s Pharmedia – Mobile Health Uncertainties in European Pharmacies | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

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

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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

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

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

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

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

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The sure way to drive business away

Gerald Quigley

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

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

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

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Community Pharmacy Research - Are You Involved?

Mark Coleman

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

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

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

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

Staff Writer

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

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

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

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Dispensing errors – a ripple effect of damage

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

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

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

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Explainer: what is peer review?

Staff Writer

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

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Dentists from the dark side?

Loretta Marron OAM BSc

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

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

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

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

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

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Attracting and Retaining Great People

Barry Urquhart

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

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Updating Your Values - Extending Your Culture

Neil Johnston

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

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

Staff Writer

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

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

Staff Writer

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

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

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Culture Drive & Pharmacy Renewal

Neil Johnston

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

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

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

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

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

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Generation and Application of Community Pharmacy Research

Neil Johnston

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

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Pharmedia – Mobile Health Uncertainties in European Pharmacies

Neil Johnston

articles by this author...

Introducing current ideas, perspectives and issues, to the profession of pharmacy

Editor’s Note:
I noticed this news item in the Chemist + Druggist online publication and wondered whether the comments made suit the current Australian experience.
I am unsure as to whether Australians have embraced mobile technology to any great extent, so I have asked Mark Coleman to undertake a brief investigation and write his own commentary.
His comments appear below the following news item:

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European experts clash over mobile future for pharmacy

By Emma Weinbren (Chemist + Druggist)

Euoropean healthcare experts have clashed over the need for pharmacy to invest in mobile health.
Mobile technology had the potential to boost medicines adherence and build customer loyalty, speakers from Lloydspharmacy and the European Commission told the annual general meeting of the European Association of Pharmaceutical Full-line Wholesalers (GIRP) in Vienna on Monday (June 2).
But John Chave, general secretary of the Pharmaceutical Group of the European Union, warned that the opportunities for using this technology were often "overhyped".

In an exclusive interview with C+D, Mr Chave questioned whether there was a significant demand for mobile health. "There aren't that many people using complex health apps, for example for adherence purposes," explained Mr Chave, who represents pharmacist organisations across Europe. "I sometimes feel the industry pushing mobile health overlooks the fact that patients like face-to-face care."

  The smartphone is the ideal health coach because it is never more than two metres away from us, says Max Wellan, president of the Austrian Chamber of Pharmacists

The group most in need of health support – the elderly – was the least likely to own a smartphone, Mr Chave added.
Emily Kelly, director of sales and marketing at Lloydspharmacy Ireland, admitted that the elderly were less likely to use mobile technology.
But she stressed that a "mix of people" were using Lloydspharmacy's MyMed app, which works alongside monitored dosage systems to increase adherence. The app was particularly useful for carers of elderly patients, she said, and Lloydspharmacy had reaped rewards from its popularity. 

"For us, [the app] has been brilliant in increasing our prescription items and loyalty," Ms Kelly told the conference. The app had made a "huge difference" to some patients, who reported being "less anxious" about taking their medication as a result, she added.

Max Wellan, president of representative body the Austrian Chamber of Pharmacists, gave further backing to the potential of mobile technology to boost adherence. "The smartphone is the ideal health coach because it's never further than two metres away from us," he said. "Things like adherence tools are ideal with the smartphone." 

The European Commission estimated that the value of the mobile health market in Europe would exceed £4 million by 2017. "I think mobile health is growing so rapidly [that] there is a great potential to improve healthcare, create significant savings and, ultimately, empower patients," said Paul Timmers, director of the commission's sustainable and secure society division.

The European Commission is consulting on how to develop the mobile health market until July 3 and hopes to take action on the findings next year. 

At the Avicenna conference in Bali last week, Alliance Healthcare commercial director John Pignone said that the proportion of the UK population who owned a smartphone meant there was a market for more mobile health apps.


 Mark Coleman

Smart phones, notepads and other forms of mobile technology ought to be a fertile are for market expansion.
In particular, pharmacy assistants represent a logical resource that is often overlooked in the marketing of a pharmacy, but a quick survey of the number of smart phones contained in any pharmacy environment would reveal a large number, generally owned by the younger sales people (<35 years old).
One of the reasons elderly patients have difficulty in using new technology is that they are not as mentally adept as they were earlier in life, but if they had one good pharmaceutical app that they valued, they would be prepared to learn how to use it.
Senior adoption of new technology has been proven to be positive and when first introduced in the form of a mobile phone, government offered short courses free or at a subsidised cost to assist in senior uptake.
Mostly, the initial use was for keeping in touch with family and no thought for health use.
So it would not be too difficult to extend that established family communication network into a local friendly pharmacy environment with the high level of basic connectivity already existing - it just needs to be taken to the next stage.
Having an empathetic staff person who would be prepared to mentor their pharmacy patients to a level of proficiency would establish a patient group, who would most likely become very loyal over time, and depending on how the app was programmed, new and more varied marketing programs could be introduced using the entire network as a platform to create leverage.

It would be the repetitive mentoring that would win the day plus regular face-to-face counseling to be valued by a pharmacy patient.
However, it is important that a pharmacist mentor be introduced at staged intervals, because the whole point of the exercise would be the extension of pharmacy care programs.

I have been a passionate supporter of pharmacy-in-the-home programs – mobile pharmacy care programs that support “ageing in place” in the patient’s own private home.
If you think carefully about this concept and blend it with a community nurse, you immediately have an alternative competitor to a nursing home.
Nursing homes have succeeded in destroying some pharmacy businesses by demanding too much in service component from the pharmacy.
Unable to attach to an alternative service, the pharmacy has lost out severely from nursing home pressure.
Well, here is the opportunity to build a better alternative as a pharmacy extension.

If you think about it, the existing nursing home/ hostel model is fast becoming too expensive for an average family to support their much-loved senior relative.
Far cheaper for governments to subsidise programs such as “pharmacy-in-the-home” and a mobile pharmacy infrastructure does not need an expensive location to set up (an industrial complex or other quiet location would be quite suitable).
Once set up for senior patients, all other family members could access the services offered including dispensing, general shopping and specialist shopping.

Nobody, as far as I know, has developed a software suite or an infrastructure operation to service willing patients who are prepared to be mentored on how to use the various apps.
When it happens, ensure that some regular face-to-face counseling is built into the project.
This also builds an independent platform to launch future services independent of government and on a level playing field with competitors of all sizes.

Pharmacy faces some uncertainties in its ability to sustainably service its traditional market.
With a bit of thought, pharmacy-in-the-home could provide a low cost but a quality service that might ensure survival and a place at the health provider’s table because you are unique.

I like the idea that mobile health could b e a “win-win” for a range of pharmacy personnel:

* Pharmacy owners who could sell the smart phones, note pads and accessories.

* Pharmacy assistants who could mentor and educate all patients (but especially seniors) to use the smart phones.

* Pharmacies that could extend the reach of apps such as eRx

* Clinical pharmacists, who could develop primary health care programs and integrate them into community pharmacies or their extensions such as pharmacy-in-the-home.

Anyone who may be interested in building on these thoughts in collaboration or alliance partnership, please contact the editor neilj@computachem.com.au

 

 

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