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
Older Māori have lower rates of ACC cover, research shows
Older Māori have lower rates of ACC cover, research shows

Older Māori have lower rates of ACC cover than other older New Zealanders and the average cost per claim is higher, suggesting the injuries are more serious, according to new research.
Earlier studies found Māori of all ages are more likely to be injured, but less likely to have good access to healthcare.
The new research out of Waipapa Taumata Rau, University of Auckland looks at five years of Accident Compensation Corporation (ACC) data (2014 to 2018) from two regions, Bay of Plenty and Lakes Taupō and Rotorua.
It found that most injuries for older Māori related to falls and happened in the home.
Of almost 150,000 claims from around 9,000 Māori and 55,000 non-Māori, all over 50 years of age, the claim rate was 46 percent higher for non-Māori. Māori had a higher average cost per claim at about NZ$1,700 vs NZ$1,200.
”It’s likely to be due a multitude of things, including previous poor experiences with primary healthcare and difficulty working with the ACC system,” says researcher Dr Joanna Hikaka, of Te Kupenga Hauora Māori in the Faculty of Medical and Health Sciences at Waipapa Taumata Rau, University of Auckland.
The group has another study set for publication asking older Māori how they would like injury care provided.
“People talked about the fact that current injury services don’t address holistic well-being,” says Dr Hikaka.
“There might be discussion about things relating to physical health, but nothing to do with the spiritual and emotional issues that come up when people are injured, especially when they are seriously injured,” she says.
This research is part of a wider project where the University is working with Te Arawa Whānau Ora Collective on a range of initiatives to reduce injuries and support older Māori to get funded healthcare.
These include strength and balance classes, which help prevent falls, education and awareness, and support to attend healthcare appointments.
This research, published in the British Medical Journal, supports the need for ACC to work with Māori to design services that better meet the needs of older Māori, Dr Hikaka says.