June edition of Australian Prescriber out now
3 June 2013
Opioid substitution therapy with methadone, buprenorphine, and buprenorphine with naloxone, is a highly effective component of the management of opioid addiction, according to Dr Michael McDonough from Western Hospital, Melbourne. Although he adds that this form of therapy is not suitable for every patient and should only be used as part of a comprehensive strategy to support a patient’s recovery from addiction. Importantly, such treatment reduces morbidity and mortality. Dr McDonough says opioid substitution therapy is not only of benefit to individual patients but also has proven public health and community benefits (such as reduced drug-related crime), but more prescribers need to be involved in the programs.
‘Statins’ are the most commonly used drugs for lowering cholesterol and are taken by more than 40% of Australians over 65 years of age. However their benefits need to be balanced against the risk of adverse events in older people. According to Associate Professor Sarah Hilmer and Dr Danijela Gnjidic of the University of Sydney, statins reduce vascular events and mortality in people over 65 with heart disease, but the risk of adverse events such as myopathy and cognitive impairment is increased. The article summarises the evidence for the benefits and risks of statins, and outlines when withdrawal of statins may be appropriate.
Dr Clayton Chiu and Professor Peter McIntyre of the Children’s Hospital at Westmead Hospital in Sydney write that universal vaccination of Australian children with the pneumococcal conjugate vaccine has substantially reduced invasive pneumococcal disease. There has also been a benefit in adults. The article outlines the recent Australian recommendations for pneumococcal vaccinations in children and in adults, and explains the introduction of updated versions of the vaccine which are expected to lead to a further reduction in disease.
Shared electronic health records are increasingly seen as having a key role in helping informed patients become active partners in their own health care. James Reeve and Yvonne Allinson of NPS MedicineWise and Victorian GP Robert Hosking examine the first steps that have been taken towards a personal electronic health record in Australia. They write that some significant challenges have already been overcome but there are more ahead. The key to success will be a common understanding of the purpose and potential of the new system, and long-term commitment from patients, clinicians and funders.
Other articles in this edition of Australian Prescriber include
To read the full articles and more visit www.australianprescriber.com
Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published every two months and distributed to health professionals free of charge, and is also available online at www.australianprescriber.com