News in brief: PBS to drop restrictions on clopidogrel antiplatelets; Consultants must act on junior doctor wage theft; Blood transfusion must go digital

PBS to drop restrictions on clopidogrel antiplatelets

The PBS listings of clopidogrel and clopidogrel with aspirin should be changed from Authority Required (STREAMLINED) to unrestricted listings, the Pharmaceutical Benefits Advisory Committee has recommended.

In its December 2021 meeting the PBAC said it had taken note of clinician feedback regarding the barriers that the current Authority Required (STREAMLINED) listings present in certain circumstances and how the place in therapy of clopidogrel has evolved over time.

“The PBAC considered that unrestricted listings would reduce the burden for prescribers and enable better access for patients in need of anti-platelet therapy,” it said.

The unrestricted listings will apply to clopidogrel 75mg tablets  and clopidogrel 75mg/aspirin 100mg tablets.

Consultants must act on junior doctor wage theft

Hospital consultants are being urged to help stop public hospital ‘wage theft’ from junior doctors.

An article in MJA Insight says that doctors-in-training are deterred from claiming overtime for fear of being labelled inefficient, incompetent or greedy. Since claims must be signed off by a consultant who usually act as a referee for the junior doctor’s reappointment, these senior clinicians are in a key position to help prevent the chronic underpayment of doctors-in-training, writes Dr Leanne Rowe. They must also support junior staff access to entitlements such extra shift allowances, on call penalties, breaks and training periods, she says.

“Senior consultants must urgently re-examine how they manage legitimate claims for the basic pay entitlements by subordinates, as well as notifying public hospital management of the need for adequate funding for payroll,” she writes.

“Continuing to expect junior doctors to perform significant additional volunteer hours in the presence of many other serious occupational health and safety issues is not only grossly unjust – it’s criminal,” she concludes.

Blood transfusion must go digital

Digital systems are needed for blood transfusion in Australia according to haematologists who say processes such as transfusion ordering and administration could benefit from inclusion in electronic medical records (EMRs) and data analysis.

“There is opportunity to improve the safety, quality and efficiency of transfusion practice, particularly through decision support and better identification procedures, by incorporating transfusion practice into EMRs,” they write in Vox Sanguinis.

However, the authors led by Dr Philip Crispin of the Clinical Practice Improvement Committee of Australian and New Zealand Society of Blood Transfusion, warn that clear guidelines and careful development will be needed for digital systems in blood transfusion to address challenges such as patient identification, multiple incompatible software systems and ‘alert fatigue’.

“Just as blood bank information systems have transformed blood issuing through the electronic cross-match, widespread adoption in clinical areas is expected also to improve safety and efficiency,” .

“Guidelines have been developed by the profession for blood banking systems in order to drive change appropriately in the laboratory. Guidelines for EMRs to facilitate clinical transfusion should likewise signpost the future of digitally assisted practice improvement.”

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