s NPS Media Releases for February 2014 | 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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NPS Media Releases for February 2014

NPS Spokesperson

articles by this author...

Regular information provided by NPS – Better choices, better health - NPS enables people to be medicinewise.

NPS is a valued independent resource for accurate, evidence-based prescribing information and education. Given the marketing pressures applied by global drug companies, NPS plays a vital and unique role across the healthcare sector. For more information please contact Stephanie Childs on (02) 8217 8667 or 0419 618 365 or schilds@nps.org.auxx

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NPS Media Releases February 2014


18 FEBRUARY 2014

Additional speakers and an antibiotic resistance stream have been added to the program for the eighth biennial National Medicines Symposium (NMS 2014) to be held in Brisbane in May.

NPS MedicineWise executive manager and chair of the NMS 2014 Scientific Programming Committee, Ms Karen Kaye, says the program which explores sustainability, translating data into action, and ethics and decision making is set to deliver an unmissable event which will live up to its reputation as the Australia’s leading forum on quality use of medicines. The biennial symposium is renowned for bringing together clinicians, experts and decision makers to take a long range view of how to overcome contemporary medicines challenges.

International and local experts

During the opening session on medicines in health: shaping our future, social researcher, demographer and commentator Mark McCrindle will present on the health landscape in 2025, and a panel of representatives from industry sectors will discuss “From here to there: The path to a healthy medicines future; where do we start?”.

Keynote speakers Durhane Wong-Rieger, President and CEO of The Institute for Optimizing Health Outcomes in Canada and Professor Ian Frazer, CEO and Director of the Research Translational Institute will explore future sustainability of medicines in terms of cost, benefit, access, quality and safety, and investment in an increasingly competitive health environment.

Professor Bert Leufkens of the Netherlands will address the data, knowledge and evidence stream, speaking on using evidence to inform action and decision making, while Gary Schwitzer, publisher of the US-based HealthNewsReview.org, will host a workshop exploring health media accountability and exploring issues around ethics in information provision as part of the ethics and decision making sessions.

Antibiotics stream

Reflecting the continued global focus on antibiotic resistance, an antibiotics stream will also take place at NMS 2014, covering new ideas and new approaches to achieving effective antibiotic community stewardship in Australia and the Asia-Pacific region. Presentations from experts in the field will be followed by facilitated discussions.

Abstract submission

Abstracts for oral presentations (ten minutes in concurrent seminar sessions with five minutes for questions), lightning talks (five minutes during the plenary program) and posters are being accepted until 24 February. Abstract submissions should fit with one of the three NMS 2014 themes: sustainability, exploring how data and evidence translates into action, and ethics and decision making.

About NMS 2014

The eighth biennial National Medicines Symposium (NMS), Australia’s preeminent quality use of medicines forum hosted by NPS MedicineWise every two years, will be held at the Brisbane Convention and Exhibition Centre from 21–23 May 2014. 

Registration for the event is now open, with discounted early registration open until 18 April. For more information and to register visit www.nps.org.au/nms


17 FEBRUARY 2014

The sixteenth NPS MedicineWise Annual Evaluation Report has been published, providing a snapshot of the organisation’s progress and key achievements for the 2012-13 financial year.

NPS MedicineWise CEO Dr Lynn Weekes says the report outlines the organisation’s success in creating both health and economic impacts.

“I’m proud of the good work we have done in the past financial year to enable people to make the best decisions about medicines and other medical choices to achieve better health and economic outcomes,” says Dr Weekes.

The report shows that programs delivered in primary care over the past decade have had considerable health impacts in terms of improving prescribing and cardiovascular management and encouraging adherence to pharmacological treatment among patients with diabetes.

It also explains that there have been improvements in appropriate prescribing, for example a 7% relative decrease in prescribing of high-dose statins and 10% decrease in anti-dementia drugs was observed in the financial year.

The evaluations of two therapeutic programs—'CVD risk: guiding lipid management' and 'Balancing benefits and harms of antipsychotic therapy'—found there were improvements in knowledge and practice changes among health professionals.

The evaluation of two programs aimed at improving quality use of medicines training in Aboriginal Community Controlled Health Sector programs succeeded in significantly increasing and improving knowledge, skill, attitudes and confidence of participants.

A total of 22,349 unique health professionals participated in NPS MedicineWise programs during the year, with 57% of registered GPs participating in an NPS MedicineWise intervention in the year.

NPS MedicineWise also increased its online presence with 1.2 million visits to our website and 1.3 million Twitter and Facebook views in the 2012-13 financial year.

“I’d like to acknowledge the tremendous work and effort that goes into achieving these results and thank NPS MedicineWise staff, member organisations, program partners, advisory groups and many others who make this work possible,” says Dr Weekes.

“We look forward to working in partnership with stakeholders and continuing to deliver on our mission to build a medicinewise Australia.”

To read the complete report go to http://www.nps.org.au/about-us/what-we-do/our-research/publications/reports/annual-evaluation-report/


14 FEBRUARY 2014

NPS MedicineWise is reminding health professionals that while various media reports have recently linked statins to a variety of adverse events and questioned their efficacy, these drugs remain one of the most effective strategies for reducing the risk of cardiovascular disease (CVD).

The latest edition of Medicinewise News — Heart and stroke risk: a catalyst for conversation has been distributed this month to 65,000 doctors, pharmacists and other health professionals around Australia.

It examines the latest evidence about determining absolute CVD risk, and treatment options including statins.

Clinical adviser at NPS MedicineWise, Dr Andrew Boyden, says that CVD is largely preventable but is still the most common cause of death in Australia.

“Statins are the most effective lipid-modifying drugs, but the benefit of a statin is greatest for those at greatest absolute risk of a cardiovascular event, including those with established CVD,” he says.

 “It’s important that statins are used in the people for whom the benefits are most likely to outweigh the potential harms. For most people at high risk of heart attack or stroke, the benefits of lowering cardiovascular disease risk with a statin generally outweigh the risk of possible adverse effects.”

Guidelines recommend that absolute CVD assessment should provide the basis of CVD risk assessment and treatment. The latest edition of Medicinewise News provides a reminder for health professionals on how to determine absolute CVD risk (including who needs assessing and how). It includes a step by step guide to drug and non-drug treatment, and key points about the importance of managing lifestyle factors in all patients.

The mailout to health professionals also includes a copy of the Statins – Frequently Asked Questions fact sheet for patients.

“NPS MedicineWise is urging health professionals to ensure they are up to date with the latest evidence and guidelines and work in partnership with their patients to manage their risk of CVD,” says Dr Boyden.

To read Medicinewise News — Heart and stroke risk: a catalyst for conversation online, or to print additional copies of the Statins – Frequently Asked Questions fact sheet for patients, go to www.nps.org.au/medicinewise-news-heart-and-stroke



NPS MedicineWise has launched a new app, MedicineList+, for both Android and iOS devices. The free app is designed to help your patients know about and manage their medicines, as well as record important health information including measurement and test results.

The app is also capable of keeping track of more than one person’s medicines list, a feature that may be particularly handy for parents and carers of older family members.

NPS MedicineWise clinical advisor Dr Philippa Binns is encouraging pharmacists to recommend the MedicineList+ app to their patients, especially those who use three or more prescription, over-the-counter or complementary medicines every day.

“We know that keeping a medicines list is an important part of being medicinewise and preventing medicines mistakes. But according to our recent survey* of people aged 65 years or older or their carers, only 55% of older Australians keep a list of their medicines while 30% have no way of keeping track of them at all, which is not ideal,” says Dr Binns.

Of those people who do keep a medicines list, almost all keep track of their prescription medicines but only 60% list their over-the-counter medicines, and just 55% list their complementary medicines. What’s more, 54% of people who keep a medicines list said they do not update it every time they stop or start a new medicine, and only 48% said they would take their list with them every time they visited a health professional.

“The new MedicineList+ app can make it easier for patients to list all the medicines they’re taking, keep the list up to date, and have the information on hand when they visit any health professional,” says Dr Binns.

“MedicineList+ can also help you to get a fuller picture of what’s happening with your patients’ health outside of your care, and fill the gaps around the medicines you don’t know they are using — especially complementary medicines. It could also help your patients to take their medicines every day, for example, through the reminder functionality.”

Top six features of the new MedicineList+ app


*      Generate a handy list of medicines which patients can email, print or save for sharing with family members, carers or health professionals.

*       Scan the barcode from the medicine’s packaging to enter it straight into the medicines list, or enter details manually.

*       Create multiple user profiles, each with personal details — great for helping family members to manage their medicines.

*       Set a reminder for individual medicine doses or for general medicine reminders, e.g. the next due dose of a vaccine.

*        Record medical test data, e.g. blood pressure, weight, height and INR, and graph these over time.

*       Add free text and notes, for example store details of health professionals, and create notes and general health reminders including allergies and emergency contacts.

The NPS MedicineWise Medicines List will continue to be available as a paper product — supplies can be ordered free from NPS MedicineWise. It is also available as an online form and as a PDF download on the NPS MedicineWise website. To find out about all the different ways to access a medicines list and to order stock for your health care setting visit www.nps.org.au/medicineslist.  

Individual medicines list data is stored locally on the app, and no data is shared with NPS MedicineWise or publicly.

To find out more and to download the apps for Android phones and devices and for Apple phones and devices, go to www.nps.org.au/medicinelist-plus.

* Survey of 796 people aged 65 years or older or their carers conducted in July/August 2013 by UMR Research


Latest edition of Australian Prescriber out now  

The latest edition of Australian Prescriber is out now and looks at the following topical issues:

Assessment and management of lower urinary tract infection in adults

Antibiotic resistance is having an impact on the way urinary tract infections are treated, according to Thomas Jarvis, Lewis Chan and Thomas Gottlieb from the University of Sydney. Management is usually simple but certain infections require further evaluation. Uncomplicated infections should almost always be treated with antibiotics to decrease duration and severity of symptoms, but formal microscopy, culture and susceptibility testing can be performed to ensure appropriate therapy. If the patient has no symptoms, bacteria in urine should only be treated in certain cases such as pregnant women and those undergoing an invasive procedure. The article outlines strategies to prevent recurrent infections, and guidance on treating complicated infections.

Management of urinary incontinence in adults

Drugs for incontinence only have modest efficacy, and can have adverse effects away from the urinary tract, write Shannon Kim, Shuo Liu and Vincent Tse from Concord Hospital, Sydney. This may be problematic in older people. The authors outline the drug and non-drug treatments for urgency incontinence, which can be managed with bladder training and antimuscarinic drugs. Pelvic floor muscle training is useful for treating stress incontinence, but if this fails, surgical treatment is often required as drug treatment has a limited role.

Medicinal mishap – Intravenous paracetamol in paediatrics: cause for caution

Paracetamol has a good safety record when used appropriately. However, since intravenous paracetamol has become widely available there have been multiple inadvertent overdoses in infants. Madlen Gazarian, from the University of New South Wales and NSW Therapeutic Advisory Group, and Anna Drew and Alexandra (Sasha) Bennett, from the NSW Therapeutic Advisory Group, review cases involving small babies inadvertently given up to ten times the recommended dose of paracetamol.

The authors give recommendations for safe use of paracetamol in paediatric patients, including guidance about when and how to use it intravenously. They suggest reserving intravenous paracetamol for acute, short-term treatment of mild-moderate pain, undertaking a comprehensive risk assessment before starting treatment, and reviewing patients daily. They also recommend following general principles for safe paediatric prescribing, especially those to do with correct dose choice and calculations, using accurate weights and standard dose units, and double-checking calculated doses.

Other articles in this edition of Australian Prescriber include

To read the full articles and more visit www.australianprescriber.com

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