Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
New Choosing Wisely pharmacy recommendations
New Choosing Wisely pharmacy recommendations
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More than 40 New Zealand pharmacists have worked together to develop new Choosing Wisely pharmacy recommendations.
Choosing Wisely is a global initiative promoting a culture where low value and inappropriate clinical interventions are avoided, and patients and health professionals have well-informed conversations about their treatment options, leading to better decisions and outcomes.
Initially the group of New Zealand pharmacists reviewed recommendations from other pharmacy groups world-wide. They then narrowed them down to the ones they believe work in a New Zealand context and would have the most impact.
The new recommendations for pharmacists include:
- Not recommending complementary medicines or therapies without reviewing the patient’s medicine regime to assess for safety and ensure the benefit of use outweighs the risk.
- Question repeated prescription of over the counter (OTC) supply of a NSAID, colchicine and or prednisone for the acute treatment of gout. Ensure patients who suffer from gout are managed appropriately with a urate lowering agent (eg, allopurinol or febuxostat).
- Identify and ensure at-risk patients are not exposed to ‘the triple whammy’ – a diuretic plus ACE-I or ARB and a NSAID or COXIB.
- Do not dispense regular opioids without checking the requirement for laxatives.
More information about the rationale for these recommendations, including how they were developed, is available on the Choosing Wisely website.