Primary healthcare news, information & resources

What we've been reading - August 2017

Keeping up with medicine is made easier when we share clinical stories with our colleagues. On this page we share brief learnings and articles that have interested our GP liaison team during the month of August.

Genomics and gastro - just your usual holiday reading!

Dr Jo Scott-Jones, medical director for Pinnacle MHN has been keeping up with his reading while on leave in the Northern hemisphere.

Genomic and Precision Medicine - Primary Care

3rd edition, edited by Sean P David and published by Academic Press

The human genome was completely mapped 14 years ago and since then it has become cheaper and quicker for researchers to analyse and create meaningful information about associations between specific gene sequences and disease, and increasingly to understand links between or genetic profile and how we respond to medications. 

Currently there are over 130 medications that the FDA recommend are used with guidance from genetic sequencing - it's an area of medicine that will become more important over the next 3-5 years. This is a domain that is full of snake oil salesmen and ethical pitfalls and I look forward to helping disseminate good information through the Pinnacle network in the future. 


Dr Alan Fraser is a gastroenterologist in Auckland and has over 130 research papers under his belt - his website is stuffed full of great information on everything from IBS to Hepatitis C. Check it out at

Infant immunisation: negative messages more influential than positive

The University of Auckland Centre for Longitudinal Research - He Ara ki Mua has published findings from its study on infant immunisation. The study, part of Growing Up in New Zealand, interviewed 6,182 pregnant women on the information they received about infant immunisation during their pregnancy.

The study found that infant immunisations are more likely to be delayed if women receive information during pregnancy that discourages infant immunisation. There was no effect on the timeliness of infant immunisation if they received encouraging information about immunisation or no information at all. The main sources of immunisation information identified were health care providers (35 per cent), family and friends (14 per cent) and media (14 per cent).

Less than half (44 per cent) of the women interviewed recalled having any information about the immunisation of their future children. Thirty per cent said they received both encouraging and discouraging advice and five per cent received only discouraging information. One in six women received discouraging information on immunisations from their health care provider.

Of the women who did not recall receiving any information during pregnancy, 70 per cent of their infants were immunised on time, compared with 57 per cent of infants of women who received discouraging information and 61 per cent of infants of women who received both encouraging and discouraging information.

For national immunisation programmes to have the best results, children need to receive scheduled vaccinations on time.

Pinnacle MHN works alongside the Ministry of Health's National Immunisation Register and Schedule to encourage and facilitate timely immunisation for children through its Child and Youth Health Coordination Service (Cay-C).

Providing pregnant women with immunisation information is critical. Visit itsmyhealth for more information on the Cay-C team and immunisation. Do you feel your practice has what it needs to talk to pregnant woman about the immunisatin programme? If you have ideas on resources that might help we'd love to hear from you, email Andrew Swanson-Dobbs, general manager, practice and network services.

Read the full press release on the study's findings here.

Pre/post-splenectomy care by Dr Dave Maplesden

Dr Dave Maplesden works with Waikato practices and supports the PHO network through his special interest in quality of care. 

Dr Maplesden had a colleage recently report a case where an elderly lady, who had had a splenectomy in her twenties, presented with mild flu-like symptoms, then died within 24-hours from pneumococcal sepsis. The patient never had the currently recommended post-splenectomy vaccination regime. Patients with a history of splenectomy or other functional asplenia are at increased risk of overwhelming sepsis from some bacterial infections, particularly streptococcus pneumoniae, haemophilus influenzae, and meningococcus. There may be some value in auditing your patients with a coded history of splenectomy (even in the distant past) to ensure there are appropriately vaccinated. 

Make election 2017 about policy - a tool from The Spinoff

Dr Jo Scott-Jones, medical director for Pinnacle MHN recently came across an app that aims to make the upcoming election about policy not personalities. It will be regularly updated as time progresses and allows you to compare the policy statements of each political party, to "like" them and use the tool to help you weigh up where your vote should go. 

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