HalswellHealth strives to provide excellent, evidence-based care.

We regularly undertake practice-wide clinical audits to assess the care we are providing against best practice guidelines.

Bone Health in Patients with Malabsorption– September 2025

We decided to look at another group of patients who are potentially at increased risk of Osteoporosis (brittle bones) – those with gut conditions that can cause malabsorption of nutrients. We looked at patients with a diagnosis of Coeliac Disease and/or Inflammatory Bowel Disease aged over 55 years. These patients are often managed between specialists and GPs and we recognised that there may be gaps in care.

We reviewed medical records to see if these patients had been offered a Bone Mineral Density Scan – to check for Osteoporosis or low bone density – or a prescription for Vitamin D, which supports healthy bones.

Of the 114 patients studied, we identified a significant number who may benefit from interventions:

20 patients were started on Vitamin D

28 patients were referred for their first ever Bone Mineral Density Scan

10 patients were referred for an overdue follow-up Bone Mineral Density Scan

Interested in finding out more about Osteoporosis and Vitamin D?

https://healthify.nz/health-a-z/o/osteoporosis

https://healthify.nz/hauora-wellbeing/v/vitamin-d

Our project was a collaboration between our practice pharmacists, bone health nurse and GPs and our project was presented to the wider team at our September Education meeting.

Heart Failure & Diabetes – March 2025

Heart Failure and Diabetes Management has evolved significantly over recent years and we have a greater range of medications available, which can significantly improve control of both these chronic health conditions. One of the medications which can be very effective for both conditions is Empagliflozin. Empagliflozin is sometimes used in combination with other medications such as Metformin and other diabetes tablets, ACE inhibitors, Entresto, and diuretics like Frusemide and Spironolactone. We are very excited about the improvements in health and wellbeing that can be achieved with modern management of Heart Failure and Diabetes.

However, if a person taking one or more of these medications becomes unwell, for example with diarrhoea and vomiting, they may need to pause some medication until they have recovered. This may reduce the risk of kidney damage or a serious electrolyte imbalance.

Our team recognised that we needed to be clearer in our advice to patients prescribed these medications. We conducted an audit of our practice and have contacted patients affected and sent them ‘sick day’ advice about what to do if they become unwell.

You can see the patient information sheet via this link

https://cdn.accentuate.io/8018515755236/11408390422661/HE2647-At-home-sick-day-advice-v1691632963573.pdf

We also discussed this at our monthly education meeting attended by all clinical staff.

Bone Protection Audit – August 2024

We looked at whether patients prescribed long-term steroids (Prednisone) were receiving recommended bone health investigations and treatment. Long-term (> 3 months) steroid use is sometimes necessary for a variety of inflammatory or immune system disorders. The use of long-term steroids has well-established detrimental effects on bone mineral density, increasing the risk of Osteoporosis and fractures occurring with minimal force. The Practice audited all patients prescribed Prednisone (any dose) for more than 3 months in the preceding 12 months, to ensure they had been offered bone mineral density screening and appropriate medications for bone health. Any gaps in care were corrected and we have developed a clinical template to ensure that patients prescribed longterm steroids are informed of potential risks and investigated and managed as appropriate. You can read more about the use of long-term steroids via this link: https://www.healthinfo.org.nz/index.htm?Oral-steroids.htm

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