s The Health Legacy of Nicola Roxon | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
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.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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The Health Legacy of Nicola Roxon

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.

Back in 2007 when John Howard was defeated in a general election and the new  team was assuming the reins of power, I remember looking for the name of who the new Minister for Health and Aging was going to be.
That person, of course, was Nicola Roxon, a virtual unknown at that time.
I decided to do a background article to understand the attitudes and values of the person who was going to control Pharmacy’s destiny for the ensuing years.
Now we have had time to observe her in action and I would say that Nicola represents one of the best young political minds ever to serve in the Australian Parliament and deserves wider recognition for her achievements in containing the tobacco industry’s marketing thrust, saving many Australian lives now, and for the future.

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Before entering the current parliament she had been appointed Shadow Attorney-General, a position she filled until 2006.
She had previously worked for well-known Melbourne law firm
As Shadow Attorney-General she lobbied hard for the release of David Hicks from Guantanamo Bay, and in 2005 in partnership with Greg Combet (ACTU secretary) launched a High Court challenge to the Federal Government’s use of taxpayer money on advertisements to promote its new industrial laws
At the time I was surprised to find that her mother was a pharmacist and her father was a medical student who switched to pharmacy to eventually become a researcher.

The title of the background article was “Have you met Nicola Louise Roxon?" and I noted some predictions on the basis of my research towards the end of that article as follows:

“Well, what is contained in this article has been researched from information publicly available on the Internet.
I have attempted to go behind the public face of the ministerial position as a guide as to what the profession of pharmacy may expect.
My summary is as follows:

* Nicola appears to be a very normal and stable personality with strong family values, and is direct, straightforward and honest in her professional life.

* Nicola will endeavour to broaden the concept of health from illness treatment to illness prevention. She is well documented in many statements that “prevention is better than cure”.


* Pharmacy will be included within primary health care (something that other professions have tried to restrict), and the role pharmacy already plays in self-care will be recognised. I am sure that funds will be made available for the extension of self-care, work that has always been unpaid work performed by pharmacists.

* Nicola, however, needs to understand exactly what depth pharmacists have provided primary care, almost in a secretive fashion, because of constant harassment by doctors. While there is a surface cooperation between doctors and pharmacists, it is really only lip service.
The removal of this harassment would allow pharmacists to thrive as well as the general public.

* Nicola also needs to understand that while pharmacy owners provide infrastructure to provide medicine distribution, the pressure of this infrastructure works against the development of clinical services.
For this role she needs to recognise pharmacists individually as health practitioners and separate their income from the PBS model.
By providing incentives to individual pharmacist practitioners, development ideas and capital would flow in from these people and pharmacy owners would form beneficial relationships to harness benefit for the supply side of their businesses.

* From the recent address given at the Pharmacy Guild of Australia annual dinner, Nicola said, in part:
‘The examples of existing Professional Programs and Services confirm the pharmacist’s role within the primary healthcare team.

There may still be some debate about the borders of that role – but the direction is already well and truly established.
I want to be clear here – and I suspect my earlier comments have already given this away – any expanded role for pharmacists will take an incremental approach, and will be dictated by the need for safety and quality in health care.’

In other words, she will do what she has always done – carefully plan and test any program before it becomes policy.

I judge Nicola Roxon has the capacity to become an outstanding Minister in the health portfolio. Her inherent caution allows for less pain in the event of mistakes being made in policy and in implementation.
She is intelligent, a high achiever and a quick learner.
Keeping the focus on the patient and not on the selfish interests of each health profession will ensure the best of outcomes.
There will be obviously some mistakes made, and in the case of pharmacy I hope she applies appropriate discretion to pharmacy owners and pharmacist practitioners, the latter being the “silent 65%” for the moment.

And as for taking tough decisions, you only have to look in on current PBS negotiations with drug manufacturers as they gear up for a round of talks that must inevitably lead to price reductions for some of the more expensive PBS items.”


I am pleased to observe that many of the i2P predictions made on her entry to the health portfolio came true, or are well under way.

During her term as Minister for Health and Aging from 2007 to 2011, Nicola oversaw major reforms to Australia’s public hospital, primary care and preventative health systems. In 2011 Nicola was awarded the World Health Organization Director-General’s Special Recognition Certificate for her accomplishments in tobacco control

Nicola Roxon was sworn in as Attorney-General on 14 December 2011; and as Minister for Emergency Management on 5 March 2012. Tanya Pliberseck succeeded her in the health portfolio.
Obviously with Nicola in her current role as Attorney-General she is able to continue her anti- tobacco activities
In her campaign to eliminate tobacco as a cause of major illness in Australia she endeavoured to have legislation introduced to ban all forms of advertising on cigarette packaging.
This was an undertaking requiring an enormous focus, courage and political will.
The campaign was bitterly contested by tobacco companies on the basis of misappropriation of intellectual property, but a recent High Court ruling found in favour of the Australian government.
The fight is now being taken to the United Nations Commission on International Trade Law by the tobacco companies.
Australia should expect pressure being exerted through any treaties entered into, particularly those with the US, where political parties receive large political donations routinely to ensure tobacco interests are well served.

In a recent media statement, Nicola Roxon said:

“The federal government's High Court victory on plain packaging is a watershed moment for tobacco control globally.

"Australia's actions are being closely watched by governments around the world,"

"The message to the rest of the world is big tobacco can be taken on and beaten.

"Without brave governments willing to take the fight up to big tobacco they'd still have us believing that tobacco is neither harmful nor addictive."

The enormity of what Nicola Roxon has delivered will have many long-term health benefits, chief among them an expansion in lifespan and an improvement in lifestyle for all Australians, particularly young Australians.

In January 2012 in an interview published by the Australian Journal of Pharmacy, Nicola Roxon encouraged pharmacists to “jump in” to reform health.
Unfortunately our pharmacy leaders have shown little political will to ensure that pharmacists are able to be in that position. If anything, we have fallen way behind the competition (other health professions). They continually erode our “turf” very profitably.

Historically,it seems as though the light went out for the Pharmacy Guild of Australia on the death of Kevin McAnuff who was a driver of a transformation in Australia's modern community pharmacy practice which had its direct origins in the CAPS group in 1989 and evolved into the Third Community Pharmacy Agreement (2000-2005).
No other PGA politician has had the inspirational and intellectual qualities required for true leadership since, and the profession has suffered dearly.
McAnuff was preparing for the Fourth Agreement in Canberra, away from his home in Perth, at the time of his sudden passing.
It is recommended that to get a context for all of the above that readers should revisit two articles written by Con Berbatis, a pharmacy researcher (now retired), who was originally attached to Curtin Unversity in Western Australia.

Go to “A Tribute to Kevin McAnuff” and “Strategies for pharmacy in the 21st century : discourses with Kevin McAnuff”

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