s Last Pre-Christmas News Roundup- APESMA - Australian Prescriber - NSW Guild - NPS on Methotrexate - PSA - Competency Tool | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


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

Comments: 1

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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

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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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Last Pre-Christmas News Roundup- APESMA - Australian Prescriber - NSW Guild - NPS on Methotrexate - PSA - Competency Tool

Staff Writer

articles by this author...

Editing and Researching news and stories about global and local Pharmacy Issues

i2P news and articles will continue to be published weekly over the Christmas/New Year period, but not quite so "in-depth".
You are invited to explore the recent archives of i2P when you begin to plan for the coming year.
We also encourage you to post comments at the foot of each published item.
i2P knows that the coming year will be more challenging than in previous years.
It will be a year of sorting out priorities - those within the industry wishing to needlessly fight to prop up inappropriate structures will be seen to waste time and resources.
They will be judged harshly by participants at the "coalface"- the silent majority.

i2P hopes that all of its subscribers have a peaceful and safe festive season.

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The wages of Australia’s community pharmacists have gone into reverse with the average pharmacist earning $34.38 per hour in 2011 (9.3 per cent reduction), down from $37.92 last year according to an APESMA survey of more than 1500 pharmacists.

CEO of APESMA, Chris Walton, said it was the first time average pharmacy wages had declined since the survey was first conducted eleven years ago.

“If pharmacists want to check they getting the wages and conditions they deserve they should contact APESMA immediately,” Mr Walton said.

“It is highly concerning that the average Australian pharmacist is earning less than they did four years ago.

“Given that inflation is rising at 3.5 per cent and the average Australian wage is

going up by 4.9 per cent it is clear that pharmacists are being left behind.

“Unfortunately we do know that some pharmacy owners are not paying pharmacists what they are lawfully entitled to. We are currently working on a range of complaints lodged by our pharmacist members.”

Mr Walton said the report found that hospital pharmacists generally enjoyed better pay and better conditions, partly reflecting the fact they typically worked in larger organisations where it was easier for them to work together and present a case for better wages and conditions.

The Association of Professional Engineers, Scientists and Managers, Australia (APESMA) is the largest national non-profit organisation representing professional employees including engineers, scientists, managers, architects, IT professionals, pharmacists, surveyors, veterinarians, collieries staff and many other professionals. Our 25,000+ members are found in all areas of public and private employment across Australia.

For more information contact Matt Nurse, APESMA Media and Marketing Manager on 0407 351 277

“This situation will not change unless pharmacists decide to join together through APESMA to achieve true recognition for their professional skills,” Mr Walton said.

The survey also found:

• 21.9 per cent of community pharmacists have not had a pay increase since 2008 (88 per cent of hospital pharmacists have had a pay increase either this year or last year);

• 62.5 per cent of community pharmacists regularly work through their lunch break (only 36.3 per cent of hospital pharmacists); and

• Community pharmacists are feeling the pinch from their declining wages with 21.3 per cent wanting to earn more by working additional hours.

Mr Walton said community pharmacists interested in checking their wages and conditions should contact APESMA on 1300 APESMA (1300 273 762).

A copy of the survey is available to APESMA members.

Australian Prescriber: two viewpoints on deferring PBAC recommendations

Earlier in 2011 the government deferred the listing of seven medicines and one vaccine on the Pharmaceutical Benefits Scheme (PBS). Two opinion pieces examining this issue are now available on the website of Australian Prescriber.

The articles — Deferring PBAC decisions: industry view by Brendan Shaw, Chief Executive, Medicines  Australia and Deferring PBAC decisions: rationing as a reality by Rob Moulds, Medical adviser, Therapeutic Guidelines Ltd — provide two differing views about the decision by government to defer the listing of these medicines.

Both articles are available online under ‘Latest News’ at http://www.australianprescriber.com/

Catch the early wave in 2012 and secure your valuable CPD Credits at the Guild Pharmacy Academy – NSW Convention.

After a very successful inaugural event in February 2011, this focussed Convention Weekend returns to the Novotel Manly Pacific. The event will run from Friday 24 to Sunday 26 February 2012 – register now and you can earn up to 24 CPD Credits in just 2 days.

The Convention weekend offers a full package of education, social networking and an opportunity to speak face-to-face with manufacturers and suppliers at the boutique trade show. See, touch and discuss products or services that can assist you with servicing your customers. The website includes the extensive line up of industry experts and an overview on each of the sessions. Further information will be updated as it becomes available.

Make a weekend of it and bring your family so they can enjoy the beautiful surrounds Manly has to offer during the day as well as the social functions on Friday and Saturday nights.

Don’t delay! Further information and Registrations are available online now - visit www.guildpharmacyacademy-nswconvention.org.au.


NPS is reminding health professionals to be alert to the risks associated with prescribing oral methotrexate.

Methotrexate has been used for many years in the treatment of some cancers.  Increasingly low dose methotrexate is being used in the treatment of autoimmune or inflammatory disorders such as rheumatoid arthritis and severe psoriasis where it is usually prescribed as a weekly dose.  This can present difficulties for some people in making sure they take the correct dose on the correct day.  If the weekly dose is exceeded this may result in a high rate of adverse events, sometimes resulting in fatal toxicity.

NPS CEO Dr Lynn Weekes says it is important for prescribers and other health professionals to be aware of the risks and to take practical measures to reduce the chance of adverse effects due to errors.

“Methotrexate is taken either as a single dose once a week or as a divided dose at 12 hourly intervals over two days, once a week, and this dosage can translate poorly into instructions for patients,” says Dr Weekes.

“We know that prescribing, dispensing and administration errors, a lack of regular monitoring and poor patient awareness are all contributing factors to the possible development of methotrexate toxicity.

“A range of common sense measures can be implemented by doctors prescribing methotrexate to help reduce adverse events around this medicine,” says Dr Weekes.

When prescribing or dispensing methotrexate to patients or carers, prescribers should:

·         stress the importance of taking methotrexate only as prescribed

·         provide clear written and verbal instructions to ensure the dosage regimen is understood (for example, the Methoblastin consumer medicine information leaflet contains instructions about safe use and may be a useful counselling aid)

·         for weekly regimens, agree on a specific day of the week for taking methotrexate (preferably one of significance for the individual) and make sure once-weekly dosing is not confused with once-daily dosing

·         explain that extra or irregular doses are dangerous

·         advise not to take a catch up dose if one dose is missed; the flare-up of disease is unlikely

·         emphasise the importance of regular monitoring (blood tests)

·         warn about possible signs and symptoms of toxicity and explain what to do if these develop.


Nurses looking after patients in different care settings should also be vigilant when monitoring patients taking methotrexate. By being aware of the correct dosage and frequency, nurses can help identify potential errors and ensure the safety of patients being treated with methotrexate.

For more information about methotrexate, see the Australian Prescriber article at http://www.australianprescriber.com/magazine/23/2/44/5/ or read the NPS RADAR article at http://www.nps.org.au/health_professionals/publications/nps_radar/2008/august_2008/brief_item_methotrexate 

For consumers, the Methoblastin consumer medicine information (CMI) leaflet is available at http://www.nps.org.au/__data/assets/pdf_file/0006/26772/pfcmetht.pdf


The Advanced Pharmacy Practice Framework Steering Committee (APPFSC) is a profession-wide collaborative forum which is working on a number of projects associated with the national competency standards for pharmacists.

The APPFSC is pleased to release for pharmacists the Professional practice profile for initial registration as a pharmacist: a customised tool of entry-level competencies incorporating guidance on pharmacy school and intern training provider contributions.

This is a practical tool derived from the National Competency Standards Framework for Pharmacists in Australia 2010. It presents the professional practice profile expected at initial registration as a pharmacist (ie at entry-level to the profession) and additional advice on the contributions of pharmacy schools (PS) and intern training providers (ITP).

While the document provides the articulation of PS and/or ITP for all Performance Criteria, it is not intended to segment the learning or training requirements for student and intern years but rather, confirms that the competency standards represent a continuum of learning.

In addition to the organisations represented on the APPFSC, the development of this tool has involved pharmacists and personnel from pharmacy schools and intern training providers, as well as preceptor pharmacists and intern pharmacists.

Following approval of the document by the APPFSC, the Pharmacy Board of Australia has adopted the competency tool to help inform future standards for the accreditation of pharmacy schools and intern training providers.

Recognising the evolving nature of the competency tool, the APPFSC has recommended that the tool be reviewed in 2013. To help inform this review, feedback is being sought over the next 12 months from users of this document, particularly in relation to their experience in the application of this tool.

The competency tool can be downloaded from: www.psa.org.au/archives/6230

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