4 June 2007

An editorial in the latest edition of Australian Prescriber discusses the extension of prescribing rights to nurses and other non-medical health professionals. Other articles examine:

• maintenance treatments for patients with bipolar disorders

• management of chronic obstructive pulmonary disease

• the use of metformin in pregnant and breastfeeding women

• medical management of dental and oral pain.

In his editorial Competency for new prescribers, Professor Anthony Smith, Newcastle Mater Hospital and University of Newcastle, discusses extending prescribing rights to non-medical health professionals. He discusses prescribing competency, and the need for adequate training and ongoing evaluation of non-medical health professionals prescribing within limited formularies to an appropriately high standard.

“The issue of prescribing extension brings into focus the competence of doctors and pharmacists – the current prescribers in our society,” says Professor Smith. “Prescribing worldwide is not uniformly of high quality (for example, over-prescription of antibiotics) and until recently training in prescribing has been inadequate.”

For patients with bipolar disorders, authors Dr David Pyle (Prince of Wales Hospital) and Professor Philip Mitchell (University of NSW) discuss various maintenance therapies.

“Bipolar disorders are highly recurrent for most patients, and it is the recurring nature of the condition that, unless adequately treated, gradually takes its toll in terms of the patient’s capacity to maintain relationships, career and self-esteem.”

Lithium is still regarded as the ‘gold standard’ therapy but many patients are unable to tolerate it, and it has limited effectiveness for the depressive phase of bipolar disorders. The authors also examine anticonvulsants including lamotrigine, antipsychotics such as olanzapine, and combination therapy.

The authors conclude that “while none of the newer drugs has been shown to be more effective than lithium, they are better tolerated by some patients”.

For the complete articles visit the Australian Prescriber website www.australianprescriber.com

ENDS

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 by the National Prescribing Service Limited (NPS), an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing. Australian Prescriber is distributed every two months in hard copy to health professionals, free of charge, and online in full text at www.australianprescriber.com.