td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12672 [post_author] => 3410 [post_date] => 2021-02-24 14:02:13 [post_date_gmt] => 2021-02-24 03:02:13 [post_content] => With the beginning of the COVID-19 vaccine rollout this week, here's what pharmacist vaccinators need to do now to ensure both their staff and practice are prepared for delivery. Community pharmacists will be able to administer the COVID-19 vaccine to patients in the 2a priority group. For accredited pharmacists who submitted an expression of interest to deliver the vaccine, PSA General Manager Policy and Program Delivery Chris Campbell said there is a lot pharmacists can do to get ready while awaiting the outcome, which is expected in mid-March. 'This should start with a self-audit of your current vaccination service – particularly for cold chain – and set-up of the clinic rooms, waiting areas and preparing your team,' he told Australian Pharmacist. 'Pharmacists should also maximise targeted influenza immunisations through March and April, particularly for patients in Phase 2, giving ample space for the 14-day window when their COVID-19 vaccination “turn” starts from May. 'It’s also time to start to think of scheduling and rosters for what will be a busy period from April through to October,' he added.
Preparing yourself and your staffMr Campbell said pharmacists should ensure their vaccination credentials are up to date, including First Aid and CPR. It is also important to check your anaphylaxis kit is fully stocked and in-date. 'There is a lot of demand for CPR and first aid courses at the moment, and I would put in as much effort as possible to make sure you and your teams are up to date,' he said. 'This is a skill set that is important year round and even more so as we enter the peak immunisation season. 'Although having a defibrillator on site is not mandatory to administer COVID-19 vaccinations, we know it will be taken into account and many pharmacists have recently had them installed. The more of the team skilled in this area will ultimately save lives,' Mr Campbell added. Running through training scenarios in the practice is also a helpful preparation method, said Mandy Wang MPS, an accredited pharmacist immuniser at Chemist Warehouse in Canberra. ‘In the heat of the moment it can be difficult to remember emergency protocol, so we do some in-house training beforehand, so everyone is aware of their responsibilities if something were to happen,’ she told AP. ‘We have a chart on the wall that we update daily, which indicates who is responsible for calling an ambulance in case of emergency, or who will administer adrenaline, so we are up to speed prior to the vaccination clinic opening,’ she added. Pharmacists should also consider participating in the online government COVID-19 vaccine training now, so they are prepared to answer patient queries, including questions about multidose vials and second doses. The training comprises a number of foundation modules that are common to all vaccines, and pharmacists will need to allow up to 6 hours to complete the course. The modules can be accessed more than once, so a refresher closer to the date of delivery can be undertaken.
Ensure an efficient serviceA review of your current vaccination service with some COVID-19 specific additions will help to ensure the process runs smoothly. Importantly, pharmacists should consider how they plan to accommodate the influx of patients who will present for both the COVID-19 and influenza vaccines. Ms Wang said her practice used a separate space to deliver influenza vaccines last year in accordance with social distancing requirements. ‘It’s not just the people who are getting vaccinated that turn up,’ Ms Wang said. ‘Sometimes they bring partners, support people, children, etc., so you have to take that into consideration as well.’ State-specific mandates will stipulate whether the COVID-19 vaccine must be delivered in the pharmacy practice, but pharmacists can reduce foot traffic by delivering other vaccines in a different space where appropriate. Pharmacists also need to consider if they have space for patients during the observation period after their vaccination. While the wait currently sits at 15 minutes, it could be subject to change, so adequate capacity needs to be allocated. To ensure vaccine patients' records can be accessed and updated, pharmacists should also ensure that their premises and all the pharmacists on their team are linked into PRODA, Mr Campbell said. 'The process of getting your pharmacy and pharmacists online with PRODA can be tedious and needs to be done well in advance,' he said. 'I did this recently this with my pharmacies and recommend all pharmacist vaccinators get this organised now, as you want the most seamless access for all your pharmacists immunisers as possible.' Pharmacists should also ensure their cold chain management is impeccable, including familiarity with bi-daily monitoring, annual thermometer calibration and data loggers. It is important to self-audit and make any necessary adjustments or corrections if issues are identified. Pharmacies should also have an effective system to notify external bodies in the event of a cold chain breach. For further information on the COVID-19 vaccine and state-by-state guidelines, visit the PSA Microsite. [post_title] => A practical guide to delivering COVID-19 vaccinations [post_excerpt] => With the beginning of the COVID-19 vaccine roll out this week, pharmacists need to ensure both their staff and practice are prepared for delivery. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => delivering-covid-19-vaccine [to_ping] => [pinged] => https://www.australianpharmacist.com.au/community-pharmacists-covid-19-vaccination-program/ [post_modified] => 2021-02-24 17:07:41 [post_modified_gmt] => 2021-02-24 06:07:41 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12672 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => A practical guide to delivering COVID-19 vaccinations [title] => A practical guide to delivering COVID-19 vaccinations [href] => https://www.australianpharmacist.com.au/delivering-covid-19-vaccine/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12676 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12668 [post_author] => 3410 [post_date] => 2021-02-24 13:37:01 [post_date_gmt] => 2021-02-24 02:37:01 [post_content] => When under the care of a general practice pharmacist, patients recently discharged from hospital are far less likely to re-present, according to new research. PSA National President Associate Professor Chris Freeman is the lead author of a report that showed how embedding pharmacists in general practices can reduce both hospital readmissions and emergency department (ED) presentations. ‘When pharmacists work closely with GPs, high-risk groups are 31% less likely to be readmitted or re-present to hospital at 12 months, and 64% less likely at 30 days,’ said A/Prof Freeman, who is also a GP pharmacist. ‘More funding is required to support this collaborative model of care.’ REMAIN HOME was a stepped wedge, cluster randomised controlled trial that assessed patients from 14 general practices in southeast Queensland who were recently discharged from public hospitals. Participants were split into control (177 patients) or intervention (129 patients) groups, with the latter the recipients of medicine management reviews conducted by pharmacists integrated into their general practice. The intervention, which took place 1 week post-discharge, included:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12659 [post_author] => 235 [post_date] => 2021-02-24 13:11:34 [post_date_gmt] => 2021-02-24 02:11:34 [post_content] => Pharmacists were among the first to receive the COVID-19 vaccine on Monday in what has been labelled a ‘momentous day’ in Australia’s history. Alfred Health Pharmacist Uyen Hua received her vaccination on Monday (22 February) before starting her role in a specialist team that will be vaccinating Victoria’s hotel quarantine staff. ‘Our nursing and pharmacy teams are really excited to be involved in the vaccine rollout, helping to keep our most at-risk workers safe,’ Alfred Health tweeted.The Alfred pharmacy team received its first shipment of the Pfizer vaccine on Sunday and began preparing syringes for nurses to administer on Monday. Director of Pharmacy Professor Michael Dooley said the team had been working around the clock to prepare for the arrival of the vaccine. 'We’re really happy to be involved with the vaccine program, and to assist in protecting our key frontline workers with the best defence we have against COVID-19,’ he said. ‘I’ll be very happy to roll my sleeve up when my turn comes.’ PSA National President Associate Professor Chris Freeman said administering the first vaccines represented a ‘momentous day’ for the nation and marked the beginning of Australia’s exit from the pandemic. ‘Australia’s health response to the pandemic has been led by expert scientific health advice, and our national COVID-19 vaccination strategy is no different,’ he said. ‘All Australians can have confidence in the safety and effectiveness of approved COVID-19 vaccines, which will be administered by competent, well-trained vaccinators, including pharmacists.’ Pharmacists at Monash Medical Centre took delivery of their first 5,000 doses of the Pfizer vaccine on Sunday, storing them in a -80°C freezer. The vaccines will be administered to an initial 5,000 ‘priority A’ healthcare workers, including those in emergency departments, intensive care units and in the COVID-19 ward. Once the vaccine is removed from the ultra-cold freezer it can be thawed and stored for up to 5 days in a normal fridge. Once it has been taken out of the vaccine fridge, it must be prepared and used within 6 hours. Monash Health Director of Pharmacy Associate Professor Sue Kirsa, who is responsible for ordering and distributing the vaccines, explained the process. ‘Very early in the morning, our staff will pull [the vaccine] out of the fridge and put them into a vaccine portable fridge, take them over to the clinic and reconstitute the vials and draw them up into syringes.’ [caption id="attachment_12664" align="alignright" width="2560"] Alfred Health Deputy Director of Pharmacy Erica Tong preparing syringes of the first COVID-19 vaccine. (Image: Alfred Health)[/caption] To reduce wastage, staff at the Monash Medical Centre vaccine hub will vaccinate healthcare workers from 7.30 am for 7 days a week. This will allow the centre to vaccinate night staff before they go home, and help prevent people needing to queue. Once five doses have been extracted from each vial, a small amount of liquid remains. It has been reported that a worldwide shortage of low dead space syringes designed to extract these last drops will mean some of the Pfizer vaccine will be wasted. However, this isn’t always the case, with Victoria’s Deputy Chief Health Officer Professor Allen Cheng tweeting his congratulations to Alfred Health Deputy Director of Pharmacy Erica Tong on getting ‘6 doses from the first vial without needing low dead space syringes!’ ‘For full transparency I didn’t draw them up, but our very capable senior pharmacist in aseptic manufacturing did!’ Dr Tong replied. In New South Wales, Royal Prince Alfred (RPA) Hospital’s vaccination centre officially opened its doors on Monday, after pharmacist Branko Radojkovic prepared a simulated vaccine to show Prime Minister Scott Morrison on Friday. About 1,200 healthcare workers and quarantine staff were vaccinated on the first day. Roughly 35,000 frontline healthcare and quarantine staff will be vaccinated over the next 3 weeks at Sydney’s three hubs: RPA, Westmead and Liverpool hospitals. [caption id="attachment_12665" align="alignright" width="390"] NSW Premier Gladys Berejiklian and Minister for Health Brad Hazzard look on as RPA Environmental Services Supervisor Gaya Vellangalloor Srinivasan receives a COVID-19 vaccination.[/caption] The PSA worked with the federal government and state and territory health departments to prepare for the rollout, including consulting on regulatory milestones, such as:
Pharmacist Uyen just got her COVID-19 vaccination! She's proud to a part of the specialist team who'll be vaccinating Victoria’s hotel quarantine staff - starting with the Health hotel this week. #covid19 #vaccine pic.twitter.com/gDljf4xKLk— The Alfred (@AlfredHealth) February 22, 2021
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12643 [post_author] => 235 [post_date] => 2021-02-17 15:15:04 [post_date_gmt] => 2021-02-17 04:15:04 [post_content] => Residents in more than 240 aged care facilities across the country will receive their first vaccine dose against COVID-19 from Monday (22 February). Federal Minister for Health and Aged Care Greg Hunt confirmed the start date yesterday (16 February), after the first doses of the Pfizer vaccine arrived in Australia on Monday. ‘The Eagle has landed,’ Minister Hunt said following the shipment. ‘They have touched down, they are currently being secured, and the advice that I have is that 142,000 doses have arrived in Australia.’ Of these, 62,000 doses will be set aside for second doses in case of supply interruptions. The remaining 80,000 doses will be split between the federal and state and territory governments, with 30,000 administered by the federal government in aged care facilities. The remaining 50,000 will be administered by the state and territory governments to those most at risk of coming into contact with international arrivals, including hotel quarantine and border workers. The states and territories will also focus on residential aged care facilities (RACFs) that are within their systems, and on frontline healthcare workers. ‘We are expecting that by the end of February, probably 60,000 of those doses will have been administered,’ Minister Hunt said. ‘We have to allow for the time taken to be administered, for any issues that occur along the way, we have to be realistic – at some point, there will be a vial which is dropped.’
Priority populationThe aged care roll out will begin in every state and territory, Minister Hunt said, and will include regional and rural aged care facilities. It is expected to take about 6 weeks. ‘Vaccination for residents and staff will be made available through residential aged care facilities where they live or work, and it will be administered through an in-reach workforce provider,’ he said. Healthcare Australia will provide the vaccination workforce in New South Wales and Queensland, while Aspen Medical will be responsible for the other states and territories Everyone responsible for providing the vaccine in aged care settings will be required to have completed the relevant training, including on the use of multi-dose vials, cold storage and infection control. In coming weeks, the vaccination program will reach more than 2,600 RACFs, more than 183,000 residents and 339,000 staff.
State responseIn New South Wales (NSW), Premier Gladys Berejikilan has confirmed that about 35,000 frontline workers – including those working in hotel quarantine, emergency departments, at testing clinics and paramedics – will receive the Pfizer vaccine from Monday. The process will take 3 weeks and includes vaccination sites at Westmead, Liverpool and Royal Prince Alfred hospitals. ‘While the scale is not large to begin with ... we anticipate the scale of the receipt of the vaccine will increase over the next few weeks,’ Ms Berejiklian said. In Queensland, the first 100 vaccinations will be delivered at a hub on the Gold Coast. Queensland Health has confirmed the locations of its five other vaccination hubs: Townsville, Cairns, the Sunshine Coast and Brisbane (RBWH and PA hospitals). ‘These sites were selected as having the highest COVID19 risk due to being major destinations and entry points for international travellers,’ according to the department. Tasmania has confirmed ‘all Tasmanians aged 18 and over will be able to get vaccinated for free by the end of October 2021’. The state-managed doses will be given in hospital hubs at: North West Regional Hospital in Burnie, Launceston General Hospital and Royal Hobart Hospital. In South Australia, the Royal Adelaide Hospital will be the first hub to deliver the Pfizer vaccine to the first round of priority groups. During later phases, every public hospital across the state will be involved in the vaccine roll-out. Northern Territory Chief Minister Michael Gunner said the territory was ‘starting small, but the most important thing is that we are starting’. The territory government expected to deliver vaccinations to about 3,000 people as part of Phase 1a, with the Commonwealth anticipated to cover an additional 1,500 aged care residents and workers. It has also announced plans to amend legislation to allow 'all registered practitioners – who are qualified and trained to provide immunisations – to administer COVID-19 vaccines to Territorians without gazettal'.
Approval for AstraZenecaMeanwhile, the Therapeutic Goods Administration (TGA) has granted provisional approval to AstraZeneca for its COVID-19 vaccine for the active immunisation of people 18 years and older. The provisional approval is valid for 2 years and means the vaccine can now be legally supplied in Australia. ‘The approval is subject to certain strict conditions, such as the requirement for AstraZeneca to continue providing information to the TGA on longer term efficacy and safety from ongoing clinical trials and post-market assessment,’ according to the TGA. ‘[The vaccine] has been shown to prevent COVID-19, however, it is not yet known whether it prevents transmission or asymptomatic disease.’ The TGA advised the vaccine be administered in two doses, 12 weeks apart. If that is not possible, a minimum of 4 weeks between doses should be observed. Of the 53.8 million doses of the AstraZeneca vaccine Australia has secured, 50 million will be made in Melbourne by CSL. Bottling of the first batch began at the CSL facility this week. Delivery of the AstraZeneca vaccine should see ‘a doubling of the number of doses per week by early March, if not earlier,’ according to Minister Hunt. About one million doses a week should be available from the end of March, he said.
Victorian lockdown liftedVictorian Premier Daniel Andrews has announced the state’s 5-day ‘circuit breaker’ lockdown, which began at 11.59 pm on 12 February, will end at 11.59 pm tonight (Wednesday, 17 February). The 5 kilometre restriction will no longer reply, and restaurants and retail business can reopen. Masks are still required indoors, and outdoors where people are unable to practice social distancing. Victorians can have no more than 5 visitors in their home per day, and public gatherings will be limited to 20. It comes as no new coronavirus cases were reported in the state after almost 40,000 test results were received yesterday. Two locally acquired cases were confirmed on Monday. During the lockdown, the Victorian Department of Health managed 3,400 close primary contacts, 212,000 test results and 850,000 SMS alert messages. ‘Because of the efforts of every Victorian – the sacrifices and the hard slog – we can be confident that, slowly and surely, we are driving the virus into the ground,’ Mr Andrews said in a statement. ‘It hasn’t been easy or straightforward. In fact, for those Victorians who are part of our health response, it’s been bloody hard work.’ Are you interested in providing COVID-19 vaccinations? Expressions of interest for community pharmacies to deliver the vaccine close on Friday. For more information, don’t miss PSA’s webinar Are you ready for the COVID-19 vaccine roll out? tomorrow (Thursday 18 February). [post_title] => Aged care residents to receive first COVID-19 vaccination next week [post_excerpt] => Residents in more than 240 aged care facilities across the country will receive their first vaccine dose against COVID-19 from Monday (22 February). [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => aged-care-residents-receive-first-covid-19-vaccination [to_ping] => [pinged] => [post_modified] => 2021-02-18 12:41:19 [post_modified_gmt] => 2021-02-18 01:41:19 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12643 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Aged care residents to receive first COVID-19 vaccination next week [title] => Aged care residents to receive first COVID-19 vaccination next week [href] => https://www.australianpharmacist.com.au/aged-care-residents-receive-first-covid-19-vaccination/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12641 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12639 [post_author] => 3410 [post_date] => 2021-02-17 15:06:55 [post_date_gmt] => 2021-02-17 04:06:55 [post_content] => Between mid-March and late April last year, the Pharmacists’ Support Service (PSS) received a massive 88% increase in calls from distressed pharmacists compared with the same period in 2019, after the extraordinary bushfire crisis followed closely by the start of the COVID-19 pandemic. The most common reasons for calls related to COVID-19 were physical and mental health-related, including stress and anxiety, clinical matters relating to patient care, employment conditions and workload. Since then, according to a new personal view article published in the International Journal of Pharmacy Practice, Australian researchers, including Executive Director of the PSS Kay Dunkley MPS, have stated it was ‘barely’ acknowledged that community pharmacy staff were at high risk for long-term psychological impacts. According to the paper, community pharmacists and pharmacy staff were under immense pressure to remain open and serve communities during a time of rapidly changing legislation and – at times – conflicting advice from state and federal health agencies, which led to ‘confusion and frustration around what was legal and what was not’. ‘Rapid changes to workload and workflow were combined with the dilemma of balancing professional obligations with the personal duty of keeping themselves and their sometimes geographically distant families safe,’ the authors wrote. ‘Fluctuating demands and traumatic situations found community pharmacy staff often feeling distressed and underprepared.’ Aside from COVID-19-related calls, other reasons pharmacists contacted the PSS included legal issues relating to medicine supply, conflict with a pharmacy manager or owner, perceived bullying and conflict with patients, the paper stated. Ms Dunkley told Australian Pharmacist that new initiatives, such as electronic and active ingredient prescribing, would further contribute to pharmacist workload and patient confusion this year. ‘There are all these extra stresses on top of infection risk, which can be very draining and create tense interactions – whether with patients or doctors,’ she said. Prolonged stress from all these factors can result in burnout, which can lead to more long-term mental health problems. ‘Ongoing stress not only impacts mental health but physical health as well,’ Ms Dunkley said. ‘It raises blood pressure, increases blood glucose levels and leads to poor sleeping, which, in turn, ultimately increases the risk of cardiovascular disease.’
Support for pharmacistsThe paper acknowledged federal Minister for Health and Aged Care Greg Hunt’s public statement on World Pharmacists’ Day about ‘the outstanding work of Australia’s pharmacists and pharmacy staff in communities across the nation, specifically keeping their doors open to support Australians throughout some of the most challenging times in our history, including bushfires, bloods, drought and a global pandemic’. ‘In the long term, governing bodies and professional agencies should come together and provide a forum for community pharmacists to safely discuss the emotional and social challenges that they faced during the bushfires and the COVID-19 pandemic,’ the article states. Ms Dunkley emphasised that pharmacists should join a professional body that will advocate on their behalf and provide support services in the workplace. ‘The PSA, for example, has an advice line for people to discuss pharmacy issues, and they have provided support during the rollout of electronic and active ingredient prescribing,’ she said. Aside from the PSS and other crisis resources such as Beyond Blue and the Black Dog Institute, Ms Dunkley said all pharmacists should engage a GP that they can trust. ‘If you are finding that you're experiencing ongoing stress, it’s important to consult a GP who you can talk these things over with and who can help you manage it,’ she said.
Self-care strategiesTo prevent burnout, Ms Dunkley suggested pharmacists take breaks and holidays when the opportunity arises, and engage in routine self care. ‘Self care has to be built into your life, it's not just something you can do when you're stressed,’ she said. ‘It can be simple practices such as making sure that you have a meal break during the day at work, and that you’re eating well and getting regular exercise.’ Hobbies and interests outside of pharmacy can also help to create work-life balance. ‘Getting out into nature, cooking or having a pet are good methods of relaxation,’ she said. ‘Focusing on family and doing things you enjoy together, such as taking the kids to the park or the beach, also help to create that balance.’ Ms Dunkley suggested community engagement activities as another way to switch off from work. ‘Join a sporting club, or a special interest group – something that's outside of pharmacy.’ [post_title] => Data shows pharmacists more distressed in 2020 [post_excerpt] => Between mid-March and late April last year, the Pharmacists’ Support Service received a massive 88% increase in calls from distressed pharmacists compared with the same period in 2019, [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacy-staff-distressed-in-2020 [to_ping] => [pinged] => [post_modified] => 2021-02-18 12:41:25 [post_modified_gmt] => 2021-02-18 01:41:25 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12639 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Data shows pharmacists more distressed in 2020 [title] => Data shows pharmacists more distressed in 2020 [href] => https://www.australianpharmacist.com.au/pharmacy-staff-distressed-in-2020/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12640 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12583 [post_author] => 3410 [post_date] => 2021-02-10 11:52:18 [post_date_gmt] => 2021-02-10 00:52:18 [post_content] => New boxed warnings for pregabalin and gabapentin give pharmacists the opportunity to discuss pain management with patients. The Therapeutic Goods Administration (TGA) announced on 1 February that medicines containing pregabalin and gabapentin will now come with boxed warnings in the Product and Consumer Medicine Information (CMI), following an investigation of ongoing misuse of pregabalin, and abuse of and dependence on both pregabalin and gabapentin. In its investigation, the TGA cited data from the National Coronial Information System, which found that pregabalin-related deaths have increased exponentially, rising from 16 in 2013 to 121 in 2016. Most of these deaths were unintentional. The warnings will serve as a guide for health professionals to screen for abuse or misuse, as well as inform patients about the risks associated with use.Gabapentinoids have been increasingly prescribed as the “non-opioid alternative” for all types of chronic pain, including non-neuropathic conditions such as non-specific lower back pain, fibromyalgia and osteoarthritis, despite there being little or no evidence for their use to treat these conditions. But even in the treatment of neuropathic pain, Ms Ellis said, gabapentinoids should be prescribed and dispensed judiciously, as much of the trial evidence is limited to those who live with post-herpetic neuralgia or diabetic peripheral neuropathy. Guidelines also recommend that patients on long-term therapy should attempt to challenge the efficacy and dose of therapy on an annual basis. ‘The benefits and risks of gabapentinoids can be a lot to unpack, and I would encourage pharmacists to use services such as a MedsCheck or Home Medicines Review,’ Ms Ellis, said. ‘Pharmacists should feel confident to discuss medicine risks and how to manage them, particularly when there is concomitant prescribing with other high-risk medicines.’ Evidence indicates that there may be up to a 49% increase in the risk of opioid overdose when combined with gabapentinoids. ‘If a pharmacist believes a patient is at risk of overdose, they should confidently discuss their concerns with the prescriber and ascertain how this risk is being managed,’ Ms Ellis said. ‘If there is no plan, pharmacists need to take a supportive approach and recommend harm minimisation strategies, such as staged supply, dose administration aids, gradual tapering plans and naloxone therapy, if combined with opioids.’
Impact on patientsAccording to Jarrod McMaugh MPS, PSA Senior Pharmacist, Consulting and past President of Chronic Pain Australia, the boxed warnings may have a particular impact on patients who inadvertently overuse pregabalin and gabapentin. [caption id="attachment_10922" align="alignleft" width="216"] Jarrod McMaugh MPS[/caption] ‘Patients who are not achieving adequate pain relief may be less likely to take an extra dose when they are made aware of the black box warning,’ he said. Despite this benefit, Mr McMaugh said some prescribers may be over cautious and see the warnings as a reason to reduce the supply of these medicines. ‘There is a risk that patients might suddenly lose access to these medicines, or they might decide to cease or reduce their use of pregabalin or gabapentin of their own accord,’ Mr McMaugh told Australian Pharmacist. ‘But as long as healthcare professionals review their patients adequately and provide a treatment plan around ceasing use, then it shouldn't be a problem. ‘It would also be useful if gabapentin and pregabalin were included in Real Time Prescription Monitoring (RTPM) programs to ensure that people at increased risk of overuse can be identified and assisted early on,’ he said. Both gabapentin and pregabalin will be incorporated in some jurisdictions’ RTPM systems, including Queensland’s QScript, which should roll out later this year.
Counselling adviceMr McMaugh said the CMI provides pharmacists with an opportunity to discuss patients’ treatment with pregabalin and gabapentin, particularly those who have just commenced use. ‘Pharmacists should inform patients that gabapentinoids are quite potent and they do have some risks associated with them,’ he said. ‘But it’s important to ensure that message is delivered appropriately without alarming the patient, which could lead to cessation.’ If patients do exhibit increased anxiety, pharmacists should reassure them that medicines prescribed for the correct indication are safe, but carry risks. ‘It's very much about allaying a patient's unnecessary fears and putting any concerns they have into perspective,’ Mr McMaugh said. ‘Pharmacists should balance the realistic harms that a patient could be exposed to against the benefits of treatment and the harms of stopping suddenly. ‘It's a matter of taking each person's case individually, and understanding what their risks are and what they are hoping to gain from treatment without lecturing them.’ If a patient is still hesitant, pharmacists should refer them to their prescriber to discuss a treatment plan for tapering to reduce any side effects associated with sudden cessation.
Efficacy of treatmentNicolette Ellis MPS, Senior Clinical Pharmacist for Beyond Pain, said pharmacists should be acutely aware that increased use of pregabalin or gabapentin does not necessarily mean the patient has a substance use disorder. [caption id="attachment_10175" align="alignright" width="220"] Nicolette Ellis MPS (right) with Beyond Pain founder Anjelo Ratnachandra[/caption] Many patients who live with chronic pain may increase their dose with the expectation that the medicine will improve their pain experience, so it’s important to start the conversation with open-ended questions, such as inquiring about how the pain might be impacting their day-to-day life or what they find beneficial about the medicine for their pain. ‘Gabapentinoids have many side effects including weight gain, peripheral edema, low mood, cognitive decline and sedation which can pose a significant barrier to improving an individual’s function, psychosocial abilities and quality of life,’ Ms Ellis told AP. ‘Up to 50% of patients taking gabapentinoids will experience adverse effects and identification of these medicine-related harms tends to be under-recognised. It’s essential that when we are having these conversations we are also screening for these symptoms.’ Ms Ellis also emphasised the importance of talking to patients about the purpose of taking a medicine for chronic pain, which is to improve their function and quality of life. ‘There should be a measurable goal in mind when patients start or continue a medicine for persistent pain, such as being able to walk for 20 minutes daily in the next 1–2 months,’ she said. Ms Ellis suggested pharmacists offer the use of validated tools to measure the benefits of their treatment, which should be selected based on the purpose of use, such as to improve their function, sleep or mood. These tools include:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12580 [post_author] => 235 [post_date] => 2021-02-10 11:33:02 [post_date_gmt] => 2021-02-10 00:33:02 [post_content] => The first government-funded training modules for the COVID-19 vaccination have been released, as federal Minister for Health Greg Hunt confirms the rollout will begin later this month. In a statement launching the training on Monday (8 February), Minister Hunt said the first modules are aimed at health professionals in hospitals who will administer the Pfizer vaccine, with modules for the AstraZeneca vaccine to come shortly. Training will include ‘all of the elements which will be critical to ensuring that vaccination occurs in a safe and effective way’, Minister Hunt said, including handling, storage, safety and surveillance. ‘[The training is] not difficult, but it’s an important step, and that includes content which is relevant to the vaccines that Australia will be using, in particular the use of what are called multi-dose vials,’ he said. ‘Instead of a single shot from one vial, what we’ll see is that there are multiple doses, six in the case of Pfizer, 10 in the case of AstraZeneca on provisional advice, subject to TGA [Therapeutic Goods Administration] approval.’ Minister Hunt said the Pfizer vaccine remains on track for a late February start, with an early March commencement for the AstraZeneca vaccine. Last week, the Federal Government called on community pharmacists to help vaccinate millions of Australians against COVID-19 from the start of Phase 2a. Expressions of interest for community pharmacists to participate close on 19 February. At a senate hearing on Friday (5 February), Secretary of the Department of Health Professor Brendan Murphy said the government expected a strong response from pharmacists, and that there would be ‘stringent conditions’ for vaccine centres. ‘We've got to be able to deliver no wastage, have the right facility and have all the right support structures,’ he said. Hope Peisley, Assistant Secretary, COVID-19 Vaccine Taskforce, Department of Health, said the aim of the expression of interest process was to ensure ‘equity and coverage across the country’. ‘The worst thing that could happen is that we have an oversupply in one area and not in another, so we need to ensure that we've equity coverage so that people can be accessing the vaccine as soon as it's available to them,’ she said. PSA General Manager Policy and Program Delivery Chris Campbell said there had been a surge in demand for immunisation training. ‘Pharmacist immunisers will be needed now more than ever, and we are seeing record numbers put up their hands to complete immunisation training before the COVID-19 vaccine arrives,’ he said. While it is important to remain up-to-date with the release of mandatory government-funded training modules, Mr Campbell said it would also be prudent for pharmacists keep an eye out for additional modules that relate to the vaccines they will be administering, in addition to the current required training for pharmacist immunisers and the newly released modules. The AstraZeneca module is expected to be released in the coming weeks. 'It is expected community pharmacists and general practice will be largely administering vaccines yet to be approved in Australia, such as the AstraZeneca vaccine,’ he said. ‘It is suggested that pharmacists complete the core modules as soon as practical, keeping in mind they will need to complete additional modules for the vaccine they will be administering. 'Pharmacist immunisers working in hospitals and across vaccine hubs as part of the Phase 1 roll out have already started completing the modules, in preparation for vaccination to start hopefully the end of February.'
Pharmacists critical to rolloutCommunity pharmacies will be ‘critical in the rollout to the wider population’ given their footprint across the country, according to the Member for the federal seat of Dobell and pharmacist Emma McBride MPS. But it is important to ensure pharmacists receive adequate remuneration for non-Pharmaceutical Benefits Scheme (PBS) services, she said in parliament last week. ‘I and many others were pleased to see the government commit $200 million to supporting the administration of COVID-19 vaccines by community pharmacists,’ she said. ‘I've undergone the training myself to be an immuniser, as have thousands of other pharmacists who are trained, prepared and ready to be part of this big nationwide effort.’ While the funding was welcome, Ms McBride said there was a clear need ‘to ensure adequate funding for services that pharmacists provide outside PBS expenditure’. ‘Pharmacists, like general practitioners and other medical professionals, are required to adhere to the strict protocols to administer the vaccine to the community,’ she said. ‘GPs are concerned around the level of remuneration, and, intuitively, pharmacists are concerned as well, particularly given that they must adhere to the same criteria and, as it stands currently, for less remuneration.’ Ms McBride also paid tribute to pharmacists across the country for their ongoing efforts during the pandemic. ‘I would like to acknowledge my fellow pharmacists, who have made a considerable contribution on the front line, staying open and offering critical services when many other primary care providers were closed – hospital pharmacists managing supply and aged-care pharmacists providing telehealth services,’ she said. ‘For many of our most vulnerable Australians who have been forced into isolation, pharmacists have often been the only health professional they've had contact with.’ More information on the COVID-19 vaccination training can be found here. [post_title] => Pfizer COVID-19 vaccine training open, AstraZeneca shortly [post_excerpt] => The first government-funded training modules for the COVID-19 vaccination have been released, as federal Minister for Health Greg Hunt confirms the rollout will begin later this month. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pfizer-covid-19-vaccine-training-open-astrazeneca-shortly [to_ping] => [pinged] => [post_modified] => 2021-02-18 12:41:44 [post_modified_gmt] => 2021-02-18 01:41:44 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12580 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pfizer COVID-19 vaccine training open, AstraZeneca shortly [title] => Pfizer COVID-19 vaccine training open, AstraZeneca shortly [href] => https://www.australianpharmacist.com.au/pfizer-covid-19-vaccine-training-open-astrazeneca-shortly/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12600 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12575 [post_author] => 3410 [post_date] => 2021-02-10 09:15:02 [post_date_gmt] => 2021-02-09 22:15:02 [post_content] => People with diabetes need to constantly monitor their diet and weight, which can lead to a difficult relationship with food. And when body image is thrown into the mix, the situation can be more problematic. A recent article from the ABC highlighted the prevalence of eating disorders in people living with diabetes, who may resort to dangerous tactics to control their weight. Credentialed diabetes educator and pharmacist Angelica Rostov MPS said that because insulin can cause weight gain, impressionable young patients with type 1 diabetes may skip or reduce their insulin without supervision – a practice dubbed “diabulimia” – or engage in self-induced vomiting to keep slim. The prevalence of underlying anxiety and depression in people with diabetes can further contribute to disordered eating, Ms Rostov said.
A lack of knowledgeIt is common for patients living with diabetes to have a skewed understanding of what healthy eating to manage their condition looks like. ‘Patients will often have their own ideas when it comes to their diet,’ Ms Rostov told Australian Pharmacist. ‘Some might think it’s best to go gluten free, which will not control their diabetes, or others will become a vegetarian, which may lead them to seek sustenance by increasing their carbohydrate intake.’ Ms Rostov said some of her patients seek dietary advice via unauthorised online sources, social media or family and friends that is not catered to their type of diabetes and can therefore impact their condition. The focus on when, what and how to eat can also influence how patients feel about food, according to the National Diabetes Services Scheme, which can lead to unhealthy fixations and skipped meals.
Pharmacist interventionMs Rostov said if a pharmacist suspects a presenting patient may have a comorbid eating disorder with their diabetes, they should initiate a conversation about their care. ‘Pharmacists can inquire whether the patient is seeing a diabetes educator, dietician, endocrinologist or GP, but it’s important not to stigmatise if they appear to be very slim,’ she said. If they are not managing their diabetes under specialist care, pharmacists could offer to refer them to their GP, or to make an appointment with a diabetes educator or dietician on their behalf. Ms Rostov said pharmacists can also emphasise the need to take insulin as advised when dispensing the medicine. ‘We try to explain to our patients that if they have continued high blood sugar levels, they risk seriously damaging their health and organs,’ she said. Directing patients to accredited online diabetes resources, such as the Baker Heart and Diabetes Institute, Diabetes Australia, or their state-run diabetes service can also provide them with some guidance for managing their diet. ‘I always say to patients, “If you want to do your own research please visit government-accredited websites”,’ Ms Rostov said. ‘Baker, for example, has fact sheets, carbohydrate-counting tools and advice from dieticians, and Diabetes Victoria has information about the different types of diabetes, along with prevention tactics, recipes, guidance around eating take away foods and exercise.’ Above all else, however, Ms Rostov said it’s important to tread lightly. ‘If you push these patients, they are unlikely to return or seek the specialist advice they need,’ she added. [post_title] => Disordered eating common in people with diabetes [post_excerpt] => People with diabetes need to constantly monitor their diet and weight, which can lead to a difficult relationship with food. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => disordered-eating-diabetes [to_ping] => [pinged] => [post_modified] => 2021-02-11 15:10:55 [post_modified_gmt] => 2021-02-11 04:10:55 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12575 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Disordered eating common in people with diabetes [title] => Disordered eating common in people with diabetes [href] => https://www.australianpharmacist.com.au/disordered-eating-diabetes/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12576 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12560 [post_author] => 3591 [post_date] => 2021-02-09 11:37:37 [post_date_gmt] => 2021-02-09 00:37:37 [post_content] => In a world of information overload, how can pharmacists prevent patients from falling into a medicine-induced downward spiral? Every day Australians swallow millions of pills without much awareness of adverse effects or drug interactions. Problems with medicines are ‘alarmingly common’, according to PSA. The biggest failing in patient safety comes ‘from ineffective communication, rather than a lack of clinical knowledge or skill’, with 250,000 hospital admissions each year for medicine-related problems.1 Yet many people assume that medicines are safe, unless told otherwise. Similarly, many pharmacists and health professionals assume consumers are confident to use medicines safely, unless they disclose pertinent information or ask questions. This clash of assumptions can lead to crucial information gaps that place patients’ health at risk.
Flying blindCommunication gaps and delays are found right across the healthcare system. Often the pharmacist must turn detective to ascertain what consumers know about their medicines – the potential harms and benefits – or if they are taking them correctly, sharing with family and friends, or stockpiling. Professor Richard Osborne, Director of the Centre for Global Health and Equity at Swinburne University of Technology, says the teach-back communication method is widely used in Australia and internationally by healthcare providers. Teach-back involves asking the patient to repeat in their own words what a healthcare provider has told them. This ‘checks and balances’ approach puts the onus on the provider to ensure consumers understand their medicines and how to take them safely, Prof Osborne says. ‘If a person can’t recount back accurately, then the healthcare provider can explain it in a different way, maybe using smaller chunks of information.’ And as Deborah Hawthorne MPS, a consultant and general practice pharmacist based in Wangaratta, Victoria, has learned when asking about drug-specific adverse effects during any sort of medicine review, it is useful to build a rapport with a patient by explaining why questions are asked and how some drugs cause certain symptoms to exhibit in the body. ‘If needed, I’ll also ask specific disease-state monitoring questions. For example: “How often do you measure your blood sugar levels at home? Would you mind showing me your book?” ‘If specific issues are identified, I like to raise these with the patient at the interview, as I believe it helps to empower patients to have greater interest in and control over their own health. It also helps to enforce that we are making a plan together, with pharmacist-doctor-patient involvement.’ Professor in Medicines Use Optimisation at the University of Sydney Parisa Aslani MPS, says consumers often accept that prescription drugs may have adverse effects but think that non-prescription and complementary medicines are safe ‘simply because they can buy them off a shelf’. ‘All medications have a risk of harm, even paracetamol,’ she says. ‘Health professionals are fully aware of the harms but consumers aren’t always.’ Every day 9 million Australians take a prescribed medicine, 2 million take non-prescription medicine, and 7 million take a complementary medicine, according to a YouGov Galaxy poll conducted for NPS MedicineWise.2 Health and wellbeing data collected in 2017 by market researcher Roy Morgan found that almost 90% of Australians had taken a medicine in the previous 12 months, with general medicines such as aspirin, paracetamol and ibuprofen the most common, followed by allergy drugs and antihistamines, cold and flu medications, vitamins, supplements and digestive system medicines.3 Prof Aslani advises School of Pharmacy students to obtain a complete picture from consumers of all their medicines. This fact-finding includes consumer awareness of adverse effects, drug interactions, drug and food interactions, allergies, and the complexities of polypharmacy, and requires the pharmacist to have the people skills of emotional intelligence, communication, teamwork and negotiation.
Words matterTime is also one of the rewards of being a consultant pharmacist, according to Deborah Hawthorne. ‘For an hour or more, we can sit with a patient and get a good feel for their health literacy and general understanding of their medicines – something not always evident in quicker interactions. Another advantage is the ability, generally when meeting a patient for the first time, to ask the most basic of questions. For example: “How many paracetamol tablets do you take on a normal day?” ‘To fully investigate patients’ medicines and disease-state understanding, my consultancy-work interviews, both in the GP clinic and in a patient’s home, follow a rough plan. I also like the conversation to be patient-led where possible, as I find a natural flow will unearth more issues than a one-sided question/answer-type interview. ‘It also allows the patient to say what they want from their medicines. For example: “I wish I didn’t have to take so many (deprescribing hint)”.‘
A patient’s perspectiveDuring a Home Medicines Review, Deborah Hawthorne discovered a patient had seen a television advertisement for [paracetamol] Panadol Rapid and had bought it hoping for relief from chronic back pain. She went through his dose administration aid and his other medicines. ‘It took quite a while to go through everything, e.g. magnesium, [paracetamol] Panadol Rapid, fexofenadine, vitamin D, [docusate] Coloxyl, [dulaglutide] Trulicity (weekly) injections, [glyceryl trinitrate] Nitrolingual Pumpspray, etc,’ the patient told AP. ‘Debbie explained the chemical compound between the [paracetamol SR] Panadol Osteo, which I take 6 a day in my Webster pack (morning, 2 pm and before bedtime), and that by taking the [paracetamol IR] Panadol Rapid it could create a problem in my liver in the near future.’ The patient immediately stopped the [paracetamol IR] Panadol Rapid, and at a later consultation with both his GP and Ms Hawthorne, his nightly temazepam was ceased and [oxycodone/naloxone CR] Targin was reduced. ‘I was advised I could become tolerant to both medications with very little benefit if taken over a long period of time,’ the patient said. ‘Deborah’s expertise and help have been tremendous.’
ILWOO PARK MPSManager, Oatlands Pharmacy, Oatlands, Tasmania Tasmania’s Early Career Pharmacist of 2020 finds the teach-back method easier, as a non-native English speaker, to check whether both her pronunciation and her explanation have been understood by her patients. When switching antidepressants, Ms Park says she explains the washout periods, how to be safe, and how many pill-free days are necessary. Then she asks: ‘Did I explain that OK?’ After a usually affirmative answer, she continues: ‘So you took the [fluoxetine] Lovan this morning. Could you tell me when you need to take this new tablet? I would like to check that I didn’t confuse you and keep you safe.’ The answer is often a smile and the response: ‘I won’t take anything for 7 days and will start this new tablet next Wednesday morning. You did well!’ On preventive inhalers for those with asthma who already use a reliever, Ms Park explains the differences between the new preventer and the current blue puffer, emphasises regular use, and demonstrates how to use it. ‘Then I ask: “Did I show you clearly? You can’t just say yes, because it’s your turn next when you show me!” Then I show them one more time.’ Ms Park then talks the patient through the correct technique. ‘So, first? Yap... yap... yes... and hold breath... and yes, what about the lid? The last step? Where’s the water?’ Some people, Ms Park says, recite each step out loud. Then she explains that the new preventer is to be used each day ‘whether you feel good or bad’, and the blue one is for breathing difficulties. She stresses the devices do not replace each other, but with more use, the preventer will mean less use of the blue puffer. ‘You will feel the difference, but not straight away. If not, please come back.’
Instead of saying . . .
Perhaps try . . .
|Do you have any questions?||What questions do you have? (An example to prompt might be: Have you ever been worried about side effects or drug interactions?)|
|Take four times each day on an empty stomach||Taking a capsule four times a day on an empty stomach can be hard to organise. Can you explain for me how you will fit this into your daily meal routine for the next 5 days?|
|Do you take any other medicines?||This tablet can cause problems with some medicines, particularly antidepressants and diabetes medicines. What other medicines do you use?|
|Have you used this medicine before?||How effective has this medicine been for you in the past? OR If you had to give this medicine a score out of 10, what would it be?|
|Take this tablet every morning||When would you usually take your medicine?|
Assumption . . .
Safer practice: Assume little to no knowledge with questions like . . .
|Assuming patients know their medicines well||Why do you use that medicine? How do you take it? What time of day? Is it every day or just when you need it? How do you remember to take it regularly?|
|Assuming adverse effects are known to the patient||Have you ever experienced muscle soreness? What was the pain like (for muscle issues with statins)?|
|Directing what should happen when specific issues are identified||You’ve taken that PPI for X amount of time, but haven’t had any reflux symptoms for Y amount of time. As long-term use of PPIs can lead potentially to vitamin B12 deficiency and an increased risk of fractures from falls, would you be open to reducing the PPI dose, making it ‘when required’ or ceasing it altogether with an antacid or H2 antagonist on hand if needed?|
|What other medicines and natural supplements do you take (of which the GP may be unaware)?||Have I forgotten to ask about other medicines you might use? What others – vitamin supplements, puffers, creams, etc – do you use? What do you use for pain, say, for a headache or sore muscles? How often do you use these products? Have you bought anything else from the pharmacy lately?|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12510 [post_author] => 235 [post_date] => 2021-02-03 11:29:36 [post_date_gmt] => 2021-02-03 00:29:36 [post_content] => Health hub locations in three states were announced this week for the Pfizer vaccine roll out, as the Federal Government calls on community pharmacists to help vaccinate millions of Australians against COVID-19 from Phase 2a. An expression of interest (EOI) process opened on Monday (1 February) to identify community pharmacists willing and able to deliver the AstraZeneca COVID-19 vaccine to immunise priority groups from Phase 2a, which is expected to begin in May. Participating pharmacies will be given supplies of the vaccine once it has been approved by the Therapeutic Goods Administration, and will receive vaccine-specific training, access to the Federal Government’s national booking system and funding for delivering vaccines. It will be the first Commonwealth-funded rollout of a national community pharmacy vaccination program. Vaccines will be provided free of charge to all Australian residents. Announcing the invitation to community pharmacies to join the nationwide effort to administer COVID-19 vaccines, Federal Minister for Health Greg Hunt described pharmacies as ‘an important partner in the rollout of COVID-19 vaccines’. ‘Utilising the existing network of thousands of community pharmacies will ensure the general population have broader access to COVID-19 vaccinations, provide choice in where the community receive a vaccine, and address barriers to access some parts of rural and regional Australia,’ Minister Hunt said. ‘Participation in the program will be voluntary and pharmacies will need to demonstrate they meet the highest safety standards and have capacity and capability to deliver COVID-19 vaccines, as well as ensuring they continue to provide important services to their local communities. These standards have been informed by the expert medical advice from the Australian Technical Advisory Group on Immunisation.’ Community pharmacist Lauren Haworth MPS from TerryWhite Chemmart Maddingly in outer Melbourne says she believes any community pharmacy with vaccination capabilities should apply. ‘This is the first time we’ve been offered government funding for this service, and I hope it’s a sign of things to come,’ she told Australian Pharmacist. ‘If we want to see this recognition of our services continue in the future, we should show we have the desire and the ability.’ The pharmacy already provides vaccinations through the NIP, and Ms Haworth said the only consideration in offering the COVID-19 vaccine would be staffing. ‘We may need to look at increasing our hours, but it’s tricky to know what the uptake will be like so we’ll have to be flexible,’ she said. ‘Those needs may also change depending on the different stages and who the vaccine is offered to at what time.’ After dealing with all the pandemic pressures, Ms Haworth said being able to offer the vaccine was an exciting end to a rough 12 months. ‘I think we’re finally seeing the light at the end of the tunnel,’ she said. ‘Any pharmacy with the capability should be applying and getting readying themselves.’
Pharmacies a 'vital link'PSA National President Associate President Chris Freeman welcomed the announcement, and said community pharmacists were a vital link in delivering the vaccination program. ‘COVID-19 has dramatically changed our lives and pharmacists have supported our community on the frontline,’ he said. ‘I am confident community pharmacists will step up to join Australia’s vaccination workforce, just as they have done throughout the coronavirus pandemic.’ Including pharmacists in the national rollout is in the public interest, A/Prof Freeman said, and will increase public access to vaccines and improve Australia’s vaccination rate. ‘At the core of every pharmacist is the innate desire to help the public and participating in the COVID-19 vaccine roll out is yet another way the profession is able to do just that,’ he added. ‘PSA will be dedicated to supporting pharmacists to deliver the COVID-19 vaccine both safely and effectively to the public.’ To qualify for the Phase 2 vaccination program, community pharmacies must:
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IntroductionElectronic prescriptions are providing Australians with convenient access to their medicines and will improve patient safety by reducing the risk of transcription errors.1 Electronic prescriptions are being rolled out across Australia and are currently available by providing a ‘token’ (see Electronic prescriptions, Australian Pharmacist, June 2020) for patients to receive access to their electronic prescription. The Active Script List (ASL), a token management solution, may help patients better manage their prescriptions, especially those who are on multiple medicines, and is expected to be implemented from early 2021 (see Box 1).
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
|Electronic prescription||A legal prescription that is wholly electronic in nature|
|Electronic Transfer of Prescription (ETP)||Involves the creation of an electronic message alongside the legal paper prescription. Upon scanning a barcode on the paper prescription, some prescription information from the PDS is downloaded to assist the pharmacy to supply the medicine. The pharmacy must have the legal paper prescription to supply the prescribed medicines|
|Active Script List (ASL)||A list displaying all active electronic prescriptions. On registration for an ASL, patients can also consent to having their existing active paper (ETP) prescriptions visible in their ASL, alongside their electronic prescriptions|
|Prescription Delivery Service (PDS)||A digital repository that houses and transmits electronic prescriptions and ETP between prescribing and dispensing|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12549 [post_author] => 216 [post_date] => 2021-02-09 03:23:57 [post_date_gmt] => 2021-02-08 16:23:57 [post_content] => Mr Jones, 87, was diagnosed with metastatic prostate cancer 12 months ago and was commenced on goserelin and bicalutamide. He completed 6 cycles of docetaxel 6 months ago. During a routine follow-up scan, bony metastases were evident, accompanied by a rising level of prostate specific antigen. Mr Jones is currently taking goserelin, bicalutamide, calcium and vitamin D, and paracetamol when required. He has no other medical history and does not take any other medicines.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
|KNOWN RISK FACTORS FOR PROSTATE CANCER|
|Family history of prostate cancer|
|Family history of breast or ovarian cancer|
|Genetic aberrations (e.g. BRACA1, BRACA2, Lynch syndrome)|
|POSSIBLE RISK FACTORS FOR PROSTATE CANCER|
|Diet (e.g. red meat, high-fat dairy)|
Support servicesMost cancer centres have pharmacists and allied health services who are always willing to help. The Prostate Cancer Foundation of Australia has information for healthcare professionals, men with prostate cancer and their families. It also has a network of affiliated support groups in every state and territory in Australia.61
Case scenario continuedToday, Mr Jones presents a script for abiraterone and prednisolone. While dispensing his script, you notice Mr Jones looking in the bowel medicines section of the pharmacy. He explains that he has just finished radiation to his lower back and is after something for diarrhoea. You exclude spinal cord compression (i.e. no weakness in his legs, no bowel incontinence and no new urinary symptoms). You suggest some loperamide, counsel him on how to take it and provide him with the eviQ ‘Diarrhoea during cancer treatment’ leaflet. Also, you counsel Mr Jones on his abiraterone and prednisolone. Mr Jones, you explain, needs to take his abiraterone once daily on an empty stomach, and the prednisolone needs to be taken with food. You provide Mr Jones with an eviQ patient handout for abiraterone and spend some time discussing this with him. He thanks you for your time.
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Case scenarioKaia is a 22-year-old student and resident of a shared university dormitory who has come into your community pharmacy complaining of ‘icky’ eyes. She mentions her roommate had the same issue last week, went to the pharmacy and it has now cleared up. On further questioning, she mentions it started yesterday and that it was a little difficult to open her eyes this morning, and describes some discomfort but not pain. You rule out other red-flag symptoms such as photophobia or vision changes and ensure she does not have symptoms suggestive of more sinister bacterial infection. Kaia is usually otherwise well (does not use corrective eyewear) but is concerned that this will affect her studies.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
|Age group||Children or adults||More often in adults||More often in children|
|Aetiology||Allergen response||Usually associated with upper respiratory tract infections and commonly caused by adenovirus||Usually caused by Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae|
|Clinical features||Usually bilateral Common symptoms include itchy and watery or mucoid discharge||Usually unilateral, often becoming bilateral within days Common symptoms include red eye, watery or mucoid discharge and irritation||Usually unilateral but can be bilateral Common symptoms include red eye, purulent discharge and eyelid crusting|
|TOPICAL EYE PREPARATION||ADVERSE DRUG REACTIONS|
|Chloramphenicol||Hypersensitivity, burning, itching, dermatitis, aplastic anaemia (rarely)|
|Framycetin||Hypersensitivity, hearing impairment (rarely)|
|Ketotifen||Hypersensitivity, headache, punctuate keratitis, corneal erosion, irritation, pain, dry mouth, rash|
|Azelastine||Hypersensitivity, bitter taste, local irritation (burning and stinging)|
|Olopatadine||Hypersensitivity, headaches, local irritation, taste perversion, rhinitis, eyelid oedema, keratitis|
|Sodium cromoglycate||Hypersensitivity, eyelid swelling, transient stinging and burning, local irritation|
|Lodoxamide||Hypersensitivity, dizziness, headache, ocular discomfort, dry eye, pruritus, ocular hyperaemia|
Case scenario continuedYou advise Kaia that she has likely contracted bacterial conjunctivitis but reassure her this is a common infection that is often self-limiting and usually resolves without treatment. As she is living in a shared space, experiencing marked purulent discharge, and has concerns over upcoming studies, you advise she can also use a course of chloramphenicol eye drops or ointment. You discuss the importance of self-care measures such as eye cleansing, and prevention strategies such as good hygiene practices, particularly in a dormitory living space. You discuss the antibiotic use, frequency, duration and when to discard the bottle, and advise her to visit the GP if symptoms do not resolve within approximately one week, or ‘red-flag’ symptoms develop. In the meantime, she is able to contact you should she need further help.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12499 [post_author] => 3566 [post_date] => 2021-02-03 10:55:10 [post_date_gmt] => 2021-02-02 23:55:10 [post_content] => This extension learning activity is designed to extend the learner and incorporate additional reading and research by the learner. Further reading and research is required from eTG, AMH, eMIMS and Stockley’s Drug Interactions.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
Extended learning activityAfter additional reading and research from recommended resources, pharmacists should be able to:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12490 [post_author] => 3566 [post_date] => 2021-02-02 11:23:04 [post_date_gmt] => 2021-02-02 00:23:04 [post_content] =>
IntroductionCystic fibrosis (CF) is an autosomal recessive disorder affecting the cystic fibrosis transmembrane conductance regulator (CFTR) gene.1 Patients with CF have a mutated gene, resulting in defective CFTR proteins causing thick mucus in multiple body systems.2 CF mainly affects the lungs and the digestive systems in the body.2 At present there is no cure for CF, so the aims of treatment are to delay disease progression with lifelong pharmacological and non-pharmacological interventions.3 CF pharmacists are involved in medicines optimisation, antimicrobial stewardship and medication counselling to improve treatment adherence.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
Extended learning activityAfter additional reading and research from recommended resources, pharmacists should be able to:
|CLASS OF MUTATION||TYPE OF CFTR PROTEIN MUTATION||DESCRIPTION OF CFTR PROTEIN MUTATION|
|I.||No functional CFTR||No functional CFTR protein is produced, resulting in no CFTR channels at the cell surface|
|II.||Defective CFTR trafficking||Misfolded CFTR proteins are produced and these fail to reach the cell surface|
|III.||Defective CFTR gating||The CFTR proteins reach the cell surface, however there is an insu"cient opening of the channel gate|
|IV.||Decreased CFTR conductance||The CFTR proteins reach the cell surface and can open; however, due to the impaired shape of the CFTR protein, reduced quantities of chloride ions can pass through the channel|
|V.||Decreased CFTR production||A reduced quantity of CFTR proteins are produced, resulting in fewer CFTR proteins at the cell surface|
|VI.||Decreased stability of CFTR||The CFTR proteins reach the cell surface; however, instability of the proteins reduces their lifespan to function correctly|
|TRADITIONAL TREATMENTS IN CF||ROLE OF TREATMENT IN CF||EXAMPLES OF TREATMENTS USED IN CF*|
|Mucus reduction (Inhaled therapies)||Osmotic agent – sodium ions draw water into the secretions resulting in thinner mucus||Sodium chloride 0.9%, hypertonic saline 6%|
|Osmotic agent – hyperosmotic, therefore draws additional fluid into secretions||Mannitol|
|Mucolytic agent – DNase enzyme slices the DNA in the mucus||Dornase alpha|
|Oral antibiotics||Anti-inflammatory in the lungs to slow decline in lung function||Azithromycin|
|Antibacterial activity against P. aeruginosa||Ciprofloxacin|
|Antibacterial activity against S. aureus||Flucloxacillin, dicloxacillin|
|Antibacterial activity against S. maltophilia||Sulfamethoxazole/trimethoprim|
|Inhaled antibiotics||Antibacterial activity against P. aeruginosa||Tobramycin Colistimethate sodium|
|Intravenous antibiotics||Antibacterial activity against P. aeruginosa||Tobramycin, ceftazidime, cefepime, piperacillin/tazobactam, aztreonam, meropenem|
|Antibacterial activity against methicillin-sensitive S. aureus||Flucloxacillin, piperacillin/tazobactam, cefepime|
|Inhaled bronchodilators||Bronchodilation of the airways||Salbutamol|
|Inhaled corticosteroids||Reduce inflammation in the airways||Budesonide, ciclesonide, fluticasone|
|Antifibrinolytic||Treat haemoptysis from excess coughing||Tranexamic acid|
|Pancreatic enzymes||Replacement enzymes to treat pancreatic insufficiency||Pancrelipase|
|Fat-soluble vitamins||Supplementation of vitamins A, D, E, K||Multivitamins with A,D,E,K|
|GORD||Alleviate symptoms of re!ux featured in GORD||Omeprazole, esomeprazole, pantoprazole, famotidine Aluminium hydroxide and magnesium carbonate|
|Vitamins and minerals||Supplementation of vitamins and minerals||Cholecalciferol, calcium, magnesium, zinc|
|Laxatives||To treat and prevent DIOS||Macrogol, lactulose, docusate with senna, bisacodyl|
|Insulin||To treat insulin insufficiency in CF-related diabetes||Multiple insulin forms|
|Bile sequestrant||Improves bile acid flow||Ursodeoxycholic acid|
|Intranasal saline||Sinus rinse to clear nasal passage||Normal saline|
|Intranasal corticosteroid||Reduce inflammation in the nasal passages from chronic sinusitis||Budesonide|
|Salt replacement||Replacing loss of salt and maintaining hydration||Sodium chloride tablets|
|CFTR MODULATOR GENERIC NAME/ BRAND NAME*||TYPE OF CFTR MUTATION||ADULT DOSAGE||CYP ENZYME INTERACTIONS||ACCESS TO MEDICATION**|
|Ivacaftor Kalydeco||Defective CFTR channel gating||Ivacaftor 150 mg 1 tablet||Ivacaftor 150 mg 1 tablet||Ivacaftor: substrate of CYP3A4/5||PBS written authority required S100|
|Lumacaftor/Ivacaftor Orkambi||Defect in CFTR tra!cking (including F508del)||Lumacaftor/ivacaftor 200 mg/125 mg 2 tablets||Lumacaftor/ Ivacaftor 200 mg/125 mg 2 tablets||Lumacaftor: strong inducer of CYP3A4/5 Ivacaftor: substrate of CYP3A4/5||PBS written authority required S100|
|Tezacaftor/Ivacaftor + Ivacaftor Symdeko||Defect in CFTR trafficking (including F508del)||Tezacaftor/ivacaftor 100 mg/150 mg 1 tablet||Ivacaftor 150 mg 1 tablet||Ivacaftor: substrate of CYP3A4/5 Tezacaftor: substrate of CYP3A4/5||PBS written authority required S100|
|Elexacaftor/Tezacaftor/ Ivacaftor + Ivacaftor Trikafta||Defect in CFTR tra!cking (including F508del)||Elexacaftor/tezacaftor/ ivacaftor 100 mg/50 mg/75 mg 2 tablets||Ivacaftor 150 mg 1 tablet||Elexacaftor: substrate of CYP3A4/5 Tezacaftor: substrate of CYP3A4/5 Ivacaftor: substrate of CYP3A4/5||Compassionate access only|
Cystic fibrosis EXTENDED LEARNING ACTIVITYThis extension learning activity is designed to extend the learner and incorporate additional reading and research by the learner. Further reading and research is required from eTG, AMH, eMIMS and Stockley’s Drug Interactions. Sarah is a 26-year-old female with this medical history:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12624 [post_author] => 235 [post_date] => 2021-02-11 07:06:50 [post_date_gmt] => 2021-02-10 20:06:50 [post_content] => A head for business and a desire to improve medicine safety inspired PSA Life Member Rob Richards to develop a digital opioid substitution therapy system that helps pharmacists and patients.
Why did you choose pharmacy as a career?It all began in 1955, with an after-school job at one of Melbourne’s most iconic pharmacies, O.J. Lawson Chemist in Fitzroy. Based on this experience, I decided on pharmacy.
Describe your career path?I qualified from the Victorian College of Pharmacy in 1964 and returned to complete the new Bachelor of Pharmacy in 1969. This allowed me to access a Master of Administration, Monash University’s forerunner to today’s Master of Business Administration. I have owned three pharmacies. The first was in partnership with Hugh Lloyd-Jones in 1966 in Temple Court, Melbourne. This was relocated to the largest CBD pharmacy site, nearby on Gurners Lane, before a horse of the same name won the Melbourne Cup [in 1982]. Later, I opened another site in the World Trade Centre [along the Yarra River]. I sold the Temple Court pharmacy in 1985 after being approached with an offer. The last pharmacy was a short ownership and renovation in South Yarra. I founded PharmaSea in 1998 with Matthew Peers, and we transitioned into creating iDose and expanding our drug addiction services at the World Trade Centre pharmacy into hospitals and prisons.
What is iDose?About one-third of pharmacies in Australia provide daily supervised dosing for opioid-dependent clients, and many still rely on manual systems for recording, measuring and delivering doses and maintaining daily administration records. We started doing opioid treatment manually and it was fairly onerous, particularly in terms of what the consequences were if you made an error. So we developed an automated, digital opioid substitution therapy system that enhances quality use of medicines. It is connected to an iris scanner and precision pump, which eliminates the risks of selecting the wrong patient or administering the wrong dose due to human interference or error. IDose was also designed with contactless dose delivery using iris recognition technology to avoid the transmission of hepatitis, E. coli, etc.
How has pharmacy evolved in your 50 years in the profession?Drug companies have exerted tremendous influence on the profession with research and development programs and have caused a move from botanical-based medicines to identifying key active [ingredients] and presenting innovative and convenient delivery regimes. I think there is also a deficiency in the pharmacy degree. Not all graduates are equipped with the business management skills to survive without guidance in a very competitive financial environment.
What advice would you give to early career pharmacists?Find a niche market in pharmacy and prepare to stand out as a leader with particular expertise in that market. If I had developed some financial and business management proficiency before completing my primary degree, it would have accelerated my pathway.
What’s important for medicine safety in 2021 and beyond?Interactions, be they drug-to-drug or drug-complementary medicines, should be a focus in the future. The consumption of handfuls of vitamins, minerals and nutriments should give way to scientifically driven solutions related to drug treatment and primary medical conditions. I have just given one big ‘niche specialty’ for young graduates.
Your thoughts on retirement?I am approaching it but am still quite active with iDose. It is important to be valued for opinions and innovations rather than putting your mind totally into ‘neutral’. A progressive reduction in the day-to-day corporate pressures is appealing. [post_title] => Software as a (community) service [post_excerpt] => A head for business and a desire to improve medicine safety inspired PSA Life Member Rob Richards to develop a digital opioid substitution therapy system that helps pharmacists and patients. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => software-as-a-community-service [to_ping] => [pinged] => [post_modified] => 2021-02-16 17:17:22 [post_modified_gmt] => 2021-02-16 06:17:22 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12624 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Software as a (community) service [title] => Software as a (community) service [href] => https://www.australianpharmacist.com.au/software-as-a-community-service/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12626 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12615 [post_author] => 235 [post_date] => 2021-02-11 06:37:44 [post_date_gmt] => 2021-02-10 19:37:44 [post_content] => Originally from Canada, science graduate Matthew Syrnyk MPS swapped his lab coat for a pharmacy jacket after moving to Australia. He finished PSA’s Intern Training Program in 2019 and hasn’t looked back.
What led you to pharmacy?I began my academic career in 2010 in Saskatchewan, Canada, when I attended the University of Regina to study a Bachelor of Science, majoring in chemistry. While I enjoyed science concepts and laboratory work, I always wanted to find a way to use my knowledge to benefit the broader community. My partner, who is now my wife, went on to move to Australia to study medicine. She suggested I exchange my laboratory coat for a pharmacy jacket, and eventually I did. I began studying pharmacy in 2015 at James Cook University in Townsville, Queensland. Fast forward to 2020, and I am a community pharmacist currently applying to become a permanent resident of Australia. I have been on a big journey so far in my pharmacy career, but I have enjoyed every single moment of the adventure.
What is your impression so far?Pharmacy is a welcoming profession. I was nervous initially about how well my introverted nature would adapt to a profession that is so community focused. I am eternally grateful for the patience of my mentors, preceptors and colleagues who have helped me develop confidence and the communication skills a community pharmacist must possess. Being an early career community pharmacist during the COVID-19 pandemic has also been challenging, as the humanity of our patients is on full display. I view this as a positive experience, as it has allowed me to become more empathetic and foster a more trusting relationship with my patients.
What did you find most useful about PSA’s Intern Training Program?It allowed me to make a seamless transition from university to community pharmacy practice. The face-to-face workshops really improved my confidence in completing the Pharmacy Board exams and helped me develop into a well-rounded community pharmacist. I also found the staff at PSA very accommodating in helping interns with their assessments and navigating the complexities of the exams. Plus there are plenty of resources available, including online access to eMIMS, eTG and the invaluable Self Care cards that help students with primary care/over-the-counter requests. There is currently free immunisation training, which will be incredibly useful in 2021, [given we now have] a vaccination for COVID-19.
What direction would you like your career to take?In 2021, I anticipate completing my Home Medicines Review Stage II accreditation course. I am also interested in working in general practice and aged care settings within Townsville, to provide medication reviews and to promote the quality use of medicines. While the clinical role of a pharmacist will always entice me, my ultimate goal is to own a service-based community pharmacy, often termed a ‘health hub’. I want to operate a pharmacy where my team can take a holistic, health solutions-based approach to patient care, and ensure that medicine safety is at the forefront of every encounter. I also hope to get into a role that allows me to advocate for pharmacists to work to their full scope of practice. I believe there should be more opportunities for vaccinations outside of the pharmacy, more minor ailments services and more prescribing opportunities similar to the recent UTIPP-Q trial. Pharmacists have a wide range of clinical knowledge, and now is the time to use this to provide more easily accessible services for patients.
What is your best advice for very new ECPs?Embrace expected changes in community pharmacy and don’t be afraid to advocate for them. There has never been a better time to begin a pharmacy career, and our patients need us now, more than ever before. These times may be challenging, but also remember that challenges are opportunities to learn, grow and develop resilience. In the end, our patients will benefit and our career prospects will be limitless.
DAY IN THE LIFE of Matthew Syrnyk MPS, pharmacist in charge, Priceline10.00 am - The day begins Handover with opening and manager pharmacists. Check multiple dose administration aids. Notice cardiology referral for a complex patient for which furosemide dose was changed, perindopril ceased and irbesartan started. Identified patient for a potential MedsCheck. 12.00 pm - Clinical intervention Peak time at the dispensary, which has an automated dispensing system. Assist by checking prescriptions and counselling/discussing medicines with patients. One patient on prazosin and silodosin complained of dizziness when standing. Noted both are from the same drug class and called patient’s doctor, who confirmed the prazosin was meant to be ceased previously. Recorded this clinical intervention and discussed a plan to wean patient off prazosin. 2.00 pm - Workflow meeting Meet with pharmacist manager to discuss workflow around introduction of electronic prescriptions. Suggest ideas including a scanner at scripts-in counter to input QR codes into MedView Flow, and to create colour-coded e-script tags that indicate the type of prescription dispensed. Patient would then be introduced to the pharmacist, who would promptly dispense prescription and educate patient on benefits of electronic prescriptions. 4.30 pm - MedsCheck and e-script training Completed MedsCheck with DAA patient (above). Patient educated about difference between ACE inhibitor and ARB, and the change in furosemide dosage. Implemented electronic prescriptions training with students and technicians on evening shift to ensure seamless transition. 7.30 pm - Irregular request At closing, a patient presented with right-sided eye pain requesting Systane eye drops for dry eye. Although tired, I noted this irregular request, with red flags including acute onset, severe eye pain and pain only in one eye for referral. Patient referred to the Townsville University Hospital Emergency Department. On return the next day, the patient thanked me for referral diligence for what turned out to be acute closed angle glaucoma.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12257 [post_author] => 3387 [post_date] => 2021-01-13 15:32:34 [post_date_gmt] => 2021-01-13 04:32:34 [post_content] => John Ware OAM FPS was an unparalleled leader in the pharmacy profession who sadly passed away on 27 December 2020 at the age of 92. John was a local, international and educational leader who was globally recognised for his work. He was both a National President of PSA and State President of the Victoria Branch, as well as President of the Western Pacific Pharmaceutical Forum and the International Pharmaceutical Federation (FIP) Foundation, where he worked as its representative to the World Health Organization, Western Pacific Regional Office. John was one of only a small number of Australians to have been awarded a Fellowship of the FIP in 2006. He was also awarded the FIP Distinguished Service Award in 2014, along with an Order of Australia for service to pharmacy education and professional development of pharmacy in the 2002 Australia Day Honours List. Right before his passing, John was also awarded the Victorian Lifetime Achievement Award by PSA. [caption id="attachment_12261" align="alignright" width="300"] PSA Victorian President John Jackson presenting John Ware OAM FPS with his Lifetime Achievement Award.[/caption] In the educational realm, John served as Chair of the Victorian College of Pharmacy and led the team that negotiated integration of the monodisciplinary College of Pharmacy into a single faculty structure of Monash University. He was subsequently Chair of the Faculty Council of the Victorian College of Pharmacy, Monash University. Professor Lisa Nissen FPS, Head of the School of Clinical Sciences at Queensland University of Technology, posted: ‘A fantastic advocate and contributor to the profession around the world. A sad day for pharmacy.’ Consultant pharmacist and rural pharmacy stalwart Karalyn Huxhagen MPS said: ‘John and his lovely wife were always ready to guide and advise us newbies. They certainly cemented their place in Australian pharmacy development.’ Mr Jackson added: ‘John has worked tirelessly and given much of his life to professional pharmacy both in Australia and internationally and leaves a huge legacy to the profession. He will be missed.’ John and his wife Nariel provided the John and Nariel Ware Fellowship in Pharmacy Education and Leadership, investing in postdoctoral research at the Faculty into leadership in pharmacy in 2019. The million dollar Fellowship is the largest grant in Australian history in the pharmacy profession. Besides these appointments, accolades and philanthropic efforts, John was an avid community pharmacist who practiced for 40 years in both rural Victoria and Melbourne after graduating from the Victorian College of Pharmacy in 1950. PSA National President Associate Professor Chris Freeman said John had demonstrated sustained dedication to the pharmacy profession and had been a driving force in the development and expansion of the role of the pharmacist in Australia. ‘On behalf of PSA I would like to pass on my deepest condolences to his wife Nariel, his family, friends and many colleagues,’ A/Prof Freeman said. PSA Victorian President John Jackson, who presented John with his recent award, spoke glowingly of his impact on the pharmacy profession. ‘John had broad interests both inside and beyond pharmacy, plus an extensive range of friends and colleagues, here and overseas. This gave him a sound foundation from which he could provide help and guidance, which he was always willing to do,’ Mr Jackson told Australian Pharmacist. ‘He epitomised the professional pharmacist, improving care especially through education, collaboration and commitment to pharmacy organisations such as PSA and FIP.’ Bill Horsfall FPS described John as a ‘fervent advocate for continuing education’. ‘Two events stand out to me over my 20 or so years working with John. One that he devised and promoted with great vigor was the then “famous” Victorian Dookie Education Conference, when state-based continuing education conferences were a rarity. The annual “Dookie Weekend” attracted many hundreds of pharmacists over the years, with the gala dinner bush dance a highlight,’ Mr Horsfall told AP. ‘The second concept he strongly supported was the Adventure Education conferences, which I, together with my PSA NSW colleague Geoff Pritchard, ran in many destinations around Australia.’ John also received numerous tributes on social media from influential figures in the profession. ‘John was one of the greats in Australian pharmacy. Always open to have a chat and share thoughts and experiences. Condolences to Nariel and family,’ posted Debbie Rigby FPS, Advanced Practice Pharmacist and past Vice-President of PSA. [embed]https://twitter.com/DrCDuggan/status/1346429181329076224[/embed] Professor Lisa Nissen FPS, Head of the School of Clinical Sciences at Queensland University of Technology, posted: ‘A fantastic advocate and contributor to the profession around the world. A sad day for pharmacy.’ Consultant pharmacist and rural pharmacy stalwart Karalyn Huxhagen MPS said: ‘John and his lovely wife were always ready to guide and advise us newbies. They certainly cemented their place in Australian pharmacy development.’ Mr Jackson added: ‘John has worked tirelessly and given much of his life to professional pharmacy both in Australia and internationally and leaves a huge legacy to the profession. He will be missed.’ Lead image credit: Monash University [post_title] => Vale John Ware OAM FPS: A life dedicated to pharmacy [post_excerpt] => John Ware OAM FPS was an unparalleled leader in the pharmacy profession who sadly passed away on 27 December 2020 at the age of 92. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => life-dedicated-to-pharmacy [to_ping] => [pinged] => [post_modified] => 2021-01-13 17:33:10 [post_modified_gmt] => 2021-01-13 06:33:10 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12257 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Vale John Ware OAM FPS: A life dedicated to pharmacy [title] => Vale John Ware OAM FPS: A life dedicated to pharmacy [href] => https://www.australianpharmacist.com.au/life-dedicated-to-pharmacy/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12266 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12176 [post_author] => 235 [post_date] => 2020-12-21 03:30:29 [post_date_gmt] => 2020-12-20 16:30:29 [post_content] => Dr Janet Sluggett MPS is a 2020 Young Tall Poppy of Science and 2017 PSA SA/NT Pharmacist of the Year whose academic research and expert witness testimony at the aged care royal commission last year resulted in recommendations and changes to the RMMR program.
What led you to pharmacy?I grew up on a farm in country South Australia and my parents always encouraged me to go to university. I did my high school placements at two local pharmacies and wanted to study something health-related. My first 2 years at university were spent studying medical and pharmaceutical biotechnology and working as a casual pharmacy assistant. I enjoyed working with patients more than being in the lab, so I applied to transfer over to the pharmacy degree. It was the right decision – plus I met Andrew, my partner of 18 years, in the elevator of the Reid Building on my way to my first pharmacy prac!
What sparked your interest in aged care?I completed my internship at Flinders Medical Centre (FMC) and stayed on thereafter. Six months into my first year as a registered pharmacist, a part-time position arose in a nearby transition care unit run by FMC and an aged care provider. It appealed to me instantly. I spent more than 2 years working parttime in the transition care unit, providing RMMRs, clinical services and participating in weekly case conferences before moving onto clinical pharmacist positions in comprehensive stroke units. The interdisciplinary team environment is what I love about clinical practice.
How did you wind up doing a PhD at the University of South Australia (UniSA)?During my final undergraduate year at UniSA, I undertook an honours project with Professor Allan Evans and that really sparked my interest in research. I flew on a plane for the first time ever to Melbourne to present my honours work at the 2005 APSA/ASCEPT conference. As much as I love working clinically, I knew deep down I wanted to undertake research training. I was excited about using big data to improve stroke management and began a PhD in stroke pharmacoepidemiology. Emeritus Professor Andy Gilbert was my inspirational PhD supervisor. We discussed quality use of medicines (QUM) nearly every week for almost 4 years. I’m so grateful for those discussions because QUM has informed all my subsequent research.
How would you describe your research?I use two main approaches. Firstly, I analyse big data to generate new evidence about medicines safety and effectiveness in older people. Being solutions-focused, my work also involves developing and testing interventions to improve medicine management in aged care and enhance pharmacy practice.
How did overseas fellowships help your research and career?I did a 6-week research visit with the University of Finland in 2018 and a 4-month Endeavour Research Fellowship with Kaiser Permanente, a large health maintenance organisation in San Diego in 2015. The Nordic countries have some of the most amazing registries, with medicine use data extending back decades. This means we can look for links between medicines use and health outcomes in real-world populations over many years. I fell in love with the United States and have made frequent trips back since. Working overseas was important to learn about different health systems, ways of living and working, and learning new research techniques.
Why are you passionate about pharmacy?I’m a quiet achiever but a strong advocate for our profession. I’m really excited about the emerging opportunities for pharmacists to practise at our full scope in aged care.
What do you find most satisfying about work, and what are your big dreams?I love the constant challenge of research. There is always a different problem to solve which often requires a new technique or approach. I also enjoy collaborations with pharmacists, students, health professionals from other disciplines or patients, and am constantly learning new things. I want my work to help make a meaningful difference. I’m looking forward to what’s on the horizon for our profession, both in aged care and other areas of practice.
DAY IN THE LIFE
of Dr Janet Sluggett MPS, Senior Research Fellow at UniSA and the South Australian Health and Medical Research Institute, Adelaide.Early am - Thinking ahead Check Outlook calendar and Trello app that I use to schedule tasks, and plan activities for the day. 9.00 am - Respond to reviewer comments Revise manuscript that examines variation in the provision of medication reviews on entry to aged care facilities and send to co-authors for feedback before resubmission to an academic journal. 11.00 am - Catch up with students Zoom meeting with PhD candidates to discuss current research projects in aged care, or with students/pharmacists wanting to undertake a research project/degree. 1.00 pm - Planning new projects Meet with aged care collaborators from the Registry of Senior Australians to discuss our new MRFF-funded project to examine primary care provision in aged care recipients. Busy planning projects to examine links between primary care service use, medicines use and health outcomes. 2.00 pm - Data analysis Use a statistical software package to analyse national data to uncover new information about medicines use and provision of medication reviews in aged care. In between, chat with a colleague about some new findings and the best way to present these in a report. 4.00 pm - Presentation preparation Quickly submit a bio and abstract for a presentation at an upcoming virtual conference, then work on PowerPoint slides for a talk later in the week on quality use of medicines in aged care facilities. 5.30 pm - Heading home Head home for a run then spend time with family. 8.00 pm - Homework Try to keep evenings work-free but sometimes read emails, board papers or peer-review manuscripts. This particular week I give a medicines safety presentation at a community event one night, and grant application feedback to a colleague on another, but have a few nights off too!
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 12172 [post_author] => 235 [post_date] => 2020-12-21 02:55:16 [post_date_gmt] => 2020-12-20 15:55:16 [post_content] => A desire to be his own boss set PSA Life Member Richard Edwards on the path to pharmacy ownership. The gamble paid off, with 43 years in business at his Melbourne pharmacy and no sign of slowing down.
What attracted you to a career in community pharmacy?My father was a doctor who came through the depression in the 1930s, so he saw firsthand the devastating effect of thousands of people losing their jobs. He did not care what career I followed, but was very big on the fact that if I could be my own boss I would be able to control my future and would always have a job. Pharmacy provided this pathway and, being part of a family working in health, it seemed an attractive career. I did toy briefly with engineering, but the attraction of being my own boss held sway.
Can you describe your path to pharmacy ownership?I completed my degree at the Victorian Pharmacy College in 1968 and spent my first year out as a locum pharmacist travelling around Melbourne with some stints in the country. This proved to be a great learning period. In 1969 I was offered the chance to start and manage the opening of the pharmacy at Monash University for the Friendly Societies of Victoria. I did this for about 10 months before heading to the United Kingdom for 2 years, where I travelled and worked in hospital and community pharmacies in London. This was another great work experience. After returning to Melbourne, I worked in a community pharmacy for 4 years, before deciding I would like to run my own business. A good mate of mine (and fellow pharmacist) Ed Johnson suggested Narre Warren as a good place to look, and I took the plunge in 1977. Ed’s prediction was correct, and 43 years later I’m still there as a part-owner along with one of my daughters, Rebecca, and Peter, one of Ed’s sons. We own two pharmacies in the area. They (the kids) run the show and I help fill in and do a fair bit of administration.
How has pharmacy evolved since you started out 5 decades ago?The biggest evolution has been the advancement of technology, starting with the simple machines used to process prescriptions in the 1980s, up to today with our much more advanced computers with connections to the Department of Health and Human Services, wholesalers, service providers, doctors and consumers. I need to be in partnership with young people to understand all the computer programs and apps. Legal changes over the journey have also been significant. For example, the new rules around codeine sales. The thing that hasn’t changed is the community service we provide. I firmly believe if you provide great service the rewards will follow.
Your advice for young pharmacists?Get as much experience as possible in as many fields as possible. The pharmacy industry offers a much larger number of careers now, be it in community, hospital, education or corporate roles. If you wish to go into community pharmacy as an owner, I think the days of opening a greenfield site are very limited with all the restrictions now in place. Getting involved in partnerships in existing businesses is the way to go because it gives you much more flexibility and support.
Thoughts on retirement?I am well known for saying retirement is overrated. I have retired or semi-retired twice, but I like to keep active and keep my mind working, and being a part-owner helps with this. I can still get away and travel whenever I want to (post-pandemic), but wondering how to fill in my day does not appeal to me.
What do you see as important for medicine safety in 2021 and beyond?Medicine safety is a huge issue and I am pleased to see various professional bodies are embracing the topic. In the future, I would like to have even better communication and co-operation between doctors, hospitals, pharmacists and allied health professionals, as they all have a significant role to play. It is getting better but there is still room for improvement. [post_title] => Building a community business [post_excerpt] => A desire to be his own boss set PSA Life Member Richard Edwards on the path to pharmacy ownership in Melbourne. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => building-a-community-business [to_ping] => [pinged] => [post_modified] => 2021-01-12 13:30:36 [post_modified_gmt] => 2021-01-12 02:30:36 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=12172 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Building a community business [title] => Building a community business [href] => https://www.australianpharmacist.com.au/building-a-community-business/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 12173 )
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.