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Regular updates from the global world of pharmacy.
Access and click on the title links that are illustrated.
Regular updates from the global world of pharmacy.
Practical experience is hard to acquire once you have finished your academic studies.
It is a process we all have to experience at one stage of our career.
The transition from being a student to a practising pharmacist can be a difficult time and unless early career pharmacists equip themselves for the new challenges they face, they may not be maximising their career opportunities.
It is also the type of program that could earn incentive payments for the workplaces providing the experience in the community.
The Pharmacy Council recently promoted a discussion document to encourage feedback from the health care environment on the impending legislative changes that are intended to provide the opportunity for pharmacists to prescribe.
The proposed legislation will enable suitably qualified postgraduate educated and skilled clinical pharmacists to prescribe from the drug tariff for patients under their care.
These pharmacists will have to work as part of a primary health care team and it is expected they will become an integral part of that team.
All very exciting for our profession to witness that there is a recognition that pharmacists are capable of stepping up to the mark and are worthy of greater responsibilities.
Pharma-Goss for August 2010
When selecting a team to participate in a primary health care review of the diagnosis and management of hypertension patient one would hope that a pharmacist would be a natural selection.
But in the case of a paper published recently in Australian Family Physician (http://www.racgp.org.au/afp/201007/201007howes.pdf) a pharmacist did not rate a mention in the panel set up to identify the problems associated with diagnosing hypertension and maintaining a dose that suited the needs of the patient with maximum adherence.
The thought that first struck me after reading ‘the clarification’ about the eRx Script Exchange on the editorial page of the May Issue of the Pulse+IT magazine was - Why is this clarification so necessary?
On the surface it seemed like a reasonable statement to make.
It read: “Clarification - in the March 2010 edition of Pulse+IT it was reported that the electronic prescribing service operated by eRx Script Exchange had received 7.5 million scripts "sent to the eRx script hub by prescribers" as of the middle of January.
Omitted from the article was reference to a workflow that allows pharmacists to send repeat prescriptions to the hub for later retrieval by any pharmacist connected to the eRx system.
The volume of transactions quoted in the March 2010 article included such scripts, in addition to scripts sent to the hub directly by prescribers.”
In The Australian Friday 23 July (Political creed: do no harm) Emma Connors reported that “sometime in the next four weeks both Julia Gillard and Tony Abbott are likely to sign a letter promising their support to a group of 5000 small business owners whose public standing allows them to extract an extraordinary pledge.”
She reported that the Guild had “asked the leaders of both sides of politics to agree that the terms of the recently enacted Fifth Community Pharmacy Agreement will be upheld, including the all-important promise to keep supermarkets out of pharmacy”.
Editor's Note - 15th November 2012:
When this article was first published in August 2010, Gollman-Bouw had entered into liquidation following a very turbulent period under the stewardship of Mark Bouw, managing director of the Australian enterprise.
Since that date the automated dispensing market has settled down and is now demonstrating steady and solid growth.
New people have entered into an agreement with German company Gollmann Systems and they have no relationship with any of the people associated with the former entity.
Many of the initial teething problems have been overcome and a better understanding of the Australian pharmacy market has emerged.
Gollmann Systems are globally competitive and contain innovations not seen in some of their competitors.
Any prospective purchaser should short-list this product when seeking a solution for their pharmacy.
Since the global financial crisis began to bite, Australians have shifted more of their weekly purchases into private label.
In respect of the $70 billion pa food market, private label currently accounts for 23%, with the prospect of moving to 30% within five years.
Many foods have health giving and medicinal properties.
Indeed, i2P reports frequently in its Preventive Medicine section, regular discoveries where food can be used to support various health conditions.
For example, raw beetroot juice has recently been found to be effective in treating high blood pressure (it contains nitrates) and is as effective as some antihypertensive drugs. Cinnamon is another food that is useful for diabetics, where cinnamon appears to have effects similar to metformin i.e. it sensitises insulin.
Ayurvedic medicine, developed in India over centuries, encompasses the use of many delicious foods enhanced with herbs and spices.
Ayurveda is an ancient Indian healing system. The central philosophy is that illness is caused by an imbalance of the body's three vital energies, or 'doshas'. Ayurveda uses a range of treatments including yoga, massage, acupuncture and herbal medicine.
More information can be found at the Australian government site - HealthInsite. http://www.healthinsite.gov.au/topics/Ayurvedic_Medicine
For Ayurveda diet and health information that can get you started, try this site http://www.joyfulbelly.com
People involved in e-health are bitterly disappointed with the "hung parliament" result.
At least Labour had a vision with its national broadband roll-out, even if it wasn't properly articulated in regard to cost.
Some proponents argue that the cost matters little - it is the advantage given to Australians who want to be pioneers in e-health. Opportunities could be lost and they may be priceless.
i2P went looking for some informed comment on the subject and found some excellent commentary written by Paul Budde, a telecommunications analyst.
His commentary follows:
Researchers have collected venom from octopuses in Antarctica for the first time, significantly advancing our understanding of the properties of venom as a potential resource for drug-development.
The study, conducted by an international team of researchers from the University of Melbourne, the Norwegian University of Technology and Science and the University of Hamburg, provides the first insight into the properties of Antarctic octopus venom.
It has also revealed the existence of four new species of octopus.
The effects of diabetes on organs such as the heart, eyes and kidneys are relatively well known, but women are now being warned of its potential to cause damage in another way – to sexual performance.
Victoria University’s Professor Lily Stojanovska and Dr Michael Mathai are conducting a study to assess the potential for improving sexual function in women with type 2 diabetes by taking a supplement from a plant traditionally used for this purpose in Peru.
The root of the plant Maca (Lepidium meyenii), which grows in the Peruvian Andes, has been used by locals for centuries, where it is reported to enhance fertility and to boost energy levels.
Some years ago an Australian hospital pharmacist pioneered wound management in Australian hospitals and went on to develop courses to train community pharmacists interested in setting up a specialty wound management clinic in their pharmacy setting.
This type of service initially established itself in a restricted number of pharmacy settings, but gradually faded away due to the pressure of PBS dispensing.
Now the opportunity is reappearing in WA at Curtin University with a purpose built facility established to train all health students (including pharmacy).
And here is the dilemma.
Many pharmacists would like to be involved in this type of activity but most community pharmacies are not physically designed to accommodate this service.
However, with the future development of Primary Health Care Organisations (PHCO's) under way, it may be possible for pharmacists to be part of the wound management team in that type of organisation.
Nicola Roxon is contributing $380,000 towards the project and is expected to be operational within three months.
University of Adelaide researchers are a step closer to finding a link between genetic susceptibility to cerebral palsy and a range of environmental risk factors during pregnancy, including infections and pre-term delivery.
During National Cerebral Palsy Awareness Week (August 1-7), Professor Alastair MacLennan from the University's Robinson Institute says their research shows that pregnant women who are genetically susceptible to infections and other environmental hazards could trigger cerebral palsy in their unborn babies.
Prescription vending machines are being deployed in the UK Sainsbury pharmacy chain. This is being done in conjunction with the normal in-store pharmacy service,
and is being promoted as an additional service for those who would prefer it.
It is not an automated dispensing solution.
Why do we grow old and what can we do to stop it? This is the question asked by many, but it appears that we are now closer to an answer thanks to new research published by Monash University researcher Dr Damian Dowling.
According to the research published in the August edition of the prestigious journal, The American Naturalist, a small set of genes in mitochondria (a membrane-enclosed organelle found in most eukaryotic cells), passed only from mothers to offspring, plays a more dynamic role in predicting life expectancies than ever previously anticipated.
In a shrewd management decision, the Board of the Pharmaceutical Society of Australia has announced the appointment of Liesel Wett as the organisation’s new Chief Executive Officer.
Ms Wett, who is currently Deputy Chief Executive Officer and Chief Operating Officer of the Australian General Practice Network, is expected to take up her appointment on 1 October 2010.
Given that the PSA will need to develop closer and stronger ties with GP organisations, this appointment may well prove to be critical for the future professional development of pharmacists.
Pharmacists will be enabled to get inside and understand GP thinking, guided by Liesel Wett.
Inflammation-causing cells in fat tissue may explain the link between obesity and diabetes, a team of Walter and Eliza Hall Institute researchers has shown.
The discovery, by Professor Len Harrison and Dr John Wentworth from the institute’s Autoimmunity and Transplantation division, opens the way for new anti-inflammatory treatments that prevent insulin resistance (where the body is unable to respond to and use the insulin it produces) and other complications associated with obesity.
The UK has started a new phase in private prescription discounting – no mark up on the drug and 50% off the dispensing fee.
“Millions could be saved every year if private prescription mark ups are abandoned, according to the Superdrug superintendent pharmacist.
Superdrug will dispense all private prescriptions with no mark up on the cost of the medicine, the company announced this week (3 August 2010).
It is also halving its minimum charge for dispensing medicines to £2.25.”
An opinion provided by the University of Sydney
By Professors Ben Eggleton and David Moss
Those who think our country can do without the national broadband network clearly do not fully understand the potential such a network offers to Australians. While other countries scramble to find ways to meet this exploding demand for global bandwidth, the opposition is wringing its hands and debating the need.
The network will do three things for Australia: it will pay for itself, it will stimulate the innovation economy and it will have multiple applications.
A University of Adelaide study shows that aged garlic extract may help lower blood pressure in the 3.7 million Australians who suffer hypertension.
Research trials by Dr Karin Ried and her colleagues from the University's Discipline of General Practice show that garlic could be used as an adjunct to conventional drugs for hypertension.
However, raw or cooked garlic, and garlic powder are not as effective in treating high blood pressure as aged garlic extract.
The world's first solar-diesel power station has opened in Western Australia's Pilbara region at Marble Bar, known for its record high temperatures.
WA's Mines and Petroleum Minister Norman Moore opened Horizon Power's Pippunyah Solar Diesel Power Station on Friday.
The new $34 million station is powered by the biggest sun-tracking solar panel farm in Australia.
Recently, a research report was published online in BMC Complementary and Alternative Medicine that highlighted Australian consumer attitudes towards complementary medicines and pharmacists selling complementary medicines.
An abstract is published below.
Consumers have indicated in earlier surveys that they wanted pharmacists to be the primary source of information for them and to keep a range of products that they could feel safe with.
The profession initially responded to those needs with the PGA setting up a College of Clinical Nutrition and many pharmacists (including this editor) completed the Advanced Diploma of Clinical Nutrition (Pharmacy).
Unfortunately, the college was closed and an alternative resource was never re-established.
People who did receive training in the use of nutritionals gained a new perspective in respect of practicing their profession and tended to work in the area of preventive medicine when an opportunity presented itself.
We have again asked Mark Coleman to comment on the survey and his report appears below the article abstract.
Mark Neuenschwander has earned his reputation as one of the nations' leading authorities on dispensing and point of administration automation. Whether writing, lecturing or problem solving with a client, Mark communicates in terms and concepts that are easy to grasp and apply. His fresh perspective and keen insight stem from having invested thousands of hours in research and in-depth consulting with clients.
I’ve been thinking about the Dodgers, George Carlin, Nurse Jackie and drugs—Oh yeah, and near misses.
It’s Monday about to turn Tuesday.
Our return flight to Seattle has been weather-delayed after our weekend in So Cal.
On Saturday, we nearly missed the Yankees/Dodgers game due to an equipment-delay.
United’s mechanics came close to cancelling our southbound journey.
Not sure why.
It was only the navigational system.
I’ve been thinking about the Dodgers, George Carlin, Nurse Jackie and drugs—Oh yeah, and near misses.
In April, near Dodger Stadium at Bob Hope International, two planes were involved in what The Huffington Post called a “near miss.” A jetliner came within two plane lengths of colliding with a Cessna. Was the collision-avoidance interface to the plane’s navigational system on the blink? It’s all under investigation. Meanwhile, I’m thinking about George Carlin’s airline routine. “Here’s one they just made up. When two planes almost collide, they call it a near miss. It's a near hit! A collision is a near miss. Boom. Look, they nearly missed.”
Then Carlin’s routine comes in for a landing. “Which brings me to terminal—another unfortunate word to be used in association with air travel.” Had he known how many medication errors kill patients, he might have applied terminal to hospitals.
Last year ISMP surveyed Medication Safety Alert readers regarding the definition of a near miss. Eighty-eight percent of the 3,800-plus respondents defined a near miss as “an error that happened but did not reach the patient.” However, a significant number also felt near miss is a misnomer—enough for ISMP to revise their nomenclature. One respondent argued, “A near miss is more applicable when trying to hit something, not avoid something.” Another reader suggested “close call” is a better term. ISMP agreed: “Although near miss appears to be well entrenched in healthcare terminology, we will try to refer to near misses as close calls(1)when feasible in the future to prevent confusion.”
The recent study out of Boston provides evidence that bar-code verification technology coupled with electronic medication-administration systems (bar-code eMAR) “substantially reduced” medication errors at the point of care. The May 6, 2010, New England Journal of Medicine reported that the Brigham and Women’s Hospital realized a 51 percent relative reduction in adverse drug events with bar-code eMAR. “Because the study hospital administers approximately 5.9 million doses of medications per year, use of the bar-code eMAR is expected to prevent approximately 95,000 potential adverse drug events at the point of medication administration every year in this hospital.” (2)
How about these near hits (close calls) I’ve recently learned about from pharmacy friends across the country? Credit bar-code eMAR for the saves.
• A nurse intending to administer IV vancomycin grabs an epidural bag by mistake. Scanning brings up a “wrong drug” alert and intercepts the error.
• Scanning triggers a “wrong patient” alert, stopping another nurse from administering penicillin to a patient who is severely allergic to the drug.
• Bar-code scanning saves an infant’s life by intercepting a 10-fold overdose of hydromorphone.
Besides preventing catastrophes, bar-code eMAR systems gather close-call data, which is useful for identifying gaps and improving the medication-use process. The idea is to eliminate errors upstream, preventing them from trickling down to points of care.
Over four months at one hospital, bar code eMAR interrupted nurses on three different occasions from administering Amiodarone when Mannitol had been ordered. Had the Amiodarone been administered at the prescribed Mannitol rate, the errors could have been fatal. Reviewing close-call reports led pharmacy to revisit their dispensing processes. In each instance, they discovered nurses had grabbed glass bottles from the pharmacy drop box without reading the labels. To decrease the opportunity for error, pharmacy switched Mannitrol to PVC bags so they would not be so easily confused with Amiodarone glass bottles on the units.
In the finale of Nurse Jackie’s inaugural season on Showtime, ER nurse Jackie orders Zoey to give 50 mcgs of Fentanyl to Mr. Netterman. The young nurse mistakenly administers 250 mcgs—putting their patient in a coma.
ER nurse manager Gloria wastes no time launching an investigation. While boarding an elevator she barks at Jackie, “I want to see you and Zoey in my office in five minutes.” After the doors close the elevator miraculously malfunctions. Whereupon extremely ex-Catholic Jackie relapses and whispers, “Thank you, Jesus.” Who wouldn’t be grateful to dodge a come-to-Jesus meeting?
I regularly hear about bedside epiphanies in which scanning protects nurses from harming their patients—a much better place for a thank-you-Jesus experience, if you ask me.
Well, its 2:30 AM and we’ve just landed in Seattle. Nevertheless, our flight—thank you Jesus—did not include a near miss or any close calls, for that matter. Unfortunately, the Dodgers didn’t fare as well. They had a near win because Yankee Robinson Cano nearly missed a home run in the tenth. I’d bet you a Dodger Dog those damn Yankees are thanking the baseball gods that a miss is as good as a mile as they’re winging their way to New York. The boys from the Bronx are headed for a three-game series with my Mariners.
What do you think?