Editorial
Welcome to the November edition of i2P – Information to Pharmacists.
The month just finished has been an exceptionally busy one for pharmacy with an interesting PAC being concluded.
The “Great Debate” from PAC stirred considerable interest, also the talk given by John Menadue.
The latter has been reported and commented on in the article “Pharmacy’s Professional Future” and it is recommended that this article be bookmarked.
Better still, add your comment at the foot of the article.
All our columnists are back on deck and we are delighted to report that our New Zealand columnist, John Dunlop, has been accorded high honours by the New Zealand Pharmaceutical Society.
See the article in the Recent News section or look for the editor’s logo in the column section.
Our congratulations go out to John for this honour that resulted from his work in the pharmacy professional services area..
Columns
Rollo Manning: Pharma-Goss
Loretta Marron OAM BSc: Health Watch
Barry Urquhart: Marketing Focus
Harvey Mackay: Strategic Thinking
Mark Neuenschwander: I`ve been thinking about...Recent Comments
Volume 1 Number 1
Volume 1 Number 2
Volume 1 Number 3
Volume 1 Number 4
Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
Volume 2 Number 2
Volume 2 Number 3
Volume 2 Number 4
Volume 2 Number 5
Volume 2 Number 6
Volume 2 Number 7
Volume 2 Number 8
Volume 2 Number 9
Volume 2 Number 10
Volume 2 Number 11
Volume 3 Number 1
Volume 3 Number 2
Volume 3 Number 3
Volume 3 Number 4
Volume 3 Number 5
Volume 3 Number 6
Volume 3 Number 7
Volume 3 Number 8
Volume 3 Number 9
Volume 3 Number 10
Volume 3 Number 11
Volume 4 Number 1
Volume 4 Number 2
Volume 4 Number 3
Volume 4 Number 4
Volume 4 Number 5
Volume 4 Number 6
Volume 4 Number 7
Volume 4 Number 8
Volume 4 Number 9
Volume 4 Number 10
Volume 4 Number 11
Volume 5 Number 1
Volume 5 Number 2
Volume 5 Number 3
Volume 5 Number 4
Volume 5 Number 5
Volume 5 Number 6
Volume 5 Number 7
Volume 5 Number 8
Volume 5 Number 9
Volume 5 Number 10
Volume 5 Number 11
Volume 6 Number 1
Volume 6 Number 2
Volume 6 Number 3
Volume 6 Number 4
Volume 6 Number 5
Volume 6 Number 6
Pharma News
Hospital News
Health Politics
Climate Change
EPublications
Pharmacy’s Future Professional Services
The recent “Great Debate” at the 2009 Pharmacy Australia Congress had an excellent topic choice (“The answer to our future is increasing front of shop sales, not professional services”).
The answer is, of course, that pharmacies need both activities as “core business” to survive – it just depends on what balance is required for each unique pharmacy practice sufficient to allow for differentiation and emphasis on specialties (whether professional services or retail activities).
However, it could be argued that policies in recent years have tipped the balance in favour of supply services that favour retail activity.
Little research or effort has gone into the development of professional services (there is actually major amounts of unspent grant money from the Fourth Agreement), so many pharmacies see little relevance in promoting services they may not have the training for, or the infrastructure to deliver the necessary training (which comes at a cost).
Servants to the world.
Recently I received a number of calls from a concerned relative of one of our veteran clients currently in an aged care facility.
The problems I am hearing about relate to the difficulty in getting the patient’s doctor to write prescriptions for necessary medications, echoing many of the stories I heard during my pharmacy visits about the problem of “owing scripts” and just how hard it is for pharmacists to get them written. If we break down the problem we get this sequence of events:
2
Communicate anywhere and everywhere – is getting nowhere
Is talking about talk the best way to start solving the sharing of data in a health informatics scenario?
I have often written on the subject off interoperability; referring to broken and failed systems and in the attempts to get everyone in healthcare, primarily inside a hospital, to exchange information without re-working it all the time.
This can be a complex subject matter because it has little to do with technology and all to do with people. If various departments and fiefdoms want to share their data it can happen; if they behave in a recalcitrant manner, it won’t happen.
Which takes us down a path, for perhaps another time, regarding the subject of IT systems and collaboration? We Australians are not good at this – there is something in our makeup that resists sharing certain things, notably information management systems. Not sure whether it is a streak of independence or immaturity, or both. Anyway, moving on to the matters at hand, let’s continue.
Power in Numbers rises up the charts in Pharmacy.
There is power in numbers.
It is said that Chemist Warehouse is growing at 25/30% per annum, the traditional franchises are growing at about half that rate and the poor old unbranded Pharmacy is trailing behind at about 10%. This really means that Chemist Warehouse is flying along with a wet sail doing nicely and all others are wondering where to find growth or are spending far too much time with their accountants’ trying to work out how to survive the future.
This is no surprise of course; the Chemist Warehouse business model is brilliant, they are compelling marketeers and proof that the power in numbers prevails.
It's all in the Genes
When you think about it, genetics are likely to determine your skin type.
It is little wonder that if one or more of your relatives, including your ancestors, had a predisposition to skin cancer, then you may have inherited that trait.
Researchers believe that there is up to a 50 percent risk involved that you will develop skin cancer through genetic inheritance.
Skin cancer can be inherited: studies
Source: Reuters
http://www.reuters.com/article/healthNews/idUSTRE5984VM20091010?feedType=RSS&feedName=healthNews
Why New Zealand must rapidly halve its greenhouse gas emissions
Editor: It is good to see the New Zealand medical professionals getting behind climate change strategies in their country.
Pharmacy, particularly here in Australia is conspicuous by its absence in this activity.
Yet there are many things we can influence - particularly in the areas of the supply chain, shop design and the type of fixtures and fittings we select.
Unless we all begin to be proactive in this area, events will pass us by to our detriment.
Add your comments at the foot of this article to start off a discussion.
Source: New Zealand Medical Journal
Article written by: Scott Metcalfe, Alistair Woodward, Alexandra Macmillan, et al; for the New Zealand Climate and Health group
http://www.nzma.org.nz/journal/abstract.php?id=3827
The Pharmaceutical Society of New Zealand 2009 Honours
In Issue number six of Pharmacy e-Edge, the newsletter of the Pharmaceutical Society of New Zealand, four New Zealand pharmacists were awarded a range of honours.
The report was prepared by Richard Townley, the CEO of the Society.
Among them was John Dunlop, our i2P writer representing New Zealand, and we are pleased to share in John's achievement.
John was awarded a Fellow of the Pharmaceutical Society of New Zealand in recognition of his outstanding contribution to the advancement of the practice of pharmacy in New Zealand.
Congratulations John!
Brits love the NZ version - "Fush 'n Chups"
In a press release by Dr Allan Bell of Auckland University of Technology (sure to raise eyebrows with some Australian i2P readers), it is stated that:
"The New Zealand accent has been rated the most attractive and prestigious non-British form of English, according to a BBC survey.
New Zealand English came in first ahead of Australian, American and most regional British accents in the study published in the international Journal of Sociolinguistics, edited by Professor Allan Bell, Director of AUT’s Institute of Culture, Discourse and Communication."
Food as medicine - brown rice benefits diabetic patients
Choosing your rice variety may provide an inexpensive support for a program to treat diabetes.
Menus involving varieties of brown rice may reduce glycation and the rate at which sugar is absorbed by the body.
Cinnamon is another food known to sensitise insulin and reduce sugar levels.
With a some thought it appears that a variety of foods that combat diabetes could be combined to create dishes that are not only functional, but delicious to eat as well.
Brown rice could aid diabetes control
By Anuradha Alahakoon
Source: SciDev.net
The Starting Point
It was refreshing to read some positive recent announcements, comments and opinions in the media over the past three weeks.
First was the announcement by Nicola Roxon regarding the National Preventive Health Agency and the positioning by the Pharmaceutical Society of Australia firmly in support of this development of her initiative.
It is not quite 12 months ago that i2P ran a story on Nicola Roxon, her family and political background, at a time when she was relatively unknown in health circles.
Some observational and predictive points from that i2P article dated December 2008 -"Have you met Nicola Louise Roxon?" -are shown below.
Go to http://archive.i2p.com.au/?page=site/article&id=1168 for the full article.
"* Nicola appears to be a very normal and stable personality with strong family values, and is direct, straightforward and honest in her professional life.
* Nicola will endeavour to broaden the concept of health from illness treatment to illness prevention. She is well documented in many statements that “prevention is better than cure”.
* Pharmacy will be included within primary health care (something that other professions have tried to restrict), and the role pharmacy already plays in self-care will be recognised. I am sure that funds will be made available for the extension of self-care, work that has always been unpaid work performed by pharmacists.
* Nicola, however, needs to understand exactly what depth pharmacists have provided primary care, almost in a secretive fashion, because of constant harassment by doctors. While there is a surface cooperation between doctors and pharmacists, it is really only lip service.
The removal of this harassment would allow pharmacists to thrive as well as the general public.
* Nicola also needs to understand that while pharmacy owners provide infrastructure to provide medicine distribution, the pressure of this infrastructure works against the development of clinical services.
For this role she needs to recognise pharmacists individually as health practitioners and separate their income from the PBS model.
By providing incentives to individual pharmacist practitioners, development ideas and capital would flow in from these people and pharmacy owners would form beneficial relationships to harness benefit for the supply side of their businesses.
* From the recent address given at the Pharmacy Guild of Australia annual dinner, Nicola said, in part:
“The examples of existing Professional Programs and Services confirm the pharmacist’s role within the primary healthcare team.There may still be some debate about the borders of that role – but the direction is already well and truly established.
I want to be clear here – and I suspect my earlier comments have already given this away – any expanded role for pharmacists will take an incremental approach, and will be dictated by the need for safety and quality in health care.”
In other words, she will do what she has always done – carefully plan and test any program before it becomes policy.
It would seem that we were substantially correct and that the National Health Preventive Agency will offer a great opportunity for pharmacists to take advantage of their current training and skills set.
The second item was contained in a press release by the PSA dated 16/10/09 regarding a Memorandum of Understanding that was signed in Sydney by the President of the PSA, Warwick Plunkett, and the President of the RACGP, Dr Chris Mitchell, at a ceremony during the Pharmacy Australia Congress.
While details of the memorandum still have to be released, it may eventually mean that pharmacists will be able to practice independently and in alliance with GP's without the constant sniping that has been a feature of a relationship, which if worked cooperatively, has always been proven to provide maximum patient benefit. Good work PSA!
The third item of interest was an opinion article written by Geoff Marsh, president of APESMA.
Few comments have originated from APESMA, so it was good to see a comment from this organisation, as is really the voice of non-pharmacy owners, or to put it more succinctly, the logical representative of the pharmacists who provide professional services (whether or not they are paid up members).
The following appeared in Pharmacy e-News on 23/10/09 (located at
http://static.rbi.com.au/common/contentmanagement/pharmnews/PDFNOAD/20091023.pdf
Preventive Treatments for Vision Deterioration
Printer-friendly version
Send to friend
PDF version | Staff Writer |
Editing and Researching news and stories about global and local Pharmacy Issues | |
Vision health is one of the concerns of an ageing population that will prove to one of many concerns that will have to be packaged and delivered progressively to our "baby boomers". Giving old eyes a 'tune up' Source: Velocity
And it appears that simple maintenance programs can be developed that are well within the scope of a pharmacy practice.
This appears to be another opportunity opening up for those who organise themselves to be able to effectively communicate this type of service to their patients - actual and potential.
http://velocity.ansto.gov.au/velocity/ANS1531/article5.asp
With most people now outliving their eyeballs and many going blind in later life, the need to protect or 'tune up' the visual system is becoming acute.
In a major collaborative research program undertaken by the ARC Centre of Excellence in Vision Science (The Vision Centre), significant success is being achieved with a combination of simple therapies that will not only protect - but possibly restore - functional vision.
These therapies include light management, anti-oxidant dietary supplements, near-infra-red light and short-term oxygen therapy. All are based on a deepening understanding of the cellular and genetic processes within the eye.
Recent results in animal models show that these therapies offer great promise for treating vision loss in conditions such as age-related macular degeneration (AMD - the most common cause of blindness in old age), age-related degeneration of the retina and retinitis pigmentosa, which causes permanent blindness in much younger people.
All of the techniques work by manipulating the genetic responses in the eye's vision cells in ways that improve their resilience, boost healing and reduce damage.
"Best of all they are all harmless and easy to use, which means we should be able to achieve high compliance," said researcher, Professor Jonathan Stone from the University of Sydney and Australian National University.
A specialised team, headed by Dr Krisztina Valter, has produced world-first evidence that eyesight damage caused by exposure to very bright light can be repaired or even prevented using doses of near-infra-red light.
"When an eye cell has been damaged by overexposure to light, it usually dies from stress caused by free radicals - but when the cells are stimulated with IR light, they appear to recover significantly and to withstand future damage much better," said Krisztina. The team plans to move to clinical trials shortly.
A second form of treatment is simply to restrict the amount of light entering the eye, using dark glasses or other means.
"We have shown that restricting light in young eyes in animal models of retinal degeneration greatly reduces the amount of damage they sustain from ordinary bright daylight," added Krisztina.
"In some forms of retinal degenerations, vision cells are particularly sensitive to light and become stressed or die from normally non-damaging intensity of light," she explained.
"We have shown that protecting these retinas from light from birth can slow the degeneration. Now we are asking if it is worth limiting light exposure later in life even if the eyes were unprotected during childhood. And the answer, so far, appears to be yes.
"Sunglasses are as important for protecting children and young adults from the full sun as a shirt or hat," said Krisztina.
For younger people suffering retinitis pigmentosa, controlling the amount of light that enters the eye may slow the progression of the disease, or perhaps enable them to save one good eye for when the first has lost all sight, said Jonathan.
In a third development at The Vision Centre, Professor Silvia Bisti of the University of L'Aquila in Italy, has discovered that a dietary supplement of the herb saffron may offer major benefits for protecting and repairing damaged vision.
Saffron appears to work not only as an anti-oxidant but also to regulate genes in the vision cells of the eye, which can improve their resilience and possibly slow down diseases such as retinititis pigmentosa and age-related macular degeneration (AMD).
"We have some encouraging results which suggest it may be possible to reverse the damage of AMD - but it is very early in the research and we will know more later this year," said Silvia. A fourth development concerns the possible use of oxygen as a short-term therapy to improve vision.
While oxidative damage is a major cause of the loss of our vision cells, it has been observed that saturating the eyes with oxygen for a very short time in a hyperbaric chamber can cause vision to improve. "For short periods of time oxygen acts as a tonic for the photoreceptors in the eye, but for longer periods it is a toxin," said Jonathan, who is investigating this with the rest of the team.
"The combination of several of these mild treatments may, for the first time, offer a way to restore or prevent failing eyesight in old age. They are all easy and painless to administer, especially the light restriction and dietary approaches which can be applied all through life. We've learned to take care of our teeth, so we still have them in old age - now it's time to do the same for our vision."
The team plans to take the various techniques into clinical trials in Sydney and Rome in the coming year.
* The Vision Centre brings together major research programs from the Australian National University and universities of Queensland, Sydney and Western Australia.
Bits & Pieces
* Many older people develop Age-Related Macular Degeneration (AMD) as part of the body's natural aging process. It is the most common cause of vision loss in Australia and is a degenerative condition affecting the central area of the retina called the macula, which is responsible for fine and reading vision.
* AMD sufferers typically experience a reduction in central vision, leaving the peripheral vision intact.
* Smoking increases the risk of severe visual loss from AMD six fold.
* Retinitis Pigmentosa (RP) is a genetic eye condition that causes the light-sensitive retina, located at the back of the eye, to degenerate slowly and progressively, according to Vision Australia. The first signs may include night-blindness, a narrowing field of vision, light and glare sensitivity.
* Saffron is a spice derived from the dried stigma of the crocus flower and has been treasured for its culinary, medicinal, dyeing and perfuming properties for centuries. By weight, it is worth more than gold.
* The Vision Centre has three research themes: Vision for Living: Eye and Brain, Vision for Action and Robotics, and Vision for Life: The challenge of degenerative diseases - which the 'tune up' story fits into.
* Oxygen therapy, delivered through the nose, is also being investigated in the context of improving poor vision caused by diabetic macular edema; fluid build up in the part of the eye responsible for central vision.
Return to homeResearch Reports
Practice Development
Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA): Time for a Right Model of Pharmacy - and Unity | open full screen
Information Technology
Indigenous Health
Preventive Medicine
Aged Care
If any difficulty is found in subscribing, please use the "Contact Us" panel found in the navigation bar with the message "subscribe" and your email address.
Post new comment