Home' Australian Pharmacist : Australian Pharmacist May 2013 Contents Australian Pharmacist May 2013 I ©Pharmaceutical Society of Australia Ltd. 43
level, mean pre-delivery serum folate
levels and mean pre-delivery red
Folic acid supplementation has no impact
on pregnancy outcomes such as pre-
term birth (RR 1.01, 95% CI 0.73 to 1.38)
and still births/neonatal deaths (RR 1.33,
95%CI 0.96 to 1.85).
The intervention group taking folic acid
supplementation showed improvement
in the mean birthweight.
There was a significant reduction in the
incidence of megaloblastic anaemia in
the intervention group compared to the
None of the studies reported on the
impact of folic acid supplementation on
miscarriage, pre-eclampsia, respiratory
distress or allergic disease in children.
Implications for research and
The current review included studies
addressing the efficacy of the
supplementation of folic acid in
pregnancy for maternal health and
pregnancy outcomes. There were a
limited number of studies with robust
methodologies and long follow-up time
included. Further well designed studies
are needed to confirm the above results.
The current evidence supports the use of
folic acid supplementation to reduce the
risk of megaloblastic anaemia. There is
inconclusive evidence to support the
benefit of folic acid supplementation on
1. Lassi ZS, Salam RA, Haider BA, et al. Folic acid supplementation
during pregnancy for maternal health and pregnancy
outcomes. Cochrane Database of Systematic Reviews 2013,
Issue 3. Art. No.: CD006896. DOI: 10.1002/14651858.CD006896.
2. Scholl TO, Johnson WG. Folic acid: influence on the outcome of
pregnancy. Am J Clin Nutr 2000;71:1295--303.
3. Tamura T, Picciano MF. Folate and human reproduction. Am J
Clin Nutr 2006;83(5):930--1016.
4. National Institute for Health and Clinical Excellence. NICE
public health guidance 11: Improving the nutrition of
pregnant and breastfeeding mothers and children in low
income households. London: NICE; 2011.
New JPPR editor
Dr Chris Alderman is the new Editor of
SHPA journal -- the Journal of Pharmacy
Practice and Research. Chris replaces
Professor Jo-anne Brien who stepped
down from this role at the end of 2012
after seven years. Chris is the Director of
Pharmacy at the Repatriation General
Hospital in South Australia, where he also
provides clinical pharmacy services to the
Psychiatric Unit, and is Associate Professor
(Pharmacy Practice), School of Pharmacy
and Medical Sciences, University of
South Australia. Chris said that he was
aware of the quality of his predecessors.
'In particular, I acknowledge with much
gratitude all that Professor Jo-anne Brien
has achieved in her tenure as Editor of
Revaccination rates drop
New Australian research has found a
significant decline in pneumococcal
pneumonia revaccination rates among
at-risk populations, following changes to
the National Immunisation Program (NIP)
guidelines in early 2012.
Researchers from the University of
Sydney's Family Medicine Research Centre
found that among patients most at risk
of pneumococcal pneumonia -- those
aged 70 and over with underlying chronic
conditions or tobacco smokers -- there
was a drop in revaccination rates of 12.2%
after the NIP changes were implemented
(71.7% in May 2012 compared with 83.9%
in May 2011 (p<0.01)).1
Country and city GP and Medical
Officer of Health for the Eastern Health
Authority (HA), Adelaide, Dr Rod Pearce
AM, said that given how recently the NIP
guidelines have changed, it's concerning
to see a reduction in pneumococcal
pneumonia revaccination rates.
Pneumococcal pneumonia is a leading
cause of serious illness and death among
Australians aged 85 and over, with
adults aged 65 and over at higher risk of
contracting the disease than the rest of
'GPs must prioritise identifying people
who have underlying conditions that
make them eligible for the free second
dose of pneumococcal vaccine once they
reach 70, and ensure they are vaccinated,'
Dr Pearce said.
University of Sydney researchers analysed
data from two sub-studies of the Bettering
the Evaluation and Care of Health (BEACH)
program, in which the GP specified the
pneumococcal vaccination status of each
patient. The first sub-study -- pre-measure
-- was conducted between March to May
2011,3 with the second -- post-measure --
in March to May 2012.4
In 2011, under the NIP, non-indigenous
Australians received one pneumococcal
vaccination at 65 years of age and a
second vaccination at 70 years of age (or
at least five years after the first dose). In
April 2011, the TGA advised healthcare
professionals not to administer a second
dose of vaccine, pending a review.
In January 2012 the recommendations
were reinstated, but changed to include
a second dose only for patients at high
risk of contracting invasive pneumococcal
disease. Pneumococcal risk factors,
in addition to being aged 65 years
and older, include diabetes, chronic
pulmonary, cardiac or renal disease,
impaired immunity and asplenia, as well
as tobacco smokers.5
1. Harrison C, Britt H. Recent change in pneumococcal
vaccination status of older people Byte from BEACH No: 2013;2
Sydney. FMRC, University of Sydney, 2013. At: http://sydney.
2. Better Health Victoria and Department of Health --
Pneumococcal disease. At: www.betterhealth.vic.gov.au/
3. Harrison C, Bayram C, Charles J, Britt H. Pneumococcal
vaccination coverage of Australian general practice patients.
Presented at the Public Health Association of Australia (PHAA)
13th National Immunisation Conference, Darwin, Jun 20, 2012.
4. Abstract to be published in the 2012--13 BEACH annual report.
5. NHMRC, The Australian Immunisation Handbook, 9th Edition,
2008, Chapter 3.15. At: www.health.gov.au/internet/immunise/
12 Mar, 2013].
Veterans' mental health
Veterans and Australian Defence Force
seeking mental health support will
benefit from a new web portal developed
by the Department of Veterans' Affairs.
Minister for Veterans' Affairs, Warren
Snowdon said: 'The new At Ease portal
(www.at-ease.dva.gov.au) offers pathways
to achieving mental fitness and resilience,
self-help tools, access to professional
support, treatment options, healthy
drinking and clinical information for GPs
and mental health professionals.
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