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
Health and safety system needs a big leap forward not baby steps
Health and safety system needs a big leap forward not baby steps

Statement from Mike Cosman, Chair, NZ Institute of Safety Management:
The Government’s latest WorkSafe reforms tinker at the margins rather than investing in making workplace safer.
Our fatality rate is 1.6 times that of Australia and 6.4 times of the UK. These are avoidable tragedies. Yet Minister van Velden says nothing about a goal to reduce harm in her Cabinet paper, press release or letter of expectations to WorkSafe.
If the Government is serious about an investment approach then health and safety should be the poster child. Workplace harm costs us $4.9 billion a year and theres much we can do to prevent it. WorkSafe plays a key role but successive governments have cut funding to WorkSafe and laid off nearly one in five staff at WorkSafe in the last two years.
The Minister’s announcements today have a couple of good ideas but without adequate resourcing they are likely to fall short. The system needs funding and ambition.
We agree that better, clearer guidance is a good thing but investment is needed to turbocharge the guidance development process. Health and safety experts like our members can provide assistance and clarity. However, saying to WorkSafe and industry "we want you to develop more guidance" without providing additional resourcing is a wish not a plan. More resource is required.
Greater investment in the inspectorate is needed. We have a third less inspectors proportionately than Australia and our inspectors receive less comprehensive training or orientation.
We need to be real that, after two restructures in two years, WorkSafe is a lean organisation. If the Minister wants to achieve the outcomes she’s looking for then she’s needs to invest in the system. Otherwise, she’s just tweaking at the margins while workers die every week.