Published: 25 March, 2022
Contents
New article: An overview of medicinal cannabis for health practitioners
On 1 April, 2020, the Medicinal Cannabis Scheme came into effect, which is intended to improve access for patients to quality medicinal cannabis products. For most health professionals, medicinal cannabis was not a focus of their conventional medical training, and therefore there is much uncertainty and questions about the risks and benefits, and when and how it should be prescribed.
We have published a new resource, supported by the Ministry of Health, aiming to provide health practitioners with an overview of these regulatory changes, the potential indications, as well as safety and prescribing considerations. While medicinal cannabis is not a first-line treatment for any condition, this information may improve prescriber confidence if a shared decision is made to trial medicinal cannabis.
A quick reference card, case study, clinical audit and peer group discussion for prescribers are included in the resource package.
Read "An overview of medicinal cannabis for health professionals".
Guide for pharmacists coming soon
A follow up guide for community pharmacists, along with a peer group discussion, will also be released soon. This guide complements the other resources, and more specifically focuses on the role of the pharmacist in procuring and dispensing medicinal cannabis products.
All Sorts campaign to promote mental wellbeing
The Ministry of Health in conjunction with the Mental Health Foundation has launched a campaign which runs through to July, 2023, to promote mental wellbeing and provide support throughout the COVID-19 pandemic. A new website, All Sorts, has been developed as part of the campaign – here you can find resources, tips and advice to help people take care of their wellbeing during these challenging times.
Some of the resources include:
Reminder about extension to driver relicensing
The heavy COVID-related workload and the impact of staff illness or isolation on day-to-day life in General Practice is taking its toll. Many General Practices are not able to offer “business as usual”. Consultations for driver’s medicals are one of the many tasks that fall within this scope. A reminder that at the end of 2021, it was announced that people with driver licences and licence endorsements that have expired or are due to expire (on or after 21 July, 2021) are extended until 31 May, 2022.
Further information about temporary extensions is available on the Waka Kotahi NZ Transport Agency website.
Seeking feedback: when another person is present during a consultation
The Medical Council of New Zealand is reviewing their existing statement “When another person is present during a consultation” and has issued a consultation to seek feedback on proposed changes. Having another person, e.g. support person, interpreter, observer, trainee or chaperone, present during the consultation can affect the dynamics of the treating relationship and what information the patient shares.
The draft statement has a stronger emphasis on obtaining patient consent prior to the consultation starting and ensuring the role and level of involvement of the person attending the consultation is understood, compared to their existing statement.
The consultation closes on 22 April, 2022. You can submit your response here.
ESR seeking pregnant women in Wellington for study
The WellKiwis Infant study, led by researchers from ESR, is seeking to enrol pregnant women in Wellington, especially from Māori, Pacific and Asian families. The WellKiwis study is aiming to discover how more effective vaccinations can be developed for influenza and other viruses for children from all ethnicities. This is achieved by researching an infants first exposure to viruses and looking at how "immune imprinting" creates long-lasting immunity when they subsequently encounter the virus again. Consider discussing this study with eligible patients; a good time may be during influenza vaccination.
To read more about the WellKiwis Infant Study, visit: https://www.wellkiwis.co.nz/infant-study/
Paper of the Week: Gone to the dogs
We felt like we needed something a little more light-hearted for our paper of the week, and who doesn’t love dogs!
A recently published controlled trial conducted in an emergency department in Canada found that patients had significant improvements in pain, anxiety, depression and general wellbeing after a ten-minute visit from a therapy dog, compared to those who were not fortunate enough to be chosen for the canine companionship. The dog didn’t take credit for the entire outcome, as this was of course conducted in addition to usual care from the human health professionals.
The conclusion is that obviously every consultation waiting room needs a pup to calm the patients. The only question that remains for further study is whether a Border Collie would be more or less reliable than a Labrador?
Main findings
- Therapy dogs first started visiting the Royal University Hospital ED in Saskatoon, Saskatchewan in 2016 to distract patients from long wait times; now more than eight EDs across Canada have therapy dogs
- The study was conducted in Royal University Hospital ED. There were 198 participants in the study with no differences in age, gender or ethnicity between the control and intervention groups.
- Patients were assigned to intervention or control groups based on the day of the week so there was no cross-over with the dogs
- Data was collected for the intervention group immediately before the 10-minute dog visit, immediately after and 20 minutes later; data was collected for the control group twice, with a 30-minute interval
- The dog visiting protocol included meeting the dog, learning information about the dog, asking about the patients pets and getting a "trading card" of the dog to take away
- Pain severity, anxiety, depression and general wellbeing were measured with 11-point numeric rating scales
- Physiological measures were taken of heart rate and arterial blood pressure
- Participants in the therapy dog group rated pain significantly lower than those in the control group at the post-intervention measurement, with no differences between gender
- Participants in the therapy dog group rated anxiety significantly lower than those in the control group at the post-intervention measurement; there was a slight difference between genders with males rating a greater improvement in anxiety with the dog therapy
- The therapy dog visits did not have any significant effect on the physiological measures, i.e. blood pressure and heart rate; this was possibly confounded by participants in the intervention group being excited by the dogs visit and therefore increasing their heart rate
Carey B, Dell C, Stempien J, et al. Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department. PLOS One. March 9, 2022. https://doi.org/10.1371/journal.pone.0262599
This Bulletin is supported by the South Link Education Trust
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