s NPS Media Releases for January 2013 | 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 January 2013

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.au

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31 JANUARY 2013

Following a call from the Pharmacy Guild of Australia for an immediate moratorium on Home Medicines Reviews (HMRs), NPS MedicineWise is reiterating the importance of the program that has demonstrated success since its inception.

NPS MedicineWise CEO Dr Lynn Weekes says that patient safety needs to remain at the centre of discussions about whether to cap or change funding to the Home Medicines Reviews Program.

“NPS does not support a moratorium on Home Medicines Reviews,” says Dr Weekes.

“There is good evidence that Home Medicines Reviews reduce hospitalisations for some patient groups such as people taking warfarin or who have congestive cardiac failure, and as such, they are a highly cost-effective intervention that result in improved patient outcomes.

“Home Medicines Reviews are an important patient-centred service and the short- and long-term impact of a moratorium would be putting patient safety at risk.

“If there is a problem with over-servicing then an audit of HMRs would be a more direct way of addressing this issue.

“In the interest of patient safety, we hope this issue is resolved quickly.”


31 January 2013

February edition of Australian Prescriber out now  

Calcium and cardiovascular risks

Calcium supplements, commonly used with vitamin D in the treatment or prevention of osteoporosis, have recently been shown to increase cardiovascular risk and may be less effective in preventing bone fractures than previously thought, according to Senior research fellow Mark Bolland, Associate professor Andrew Grey and Professor Ian Reid of the Bone and Joint Research Group, University of Auckland. The authors review the evidence for the use of calcium and vitamin D supplements in people with osteoporosis, including the role of dietary calcium, and provide recommendations for practice.

Editorial: Are prescription copayments compromising patient care?

As the cost of patient copayments continues to rise, evidence is emerging that more patients are failing to collect their prescriptions and are less adherent to their medicines due to large out-of-pocket costs. Michael Ortiz, Conjoint associate professor at St Vincent’s Clinical School in Sydney, writes that this can lead to unintended effects on patients and the health system.

After 25 years of a fixed copayment system in Australia, Associate Professor Ortiz says it's time for a review to ensure that medicines remain affordable for those who need them, and that adherence is not compromised by cost.

Safe use of oral cytotoxic medicines

The last decade has seen increase in the use of oral chemotherapies to treat both cancer and non-cancer conditions, but despite the practical advantages they offer there are still many risks to consider, writes Christine Carrington, Senior consultant pharmacist at Princess Alexandra Hospital in Brisbane. She details why it is essential for health professionals involved in providing oral chemotherapies to understand how they are used, what adverse effects can occur and how medication errors can be minimised. Christine Carrington emphasises the importance of written and verbal communication for patients and carers to ensure the safe and effective use of these therapies.

Other articles in this edition of Australian Prescriber look at the safe and effective use of lithium, and new developments in electroconvulsive therapy (ECT). Also read about the safety of leflunomide, and safety updates for thyroxine and oral bowel cleansing products.

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


23 JANUARY 2013


The latest NPS MedicineWise online learning activities offer GPs and pharmacists the opportunity to review their management of people with type 2 diabetes and further contribute to improved patient outcomes. 

Having type 2 diabetes more than doubles a person’s risk of dying from cardiovascular (CV) causes.

Tight control of blood glucose helps prevent CV events in the long term in people who are newly diagnosed with type 2 diabetes. However the latest studies show that lowering blood pressure and LDL cholesterol has a more immediate effect in reducing cardiovascular risk in the short term (3-5 years).

NPS clinical adviser Dr Philippa Binns says that the online Clinical e-Audit for GPs and GP registrars and the online Pharmacy Practice Review for pharmacists help guide a best practice approach to management. They also place an emphasis on empowering patients to be in control of their condition, including taking an active role in regular monitoring, having a better understanding of the medicines they use, and understanding the importance of adherence to their management plan and ongoing lifestyle changes.

“With the prevalence of known diabetes tripling over the past decade, health professionals need to rigorously manage their patients with this condition in order to ensure the best outcomes for them and help educate people at risk of this disease to reduce it’s incidence,” says Dr Binns.

“We recognise that these reflective learning activities can appear to be time consuming, but we also know that GPs and pharmacists find them professionally rewarding and as a result may implement meaningful practice changes leading to better patient outcomes.”

Participating GPs and pharmacist will receive immediate individualised feedback on their patient management and results can be compared with those of their peers. Commentary is also provided by a diabetes expert.

The Clinical e-Audit for GPs and GP registrars: Type 2 diabetes – Priorities and targets is approved by the RACGP Quality Improvement & Continuing Professional Development Program for 40 (category 1) points and the ACRRM Professional Development Program for 30 PRPD points. It is also recognised for the Quality Prescribing Initiative of the Practice Incentives Program (May 2012 to April 2013). 

The Pharmacy Practice Review for pharmacists and pharmacy interns: Type 2 diabetes – Enhancing patient care is accredited by the Pharmaceutical Society of Australia as a Group 2 activity for 16 credit points (8 hours).

To register for the Clinical e-Audit visit www.nps.org.au/clinical_audits

To register for the Pharmacy Practice Review visit www.nps.org.au/pharmacy_practice_reviews


18 JANUARY 2013


In light of research released today by Canstar Blue showing more than half of Australians who take multivitamins don’t know they are medicines, NPS MedicineWise is reminding people that complementary medicines are medicines too.

NPS MedicineWise clinical adviser Dr Andrew Boyden says that people often consider complementary medicines, including herbal remedies and multivitamins, to be less powerful than prescription medicines. But like all medicines, complementary medicines can still cause side effects in some people, and may interact with other medicines and food. 

“There is the potential for side effects or interactions when taking medicines available over the counter or from supermarkets, health food shops or other shops, herbalists, naturopaths and the internet,” says Dr Boyden.

“Multivitamins and other complementary medicines should be treated as medicines and taken with care. And you should also keep in mind that compared with prescription and pharmacy medicines, complementary medicines undergo less testing in general, so less is usually known about their effectiveness.”

Multivitamins typically contain various vitamins and minerals, but many also contain other complementary medicines such as herbs. Even though herbs come from a ‘natural’ source, many are known to interact with other medicines, and can cause side effects for some people.

“It’s really important to be open with your health professional about any medicines you take, including supplements,” says Dr Boyden. 

“People may think that some doctors disapprove of complementary medicines, but that’s not always the case and your health professional will want to help you avoid any side effects and interactions with your other medicines.”

Many examples of ingredients that may be in your multivitamin can interact with other medicines or cause side effects. Supplements containing calcium, iron, magnesium or zinc can reduce the absorption of certain prescription medicines through the gut. Some people need to be careful how much vitamin C they take a day as it may increase their chance of kidney stones. And vitamin K can reduce the effect of a medicine called warfarin in preventing a blood clot.

“These examples of possible interactions are all dependent on what else you are taking and at what doses, and sometimes also dependent on other lifestyle factors, so it really is important to talk to your health professional about all the medicines you’re taking to avoid adverse effects,” says Dr Boyden.

For more information on prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a health professional, call NPS Medicines Line on 1300 MEDICINE (1300 633 424) for the cost of a local call (calls from mobiles may cost more). Hours of operation are Monday–Friday 9am–5pm AEST (excluding public holidays).

To report suspected adverse events from medicines, people can call the Adverse Medicines Events (AME) line on 1300 134 237 from anywhere in Australia (Mon–Fri, 9am–5pm AEST).

About the survey

Canstar Blue commissioned Colmar Brunton to conduct the survey. More information about the survey is available at http://www.canstarblue.com.au/media-releases/


17 January 2013

NPS Medicinewise Professional NPS Direct January 2013

Increasing use of MRI in primary care
Immunisation - physicians call for vigilance not complacency
Can statins reduce cancer-related mortality?
Khamidulin Sergey/shutterstock.com nav/shutterstock.com Rashevskyi Viacheslav/shutterstock.com

A recent meta-analysis demonstrated a small, statistically non-significant, increase in cardiovascular events in people taking varenicline. Health professionals are advised to weigh up the small risk of cardiovascular adverse events against the cardiovascular benefits of quitting smoking when considering varenicline.

MRI has the advantage of not using ionising radiation, which is a concern around the use of X-ray and computed tomography. However, most of the MBS items for MRI imaging requested by GPs require X-ray as a first investigation prior to reimbursement, so where is the benefit?

An announcement by the Australian Minister for Health indicated that the decision recommending PBS listing of dabigatran should be reviewed. It recommended that more work is needed before new oral anticoagulants could be listed for stroke prevention in atrial fibrillation.

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EARN CPD points with NPS MedicineWise online activities

GPs – register for the Clinical e-Audits and earn 40 RACGP QI&CPD (Category 1) points or 30 ACRRM PRPD points. Latest topic: Type 2 Diabetes - Priorities and Targets

Pharmacists – register for Pharmacy Practice Reviews and earn 8 hours of Group 2 CPD (or 16 CPD credits). Latest topic: Type 2 Diabetes - Enhancing patient care


Attended by over 500 delegates, this symposium featured a variety of high-profile national and international speakers who discussed quality use of medicines and the challenges around building a medicinewise community in Australia


Evidence-based interventions, including one-to-one educational visits with GPs and group training with pharmacists, nurses and other health professionals, were launched in three new therapeutic areas in 2012; antipsychotics, diabetes and antibiotics

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  Medical tests and medicines use are closely linked in many areas of clinical practice, thus NPS MedicineWise education programs have been expanded to include synergistic learning about the quality use of medical tests


NPS MedicineWise played a leading role in the global Antibiotic Awareness Week in November and was at the forefront of the fight against antibiotic resistance throughout the year with a national campaign


Providing timely, independent, accurate and evidence-based medicines information to consumers, Medicines Line (1300 MEDICINE) and the Adverse Medicines Events Line (1300 134 237) are available to consumers who have questions or concerns about medicines

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What to expect from NPS MedicineWise in the coming year

The first therapeutic topic for 2013 will be launched in February and it will discuss good anticoagulant practice and the management of atrial fibrillation and venous thromboembolism in general practice. To find out more, book an educational visit with an NPS facilitator.
Find out more about facilitator visits
Medication recall: Ventolin and Asmol (salbutamol) metered dose inhalers

A fault in the delivery mechanism of certain batches may result in less than the full dose of medicine being delivered for each puff. Find out the essential information to help ensure patient safety.

Find out more safety details

Please take a couple of minutes to answer a few questions and let us know what you think about NPS Direct. We also welcome suggestions for information you would like to receive in future issues.
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Head Office: 7/418A Elizabeth Street, Surry Hills NSW 2010
© 2013 National Prescribing Service Limited.

16 JANUARY 2013


NPS MedicineWise is reiterating advice that health professionals need to weigh the potential small cardiovascular risks associated with the quit-smoking medicine varenicline (Champix) against the immediate and substantial benefits of quitting smoking. 

Following the release of a new meta-analysis from varenicline’s manufacturer, NPS MedicineWise clinical adviser Dr Philippa Binns says the medicine’s risks should be considered in balance with the patient’s long-term health objectives. 

“For people with no history of cardiovascular disease who are starting varenicline for smoking cessation, health professionals should advise that the medicine may cause a small increase in their absolute risk of a cardiovascular event,” says Dr Binns.

“But this small risk needs to be weighed up against the cardiovascular benefits if the patient is successful in quitting smoking as a result of taking the medicine.”

For people with cardiovascular disease who wish to quit smoking, there are other smoking-cessation options to be considered including counselling support alone and nicotine replacement therapy. 

“Health professionals should advise patients to seek medical attention if they experience new or worsening symptoms of cardiovascular disease while taking varenicline,” says Dr Binns.

Following a US Food and Drug Administration (FDA) warning in 2011 of a possible increase in risk of serious cardiovascular events in people using varenicline, the sponsor was required to conduct a meta-analysis of randomised placebo-controlled trials.

The completed meta-analysis reported on the FDA website indicates a small, statistically non-significant increase in cardiovascular events in people taking varenicline. Nevertheless, the FDA concluded that since this increase was consistent throughout different analyses it is likely to be drug-related and not purely a chance finding. 

An article about the meta-analysis will appear in this month’s NPS Direct e-newsletter, written by NPS MedicineWise and distributed free to health professionals.

To read the full article and to subscribe to NPS Direct visit http://www.nps.org.au/nps-direct 

NPS MedicineWise also has resources for health professionals about medicines to treat nicotine addiction at http://www.nps.org.au/topics/quitting_smoking

For more information on prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a health professional, patients can call NPS Medicines Line on 1300 MEDICINE (1300 633 424) for the cost of a local call (calls from mobiles may cost more). Hours of operation are Monday–Friday 9am–5pm AEST (excluding public holidays).

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