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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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News Flash

Newsflash Updates for July 2014

Newsflash Updates

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

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

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

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

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

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The sure way to drive business away

Gerald Quigley

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

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

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

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Community Pharmacy Research - Are You Involved?

Mark Coleman

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

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

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

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

Staff Writer

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

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

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

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Dispensing errors – a ripple effect of damage

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

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
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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From this page you can share ASMI Media Releases March 2010 to a social bookmarking site or email a link to the page.
Social Web

ASMI Media Releases March 2010

Bob Bowden

articles by this author...

Information and news from the Australian Self Medication Industry provided by Bob Bowden, Foresight Communications. Contact him on (02) 9241 2811 or 0412 753 298.He is supported by Filomena Maiese (ASMI Marketing & Business Development Director) and Michelle Sollitt-Davis (ASMI PR Manager).

About ASMI: The Australian Self-Medication Industry (ASMI) is the peak industry body for the Australian self care industry representing consumer healthcare products including over-the-counter medicines and complementary medicines.
ASMI’s mission is to promote better health through responsible self-care.
This means ensuring that safe and effective self-care products are readily available to all Australians at a reasonable cost.
ASMI works to encourage responsible use by consumers and an increasing role for cost-effective self-medication products as part of the broad national health strategy. www.asmi.com.au

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18 March 2010
ASMI launches self care into cyberspace

 The Australian Self-Medication Industry (ASMI), the industry body representing non-prescription consumer healthcare products, today launched its social media initiative ‘Self Care for Australians’ aimed at educating consumers about the benefits of greater personal responsibility for health.

The initiative will include three elements, a blog, Facebook and Twitter, which will work jointly to promote the importance of self care - the steps that individuals, families and communities can take to improve their health and wellbeing through such things as diet, exercise, regular health check-ups, and appropriate self-medication.

ASMI Executive Director, Juliet Seifert said the move into social media was a first for ASMI, as the organisation looks to engage in more extensive discussion about the community-wide benefits of self care.

“There is a thirst for health knowledge within the community and people want to feel empowered to take control of their own health.

“We want to create a comprehensive collection of news and information to ensure that consumers have the knowledge and the tools to effectively and safely take greater personal responsibility for their health.

“In creating these social media outlets, we hope to build an online community in which the importance of self care can be shared.”

ASMI will be engaging outside experts across the health spectrum including pharmacists, GPs, policy makers, commentators, and allied health professionals to contribute their knowledge to the debate.

You can visit the sites here:

Blog: www.self-care.net.au

Twitter: www.twitter.com/selfcare4aust

 Facebook: http://www.facebook.com/pages/Self-Care-for-Australians/444602165516?ref=ts

17 March 2010
Industry and pharmacists call for minor ailments strategy to help ease doctor shortage

The non-prescription medicines industry today joined national pharmacy organizations to urge the Federal Government to do more to address GP shortages through a scheme that would see some minor ailments redirected to pharmacists.

The Executive Director of the Australian Self-Medication Industry (ASMI), Juliet Seifert said that the Government’s announcement of additional GP training places was very welcome, but would not see more doctors actually available for a number of years.

The GP shortage could be addressed in a more timely way through a program that encourages patients with minor ailments to visit their pharmacist as a first port of call. It is supported by the peak professional organizations representing pharmacists.

Kos Sclavos, National President of the Pharmacy Guild: “ASMI is right. At a time when the Government is intent on getting maximum value for the dollars taxpayers put into the health system, it makes sense to utilise the skills and knowledge of Australia’s most accessible health professionals in 5,000 community pharmacies.”

Warwick Plunkett, National President of Pharmaceutical Society of Australia said: “The treatment of minor ailments in pharmacies provides better health outcomes for patients and frees up GPs’ time to treat more serious illnesses and complaints. 

“Pharmacists have the expertise and accessibility to treat minor ailments and are highly trained so they know when a patient should be referred to their doctor. It is estimated that GPs in Australia face 25 million consultations annually for minor ailments and directing many of these ailments to community pharmacists will enable GPs to focus more on serious ailments.”

Recent work undertaken by ASMI shows that the GP resources devoted to coughs, colds and other minor ailments could free-up the equivalent of 1,000 full time GPs to treat more serious health problems.[i]

“A program of self care in pharmacies could make serious inroads into the current shortage of GPs across the country and could produce results in a relatively short period of time,” Ms Seifert said.

“There is also some $260 million in ‘waste and resource misallocation’ as a result of Medicare benefits associated with GP treatment of minor ailments,” she said.

The study was based on only the ten most frequently treated minor ailments which account for 58% of all GP attendances attracting Medicare benefit for minor ailments, and which represented some 15 million GP consultations.

“In the face of a severe national shortage of GPs, it makes sense to look at what people can do to take greater personal responsibility for their health through improved diet, exercise and self care of minor ailments. 

“By moving some of the most common minor ailments away from overstretched GPs and into pharmacies, we would enable GPs to concentrate on more urgent primary care needs”.

The most common minor ailments identified in the study were acute upper respiratory tract infection, back pain, diarrohea and gastroenteritis, joint pain, coughs, viral infection, malaise and fatigue, headache and constipation. Approximately half of all patients presenting at a GP for the 10 most frequently treated minor ailments were also treated with a prescription.

 “Additional GP places are much-needed but we also need to look at how we can address the unsustainable demand for health services that threatens to outstrip future GP capacity, and overrun health budgets,” Ms Seifert said.

[1] Gadiel D L. The Potential Economic Impact of Expanded Access to Self-medication in Australia, for the Australian Self-Medication Industry, www.asmi.com.au  August 2009

10 March 2010
Over-the-counter NSAIDS a safe and effective remedy for pain and inflammation

The Australian Self-Medication Industry (ASMI) today reassured patients that non-steroidal anti-inflammatory medicines (NDAIDs) continue to play an important role in short term pain relief for the majority of consumers.

The Deputy Executive Director of ASMI, Dr Deon Schoombie was responding to media reports quoting The Gut Foundation as raising questions about the use of NSAIDs by people with a history of stomach or kidney disorders or heart problems.

Dr Schoombie said that NSAIDs, such as ibuprofen and diclofenac, are available without a prescription at low doses for short-term use in self-limiting conditions. They are safe and effective for the temporary relief of pain and inflammation.

“NSAIDs are available as non-prescription medicines world-wide and have a long history of safe use. These products are safe when used as directed, but like any medicine they can cause problems when used incorrectly, or by people with certain conditions or taking specific medicines”, he said.

Over-the-counter (OTC) labels on NSAIDs provide warning statements, including that they not be taken by patients over the age of 65 or those with stomach, kidney or heart problems, without first talking to a health professional. The labels also advise that people who are taking other medications regularly for other conditions should first obtain the advice of their healthcare professional.

“NSAIDs available over-the-counter without a prescription are all labeled with warning statements and dosage instructions regarding their purpose and appropriate use.  It is important to read labels carefully, and to strictly follow all the directions and, if the pain or other symptoms persist, to consult a doctor or pharmacist,” Dr Schoombie said.

health news headlines provided courtesy of Medical News Today.

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