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
War on tooth decay in the Bay
War on tooth decay in the Bay

Free dental care was provided in the Eastern Bay township of Taneatua recently in a New Zealand Defence Force (NZDF) exercise with the Bay of Plenty District Health Board (BOPDHB) and Tuhoe iwi.
Exercise Wisdom Tooth saw the 25-member NZDF team providing dental treatment at a temporary clinic set up in the town over two weeks.
The NZDF contingent had a mix of Regular Force personnel and reservists, including up to six dentists, four dental hygienists, eight dental assistants and a physical training Instructor.
Amongst the contingent of Army reserves were BOPDHB Community Dental Oral Health Therapist Timmy Reiber and Dental Assistant Elle Lloyd. Lieutenant Reiber and Private Lloyd are Army reserves outside of their day jobs.
“The NZDF engages regularly in community outreach activities in New Zealand and the southwest Pacific region,” says Warrant Officer Class 2 Ross Heald, who led the team.
“An important part of our training is practising delivery of treatment in a field environment. This is what we do on operations such as when we deploy to the Pacific as part of a humanitarian aid response.”
The NZDF ran a similar programme in Kaitaia four years ago, and does so as part of its regular humanitarian assistance and disaster relief exercises in the southwest Pacific.