s NPS Media Releases for May 2009 | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

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

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

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

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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NPS Media Releases for May 2009

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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5 May 2009
Antiviral guidelines and rapid tests for diagnosing influenza available on NPS website

Health professionals are urged to follow guidelines issued by the Department of Health and Ageing when prescribing antivirals for the treatment of swine influenza (H1N1).

The National Prescribing Service Ltd (NPS) made these guidelines available on its website last week, along with links to information from the US Centers for Disease Control, World Health Organisation and other industry organisations.

Current recommendations for the treatment of swine influenza using oseltamivir (Tamiflu®) or zanamivir (Relenza®) are only in the event of:


• Close contacts of confirmed or probable cases, in consultation with the local Public Health Unit, within 48 hours of contact

• Suspected cases, in consultation with the local Public Health Unit, if started within 48 hours of onset of symptoms, until influenza A is excluded or an alternative diagnosis is made.


There is no current recommendation for oseltamivir to be used as a prevention by travellers visiting affected countries, apart from Mexico.

These recommendations are in line with those issued by the US Centers for Disease Control (CDC), which can be accessed at www.cdc.gov/swineflu/recommendations.htm.

An article ‘Rapid tests for the diagnosis of influenza’ from the June edition of Australian Prescriber has been released early and can also be accessed via the NPS website.

The article, written by Microbiology Registrar Hong Foo and Clinical Professor of Medicine, Dominic Dwyer, from the Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, outlines rapid influenza tests based on viral antigen detection with point-of-care tests and immunofluorescence, how they work and their limitations.

It is not expected that the Australian seasonal influenza vaccine will provide protection against this new strain of influenza virus. However, people over 65 and other vulnerable groups should still be encouraged to be vaccinated as this will provide protection against seasonal influenza.

Community pharmacists can access more detailed information through The Pharmacy Guild of Australia and Pharmaceutical Society of Australia websites.


Doctors and other prescribers can access further information through the AMA and RACGP websites.


12 May 2009
Funding boost acknowledges importance of quality use of medicines

The National Prescribing Service Ltd (NPS) has welcomed a funding enhancement from the Federal Government to expand on our quality use of medicines work.

NPS will receive additional funds over the next four years to continue programs that improve medicines use among Australians.

“This announcement acknowledges NPS’ role in providing accurate, independent information to health professionals and consumers. It also reflects the Government’s commitment to integrative and preventative health measures that benefit all Australians,” NPS CEO, Dr Lynn Weekes said.

“This was not an easy Budget for the nation, but through our continued work promoting the safe and effective use of medicines, NPS will contribute to long term savings.”

It was also announced in the Budget that NPS will receive funding to run a national diagnostic requesting service to promote best clinical practice for efficient use of diagnostic imaging and pathology tests.

“We are yet to determine the details with the Department of Health and Ageing but it is likely to reflect our successful quality use of medicines program model,” Dr Weekes said.

This includes decision support tools, implementation of evidence-based guidelines, peer feedback and educational programs designed to assist health professionals and consumers make the best health decisions.

“Diagnostic imaging and pathology programs are a logical expansion of our current work with health professionals. Ultimately we hope to run synergistic programs that link diagnostics with medicines, ensuring tests are used efficiently and result in the best outcomes for patients.”

“We look forward to working closely with industry stakeholders in this new and interesting area for NPS,” Dr Weekes said.

The additional funding includes an additional $21 million over four years to enhance its existing work and $9.4 million over four years for the new diagnostics work.

Further detail about the work NPS will be doing over the next four years is expected to be announced in coming weeks.

14 May 2009
New medicine evaluation tools for aged care facilities

Two new Drug Use Evaluation (DUE) tools have been developed by the National Prescribing Service Ltd (NPS) to assist health professionals working in aged care facilities with optimal drug therapy relating to laxative use, and hypnotics.

The NPS DUE toolkits provide localised activities to compare current drug use against best practice and guide health professionals in their decision making to achieve the best outcomes for patients.

“Laxatives are one of the most frequently used medicines in long term aged care facilities - up to half of nursing home residents have reported experiencing constipation and 74% are receiving at least one laxative preparation[1],” NPS Education and Quality Assurance Program Manager, Judith Mackson said.

“But despite their widespread use, it is often difficult to assess the efficacy of laxatives. The inappropriate treatment of constipation can have a significant impact on the resident’s quality of life and increase the cost of care. The Laxative use for chronic constipation DUE will support health professionals to ascertain if current practice is at odds with best practice,” Ms Mackson said.

Benzodiazepine and non-benzodiazepine hypnotics for insomnia is the first electronic DUE toolkit to be available as a downloadable application for health professionals. The tool is a standalone data collection and analysis tool which is a valuable addition to the DUE resources.

This eDUE examines the appropriate use of medicines to manage insomnia in aged care facilities. The new electronic format contains fewer questions than other DUE tools, offers an intuitive interface and a variety of drop down menus. It also has a ‘save as you go’ mechanism, recognises appropriate dosage quantities and provides automatic feedback.

There are now four DUE toolkits available from NPS:

1. Benzodiazepine and non-benzodiazepine hypnotics for insomnia (NEW eDUE version)

2. Laxative use for chronic constipation (NEW)

3. Antipsychotics for behavioural and psychological symptoms of dementia

4. Analgesics for persistent pain

Participation in these DUE activities will assist the aged care facility to meet components of the Residential Care Standards issued by the Aged Care Standards and Accreditation Agency and comply with the Australian Pharmaceutical Advisory Council Guidelines for medication management in Residential Aged Care Facilities.

These DUE activities are also recognised by a number of health professional bodies as contributing to continuing education and professional development. To be eligible for professional development points, enter your details on the DUE access page on the NPS website.

The NPS DUE toolkits are downloadable at www.nps.org.au/due. For more information about DUE in aged care facilities, contact Aine Heaney at NPS on (02) 8217 8700 or aheaney@nps.org.au.

[1] 1. Harari D, Gurwitz JH, Avorn J, et al. Bowel habit in relation to age and gender: findings from the National Health interview Survey and clinical implications. Arch Int Med 1996;156:315-20.

2. Williams SG, DiPalma JA. Constipation in the long-term care facility. Gastroenterol Nurs.1990;12:179-82.

3. Woodward M, Moran J, Elliot R, et al. Constipation in older people Pharmacological Management Issue. J Pharm Pract Res 2002;32:37-43.


20 May 2009
Pharmacy Practice Review – improving quality care

The National Prescribing Service Ltd (NPS) has developed a new Pharmacy Practice Review to support pharmacists to deliver best practice care for patients prescribed proton pump inhibitors (PPIs).

The Pharmacy Practice Review – a counselling and action resource: Quality use of prescription Proton Pump Inhibitors (PPIs) is part of the broader vision of NPS to encourage quality use of medicines. It is one of the activities of the 2009 NPS therapeutic program on prescribing and use of PPIs for health professionals.

“The NPS Pharmacy Practice Reviews allow pharmacists to self-assess their practice against pharmacist competencies and professional practice standards to determine training and development needs,” NPS Deputy CEO, Karen Kaye said.

“Last year 1500 pharmacists and interns completed the NPS ‘Enhancing patient care in type 2 diabetes’ review. Pharmacists participating in NPS activities are committed to providing patients with best-practice care.”

“Feedback we have had from both hospital and community pharmacists has been largely positive. Most acknowledge that by the time they complete two or three reviews, they can see improvements in the way they communicate with patients which benefits the whole relationship,” Ms Kaye said.

Participating in the activity assists pharmacists to identify counselling points and provide appropriate lifestyle advice for patients prescribed PPIs as well as allowing pharmacists to reflect on individual episodes of care. Pharmacists completing the Review will be in a better position to identify patients for referral to their GP.

The Pharmacy Practice Review includes a tear-off pad with information to give to patients, an action checklist for pharmacists to work through for each patient and current clinical information on the use of PPIs.

By participating in this Review, pharmacists can earn continuing professional development points:

• Australian Association of Consultant Pharmacy (AACP) — 8 points

• Pharmaceutical Society of Australia (PSA) CPD&PI program — 8 points

• Pharmacy Board of South Australia — up to 8 ENRICH credits

• Society of Hospital Pharmacists of Australia (SHPA) CPD Program — 8 hours of content as a group 2 activity

To participate in the Pharmacy Practice Review and ensure feedback will be provided in late November, pharmacists must enrol by 26 June 2009. Visit www.nps.org.au/pharmacy_practice_reviews.

The NPS publication, Prescribing Practice Review (45) Proton pump inhibitors: step-down to symptom control is available at www.nps.org.au/health_professionals.


29 May 2009
Managing acute post-operative pain in hospital

Health professionals caring for patients with acute post-operative pain can improve pain management with a new drug use evaluation toolkit developed by the National Prescribing Service Ltd (NPS).

The Acute postoperative pain drug use evaluation (DUE) toolkit can be used by hospitals to assess practices and ensure interventions lead to improvements in a patient’s experience of pain. It is designed to support surgical, anaesthetic, pharmacy and nursing staff in public and private hospitals to manage acute pain after surgery and assist hospitals to review practice when new drugs become available.

“Health professionals, hospital and day surgery services that choose to use these resources will be able to audit the quality of acute postoperative pain management by measuring key quality indicators, provide real-time reporting and feedback data in a format that supports educational quality improvement strategies,” Ms Mackson said.

The DUE toolkit was developed following a national quality improvement project on management of acute postoperative pain in 62 Australian public and private hospitals in 2006 and 2007 and includes an electronic data collection tool (e-DUE) and educational resources.

The e-DUE audit tool is a standalone windows application that provides a streamlined method of data entry and reporting of clinical measures that ensures both hospital and patient confidentiality. It measures 13 quality indicators including pain assessment, sedation scores and management of acute pain post-discharge.

The educational resources include:

• a PowerPoint feedback presentation for hospital staff;

• wall posters on pain assessment and prescribing of analgesia;

• pain scales, assessment and a discharge checklist;

• a patient brochure; and

• a summary to be used in one-on-one education with clinical staff.

“The technology allows for improved functionality and can be used more than once to store data in order to show comparisons between data collections.” Ms Mackson said.

The educational resources in the toolkit were developed in consultation with the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine for the acute postoperative pain project.

The electronic DUE toolkit is free and can be downloaded from



For more information contact NPS on (02) 8217 8700.

Media enquiries to Katie Butt, Media Adviser, 0419 618 365 or kbutt@nps.org.au


The National Prescribing Service Limited (NPS) is an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.



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