NEWS 11
ausdoc. com. au 16 MAY 2025
NEWS 11
Gun health checks trigger concern
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Carmel Sparke GPs are being tasked with conducting health assessments to ensure gun owners in WA have the physical and mental capacity to shoot straight and hold a firearm steady, as well as adequate impulse control.
New legislation that came into effect last month means some 90,000 gun owners in the state have to undergo regular health assessments to ensure they are fit to hold a firearms licence.
The RACGP says the laws place GPs in a“ complex situation”, adding that many doctors feel uneasy about making determinations that have significant consequences for both patient relationships and community safety.
The WA Police Force has produced an 18-page guideline booklet for its Firearm Authority Health Assessment
Doctors could be subject to hostility should‘ patients fear the loss of their firearm authority’.
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potential of risk to themselves or others,” Dr Bahemia said.
“ Many GPs feel they are being asked to make decisions that fall outside of the typical scope of practice, particularly when it comes to risk assessment and prediction of future risk.”
However, GPs were not compelled to conduct the assessments.
In an RACGP web poll last
Reasons to consider LAGEVRIO
as the preferred * oral antiviral on the PBS for your patients aged ≥70 years who test positive for COVID-19 1, 2
* LAGEVRIO must be for use when nirmatrelvir-ritonavir is contraindicated. 1, 2
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year, 80 % of the 1300 surveyed said they were unwilling to carry out a health assessment, while only one in 10 said they would complete one for a patient.
Among the 90,000 firearm owners in WA, many are working in pest control or security; or involved in shooting competitions, hunting or farming; or they sell or repair guns.
Under the laws, all new
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firearm owners need to undergo a medical assessment, and existing owners require one within five years.
Those aged over 80 must have a health assessment every year.
The WA Police Force has issued assurances that doctors would have no liability in the event of an adverse incident.
There is also no MBS funding for the assessments.
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in which doctors are advised that, to use a firearm safely, applicants require the ability to“ accurately aim at and hit a target” and“ hold the firearm steady” and that they must possess emotional and impulse control.
In the assessments, GPs are to examine the applicant’ s mental and physical health history but also advise their patients if a medical condition, treatment or behaviour over the past five years could impact their ability to safely handle a firearm. The guidelines go on to warn doctors that they could be subject to hostility should“ patients fear the possibility of restrictions or loss of their firearm authority”.
They are then directed to the RACGP’ s website for advice on managing patient aggression.
RACGP WA co-deputy chair Dr Mariam Bahemia said the effect on doctor – patient relationships was one of the many concerns previously flagged by WA GPs in relation to the new laws, particularly in small communities where social and professional relationships overlapped.
“ We are being asked to make clinical judgements about a patient’ s physical and mental health and the
Proven
In MOVe-OUT, LAGEVRIO reduced the risk for hospitalisation or death vs. placebo through Day 29 by 30 %( adjusted relative risk reduction) in adult patients with mild to moderate COVID-19 4
( 95 % CI: 1 %, 51 %; 6.8 %( 48 / 709 ] vs 9.7 %( 68 / 699). Adjusted risk difference-3.0 %( 95 % CI-5.9 %,-0.1 %), p-value not available). Based on a planned interim analysis of LAGEVRIO vs placebo: The adjusted risk difference was-6.8 %( 95 % CI:-11.3 %,-2.4; 7.3 %( 53 / 377) vs 14.1 %( 28 / 385); p = 0.0024).
Real-world studies, 5-9 including the local Victorian study published in 2023, 5 also support the use of LAGEVRIO in treating older vaccinated patients with mild to moderate COVID-19.
Treatment-related adverse events ≥ 1 %( MOVe-OUT, LAGEVRIO vs placebo): 3 Diarrhoea( 2 % vs 2 %), nausea( 1 % vs 1 %), dizziness( 1 % vs 1 %)
No No to reduce risk of hospitalisation or death 3, 4
known drug interactions based on limited data available 3
dose adjustments required in patients with renal and / or hepatic impairment 3
▼This medicine is subject to additional monitoring in Australia. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse events at www. tga. gov. au / reporting-problems.
SELECTED SAFETY INFORMATION 3 INDICATION: LAGEVRIO has provisional approval for the treatment of adults with COVID-19 who do not require initiation of oxygen due to COVID-19 and who are at increased risk for hospitalisation or death. The decision to approve this indication was based on efficacy and safety data from a Phase 3 trial. Continued approval of this indication depends on additional data. CONTRAINDICATIONS: Hypersensitivity to the active substance or any of the excipients. Hypersensitivity reactions have been reported with LAGEVRIO. If signs or symptoms of a clinically significant hypersensitivity reaction occur, immediately discontinue LAGEVRIO and initiate appropriate medications and / or supportive care. PRECAUTIONS: Pregnancy Category D: The use of LAGEVRIO is not recommended during pregnancy. In women of childbearing potential, health care providers should discuss the chance that they may be pregnant and consider the need for a pregnancy test. Contraception: Advise women of childbearing potential to use effective contraception for the duration of treatment and for 4 days after the last dose of LAGEVRIO. Sexually active men with a partner of childbearing potential should use contraception during and for 3 months after treatment. Based on animal data, LAGEVRIO may cause foetal harm when administered to pregnant women. Breastfeeding: Based on the potential for adverse reactions on the infant from LAGEVRIO, breastfeeding is not recommended during treatment and for 4 days after the last dose of LAGEVRIO. Paediatric patients: Use in patients under the age of 18 years is not recommended. ADVERSE REACTIONS: Common: nausea, diarrhoea, dizziness. The following have been reported in post-marketing experience: hypersensitivity, angioedema, erythema, pruritus, rash, urticaria, vomiting.
Scan to access study design for registration study 4
PBS information: Authority required( STREAMLINED): LAGEVRIO must be for use when nirmatrelvir(&) ritonavir is contraindicated. 1 The contraindications to nirmatrelvir(&) ritonavir can be found using the Liverpool COVID-19 Drug interaction checker or the TGA-approved Product
1, 10, 11
Information for nirmatrelvir(&) ritonavir. Visit www. pbs. gov. au for more information.
References: 1. Pharmaceutical Benefits Scheme. www. pbs. gov. au( accessed March 2024). 2. Pharmaceutical Benefits Scheme. Lagevrio ®( molnupiravir) Pharmaceutical Benefits Scheme Factsheet – Updated 1 December 2024. https:// www. pbs. gov. au / publication / factsheets / covid-19-treatments / PBS-Factsheet-lagevrio-molnupiravir-updated- December-2024. pdf( accessed December 2024). 3. LAGEVRIO Product Information, October 2023. 4. Bernal AJ et al. N Engl J Med 2022; 509 – 520. 5. Van Heer C et al. Lancet Reg Health West Pac 2023; 41:100917. 6. Gentry CA et al. J Infect 2023; 86( 3): 248 – 255. 7. Lin DY et al. JAMA Netw Open 2023; 6( 9): e2335077. 8. Park HR et al Infect Chemother 2023; 55( 4): 490 – 499. 9. Abu Ahmad W et al. Clin Microbiol Infect 2024; 30( 10): 1305 – 1311. 10. Paxlovid( nirmatrelvir-ritonavir) Product Information. December 2024. 11. University of Liverpool. COVID-19 Drug Interaction Checker. Available at https:// covid19-druginteractions. org / checker( accessed March 2024).
Before prescribing, please review the full Product Information available at www. msdinfo. com. au / lagevriopi or by scanning the QR code.
Copyright © 2025 Merck & Co., Inc., Rahway, NJ, USA and its affiiates. All rights reserved. Merck Sharp & Dohme( Australia) Pty Limited. Level 1 – Building A, 26 Talavera Road, Macquarie Park NSW 2113. MSDA0156 / 01. AU-ANV-00634 v1.0. Issued January 2025.