Watch the August clinical update from Jo Scott-Jones joined by Dave Maplesden, Pinnacle GP liaison in this 33 minute video. (Written version below.)
Clinical snippets are now available as a podcast too! Search on your favourite podcast platform for The New Zealand General Practice Podcast to listen, or click here to listen on Anchor.
The Assisted Dying Service – Ngā Ratonga Mate Whakaahuru annual report has recently been released covering the period 7 November 2021 to 31 March 2022. Between those dates 206 people formally applied for assisted dying. As of 31 March:
A recent edition of the BMJ contained a meta-analysis and systematic review of 42 clinical trials looking at fever therapy in febrile adults. The trials assessed antipyretic medicines (mainly paracetamol and ibuprofen), physical cooling and combination treatment v.s. no fever treatment or placebo, in patients with fever who were critically ill, non-critically ill, with and without infectious illness. There was no evidence that fever therapy reduced the risk of death or the risk of serious adverse events; conversely there is no evidence that fever therapy increases these risks. There was insufficient evidence to determine whether fever therapy influences quality of life or non-serious adverse events – we can’t even say for certain that at least it will make the patient feel better!
A 2020 systematic review and meta-analysis on use of antipyretics for preventing recurrence of febrile seizures in children concluded there was weak evidence suggesting a possible role in preventing febrile seizure recurrence within the same fever episode but there is clearly no role for antipyretic prophylaxis in preventing febrile seizures during distant fever episodes.
It is important to have a working knowledge of prescribing options, and pre-prescribing assessment and surveillance/follow-up requirements. There are multiple useful resources available to assist with this: