changes will affect you.
“These medicines are already available over-the-counter from pharmacies. As you move to purchasing these medicines ‘over-the-counter’ rather than relying on a prescription with labelled instructions, remember to ask questions about dosage and anything else you are confused about.”
Your doctor can write a private prescription for the medicine although this may be more expensive than an over-the-counter purchase. Some of the medicines will continue on the PBS for specific groups, such as people identifying as an Aboriginal or Torres Strait Islander person, paraplegic or quadriplegic individuals, or those receiving palliative care.
It is always a good idea to keep a complete list of your medicines both prescribed and over-the-counter and to share this with your doctor or pharmacist. The free MedicineList+ smartphone app is one tool that can help, for example by setting reminders and keeping track of medications for yourself or someone you care for.
Further information is available on the NPS MedicineWise website here.
For a full list of all the medicines and the proposed changes please refer to the PBS website.
For more information on prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a health professional, call NPS Medicines Line on 1300 MEDICINE (1300 633 424). Calls from mobiles may cost more. Hours of operation are Monday–Friday 9am–5pm AEDT (excluding public holidays).