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Resources for Registered Nurse Diabetes Prescribers

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REGISTERED NURSE DIABETES PRESCRIBERS

Medicines and devices entitled for subsidy

GUIDELINES AND RESOURCES

Guidelines and best practice outlines Links to health sector organisations

PATIENT COSTS – PRESCRIPTION MEDICINES

Outlines from the Ministry of Health

DIABETES MEDICATION

Overview of diabetes medications Professional papers about diabetes medication

LINKS to PHARMAC and the Schedule

Online Pharmaceutical Schedule www.pharmac.govt.nz/healthpros/Schedule

Online Hospital Medicines List www.pharmac.govt.nz/HMLOnline.php

PDF Copies of the Schedule and Updates

Pharmaceutical Schedule http://www.pharmac.govt.nz/latest/Sched.pdf

Pharmaceutical Schedule Current Update http://www.pharmac.govt.nz/latest/SU.pdf

Section H Current Update http://www.pharmac.govt.nz/latest/SectionH.pdf

Special Foods

SPECIAL FOODS Explanatory notes
Please see Section D of the PDF version of the Pharmaceutical Schedule

 

Link to PDF copies of the Pharmaceutical Schedule and updates

Pharmaceutical Schedule http://www.pharmac.govt.nz/latest/Sched.pdf

Pharmaceutical Schedule Current Update http://www.pharmac.govt.nz/latest/SU.pdf

Subscribe to/Purchase a hard copy of the Schedule

Scbscribe to the hard copy Pharmaceutical Schedule (the link enables you to purchase a copy)

Email copy Completing this email subscription page will mean a link to a free downloadable PDF document will be sent to your nominated email address

 

LINK to the online Phamaceutical Schedule

www.schedule.co.nz

Using the Schedule

Explaining drug entries

The Pharmaceutical Schedule lists pharmaceuticals subsidised by the Government, the amount of that subsidy paid to contractors, the supplier’s price and the access conditions that may apply.

Example

Schedule

Source – New Zealand Pharmaceutical Schedule April 2013 

 

ATTACHMENTS (printable)

PHARMAC  Information Sheet # 14 – Inside the Pharmaceutical Schedule

PHARMAC Information Sheet # 6 The facts about generic medicines

PHARMAC brochure: My Medicine Looks Different

Special Authority Applications

Special Authority is an application process in which a prescriber requests government subsidy on a Community Pharmaceutical for a particular person. Applications must be submitted to the Ministry of Health by the prescriber for the request to be processed.

(Note: Registered Nurse Diabetes Prescribers are not currently able to make Special Authority applications.)

LINKS

Special Authority Forms - www.pharmac.health.nz/tools-resources/forms/special-authority-application-forms

Blood glucose changes

Blood Glucose Meters
Information for people with diabetes 2013

http://www.pharmac.health.nz/medicines/your-health/diabetes/blood-glucose-meters-changes

Registered Nurse Diabetes Prescribers Medicines and devices list

‘Diabetes Nurse Prescriber’ means a registered nurse practicing in diabetes health who has authority to prescribe specific diabetes medicines in accordance with regulations made under the Medicines Act 1981, and who is practicing in an approved DHB demonstration site.

Source – New Zealand Pharmaceutical Schedule April 2013 

 

Below is the list of medicines and medical devices Registered Nurse Diabetes Prescribers can prescribe and are entitled for subsidy.

Source – PHARMAC 24 January 2013

 

Scroll down for the list BY THERAPEUTIC CLASS 

ALPHABETICAL BY CHEMICAL NAME 

Chemical Name Therapeutic Class
Amlodipine Dihydropyridine Calcium Channel Blockers
Aspirin Antiplatelet Agents
Atorvastatin HMG CoA Reductase Inhibitors (Statins)
Bendrofluazide Thiazide and Related Diuretics
Blood glucose diagnostic test meter Blood Glucose Testing
Blood glucose diagnostic test strip Blood Glucose Testing
Blood ketone diagnostic test meter Ketone Testing
Candesartan Angiotension II Antagonists
Captopril ACE Inhibitors
Cilazapril ACE Inhibitors
Cilazapril with hydrochlorothiazide ACE Inhibitors with Diuretics
Diltiazem hydrochloride Other Calcium Channel Blockers
Enalapril ACE Inhibitors
Enalapril with hydrochlorothiazide ACE Inhibitors with Diuretics
Felodipine Dihydropyridine Calcium Channel Blockers
Glibenclamide Oral Hypoglycaemic Agents
Gliclazide Oral Hypoglycaemic Agents
Glipizide Oral Hypoglycaemic Agents
Glucagon hydrochloride inj 1 mg syringe kit Hyperglycaemic Agents
Hydrochlorothiazide  
Insulin pen needles Insulin Syringes and Needles
Insulin pump accessories Insulin Pump Consumables
Insulin pump infusion sets Insulin Pump Consumables
Insulin pump reservoirs Insulin Pump Consumables
Insulin syringes disposable with attached needle Insulin Syringes and Needles
Insulin(s)  
Ketone blood beta-ketone electrodes test strip Ketone Testing
Lisinopril ACE Inhibitors
Losartan Angiotension II Antagonists
Losartan with hydrochlorothiazide Angiotension II Antagonists with Diuretics
Metformin Oral Hypoglycaemic Agents
Nicotine Stimulants/ADHD treatments
Perindopril ACE Inhibitors
Quinapril ACE Inhibitors
Quinapril with hydrochlorothiazide ACE Inhibitors with Diuretics
Simvastatin HMG CoA Reductase Inhibitors (Statins)
Sodium nitroprusside test strip Ketone Testing
Trandolapril ACE Inhibitors
Verapamil hydrochloride Other Calcium Channel Blockers

 

BY THERAPEUTIC CLASS

Therapeutic Class Chemical Name
ACE Inhibitors Captopril
ACE Inhibitors Cilazapril
ACE Inhibitors Enalapril
ACE Inhibitors Lisinopril
ACE Inhibitors Perindopril
ACE Inhibitors Quinapril
ACE Inhibitors Trandolapril
ACE Inhibitors with Diuretics Cilazapril with hydrochlorothiazide
ACE Inhibitors with Diuretics Enalapril with hydrochlorothiazide
ACE Inhibitors with Diuretics Quinapril with hydrochlorothiazide
Angiotension II Antagonists Candesartan
Angiotension II Antagonists Losartan
Angiotension II Antagonists with Diuretics Losartan with hydrochlorothiazide
Antiplatelet Agents Aspirin
Blood Glucose Testing Blood glucose diagnostic test meter
Blood Glucose Testing Blood glucose diagnostic test strip
Dihydropyridine Calcium Channel Blockers Amlodipine
Dihydropyridine Calcium Channel Blockers Felodipine
HMG CoA Reductase Inhibitors (Statins) Atorvastatin
HMG CoA Reductase Inhibitors (Statins) Simvastatin
Hyperglycaemic Agents Glucagon hydrochloride inj 1 mg syringe kit
Insulin Pump Consumables Insulin pump accessories
Insulin Pump Consumables Insulin pump infusion sets
Insulin Pump Consumables Insulin pump reservoirs
Insulin Syringes and Needles Insulin pen needles
Insulin Syringes and Needles Insulin syringes disposable with attached needle
Ketone Testing Blood ketone diagnostic test meter
Ketone Testing Ketone blood beta-ketone electrodes test strip
Ketone Testing Sodium nitroprusside test strip
Oral Hypoglycaemic Agents Glibenclamide
Oral Hypoglycaemic Agents Gliclazide
Oral Hypoglycaemic Agents Glipizide
Oral Hypoglycaemic Agents Metformin
Other Calcium Channel Blockers Diltiazem hydrochloride
Other Calcium Channel Blockers Verapamil hydrochloride
Stimulants/ADHD treatments Nicotine
Thiazide and Related Diuretics Bendrofluazide
  Hydrochlorothiazide
  Insulin(s)

 

Note:
DIABETES MEDICATION UNFUNDED BY PHAMAC and not prescribed by Registered Nurse Diabetes Prescribers
At Sept 2013
Incretins or Glucagon-like peptide-1 agonists (GLP-1) Exenatide (Byetta)
DPP4 inhibitors – Sitagliptin (Januvia)

Registered Nurse Diabetes Prescribers and their DHB

Below is the list of Registered Nurse Diabetes Prescribers. More details of their individual registrations can be found on the Nursing Council of New Zealand website www.nursingcouncil.org.nz

As at 24 January 2013

District Health Board   

Registered Nurse

Practising in Diabetes Health

NCNZ Registration Number

Northland DHB

Bronwyn

Henderson

124928

Northland DHB

Amy

Savage

152390

Northland DHB

Rosemarie Adrienne

Coats

148277

Auckland DHB

Patricia

Ball

052157

Auckland DHB

Mele

Kaufusi

114474

Auckland DHB

Jennifer

Somerville

060927

Auckland DHB

Melanie

Lubeck

151268

Auckland DHB

Jane

Wilkinson

124468

Auckland DHB

Diane

Bermingham

137642

Counties Manukau DHB

Kathryn

Smallman

148492

Counties Manukau DHB

Roberta

Milne

114488

Counties Manukau DHB

Sally

Morgan

060775

Counties Manukau DHB

Claire

O'Brien

153805

Hawkes Bay DHB

Andrea

Rooderkerk

117987

Hawkes Bay DHB

Heather

Charteris

117839

Hawkes Bay DHB

Tony

Loversuch

138813

MidCentral DHB

Mary

Meendering

108408

MidCentral DHB

Alison

Fellerhoff

064890

MidCentral DHB

Kerrie

Skeggs

112025

MidCentral DHB

Lois

Nikolajenko

049016 

Whanganui DHB

Delia

Williams

147694

Hutt Valley DHB

Anne-Marie

Heffernan

148903

Hutt Valley DHB

Hazel

Phillips

160328

Hutt Valley DHB

Lynette

McPherson

136832

Southern DHB

Sharon

Sandilands

110421

 Source – PHARMAC 24 January 2013

 

NURSE PRACTITIONERS

Nurse practitioners are expert nurses who work within a specific area of practice that requires advanced knowledge and skills. They practise both independently and in collaboration with other health care professionals to promote health, prevent disease and to diagnose, assess and manage people’s health needs.

New Zealand Nursing Council September 2013

Helen Snell MidCentral DHB

Pauline Giles MidCentral DHB

Isabel Raiman Bay of Plenty DHB

Guidelines and comments

ATTACHMENTS (printable)

  • MCNZ: Good Prescribing Practice April 2010
  • MoH: NZ Primary Care Handbook 2012
  • MoH: Standing Order Guidelines 2012
  • MoH: Diabetes Nurse Specialist Prescribing Q / A
  • NZNO: Guidelines for Nurses on the Administration of Medicines
  • NZNO: Nurse prescribing library resource guide
  • NZNO: Independent Nurse Prescribing
  • NZSSD: Prescribing Practicum for Diabetes Nurse Specialist Roll Out 2012
  • NZGG: Guidance on the Management of Type 2 Diabetes 2011

 

Links to organisations

PHARMAC

The Pharmaceutical Management Agency (PHARMAC) is the New Zealand Government agency that decides, on behalf of District Health Boards, which medicines and related products are subsidised for use in the community and, in some cases, funded in public hospitals.

www.pharmac.health.nz

Health Quality and Safety Commission

The Health Quality & Safety Commission was established under the New Zealand Public Health & Disability Amendment Act 2010  to ensure all New Zealanders receive the best health and disability care within our available resources.

www.hqsc.govt.nz

Medical Council of New Zealand

The Medical Council registers doctors in of New Zealand and caries responsibilities in the areas of standards, conduct and competence.

www.mcmz.org.nz

Medsafe

Medsafe is the New Zealand Medicines and Medical Devices Safety Authority. We are responsible for the regulation of medicines and medical devices in New Zealand. We ensure that medicines and medical devices are acceptably safe.

www.medsafe.govt.nz

Ministry of Health

The Government's principal advisor on health and disability: improving, promoting and protecting the health of all New Zealanders.

www.health.govt.nz

National Health IT Board

The role of the IT Health Board is to provide leadership on the implementation and use of information systems across the health and disability sector. The IT Health Board is a sub-committee of the National Health Board and is charged with ensuring that health sector policy is supported by appropriate health information and IT solutions.

http://ithealthboard.health.nz/

New Zealand Nurses Organisation (NZNO)

The New Zealand Nurses Organisation is a professional and industrial organisation representing approximately 46,000 members in all areas of the health service.

www.nzno.org.nz

Nursing Council of New Zealand (NCNZ)

The Nursing Council of New Zealand registers nurses and makes sure they are 'competent and fit' to practise.  The Nursing Council's role and responsibilities are outlined in the Health Practitioners Competence Assurance Act 2003.

http://nursingcouncil.org.nz

New Zealand Society for the Study of Diabetes (NZSSD)

NZSSD is the national advisory body on scientific and clinical diabetes care and standards. NZSSD's objectives are to promote the study of diabetes and the best standards of care of diabetes in New Zealand. It also provides the national reference source in the subject.

www.nzssd.org.nz/professionals.html

The New Zealand Formulary (NZF)

The NZF is based on the British National Formulary (BNF) and specifically adapted for New Zealand. It is a resource for healthcare professionals with information about medicines that are used in New Zealand.

http://nzformulary.org/

NZ Universal List of Medicines (NZULM)

NZULM combines standardised medicine descriptions from the New Zealand Medicines Terminology (NZMT) with information from Medsafe and the PHARMAC.

www.nzulm.org.nz

 

ATTACHMENT (for print)

Health Quality & Safety Commission National Medication Chart - Toolkit-Information-Leaflet.pdf

Medicine interactions: using the New Zealand Formulary

New Zealand Formulary launches

Ministry of Health patient information

 

Prescription charges

Link to Prescription charges

Pharmaceutical Subsidy Card

The Pharmaceutical Subsidy Card (PSC) allows the cardholder and named family members to pay a lower amount on government prescription charges.

Link to Pharmaceutical Subsidy Card

Prescription Charges (tear-off pad, plus ordering)

Link to Prescription Charges

 

ATTACHMENTS (to print)

Prescription Charges and Pharmaceutical Subsidy Card

Diabetes Medication Overview

Most people with type 2 diabetes need medications for a range of other diabetes related medical issues e.g. control of complications or reduction of risk complications.

Three major factors:

  • Blood glucose levels
  • Blood pressure
  • Blood cholesterol levels

 

BLOOD GLUCOSE LOWERING MEDICATIONS

TYPE 1 DIABETES

Usually within a year of diagnosis there is a total lack of insulin production. Therefore, all people with type 1 diabetes need to be treated with insulin from either the day of diagnosis, or within a fairly short time of diagnosis. 



Because people with type 1 diabetes don’t make any of their own insulin, they are said to be ‘insulin deficient’. They do not require blood glucose lowering tablets, insulin is sufficient.

Occasionally people with type 1 diabetes who are obese may benefit from an insulin sensitiser as well as insulin – in this case the sensitiser would usually be Metformin.

TYPE 2 DIABETES

In type 2 diabetes there is usually a combination of decreased insulin production, and insulin resistance. Treatment often begins with diet, exercise and weight loss management. If these strategies are not sufficient to achieve healthy blood glucose levels after three months (NZGG, 2011), people with type 2 diabetes usually move first onto tablets.

When, or if, tablet therapy fails to help them achieve healthy blood glucose levels, they then require insulin therapy, often in combination with tablets.

 

INSULIN

TYPE 1 DIABETES

The aim of insulin therapy in type 1 diabetes is to replace the supply of insulin the patient’s pancreas is no longer producing.

TYPE 2 DIABETES

The aim of insulin therapy in type 2 diabetes is to supplement the supply of insulin that the patient’s pancreas is still producing. 

 

BLOOD PRESSURE LOWERING MEDICATIONS

Having healthy blood pressure has been shown to be very important in reducing the risk of most diabetes complications. The NZ Guidelines Group recommend that people with early kidney damage should be started on an ACE inhibitor or Angiotensin 2 receptor-blocker (ARB), irrespective of blood pressure levels. These medications can slow diabetes related kidney damage. ACE I and ARB can also slow retinopathy.

The current recommended blood pressure for those with diabetes is less than, or equal to, 130 / 80mmHg. This target should be aggressively pursued in those with diabetes, as the benefits of normotension (normal) are very significant in this group of patients. 

 

CHOLESTEROL IMPROVING MEDICATIONS

Improved control of cholesterol can reduce cardiovascular complications by 20 – 50 %. Below are the current recommended lipid levels for people with diabetes 

NEW ZEALAND PRIMARY CARE HANDBOOK 2012

Optimal levels (targets) for people with known cardiovascular disease, or cardiovascular risk 

Known cardiovascular disease or cardiovascular risk > 15% or diabetes

Lipids

Total cholesterol

< 4.0 mmol/L

LDL cholesterol

< 2.0 mmol/L

HDL cholesterol

≥ 1.0 mmol/L

TC:HDL ratio

< 4.0

Triglycerides

< 1.7 mmol/L

Publications - References

Please click on the title to view and print the document.

National Evidence-Based Clinical Care Guidelines for Type 1 Diabetes for Children, Adolescents and Adults has been developed by the Australasian Paediatric Endocrine Group and the Australian Diabetes Society

SIGN Scottish Intercollegiate Guidelines Network: Management of Diabetes

ADA Standards of Medical Care in Diabetes 2013

NEMJ Effects of Intensive Glucose Lowering in Type 2 Diabetes.pdf

NMJ A Clinical Trial to Maintain Glycemic Control in Youth with Type 2 Diabetes.pdf

NMJ Effects of Medical Therapies on Retinopathy Progression in Type 2 Diabetes.pdf

The Schedule

Online Pharmaceutical Schedule www.pharmac.govt.nz/healthpros/Schedule

Online Hospital Medicines List www.pharmac.govt.nz/HMLOnline.php

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