Medicinal use of cannabis products
Recent changes to legislation around medical cannabis, as well as media coverage of the issue, have created a perception of easy access to cannabis products. GPs may now experience greater patient demand to prescribe cannabis-based medications.
To address this, the RACGP position statement on the medicinal use of cannabis products has been developed to outline the RACGP's position on prescribing medicinal cannabis products in general practice, the challenges GPs face, the current evidence and the legal framework in Australia.
The current evidence-base for the use of cannabis-based medicines is still emerging, and these products can be prescribed only under strict protocols. As is the case with all medications, cannabis products must be approved or registered through the Therapeutic Goods Administration (TGA) before they can be prescribed.
Visit the RACGP website to view the RACGP position statement on the medicinal use of cannabis products.
Your feedback sought on Redesigning the Practice Incentives Program
The Department of Health (DoH) has released a consultation paper seeking stakeholder feedback on the redesign of the Practice Incentives Program (PIP).
The stated intention of the redesign is to reduce the administrative burden associated with multiple PIP payments. A Quality Improvement Incentive will replace seven of the 11 incentives in the current PIP. Funding for PIP will remain unchanged from current levels.
The RACGP is seeking your feedback on the key questions and preliminary redesign options raised in the consultation paper.
The RACGP consultation period closes on Wednesday 9 November, and your feedback can be provided via the RACGP consultations page.
The DoH is offering a series of stakeholder forums and webcasts across the nation in November 2016. Additional information regarding attendance at one of these forums can be found on the DoH Consultation Hub.
The National Shingles Vaccination Program 2016
The National Shingles Vaccination Program will commence from 1 November 2016. People eligible to receive the free shingles vaccine include:
- people aged 70 years of age as an ongoing program.
- people aged 71-79 years of age as a catch-up program until 31 October 2021.
People who are not eligible to receive the vaccine as part of the program can purchase the vaccine on the private market.
Providers should submit shingles vaccination data to the Australian Immunisation Register (AIR) – to ensure capture of whole of life data on immunisation.
Copies of promotional materials, additional resources specifically for Aboriginal and Torres Strait Islander people, and translated brochures for people from non-English speaking backgrounds are available on the Immunise Australia website.
New and amended Medicare Benefits Schedule listings
New and amended listings on the Medicare Benefits Schedule (MBS) will take effect on 1 November.
The changes pertain to services for addiction medicine, sexual health medicine, retinal photography and circumcision.
- 15 new items will be listed on the MBS for patients of addiction medicine specialists, as part of the Government’s response to the findings of the National Ice Taskforce
- 16 new items will be listed for patients of sexual health medicine specialists
- Two new items will be available to cover testing of diabetic retinopathy with a non-mydriatic retinal camera
- Four existing circumcision items (30653 – 30660) will be replaced with two new items; one for circumcision procedures performed under general or regional anaesthesia and one for all other circumcision procedures.
These changes were announced in the 2016-17 Federal Budget and are the result of recommendations by the Medical Services Advisory Committee (MSAC) or consultation with stakeholders, including the RACGP.
The full list of changes is now available to download on the MBS website.
International Medicine in Addiction Conference 2017
The 4th International Medicine in Addiction Conference, IMiA17 will be held at the new Sydney International Convention Centre (ICC Sydney) from 24–26 March 2017.
The RACGP has collaborated with The Royal Australian and New Zealand College of Psychiatrists (RANZCP) and The Royal Australasian College of Physicians (RACP) to host IMiA17, the premier addiction conference for medical practitioners and allied clinicians in Asia and Oceania.
The conference brings together a wide range of local and international medical professionals who specialise in treating addiction.
Early bird registrations are now open with discounted rates available until 12 December 2016.
IMiA17 is seeking abstracts on the themes of ‘Comorbidity, Education, Neuroscience, Prevention, Policy and Treatment’.
The call for abstracts has now been extended to 11 November 2016.
More information and the preliminary program is now available on the IMiA17 website.
Clinical Pearl
Investigating fatigue
In a patient with fatigue, avoid performing multiple serological investigations, without a clinical indication or relevant epidemiology.
Fatigue is a very common presentation to the GP. Presentations of fatigue lead to high rates of test ordering, but serious somatic disease is uncommon. One Australian study found that only 16% of tests returned abnormal results, leading to a ‘significant clinical diagnosis’ in only 4% of patients.
In 2011, Australian guidelines for the investigation of fatigue were published by the Therapeutic Guidelines. These recommend a comprehensive history and examination, consideration of the pre-test probability, a period of watchful waiting in the absence of red flags, and the judicious use of tests if the decision to investigate is made. The importance of appropriate follow-up was also highlighted.
In patients with unexplained or persisting fatigue, the guidelines recommend a limited number of tests (urinalysis, FBC, BGL, TSH, EUC, LFT, ESR/CRP). Over-testing is not only unhelpful, but it can lead to false positive results and subsequent unnecessary further investigations and treatments.
For more information, visit Choosing Wisely Australia.
In Practice poll
Mental Health Nurse Incentive Program
The Mental Health Nurse Incentive Program (MHNIP) provides a non-MBS incentive payment to community based general practices for a mental health nurse to assist in the provision of coordinated care for people with severe mental disorders.
Funding for the MHNIP was transferred to PHNs on 1 July 2016.
The RACGP is seeking input from members about the impact of this funding shift on their practice and patients. The following link is to a brief poll seeking your input: MHNIP Poll.