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
New Zealand needs to start manufacturing COVID-19 vaccine
New Zealand needs to start manufacturing COVID-19 vaccine

The Royal New Zealand College of General Practitioners is calling on the Government to ensure New Zealand can produce and develop COVID-19 vaccines independently.
"While New Zealand has secured access to the current COVID-19 vaccine, evidence shows that the virus does mutate and is likely to require regular booster vaccinations, much like the flu-jab," says Dr Bryan Betty, Medical Director of the College.
"We cannot allow ourselves to be jostled around and forgotten in an international scramble for access to future vaccines."
The College of GPs says the ability to produce and develop vaccines in New Zealand must be an urgent consideration for the Government and decision-makers. And while the Government has made some investments in domestic vaccine development during the COVID-19 pandemic, there needs to be a continued focus on resources and support. It cannot be a short-term focus.
New Zealand’s continued success in combating the virus will likely be dependent on future vaccines as new mutations of the virus emerge.
"We need to act now and develop a resilient system which allows New Zealand to develop and produce COVID-19 vaccines ourselves. We must ensure we have the upper hand against this virus, its potential mutations and any future viruses," says Dr Betty.
The College of GPs says patients are demanding more secure access to COVID-19 vaccines.
"We cannot be left dependent on other countries in this new COVID-19 reality we are all living in, especially when we’ve done such an outstanding job to date."