PBS changes improve access to antiplatelet therapy

The easing of PBS restrictions for clopidogrel will reduce prescribing barriers for antiplatelet therapy in primary care, according to NPS MedicineWise
From 1 May 2022 the restrictions in the General Schedule (S85) for clopidogrel and clopidogrel with aspirin changed from Authority Required (Streamlined) with multiple codes to unrestricted listings.

The change means that GPs can now prescribe antiplatelets within their scope of practice, according to clinical evidence and evidence-based guidelines, an article in Radar stated

The previous listings required prescribers to select the correct streamlined authority codes for clopidogrel or clopidogrel with aspirin from a list of numerous codes.

According to NPS MedicineWise, the latest evidence encouraged individualised consideration of the antiplatelet agents for dual antiplatelet therapy, with DAPT having been shown to be efficacious in patients with acute coronary syndrome, regardless of the clinical setting (STEMI or NSTEMI) and the management strategy (conservative treatment, percutaneous coronary intervention or coronary artery bypass graft).

Rethink needed on organ donor BBV risk assessment

The methods currently used to screen  potential organ donors for risk of blood borne viruses (BBV) are likely ineffective and could be replaced with routine post-transplant recipient screening, Australian research suggests.

A review of BBV risk  in 3650 potential organ donors on a national database between 2014–2020 showed that the prevalence of HIV, Active HBV and Active HCV was 0.16%, 0.9%, and 2.2%, respectively.

The rates for HBV and HIV were similar to the broader community while HCV rates were slightly higher, according to researchers from the Royal Melbourne Hospital, and the Australian Organ and Tissue Authority, Canberra.

However behavioural transmission risks as assessed by questionnaire were poorly predictive of HIV and HBV, they noted.

“Rather than pre-transplantation behavioural risk screening, routine post-transplant recipient screening may provide a more powerful tool in mitigating the consequences of unexpected viral transmission.

“The more logical approach seems to be undertaking nucleic acid testing in all recipients so that in the uncommon event of donor derived BBV infection it is detected and able to be treated before there are clinical ramifications,” they wrote in Transplantation International

Record number of doctors elected to parliament

The number of doctors in Federal Parliament has risen to four, with specialists, GPs and emergency doctors all gaining seats for the first time.

Perhaps the biggest headline to come out of Saturday’s election was the victory of paediatric neurologist Professor Monique Ryan over sitting Liberal MP and Federal Treasurer Josh Frydenberg in the Melbourne division of Kooyong.

Mr Frydenberg conceded on Monday, with Professor Ryan leading by more than 6,000 votes.

Professor Ryan, who had previously served as director of the neurology department at the Royal Children’s Hospital, Melbourne, ran as one of the so-called Teal Independents, receiving funding from the Climate 200 group.

“We’ve started because we wanted action on climate change and we felt that it was the most important challenge of our time,” she told supporters on Saturday night.

“It bloody well is. Our government wasn’t listening to us so we have changed the government.”

Fellow Teal Independent Dr Sophie Scamps also enters parliament for the first time in the Sydney seat of Mackellar, where she lives and works as a GP.

And infectious diseases physician Dr Michelle Ananda-Rajah has won the blue ribbon Melbourne seat of Higgins for Labor, unseating Liberal MP and fellow specialist, Dr Katie Allen.

Dr Ananda-Rajah rose to prominence last year after publicly criticising the Federal Government’s vaccine rollout, controversially declaring the AstraZeneca COVID-19 vaccine had “failed in terms of its efficacy” on the ABC’s Q+A program.

Her campaign focussed on action to tackle climate change and a stronger response to the pandemic.

The other doctor elected for the first time was Dr Gordon Reid, who became the Labor MP for Robertson, on the NSW Central Coast.

A Wiradjuri man, he said he had been inspired to run while working in the emergency department at the local Wyong Hospital by the bungled vaccine rollout and quarantine program.

Dr Reid said he planned to dedicate his parliamentary work to improving healthcare as well as protecting the Central Coast economy and addressing housing affordability.

Paediatrician Dr Mike Freelander retained the Sydney seat of Macarthur for Labor.

However, cardiologist Dr Michael Feneley, who ran as the Liberal candidate for the NSW electorate of Dobell, was unsuccessful in unseating Labor’s Emma McBride.