s NPS Media Releases for Nov 2011 & Dec.2012 | I2P: Information to Pharmacists - Archive
Publication Date 01/12/2011         Volume. 3 No. 11   
Information to Pharmacists


From the desk of the editor

There is no other word for it other than depressing.
The world of pharmacy is falling on its own sword with pharmacist organisations at loggerheads with pharmacy organisations, principally the PGA.
Essentially it is wrong for a minority pharmacy organisation to dominate all others and leave in its wake some very unhappy people.
It is not a pretty sight seeing the juggernaut that is the PGA begin the process of decimation, wasting  resources in a negative fashion that ought to have been distributed more equitably.
It is neither smart or strategic to be entering into warfare when leadership would offer the more decent alternative.

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News Flash

Newsflash Updates for December 2011 & January 2012

Newsflash Updates

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

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Pipeline for Dec. 2011 & Jan.2012

Pipeline Extras

A range of global and local news snippets and links that may be of interest to readers.
Pipeline Extra simply broadens the range of topics that can be concentrated in one delivery of i2P to your desktop.

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Feature Contribution


Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)

Over the past year I have written about the need to recognize and remunerate pharmacists appropriately in order that pharmacy can take a necessary step forward in the new Millenium. Following are some points that are worthy of note.

1. In New Zealand, we now have approximately four hundred owners of pharmacies. Within this group, incomes range between $200,000 and $600,000.00. The average income for an employed pharmacist working in community pharmacy is around $65,000.00, and the salaries for young graduates in Auckland, (and Melbourne too I believe) is $24.00 per hour - around $48,000.00 per year. Not much of a reward for 5 years of study and very indicative of the value and respect placed on the employed professional by the employer!!! 

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Inquiry into the PBS – GET IT RIGHT FIRST TIME

Rollo Manning

A failing in the push for a Senate Inquiry into the 5th Community Pharmacy Agreement is recognition that the Pharmacy Guild is named in the National Health Act as the party the Government must liaise with before making decisions on fees paid to pharmacists for supply and services.
It is not the Society of Hospital Pharmacists, the Pharmaceutical Society, the National Australian Pharmacy Students Association or APESMA - but the Pharmacy Guild.
It is therefore no wonder that the Guild is the party at the negotiating table.
An amendment to the National Health Act would be needed to change this and while there is a Clause that says another organisation can be included if it represents a majority of pharmacists this has never been tested.

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Who’s driving our Heath Robinson?

Neil Retallick

Last month I likened the community pharmacy industry to a “Heath Robinson”.
According to Wikipedia, “William Heath Robinson (signed as W. Heath Robinson, 31 May 1872 – 13 September 1944) was an English cartoonist and illustrator, best known for drawings of eccentric machines....
In the UK, the term "Heath Robinson" has entered the language as a description of any unnecessarily complex and implausible contraption...”
This month I’m worried about who’s driving it.

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It's Raining Training

Barry Urquhart

Some choice.
For most business leaders and owners the next decade will provide scope for two strategic options - "hard" or "bad".
A touch of reality is needed.
It will be a daunting prospect for some. For others, who do not recognise or appreciate the unfolding marketplace there will be blissful ignorance and a shortened business life.
Among those who are "hanging on until things turn up for the better", there will be disappointment.
This is not the time to hang in our hang out.
Let me emphasise, the circumstances being confronted at present are neither cyclical nor seasonal. They are structural and accordingly, changes are essential in philosophies, operations and outputs.
The next three years will inevitably be "bad" for those who adopt a "victim mentality" and do little or nothing. Those well-reported "headwinds" will remain and will eventually push the inert (becalmed) "boats" backwards and out of the race.
Rationalisations and consolidations will be in evidence across a wide sweep of industry sectors. Established companies, brands, products and services will disappear from the corporate landscape, replaced by high-energy, and focused new applications, innovations and belief-driven entrepreneurs.
Thus from "bad" will come "good".

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Man bites dog – mongrel rules needed

Pat Gallagher

Here I am.
Back from another lengthy and self enforced break and reporting in i2P on things and matters with ICT in pharmacy-land and health generally.
It is not that I am lazy.
It is that there hasn’t been much ‘news’ happening worth getting our knickers in a knot.
It is all the same old; same old in e-health playing field and that is rather uninspiring to say the least. So I have taken the view that if there is nothing positive to say it’s best to stay stum.
But now as 2011 is coming to a rattling death perhaps there are some things worth saying, usefully or otherwise.
What is a snapshot of some of the year’s achievements in the e-health community?
Hard to say that the world is on fire with overwhelming success, but a summary of the activities that might interest the i2P reader, in some order of oomph are:

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A TGA-Managed Database of Fully Evaluated Complementary Medicines Evidence – a Real Possibility

Neil Johnston

Last month when the controversy surrounding the PGA/Blackmore’s proposed alliance brought out a large number of critics, the PGA found itself in an extremely vulnerable position.
Some criticism was well-deserved - other criticism arose from misperception surrounding the proposed alliance, while other criticism evolved surrounding the “evidence” relied on by the alliance to underpin their clinical promotion - was blown out of all proportion, or negatively criticised.
More positively, academic Dr Ken Harvey called for the TGA to manage an evidence database for complementary medicines that have had a full evaluation.

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Hypnotherapists - Hero's or heisters?

Loretta Marron OAM BSc

He spoke softly as he lifted my arm while telling me it would stay afloat.  It didn't. 
In fact, several times during the session, it fell back to my side no matter he said. 
While I felt reasonably relaxed after my first visit to a hypnotherapist, I left disappointed. 
So does hypnotherapy work and why do some of my skeptical friends support it and, more interestingly, why do they say it is part of acupuncture?

Comments: 1

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Support services for pharmacists and doctors in the United Kingdom – Part 2 Practitioner Health Programme

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

In Australia the Pharmacists’ Support Service (PSS) provides a listening ear and support over the telephone to pharmacists in Victoria, Tasmania, South Australia and the Northern Territory and has plans for expansion to all states of Australia.  The medical profession in Australia has a range of state based Doctors’ Health Advisory Services including the AMA Victoria Peer Support Service which provides peer support over the telephone.  Victorian is the only state to have a state based health program for doctors; the Victorian Doctors Health Program (VDHP)
Funding from the Cyril Tonkin Fellowship enabled me to undertake a study tour of services which support pharmacists and doctors in the United Kingdom (UK) in March 2011.

The aim of the visit was to find out how these services support the health and well being of pharmacists and doctors, including the services provided and how they are funded.

The support services visited were Pharmacist Support, including participation in a Listening Friends training weekend; the Royal Pharmaceutical Society; the Practitioner Health Programme; the Royal Medical Benevolent Fund; the British Medical Association Doctors for Doctors program and the National Clinical Assessment Service.  In addition to obtain background material on the environment for health professionals in the United Kingdom visits were also made to the General Pharmaceutical Council; Manchester University School of Pharmacy and Pharmaceutical Sciences and the Pharmacy Department of the Central Manchester University Hospitals NHS Foundation Trust.
This article is the second in a series reporting on my visit and will detail the services available to doctors and dentists living in London through the Practitioner Health Programme.

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Rollo Manning

The future supply of pharmacists to work in Aboriginal health is healthy if the outcome of a National Australian Pharmacy Students’ Association survey is anything to go by.
While 83% of respondents felt it is important to be taught about Aboriginal and Torres Strait Islander health issues as part of their pharmacy course curriculum, only 60% have access to such education. Furthermore, only half of those respondents feel they are taught enough about this topic.

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Thankful for an MRI

Mark Neuenschwander

I’ve been thinking about magnetic resonance imaging, sleeping bags, allergies, and great hospitals.
Well, I went in for an MRI, and the diagnosis was not good: Claustrophobia. But I’m getting ahead myself.
While studying x-rays of my shoulder, my doc ordered an MRI. I told him we were nearing eight on the p
ain scale and pressed for the earliest appointment.
Seven o’clock the next morning, after being scanned for metal, a rad tech strapped me to the transport board and pushed a button.
Moving into the magnetic abyss, I felt like dead man walking. Except, I couldn’t walk. But I could talk. It took about two seconds to find my authoritative voice:
She got the hint, and I was pardoned.

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The power of 'why'

Harvey Mackay

Whether you're managing a team of employees or you're on your own, remember that although what you do and how you do it are important, it's the "why" that provides real motivation to succeed.
An experiment conducted by the University of Pennsylvania's Wharton School of Business demonstrates the power of "why." 
At a university call center where employees phone alumni to solicit contributions to scholarship funds, the staff was randomly divided into three groups:  The first group read stories written by former call center employees about the benefits of the job (such as improved communication and sales skills).  The second group shared accounts from former students about how their scholarships helped them with their education, careers and lives. 
The third, a control group, read nothing, just explained the purpose of the call and asked for a contribution.

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The Farmerscy Guild and the straw man argument

Geoff March PhD B.Pharm

Straw Man “An argument deliberately put up so that it can be knocked down, usually as a distraction from other arguments which cannot be so easily countered,”  - The Macquarie Dictionary.

Comments: 2

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Kos Sclavos Superstar

Peter Sayers

It appears that pharmacists, in general, are tired of the leadership style imposed by Kos Sclavos, the incumbent president of the Pharmacy Guild of Australia (PGA).
While criticism of PGA leadership style and policy has been building for some time, opposition solidified recently with formation of the Pharmacy Coalition for Health Reform – a body that boasts over 20,000 pharmacists among its membership.

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NAPSA and the PGA

Neil Johnston

Recently, i2P was sent a media release from APESMA, the pharmacist trade union.
It was embargoed until Saturday December 10, which was a point at the beginning of the i2P update cycle.
The release contained a link to an email that is alleged to have emanated from NAPSA – the National Australian Pharmacy Students' Association.
Because it was politically sensitive to that organisation and because it also contained a number of normally private contact details for their members, i2P decided to withhold the information unless it became public knowledge through other media sources - and that has happened..
The email provided the basis for published claims that the PGA was engaged in a bullying process with NAPSA to force their disengagement with the newly-formed PCHR- the Pharmacist Coalition for Health Reform, and it is hard to avoid this view when an examination of the pressures exerted by the PGA are examined in broad daylight.

Comments: 1

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Where is the Best Future Business Model for Pharmacy?

Neil Johnston

Because it is near the end of the year, I thought it appropriate to highlight one of our earlier articles published in July 2010, because it gave a foretaste of things to come -
 “The New Competitors- Wholesalers, Manufacturers, Pharmacists and Nurses”
The gist of the article was that because global pharma companies would be unable to sustain the “blockbuster” business model and that there would be only modest growth in future drug developments, an unstoppable chain reaction would begin to occur where global pharma would create a new disruptive business model that would remove wholesaler discounts and begin a process of different segments of the health services “scavenging” from each other.

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Pharmacy Needs a Peak Body

Neil Johnston

Once upon a time pharmacy was a small, typically one-person show that focussed on patients (as distinct from customers).
It was considered very bad form if a patient presented with a problem and ;
(i) they were not immediately attended to by a qualified pharmacist and;
(ii) they left the pharmacy holding a product in their hands that had not been personally compounded by the pharmacist.
Most patients asked for “their pharmacist” by name and entered into an obvious and valued pharmacist/patient relationship. The care was obvious and not substituted with branded medicines or had the patient interviews delegated to pharmacy assistants or technicians.
In other words the human relationships were respectful and this respect extended between pharmacists as a collegiate relationship.

Comments: 1

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Come to Shop – Return to Learn

Neil Johnston

I started the New Year by researching retail environments that could be adapted to pharmacy and deliver pharmacy 2012 marketing requirements, with emphasis on "professional".
When I got to the Apple retail environment, it simply jumped off the page.
This could be the most important article you read this year.
Few would realise that the title to this article is actually the slogan for Apple Retail Stores, and is in fact the base philosophy behind one of the most successful forms of retail enterprise experienced in the 21st century.
The story of the Apple retail experience has a direct translation across to the malaise that is currently being felt by most Australian pharmacists, so a brief history of the Apple company may help to illuminate a realigned direction for community pharmacy that would capitalise on its strengths and help get off the discount treadmill.

Comments: 3

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A New Escalation of Turf Wars - Is the best defence, offence?

Mark Coleman

Recently I noticed an article published in "The Conversation" authored by John Dwyer Emeritus Professor at University of New South Wales. The article opens with:

"It’s difficult enough to counter the massive amount of misleading information provided to consumers through the media and online. But the task becomes much harder when tertiary institutes give an undeserved imprimatur to pseudo disciplines by offering them as courses. Central Queensland University (CQU) is the latest to do so, announcing it will offer a Bachelor of Science degree (Chiropractic) from 2012. I’m one of thirty-four doctors, scientists and clinical academics who, in an attempt to protect health-care consumers from the dangers associated with unscientific clinical practices, have today written to the science deans at CQU urging them, as fellow academics, to reconsider this decision.
We want the deans to acknowledge the importance of our universities remaining champions of rigorous academic standards and remind them of the primacy of the evidence base for scientific conclusions and health-care practices." Read more at this link

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New Year Uncertainty

Peter Sayers

Coming up to speed after the festive break, I have been astounded at the number of community pharmacy prescription out-of-stocks, both short-term and long-term, that are mounting by the day.
This has a number of financial impacts on a community pharmacy and one assumes that the PGA has a strategy to lessen these impacts - but where is it?

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Take care of your customers or someone else will

Harvey Mackay

No business can stay in business without customers.
How customers are treated and sadly, mistreated, determines how long the doors stay open. Poor quality service has probably doomed as many businesses as poor quality products.
Enter the "guru of customer service," John Tschohl.
He earned that moniker from USA Today, Time and Entrepreneur magazines. After 31 years focused solely on customer service, he is president of Service Quality Institute, which has representatives in 40 countries.
He's authored hundreds of articles and six best-selling books. And he is willing to share his wisdom with my readers. I don't often devote so much of my column to one resource, but John is the best of the best.


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Nicola Roxon’s Parting Advice

Neil Johnston

I was thumbing through my January copy of the AJP when I noticed a small column covering a conversation with Nicola Roxon, the ex-Minister for Health and Ageing.
She, along with other commentators on the same page, was basically encouraging pharmacists to “jump in” to reform health.
The encouraged pathway was through fee for service arrangements, some of which are covered under the 5CPA.

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Big Pharma impacts on the pharmacy profession

Peter Jackson

“Staff in almost one fifth of pharmacies could be wasting more than five hours per week, the equivalent of one month's working time a year, trying to source out-of-stock medicines.”
So claims a report published in the UK newsletter Chemist & Druggist this month.
The report goes on to claim:

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Do you have the urge to speak out?

Mark Coleman

With all the change and distress that is apparent in all ranks of pharmacy at the moment, do you have the urge to lash out at someone or some organisation or just something?
All pharmacists want to evolve their version of an ethical practice, balancing some commercialism with professional core business – whether they own a pharmacy or not.
Multiple groupings of pharmacists have formed up around each special interest and this has created a range of competitive groups, some more aggressive than others, to compete for absolute dominance of pharmacy – and endeavour to create a single voice.

Comments: 1

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Drug Shortages Require Urgent Government Intervention

Neil Johnston

When something does not make sense I always find there is a political objective involved.
And underlying the politics always is the motivation of greed.
Make no mistake about it, Australian pharmacy is about to enter a period of manipulation never before experienced, and it involves supply chain manipulation by government and by Big Pharma.
It is globally orchestrated and tactics vary slightly country to country and the victims of this strategy are very ill patients and the pharmacies behind them desperately trying to bridge supply to keep them alive.

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Staff Writer

APESMA today proposed a new Terms of Reference for a Senate Inquiry into pharmacy which focuses on new potential benefits to the pharmacy profession including providing a role for pharmacists in medicare locals and GP clinics and new measures to reform the health care system.
Mr Walton said despite incorrect and mischievous claims by the Pharmacy Guild there was nothing in the Senate Inquiry before the Senate that would cause the current Community Pharmacy Agreement to cease.

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Pharmacists heading to Hobart for Medicines Management 2011, the 37th SHPA National Conference

Staff Writer

More than 850 delegates will be in Hobart this week for Medicines Management 2011, the 37th SHPA National Conference.

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SHPA commences celebration of a milestone year at Medicines Management 2011, the 37th SHPA National Conference

Staff Writer

At Medicines Management 2011, the 37th SHPA National Conference, SHPA will celebrate 50 years as a national organisation and 70 years since its inception.
In 1941, 25 pioneer pharmacists from public hospitals in Victoria first conceived SHPA, and in 1961 SHPA moved formally to become a national organisation and held its first national conference in Adelaide.

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Bill Thomson receives SHPA’s highest award

Staff Writer

Medicines Management 2011, the 37th SHPA National Conference opened today in Hobart.  With over 800 delegates, 80 presented papers and 200 posters, this year’s conference is yet another example of the enthusiasm and dedication of pharmacists in hospitals and other parts of the healthcare system to share their work and learn from their peers.

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Australian Clinical Pharmacy Award 2011 to Adelaide Pharmacist, Greg Roberts

Staff Writer

During Medicines Management 2011, the 37th SHPA National Conference, held in Hobart last weekend, the SHPA Australian Clinical Pharmacy Award for 2011 was awarded to Mr Greg Roberts, Clinical Research Pharmacist at the Repatriation General Hospital in Adelaide.

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Pharmacist Coalition for Health Reform and the call for a Senate Inquiry

Staff Writer

SHPA believes that consumer interests should be at the centre of health delivery and the health reform agenda.  SHPA members have a strong ethos of working collaboratively within interdisciplinary healthcare teams and across the continuum of care.

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NTU-led research probes potential link between cancer and a common chemical in consumer products

Staff Writer

Editor's Note: Nano-particles have been adopted by various manufacturers of consumer products because they improve absorption of their active ingredients and the cosmetic appearance of the product.
Early researchers in this field warned that conditions similar to mesothelioma may result through exposure to nano-particles and that more research is required before endangering the general public.
Very few manufacturers identify that their products contain nano-particles, but recent studies have confirmed the potential for an association with cancer.
Certainly, the least that needs to occur is a warning label, particularly as some sunscreen preparations contain zinc oxide.
It is ironical that the Australian Cancer Council promote the message of "slip, slop and slap" yet allows for another form of potential cancer exposure through the "back door" involving nano-particles in sunscreen products, including the zinc oxide identified in the following study.

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Apply First Aid – Guild Clinical 2012

Staff Writer

Guild Clinical is pleased to announce the course dates for Apply First Aid 2012.
REVIVA First Aid Training provides industry specific, highly interactive training perfect for pharmacists, graduates and pharmacy assistants.

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Award Winning NPS IPhone APP Now Includes a Medicines Reminder Function

NPS Spokesperson

No more forgetting to take your medicine! NPS has introduced a range of new features to its award-winning Medicines List iPhone app that allow people to schedule in reminders to prompt them to take their medicine.
As part of the upgrade, people can also record whether they took their medicine on time — and if not, why not, which is useful information to share when they next see their doctor.

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ASMI response to TGA reform blueprint

Bob Bowden

The Australian Self-Medication Industry (ASMI) today welcomed the announcement of a series of significant reforms to the Therapeutic Goods Administration (TGA) and the regulation of non-prescription products.
The measures will impact areas including product advertising and promotion, regulation of complementary medicines, and the transparency of TGA decision-making.

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New test to indicate likely spread or recurrence of breast cancer

Staff Writer

A Queensland University of Technology (QUT) PhD student has developed a potential breakthrough test for predicting the likelihood of the spread or return of breast cancer.
"While in recent years there have been fantastic advances in the treatment of breast cancer there has been no way of predicting its progress," said Helen McCosker, a PhD student at the Institute of Health and Biomedical Innovation (IHBI).

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PSA Releases Guidance For Pharmacists Using Internet and Social Media

Staff Writer

In our July edition of i2P, Kay Dunkley wrote an excellent article relating to social media and its use by health professionals. In that article Kay noted:
The Medical Journal of Australia recently published an excellent article on the topic of social media and the medical profession. It was this article that prompted me to write this opinion piece and I recommend that it should be read by all health professionals who are users of social media. I believe that many of the issues raised for medical practitioners are equally applicable to pharmacists and other health professionals. That article can be found at http://www.mja.com.au/publicissues/194_12_200611/man10874_fm.html

Now the PSA have weighed in with an official version for pharmacists.

Comments: 1

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Athletes warming up incorrectly

Staff Writer

Dynamic warm-ups included range of motion activities like high-knee raises, leg swings and run-throughs or change of direction tasks.
Mr Zois said the study proved that, from a power point of view, static stretching was worse than no warm up at all.

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Last Pre-Christmas News Roundup- APESMA - Australian Prescriber - NSW Guild - NPS on Methotrexate - PSA - Competency Tool

Staff Writer

i2P news and articles will continue to be published weekly over the Christmas/New Year period, but not quite so "in-depth".
You are invited to explore the recent archives of i2P when you begin to plan for the coming year.
We also encourage you to post comments at the foot of each published item.
i2P knows that the coming year will be more challenging than in previous years.
It will be a year of sorting out priorities - those within the industry wishing to needlessly fight to prop up inappropriate structures will be seen to waste time and resources.
They will be judged harshly by participants at the "coalface"- the silent majority.

i2P hopes that all of its subscribers have a peaceful and safe festive season.

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No Deaths from Vitamins - America's Largest Database Confirms Supplement Safety

Staff Writer

The following news item from Orthomolecular.org adds one more dimension to the debate on nutritional supplements. It seems that safety is definitely not an issue where nutritional supplements are used.

Comments: 3

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Multiple medicines may double fall rate for young and middle aged

Staff Writer

Editor's Note: In Australia, criteria for generating a medication review includes a patient currently taking five or more regular medicines or taking more than 12 doses of medicine per day.
Patient falls are a major reason for patients being admitted to a hospital and quite commonly, patients are further damaged through falls while they are already in a hospital.
The system currently requires a referral by a GP to an accredited pharmacist, which is a slow and cumbersome (sometimes very unrewarding) process.

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Pharmedia: Academic Manipulation & the Growth of "Junk Science"

Neil Johnston

Editor"s Note: Global Pharma has an unusual and pervasive influence on politicians, regulators and statutory bodies around the globe.
I’ve always had a philosophy of recognising that when things do not go as they are supposed to, first look at the surrounding politics and then follow the money trail.
In the US the main regulator for drug registration and marketing is the Food and Drug Administration (FDA) which has come under greater scrutiny by industry commentators because of seemingly corrupt and improper decisions increasingly made in favour of drug manufacturers.

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Does the PGA Really Represent its Members

Neil Johnston

This month we have selected a media story that appeared in Pharmacy News on the 3 November 2011, and it is story of the continuing saga of direct distribution by Pfizer.
The bigger story underneath is - what is the Pharmacy Guild of Australia doing to represent its members in this ongoing dispute?
i2P has covered the direct distribution saga since its inception here in Australia.
The problem seems to be worsening rather than improving, so we have asked Mark Coleman to comment.
His comments appear below the media item that follows.

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NPS Media Releases for Nov 2011 & Dec.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 ,0419 618 365 or schilds@nps.org.au

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No more forgetting to take your medicine! NPS has introduced a range of new features to its award-winning Medicines List iPhone app that allow people to schedule in reminders to prompt them to take their medicine. 

As part of the upgrade, people can also record whether they took their medicine on time — and if not, why not, which is useful information to share when they next see their doctor. 

NPS clinical adviser Dr Danielle Stowasser says the scheduling functions are a lifesaver for those who have trouble taking their medicines as recommended by their health professional.

“With the Medicines List iPhone app upgrade, your patients can set reminders to help them take the right doses of their medicines at the right time,” says Dr Stowasser.

“Health professionals should encourage their patients to record information about any possible side effects of their medicine, and whether they are taking their medicine as prescribed.” 

Using the Medicines List app, your patients can set the frequency of how often they should take each medicine from a range of default options, or they can set the times to their own custom preferences.

Reminders will alert your patient at the appropriate times, which they respond to by selecting whether they took their medicine on time, late or did not take it at all.

If they miss a dose, they can record why, so they have the information to take with them to discuss with their health professional.

“The information captured using the new features in the app creates a record of your patient’s adherence over time, which they can later share with you to help inform discussions about their medicines use,” says Dr Stowasser.

“For example, your patient may have missed a dose or several doses because they were nauseous, and making use of the Medicines List app and recording each time this occurs — and sharing this record with their health professional — can provide useful information to help make decisions about their treatment going forward.”

The NPS Medicines List iPhone app has been downloaded more than 9000 times since its launch in mid 2011, and received an award for Best Medical App at the 2011 Australian Mobile Awards. 

It can be downloaded for free from the Apple iTunes store, and for those who already have the app, the upgraded features will be available automatically when you next update your apps.

For more information, including how-to videos outlining the app’s features, visit http://www.nps.org.au/iphonemedicineslist




The December edition of Australian Prescriber, out now, looks at the following topical issues:

The prescribing cascade

A ‘prescribing cascade’ occurs when a new medicine is prescribed to ‘treat’ an adverse reaction to another drug in the mistaken belief that a new medical condition requiring treatment has developed, write Lisa Kalisch and colleagues from the University of South Australia.

Recognising and preventing all types of adverse drug events is a priority, according to the authors, given that 10% of patients visiting general practices will have had an adverse drug event in the previous six months. This affects more than 1.5 million people per year and results in at least 190,000 hospital admissions annually. 

Failure to recognise an adverse drug reaction has the potential to further compound poor health, particularly when the reaction is mistaken for a symptom of a new health problem, say the authors.

Appropriate primary prevention of cardiovascular disease: does this mean more or less statin use?

It is likely doctors are over-prescribing statins to low-risk patients, according to Associate Professor Jane Smith of Bond University. Treatment should focus on those who are more likely to benefit from statin treatment.

In people at high risk, especially those who have had prior cardiovascular disease, statins lower heart attack rates and mortality.  But in other people, it may not be beneficial to focus on single risk factors such as high cholesterol to determine whether statins should be used.

Statin treatment in those with a lower cardiovascular risk offers limited benefit and may result in harm, such as myopathy, writes the author.

New drugs for osteoporosis

Despite the numerous treatments available, the majority of Australians with osteoporosis remain untreated. New treatments for osteoporosis may offer advantages over oral bisphosphonates, particularly regarding adherence.

Professor Peter Ebeling of the University of Melbourne and Western Health, Melbourne, writes that newer parenteral treatments, intravenous zoledronic acid and subcutaneous denosumab injections can be administered less frequently than the oral bisphosphonates. However, these and some other newer drugs are not currently approved to treat osteoporosis in men and patients with corticosteroid-induced osteoporosis. 

This edition also includes a list of the top 10 drugs used in Australia. To read the full articles and more visit www.australianprescriber.com

Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published by NPS, an independent, not-for-profit organisation for quality use of medicines funded by the Australian Government Department of Health and Ageing. Australian Prescriber is published every two months, in hard copy that is distributed to health professionals free of charge, and online in full text at www.australianprescriber.com


24 NOVEMBER 2011


NPS has applauded the TGA’s decision to cancel four prescription pain relief medicines containing dextropropoxyphene from 1 March 2012.

The TGA has decided to cancel the products known by the brand names Capadex, Di-Gesic, Doloxene and Paradex following an extensive review of information about the medicines’ safety and efficacy.

NPS CEO Dr Lynn Weekes says that the decision to cancel the medicines was a logical step given the available evidence, and their withdrawal from sale in many other countries.

The TGA decided to cancel these medicines as the active ingredient, dextropropoxyphene, has been shown in many studies to affect the electrical activity of the heart, increasing the risk of serious arrhythmias (disturbances in the normal rhythm of the heart-beat). The TGA review of its efficacy also found that only limited pain relief is provided by these medicines.

“It is important that decisions about medicines regulation are always made in the context of the evidence,” says Dr Weekes.

All medicines have both benefits and risks.  In a previous review of the evidence NPS concluded that taking medicines containing a combination of paracetamol and dextropropoxyphene (including Capadex, Di-Gesic and Paradex) is no more effective than taking paracetamol alone.

Fixed-dose combinations such as is found in these medicines are also generally taken at a frequency that increases the risk of adverse effects from accumulation of the active ingredient dextropropoxyphene and its cardiotoxic metabolite.

“Given the limited benefit of pain relievers containing dextropropoxyphene, the risks associated with their use, and the fact that we also know dextropropoxyphene can cause dependency, on balance we agree with the TGA’s decision to cancel these four pain relief medications containing this active ingredient,” says Dr Weekes.

“However, it is very important that anyone who had been taking Capadex, Di-Gesic, Doloxene or Paradex regularly for chronic pain or from time to time for short term pain relief speaks to their doctor about alternative pain relief medicines, and does not stop taking their medicine as prescribed until they have spoken to their doctor as suddenly stopping a medicine can cause a range of withdrawal symptoms.

“Your doctor is best placed to work with you to establish what medicines you need to take.”

Top 5 medicinewise questions for people managing pain

NPS always encourages consumers to speak to their health professional about what is right for them. Our top 5 questions for people to ask include:

·                     What pain reliever medicine is best for my condition?

·                     Does my condition affect which pain relievers I can take safely?

·                     What is the active ingredient in this pain reliever?

·                     What do I need to tell my health professionals before taking this medicine?

·                     How regularly should my medicines and pain management plan be reviewed?


NPS has resources for people who take pain relief medicines

The NPS website, www.nps.org.au, has information for consumers to learn more about being medicinewise when managing their pain. Our website also contains the latest information for health professionals on medicines for managing pain. NPS also offers a Medicines List to help your patients keep track of their medicines.


If your patients have questions about their medicines, we encourage them to speak to their health professional, or phone our Medicines Line on 1300 MEDICINE (1300 633 424).

24 NOVEMBER 2011


Abstract submissions are now being invited for the seventh biennial National Medicines Symposium (NMS), to be held 24 – 25 May 2012 at the Sydney Convention & Exhibition Centre.

Submissions are invited from everyone involved in quality use of medicines, including students, community groups, health organisations, health professionals and researchers.

NPS CEO Dr Lynn Weekes says the event is already attracting interest from all segments of Australia’s health industry.

“NMS 2012 will provide the opportunity for participants to network and share expertise at the leading symposium on quality use of medicines in Australia,” says Dr Weekes.

“NPS is excited to be bringing together the partners to Australia’s National Medicines Policy along with international representatives to learn, discuss and debate contemporary quality use of medicines issues.

“The theme for NMS 2012 is building a medicinewise community, and the symposium program will allow attendees to explore the challenges and the opportunities available to make this a reality,” says Dr Weekes.

The program has been compiled by some of Australia’s leading quality use of medicines health professionals and academics. Topic streams as part of the symposium will include:


*        safer use of medicines

*         an ever changing health system

*       enabled by new technologies

*        valuing the consumer experience; and

*        putting policy into practice.

Abstract submissions for NMS 2012 are now open. To view the preliminary program, register your interest in attending NMS 2012, or submit an abstract visit www.nps.org.au/nms2012


18 NOVEMBER 2011


Three honorary members of NPS have been appointed by the NPS Board following an extensive call for nominations and shortlisting process.

The NPS Board resolved unanimously to invite consumer health advocate Ms Jan Donovan, leading figure in Australian health Professor Emeritus Lloyd Sansom AO and long-standing quality use of medicines advocate Professor Richard Day AM to become honorary members of NPS. 

NPS Chair Dr Janette Randall says each of the inaugural honorary members have demonstrated a strong and ongoing contribution to quality use of medicines over the years.

“The NPS constitution was revised in 2010 to enable the Board to publicly recognise individuals who have made outstanding contributions towards quality use of medicines,” says Dr Randall.

“On behalf of the Board I would like to thank Ms Donovan, Professor Sansom and Professor Day for their support of NPS and its work over the years, and congratulate them on their appointment as honorary members.”


The NPS Board has also endorsed the appointment of Associate Professor Kay Price as the Health Practitioner Class (Other) Director for a further term of three years.

Dr Randall says the Board looks forward to continuing to work with A/Prof Price, especially given her extensive knowledge of policy directions and emerging trends relevant to nursing and quality use of medicines and medical tests.

“We are delighted that we will continue to benefit from Kay’s extensive, established networks, and her broad and in-depth understanding of nursing in Australia,” says Dr Randall.

Associate Professor at the School of Nursing & Midwifery, University of South Australia and an experienced and active qualitative researcher, Kay was appointed to the NPS Board in 2008. She is a member of the NPS Board Governance and Nomination Committee and represents the Board on the Program Evaluation and Research Development Advisory Group.


17 NOVEMBER 2011


A presentation on the award-winning NPS Medicines List iPhone app has been recognised with two awards at the Society of Hospital Pharmacists Australia (SHPA) federal conference, held in Hobart last weekend.

The paper won an award for Best Paper in IT and Innovation, as well as Best Paper overall.

NPS clinical adviser Dr Danielle Stowasser, who presented the paper, says that she is thrilled by the huge interest in — and praise for — the app from delegates at the conference.

“I’m delighted with the recognition for the NPS Medicines List iPhone app from the pharmacy sector,” said Dr Stowasser.

“The app plays an important role in our wider goals of working towards a medicinewise Australia and increasing medicines literacy in consumers.

“We’re grateful for the instrumental role pharmacists have played in ensuring its success so far, as we have had the app downloaded more than 9000 times since it was released mid-year.” 

The NPS Medicines List app, available for free from iTunes, allows people to be medicinewise by tracking the brand, active ingredient, strength and dosage of their medicines.

“The more people know about their medicines, the more confident they are to talk about their options with their prescriber or pharmacist, and that helps people get the most benefit from their medicines – and the Medicines List iPhone app provides a way for people to keep this essential information on hand,” says Dr Stowasser.

“The presentation at the SHPA conference covered the methods we used to develop an app that would bring the paper NPS Medicines List online so that people could reap those benefits that we know come from keeping a Medicines List on them at all times. It also examined what processes we used to evaluate the app to inform future functionality.”

A range of new scheduling features will be released at the end of November, which will appear as an automatic update for those who have already downloaded the app.

Download the NPS Medicines List iPhone app for free from the Apple iTunes store, and for more information including how-to videos explaining the app’s features, visit http://www.nps.org.au/consumers/tools_and_tips/iphone_medicines_list


14 NOVEMBER 2011


On World Diabetes Day (14 November 2011), NPS is launching an online information hub for consumers, to help people with type 2 diabetes be medicinewise about their condition. 

NPS Clinical Adviser Dr Danielle Stowasser says the online hub is a comprehensive source of information about type 2 diabetes, including its causes, diagnosis and treatment.

“There’s no doubt that managing your health can be like taking on a part-time job when you have a chronic condition, and the new NPS online information hub seeks to make this easier by providing independent and evidence-based information that is easy to understand,” says Dr Stowasser.

“Being diagnosed with a condition like diabetes often means lifestyle changes and having to manage a range of medicines, tests, and relationships with different health professionals who all have a role to play in helping you live well with your condition.

“NPS encourages people to be medicinewise by asking questions and learning about their condition and the available treatments.

“The theme for World Diabetes Day is education and prevention, and in line with this, the new NPS diabetes hub offers information on the vital role of healthy eating and physical activity, as well as in-depth information on the diabetes medicines available in Australia, how they work and their possible side effects and interactions.”

The incidence of type 2 diabetes worldwide is increasing and in Australia it is believed that almost one million people have type 2 diabetes, though not all of these people know that they do. 

“Along with the increasing prevalence of diabetes worldwide, we have seen an increase in the number of medicines available to treat diabetes, with several new classes of medicines released over the past few years and more in the pipeline,” says Dr Stowasser.

“Although more medicines means that there are more treatment options, it also makes understanding all the options and their risks and benefits much harder, and not surprisingly people often turn online for that information.”

The type 2 diabetes online hub is the first in a series of information hubs for consumers to be launched on a range of conditions and health topics, including depression, vaccines and respiratory tract infections. The introduction of the hubs is part of a greater website upgrade project for NPS over the coming year.

The NPS type 2 diabetes information hub is available at www.nps.org.au/conditions/type_2_diabetes 




As part of the inaugural National Medication Safety Week (7–13 November 2011), NPS encourages community pharmacists to get involved in an incident reporting project that will help provide insights into medication safety incidents and how they can be prevented.

During National Medication Safety Week — an initiative by the Faculty of Pharmacy at the University of Sydney — community pharmacists from around Australia are encouraged to identify and anonymously report preventable medication safety incidents they encounter throughout the week.

NPS CEO Dr Lynn Weekes says the National Medication Safety Week initiative is an opportunity for pharmacists to contribute to improving the safety of patients in the primary health care environment.

“Patient safety is paramount when it comes to medicines, especially given the 190,000 medicine-related hospital admissions that happen in Australia every year,” says Dr Weekes.

“Pharmacists are well placed to identify when medicines safety issues arise and to ask why they happened. We encourage pharmacists to get involved in National Medication Safety Week and report medication safety incidents and near misses to help build the body of knowledge in this area.”

Initiatives like National Medication Safety Week complement other initiatives for health professionals to support patient safety in the primary health care setting, including the NPS Pharmacy Practice Reviews for pharmacists which use best practice standards and guidelines to help pharmacists review and improve their practice.

The University of Sydney has set up a website containing information about how to participate in the incident reporting project along with an online reporting tool for community pharmacists at www.australianpharmsafety.org.

Resources for consumers:

* To report and discuss side effects that might be related to their medicine, consumers can call the Adverse Medicine Events (AME) Line on 1300 134 237. The side effects — but not personal details — are reported to the TGA.

* Consumers with questions about the medicines they’re offered, including how the medicine works, possible side effects and interactions with other medicines, can contact Medicines Line on 1300 MEDICINE (1300 633 424) from anywhere in Australia for the cost of a local phone call (Monday – Friday, 9am – 5pm EST).


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