Welcome to the December 2009 edition of i2p - Information to Pharmacists E-Magazine.
When i2P first began in February 2000, it was decided that a fortnightly publication might prove to be the optimum publishing cycle.
This thought was soon dispelled as it was found that having sufficient content to maintain this cycle became a problem.
Oh for those quieter times!
The cycle then became monthly and has been maintained up to now.
The problem is now coping with the volume of news and opinion that is generated on a daily basis.
Very much the reverse of the year 2000 - a statement for our time and how the pace of pharmacy life has increased.
Volume 1 Number 1
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Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
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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
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Volume 3 Number 5
Volume 3 Number 6
Volume 3 Number 7
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Volume 4 Number 1
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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
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Volume 5 Number 4
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Volume 5 Number 6
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Volume 6 Number 1
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Volume 6 Number 5
Volume 6 Number 6
Sir Winston Churchill said “Truth is incontrovertible, malice may attack it and ignorance may deride it, but, in the end, there it is.”
Elvis Presley said “Truth is like the sun. You can shut it out for a time, but it ain't goin' away.”
At the PAC 2009 Conference John Menadue’s forthright messages made it abundantly clear that the sun was shining very brightly indeed.
Here are the ‘message sticks’ that resonated with me:
It was interesting reading John Menadue’s speech given at the Pharmacy Australia Congress in Sydney in October.
It was even more interesting to read of the UN-invitation by the Queensland branch of the College of Pharmacy Practice and Management, the stance taken by the Pharmacy Guild of Australia and the Pharmaceutical Society, to support only pharmacy activities provided from within a community pharmacy.
How draconian is that?
Research has demonstrated, as has the low uptake of new professional services from within a community pharmacy, that the existing community pharmacy model is not compatible with the implementation of these new professional opportunities.
The two major arguments put forward are ‘lack of time’ and ‘lack of funding’.
Simon Divecha, Director of GreenMode, a consultancy that assist business and people to find their carbon and sustainable advantages spoke at the recent Pharmacy 2009 Conference.
Simon has assisted businesses including BP Solar, Origin Energy, Lend Lease, ANZ and IAG.
His challenge to community pharmacy is to identify and take advantage of the opportunities that exist for businesses that have such close relationships with their local communities.
Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.
In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?
And if so, what is our future likely to hold?
What can we do about it?
Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?
Another year has gone by and what have we done with technology in the health sector?
A good question that deserves a long and detailed review as a written dissertation by somebody learned and influential in health informatics, government, consulting or from the many agencies, departments and committees engaged in delivering e-health service to the Australian public; notably as a value proposition for the tax payers in the greater voting public cohort.
Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.
Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.
It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.
One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.
Source: AAP NewsWire
National Health IT assumed prominence recently when the National Business Council of Australia wrote directly to prime minister, Kevin Rudd, urging him to create a focus on communications technology and to invest appropriate funds.
I wonder if they were aware of the organisational performance 0f NEHTA and their inability to date, to actually deliver suitable infrastructure and systems.
And with $'s millions already wasted by NEHTA I am sure there is hesitancy by government to spend even more, given the dismal track record to date.
Health communications is stuck in a deep groove.
But it is interesting to note that the Business Council of Australia see productivity and investment opportunities in health if only the primary health players could integrate better and talk to one another.
Shared health communications underpins this potential benefit as the many writers for i2P have continually pointed out.
With the big end of town taking more interest, maybe government and health professionals can align themselves more fluidly.
A read of David More's blog article from a NEHTA insider in this edition of i2P, leaves you still wondering how an alignment can take place without removing the NEHTA structure completely.
Health info needs urgent technological injection
Source: Industry Search -24/11/2009
An unusual form of renewable energy has emerged recently in a novel format involving the use of fresh water and salt water interaction across a membrane that creates osmotic pressure.
This pressure has been demonstrated to be able to drive a turbine that can produce an electric current.
Osmotic pressure is well known in medicine with adjustments having to be made to eye drop and injection formulas to minimise the pain associated with the administration of these medicine forms.
The process is a more controllable form of natural energy when compared with weather-dependent versions of energy generation (solar, wind, tidal etc) and has a reasonably small and discrete footprint in the environment.
With a bit of imagination it is not too far of a stretch to have the salt water filtered through another form of membrane to create fresh water to be recycled within a closed system.
Source: Industry Search
Prime Minister Kevin Rudd is to be commended for the initiative in having a look at the feasibility of creating a no fault disability insurance scheme.
Disability can cause disaster to any family structure and can be a constant drain on financial resources that can add to further stresses up to, and involving bankruptcies.
By putting in place a proper financial underpin, each family member is enabled to be productive and self-sustaining. This can create a net gain to the taxation base when viewed globally, to include service providers and industries that can feed off that activity stream.
PM calls for national disability reforms
Source:DPS Guide to Aged Care
I can't but help wonder if the move to be able to patent all things natural is a smart move.
Take for example the Neam tree that grows wild in the northern part of Australia.
The leaves of this tree make a great insect repellent with no known side effects.
An entrepreneurial Australian a few years back, decided to grow these trees and was surprised to have legal documents served on him claiming royalties and damages from some obscure US company that had registered a patent for all things Neam.
Unfortunately, there was no legal defence for the Australian grower.
Now there is an outcry by vested interests because the Australian government has resisted pressures to allow the patenting of human genes.
All sorts of calamities are therefore predicted for the local biotech industries.
But I wonder if these claims will prove to be valid?
Follow the debate in this article:
Ban drives 'biotech industry to its knees'
Queensland Health struggles through another drama after using instruments that had been used on patients and left unsterilised.
But it's not just Bundaberg Hospital that is sick - the entire Australian hospital system needs a radical overhaul.
The Rudd government had promised to "fix" the problem after taking office, but so far has not made any noticeable progress.
Read about the latest problem.
Qld Health cleaning up after dental sterilisation scare
Source: ABC Online
By Chris O'Brien
If anyone has ever been a patient in a hospital and tried the buzzer to get assistance from a nurse, then here is a new innovation to get attention.
Not that the nursing fraternity should shoulder the blame.
It's the politicians and the lack of political will to solve this issue and many others.
Congratulations to the patient and his initiative in dialling triple O.
Read the full story here:
Man rings triple-0 from hospital bed
Source: ABC Online
by Cate Grant
Health professionals from around the world are slowly waking up to the fact that climate change can induce adverse effects on health.
At i2P we have been carrying messages for just on two years, regarding climate change effects, including research reports from our own writer Con Berbatis, in the hope that official pharmacy would see the need and develop policies and strategies for pharmacists to adopt.
Now, with the formation of the International Climate and Health Council a recognised forum is available to be addressed.
Will pharmacists be given a seat at the table?
Perhaps the Pharmaceutical Society of Australia should find out.
Health Professionals Around The World Launch The International Climate And Health Council
Source: Medical News Today
The ageing process is relentless with function loss noticeably diminishing over the age of 60.
Supplementation of nutrients holds one key to slowing down some of the processes, in particular the loss of muscle mass and the subsequent aches and pains that follow as the skeletal system is no longer held together in an optimum manner.
This process can be a contributor to falls and more serious damage.
Not being able to adequately stay on your feet as you age, robs you of your independence.
It would seem that a strategy of slowing down slowly might be prudent for the age demographic entering retirement - the "baby-boomers".
Antioxidants could help preserve muscle strength
Source: Reuters Health
By Marilynn Larkin
National Seniors Agency have published a report indicating that Australia will have a shortfall of 1.4 million workers by 2025.
This shortage will also be reflected in the profession of pharmacy.
It is pointed out that a smart move would be to match an improved workplace to match specific requirements for mature-aged employees and thus retain them for longer periods..
APESMA has recently published an online survey in an endeavour to poll employed pharmacists on the issues that affect them specifically. Obviously, this is a move in the right direction, and much of what they are polling has a direct relationship to mature-aged employees.
So what is community pharmacy doing to retain their senior pharmacists?
Very little, it seems.
i2P asked Mark Coleman to comment and his commentary appears below the news item:
Rollo Manning has experienced pharmacy practice from all sectors of the industry – retail, administrative, policy and remote Aboriginal practice. He spent 10 years with Glaxo Australia and was the first Director of Public Relations at the Pharmacy Guild National Secretariat in Canberra.
MOVING AHEAD WITH PHARMACY SERVICES FOR ABORIGINAL PEOPLE Concerned about the quality in the use of medicine at an Aboriginal Medical Service? – Remote, urban or regional centre? The answer is simple – employ (or engage) a pharmacist.
MOVING AHEAD WITH PHARMACY SERVICES FOR ABORIGINAL PEOPLE
Concerned about the quality in the use of medicine at an Aboriginal Medical Service? – Remote, urban or regional centre?
The answer is simple – employ (or engage) a pharmacist.
This conclusion is the major thrust for improving the Quality Use of Medicine (QUM), from ordering in to evaluating drug utilisation. Many hundreds of pages of reviews, analyses, research and conference transcripts have been written on the subject of needs analysis.
It all comes down to control – the control of the medicine supply from AMS to client must rest with the AMS so the process meets the modes of medical practice in the sector.
“Pharmacy” is renowned for being driven by regulatory process and adherence to professional standards with a reluctance to stray away from the mainstream model developed over the past 100 years. This model (paradigm) has been influenced by manufacturers and the enthusiastic protectionism heaped upon a retail sector renowned for its “four walled” syndrome. The vigour of the lobby for this retail sector has eliminated any aspirations other health service delivery agencies may have had for including a pharmacy operation in their service.
Aboriginal Medical Services are one such agency. Aged Care Facilities, Nursing homes, private hospitals, Primary Health Care Centres and GP Super Clinics are other examples of health facilities unable to own (and therefore control) the way pharmaceutical care is delivered to their clients.
The quest for improvements to QUM in Aboriginal Medical Services is really a simple matter of introducing a logical sequence of activities that enlightens each step of the path from acquiring the medicines into the pharmacy room, to dispensing to clients, informing them of likely actions and consequences of taking the medicine and evaluating the result. This simple process is at the core of the training for all pharmacy graduates from the 17 Universities around Australia that deliver the Batchelor of Pharmacy degree. So why is it so hard to introduce a registered pharmacist to the primary health care team at an AMS?
The answer to that question is simple too. The retail pharmacy lobby is adamant (some may say fanatical) about having all money derived from the PBS going through the cash register of the retail pharmacy.
There is the need for a paradigm shift. A shift away from this model to one that is under the control of the AMS itself so it can model the practice of pharmaceutical care in a manner that suits it and its clients.
That is after all what it is all about – good patient outcomes – better health for Aboriginal people – and thus prolonging life expectancy thereby closing the gap.
The past ten years has seen a significant improvement in the way pharmacy services have been delivered to Aboriginal Medical Services in both the urban/rural and remote areas of Australia. This was sparked by the introduction of the special arrangements for the supply of PBS medicines to remote health clinics.
To come is the involvement of registered pharmacists as a member of the primary health care team at the AMS.
The flow on was for the urban AMSs to ask “why not us?” The activity has focussed on the supply side of the pharmacy function. In remote this has resulted in an ample supply of “free” medicines listed on the PBS to be available directly to the health clinics with no audit trail on what happened after the arrival into the clinic pharmacy room. In the urban AMSs not much has changed and whilst the QuMAX Program has assisted to meet the costs of dispensing to clients (either as one off dispensing or dose administration aid packing) the understanding of the client towards the medicines being supplied has not had any concerted effort.
Some will argue that cost is the main factor for the client (Urbis Keys Young, 1998 and 2007)
This must now move on to improve the areas of clinical information and employment and training opportunities for young Aboriginal Australians.
The following chart describes how pharmacists can now move ahead in interacting with Aboriginal Medical Services and their primary health care clinicians.
A satisfactory supply at an affordable cost is the first plank of the National Medicines Policy (NMP) surrounding the use of Pharmaceutical Benefits Scheme (PBS) medicines at Aboriginal Medical Services. This is an operational function of ordering and supplying and its efficiency can be easily measured and quantified. The next step of supplying on to the patient is to some extent mechanical but should also involve the supply of information to help the patient understand why the medicine has been prescribed and the effects that can be expected.
The western medicine model of treatment needs to be explained alongside the desire to use traditional “bush” medicines.
The chart below shows the relative responsibilities in the continuum of the National Medicines Policy.
This qualitative aspect of the NMP is provided to all Australians having medicine prescribed by a doctor and dispensed at a local “community” pharmacy. This is not so for Aboriginal people visiting a remote health centre and obtaining free medicine through the special arrangements using Section 100 of the National Health Act. The local pharmacy supplies the medicines in bulk.
What then needs to happen is for the cost of dispensing to be recognised by the Department of Health and Ageing to bridge the gap between the fee paid to pharmacies to dispense Section 85 scripts ($6.42) and the fee paid for supply of Section 100 arrangement to ACCHOs ($2.69). It is believed in this $3.73 that should be available and paid to those ACCHOs which choose to go down the path of employing a pharmacist to improve the quality use of medicine in every respect. It is a matter of equity with mainstream Australians having access to a pharmacist whenever they have a PBS prescription dispensed compared to remote living Aboriginals who have no such access. The key to this happening will be closing the gap in the payment of a dispensing fee.
Questions or comments to the author at firstname.lastname@example.org
December 2009Return to home