s NPS Media Releases March 2010 | 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 March 2010

NPS Spokesperson

articles by this author...

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

The National Prescribing Service (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.

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19 March 2010
New medicine information resource for Arabic speakers

Australia’s growing population of Arabic speakers now have access to a translated brochure explaining what they need to know about their medicines.

The Medimate brochure contains information about prescription medicines, over-the-counter medicines and natural and herbal medicines. It includes advice about how to use medicines safely, managing multiple medicines and keeping healthy with and without medicines.

This brochure was first published by the National Prescribing Service (NPS) in English in 2004 and, in partnership with the Federation of Ethnic Communities’ Councils of Australia (FECCA), has been translated into 7 other languages - Chinese, Greek, Italian, Vietnamese, Macedonian, Croatian and Arabic.

“Each year approximately 400,000 Australians experience problems related to using medicines. Australians from non-English speaking backgrounds are at higher risk of experiencing these problems,” NPS CEO Dr Lynn Weekes said.

“It can be difficult for people with low English language proficiency to determine appropriate treatment plans with their health professionals due to language and literacy barriers as well as differing cultural beliefs about health and medicines.”

“We are committed to ensuring that all Australians have access to the same high-quality information about using medicines safely, and will continue to develop information in languages other than English,” Dr Weekes said.

The number of Arabic speakers in Australia has grown over the last decade. According to the 2006 Census, there were 243,672 people from an Arabic-speaking background living in Australia, constituting the fourth largest language group other than English.

With this in mind, NPS and FECCA conducted research into the medicines issues faced by Arabic speakers and found common problems with following medicine instructions. These included difficulties understanding what to take, when to take it, how often, and with or without food. The new Arabic Medimate brochure addresses the main issues found in this research and provides simple tips on how to prevent problems.

“Our Medimate brochure has been extremely popular – it provides practical, easy to understand advice, which can help prevent serious mishaps with medicines,” Dr Weekes said.

The brochures are available from NPS at no cost. To order some for your general practice or pharmacy go to www.nps.org.au/medimate or call 02 8217 8700.

To view a copy of the research report into the medicines issues for Arabic speakers in Australia, go to http://www.fecca.org.au/MCQUM.cfm



16 March 2010
Education the key to addressing misuse of diagnostic technologies

The inappropriate use of diagnostic imaging has been recognised as an issue by Government, and in August the National Prescribing Service will begin the first phase of its program to improve referrals for diagnostics.

This program was announced in the last federal budget, with funding of $9.4 million over four years to improve the use of diagnostic tools including CT scans, pathology and other diagnostic technologies.  

The NPS program will focus on improving requests by doctors for pathology and diagnostic tests, and draws on the same successful model it has used over the last decade to improve medicines use.

"Our model for improving medicines use in Australia has been extremely successful. It focuses on both education of health professionals and of consumers, and we are proud to say that we have achieved significant changes in prescribing behaviour. For some medicines this has meant a decrease in prescribing and for others it has meant an increase", NPS CEO, Dr Lynn Weekes said.

"Our ultimate concern is that medicines and medical technologies are used in the best way possible for the patient's health."

The first phase of the NPS program will address technologies used to diagnose lower back pain, as back complaint is the second most common reason why people presented to their doctor asking for analgesics.  Back pain generates 5% of imaging orders.

A review of GP activity using the BEACH dataset shows the proportion of encounters generating imaging orders increased from 6.7% in 1999-2000 to 8.5% in 2008-09 (approximately 2.7 million more encounters for which imaging was ordered). Diagnostic radiology accounts for almost half (48.4%) of all imaging ordered in 2008-09.

"One of the difficulties doctors face is that people with lower back pain often expect to receive a referral for an x-ray or CT scan in the hope that it will identify the root cause of their pain. In reality, imaging rarely is helpful in guiding the best treatment choices for back pain", Dr Weekes said.

A diagnostics expert advisory panel has been established and is chaired by Tim Usherwood, Professor of General Practice and Head of Department, Sydney Medical School, Westmead Hospital.

11 March 2010
New appointments to NPS Board

Several changes have been made to the National Prescribing Service Board with the appointment of two new directors and the reappointment of an existing director.

Dr Chris Mitchell has replaced Ross Maxwell as a General Practice Class director, after Dr Maxwell’s retirement from the Board late 2009. 

Dr Mitchell has been a rural GP in northern NSW for 20 years and is currently President of the Royal Australian College of General Practitioners (RACGP). He brings to the NPS Board more than 10 years’ experience as a director serving on not-for-profit boards, and he holds a Fellowship at the Australian Institute of Company Directors.

NPS Chair, Dr Janette Randall welcomed Dr Mitchell’s appointment, recognising his recent high profile and extensive networks in the primary care sector.

“In calling for nominations for this position, the Board sought candidates with particular experience working in rural settings as we recognise the medicines use issues in rural areas need ongoing consideration.”

“With his commitment to and understanding of rural general practice and general practice training, Chris will bring invaluable insight and experience to the NPS Board.” 

The second director appointment is Dr Jim Langridge who brings a wealth of business management expertise which will complement the Board’s strengths.

Jim’s career over the past 30 years has been in higher education administration, specialising for over 20 years in international education, entrepreneurship in higher education and business management.

Until early 2009 he held the joint appointments of vice principal (international) at the University of Wollongong and CEO/managing director of the ITC group of Companies (UOW’s commercial arm). 

“Jim brings to the NPS Board experience gained from directorships of organisations in the private education sector, entrepreneurial start-up companies and those involved in regional and economic development. As NPS looks at new ways to expand quality use of medicines and achieve our organisational objectives, Jim’s expertise will be highly valued,” Dr Randall said.

Kate Moore has been reappointed for a second three-year term as the Consumer Class director. Kate has broad understanding of community quality use of medicines issues and is chair of the ACT Health Council and a member of several other committees. 

Dr Randall said Kate’s expertise in consumer medicines issues will assist the Board to realise its key strategic objectives of improved medicines literacy and broader community engagement with quality use of medicines.

10 March 2010
Methylnaltrexone reviewed in the latest edition of RADAR    

Written by the National Prescribing Service, RADAR is a timely publication containing independent, evidence-based assessments of new drugs, new PBS listings and the latest research for doctors, pharmacists and other health professionals.

Information about the following PBS-listed medicines can be found in the March edition of RADAR:

Nebivolol (Nebilet): Nebivolol is a new selective beta1-receptor antagonist for treating chronic heart failure. It is an alternative to bisoprolol, carvedilol, and controlled-release metoprolol but has less robust evidence of survival benefit. Although the major trial with nebivolol was conducted in older people there is no evidence it is more effective in any age group than other beta blockers used in heart failure.

Methylnaltrexone (Relistor): Methylnaltrexone injections are a new option for treating opioid-induced constipation in people receiving palliative care who have not responded to adequately titrated laxatives. Methylnaltrexone increases bowel movements without reversing analgesia.

Around 50–60% of people with opioid-induced constipation experience a bowel movement within 4 hours of a single dose of methylnaltrexone. However, around 30% of people may not respond within 24 hours of a single dose. Patients should be advised that bowel movements may occur within 30 minutes of an injection.

Methylnaltrexone should only be used in addition to other therapies that prevent or treat opioid-induced constipation, and no more than once in any 24-hour period.

Other PBS-listed drugs reviewed in this edition of RADAR include:

-          Albendazole (Zentel) – listing extended to treat hookworm and Strongyloidiasis

-          Terbinafine – authority listing extended to children under 18 years


To read the full reviews go to www.nps.org.au/radar


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