Editorial
Welcome to the December 2009 edition of i2p - Information to Pharmacists E-Magazine.
When i2P first began in February 2000, it was decided that a fortnightly publication might prove to be the optimum publishing cycle.
This thought was soon dispelled as it was found that having sufficient content to maintain this cycle became a problem.
Oh for those quieter times!
The cycle then became monthly and has been maintained up to now.
The problem is now coping with the volume of news and opinion that is generated on a daily basis.
Very much the reverse of the year 2000 - a statement for our time and how the pace of pharmacy life has increased.
Columns
Rollo Manning: Pharma-Goss
Loretta Marron OAM BSc: Health Watch
Barry Urquhart: Marketing Focus
Harvey Mackay: Strategic ThinkingRecent Comments
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Pharma News
Hospital News
Mark Neuenschwander: I’ve been thinking about Roy Rogers, meaningful use, and wet cement. | open full screen
Health Politics
James Ellerson: For some pharmacists the truth will be ‘inconvenient’. WHY is it so?? | open full screen
Dr David More: An Insider's Comment on NEHTA's PerformanceClimate Change
EPublications
For some pharmacists the truth will be ‘inconvenient’. WHY is it so??
Sir Winston Churchill said “Truth is incontrovertible, malice may attack it and ignorance may deride it, but, in the end, there it is.”
Elvis Presley said “Truth is like the sun. You can shut it out for a time, but it ain't goin' away.”
At the PAC 2009 Conference John Menadue’s forthright messages made it abundantly clear that the sun was shining very brightly indeed.
Here are the ‘message sticks’ that resonated with me:
About that "Un-Invitation"
Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)
It was interesting reading John Menadue’s speech given at the Pharmacy Australia Congress in Sydney in October.
It was even more interesting to read of the UN-invitation by the Queensland branch of the College of Pharmacy Practice and Management, the stance taken by the Pharmacy Guild of Australia and the Pharmaceutical Society, to support only pharmacy activities provided from within a community pharmacy.
How draconian is that?
Research has demonstrated, as has the low uptake of new professional services from within a community pharmacy, that the existing community pharmacy model is not compatible with the implementation of these new professional opportunities.
The two major arguments put forward are ‘lack of time’ and ‘lack of funding’.
A Green Pharmacy is Gold
Simon Divecha, Director of GreenMode, a consultancy that assist business and people to find their carbon and sustainable advantages spoke at the recent Pharmacy 2009 Conference.
Simon has assisted businesses including BP Solar, Origin Energy, Lend Lease, ANZ and IAG.
His challenge to community pharmacy is to identify and take advantage of the opportunities that exist for businesses that have such close relationships with their local communities.
What are we doing to ourselves?
Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.
In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?
And if so, what is our future likely to hold?
What can we do about it?
Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?
Picture - the wood for the trees
Another year has gone by and what have we done with technology in the health sector?
A good question that deserves a long and detailed review as a written dissertation by somebody learned and influential in health informatics, government, consulting or from the many agencies, departments and committees engaged in delivering e-health service to the Australian public; notably as a value proposition for the tax payers in the greater voting public cohort.
Advancing Self Care
Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.
Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.
It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.
One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.
Wind Farm will Power Sydney's Desalination Plant
Source: AAP NewsWire
Communications Technology - a nudge from the big end of town
National Health IT assumed prominence recently when the National Business Council of Australia wrote directly to prime minister, Kevin Rudd, urging him to create a focus on communications technology and to invest appropriate funds.
I wonder if they were aware of the organisational performance 0f NEHTA and their inability to date, to actually deliver suitable infrastructure and systems.
And with $'s millions already wasted by NEHTA I am sure there is hesitancy by government to spend even more, given the dismal track record to date.
Health communications is stuck in a deep groove.
But it is interesting to note that the Business Council of Australia see productivity and investment opportunities in health if only the primary health players could integrate better and talk to one another.
Shared health communications underpins this potential benefit as the many writers for i2P have continually pointed out.
With the big end of town taking more interest, maybe government and health professionals can align themselves more fluidly.
A read of David More's blog article from a NEHTA insider in this edition of i2P, leaves you still wondering how an alignment can take place without removing the NEHTA structure completely.
Health info needs urgent technological injection
Source: Industry Search -24/11/2009
http://www.industrysearch.com.au/Features/Health-info-needs-urgent-technological-injection-4306
Read the BCA letter in full here
Powering up by osmosis
An unusual form of renewable energy has emerged recently in a novel format involving the use of fresh water and salt water interaction across a membrane that creates osmotic pressure.
This pressure has been demonstrated to be able to drive a turbine that can produce an electric current.
Osmotic pressure is well known in medicine with adjustments having to be made to eye drop and injection formulas to minimise the pain associated with the administration of these medicine forms.
The process is a more controllable form of natural energy when compared with weather-dependent versions of energy generation (solar, wind, tidal etc) and has a reasonably small and discrete footprint in the environment.
With a bit of imagination it is not too far of a stretch to have the salt water filtered through another form of membrane to create fresh water to be recycled within a closed system.
Norway tries osmotic power to harnessing power of salt
Source: Industry Search
http://www.industrysearch.com.au/News/Norway-tries-osmotic-power-to-harnessing-power-of-salt-42094
Insuring the Disabled
Prime Minister Kevin Rudd is to be commended for the initiative in having a look at the feasibility of creating a no fault disability insurance scheme.
Disability can cause disaster to any family structure and can be a constant drain on financial resources that can add to further stresses up to, and involving bankruptcies.
By putting in place a proper financial underpin, each family member is enabled to be productive and self-sustaining. This can create a net gain to the taxation base when viewed globally, to include service providers and industries that can feed off that activity stream.
PM calls for national disability reforms
Source:DPS Guide to Aged Care
http://www.agedcareguide.com.au/news.asp?newsid=4178
Should patents apply to the natural world?
I can't but help wonder if the move to be able to patent all things natural is a smart move.
Take for example the Neam tree that grows wild in the northern part of Australia.
The leaves of this tree make a great insect repellent with no known side effects.
An entrepreneurial Australian a few years back, decided to grow these trees and was surprised to have legal documents served on him claiming royalties and damages from some obscure US company that had registered a patent for all things Neam.
Unfortunately, there was no legal defence for the Australian grower.
Now there is an outcry by vested interests because the Australian government has resisted pressures to allow the patenting of human genes.
All sorts of calamities are therefore predicted for the local biotech industries.
But I wonder if these claims will prove to be valid?
Follow the debate in this article:
Ban drives 'biotech industry to its knees'
http://www.news.com.au/story/0,23599,26309574-5011761,00.html?from=public_rss
Source: AAP
Public Hospitals - Time they were fixed
Queensland Health struggles through another drama after using instruments that had been used on patients and left unsterilised.
But it's not just Bundaberg Hospital that is sick - the entire Australian hospital system needs a radical overhaul.
The Rudd government had promised to "fix" the problem after taking office, but so far has not made any noticeable progress.
Read about the latest problem.
Qld Health cleaning up after dental sterilisation scare
Source: ABC Online
http://www.abc.net.au/news/stories/2009/11/18/2745842.htm
By Chris O'Brien
Patient uses initiative to attract nurses
If anyone has ever been a patient in a hospital and tried the buzzer to get assistance from a nurse, then here is a new innovation to get attention.
Not that the nursing fraternity should shoulder the blame.
It's the politicians and the lack of political will to solve this issue and many others.
Congratulations to the patient and his initiative in dialling triple O.
Read the full story here:
Man rings triple-0 from hospital bed
Source: ABC Online
by Cate Grant
http://www.abc.net.au/news/stories/2009/11/18/2745829.htm
What's good for climate is good for health
Health professionals from around the world are slowly waking up to the fact that climate change can induce adverse effects on health.
At i2P we have been carrying messages for just on two years, regarding climate change effects, including research reports from our own writer Con Berbatis, in the hope that official pharmacy would see the need and develop policies and strategies for pharmacists to adopt.
Now, with the formation of the International Climate and Health Council a recognised forum is available to be addressed.
Will pharmacists be given a seat at the table?
Perhaps the Pharmaceutical Society of Australia should find out.
Health Professionals Around The World Launch The International Climate And Health Council
Source: Medical News Today
http://www.medicalnewstoday.com/articles/172330.php?nfid=20247
Ageing slowly and safely
The ageing process is relentless with function loss noticeably diminishing over the age of 60.
Supplementation of nutrients holds one key to slowing down some of the processes, in particular the loss of muscle mass and the subsequent aches and pains that follow as the skeletal system is no longer held together in an optimum manner.
This process can be a contributor to falls and more serious damage.
Not being able to adequately stay on your feet as you age, robs you of your independence.
It would seem that a strategy of slowing down slowly might be prudent for the age demographic entering retirement - the "baby-boomers".
Antioxidants could help preserve muscle strength
Source: Reuters Health
By Marilynn Larkin
Are we planning for future skill shortages?
National Seniors Agency have published a report indicating that Australia will have a shortfall of 1.4 million workers by 2025.
This shortage will also be reflected in the profession of pharmacy.
It is pointed out that a smart move would be to match an improved workplace to match specific requirements for mature-aged employees and thus retain them for longer periods..
APESMA has recently published an online survey in an endeavour to poll employed pharmacists on the issues that affect them specifically. Obviously, this is a move in the right direction, and much of what they are polling has a direct relationship to mature-aged employees.
So what is community pharmacy doing to retain their senior pharmacists?
Very little, it seems.
i2P asked Mark Coleman to comment and his commentary appears below the news item:
1 NPS Media Releases November 2009
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PDF version | NPS Spokesperson |
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.
24 November 2009
R U OK with your medicines?
On Sunday 29 November 2009 the inaugural R U OK? Day will bring Australians together in a bid to raise awareness of risks contributing to suicide. The event encourages people to reach out to friends and loved ones and simply ask, ‘Are you ok?’.
As a provider of medicines information, the National Prescribing Service (NPS) is a unique supporter of R U OK? Day, and urges people to think about whether they are ok with their medicines.
“The role of medicines and non-medicine treatments in both depression and chronic diseases should not be underestimated, which is why we want people to stop and actually consider if they are ok with their medicines,” NPS CEO, Dr Lynn Weekes said.
“This includes knowing what your medicine is for and how to take it; being able to manage the cost of your medicines and speaking up if things are getting hard; and recognising that lifestyle changes can sometimes be as effective as medicines.”
The number of Australians diagnosed with chronic diseases each year is increasing rapidly and while diagnosis can be a relief, for many it means having to completely change their lifestyle. This can also affect family members and carers.
“People with chronic diseases and their carers will benefit from the new webpage we have put together which collates information about medicine management and antidepressants,” Dr Weekes said.
Resources have been provided to GP clinics and pharmacies to raise awareness of R U OK? Day and to ensure health professionals have the information necessary to help anyone who may need it.
In the lead up to R U OK? Day businesses are encouraged to take part in R U OK? Arvo on Friday 27 November which aims to reduce stress and depression in the workplace by encouraging work mates to connect and support each other.
“NPS is committed to the health and wellbeing of its staff and will be encouraging everyone to take part in activities during the afternoon. We hope our member organisations and their members are able to lead by example and take part in this event too,” Dr Weekes said.
23 November 2009
Push for complementary medicines to be in all medical, pharmacy curricula
The National Prescribing Service (NPS) welcomes calls for improved complementary and alternate medicine training in universities and says all health professionals have a responsibility to ensure these products are used safely.
Speaking at the annual scientific meeting of the Australasian College for Emergency Medicine in Melbourne, Dr Lesley Braun said health professionals need better training at university about complementary medicines and their interactions with conventional drugs, and to make an effort to stay informed.
Research conducted by NPS last year into the complementary medicine information needs and uses found a number of issues relating to the transfer of information between health professionals and consumers.
“Most complementary medicine users are self-prescribing without understanding the implications of what they are taking, and in a number of cases, they aren’t using the products in the way they are intended,” NPS CEO, Dr Lynn Weekes said.
“At best, this may mean consumers aren’t getting the maximum benefit from the complementary medicine. At worst, they may be putting their health at risk.”
While half the consumers surveyed admitted to not telling their doctor or pharmacist they were taking complementary medicines, many health professionals said they often didn’t ask because they weren’t confident discussing these medicines with patients.
“A number of practising health professionals may not have received formal training about these medicines at university but the information is continuously changing so it’s up to each individual to keep informed,” Dr Weekes said.
A second piece of research conducted by NPS, Mater Health Services Brisbane, Bond University and the University of Queensland between June and November 2008 identified and ranked the most useful complementary medicine information sources available to health professionals.
Both studies noted the need for a centralised data point that includes accurate, independent information about adverse effects, interactions with other medicines, contraindications and clinical evidence.
“Between the growing rate of complementary medicine use, the prevalence of chronic diseases and the rising number of people being hospitalised for adverse events, it’s vital today’s medical and pharmacy students gain a comprehensive understanding of safe medicines use and have ongoing access to accurate information,” Dr Weekes said.
16 November 2009
New DVD explains medicines use issues for type 2 diabetes patients
The National Prescribing Service (NPS) and Diabetes TASMANIA have launched a new educational DVD aimed at people with type 2 diabetes, which addresses medicines use issues.
The DVD is designed to be used by health professionals and community organisations when discussing the management of type 2 diabetes with newly diagnosed patients.
“The theme of World Diabetes Day (14 November) was education and prevention, which are at the heart of diabetes management,” NPS CEO, Dr Lynn Weekes said.
“Education relates not only to understanding diabetes and how to prevent it, but also how to manage the condition. The medicines use issues associated with managing type 2 diabetes and related conditions can be complex and are unlikely to be fully absorbed by a patient during a consultation.”
The DVD comprises 11 segments which cover issues including the types of medicines used to manage type 2 diabetes, the best ways to manage medicines, and what patients should discuss with their healthcare providers. It is also being produced in Cantonese, Mandarin and German as there is a high prevalence of type 2 diabetes within these ethno-specific groups in Australia.
Diabetes TASMANIA’s CEO, Caroline Wells, said there is a need for high quality information that is easy to understand and available to people from culturally and linguistically diverse backgrounds.
“Type 2 diabetes is one of the fast-growing chronic illnesses in Australia – its prevalence is expected to nearly double over the next 40 years, but there has been a lack of educational resources that focus on medicines use issues,” Ms Wells said.
The 11 segments have also been made available at www.nps.org/type2diabetes and www.diabetestas.com.au.
“While the online videos are not a substitute for conversations between the patient and their healthcare providers, they complement the information provided by doctors and pharmacists, and can be viewed at someone’s leisure in the comfort of their home,” Ms Wells said.
To order the DVD phone Diabetes TASMANIA on 03 6215 9000.
Brochures promoting the DVD and online segments will be made available to doctors and NDSS-pharmacies shortly.
3 November 2009
Get to know your medicines campaign wins National Multicultural
Marketing Award
The National Prescribing Service Ltd (NPS) and Federation of Ethnic Communities’ Councils of Australia (FECCA) have won a prestigious National Multicultural Marketing Award for seminars and radio interviews run in Cantonese, Mandarin and Italian as part of the 2008 Get to know your medicines campaign.
The campaign took out the AFL Community Award category at the NSW Community Relations Commission presentation dinner held last night at the Westin Hotel in Sydney.
The Get to know your medicines campaign ran from September 2008 and aimed to promote skills and knowledge around using medicines safely to seniors from culturally and linguistically diverse (CALD) communities. It built on the same campaign run in 2007 which focused on English-speaking seniors. The seminars were run by 16 ethno-specific organisations across Australia between September and December 2008.
“We are thrilled to receive this National Multicultural Marketing Award and be acknowledged by the Commission for the work we are doing with ethno-specific organisations,” NPS CEO, Dr Lynn Weekes said.
“The risks of using medicines are heightened for CALD seniors, particularly those with low English language proficiency and literacy levels. This is why we are dedicating time and resources to running programs at a community level,” Dr Weekes said.
FECCA Chair, Pino Migliorino said the award shows how effectively NPS and FECCA are working together to bring the safe medicine use message to CALD communities.
“Australians from non-English speaking backgrounds are over-represented in the number of people hospitalised each year for adverse medicines events. FECCA is pleased to be working with NPS to address this issue and ensure culturally and linguistically diverse communities have the same access to vital information about medicines,” Mr Migliorino said.
NPS and FECCA’s work with CALD communities has won other multicultural awards including:
· 2008 Multicultural Communication Award for 2009 Italian Get to know your medicines calendar.
· 2008 Multicultural Communication certificate of commendation for education session resources.
· 2005 National Multicultural Marketing Awards from the Community Relations Commission.
· 2005 Multicultural Communication Award from NSW Multicultural Health Communication Service.
In 2010 information seminars about safe medicines use and good sleep practices will be run in Mandarin, Cantonese, Italian, Vietnamese, Greek and Arabic.
2 November 2009
Identifying symptoms and treating anxiety
Up to one in five people presenting to GPs and pharmacists will experience symptoms of an anxiety disorder at some point during their life.
To help health professionals accurately diagnose and treat anxiety, the National Prescribing Service (NPS) has developed a new education program, Managing anxiety disorders.
“Anxiety disorders are characterised by combinations of key symptoms; excessive anxiety, fear, worry, avoidance and compulsive rituals that are associated with impaired function or significant distress,” NPS senior clinical adviser, Judith Mackson said.
“Anxiety symptoms may be primary or secondary to other physical or psychiatric disorders. To accurately diagnose anxiety disorders, health professionals need to characterise all the anxiety symptoms against criteria.”
The NPS Managing anxiety disorders program encourages health professionals to:
· Use key symptoms to differentiate between types of anxiety disorders and determine effective treatment
· Trial non-drug therapy including psychological therapy as first line
· Consider an antidepressant for those who do not respond adequately to psychological therapies, selecting on the basis of evidence of efficacy in the diagnosed anxiety disorder
· Reserve benzodiazepines for short-term use in selected circumstances
“Psychological therapies should be the first treatment choice in most anxiety disorders to control symptoms and improve function. This includes cognitive behavioural therapy and other non-drug strategies,” Ms Mackson said.
If psychological and other non-drug therapies do not provide sufficient benefit, an antidepressant may be considered. There is however no evidence that starting with combined therapy is more effective than either an antidepressant or psychological therapies alone.
“Health professionals also need to consider the adverse effect profile before prescribing an antidepressant. Not all antidepressants have been assessed for efficacy for all anxiety disorders, nor can efficacy be generalised across an antidepressant class,” Ms Mackson warned.
“In general, benzodiazepines should only be recommended for people who have not responded to at least two therapies, as they may cause dependence. This is particularly the case in those with a history of dependence on alcohol and/or other drugs,” Ms Mackson said.
As part of the therapeutic program, health professionals can utilise:
· Case study (60): Managing anxiety disorders
· Prescribing Practice Review (48): Managing anxiety disorders in primary care
· NPS News (65): Which treatment for what anxiety disorder?
For more information visit www.nps.org.au, phone (02) 8217 8700 or email info@nps.org.au.
ENDS
Media enquiries to Katie Butt, Media Adviser, 0419 618 365 or kbutt@nps.org.au
The National Prescribing Service Limited (NPS) is an independent, not-for-profit organisation for quality use of medicines funded by the Australian Government Department of Health and Ageing.
Return to homeResearch Reports
Dr Andrew Byrne & Associates: Does methadone cause QT problems or is it often viral?Practice Development
Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA): About that "Un-Invitation" | open full screen
Dr Linda Bryant (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA): I just want them to THINK! | open full screen
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