For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
GP strike to go ahead after employer refuses to budge
GP strike to go ahead after employer refuses to budge

Twenty-one doctors at five Iwi health provider practices will take the first ever strike action by New Zealand general practitioners tomorrow (Friday) after efforts to avert the strike failed.
“This could have been avoided if the employer, Te Rūnanga o Toa Rangatira, which runs Ora Toa Health, allowed its dentists to join the collective agreement that covers its doctors,” says Lloyd Woods, Senior Industrial Officer at the Association of Salaried Medical Specialists (ASMS).
“It’s regrettable, as it didn’t need to happen if the employer had shown some goodwill and common sense.”
Te Rūnanga o Toa Rangatira and the ASMS have been in negotiations and have met unsuccessfully three times, including through mediation, to renegotiate the collective agreement.
“Generally negotiations with the Rūnanga are reasonably good-natured and both parties have looked for win-win solutions in the past,” says Mr Woods.
“The absolute refusal, without reasonable cause, to recognise the dentists’ important role as part of the wider medical team in a holistic service is unacceptable to our members.”
The hour-long strike from 9am on Friday (7 December) is the first of five one-hour stoppages, ahead of a full-day stoppage on 24 December.
“Further industrial action in 2019 is almost certain if the Rūnanga continues with this hard line.”