Generic prescribing now the rule
New PBS rules requires medicines to be prescribed by active ingredient name rather than by brand name, except for a few exemptions. From 1 February, the Active Ingredient Prescribing policy requires the inclusion of active ingredients on all PBS and RPBS prescriptions, except for handwritten prescriptions; paper based medication charts in the residential aged care sector; products containing four or more active ingredients; and certain items where brand names should be specified for safety or practicality reasons – such as EpiPens. The exempt items are listed on the List of Medicines for Brand Consideration. The Department of Health says prescribers can still prescribe medicines by brand if clinically necessary, and the brand name will appear after the active ingredient. A prescriber may also still choose to disallow brand substitution. The changes will be incorporated into prescribing software but this cannot be set to automatically include brand names for every prescription.
UC impact on life needs discussion
Ulcerative colitis has a major impact on a patient’s life and daily activities, even when in remission, but the emotional and mental health aspects of the disease are often not covered during consultations with gastroenterologists, a study has found. A global survey of more than 2000 patients and 1200 clinicians – including Australian participants – found that patients reported a diagnostic delay of two years and most patients (65%) and many were still experiencing flares and had poor general health, despite what they though was good care. UC caused disruption of daily activities and absence from work, with many patients not disclosing their condition to their employer for fear of repercussions. The study investigators said discussion of the emotional impact of UC should be more of a priority for physicians.
Organic or functional? A new rule in tool for GI disease
A clinically useful rule-in algorithm for identifying patients with organic gastrointestinal disease has been developed by Australian clinicians for use in specialist referral centres. Based on the SAGIS questionnaire related to key GI and extraintestinal symptoms, the tool provided good discrimination of organic from functional diagnoses (AUC = 0.75), when evaluated by Professor Gerald Holtmann and colleagues at the Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane. However it proved to have poor function as a rule out tool, they reported in Neurogastroenterology & Motility. Nevertheless, the SAGIS instrument could be used in outpatient clinics by staff to identify patients with probable organic disease to warrant further investigation, they suggested.