s NPS Media Releases for January 2013 | I2P: Information to Pharmacists - Archive
Publication Date 01/02/2013         Volume. 5 No. 1   
Information to Pharmacists


From the desk of the editor

Well 2013 has certainly begun and I must admit it has been hard to get out of “holiday mode” and back into “pharmacy mode”.
This year is looking quite challenging as many issues left in abeyance in 2012 are bubbling over , so I don’t anticipate a restful year.
One important issue we will cover for some time yet is the quality of drug  evidence in the Australian setting, and to kick off the debate the feature article  “Sense About Science”describes what is happening in the UK to help tidy up science in that country.
Comparisons have been made with the Australian experience and it seems that we have a long way to go before it can be regarded as “tidy”,

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News Flash

Newsflash Updates for February 2013

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated.

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Feature Contribution

Sense About Science – or Up To Your Ankles in Waste Water

Neil Johnston

My recent holiday reading included catching up on subjects that have slipped off my radar, mainly because the issues themselves have adopted a lower profile.
Then an article in the 6Minutes e-publication caught my eye.
It concerned a UK initiative by a group called Sense About Science”, that has started a campaign to have all clinical trials registered and have the results published, while simultaneously urging the patients to boycott trials if the researchers cannot guarantee the findings will be made public.
They have published a petition (found at www.alltrials.net) and are encouraging people to sign it.
The petition has the support and backing of the BMJ, the James Lind Alliance and Ben Goldacre (author of Bad Pharma) and is designed to put pressure on researchers, pharmaceutical companies and institutions who are in a position to bury research data that may reflect on reputations and drug company profits.

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Face of Priceline - Australian of the Year 2013

Peter Sayers

Few would not recognise Ita Buttrose, an iconic Australian well-deserved of the Australian of the Year Award for 2013. The award was presented in Canberra on Australia Day (January 26 2013), by PM Julia Gillard.
And there must be a lot of backslapping going on in the Priceline camp for their recent signing of her to front for their 200 member pharmacy franchise.
Ita’s profile was already stellar, but with the added impetus of the Australian of the Year Award, the Priceline brand will now increase in value considerably.

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Determining needs and wants…

Joseph Conway

In pharmacy media commentary, I often come across the idea that we need to give people advice on what they need as opposed to what they want. This is understandable given that we have specialist knowledge on medication therapy and live our lives discussing health issues with patients and dispensing their medication. We get to know very intimate details about people and many pharmacists working in community pharmacy get to follow people as they grow older and are a tiny (but important) part of their lives sharing their health issues over ongoing chats at the dispensary counter if they choose to shop at our store.

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Is the ‘weekend’ an anachronism whose usefulness and relevance has passed?

Neil Retallick

When I taught Sunday School, which seems to be about a hundred years ago but was only about forty, we learned from the Bible that on the seventh day, God rested.
After all, he had been busy for six days.
I do not wish to belittle anybody’s religious beliefs in these comments but use them to focus attention on just how much our society has changed.
At the same time I was teaching Sunday School, the shops all closed at mid-day on Saturday and at 5.30pm during the week.
A trip into town to shop on the weekend meant getting up bright and early on Saturday morning and being at the bus stop by 8.30am at the latest.

Comments: 1

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Fitting Your Pharmacy for the Future - Funding & Depreciating for Best Tax Effect

Chris Foster

Editor's Note:
I2P will be developing a series on pharmacy designs - ideas and concepts in respect of clinical services spaces.
In designing such spaces it was realised very early in the exercise, that to be properly integrated in an Australian pharmacy setting it could not be just an “add-on” but a whole of pharmacy redesign.
Similarly with the introduction of automated dispensing machines (original packs and dose administration aids) it is important to design workflows properly to capture efficiencies, and this also entails a “whole of pharmacy” redesign.
2013 may be the year of decision in terms of the type of pharmacy design to house your market offering. To survive you need to be different and there is not a lot to differentiate one pharmacy from the other, even if you belong to a marketing group.

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Ransomware - The New Kid on the Block

Steve Jenkin

Editor's Note:
Late in 2012, a medical practice on the Gold Coast of Queensland came under cyber attack in a unique way.
Instead of patient data being stolen, it was kidnapped in place, by encrypting all practice data so that it could not be read.
A key was then offered at a price so that the data could be opened.
Thus was born "Ransomware", and a a new threat had emerged.
i2P asked Steve Jenkin, our resident IT expert to give some insights to this new threat and what precautions we might all need, to eliminate this new approach to hacking.
If you need an incentive, just imagine if your PBS claim data was locked up for a week and your ability to generate a claim was locked up for six weeks, plus all attendant costs in restoring your data.
Would you survive in your business?
This reference article by Steve is important enough to use as a checklist for your IT provider or for your IT consultant to utilise in the next complete review of your entire system.
Steve's comments follow:

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Workplace Pressure in Pharmacy

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

The psychological definition of stress is a feeling of strain and pressure.  Small amounts of stress may be desired, beneficial, and even healthy.  Positive stress helps improve performance.  It also plays a factor in motivation, adaptation, and reaction to the environment.  Excessive amounts of stress may lead to many problems in the body that could be harmful.  Symptoms may include a sense of being overwhelmed, feelings of anxiety, overall irritability, insecurity, nervousness, social withdrawal, loss of appetite, depression, panic attacks, exhaustion, high or low blood pressure, skin eruptions or rashes, insomnia, lack of sexual desire (sexual dysfunction), migraine and gastrointestinal difficulties (constipation or diarrhoea).  It may also cause more serious conditions such as heart problems.

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Arm Yourself For The Battle For The Mind

Barry Urquhart

Social media, and the internet in general, are largely “blind” media.
They can be frustrating, time-wasting and inefficient.
Entries and enquires about wide-ranging but pertinent topics, products and services elicit countless responses, most of which are irrelevant and unappealing. Information overload abounds.Use of SEO's (Search Engine Optimisers) simply cluster companies, brand and service names, among large, often spuriously ranked groupings.Being on the shopping list has very little quantifiable and lasting value. Nor does the standing of being “first amongst equals”.
Establishing and sustaining unique, differentiated presences in the marketplace is difficult.
In the brave and new world of digital, mobile, on-line, multi or omni-channel reality, the importance, nature and value of effective branding is deepened and broadened.

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Positive thinking has no negatives

Harvey Mackay

One of life's great annoyances is the tendency of folks who ask you to perform an impossible task, list the issues they foresee and the problems that have plagued previous attempts -- and then admonish you to "think positive."
Wow! Does that mean you are so good that you can achieve what no one else has? Or are you being set up to fail?   
Because I am an eternal optimist, I prefer to believe the first premise. Positive thinking is more than just a tagline. It changes the way we behave. And I firmly believe that when I am positive, it not only makes me better, but it also makes those around me better. I think that good attitudes are contagious. I want to start an epidemic!

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Feasting on Fat

Loretta Marron OAM BSc

With the Christmas and New Year opportunities to over-indulge, it was easy for girths to increase a little.
If so, it might be very difficult to lose those extra kilos.
Many advertised products and services allegedly help us lose fat without diet and exercise.
Most will fail; some might even be dangerous.

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Hanukkah, Oxygen Masks and Christmas

Mark Neuenschwander

I've been thinking about Hanukkah, oxygen masks, and the Christmas presents I am duty bound to muster for my kids and grandkids. Thank God dad asked for pajamas.
Today I’m flying from Las Vegas to Seattle. About the only thing I liked about Sin City was the fountain show at Bellagio, the Elvis Christmas songs that popped up here and there, and a pretty good keynote address by Bill Clinton. Just thinking of shopping makes me wonder if the cabin isn’t losing its pressure.

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Antioxidants Prevent Cancer and Some May Even Cure It

Staff Writer

Orthomolecular Medicine News Service, January 24, 2013

Antioxidants Prevent Cancer and Some May Even Cure It

Commentary by Steve Hickey, PhD

(OMNS Jan 24, 2013) It is widely accepted that antioxidants in the diet and supplements are one of the most effective ways of preventing cancer. Nevertheless, Dr. James Watson has recently suggested that antioxidants cause cancer and interfere with its treatment. James Watson is among the most renowned of living scientists. His work, together with that of others (Rosalind Franklin, Raymond Gosling, Frances Crick, and Maurice Wilkins) led to the discovery of the DNA double helix in 1953. Although his recent statement on antioxidants is misleading, the mainstream media has picked it up, which may cause some confusion.

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HMR Moratorium – Killing Jobs in Pharmacy

Joseph Conway

It’s no secret that the Pharmacy Guild has called for a moratorium on HMRs until the alleged abuse of a tiny minority of Independent Pharmacists potentially rorting the system is investigated and the system is changed to reduce the possibility of such rorting.
They say that this is necessary as the budget for HMR’s has been overrun and any potential rorting could put the viability of future pharmacy-centric programs at risk too.
The Guild want payments stopped so that the business rules behind HMR’s are “tightened” to stop this apparent rorting.
If there is actually rorting going on, then I think that it’s in all pharmacists’ interest to “fix” this issue.
I for one have nothing against tightening the rules to stop pharmacists “Warehousing” HMRs?
This is great.

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Part one -HMR Evolution

Neil Johnston

With the furore created when the PGA went to print stating that the funds available for HMR’s were almost exhausted, it created an instant “blame game” and conjecture as to what really lay behind the belated PGA announcement.
I came to a conclusion early that it was a result of PGA mismanagement as the immediate problem, but also coupled with an underlying systemic flaw that was the major problem.
Between them they impact and threaten the long term development and survival of the consultant pharmacist program.
It has prompted me to create an analysis of some aspects of the program to evaluate what has gone wrong.

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Part two - Fixing the HMR Flaws

Neil Johnston

The PGA has succeeded in upsetting a broad spectrum of pharmacists that includes all accredited pharmacists, some employer pharmacists (with designs on creating a business model with professional services at the core), and employee pharmacists who see job opportunities being squandered.
It is obvious that the “engine room” for consultant pharmacists (The Australian Association of Consultant Pharmacy) needs urgent reform and a new focus, or be replaced completely.
And the PGA should stop its interference.

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Part three - a Better Umbrealla Organisation

Neil Johnston

Because a workable umbrella model for management consultants already exists, it is suggested that this model be adapted for consultant pharmacist use.
The existing umbrella model established for consultant pharmacists would need to be altered dramatically and be opened up to other organisations e.g Consumer Health Forum, APESMA)
Or an entirely new organisation could be developed from scratch.
This is, in fact happening and is unrelated to any of my activities.
However, I am suggesting that the umbrella model of organisation provided by the Institute of Management Consultants (Australia) provides an excellent reference to adapt to a consultant pharmacist version.

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Thought Bubbles From a Book Group Refugee

Gerald Quigley

Editor's Note:
One night recently, I received the following email from Gerald:
"My wife has a book-group here. I’m locked in my study and inspired to write!"
That's good news for an editor/publisher - getting copy in on time well in advance!
Then followed (the same night), three separate and disparate thoughts that were not directly concerned with a pharmaceutical issue.
But they all had application for pharmacy improvement, with a bit of applied creativity.
As these "thought bubbles" wafted in over the Internet I began to wonder how I might splice them together with some editorial ingenuity.
The following is the result.

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What Really Causes Kidney Stones (And Why Vitamin C Does Not)

Staff Writer

Orthomolecular Medicine News Service, February 11, 2013

What Really Causes Kidney Stones
(And Why Vitamin C Does Not)

(OMNS Feb 11, 2013) A recent widely-publicized study claimed that vitamin C supplements increased the risk of developing kidney stones by nearly a factor of two.[1] The study stated that the stones were most likely formed from calcium oxalate, which can be formed in the presence of vitamin C (ascorbate), but it did not analyze the kidney stones of participants. Instead, it relied on a different study of kidney stones where ascorbate was not tested. This type of poorly organized study does not help the medical profession or the public, but instead causes confusion.

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For health's sake, time to take on food giants

Staff Writer

Food Industry marketing practices are increasingly being brought under the spotlight as are various other worrying problems regarding additives to manufactured food products, also how food is grown using genetically modified seed and the range of toxic herbicides and pesticides.
These latter substances now pollute the entire food chain and not enough is being done to protect our food chain.
Many illnesses can be traced back to ingestion of unnatural substances over a long period of time.
It's time to grow your own.

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Consultant Pharmacists Should Lead The Way - But They Have No Leaders.

Mark Coleman

Isn’t it time that consultant pharmacists took control of their own direction and carved out a future?
Or is the current system of a single-product (HMR) service controlled by the PGA and the PSA, sufficient to provide an interesting and creative future?
How can the aspirations of consultant pharmacists be serviced by an organisation controlled by two major pharmacy-political bodies, when one of them (PGA) is directly working against consultant pharmacist interests.

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APESMA Campaigns for Pharmacist Lunch Hour Entitlements

Staff Writer

Australian pharmacists have been warned to carefully check exactly how much compensation they are getting for routinely working through lunch after an APESMA survey found 28 per cent of Australian pharmacists reported that they receive no financial compensation at all for the lack of a lunch break.
CEO of APESMA Chris Walton said working through every lunchtime was an unacceptable practice that could cause dangerous levels of fatigue.
APESMA has advised pharmacists who have signed any agreement to remove their lunch breaks to immediately ask their employer to itemise any compensation they are being paid in lieu of all award entitlements such as their lunch breaks.

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CHC Emphasises the Importance of Research

Staff Researcher

In light of a recent paper published in the Royal Society's Open Biology journal, proposing a theory that antioxidants can be detrimental in the late stages of cancer treatment, the Complementary Healthcare Council (CHC) of Australia emphasises the importance of clinical trials and studies into the prevention and treatment of cancer. Executive director of the CHC, Dr Wendy Morrow, highlighted this theory as being interesting and warranting more research.

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Advancing our understanding and treatment of motor impairment

Staff Researcher

NeuRA has secured significant funding to expand research into motor impairment, a problem that arises from many diseases and aging, and a growing public health challenge.
Everything the human body does requires movement, but our muscles—and our brain and nerves that control them—are often the first tissues attacked by a long list of disorders that includes stroke, spinal cord and brain injury, multiple sclerosis, Parkinson’s disease, musculoskeletal injury and cerebral palsy.Prof Simon Gandevia is an expert in the brain’s control of human movement at NeuRA (Neuroscience Research Australia) and will spearhead the nearly $7 million multidisciplinary program of study, funded by the National Health and Medical Research Council of Australia.

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Peter Waterman

Media releases issued from the office of Tania Pliberseck and the PSA arrived this morning.
What follows is the PSA take on recent events surrounding HMR managent.

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Pharmedia - The Vaccine Poll Hijacked by Pharmacists?

Neil Johnston

Editor's Note:
Professional services development was stymied when the AMA reneged on an agreement to support pharmacist vaccination clinics.
It has caused anger and unprofessional behavior has evolved on both sides.
It also appears that while the professional bodies of the AMA and the PGA attempt to disrupt each other, patients at large will become the eventual losers.
The PGA is central to other clinical service disruptions, even those within pharmacy involving contractor pharmacists.
This is damaging to an orderly development of clinical services in a pharmacy setting and demonstrates that current leaders of the PGA and the AMA are not fit to claim the title of "leader".
We asked Mark Coleman to provide commentary on an article recently published in Australian Doctor.

Comments: 2

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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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© 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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