Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.
Volume 1 Number 1
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Volume 1 Number 3
Volume 1 Number 4
Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
Volume 2 Number 2
Volume 2 Number 3
Volume 2 Number 4
Volume 2 Number 5
Volume 2 Number 6
Volume 2 Number 7
Volume 2 Number 8
Volume 2 Number 9
Volume 2 Number 10
Volume 2 Number 11
Volume 3 Number 1
Volume 3 Number 2
Volume 3 Number 3
Volume 3 Number 4
Volume 3 Number 5
Volume 3 Number 6
Volume 3 Number 7
Volume 3 Number 8
Volume 3 Number 9
Volume 3 Number 10
Volume 3 Number 11
Volume 4 Number 1
Volume 4 Number 2
Volume 4 Number 3
Volume 4 Number 4
Volume 4 Number 5
Volume 4 Number 6
Volume 4 Number 7
Volume 4 Number 8
Volume 4 Number 9
Volume 4 Number 10
Volume 4 Number 11
Volume 5 Number 1
Volume 5 Number 2
Volume 5 Number 3
Volume 5 Number 4
Volume 5 Number 5
Volume 5 Number 6
Volume 5 Number 7
Volume 5 Number 8
Volume 5 Number 9
Volume 5 Number 10
Volume 5 Number 11
Volume 6 Number 1
Volume 6 Number 2
Volume 6 Number 3
Volume 6 Number 4
Volume 6 Number 5
Volume 6 Number 6
Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated.
A range of global and local news snippets and links that may be of interest to readers.
Pipeline Extras simply broadens the range of topics that can be concentrated in one delivery of i2P to your desktop.
Doctor shopping concerns everyone. It costs lives, erodes the fabric of our society and imposes unacceptable cost burdens on the Australian health system.
Online eScripts and Script Exchange interoperability are pivotal to solving doctor shopping and managing S8 and S4 drugs of addiction.
As we wrestle with changes in healthcare, the patient more than ever wants a solution to his or her particular health challenge.
They want us to accept responsibility.
Perhaps as we wrestle with that puzzle, or that project, or that problem, the most likely reason we give up on it is the belief that “it can’t be done”.
That’s so different from “I can’t do it”.
Of course you can do it, and it can be done.
So why are we entrenched in the current pharmacy model?
Although the Government relies on the collection of taxes to balance its budget, it is critical as taxpayers to ensure that you do not pay any more tax that you have to.
Or, as the late Kerry Packer once told a Senate enquiry “Of course I am minimising my tax- and if anybody in this country doesn’t minimise their tax, they want their heads read, because as a government, I can tell you you’re not spending it that well that we should be donating extra!”
How much are you willing to pay for services to support health and well-being?
The working environment for many pharmacists is not ideal.
In both hospital and community settings pharmacists often experience many of the following: long periods of standing, non-ergonomic computers, minimal opportunity to take a break including visiting the toilet or eating lunch, constant demands and the expectation of working quickly without making a mistake, dealing with distressed or difficult people, working extended and sometimes unsociable hours and being a victim of hold-ups and threats of violence.
Joe Ludwig, the Minister of Agriculture, recently released Australian Food Statistics 2010-11.
It provides a message of hope for community pharmacies.
This singular agrarian message of opportunity is in stark contrast to the constant proselytising in most media how technology in the form of the internet is going to ring the death knell (or beep) for local pharmacies.
I applaud and endorse creative, positive and well executed business development and local area marketing initiatives.
A recent personal experience highlighted the adverse image and business consequences of poorly structured and executed campaigns.
An unsolicited letter and “info-sheet” were received by mail from the State General Manager of a national, high profile, public listed legal practice.
The salutation of the letter immediately suggested inadequacy. It stated:
“Dear Barry Urquhart”
Very few people are addressed with their full or given and surnames. “Barry” or “Mr Urquhart” are the norm.
Hmm. There’s more than one way you could take that, huh?
Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong.
So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
In May 2006 a group of eminent UK Professors, concerned about ways in which disproved treatments in their National Health Service (NHS) were “being encouraged for general use”, published a letter in the Times to say so. Six years on, despite calls from the British Medical Association for the funding to end, the NHS still spends around £4 million a year on homeopathy.
More recently, the Australian National Health and Medical Research Council (NHMRC) came out with their own report against homeopathy. So why has nothing changed?
Diplomacy is all about making the right choices.
When I persuaded my wife, Carol Ann, to say "I do" ages ago, we entered serious negotiations to nail down the ground rules for our marriage.
Then we hit on it.
In our family, I would make all the major decisions, and she would make all the minor decisions!
Many of my friends have asked me, "Harvey, how on earth could that ever work out?"
My answer: "Very simple . . . There have never been any major decisions."
Finally mainstream science and medical publications are waking up to the fact that evidence-based medicine has been hijacked by global Pharma companies and rewritten as part of a market plan, rather than a patient healthcare plan.
In the April edition of i2P it was reported that the British Medical Journal reported in its editorial that much of recent cancer research was fraudulent, and as a result, treatments based on this tainted evidence simply would not work (see Cancer Research Found to be Faulty )
I recently received an email from Dr Ken Harvey the well-known academic from Latrobe University, who is trying to reform some aspects of the TGA, particularly in relation as to how drugs and complementary medicines are registered, and the quality of evidence used to support claims of efficacy.
It’s a subject that has gained traction since the beginning of the year, and there are a range of viewpoints that need to be sorted out so that coherent policies can be formulated that would be broadly supported by all health professionals (not just mainstream health professionals).
About the same time I received a communication from Gerald Quigley talking about the clinical and educational resources that exist within the Society of Hospital Pharmacists of Australia.
I reflected on both these communications and decided to publish them in a positive fashion, hopefully to create an ethical and clinical direction for community pharmacy.
Dr Adam Dunn is a research fellow at UNSW’s Australian Institute of Health Innovation. Professor Enrico Coiera is the Director of the Institute’s Centre for Health Informatics.
Together, in the article below they are proposing a solution to the problems surrounding clinical evidence.
Something needs to happen to help resolve the current mess, particularly in respect of a full disclosure of evidence held by global drug manufacturers.
Currently, it could be said that thinking health practitioners have lost faith in the published evidence for any drug, no matter where it was published. Corruption has damaged any credibility the pharmaceutical industry once had, and diversionary tactics such as attacking non-mainstream medicine and their health professionals will not retrieve the situation.
What is needed is a totally new system and one where evidence can be fully and openly tested.
Following the first conversation between Dr Ken Harvey, Gerald Quigley and Neil Johnston, which was recorded in last week’s update to i2P, Dr Ken Harvey stirred the pot a little by sending a letter to the editor with sufficient content to stimulate a second conversation.
What follows below is a copy of that letter with comments by the original participants.
Readers who have not read the first conversation should visit this link.
Ken has also placed additional comment on site at the foot of this original “conversation”
Anybody reading this material is invited to comment through the panels at the foot of the article (s). Gerald and I would particularly like to hear from pharmacists who may be feeling constricted within their own practice by being herded into a channel of activity that is uninspiring through lack of challenge and incomprehensible when you try to deal with “evidence” that is contradictory or developed from a fraudulent base.
What follows is Part Two of our tripartite “Evidence Based Conversation”.
As pharmacists we believe we belong to a scientific discipline deeply involved in better patient outcomes.
We rely on “evidence” to base our own practice decisions on and we rely on reputable journals to deliver that evidence to us.
Deriving from scientific method it should be a very clear-cut process to test that evidence and build on it.
Yet increasingly, when evidence is tested for replication, it is found not possible to produce an identical result, suggesting that fraud or misrepresentation has occurred.
Most pharmacy owners would be aware that when you introduce a new professional service into the pharmacy environment that there is a period of time involved before the service begins to develop traction.
During that lead-time there is also a need to integrate the new service with as many of the existing services as possible.
The major service provided by pharmacy is dispensing. Another is “counter prescribing” often involving the sale of schedule 3 medications.
Other services are usually built around periodic promotions e.g. heart health and blood pressure monitoring; diabetes and blood sugar testing.
Dosage Recommendations and Clinical Applications
by William B. Grant, Ph.D.
(OMNS April 10, 2012) The biggest vitamin D story in 2011 was the report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine (IOM) . This report was prepared during a two-year process by 14 nutrition experts, with funding from the U.S. Food and Drug Administration and the National Institutes of Health and Health Canada. The committee reviewed the evidence for beneficial and harmful effects of vitamin D, relying solely on randomized controlled trials (RCTs) of its liking for benefits, and prospective cohort studies for adverse effects. RCTs were considered to have the highest quality, with observational studies of moderate quality and ecological studies of very low quality. However, the case can be made that since solar UVB is the primary source of vitamin D for most people, observational and ecological studies are the most relevant and therefore are of high quality, and in fact, have provided most of the information on the health benefits of vitamin D. However, the committee appeared to have a bias of excluding RCTs on such outcomes as cancer and influenza incidence and effects during pregnancy that were not in line with its eventual recommendations.
Inheriting gene variants that increase the risk of developing coronary heart disease does not necessarily mean an individual is going to have reduced life expectancy if he or she suffers a heart attack.
Two research papers revealing these findings by Dr Katrina Ellis and colleagues at the University of Otago, Christchurch have been highlighted in the leading international cardiology journal Circulation, along with 42 other papers from cardiac researchers around the world.
Scientists from RMIT and Monash Universities announced today a discovery that shows blocking a specific protein may have the ability to act as ‘hand brake’ to the progression of the disease in people with Multiple Sclerosis (MS).
These findings are published today in the prestigious journal Brain from Oxford University Press. The study was led by Dr Steven Petratos from the Monash Immunology and Stem Cell Laboratories and RMIT University. The publication of this study is coincidentally at a time when Australians are asked to Kiss Goodbye to MS in many events leading up to World MS Day in May.
International travellers, shift workers and even people suffering from obesity-related conditions stand to benefit from a key discovery about the functioning of the body's internal clock.
Professor Chris Liddle, from the Westmead Millennium Institute for Medical Research, the University of Sydney, worked with a team from the Salk Institute based in California, to demonstrate the importance of circadian receptors found in the brain and the liver. Their findings are published in Nature today.
Treating eyes with gentle infra-red light can help prevent the damage caused by subsequent exposure to bright light, new scientific research has found.
A breakthrough by researchers at Australia's Vision Centre offers new hope to people who suffer vision loss due to constant exposure to bright sunlight or artificial lights – such as construction workers, sportspeople, fishermen, farmers, welders, actors, entertainers and others.
Scientists at UQ's Queensland Brain Institute are one step closer to developing new therapies for treating dementia.
QBI's Dr Jana Vukovic said the work was aimed at understanding the molecular mechanism that may impair learning and memory in the ageing population.
As the end of the financial year approaches the Pharmacists’ Support Service (PSS) invites all Australian pharmacists to consider making a tax deductible donation to support the work of PSS.
PSS is an independent incorporated association and relies on the generosity of the profession to continue its work.
The service, which is based in Victoria, has expanded to Tasmania, South Australia and Northern Territory over recent years and now has the rest of Australia in its sights.
PSS is planning to establish a website for all Australian pharmacists and also develop resources and support networks in NSW, ACT, Queensland and Western Australia when sufficient funding becomes available.
Australian researchers have reported promising results with a new drug that shrinks brain tumours in melanoma patients. Their findings are published in The Lancet medical journal today.
Medical researchers at the University of Sydney, Melanoma Institute Australia, Sydney's Westmead Hospital and Westmead Millennium Institute, say a new drug they have been testing to treat deadly melanoma in the body also shows, for the first time, an ability to shrink secondary tumours (metastases) in the brains of patients with advanced forms of the disease.
Researchers at The University of Western Australia have contributed to the first global analysis of carbon stored in seagrasses which shows they can hold as much carbon as the world's temperate and tropical forests.
The study 'Seagrass Ecosystems as a Globally Significant Carbon Stock,' published in the journal Nature Geoscience provides further evidence of the important role the world's declining seagrass meadows have to play in mitigating climate change.
People with a curious condition that causes them to apply make-up on only one side of their face, or ignore food on half of their plate, are playing a new role in understanding stroke recovery.
Researchers from the Queensland Brain Institute (QBI) at The University of Queensland have found the condition, a subset of the stroke called ‘unilateral spatial neglect', tend to have the worst recovery outcomes in regaining lost functioning in their bodies, leading them to believe attention may have an important impact on recovering successfully.
Editor's Note: Sometimes we find ourselves in difficulty and the subject of an official complaint.
Often, the first knowledge of this complaint is when an inspector from some agency arrives on the doorstep and begins to interrogate you over the counter.
Sometimes (and I think deliberately) in earshot of staff, customers and patients.
Suddenly you find yourself fighting for your professional life.
We asked Mark Coleman what he would do if faced with a situation similar to what happened below: