s Exploring New Horizons | I2P: Information to Pharmacists - Archive
Publication Date 01/09/2010         Volume. 2 No. 8   
Information to Pharmacists

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Newsflash Updates for September 2010

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Regular updates from the global world of pharmacy.
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Feature Contribution

Pharma-Goss for September 2010

Rollo Manning

Consumer welfare program or small business support program?

This is a controversial question that is sure to invoke hot debate.
It is to be welcomed.
Is the PBS a consumer welfare program as a part of a total National Health Scheme or a small business support program for retail pharmacies?
Where does the balance lie and is the consumer getting the best deal of the arrangements?
That is the question.
How dare such an assertion be made that suggests the Pharmaceutical Benefits Scheme may have lost its way and moved from being a part of a National universal welfare program.

Comments: 1

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Using "Exergames" for Stroke and Falls Prevention

Peter Sayers

"Exergames", like Nintendo Wii, are usually designed for fun, recreation and exercise.
However, they are gradually being transformed into tools to treat depression, assist in stroke rehabilitation and improve mental health-related quality of life.
Currently researchers are exploring the potential of "exergames" to reduce the risk of falls in older adults.
When people walk through their own environment they may be subjected to an occasional "trip" or "slip" that could result in a fall if people are unable to make an adjustment to quickly and accurately to recover their balance.
Stepping is something that few of us think about, yet our ability to step declines with age, increasing our risk of having a fall.
Now the same exergames are set to become medical tools linked to a range of health programs, hopefully connected to the National Broadband Network.
It struck me that this may represent an opportunity for pharmacists to be involved in the supply of this type of equipment and assist in the training and supervision of patients involved in this evolving list of programs.
It also provides a link with aged care and community nursing and may provide a useful service in a pharmacy-style walk-in clinic, providing pharmacists with a "hands on" entry point to patient care.
This lack of "hands on" activity often sees pharmacists ignored in the primary health care practice activities.

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The Road Not Taken

Neil Retallick

The American poet Robert Frost did not have the Pharmacy Guild in mind when he wrote this incisive poem, but I think the decision-makers at the Guild need to read it.
It may help them understand the far-reaching consequences of the choices they are making today.
Frost describes walking through a wood and coming to a fork in the road. He contemplates the two. One seems to be a little more worn, probably the more popular choice. The other is a little more grassy, chosen less often. Neither path showed signs of recent travellers. Frost chooses the less worn road knowing he will never be able to reverse this seemingly trivial decision. He knows that the rest of his life is irreversibly impacted by this simple choice. His history can never be re-written.

Comments: 1

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Social Inclusion

Rollo Manning

“Hey – don’t forget us – we were here first!”
Remote Aboriginals left out of inclusion agenda

Remote living Aboriginals and the cycles of disadvantage which place them at the bottom of the socio economic ladder in Australia must get special treatment from a new Government in Canberra. The fact that Australia’s first people are still living in “Third World” conditions in one of the wealthiest countries of the World is a shameful situation and only special treatment will raise their standards to a point where they can be considered “included” in Australian society.

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Wellness - What is the Pharmacy View?

Staff Writer

Pharmacy, in general. is a destination point for illness.
It has yet to spark consumer interest in the broad concept of wellness, and this is where consumer concerns are being increasingly directed.
An interest in "wellness" used to be something exotic. And to the extent consumers gave any thought to the concept, it was often defined simply as the absence of illness. But "wellness" is now very much a mainstream preoccupation, and one that's viewed more broadly as a marker for quality of life. A report released this month by The Hartman Group, a US-based consultancy/research firm that has made a specialty of analyzing attitudes and behaviors in this area, took a detailed look at what wellness now means to various consumer cohorts and how this affects their engagement with products and services, especially foods.
One only has to look at the Woolworths logo to realise how seriously wellness is being taken in Australia and why that organisation wants to create a health and wellness environment plus leverage the pharmacy destination point of illness.
This would create a model with a strong holistic image, attractive to a majority of consumers.

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NICM - An Umbrella for Evidence-Based Complementary Medicine

Peter Sayers

The National Institute of Complementary Medicine (NICM) is an organisation established to provide leadership and support for strategically directed research into complementary medicine, and the translation of that evidence into clinical practice and relevant policy, to benefit the health of all Australians.
It is an organisation that generates much needed credibility for the complementary medicine area and will do much to temper improper use of these medicines and moderate unwarranted criticism.
Polarisation of these two extremes has occurred, generating confusion among health providers.

Comments: 2

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The Right to Die

Neil Johnston

For the last decade, Australians have been talking about their average age increasing, to the extent that at least 25% of the population will be over the age of 64 within twenty years.
With that increase in age comes an increase in lifestyle illness and the need to invest in aged care facilities and to provide funding for medicines on the PBS that will increasingly be utilised.
It seems demand will outstrip available resources.
But another social/ethical issue accompanies the ageing process and lifestyle illness, and that is quality of life.
What purpose is there to living a long life if it has no quality or becomes too unbearable and draining for the individual and their surrounding family?
So when somebody decides they wish to die ahead of schedule because of unbearable pain and suffering they suddenly find that right has been taken away from them by politicians.
Euthanasia is a subject that has been kept under the radar for a long time but containment now appears impractical as evidence of suffering will simply increase with the volume of aged persons.

Comments: 3

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UK Walk-In Clinics Gain Traction

Staff Writer

Walk-in clinics in pharmacy is an idea that is now gaining traction around the world.
Long established in the US, they are now appearing in the UK - with one great difference - the UK model is staffed mostly by pharmacists with only a small number of nurse-led clinics.
All are funded by government.
If this type of clinic was to gain sufficient traction in Australia, plus receive government funding, an easing of the oversupply of pharmacists in some parts of Australia would possibly result, as well as ease pressure on GP's.
Boots, a chain pharmacy group in the UK is providing walk-in services during extended hours to ease pressure on GPs and hospitals.
Pharmacists at a Boots store in Edinburgh have started to provide walk-in services during extended opening hours this month as part of the Pharmore pilot project funded by the Scottish Government.
It's really just a more professional and properly resourced version of the old style counter prescribing, but this time in privacy, plus being paid for the service.

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Promising climate research awarded

Staff Writer

Dr Deanna D'Alessandro has been recognised for her promising research into climate change.
A University of Sydney researcher has won recognition for her groundbreaking work into capturing carbon emissions, which has the potential to significantly impact climate change.
Dr Deanna D'Alessandro, a postdoctoral fellow based in the School of Chemistry, is one of three female researchers to be awarded a L'Oréal Australia For Women in Science Fellowship.

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New therapy could combat the weight loss and muscle wasting experienced by cancer patients

Staff Writer

Deakin University medical researchers are working on a treatment for cancer cachexia, the debilitating weight loss and muscle wasting condition that affects patients with cancer.
Cancer cachexia has a major impact on quality of life for cancer patients. It can also inhibit the effectiveness of cancer treatments such as chemotherapy and radiotherapy.
There is currently no effective treatment.

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Prevention Saves Money and Lives

Staff Writer

University of Queensland and Deakin University researchers have  released a report with dozens of recommendations that strongly support more spending on prevention, but also warn that not all prevention measures are wise investments.
The Assessing Cost Effectiveness of Prevention (ACE-Prevention) project is the result of five years of research, funded by the National Health and Medical Research Council.
It is believed to be the most comprehensive evaluation of health prevention measures ever conducted world-wide, involving input from 130 top health experts.

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FIP Professional Innovation Grant

Staff Writer

Jonathan Penm, a PhD candidate at the Faculty of Pharmacy has just been awarded the Young Pharmacists Group (YPG) Grant for Professional Innovation 2010.
The announcement was made by the International Pharmaceutical Federation (FIP) Board of Directors during the 70th FIP World Congress of Pharmacy /Pharmaceutical Sciences in Lisbon, Portugal, which ran from 28th August to the 2nd September 2010.

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New Drug a Potential Treatment for Type 2 Diabetes

Staff Writer

Australian scientists, in association with US pharmaceutical company DiaKine Therapeutics, have shown that a drug candidate, Lisofylline, could be useful in treating Type 2 diabetes.
Drs Georgia Frangioudakis and Carsten Schmitz-Peiffer from Sydney’s Garvan Institute of Medical Research, tested the anti-inflammatory drug which is undergoing clinical trials for other diseases, on mice being fed high-fat diets.
Their findings are published in the journal Endocrinology, now online.

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Mobile Phone Technology - A Need to Integrate for Patient Benefit

Staff Writer

Mobile technology is advancing at a rapid pace and mobile phones in particular are now beginning to overtake fixed landline phones.
Some technology companies are now providing physical platforms to handle both mobile phone calls and fixed landline calls in a more integrated fashion, distributing all calls throughout the home or office using "hands free" extension phones.
The new platforms include other applications such as electronic diaries, Internet connection, Facebook and other social media extensions, weather displays, latest news displays, personal or other photo albums - the list is becoming very extensive.
Health technology developers now need to factor this expanding "tool" into their various architectures to ensure that they too are able to "keep in touch".
The mobile phone is now cemented into all age demographics, including "seniors", where it is regarded as an essential tool for keeping in touch with family and friends, and more importantly, for connection to their health professionals for emergencies.
I also notice that health professionals, particularly GP's and dentists, are using the telephone to remind patients of their appointments, usually a day or so in advance.
Health telephone systems need to become more intuitive to handle emergencies to bypass the normal blockages to a health practitioner in the event of an emergency.
A recent survey published in Retail Clinician indicates to what extent consumers would currently engage in an integrated and interactive system.

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Drug-herb interactions information available to all healthcare professionals

Staff Writer

MIMS Australia and IMgateway recently signed a Memorandum of Understanding (MoU) with the intention of delivering a unique Australian developed, evidence based drug-herb interactions database directly to a healthcare professional's desk top.
This database has been developed by researchers from the Faculty of Pharmacy at The University of Sydney.

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Health sector treats almost 6 million in flood-affected Pakistan

Staff Writer

The objective of WHO and health partners in Pakistan is to reduce avoidable death and illness
In a massive health relief effort underway in the flood-affected parts of Pakistan, nearly six million people have been treated for health conditions since the floods began in late July; but there are urgent needs to prevent further health crises or food insecurity caused by large-scale damage to crops and agricultural land.
"Increasing cases of communicable diseases, like diarrhoea and malaria, fears about children being malnourished, the massive disruption to healthcare, crop systems and rising food insecurity are the main health threats facing Pakistan's flood-affected people," says Dr Guido Sabatinelli, WHO's Representative to Pakistan.

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Kidzcomics-empowering kids (and possibly their parents)

Staff Writer

Children affected by serious diseases and medical conditions either personally or in their families often don't really understand those illnesses or the treatments required to fight them. New Zealand-based Kidzcomics aims to change all that with a series of comic books designed to explain medical information for children.
The Medikidz series features five superheroes by the same name, each of them a specialist in a different part of the body. With stories designed to be fun and appealing, the comics aim to entertain as well as educate children about serious medical issues. Conditions covered in the Medikidz line so far include leukemia, epilepsy, diabetes, HIV and ADHD, among many others; rather than “sugar-coating” the topics, Kidzcomics' books aim to empower and educate children for better self-management and less fear. All content is written by professional medical writers and doctors and then peer-reviewed.
And while the comics attract children they also serve to educate parents who sneak the occasional look.

There are currently more than 50 million children afflicted by illness in English-speaking countries.

Website: www.kidzcomics.com

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Water-Based "Artificial Leaf" Produces Electricity

Staff Writer

A team led by a North Carolina State University researcher has shown that water-gel-based solar devices – “artificial leaves” – can act like solar cells to produce electricity.
The findings prove the concept for making solar cells that more closely mimic nature.
They also have the potential to be less expensive and more environmentally friendly than the current standard-bearer: silicon-based solar cells.

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Exploring New Horizons

Neil Johnston

A message delivered to delegates attending the International Pharmacy Federation (FIP) Congress in Lisbon Portugal was for pharmacists to explore new horizons.
One can sense and appreciate this message because pharmacy does seem to be stuck in a time warp without a unified sense of purpose for the future.
Our two major peak bodies, the PSA and the PGA have not closely worked together, with open warfare being declared on occasions.
There does not yet seem to be a coherent positive theme running from either organisation that the "troops" can align with, although there are signs of positivity developing in PSA and a slightly lesser aggressive stance being taken by PGA.
But what's on your horizon and what is your future vision?
To help kick off a discussion, i2P asked Mark Coleman to comment on the media item reported in Pharmacy News on the 31 August 2010

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Exploring New Horizons

Neil Johnston

articles by this author...

Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

A message delivered to delegates attending the International Pharmacy Federation (FIP) Congress in Lisbon Portugal was for pharmacists to explore new horizons.
One can sense and appreciate this message because pharmacy does seem to be stuck in a time warp without a unified sense of purpose for the future.
Our two major peak bodies, the PSA and the PGA have not closely worked together, with open warfare being declared on occasions.
There does not yet seem to be a coherent positive theme running from either organisation that the "troops" can align with, although there are signs of positivity developing in PSA and a slightly lesser aggressive stance being taken by PGA.
But what's on your horizon and what is your future vision?
To help kick off a discussion, i2P asked Mark Coleman to comment on the media item reported in Pharmacy News on the 31 August 2010

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Pharmacists urged to explore new horizons

Explore beyond the horizon is the message being sent to pharmacists at the International Pharmacy Federation (FIP) Congress in Lisbon, Portugal.
In his opening address to the congress, FIP president Dr Kamal Midha urged members to follow the example set by Portuguese navigators in the 14th Century and sailed out from the port of Lisbon into the horizon to explore new possibilities.

“At that time people believed that the world was flat, so what reassurance would a navigator have had that he would not sail out and fall off the horizon?” he asked.

 “As in all major undertakings, lessons have been learned through risks in exploring beyond the horizon.

“Today, we continue a journey of exploration – not in navigating the seas, but exploring the challenges and critical needs in our schools, our laboratories and in our communities, in the pursuit of global health,” Dr Midha said.

While pushing the line on the horizon further back, the FIP president described the federation as a “collaborative platform” for pharmacists worldwide to learn from each other and address the challenges facing the profession.

Dr Midha added the role of pharmacists and pharmaceutical scientists was constantly evolving, stressing the need for members from different countries to work together to strengthen the profession globally.

“Through FIP we do together, with and for each other, what we cannot do alone,” he said.

Alongside nurturing closer relationships between FIP members, Dr Midha said the federation had worked arm-in-arm with other international health groups including the World Health Organization (WHO) to improve the standing of pharmacists globally.

“This year’s annual report highlights some of the collaborative initiatives with the WHO.

“These include rational use of medicines, strengthening the pharmaceutical workforce and patient safety,” he said.

 

Mark Coleman


I am asked to comment on the "new horizons" noted in the above media report generated from a recent FIP Congress inLisbon, Portugal.
Now this is a very large topic I have had tossed to me, and I don't want to get bogged down in detail.
To develop some sort of perspective I need to examine what point we have come from, the developments to this current date and then project some future thoughts.

i2P began publication in February 2000 in response to a wide ranging report that became known as the Wilkinson Review. That is a good enough starting point.
At the time it was regarded as quite radical by the PGA, and many of its recommendations were simply ignored or muted.
For example, the opportunity to create company infrastructures was noted, and this looked like it might allow non-pharmacist shareholders and directors to introduce new ideas and capital investment not controlled by wholesaler interests. This was muted by only allowing pharmacist directors and shareholders to be involved in pharmacy companies.
There was also a recommendation to relax the number of pharmacies a pharmacist could own.
To a certain extent this has occurred, but without clear cut guidelines.
Location Rules became "twisted" and many "shonky" partnerships were formed with young pharmacists but with no proper pathway to transition to real ownership.
So the opportunity to develop new company structures to absorb new pharmacists, I think, is one of the tragedies of that time, with the result that pharmacy today has an apparent surplus of pharmacists, plus a disconnect between pharmacy schools and pharmacy owners.
Pharmacy schools lost the conduit they needed to deliver their research and training through to new pharmacist shareholders, who after completing their "apprenticeship" in business would have eventually been in a position to financially back the ideas that would have evolved into a positive activity for pharmacists.

So the "new horizons" that can be immediately looked at are pharmacy schools researching valid income producing clinical services and become a full time resource for a community pharmacy, including the provision of consultancy services to ensure any new activity "sticks".
Consultancies would also generate a new income stream for the pharmacy schools, reducing the need to increase course fees.
The second is a repair job on the concept of pharmacy companies, because in their present state they are going nowhere. Pharmacy companies should be a fertile area for young pharmacists to be recruited - and they need to be asked what ideas they will bring to enhance the professional aspects of a pharmacy before they are recruited. They should earn their shareholding by producing a business plan for the pharmacy they wish to be part of, and then given the resources to implement it.
Pharmacy practice companies, those that perform medication reviews in various settings, would also be valuable shareholders and by osmosis, would also be created as PGA members, giving them a voice that is currently ignored in PGA circles.

Over the past decade there has been a small debate on "walk-in" clinics for community pharmacies.
This idea has not gathered "legs" as yet, but the fact remains that having such a clinic creates a physical and financial commitment to clinical pharmacy, with the big plus of having a high profile area to show off as a primary health care centre.
Pharmacy has not stood still over time. It has efficiently delegated dispensing to IT systems and pharmacy technicians.
What it did not do was have a parallel planning process to create clinical forms of income to take up the slack as pharmacists were delegated from their jobs.
They had nowhere to go and the result is a pharmacist surplus with no new work to create revenue to pay them.
The whole process has been exacerbated in recent years by the PGA inflicting its supply-type pharmacy on the profession and not being open to whole-of-profession solutions.
While pharmacy operates within separate compartments, you cannot maintain balance when one segment is developed at the expense of another.
Government exacerbates the entire situation by not allowing pharmacies to keep the productivity gains they produce for the PBS - even a sharing formula would be better than total rape, which we currently have.
This strips out any surplus capital that could be gainfully utilised to develop the clinical side of the business.

I also note that e-health is beginning to burgeon in the pipeline, but again, pharmacy does not seem to have a coherent plan to attract new innovations before they are dispersed to other areas of health.
For example, developments are occurring in neurology and mental health that involve using the Nintendo game Wii, developed as an "exergame" for stroke rehabilitation and falls prevention.
What would prevent the PSA from setting up a clearing house to attract innovations like this and coordinate a service for clinical pharmacy? This is an ideal service to partly deliver from a "walk-in" clinic or as an outreach to aged care facilities and community nurses.

My horizon is suddenly becoming cluttered as I write, because there are many more opportunities than what I have covered.
It makes me so frustrated to see that we have any unemployment within pharmacy.

In summary, my "horizon" recommendations are:

1. Fix the pharmacy company problem so that they can be attractants for new capital and new pharmacists.

2. Straighten out the disconnect between various pharmacy bodies.
a. Pharmacy schools to equip students with the relevant skills to develop clinical services for a fee.
b. Pharmacy schools to provide consultancies in the clinical skills area.
c. PGA to come onside and see its role as providing physical infrastructure.
d. PSA to get on with its practice education, managed into all geographic areas in a decentralised fashion.

3. Embrace new areas of e-health, not just in developing new IT software.
The Nintendo Wii represents just such an opportunity. When connected to the National Broadband Network other initiatives and opportunities will emerge to create "hands on" services in the primary health care area.

The above are initiatives we can all get involved with without the constant bickering that seems to occur.
Getting ouselves busy in a creative activity will dissipate all the doom and gloom plus, I suspect, the pharmacist surplus.
FIP seem to have delivered the right message at the right time.

 

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