s NPS Media Releases for March 2012 | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

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
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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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 March 2012

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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30 MARCH 2012

CONSUMER SHOULD BE CENTRE OF CARE WHEN OFFERING ALTERNATIVE MEDICINE BRANDS

NPS is reminding pharmacists to place patient care first and avoid multiple switching of medicine brands for patients who may be at higher risk of confusion from switching, as price disclosure arrangements come into effect this weekend.

NPS Head of Programs, Ms Karen Kaye, says that consumers always need to be at the centre of care when pharmacists give advice about medicine brand choices.

“It’s important people know that if they are offered an alternative brand of their medicine that it will be just as safe and effective as their original brand, however for some people the benefits of choosing a different brand, such as a lower price, may not be worth the drawback of an unfamiliar medicine packet,” says Ms Kaye. 

“One way to help patients who do consent to a switch is for pharmacists to use auxiliary label 15 which points out that the medicine replaces another, and that the patient should not use both.”

However, for people on multiple medicines or those likely to get confused about their medicines, such as older people, adjusting to a different-looking medicine with an unfamiliar packet and brand name can be difficult and may cause distress and/or medicines mishaps.

“There are also certain medicines, such as warfarin, as well as some medicines for certain conditions, such as epilepsy, thyroid conditions, and transplant rejection that should not be substituted without permission from the doctor.” 

As part of Be Medicinewise Week, NPS has released a new quick question guide for consumers designed to help them make a safe and confident choice between medicine brands. Available on the NPS website, the 5 questions cover what consumers should ask their pharmacist when they are offered a different brand of their medicine so that they make the right choice for them.

New research from NPS* found that 74% of Australians who take a prescription medicine were offered an alternative brand of one of their medicines by their pharmacist the last time they purchased it. Of those offered a choice, 72% accepted the offer and purchased the alternative brand while 25% stayed with the brand they were originally prescribed.

“Ultimately the choice of medicine brand lies with the consumer but it’s important pharmacists always ensure the consumer is at the centre of care and that their individual circumstances are taken into account when discussing choice of medicine brand with them,” says Ms Kaye.

NPS has also been communicating with consumers to help them understand that a pharmacist can only offer an alternative brand of a medicine if it has been accepted by the regulatory body —The Therapeutic Goods Administration  — as being bioequivalent to — that is, it works in the same way as — the original brand.

“An important message for patients is that when the patent for a medicine expires, other companies can manufacture medicines containing the same active ingredient and dose as the original brand. This means both brands will have the same effect in your body,” says Ms Kaye.

“We always direct consumers to talk with their doctor, pharmacist or health professional if they are confused or unsure about which choice is best for them.”

5 questions to ask when you are offered an alternative brand of medicine

1.     Is it okay for me to choose a different brand of my medicine?

2.     What are the benefits and disadvantages for me if I use a different brand?

3.     Is there a difference in cost?

4.     Which of my usual medicines does this replace?

5.     What is the active ingredient in my medicine?

To find out more about generic medicines and informing patients about multiple brands, read NPS News 76 on the NPS website at http://www.nps.org.au/health_professionals/publications/nps_news  

Information for your patients about making safe medicine brand choices is available on the NPS website at http://www.nps.org.au/bemedicinewise/brand_choices

If your patients have questions about their medicines they can also call the Medici

28 MARCH 2012

1 IN 5 AUSTRALIANS HAVE EXPERIENCED AN ADVERSE EFFECT FROM THEIR MEDICINE: NPS SHOWS YOU HOW TO BE MEDICINEWISE

New research from NPS* has found 1 in 5 Australians have experienced an adverse effect from their medicine in the past 12 months, like nausea, vomiting, diarrhoea and fatigue.

The survey also found medicine use was almost universal, with 95% of the 1205 respondents reporting they had taken a medicine in the past 12 months. Overall 68% had taken a prescription medicine and 76% had taken an over the counter pain relief medicine. More than half (52%) had taken another over the counter medicine, such as eye drops, cold and flu tablets or nasal sprays for hay fever and 56% had taken a vitamin mineral or herbal supplement.

NPS clinical adviser Dr Danielle Stowasser said with medicine use being so common, it’s likely some people will experience adverse effects, but sometimes these can be reduced or avoided if people take simple steps to be more medicinewise.

“With 190,000 medicine-related hospital admissions Australia every year, it’s so important for people to stop and think about what they are taking,” says Dr Stowasser.

“This is why we are urging people to be medicinewise by knowing what a medicine is, always following instructions, asking the right questions, and knowing the active ingredient of their medicine.

“These simple steps will not only help people avoid harm but will help them get the most benefit from their medicines.”

The research has been released to coincide with Be Medicinewise Week 2012, which encourages all Australians to stop, think and learn more about the medicines they are using and to ask their health professional questions.

Other interesting findings include:

*      57% of Australians have made a mistake with their medicines in the last 12 months

*      1 in 5 Australians have taken an out-of-date or expired medicine

*        Just under half have missed a dose of their medicine

*      1 in 4 have taken medicine without food which were meant to be taken with food 

BE MEDICINEWISE EVENT IN SYDNEY CBD

NPS is holding an event for members of the public in Sydney’s CBD on Thursday March 29 from 7am – 3pm, with a number of different displays and activities designed to help people be more medicinewise including:

*         Activities demonstrating how to weigh your child and measure an accurate dose of medicine using a syringe and water

*       An activity to help people identify products which are or are not medicines

*    A demonstration on how to find the active ingredient, brand name and other details on giant medicine boxes

*     Pharmacists on site to answer questions on how you can be more medicinewise.

From 7.30am-9.30am GP and media personality Dr John D’Arcy will be with NPS clinical adviser Dr Danielle Stowasser to answer your questions about being medicinewise. 

For further details regarding the event, please contact Lisa Chikarovski on (02) 8217 8645.

26 MARCH 2012

57% OF AUSTRALIANS MAKE MISTAKES WITH THEIR MEDICINES: BE MEDICINEWISE WEEK 2012

New research* from NPS has found that 57% of Australians report they have made a mistake with their medicines in the past 12 months.

In a survey of 1205 people, 44% said they had forgotten to take a dose, and 1 in 4 had taken a medication without food when they were directed to take it with food.

Other mistakes reported included taking a higher or lower dose than prescribed or accidentally taking the wrong medicine.

Released to coincide with the start of Be Medicinewise Week 2012, NPS clinical adviser Dr Danielle Stowasser says the results show how important it is that people pay more attention to their medicines.

“It’s likely we will all make a mistake with our medicines at some point,” says Dr Stowasser. 

“Most of the time these mistakes will cause little harm but sometimes the consequences can be serious, or even deadly.  During Be Medicinewise Week 2012 we are urging all Australians to stop, think and learn about their medicines to help avoid mishaps.”

As part of the week’s activities NPS is launching a variety of resources and new information for consumers, including the ‘Medicinewise Challenge’ — a quick 5-question quiz that delves into some crucial things people need to know about medicines. All participants will go into a random draw with three winners selected to win an iPad.

Dr Stowasser says there are a few simple steps we can all take to be more medicinewise:

Know it’s a medicine. 

“Medicines are sold in many places, come in many forms and are used in many different ways,” says Dr Stowasser. “So when you buy a tablet, lotion or syrup from a pharmacy, supermarket or even the local convenience store ask yourself, is this a medicine?  If you’re expecting it to affect your body or your health, the answer is likely to be yes.”

Know the active ingredient of your medicine. 

“The active ingredient is the chemical which makes a medicine work and its name is normally found on the label or packaging.  If you’re offered a different brand of medicine with the same active ingredient you can be confident that both of them will work the same in your body,” says Dr Stowasser.  “It’s also important to know your active ingredient as it may interact with other medicines you are taking, including complementary medicines such as herbs and vitamins.”

Always follow instructions from your doctor or pharmacist on how to use the medicine.

“Carefully read all labels on your medicine and the packaging. For more detailed information, consult the Consumer Medicine Information (CMI) leaflet for your medicine if available. And you can always ask your doctor or pharmacist if you’re unsure about anything.”

Ask your health professional – such as your doctor or pharmacist – questions about your medicines. 

“The more information you have, the better the decisions you will be able to make about your health and medicines,” says Dr Stowasser.

Be Medicinewise Week 2012 runs from March 26 - 31.  For further details on being medicinewise, visit www.nps.org.au/bemedicinewise

To take the Medicinewise Challenge and go into the draw to win an iPad, visit http://www.nps.org.au/bemedicinewise/medicinewisechallenge or check out NPS Medicinewise on Facebook.

 

23 MARCH 2012

NPS REAPPOINTS TWO DIRECTORS

NPS: Better choices, Better health has reappointed two directors to its board for further terms of three years.

Dr Graeme Killer AO has been reappointed as the Government Class Director, while current Chair Dr Janette Randall was reappointed as Additional Director.

NPS CEO Dr Lynn Weekes says both Dr Killer and Dr Randall bring a wealth of experience, knowledge and enthusiasm to the NPS Board.

“Graeme has a good level of understanding of all levels of government and the political landscape,” says Dr Weekes.

“His extensive networks and ability to build and use them is embedded in his role in government and on the NPS Board.

“Janette’s high level strategic decision making qualities and her ability to work on big picture matters with objectivity and passion are some of the attributes that make her so valuable to the board,” says Dr Weekes.

“These qualities, together with her in-depth understanding of our organisation and environment and her experience and leadership skills in the non-for-profit sector, are of principal significance to the NPS Board.”

 

22 MARCH 2012

TRAINING IN GOOD MEDICINE IMPROVES ABORIGINAL HEALTH 

This year on National Close the Gap Day — 22 March 2012 — NPS is playing its part through its work with Aboriginal Health Workers and pharmacists to increase people’s understanding of being medicinewise in helping to close the gap. 

Aboriginal and Torres Strait Islander people as a whole are between two and five times sicker than other Australians, yet expenditure on medicines per Aboriginal and Torres Strait Islander person is around 40% of the amount spent on other Australians*. Many Aboriginal and Torres Strait Islanders live with chronic conditions such as asthma, diabetes and high blood pressure. 

NPS manages a range of programs designed to improve health in Aboriginal and Torres Strait Islander communities through assisting Aboriginal Health Workers improve their knowledge and skills about medicines to then use this knowledge in a clinical setting with patients.

NPS Head of Programs Ms Karen Kaye says that NPS is delighted with the response to – and the results from the Aboriginal Health Workers training program.

“We have had excellent feedback on the program from participants,” said Ms Kaye.

Three members of the chronic care team at the Aboriginal Medical Service in Western Sydney – Mrs Joyce Davison, Ms Tania Davison and Ms Louise Moore - completed the NPS training. The three women found their confidence increased greatly in answering their clients’ questions about medicines.

“The course itself looked rather confusing at first, but NPS trainer Jo McMahon, who is a pharmacist, made it simple to understand,” said course participant Louise Moore.

“I found the course really beneficial for our jobs — for understanding when patients come and ask you about their medicines.” 

Participant Joyce Davison said that part of the course involved everyone receiving a copy of the Australian Medicines Handbook, which has come in very handy as an information resource and for explaining important concepts around medicine brand choices.

“We often have patients say ‘How come we’ve been given the generic brand?’. Some of them think they’ve been given the wrong medicine, while others think they are being given an inferior brand,” said Mrs Davison.

“Before I did the course, I was querying that too with my own prescriptions. Now that we each have our own handbook, we can look up each medication.”

The training also covers some of the common medicine safety issues that Aboriginal Health Workers can help to address, such as knowing not to share medicines, safe dispensing, storage, contraindications of medicines, identifying adverse events, assisting clients to administer their own medicine.

“There have been some of our clients out in the community who I know have been sharing their medication if they run out. For example they think all blood pressure tablets or diabetes medicines are the same, so they can share them with other people. But now I can tell them, that they’re not all the same and it’s important not to share your medicines,” said Mrs Davison.

Louise Moore says that some of her patients don’t want to ask the doctor the questions, so they approach their Aboriginal health workers instead.

“We’re not the ones prescribing the medicines and we still encourage patients to talk to their doctor,” says Mrs Davison, “but now if anyone comes in and asks me ‘what’s this medicine for?’ or ‘what does this one do?’ or if they can show me the bottle, I can look up the medicine in my book and help them find out more.”

Penny Abbott, a GP who works with the chronic disease team at the Aboriginal Medical Service in Western Sydney, said the course had been quite inspiring for her colleagues who took part.

“They came back fired up about the changes we could make at our service to help people manage and understand their medications better,” said Dr Abbott.

In 2011, a total of 32 Aboriginal workers from New South Wales, Queensland, Western Australia, and South Australia participated in four workshops. An NPS evaluation reported  an increase in both knowledge and confidence across all participants surveyed, with participants ranking their satisfaction with the course as either ‘satisfied’ or ‘very satisfied’ and all indicating they were keen to continue with more training.

22 MARCH 2012

REGISTRATIONS NOW OPEN FOR NMS 2012; SCHOLARSHIP WINNER ANNOUNCED

Registrations are now open for the National Medicines Symposium (NMS), which is being held in Sydney from 24-25 May 2012.

An early bird discount is being offered to those who register before 30 March.

This year’s theme for the biennial event is ’Building a medicinewise community‘ and focuses on consumers at the centre of medicines use discussions. NMS brings together allied health professionals and other partners to Australia’s National Medicines Policy, along with international representatives to learn, discuss and debate contemporary quality use of medicines issues.

NPS Head of Programs Ms Karen Kaye says that NMS 2012 will tackle quality use of medicines issues from a new angle, looking at all the facets that contribute to achieving safe medicines use.

“The concurrent streams offer something of interest for everyone working in this space and will address a broader range of issues than ever before,” said Ms Kaye. 

The stellar lineup of keynote speakers includes international delegates from the World Health Organization and the University of London School of Pharmacy. 

Winner of the NMS 2012 Asia-Pacific scholarship, Dr Li Yang, will also present her research into the impact of the free medicines policy in rural Beijing for adults with cardiovascular diseases.

Dr Yang is Associate Professor at the School of Public Health at Peking University and holds a PhD in health economics.

Some of the major studies she has been involved in include evaluating the impact the national essential medicines policy and analysing the evidence for rational drug use in clinical practice alongside cost effectiveness of new drugs.

Ms Kaye said the high standard of applications for the scholarship was overwhelming and there will be many opportunities for individuals and organisations to learn from international peers at NMS 2012. 

For more information and to register for NMS 2012 visit www.nps.org.au/nms2012

 

12 MARCH 2012

AN NPS FIRST FOR PHARMACISTS 

NPS has launched its first online Pharmacy Practice Review, providing pharmacists with a new and convenient way to reflect on their practice and provide the latest evidence based advice to patients prescribed a statin and/or ezetimibe.

Building on the 2011 paper version of the activity, Pharmacy Practice Review: Reducing cardiovascular disease (CVD) risk pharmacists can now complete the activity online and immediately receive tailored feedback and individual patient management plans to support ongoing care for their patients.

NPS Clinical Adviser Dr Danielle Stowasser says that this online activity is a first for NPS and sets the benchmark for a whole suite of online professional development activities for health professionals to come.

“We are excited to be working more and more in the online space and to be providing pharmacists with the flexibility and individualisation that online activities can offer,” says Dr Stowasser.

The activity gives pharmacists access to the latest evidence-based clinical information on cardiovascular disease risk and optimal use of statins, and where indicated, ezetimibe.

By reflecting on 10 episodes of care, pharmacists can plan actions for their ongoing patient management and identify areas for their own practice improvement based on best practice standards, guidelines and competencies.

“The changing environment of pharmacy is seeing more pharmacists take part in patient education, screening and monitoring of conditions, lifestyle modification and medicines adherence,” says Dr Stowasser. 

“The Pharmacy Practice Review helps foster these behaviours and instils more confidence in pharmacists when providing advice to patients with or at risk of cardiovascular disease.”

Other benefits for pharmacists participating in the new online activity include:

 *   comparison with peer group results        
 *  access to expert commentary
*    immediate availability of a completion certificate so pharmacists can log their CPD points; and
*  access to the activity on an ongoing basis so pharmacists can continue to reflect on their encounters with patients using statins and/or ezetimibe.

“We urge pharmacists to register for the online NPS Pharmacy Practice Review and see for themselves what a valuable investment of their time it is,” says Dr Stowasser.

The activity is free and accredited as a Group 2 activity for 16 credit points.     

To register for Pharmacy Practice Review: Reducing CVD risk, visit www.nps.org.au/ppr_cvd

For further information, contact Le Moss on 02 8217 8700 (select option 2) or email info@nps.org.au

9 MARCH 2012

GET READY FOR BE MEDICINEWISE WEEK 2012

NPS is excited to announce ‘Be Medicinewise Week’ will be held again this year from March 26-31.

Building on the success of last year’s inaugural event, the week will urge all Australians to stop, think and learn more about the medicines they are using and encourage them to seek information to make better decisions about their health.

NPS clinical adviser Dr Danielle Stowasser says millions of Australians take medicines every day but often don’t know a lot about what they are putting on or in their bodies. They may be unsure about the right questions to ask their health professionals.

“Medicines have become so commonplace that often people don’t stop and ask questions like am I using this medicine the right way or is this the best medicine for my condition?” says Dr Stowasser.

“During Be Medicinewise Week NPS is once again urging all Australians to be medicinewise – to get to know their medicines better and to understand the right questions to ask their health professional.”

Dr Stowasser says people often think that medicines only come on prescription from their doctor, however there are many other substances which are also considered medicines.

“A medicine can be anything that you expect to affect your body or your health,” says Dr Stowasser. 

“This can include substances bought over-the-counter — such as pain relief medicines — or complementary and herbal medicines, such as echinacea, multivitamins or fish oil.”

“Medicines also come in different forms, such as eye drops, creams and puffers – things people often don’t think of as medicines, but which have benefits and risks like any other medicines.” 

With a number of commonly-prescribed medicines coming off patent this year, one focus of the week will be how to make a safe and confident choice between medicine brands. 

“When medicines come off patent, often a number of generic brands with the same active ingredient will become available,” says Dr Stowasser.

“This can be confusing, but remember if your pharmacist offers you an alternative brand of a prescription medicine you can be sure it will work the same way as your usual brand. To avoid confusion, make sure you know where to find the active ingredient of your medicine and don’t just rely on the brand name.”

“This is also a good opportunity to talk to your health professional about your medicines, which is one of the most important steps to being medicinewise,” says Dr Stowasser.

Be Medicinewise Week 2012 will include various activities to encourage people to get actively involved with their medicines, including new resources for consumers, an online quiz to test your medicines knowledge and new facts and figures showing areas where Australians are not so medicinewise.

For further information on being medicinewise visit www.nps.org.au/bemedicinewise

2 MARCH 2012

NEW NPS INFORMATION ON DEXTROPROPOXYPHENE: RECOMMENDATIONS AND ALTERNATIVES

 

NPS has published information online for prescribers to help them prepare for the TGA’s cancellation of Capadex and Paradex, two of the four medicines available in Australia containing dextropropoxyphene. 

This information outlines recommendations for prescribers, new contraindications and alternatives to dextropropoxyphene for analgesia.

NPS CEO Dr Lynn Weekes says that the TGA cancellation reflects well-known concerns that dextropropoxyphene has an unfavourable balance of analgesic efficacy and toxicity.

“While Di-Gesic and Doloxene will remain on the market for the time being, the advice remains the same for all these medicines —the potential harms outweigh the possible benefits,” says Dr Weekes.

NPS recommends prescribers should not initiate dextropropoxyphene treatment for any new patients, they should review all patients currently taking dextropropoxyphene (Doloxene) or paracetamol with dextropropoxyphene (Capadex; Di-Gesic; Paradex), and they should inform patients taking Capadex or Paradex that their current analgesic is being withdrawn for safety reasons and they will need to change to a different treatment.

For patients currently taking Doloxene or Di-Gesic, prescribers should advise them that these may become unavailable at short notice and they should consider substituting with an alternative analgesia.  As a consequence of the TGA decision, the Department of Veterans' Affairs has withdrawn Doloxene from the Repatriation Pharmaceutical Benefits Scheme as of 1 March 2012.     

NPS also outlines some of the side effects and withdrawal reactions for GPs to be aware of, information about checks and tests, and contraindications to be aware of.

“There are alternatives to dextropropoxyphene for analgesia,” says Dr Weekes. 

“Importantly, prescribers should review the patient’s analgesic requirements as the need for analgesia may have changed.” 

Prescribers can also consider switching to paracetamol — there is no evidence that dextropropoxyphene in combination with paracetamol is any more effective than paracetamol alone — or if paracetamol is insufficient, a low dose NSAID (e.g. ibuprofen) may be added or used instead of paracetamol. NSAIDs should be used at the lowest possible dose for the shortest possible duration.

If NSAIDs are contraindicated consider a weak opioid (e.g. codeine) added to maximum daily dose paracetamol, but strong opioids (e.g. oxycodone) or tramadol are not recommended as first-line alternatives to dextropropoxyphene.

The information for prescribers is available at the NPS website at: http://www.nps.org.au/health_professionals/withdrawal_of_dextropropoxyphene  

NPS has resources available for people who take pain relief medicines

The NPS website, www.nps.org.au, has information to help your patients learn more about being medicinewise when managing pain.

NPS also offers a Medicines List and an iPhone app which helps your patients keep track of their medicines; to find out more and to order copies of the NPS Medicines List visit www.nps.org.au/medicineslist

1 MARCH 2012

STATINS REMAIN IMPORTANT FOR PEOPLE AT HIGH RISK OF HEART ATTACK OR STROKE

NPS is urging people taking statins to continue to take their medicine as prescribed and to see their doctor if they are unsure about the benefit of the medicine for them.

The recommendation comes in light of regulators in the US announcing that the cholesterol-lowering drugs will now carry advice about a small increased risk of diabetes and reports of memory problems.

NPS Head of Programs Ms Karen Kaye says that statins are recommended for people at high risk of cardiovascular events, such as a heart attack or stroke. The risk of developing diabetes with statins is small compared with their benefits for preventing heart attacks, strokes and deaths from such events.

Evidence shows that for every 255 people treated with a statin for four years, at least five cardiovascular events are avoided, while there is one extra case of diabetes.

In an analysis of statin trials involving more than 90,000 people, new diabetes cases occurred in people taking statins as well as those who didn’t. This shows that some people at risk of cardiovascular disease may develop diabetes anyway, although the number of new diabetes cases was 9% higher in those people taking statins.

“Statins lower blood cholesterol levels and reduce the risk of heart attack and stroke in people at high risk of these events,” says Ms Kaye.

“This includes people who have already had a heart attack or other cardiovascular event in the past, as well as people who have a number of important risk factors for cardiovascular events, such as diabetes, high cholesterol and high blood pressure.”

“The benefits of statins are less for people at low risk of cardiovascular events. Taking a medicine without a clear benefit is unwise, and people with few risk factors for cardiovascular disease who are taking a statin should ask their doctor about their risk of having a heart attack or stroke and their need for statin therapy.”

“Your doctor can estimate your heart and stroke risk score and tell you if the benefits of the statin outweigh the risk of side effects,” says Ms Kaye.

“Making lifestyle changes, such as giving up smoking, exercising more regularly and eating more healthily is the priority for people at low risk of cardiovascular disease, and these remain important for those at higher risk.”

“Importantly, people should not stop taking statins without seeing their doctor.”

There have also been reports of memory loss and confusion with statins, but according to NPS, there is not enough evidence to be certain that statins cause these effects.

Trials with statins have not found an increased risk of memory loss or confusion with the medicines. In reports to regulatory agencies where these effects were seen, they improved once the person stopped taking the statin.

“Again, people who are concerned about the risk of memory loss with statins should see their GP,” says Ms Kaye.

An NPS study published in the Medical Journal of Australia in January 2012 found that 30% of Australians aged over 50 had taken medicines to lower cholesterol on the day the survey was taken.

More information

More information about statins and the risk of diabetes and memory problems is available on the NPS website at http://www.nps.org.au/bemedicinewise/medicinewise_articles/statin_benefits_outweigh_diabetes_memory_risks  

Information on the benefits of statins is available at http://www.nps.org.au/topics/cholesterol/cholesterol_lowering_medicines_can_extend_life

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