Aust Prescr
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Australia’s National Medicines Policy was launched 20 years ago with the aim of improving health outcomes for all Australians. It was developed in partnership with healthcare professionals, consumers and the pharmaceutical industry The key parts of the Policy focus on timely access to high-quality and affordable medicines and their safe and judicious use. It also supports a viable and responsible pharmaceutical industry Since the Policy was first launched, Australia has seen significant changes in healthcare systems, medicines subsidies, health services remuneration, digital technologies and the pharmaceutical industry Medicines themselves have also changed, as have consumers’ expectations. To respond to these changes, the National Medicines Policy needs to be updated with a greater focus on implementing and measuring outcomes
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Acute herpes zoster and associated postherpetic neuralgia is caused by reactivation of latent varicella zoster virus. It can be debilitating for older adults and interfere with activities of daily living A live, attenuated single-dose vaccine, that protects against both acute herpes zoster and postherpetic neuralgia, is available for free to all Australians aged 70 years, and in a catch-up program for those aged 71–79 years The vaccine is contraindicated in people who are immunocompromised, but can be considered in those who are receiving low doses of selected disease-modifying antirheumatic drugs Records of the Australian Immunisation Register suggest that only a third of 70 year olds received the vaccine in the first year-and-a-half of the program. This is likely an underestimation, but emphasises the importance of ensuring the vaccine is offered to all eligible patients and that vaccination is recorded on the Register A non-live recombinant herpes zoster vaccine has recently been developed which is more efficacious than the live vaccine in clinical trials. It is registered in Australia but not currently available
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Heart failure with preserved ejection fraction is a highly heterogenous disease. There is emerging evidence that treatment should be tailored to the individual’s associated comorbidities No current algorithms exist for the management of heart failure with preserved ejection fraction. Conventional therapies used in heart failure with reduced ejection fraction are yet to show a mortality benefit Key treatment objectives include control of hypertension and fluid balance Common comorbidities include coronary artery disease, atrial fibrillation, obesity, diabetes, renal impairment and pulmonary hypertension. These comorbidities should be considered in all patients and treatment optimised
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Drug interactions can lead to significant toxicity or loss of clinical effect. The risks increase with the number of drugs the patient takes General and specialised drug interaction resources are available. ⋯ It may be necessary to use multiple resources to find the information When assessing information about interactions, clinicians should evaluate the relevance for each patient. In high-risk situations, expert advice can be valuable Clinicians should report new or unusual drug interactions to the Therapeutic Goods Administration