Welcome to the November edition of i2P – Information to Pharmacists.
The month just finished has been an exceptionally busy one for pharmacy with an interesting PAC being concluded.
The “Great Debate” from PAC stirred considerable interest, also the talk given by John Menadue.
The latter has been reported and commented on in the article “Pharmacy’s Professional Future” and it is recommended that this article be bookmarked.
Better still, add your comment at the foot of the article.
All our columnists are back on deck and we are delighted to report that our New Zealand columnist, John Dunlop, has been accorded high honours by the New Zealand Pharmaceutical Society.
See the article in the Recent News section or look for the editor’s logo in the column section.
Our congratulations go out to John for this honour that resulted from his work in the pharmacy professional services area..
Volume 1 Number 1
Volume 1 Number 2
Volume 1 Number 3
Volume 1 Number 4
Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
Volume 2 Number 2
Volume 2 Number 3
Volume 2 Number 4
Volume 2 Number 5
Volume 2 Number 6
Volume 2 Number 7
Volume 2 Number 8
Volume 2 Number 9
Volume 2 Number 10
Volume 2 Number 11
Volume 3 Number 1
Volume 3 Number 2
Volume 3 Number 3
Volume 3 Number 4
Volume 3 Number 5
Volume 3 Number 6
Volume 3 Number 7
Volume 3 Number 8
Volume 3 Number 9
Volume 3 Number 10
Volume 3 Number 11
Volume 4 Number 1
Volume 4 Number 2
Volume 4 Number 3
Volume 4 Number 4
Volume 4 Number 5
Volume 4 Number 6
Volume 4 Number 7
Volume 4 Number 8
Volume 4 Number 9
Volume 4 Number 10
Volume 4 Number 11
Volume 5 Number 1
Volume 5 Number 2
Volume 5 Number 3
Volume 5 Number 4
Volume 5 Number 5
Volume 5 Number 6
Volume 5 Number 7
Volume 5 Number 8
Volume 5 Number 9
Volume 5 Number 10
Volume 5 Number 11
Volume 6 Number 1
Volume 6 Number 2
Volume 6 Number 3
Volume 6 Number 4
Volume 6 Number 5
Volume 6 Number 6
The recent “Great Debate” at the 2009 Pharmacy Australia Congress had an excellent topic choice (“The answer to our future is increasing front of shop sales, not professional services”).
The answer is, of course, that pharmacies need both activities as “core business” to survive – it just depends on what balance is required for each unique pharmacy practice sufficient to allow for differentiation and emphasis on specialties (whether professional services or retail activities).
However, it could be argued that policies in recent years have tipped the balance in favour of supply services that favour retail activity.
Little research or effort has gone into the development of professional services (there is actually major amounts of unspent grant money from the Fourth Agreement), so many pharmacies see little relevance in promoting services they may not have the training for, or the infrastructure to deliver the necessary training (which comes at a cost).
Recently I received a number of calls from a concerned relative of one of our veteran clients currently in an aged care facility.
The problems I am hearing about relate to the difficulty in getting the patient’s doctor to write prescriptions for necessary medications, echoing many of the stories I heard during my pharmacy visits about the problem of “owing scripts” and just how hard it is for pharmacists to get them written. If we break down the problem we get this sequence of events:
Is talking about talk the best way to start solving the sharing of data in a health informatics scenario?
I have often written on the subject off interoperability; referring to broken and failed systems and in the attempts to get everyone in healthcare, primarily inside a hospital, to exchange information without re-working it all the time.
This can be a complex subject matter because it has little to do with technology and all to do with people. If various departments and fiefdoms want to share their data it can happen; if they behave in a recalcitrant manner, it won’t happen.
Which takes us down a path, for perhaps another time, regarding the subject of IT systems and collaboration? We Australians are not good at this – there is something in our makeup that resists sharing certain things, notably information management systems. Not sure whether it is a streak of independence or immaturity, or both. Anyway, moving on to the matters at hand, let’s continue.
There is power in numbers.
It is said that Chemist Warehouse is growing at 25/30% per annum, the traditional franchises are growing at about half that rate and the poor old unbranded Pharmacy is trailing behind at about 10%. This really means that Chemist Warehouse is flying along with a wet sail doing nicely and all others are wondering where to find growth or are spending far too much time with their accountants’ trying to work out how to survive the future.
This is no surprise of course; the Chemist Warehouse business model is brilliant, they are compelling marketeers and proof that the power in numbers prevails.
When you think about it, genetics are likely to determine your skin type.
It is little wonder that if one or more of your relatives, including your ancestors, had a predisposition to skin cancer, then you may have inherited that trait.
Researchers believe that there is up to a 50 percent risk involved that you will develop skin cancer through genetic inheritance.
Skin cancer can be inherited: studies
Editor: It is good to see the New Zealand medical professionals getting behind climate change strategies in their country.
Pharmacy, particularly here in Australia is conspicuous by its absence in this activity.
Yet there are many things we can influence - particularly in the areas of the supply chain, shop design and the type of fixtures and fittings we select.
Unless we all begin to be proactive in this area, events will pass us by to our detriment.
Add your comments at the foot of this article to start off a discussion.
Source: New Zealand Medical Journal
Article written by: Scott Metcalfe, Alistair Woodward, Alexandra Macmillan, et al; for the New Zealand Climate and Health group
In Issue number six of Pharmacy e-Edge, the newsletter of the Pharmaceutical Society of New Zealand, four New Zealand pharmacists were awarded a range of honours. The report was prepared by Richard Townley, the CEO of the Society. Among them was John Dunlop, our i2P writer representing New Zealand, and we are pleased to share in John's achievement. John was awarded a Fellow of the Pharmaceutical Society of New Zealand in recognition of his outstanding contribution to the advancement of the practice of pharmacy in New Zealand. Congratulations John!
In a press release by Dr Allan Bell of Auckland University of Technology (sure to raise eyebrows with some Australian i2P readers), it is stated that:
"The New Zealand accent has been rated the most attractive and prestigious non-British form of English, according to a BBC survey.
New Zealand English came in first ahead of Australian, American and most regional British accents in the study published in the international Journal of Sociolinguistics, edited by Professor Allan Bell, Director of AUT’s Institute of Culture, Discourse and Communication."
Choosing your rice variety may provide an inexpensive support for a program to treat diabetes.
Menus involving varieties of brown rice may reduce glycation and the rate at which sugar is absorbed by the body.
Cinnamon is another food known to sensitise insulin and reduce sugar levels.
With a some thought it appears that a variety of foods that combat diabetes could be combined to create dishes that are not only functional, but delicious to eat as well.
Brown rice could aid diabetes control
By Anuradha Alahakoon
It was refreshing to read some positive recent announcements, comments and opinions in the media over the past three weeks.
First was the announcement by Nicola Roxon regarding the National Preventive Health Agency and the positioning by the Pharmaceutical Society of Australia firmly in support of this development of her initiative.
It is not quite 12 months ago that i2P ran a story on Nicola Roxon, her family and political background, at a time when she was relatively unknown in health circles.
Some observational and predictive points from that i2P article dated December 2008 -"Have you met Nicola Louise Roxon?" -are shown below.
Go to http://archive.i2p.com.au/?page=site/article&id=1168 for the full article.
"* 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.
It would seem that we were substantially correct and that the National Health Preventive Agency will offer a great opportunity for pharmacists to take advantage of their current training and skills set.
The second item was contained in a press release by the PSA dated 16/10/09 regarding a Memorandum of Understanding that was signed in Sydney by the President of the PSA, Warwick Plunkett, and the President of the RACGP, Dr Chris Mitchell, at a ceremony during the Pharmacy Australia Congress.
While details of the memorandum still have to be released, it may eventually mean that pharmacists will be able to practice independently and in alliance with GP's without the constant sniping that has been a feature of a relationship, which if worked cooperatively, has always been proven to provide maximum patient benefit. Good work PSA!
The third item of interest was an opinion article written by Geoff Marsh, president of APESMA.
Few comments have originated from APESMA, so it was good to see a comment from this organisation, as is really the voice of non-pharmacy owners, or to put it more succinctly, the logical representative of the pharmacists who provide professional services (whether or not they are paid up members).
The following appeared in Pharmacy e-News on 23/10/09 (located at
Editing and Researching news and stories about global and local Pharmacy Issues
Editor's Note: The following material has been circulated by the Truefood Network, a US lobby group that advocates for food safety. Nanotechnology is a powerful new platform technology for taking apart and reconstructing nature at the atomic and molecular level. The nano-scale is exceedingly tiny; it is the world of atoms and molecules, involving the manipulation of matter at the nanometer scale (nm), one billionth of a meter. “Nano” means more than just tiny manufacturing: it is well-known that materials engineered or manufactured to the nano-scale exhibit radically different fundamental physical, biological, and chemical properties from bulk materials–properties that also create unique human health and environmental risks. While the first wave of nanomaterial products has been consumer products, food and food packaging products appear to be next in line. Many of the world's leading food companies - including H.J. Heinz, Nestle, Hershey, Campbell, General Mills, PepsiCo, Sara Lee, Unilever, and Kraft - are investing heavily in nanotechnology applications. Hundreds of new food and agriculture products are under development and many could be on the market soon. By 2010 the nano-food market could be worth $6 billion. Examples of current products include a nutritional supplement drink for children that contains iron nanoparticles, McDonald's hamburger containers, Cadbury chocolate bar wrappers, and Miller Lite beer bottles.
They have a point - every time some aspect of the food chain has been manipulated (pesticides, fertilisers, preservatives, seed sterility, genetic modification etc) it has resulted in adverse health consequences.
Now we have nanoparticles in our food and personal use products with no warning labels to enable a proper choice to be made by consumers.
Source: The Center for Food Safety
What's At Stake:
Editor's Note: The following material has been circulated by the Truefood Network, a US lobby group that advocates for food safety.
Nanotechnology is a powerful new platform technology for taking apart and reconstructing nature at the atomic and molecular level. The nano-scale is exceedingly tiny; it is the world of atoms and molecules, involving the manipulation of matter at the nanometer scale (nm), one billionth of a meter. “Nano” means more than just tiny manufacturing: it is well-known that materials engineered or manufactured to the nano-scale exhibit radically different fundamental physical, biological, and chemical properties from bulk materials–properties that also create unique human health and environmental risks.
While the first wave of nanomaterial products has been consumer products, food and food packaging products appear to be next in line. Many of the world's leading food companies - including H.J. Heinz, Nestle, Hershey, Campbell, General Mills, PepsiCo, Sara Lee, Unilever, and Kraft - are investing heavily in nanotechnology applications. Hundreds of new food and agriculture products are under development and many could be on the market soon. By 2010 the nano-food market could be worth $6 billion. Examples of current products include a nutritional supplement drink for children that contains iron nanoparticles, McDonald's hamburger containers, Cadbury chocolate bar wrappers, and Miller Lite beer bottles.
Nanotechnology is contrary to Organic Principles. Nanotechnology will further entrench industrial/chemical agriculture and industrial food as our dominant paradigm, to the detriment of public health and the environment. As such, nanotechnology is antithetical to organic principles and should be banned from the USDA Organic standard.
Size matters. "Nano" is best understood to mean more than merely tiny manufacturing and materials; rather it means substances that have the capacity to be fundamentally different, with new chemical, physical and biological properties. These same new properties that excite industry create new and novel risks to human health and the environment. Not all nanomaterials will be hazardous, but the materials' safety cannot be assumed from testing or approval of larger cousins and should be assumed to have added risk.
Labeling Nanotech Materials as Synthetic Is a Dangerous Idea. A Ban on the Technology, Like Genetic Engineering, Is Required To Protect Organic Integrity. Labeling nanotech materials as "synthetic" without recommending a prohibition on the technology is a very dangerous idea that would create a future system where proponents of each specific nanomaterial would be able to petition for inclusion on the National List. It would be as if biotechnology cro ps could petition one by one to be organic! The only way to protect Organic is by prohibiting nanotechnology as a class because it is antithetical to the principles and purpose of the Organic Standard.
Human and Animal Health: Due to their size, nanoparticles can cross biological membranes, cells, tissues, and organs more readily than larger particles. When inhaled, they can go from the lungs into the blood system. There is growing evidence that some nanomaterials may penetrate intact skin and gain access to systemic circulation. When ingested, nanomaterials may pass through the gut wall and into the blood. Once in the blood stream, nanomaterials can circulate throughout the body and can lodge in organs and tissues including the brain, liver, heart, kidneys, spleen, bone marrow, and nervous system. Once inside cells, they may interfere with normal cellular function, cause oxidative damage and even cell death.
Environmental Impacts: There are serious concerns about environmental impacts that conflict with Organic's land stewardship ethos. Once loose in nature, manufactured nanomaterials represent a new class of pollutants. Potentially damaging environmental impacts stem from the novel nature of manufactured nanomaterials, including mobility and persistence in soil, water and air, bioaccumulation, and unanticipated interactions with chemical and biological materials. Existing studies have raised red flags, such as damage to beneficial microorganisms from nano-silver. The U.K. Royal Society has recommended that, "the release of nanoparticles and nanotubes in the environment be avoided as far as possible" and that, "factories and research laboratories treat manufactured nanoparticles and nanotubes as hazardous, and seek to reduce or remove them from waste streams."
Broader Impacts: In addition to health and environmental impacts, nanotechnology is a platform, converging technology which will continue to industrialize food and agricultural. Some of these issues include: the use of nanotechnology in conjunction with biotechnology and synthetic biology; the use of nanomaterials in food packaging in order to ship further distances and increase shelf life, exacerbating climate change impacts and contrary to organic principles of small-scale and local farming; and the intellectual property privatization of nanotechnology's basic building blocks.
The Time to Act is Now. Nanotechnology commercialization is currently exploding without any oversight or labeling and little emphasis on risk research. Food and agriculture is a growing sector of nanomaterial research and development and commercialization. Regulating authorities must act to protect organic.Return to home