SOP Bulletin No. 91

Decision Support Unit

8 — th Floor, 259 Queen St, Brisbane — 3 — rd Floor Blackburn House, 199 Grenfell St, Adelaide

Intranet site:  http://intranet/nat/comp/dp/Nop/dsu/dsudefault.htm

08 April 2005

THE FOLLOWING RMA SOPS WILL TAKE EFFECT ON 13 APRIL 2005

New SOPs	Dermatomyositis
Revocations & Replacements	Gastro-oesophageal reflux disease Sleep apnoea
Amendments	Nil

IMPORTANT OPERATIONAL FEATURES

Gastro-oesophageal reflux disease

Revocation – 11 & 12 of '05 Replaces 52 and 53 of '02

• The definition has been slightly changed to specify that the condition must be chronic.  In the medical context “chronic” means persisting over a long period of time (and it has no meaning with regard to severity).
• The minimum smoking factor requirements have been changed from 5/day + 1 pk yr (RH) and 10/day + 2 pk yrs (BOP) to 10/day for 6 months (RH) and 20/day for 6 months (BOP).
• The alcohol factor, previously requiring dependence or abuse, has been changed to a dose of alcohol.
• Treatment with a nonsteroidal anti-inflammatory drug, previously a factor for onset and worsening in both RH and BOP SOPs, is now just a worsening factor in the RH SOP only.
• Undergoing a gastrectomy, previously covered by the surgical procedure factor, is now included as a factor on its own.
• There are new factors for:
• Sjögren's syndrome (RH & BOP);
• eradication of Helicobacter pylori in a person with chronic gastritis (RH only);
• doxycycline (RH worsening only); and
• a drug causing acute erosive oesophagitis (RH worsening only).

Sleep apnoea

Revocation – 13 & 14 of '05 Replaces 39 and 40 of '97

• As before, the SOP does not cover isolated sleep apnoea without clinical consequences.  Brief and infrequent cessation of breathing (apnoea) during sleep is normal and not a disease.
• In the previous SOP there was a definition note that excluded temporary sleep apnoea due to alcohol consumption.  That note has been removed, and alcohol-related sleep apnoea is now covered by the SOP, but note that alcohol is included as a worsening factor only.
• There are new causal and worsening factors in both RH and BOP SOPs for end-stage renal failure. 
• Changes to other factors are cosmetic only.

Dermatomyositis

New  – 15 & 16 of '05

• This SOP covers a rare disorder involving progressive muscle weakness and skin changes.  Claims will be very infrequent.  There are causal factors in the RH SOP only, for being treated with certain drugs.