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AUSTRALIAN PHARMACIST
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    • Dr Ross Holland
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                  [post_content] => Australian and indeed international pharmacy has lost one of its true servants and pharmacy practice innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025) in Louisville Colorado, USA.
      
      Ross completed his pharmacy training in the late 1950s via the old apprenticeship and materia medica-based course at University of Sydney while working at Hallam’s ‘Chemists to Sydney since 1883’ Pharmacy in Pitt Street (with another of our pharmacy innovators Ted Crook of Chemdata fame) before moving to the Hunter Street Branch, and then managing the King’s Cross premises. 
      
      His early desire to make things better and easier for pharmacists in the practice of their profession saw Ross develop a unique algorithm-based stock control system to use in these pharmacies.
      
      This desire for improvement both professionally and personally saw him become closely involved with both hospital pharmacy and higher learning, resulting in his doctorates in educational training and development areas. How he applied this knowledge to the pharmacy sector, especially community pharmacy, created the basis of his lifelong commitment to the improvement of pharmacy practice – both in Australia and internationally.  
      
      His completion of the Society of Hospital Pharmacists of Australia Fellowship program kindled the flame of how this model could be applied to community pharmacy which, with the support of PSA led to the formation of the Australian College of Pharmacy Practice (ACPP) – with Ross being its ‘founding father’, Registrar and Dean. That the College will once again be back under the aegis of PSA was welcome news to Ross in his last days.
      
      [caption id="attachment_29498" align="aligncenter" width="500"] L-R: Col (Rtd) Bill Kelly FPS, Dr Ross Holland AM FPS, Warwick Plunkett FPS and Peter Carroll FPS[/caption]
      
      Ross’s vision of community pharmacists being able to undertake postgraduate studies in their chosen area of practice through distance learning created a wonderful opportunity undertaken by many in subsequent years, who were awarded Graduate Diplomas after having been subjected to the dreaded ‘Ross’s green pen’ marking comments.
      
      The advent of remunerated medication reviews for pharmacists in Australia again saw Ross and ACPP come to the fore with specially developed training and education support programs. Likewise, the introduction and development of pharmaceutical care further cemented in place Ross’s vision of the expanded and rightful role of pharmacists in patient care – an area in which he contributed to extensively both nationally and internationally. 
      
      A prolific writer, Ross authored books on pharmacology and drug information, a wonderful series of journal articles (with his wife Christine) in the American Society of Health Systems Pharmacy journal on Transitions in Pharmacy Practice, as well as reviewing and editing numerous other works. His excellent work When to Refer published by PSA in 1999 was prescient – given that Australian pharmacists are now embracing a wider scope of practice.
      
      Ross’s foray into the world of international pharmacy through both the International Federation of Pharmacy (FIP) and the Federation of Asian Pharmaceutical Associations (FAPA) saw his extensive contribution recognised with the awarding of his FIP Fellowship (2007) and the FAPA Ishidate Award (1988). His international training and development experience was also utilised to good effect with his involvement in Australian Government health-related aid programs in several South Pacific nations.  He was also a past faculty member of the World Health Organization Regional Teacher Training Program, contributing to the development of clinical pharmacy in South Korea.
      
      In recognition of his significant service to pharmacy practice, medical education and professional organisations, Ross was appointed a Member of the Order of Australia (AM) in 2019 and was also made a Life Fellow of PSA – reflecting his enduring impact on the profession.
      
      Ross was a true visionary in pharmacy and today’s pharmacists are benefitting greatly from his vision, energy and love of the profession to earn its rightful place in the delivery of patient care. 
      
      Ross is survived by his current wife, Christine, and children from his first marriage, Frederick, Adrienne, and Christopher. Ross is preceded in death by his first wife, Rosalind (Dec. 2001).
      
      He leaves grandchildren and great grandchildren in Australia, an extended family in the US, and many loving friends, both within and outside of pharmacy.
                  [post_title] => Vale Dr Ross William Holland AM FPS
                  [post_excerpt] => Pharmacy has lost one of its true servants and  innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025).
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          [title_attribute] => Vale Dr Ross William Holland AM FPS
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      Vale Dr Ross William Holland AM FPS

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                  [post_content] => It’s no secret that Australia is bracing for one of the most intense influenza seasons in recent memory, with confirmed case numbers already reaching 89,165. And it’s not even winter yet – when influenza cases really start to take off.
      
      Alarmingly, influenza vaccination is also at its lowest in some time, particularly among young children. 
      
      According to Dr Anthea Rhodes, paediatrician and Director of the Royal Children’s Hospital National Child Health Poll, the convergence of early flu activity and low vaccination rates is creating a perfect storm for severe illness and hospitalisation.
      
      ‘We were really struck, in the latest National Child Health Poll, how much confusion there still is among parents about whether or not it's recommended for kids [and] whether or not it's worthwhile,’ said Dr Rhodes on 774 ABC Radio Melbourne.
      

      Why are the vaccination rates so low?

      There has been an uptick in the number of children hospitalised for influenza in Victoria, Dr Rhodes said. But one of the most troubling revelations this season is the low rate of flu vaccination among children under 5 years of age, with just 13.9% of children in this age cohort receiving the vaccine. ‘As a community, we still think about flu as being an older person's illness,’ she said. ‘But in fact, younger kids, between 6 months and 5 years are the group second most likely to be hospitalised … with complications of flu.’
      ONLY 3.9% of children < 5 years are up to date with flu vaccination.  
      Those complications include pneumonia –  one of the leading causes of hospitalisation among Australian children. Worryingly, many parents still view influenza as a mild illness in otherwise healthy kids, a perception Dr Rhodes says is both outdated and dangerous. ‘A third of parent respondents to the … poll indicated that they weren't aware that healthy kids can [get] seriously unwell from influenza,’ she said. ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.’ Compounding the problem is a widespread misunderstanding about the need for annual vaccination. ‘Because the flu virus … keeps changing and moving around the world, we have to have a vaccine each year to get the best match for the strain that's in the community,’ Dr Rhodes said. ‘And people aren't aware of that.’ The National Child Health Poll also uncovered psychological barriers to vaccination, with rising rates of needle phobia among children. ‘We found that in children over 4, nearly a quarter are described as having a severe fear of needles, and 13% had parents tell us that’s the reason why they couldn't have the flu vaccine,’ Dr Rhodes said.
      ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.' DR ANTHEA RHODES
      This fear often stems from a combination of anxiety and early negative experiences, such as those during the COVID-19 vaccine rollout. ‘Not everyone had a positive experience, [so] what we're seeing now is some of those kids coming back really fearful and avoiding having other vaccinations.’

      Filling in childhood vaccination gaps

      There is a naivety about the difference between a cold and the flu, said Karen Brown MPS, pharmacist at TerryWhite Chemmart in Arana Hills, Brisbane who regularly administers influenza vaccines to children 6 months and older. [caption id="attachment_29505" align="alignright" width="234"] Karen Brown MPS[/caption] ‘Even if they don't get sick enough to go to hospital, that parent doesn't have time to have a week off work to care for their child,’ she said. While there has consistently been a focus on herd immunity and protecting those most vulnerable, the cost of living pressures has brought a new variable to the equation. ‘It’s always been about protecting grandma and grandpa, but now they realise, particularly if they know people who have had influenza, that if you have a really sick child for a week, it has a huge impact on your life.’ Ms Brown has been at the forefront of paediatric flu vaccination ever since Queensland allowed pharmacists to administer the vaccine to young children. Her pharmacy has become a trusted destination for families due to its clear messaging and consistent availability. ‘We know what we're doing. We do every age group. There's no ‘will they won't they?’ They just know 7 days a week that they can walk in,’ Ms Brown said. ‘They know we'll always have the stock, we know the rules and the regulations, and they can walk in after school. We make it a really simple process.’ While infants and toddlers are a ‘piece of cake’ primary-school-aged children can be more challenging. ‘They know what's going on and they've got an opinion,’ she said. But Brown and her team use a combination of humour, distraction and engagement to ease anxiety, with the pharmacy’s  vaccination room decorated with caricatures of staff in a ‘Where’s Wally’-style poster to amuse their young patients ‘We’ll say to the kids, “Will I vaccinate you quicker than it takes for you to find my face?”’ she said. Engaging children on their level is also crucial. “If they walk in with a superhero shirt on, you can say, “Who's your favourite superhero? What would Spider-Man do?’” she said.

      Tackling rising needlephobia among children

      While needlephobia is growing in prominence, there are ways to address, said Ms Brown – citing an example of a 6-year-old boy who was diagnosed with leukaemia 12 months earlier. ‘His mum gave us the heads up and said he is petrified of needles as a result of getting lots of chemo,’ she said. In such cases, the key is to empower the child. ‘We said, “this is how it’s going to feel compared to having blood taken or having an infusion”. He also understood how important it was for him to get vaccinated to protect his immune system.’ Post-vaccination, it’s important to debrief with the child to prime them for the next time around.  [caption id="attachment_17706" align="aligncenter" width="500"] Children after receiving their vaccinations at TerryWhite Chemmart Arana Hills, Brisbane. (Image: Karen Brown MPS)[/caption] ‘For example, you could say “remember for next time that you didn’t even feel me do it, and it’s not as bad as you thought”.’

      Building trust and long-term loyalty

      Childhood vaccination can be a powerful tool for pharmacies to build community trust. ‘That vaccine experience is a very good way to breed loyalty,’ Ms Brown said. ‘They will be customers of yours ongoing.’
      ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.' karen brown MPS 
      For hesitant pharmacists, she recommends administering your first vaccination to a child you’re familiar with – whether a family friend, someone from the local sporting club or a staff member’s child. ‘It’s almost like a trial,’ she said. ‘For example with COVID-19 vaccinations during the pandemic, my kids who were 7 and 8 years old at the time brought all their friends in, so they all did it together.’ And from there, it just gets easier. ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.’ There are several session dedicated to vaccination at PSA25, held in Sydney from 1–3 August. Register here to attend. [post_title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [post_excerpt] => Why this paediatrician is speaking out about low childhood vaccination rates as more kids become hospitalised. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician [to_ping] => [pinged] => [post_modified] => 2025-05-28 18:02:31 [post_modified_gmt] => 2025-05-28 08:02:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29491 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [href] => https://www.australianpharmacist.com.au/get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29497 [authorType] => )

      ‘Get the flu vaccine for your kids as soon as you…

      Vietnam
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                  [post_content] => Good morning, Vietnam!
      
      It was the late, great Robin Williams who immortalised the “good morning, Vietnam” phrase from the 1987 film of the same name. But 38 years later at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025, it was the mornings, afternoons and evenings that truly lived up to the greeting.
      
      Certainly, no surprise; the same successful format initiated at the first Offshore Refresher Course in 1977 has been continued – education each day from 8.30 am to 1.00 pm, then cultural activities, tours and social events.
      
      The Vietnam safari began in Hạ Long Bay, then to Hanoi, Hoi An and on to Ho Chi Min City. There were ‘Hs’ in abundance, although most of the locals still call Ho Chi Min City Saigon.
      
      This year, there were 37 hours of lectures and workshops in six locations – including the post-conference tour to Cambodia. Our four principal speakers were all experienced and popular Offshore Refresher Course presenters: Bruce Annabel (business management), Dr Phillip Artemi (dermatology), Dr Terri Foran (women’s health) and Dr Sepehr Shakib (pharmacology).
      
      And what social events! A highlight this year was the Vietnamese-themed dinner with apparently no time or expense spared by delegates to dress for the occasion. Of course, there was no shortage of tailor shops around town that could run up traditional men’s and women’s outfits in less than 24 hours.
      
      This kind of learning sure can be fun, but there’s plenty of hard work for the delegates as well. Many continue to deliberate long after the education sessions are over for the day – just to ensure they get correct answers to the questions in the ‘Jack Thomas Quiz’. The winner’s name engraved on the perpetual trophy is an incentive; and so is maximising your CPD points for the year.
      
      This year saw one of the closest Jack Thomas Quiz contests in Refresher Course history. Of
      the over 150 responses to the 75-question quiz, six delegates finished with a score of 97% – and placegetters were separated only by assessment of the written case study. First prize
      went to Johanna Bou-Samra, who works as Indigenous Outcomes Pharmacist with
      Queensland Health. Meredith Bell and former Jack Thomas Quiz winner Louise Braddock were joint runners-up.
      
      Skin has been a big thing at the conference this year – well, it is our biggest organ. Dermatology is a major part of our extended practice, so expertise in this area will help us take advantage of new opportunities. However, don’t despair if you missed out on the Offshore Refresher Course this year. Dr Phillip Artemi will also have a cameo role as part of the speaking faculty next year.
      
      Planning to attend the next Offshore Refresher Course? You should, and you should act now.
      
      Next year we celebrate the 50th Offshore Refresher Course in a very special way. The main conference in Japan will be on the luxury cruise ship Crystal Symphony. Bookings are filling fast, and we can’t take more than our cabin allocation will allow.
      
      So, it’s sayonara Saigon; Tokyo here we come.
      
      Find out more about what’s instore for 50th Offshore Refresher Course in Tokyo here.
                  [post_title] => PSA's Offshore Refresher wraps with style, and tailor-made outfits
                  [post_excerpt] => Clothes, culture and clinical learnings were in abundance at at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025.
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          [title_attribute] => PSA’s Offshore Refresher wraps with style, and tailor-made outfits
          [title] => PSA’s Offshore Refresher wraps with style, and tailor-made outfits
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      PSA’s Offshore Refresher wraps with style, and tailor-made outfits

      ACOP
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                  [post_content] => Since new cut-off dates were announced for pharmacists to comply with updating credentialing requirements, queries to PSA’s Pharmacist to Pharmacist Advice Line have surged.
      
      Here’s a round up of your top questions, answered.
      

      1. Why do I need to transition to a new credentialing system?

      After the Australian Association of Consultant Pharmacy (AACP) ceased operations in 2022, the Australian Pharmacy Council (APC) was charged with developing updated accreditation standards for Medication Management Review (MMR) and Aged Care pharmacist services. This process yielded two new credentials – the MMR Credential and the Aged Care On-site Pharmacist (ACOP) Credential. All pharmacists, whether originally accredited by the AACP or by another provider since its closure, must now transition to these new credentials. The primary change is the separation of MMR and ACOP into distinct credentials, each mandating dedicated training for pharmacists, said Bill Wallace MPS, PSA Pharmacist – Professional Support Adviser, who supports PSA members through the Pharmacist to Pharmacist Advice Line. ‘Those with prior experience in either area may apply for Recognition of Prior Learning (RPL) to receive credit toward their new credential(s), while others will need to complete additional education to fulfil the updated requirements,’ he said.

      2. How do I apply for MMR recognition of prior learning?

      Pharmacists who were accredited by AACP, PSA or ACP can submit proof of initial accreditation along with additional evidence as outlined in PSA’s RPL course page, Mr Wallace said. The performance outcomes not assessed by prior study are those relating to cultural competence (1.1) and individual quality improvement activities (4.2).  Examples of appropriate evidence to submit include:  
      • 1.1  – completing the free Deadly pharmacists foundation training course
      • 4.2 – establishing a personal quality-improvement plan that incorporates reflective practice or participation in a peer-review forum to receive feedback on your MMR work.

      3. What credentialing pathway do I need to take to work as an Aged Care Onsite Pharmacist?

      To work as an Aged Care Onsite Pharmacist , pharmacists need to have completed the MMR course and complete one of the following before 30 June 2026:
      • an ACOP credentialing course through PSA or other provider
      • the ACOP RPL process.
      ‘The ACOP RPL process is more comprehensive than the MMR RPL process, requiring the development of a detailed portfolio of evidence to demonstrate competency against each of the performance outcomes set by the APC,’ Mr Wallace said. Examples of ACOP performance competencies include:
      • Collaborative Practice: producing clear and concise clinical documentation using standardised communication tools and according to the RACF’s systems and preferences
      • Safe and Quality Use of Medicines: participating in the implementation and maintenance of clinical-governance systems to improve medicines-related safety and quality

      4. What’s the new deadline for transition arrangements for the MMR and ACOP credentials?

      From 1 January 2026, all MMR-credentialled pharmacists who wish to continue claiming for Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) services, or to participate in the ACOP Measure under transition arrangements must comply with the APC’s MMR standards.

      Medication Management Reviews

      The transition period for MMRs has been extended to 31 December 2025. The Department of Health and Aged Care has confirmed that there will be no further extensions.  This extension gives MMR-credentialed pharmacists additional time to complete an APC-accredited RPL or approved training program. The following MRNs will remain valid until 31 December 2025, or until they are replaced by an updated MRN issued upon completion of an APC-accredited RPL or training program, whichever comes first:
      • AACP MRNs held as of 31 December 2022 (i.e. those active and not lapsed before that date)
      • PSA MRNs
      • ACP MRNs
      • Advanced Pharmacy Australia (formerly SHPA) MRNs.

      ACOP Measure

      The ACOP Measure transition period has been extended until 30 June 2026. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date, provided they complete an APC-accredited ACOP training program by 30 June 2026. ‘If an MMR-credentialed pharmacist transfers to a different training provider and is issued a new MRN, they must use the new MRN when claiming HMRs/RMMRs or when participating in the ACOP Measure,’ Mr Wallace added.

      5. When do I need to get my RPL applications in by?

      Pharmacists should be looking at completing the RPL process prior to the extension deadlines, Mr Wallace said.  ‘The RPL process requires an assessor to examine the submitted evidence and provide feedback if required,’ he said.  ‘This process may take up to 4 weeks if there is no extra information or resubmission required.’ To ensure uninterrupted provision of medication review services, RPL evidence should be submitted at least 2 months prior to the deadline.

      6. Does RPL still count if I don’t meet the deadline?

      If pharmacists miss the deadline, they will lose eligibility to deliver medicine reviews and be unable to claim services under the Pharmacy Programs Administrator programs. In other words, you won’t get paid for services. ‘Pharmacists  can still apply for RPL, but if they do not meet the criteria for the RPL they may need to complete the full training program to regain the MMR credential,’ Mr Wallace said.

      7. How long does it take to become credentialed and what’s involved?

      For pharmacists who are working and have other commitments, completing both training programs takes roughly 6–12 months, Mr Wallace said. ‘If a pharmacist has more time to invest, it could be completed in 3–6 months,’ he said. ‘Assessors have up to 4 weeks to assess written submissions.’ The MMR Credential course is organised into four structured modules that progressively develop key competencies in medication reviews.  ‘Learners are evaluated through multiple-choice quizzes to verify understanding, a reflective exercise on providing culturally safe and inclusive care, and a peer-led discussion analysing an MMR report,’ he said. ‘They also participate in an AI-driven simulated patient encounter to practise medication history taking, and undertake a live online Objective Structured Interview to showcase their practical skills.’  The course also features a quality-improvement assignment, in which participants are required to review relevant policies and reflect on their own practice to drive ongoing enhancement. Meanwhile, the four-module ACOP credential course builds on the MMR Credential framework and begins with a similar assessment process. The course includes a supervised site visit to a residential aged-care facility, during which participants observe care delivery and critically reflect on both the environment and service quality, Mr Wallace said. ‘The course further incorporates a case-conference simulation; learners view a recorded interdisciplinary meeting and appraise their prospective roles and contributions,’ he said. ‘Then, a quality-improvement project tasks participants with conducting clinical audits and preparing governance reports to foster ongoing enhancements in aged-care settings.’ For advice on all things pharmacy, ring PSA’s Pharmacist-to-Pharmacist Advice Line between 8.30am to 5.00pm AEST on 1300 369 772. [post_title] => Countdown to new MMR and ACOP credential deadline [post_excerpt] => PSA's advice line has been flooded with questions from credentialed pharmacists on how to apply for MMR and ACOP recognition. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => countdown-to-new-mmr-and-acop-credential-deadline [to_ping] => [pinged] => [post_modified] => 2025-05-27 09:22:29 [post_modified_gmt] => 2025-05-26 23:22:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29462 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Countdown to new MMR and ACOP credential deadline [title] => Countdown to new MMR and ACOP credential deadline [href] => https://www.australianpharmacist.com.au/countdown-to-new-mmr-and-acop-credential-deadline/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29463 [authorType] => )

      Countdown to new MMR and ACOP credential deadline

      risperidone
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                  [post_content] => The Therapeutic Goods Administration (TGA) has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18.
      
      In 2024 alone, 22 adverse events as a result of overdose of risperidone oral solution were reported to the TGA – most cases involved accidental administration of 10 times the prescribed dose (for example, 5 mL instead of 0.5 mL). 
      
      Although no deaths were recorded, adverse effects led to hospitalisations in most cases.
      

      Why are dosing errors occurring?

      An investigation by the TGA unearthed several drivers for dosing errors of risperidone oral solution including:
      • misinterpreting dosing instructions
      • incorrect use of the dosing syringe
      • medicine administration by non-primary caregivers (e.g. babysitters or other relatives).
      And the TGA is not the only national health agency to raise concerns about risperidone dosing confusion. The Spanish Agency for Medicines and Health Products issued a public alert after discovering that paediatric caregivers misread decimal points when administering a dose of 1 mg/mL risperidone solution, often inadvertently giving ten times the intended dose. Most (74%) of these incidents were serious, with children suffering sedation, hypotension, tachycardia, extrapyramidal symptoms, QT prolongation and, in some cases, seizures. In Ireland, the Health Products Regulatory Authority echoed these concerns, reporting ten‐fold overdoses in children aged 3–15 –  urging prescribers and pharmacists to provide clear dosing-device instructions and educate caregivers on recognising and responding to overdose symptoms.

      What’s changing?

      To address the identified risk, the Product Information (PI) and Consumer Medicines Information (CMI) for Risperdal have been revised, and generic manufacturers are now required to update PIs and CMIs to mirror these changes. The new versions for Risperdal include more detailed dosing guidance and illustrative diagrams to support accurate administration including:
      • use the supplied pipette only: do not substitute with another measuring device
      • open the child-resistant cap: push down on the plastic screw cap and turn counter-clockwise, then lift off
      • insert and draw up dose: place the pipette in the bottle; hold the bottom ring and pull up the top ring to the mark matching the prescribed dose (e.g. 0.25 mL for 0.25 mg, 0.5 mL for 0.5 mg)
      • dose equivalence: 1 mL of Risperdal solution = 1 mg risperidone; graduations on the plunger are in 0.25 mL (0.25 mg) increments
      • administer in a drink: remove the pipette, slide the top ring down to expel the dose into a non-alcoholic beverage (e.g. water, juice, milk, coffee – avoid tea)
      • after use: close the bottle; rinse the pipette with cold water, let it air dry in its case; avoid detergents or vigorous wiping to preserve the printed graduations.
      While each generic product should cover the same key details, the syringe and instructions can vary by brand. So pharmacists are advised to always double-check the individual PIs.

      What do pharmacists need to do?

      Dosing instructions need to be clearly printed on the label. According to the Australian Commission on Safety and Quality in Health Care’s National standard for labelling dispensed medicines (Standard 6), label wording  should:
      • have digits for dosage amounts (e.g. ‘Take 1 tablet,’ not ‘Take one tablet’ or ‘Take ONE tablet’)
      • express dose ranges with words between numbers (e.g. ‘1 to 2,’ not ‘1-2’ which could be read as ‘12’)
      • spell out common fractions to avoid confusion (e.g. ‘quarter,’ not ‘0.25’ or ‘¼’)
      • for small paediatric liquid doses, match the numbers on the oral dispenser (e.g. ‘0.5 mL’).
      Presenting numbers as digits generally improves clarity among patients. However, fractions written symbolically (e.g. ½’) may be misread as ‘1 or 2’ and decimal points can be overlooked (e.g. ‘1.5’ read as ‘15’). That’s why, when counselling patients prescribed risperidone oral solution, pharmacists should:
      • verify that all caregivers understand the prescribed dosing regimen
      • demonstrate precisely how to measure the required volume using the provided oral syringe
      • instruct caregivers to review the dosing label before each administration and confirm their understanding, especially with those administering the medicine for the first time.
      [post_title] => Paediatric risperidone errors prompt TGA safety update [post_excerpt] => The TGA has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => paediatric-risperidone-errors-prompt-tga-safety-update [to_ping] => [pinged] => [post_modified] => 2025-05-21 15:02:24 [post_modified_gmt] => 2025-05-21 05:02:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29429 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Paediatric risperidone errors prompt TGA safety update [title] => Paediatric risperidone errors prompt TGA safety update [href] => https://www.australianpharmacist.com.au/paediatric-risperidone-errors-prompt-tga-safety-update/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29433 [authorType] => )

      Paediatric risperidone errors prompt TGA safety update

  • Clinical
    • Dr Ross Holland
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                  [post_content] => Australian and indeed international pharmacy has lost one of its true servants and pharmacy practice innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025) in Louisville Colorado, USA.
      
      Ross completed his pharmacy training in the late 1950s via the old apprenticeship and materia medica-based course at University of Sydney while working at Hallam’s ‘Chemists to Sydney since 1883’ Pharmacy in Pitt Street (with another of our pharmacy innovators Ted Crook of Chemdata fame) before moving to the Hunter Street Branch, and then managing the King’s Cross premises. 
      
      His early desire to make things better and easier for pharmacists in the practice of their profession saw Ross develop a unique algorithm-based stock control system to use in these pharmacies.
      
      This desire for improvement both professionally and personally saw him become closely involved with both hospital pharmacy and higher learning, resulting in his doctorates in educational training and development areas. How he applied this knowledge to the pharmacy sector, especially community pharmacy, created the basis of his lifelong commitment to the improvement of pharmacy practice – both in Australia and internationally.  
      
      His completion of the Society of Hospital Pharmacists of Australia Fellowship program kindled the flame of how this model could be applied to community pharmacy which, with the support of PSA led to the formation of the Australian College of Pharmacy Practice (ACPP) – with Ross being its ‘founding father’, Registrar and Dean. That the College will once again be back under the aegis of PSA was welcome news to Ross in his last days.
      
      [caption id="attachment_29498" align="aligncenter" width="500"] L-R: Col (Rtd) Bill Kelly FPS, Dr Ross Holland AM FPS, Warwick Plunkett FPS and Peter Carroll FPS[/caption]
      
      Ross’s vision of community pharmacists being able to undertake postgraduate studies in their chosen area of practice through distance learning created a wonderful opportunity undertaken by many in subsequent years, who were awarded Graduate Diplomas after having been subjected to the dreaded ‘Ross’s green pen’ marking comments.
      
      The advent of remunerated medication reviews for pharmacists in Australia again saw Ross and ACPP come to the fore with specially developed training and education support programs. Likewise, the introduction and development of pharmaceutical care further cemented in place Ross’s vision of the expanded and rightful role of pharmacists in patient care – an area in which he contributed to extensively both nationally and internationally. 
      
      A prolific writer, Ross authored books on pharmacology and drug information, a wonderful series of journal articles (with his wife Christine) in the American Society of Health Systems Pharmacy journal on Transitions in Pharmacy Practice, as well as reviewing and editing numerous other works. His excellent work When to Refer published by PSA in 1999 was prescient – given that Australian pharmacists are now embracing a wider scope of practice.
      
      Ross’s foray into the world of international pharmacy through both the International Federation of Pharmacy (FIP) and the Federation of Asian Pharmaceutical Associations (FAPA) saw his extensive contribution recognised with the awarding of his FIP Fellowship (2007) and the FAPA Ishidate Award (1988). His international training and development experience was also utilised to good effect with his involvement in Australian Government health-related aid programs in several South Pacific nations.  He was also a past faculty member of the World Health Organization Regional Teacher Training Program, contributing to the development of clinical pharmacy in South Korea.
      
      In recognition of his significant service to pharmacy practice, medical education and professional organisations, Ross was appointed a Member of the Order of Australia (AM) in 2019 and was also made a Life Fellow of PSA – reflecting his enduring impact on the profession.
      
      Ross was a true visionary in pharmacy and today’s pharmacists are benefitting greatly from his vision, energy and love of the profession to earn its rightful place in the delivery of patient care. 
      
      Ross is survived by his current wife, Christine, and children from his first marriage, Frederick, Adrienne, and Christopher. Ross is preceded in death by his first wife, Rosalind (Dec. 2001).
      
      He leaves grandchildren and great grandchildren in Australia, an extended family in the US, and many loving friends, both within and outside of pharmacy.
                  [post_title] => Vale Dr Ross William Holland AM FPS
                  [post_excerpt] => Pharmacy has lost one of its true servants and  innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025).
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          [title_attribute] => Vale Dr Ross William Holland AM FPS
          [title] => Vale Dr Ross William Holland AM FPS
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      Vale Dr Ross William Holland AM FPS

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                  [post_content] => It’s no secret that Australia is bracing for one of the most intense influenza seasons in recent memory, with confirmed case numbers already reaching 89,165. And it’s not even winter yet – when influenza cases really start to take off.
      
      Alarmingly, influenza vaccination is also at its lowest in some time, particularly among young children. 
      
      According to Dr Anthea Rhodes, paediatrician and Director of the Royal Children’s Hospital National Child Health Poll, the convergence of early flu activity and low vaccination rates is creating a perfect storm for severe illness and hospitalisation.
      
      ‘We were really struck, in the latest National Child Health Poll, how much confusion there still is among parents about whether or not it's recommended for kids [and] whether or not it's worthwhile,’ said Dr Rhodes on 774 ABC Radio Melbourne.
      

      Why are the vaccination rates so low?

      There has been an uptick in the number of children hospitalised for influenza in Victoria, Dr Rhodes said. But one of the most troubling revelations this season is the low rate of flu vaccination among children under 5 years of age, with just 13.9% of children in this age cohort receiving the vaccine. ‘As a community, we still think about flu as being an older person's illness,’ she said. ‘But in fact, younger kids, between 6 months and 5 years are the group second most likely to be hospitalised … with complications of flu.’
      ONLY 3.9% of children < 5 years are up to date with flu vaccination.  
      Those complications include pneumonia –  one of the leading causes of hospitalisation among Australian children. Worryingly, many parents still view influenza as a mild illness in otherwise healthy kids, a perception Dr Rhodes says is both outdated and dangerous. ‘A third of parent respondents to the … poll indicated that they weren't aware that healthy kids can [get] seriously unwell from influenza,’ she said. ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.’ Compounding the problem is a widespread misunderstanding about the need for annual vaccination. ‘Because the flu virus … keeps changing and moving around the world, we have to have a vaccine each year to get the best match for the strain that's in the community,’ Dr Rhodes said. ‘And people aren't aware of that.’ The National Child Health Poll also uncovered psychological barriers to vaccination, with rising rates of needle phobia among children. ‘We found that in children over 4, nearly a quarter are described as having a severe fear of needles, and 13% had parents tell us that’s the reason why they couldn't have the flu vaccine,’ Dr Rhodes said.
      ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.' DR ANTHEA RHODES
      This fear often stems from a combination of anxiety and early negative experiences, such as those during the COVID-19 vaccine rollout. ‘Not everyone had a positive experience, [so] what we're seeing now is some of those kids coming back really fearful and avoiding having other vaccinations.’

      Filling in childhood vaccination gaps

      There is a naivety about the difference between a cold and the flu, said Karen Brown MPS, pharmacist at TerryWhite Chemmart in Arana Hills, Brisbane who regularly administers influenza vaccines to children 6 months and older. [caption id="attachment_29505" align="alignright" width="234"] Karen Brown MPS[/caption] ‘Even if they don't get sick enough to go to hospital, that parent doesn't have time to have a week off work to care for their child,’ she said. While there has consistently been a focus on herd immunity and protecting those most vulnerable, the cost of living pressures has brought a new variable to the equation. ‘It’s always been about protecting grandma and grandpa, but now they realise, particularly if they know people who have had influenza, that if you have a really sick child for a week, it has a huge impact on your life.’ Ms Brown has been at the forefront of paediatric flu vaccination ever since Queensland allowed pharmacists to administer the vaccine to young children. Her pharmacy has become a trusted destination for families due to its clear messaging and consistent availability. ‘We know what we're doing. We do every age group. There's no ‘will they won't they?’ They just know 7 days a week that they can walk in,’ Ms Brown said. ‘They know we'll always have the stock, we know the rules and the regulations, and they can walk in after school. We make it a really simple process.’ While infants and toddlers are a ‘piece of cake’ primary-school-aged children can be more challenging. ‘They know what's going on and they've got an opinion,’ she said. But Brown and her team use a combination of humour, distraction and engagement to ease anxiety, with the pharmacy’s  vaccination room decorated with caricatures of staff in a ‘Where’s Wally’-style poster to amuse their young patients ‘We’ll say to the kids, “Will I vaccinate you quicker than it takes for you to find my face?”’ she said. Engaging children on their level is also crucial. “If they walk in with a superhero shirt on, you can say, “Who's your favourite superhero? What would Spider-Man do?’” she said.

      Tackling rising needlephobia among children

      While needlephobia is growing in prominence, there are ways to address, said Ms Brown – citing an example of a 6-year-old boy who was diagnosed with leukaemia 12 months earlier. ‘His mum gave us the heads up and said he is petrified of needles as a result of getting lots of chemo,’ she said. In such cases, the key is to empower the child. ‘We said, “this is how it’s going to feel compared to having blood taken or having an infusion”. He also understood how important it was for him to get vaccinated to protect his immune system.’ Post-vaccination, it’s important to debrief with the child to prime them for the next time around.  [caption id="attachment_17706" align="aligncenter" width="500"] Children after receiving their vaccinations at TerryWhite Chemmart Arana Hills, Brisbane. (Image: Karen Brown MPS)[/caption] ‘For example, you could say “remember for next time that you didn’t even feel me do it, and it’s not as bad as you thought”.’

      Building trust and long-term loyalty

      Childhood vaccination can be a powerful tool for pharmacies to build community trust. ‘That vaccine experience is a very good way to breed loyalty,’ Ms Brown said. ‘They will be customers of yours ongoing.’
      ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.' karen brown MPS 
      For hesitant pharmacists, she recommends administering your first vaccination to a child you’re familiar with – whether a family friend, someone from the local sporting club or a staff member’s child. ‘It’s almost like a trial,’ she said. ‘For example with COVID-19 vaccinations during the pandemic, my kids who were 7 and 8 years old at the time brought all their friends in, so they all did it together.’ And from there, it just gets easier. ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.’ There are several session dedicated to vaccination at PSA25, held in Sydney from 1–3 August. Register here to attend. [post_title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [post_excerpt] => Why this paediatrician is speaking out about low childhood vaccination rates as more kids become hospitalised. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician [to_ping] => [pinged] => [post_modified] => 2025-05-28 18:02:31 [post_modified_gmt] => 2025-05-28 08:02:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29491 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [href] => https://www.australianpharmacist.com.au/get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29497 [authorType] => )

      ‘Get the flu vaccine for your kids as soon as you…

      Vietnam
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                  [post_content] => Good morning, Vietnam!
      
      It was the late, great Robin Williams who immortalised the “good morning, Vietnam” phrase from the 1987 film of the same name. But 38 years later at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025, it was the mornings, afternoons and evenings that truly lived up to the greeting.
      
      Certainly, no surprise; the same successful format initiated at the first Offshore Refresher Course in 1977 has been continued – education each day from 8.30 am to 1.00 pm, then cultural activities, tours and social events.
      
      The Vietnam safari began in Hạ Long Bay, then to Hanoi, Hoi An and on to Ho Chi Min City. There were ‘Hs’ in abundance, although most of the locals still call Ho Chi Min City Saigon.
      
      This year, there were 37 hours of lectures and workshops in six locations – including the post-conference tour to Cambodia. Our four principal speakers were all experienced and popular Offshore Refresher Course presenters: Bruce Annabel (business management), Dr Phillip Artemi (dermatology), Dr Terri Foran (women’s health) and Dr Sepehr Shakib (pharmacology).
      
      And what social events! A highlight this year was the Vietnamese-themed dinner with apparently no time or expense spared by delegates to dress for the occasion. Of course, there was no shortage of tailor shops around town that could run up traditional men’s and women’s outfits in less than 24 hours.
      
      This kind of learning sure can be fun, but there’s plenty of hard work for the delegates as well. Many continue to deliberate long after the education sessions are over for the day – just to ensure they get correct answers to the questions in the ‘Jack Thomas Quiz’. The winner’s name engraved on the perpetual trophy is an incentive; and so is maximising your CPD points for the year.
      
      This year saw one of the closest Jack Thomas Quiz contests in Refresher Course history. Of
      the over 150 responses to the 75-question quiz, six delegates finished with a score of 97% – and placegetters were separated only by assessment of the written case study. First prize
      went to Johanna Bou-Samra, who works as Indigenous Outcomes Pharmacist with
      Queensland Health. Meredith Bell and former Jack Thomas Quiz winner Louise Braddock were joint runners-up.
      
      Skin has been a big thing at the conference this year – well, it is our biggest organ. Dermatology is a major part of our extended practice, so expertise in this area will help us take advantage of new opportunities. However, don’t despair if you missed out on the Offshore Refresher Course this year. Dr Phillip Artemi will also have a cameo role as part of the speaking faculty next year.
      
      Planning to attend the next Offshore Refresher Course? You should, and you should act now.
      
      Next year we celebrate the 50th Offshore Refresher Course in a very special way. The main conference in Japan will be on the luxury cruise ship Crystal Symphony. Bookings are filling fast, and we can’t take more than our cabin allocation will allow.
      
      So, it’s sayonara Saigon; Tokyo here we come.
      
      Find out more about what’s instore for 50th Offshore Refresher Course in Tokyo here.
                  [post_title] => PSA's Offshore Refresher wraps with style, and tailor-made outfits
                  [post_excerpt] => Clothes, culture and clinical learnings were in abundance at at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025.
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          [title_attribute] => PSA’s Offshore Refresher wraps with style, and tailor-made outfits
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      PSA’s Offshore Refresher wraps with style, and tailor-made outfits

      ACOP
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                  [post_content] => Since new cut-off dates were announced for pharmacists to comply with updating credentialing requirements, queries to PSA’s Pharmacist to Pharmacist Advice Line have surged.
      
      Here’s a round up of your top questions, answered.
      

      1. Why do I need to transition to a new credentialing system?

      After the Australian Association of Consultant Pharmacy (AACP) ceased operations in 2022, the Australian Pharmacy Council (APC) was charged with developing updated accreditation standards for Medication Management Review (MMR) and Aged Care pharmacist services. This process yielded two new credentials – the MMR Credential and the Aged Care On-site Pharmacist (ACOP) Credential. All pharmacists, whether originally accredited by the AACP or by another provider since its closure, must now transition to these new credentials. The primary change is the separation of MMR and ACOP into distinct credentials, each mandating dedicated training for pharmacists, said Bill Wallace MPS, PSA Pharmacist – Professional Support Adviser, who supports PSA members through the Pharmacist to Pharmacist Advice Line. ‘Those with prior experience in either area may apply for Recognition of Prior Learning (RPL) to receive credit toward their new credential(s), while others will need to complete additional education to fulfil the updated requirements,’ he said.

      2. How do I apply for MMR recognition of prior learning?

      Pharmacists who were accredited by AACP, PSA or ACP can submit proof of initial accreditation along with additional evidence as outlined in PSA’s RPL course page, Mr Wallace said. The performance outcomes not assessed by prior study are those relating to cultural competence (1.1) and individual quality improvement activities (4.2).  Examples of appropriate evidence to submit include:  
      • 1.1  – completing the free Deadly pharmacists foundation training course
      • 4.2 – establishing a personal quality-improvement plan that incorporates reflective practice or participation in a peer-review forum to receive feedback on your MMR work.

      3. What credentialing pathway do I need to take to work as an Aged Care Onsite Pharmacist?

      To work as an Aged Care Onsite Pharmacist , pharmacists need to have completed the MMR course and complete one of the following before 30 June 2026:
      • an ACOP credentialing course through PSA or other provider
      • the ACOP RPL process.
      ‘The ACOP RPL process is more comprehensive than the MMR RPL process, requiring the development of a detailed portfolio of evidence to demonstrate competency against each of the performance outcomes set by the APC,’ Mr Wallace said. Examples of ACOP performance competencies include:
      • Collaborative Practice: producing clear and concise clinical documentation using standardised communication tools and according to the RACF’s systems and preferences
      • Safe and Quality Use of Medicines: participating in the implementation and maintenance of clinical-governance systems to improve medicines-related safety and quality

      4. What’s the new deadline for transition arrangements for the MMR and ACOP credentials?

      From 1 January 2026, all MMR-credentialled pharmacists who wish to continue claiming for Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) services, or to participate in the ACOP Measure under transition arrangements must comply with the APC’s MMR standards.

      Medication Management Reviews

      The transition period for MMRs has been extended to 31 December 2025. The Department of Health and Aged Care has confirmed that there will be no further extensions.  This extension gives MMR-credentialed pharmacists additional time to complete an APC-accredited RPL or approved training program. The following MRNs will remain valid until 31 December 2025, or until they are replaced by an updated MRN issued upon completion of an APC-accredited RPL or training program, whichever comes first:
      • AACP MRNs held as of 31 December 2022 (i.e. those active and not lapsed before that date)
      • PSA MRNs
      • ACP MRNs
      • Advanced Pharmacy Australia (formerly SHPA) MRNs.

      ACOP Measure

      The ACOP Measure transition period has been extended until 30 June 2026. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date, provided they complete an APC-accredited ACOP training program by 30 June 2026. ‘If an MMR-credentialed pharmacist transfers to a different training provider and is issued a new MRN, they must use the new MRN when claiming HMRs/RMMRs or when participating in the ACOP Measure,’ Mr Wallace added.

      5. When do I need to get my RPL applications in by?

      Pharmacists should be looking at completing the RPL process prior to the extension deadlines, Mr Wallace said.  ‘The RPL process requires an assessor to examine the submitted evidence and provide feedback if required,’ he said.  ‘This process may take up to 4 weeks if there is no extra information or resubmission required.’ To ensure uninterrupted provision of medication review services, RPL evidence should be submitted at least 2 months prior to the deadline.

      6. Does RPL still count if I don’t meet the deadline?

      If pharmacists miss the deadline, they will lose eligibility to deliver medicine reviews and be unable to claim services under the Pharmacy Programs Administrator programs. In other words, you won’t get paid for services. ‘Pharmacists  can still apply for RPL, but if they do not meet the criteria for the RPL they may need to complete the full training program to regain the MMR credential,’ Mr Wallace said.

      7. How long does it take to become credentialed and what’s involved?

      For pharmacists who are working and have other commitments, completing both training programs takes roughly 6–12 months, Mr Wallace said. ‘If a pharmacist has more time to invest, it could be completed in 3–6 months,’ he said. ‘Assessors have up to 4 weeks to assess written submissions.’ The MMR Credential course is organised into four structured modules that progressively develop key competencies in medication reviews.  ‘Learners are evaluated through multiple-choice quizzes to verify understanding, a reflective exercise on providing culturally safe and inclusive care, and a peer-led discussion analysing an MMR report,’ he said. ‘They also participate in an AI-driven simulated patient encounter to practise medication history taking, and undertake a live online Objective Structured Interview to showcase their practical skills.’  The course also features a quality-improvement assignment, in which participants are required to review relevant policies and reflect on their own practice to drive ongoing enhancement. Meanwhile, the four-module ACOP credential course builds on the MMR Credential framework and begins with a similar assessment process. The course includes a supervised site visit to a residential aged-care facility, during which participants observe care delivery and critically reflect on both the environment and service quality, Mr Wallace said. ‘The course further incorporates a case-conference simulation; learners view a recorded interdisciplinary meeting and appraise their prospective roles and contributions,’ he said. ‘Then, a quality-improvement project tasks participants with conducting clinical audits and preparing governance reports to foster ongoing enhancements in aged-care settings.’ For advice on all things pharmacy, ring PSA’s Pharmacist-to-Pharmacist Advice Line between 8.30am to 5.00pm AEST on 1300 369 772. [post_title] => Countdown to new MMR and ACOP credential deadline [post_excerpt] => PSA's advice line has been flooded with questions from credentialed pharmacists on how to apply for MMR and ACOP recognition. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => countdown-to-new-mmr-and-acop-credential-deadline [to_ping] => [pinged] => [post_modified] => 2025-05-27 09:22:29 [post_modified_gmt] => 2025-05-26 23:22:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29462 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Countdown to new MMR and ACOP credential deadline [title] => Countdown to new MMR and ACOP credential deadline [href] => https://www.australianpharmacist.com.au/countdown-to-new-mmr-and-acop-credential-deadline/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29463 [authorType] => )

      Countdown to new MMR and ACOP credential deadline

      risperidone
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                  [post_content] => The Therapeutic Goods Administration (TGA) has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18.
      
      In 2024 alone, 22 adverse events as a result of overdose of risperidone oral solution were reported to the TGA – most cases involved accidental administration of 10 times the prescribed dose (for example, 5 mL instead of 0.5 mL). 
      
      Although no deaths were recorded, adverse effects led to hospitalisations in most cases.
      

      Why are dosing errors occurring?

      An investigation by the TGA unearthed several drivers for dosing errors of risperidone oral solution including:
      • misinterpreting dosing instructions
      • incorrect use of the dosing syringe
      • medicine administration by non-primary caregivers (e.g. babysitters or other relatives).
      And the TGA is not the only national health agency to raise concerns about risperidone dosing confusion. The Spanish Agency for Medicines and Health Products issued a public alert after discovering that paediatric caregivers misread decimal points when administering a dose of 1 mg/mL risperidone solution, often inadvertently giving ten times the intended dose. Most (74%) of these incidents were serious, with children suffering sedation, hypotension, tachycardia, extrapyramidal symptoms, QT prolongation and, in some cases, seizures. In Ireland, the Health Products Regulatory Authority echoed these concerns, reporting ten‐fold overdoses in children aged 3–15 –  urging prescribers and pharmacists to provide clear dosing-device instructions and educate caregivers on recognising and responding to overdose symptoms.

      What’s changing?

      To address the identified risk, the Product Information (PI) and Consumer Medicines Information (CMI) for Risperdal have been revised, and generic manufacturers are now required to update PIs and CMIs to mirror these changes. The new versions for Risperdal include more detailed dosing guidance and illustrative diagrams to support accurate administration including:
      • use the supplied pipette only: do not substitute with another measuring device
      • open the child-resistant cap: push down on the plastic screw cap and turn counter-clockwise, then lift off
      • insert and draw up dose: place the pipette in the bottle; hold the bottom ring and pull up the top ring to the mark matching the prescribed dose (e.g. 0.25 mL for 0.25 mg, 0.5 mL for 0.5 mg)
      • dose equivalence: 1 mL of Risperdal solution = 1 mg risperidone; graduations on the plunger are in 0.25 mL (0.25 mg) increments
      • administer in a drink: remove the pipette, slide the top ring down to expel the dose into a non-alcoholic beverage (e.g. water, juice, milk, coffee – avoid tea)
      • after use: close the bottle; rinse the pipette with cold water, let it air dry in its case; avoid detergents or vigorous wiping to preserve the printed graduations.
      While each generic product should cover the same key details, the syringe and instructions can vary by brand. So pharmacists are advised to always double-check the individual PIs.

      What do pharmacists need to do?

      Dosing instructions need to be clearly printed on the label. According to the Australian Commission on Safety and Quality in Health Care’s National standard for labelling dispensed medicines (Standard 6), label wording  should:
      • have digits for dosage amounts (e.g. ‘Take 1 tablet,’ not ‘Take one tablet’ or ‘Take ONE tablet’)
      • express dose ranges with words between numbers (e.g. ‘1 to 2,’ not ‘1-2’ which could be read as ‘12’)
      • spell out common fractions to avoid confusion (e.g. ‘quarter,’ not ‘0.25’ or ‘¼’)
      • for small paediatric liquid doses, match the numbers on the oral dispenser (e.g. ‘0.5 mL’).
      Presenting numbers as digits generally improves clarity among patients. However, fractions written symbolically (e.g. ½’) may be misread as ‘1 or 2’ and decimal points can be overlooked (e.g. ‘1.5’ read as ‘15’). That’s why, when counselling patients prescribed risperidone oral solution, pharmacists should:
      • verify that all caregivers understand the prescribed dosing regimen
      • demonstrate precisely how to measure the required volume using the provided oral syringe
      • instruct caregivers to review the dosing label before each administration and confirm their understanding, especially with those administering the medicine for the first time.
      [post_title] => Paediatric risperidone errors prompt TGA safety update [post_excerpt] => The TGA has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => paediatric-risperidone-errors-prompt-tga-safety-update [to_ping] => [pinged] => [post_modified] => 2025-05-21 15:02:24 [post_modified_gmt] => 2025-05-21 05:02:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29429 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Paediatric risperidone errors prompt TGA safety update [title] => Paediatric risperidone errors prompt TGA safety update [href] => https://www.australianpharmacist.com.au/paediatric-risperidone-errors-prompt-tga-safety-update/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29433 [authorType] => )

      Paediatric risperidone errors prompt TGA safety update

  • CPD
    • Dr Ross Holland
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                  [post_content] => Australian and indeed international pharmacy has lost one of its true servants and pharmacy practice innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025) in Louisville Colorado, USA.
      
      Ross completed his pharmacy training in the late 1950s via the old apprenticeship and materia medica-based course at University of Sydney while working at Hallam’s ‘Chemists to Sydney since 1883’ Pharmacy in Pitt Street (with another of our pharmacy innovators Ted Crook of Chemdata fame) before moving to the Hunter Street Branch, and then managing the King’s Cross premises. 
      
      His early desire to make things better and easier for pharmacists in the practice of their profession saw Ross develop a unique algorithm-based stock control system to use in these pharmacies.
      
      This desire for improvement both professionally and personally saw him become closely involved with both hospital pharmacy and higher learning, resulting in his doctorates in educational training and development areas. How he applied this knowledge to the pharmacy sector, especially community pharmacy, created the basis of his lifelong commitment to the improvement of pharmacy practice – both in Australia and internationally.  
      
      His completion of the Society of Hospital Pharmacists of Australia Fellowship program kindled the flame of how this model could be applied to community pharmacy which, with the support of PSA led to the formation of the Australian College of Pharmacy Practice (ACPP) – with Ross being its ‘founding father’, Registrar and Dean. That the College will once again be back under the aegis of PSA was welcome news to Ross in his last days.
      
      [caption id="attachment_29498" align="aligncenter" width="500"] L-R: Col (Rtd) Bill Kelly FPS, Dr Ross Holland AM FPS, Warwick Plunkett FPS and Peter Carroll FPS[/caption]
      
      Ross’s vision of community pharmacists being able to undertake postgraduate studies in their chosen area of practice through distance learning created a wonderful opportunity undertaken by many in subsequent years, who were awarded Graduate Diplomas after having been subjected to the dreaded ‘Ross’s green pen’ marking comments.
      
      The advent of remunerated medication reviews for pharmacists in Australia again saw Ross and ACPP come to the fore with specially developed training and education support programs. Likewise, the introduction and development of pharmaceutical care further cemented in place Ross’s vision of the expanded and rightful role of pharmacists in patient care – an area in which he contributed to extensively both nationally and internationally. 
      
      A prolific writer, Ross authored books on pharmacology and drug information, a wonderful series of journal articles (with his wife Christine) in the American Society of Health Systems Pharmacy journal on Transitions in Pharmacy Practice, as well as reviewing and editing numerous other works. His excellent work When to Refer published by PSA in 1999 was prescient – given that Australian pharmacists are now embracing a wider scope of practice.
      
      Ross’s foray into the world of international pharmacy through both the International Federation of Pharmacy (FIP) and the Federation of Asian Pharmaceutical Associations (FAPA) saw his extensive contribution recognised with the awarding of his FIP Fellowship (2007) and the FAPA Ishidate Award (1988). His international training and development experience was also utilised to good effect with his involvement in Australian Government health-related aid programs in several South Pacific nations.  He was also a past faculty member of the World Health Organization Regional Teacher Training Program, contributing to the development of clinical pharmacy in South Korea.
      
      In recognition of his significant service to pharmacy practice, medical education and professional organisations, Ross was appointed a Member of the Order of Australia (AM) in 2019 and was also made a Life Fellow of PSA – reflecting his enduring impact on the profession.
      
      Ross was a true visionary in pharmacy and today’s pharmacists are benefitting greatly from his vision, energy and love of the profession to earn its rightful place in the delivery of patient care. 
      
      Ross is survived by his current wife, Christine, and children from his first marriage, Frederick, Adrienne, and Christopher. Ross is preceded in death by his first wife, Rosalind (Dec. 2001).
      
      He leaves grandchildren and great grandchildren in Australia, an extended family in the US, and many loving friends, both within and outside of pharmacy.
                  [post_title] => Vale Dr Ross William Holland AM FPS
                  [post_excerpt] => Pharmacy has lost one of its true servants and  innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025).
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          [title_attribute] => Vale Dr Ross William Holland AM FPS
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      Vale Dr Ross William Holland AM FPS

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                  [post_content] => It’s no secret that Australia is bracing for one of the most intense influenza seasons in recent memory, with confirmed case numbers already reaching 89,165. And it’s not even winter yet – when influenza cases really start to take off.
      
      Alarmingly, influenza vaccination is also at its lowest in some time, particularly among young children. 
      
      According to Dr Anthea Rhodes, paediatrician and Director of the Royal Children’s Hospital National Child Health Poll, the convergence of early flu activity and low vaccination rates is creating a perfect storm for severe illness and hospitalisation.
      
      ‘We were really struck, in the latest National Child Health Poll, how much confusion there still is among parents about whether or not it's recommended for kids [and] whether or not it's worthwhile,’ said Dr Rhodes on 774 ABC Radio Melbourne.
      

      Why are the vaccination rates so low?

      There has been an uptick in the number of children hospitalised for influenza in Victoria, Dr Rhodes said. But one of the most troubling revelations this season is the low rate of flu vaccination among children under 5 years of age, with just 13.9% of children in this age cohort receiving the vaccine. ‘As a community, we still think about flu as being an older person's illness,’ she said. ‘But in fact, younger kids, between 6 months and 5 years are the group second most likely to be hospitalised … with complications of flu.’
      ONLY 3.9% of children < 5 years are up to date with flu vaccination.  
      Those complications include pneumonia –  one of the leading causes of hospitalisation among Australian children. Worryingly, many parents still view influenza as a mild illness in otherwise healthy kids, a perception Dr Rhodes says is both outdated and dangerous. ‘A third of parent respondents to the … poll indicated that they weren't aware that healthy kids can [get] seriously unwell from influenza,’ she said. ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.’ Compounding the problem is a widespread misunderstanding about the need for annual vaccination. ‘Because the flu virus … keeps changing and moving around the world, we have to have a vaccine each year to get the best match for the strain that's in the community,’ Dr Rhodes said. ‘And people aren't aware of that.’ The National Child Health Poll also uncovered psychological barriers to vaccination, with rising rates of needle phobia among children. ‘We found that in children over 4, nearly a quarter are described as having a severe fear of needles, and 13% had parents tell us that’s the reason why they couldn't have the flu vaccine,’ Dr Rhodes said.
      ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.' DR ANTHEA RHODES
      This fear often stems from a combination of anxiety and early negative experiences, such as those during the COVID-19 vaccine rollout. ‘Not everyone had a positive experience, [so] what we're seeing now is some of those kids coming back really fearful and avoiding having other vaccinations.’

      Filling in childhood vaccination gaps

      There is a naivety about the difference between a cold and the flu, said Karen Brown MPS, pharmacist at TerryWhite Chemmart in Arana Hills, Brisbane who regularly administers influenza vaccines to children 6 months and older. [caption id="attachment_29505" align="alignright" width="234"] Karen Brown MPS[/caption] ‘Even if they don't get sick enough to go to hospital, that parent doesn't have time to have a week off work to care for their child,’ she said. While there has consistently been a focus on herd immunity and protecting those most vulnerable, the cost of living pressures has brought a new variable to the equation. ‘It’s always been about protecting grandma and grandpa, but now they realise, particularly if they know people who have had influenza, that if you have a really sick child for a week, it has a huge impact on your life.’ Ms Brown has been at the forefront of paediatric flu vaccination ever since Queensland allowed pharmacists to administer the vaccine to young children. Her pharmacy has become a trusted destination for families due to its clear messaging and consistent availability. ‘We know what we're doing. We do every age group. There's no ‘will they won't they?’ They just know 7 days a week that they can walk in,’ Ms Brown said. ‘They know we'll always have the stock, we know the rules and the regulations, and they can walk in after school. We make it a really simple process.’ While infants and toddlers are a ‘piece of cake’ primary-school-aged children can be more challenging. ‘They know what's going on and they've got an opinion,’ she said. But Brown and her team use a combination of humour, distraction and engagement to ease anxiety, with the pharmacy’s  vaccination room decorated with caricatures of staff in a ‘Where’s Wally’-style poster to amuse their young patients ‘We’ll say to the kids, “Will I vaccinate you quicker than it takes for you to find my face?”’ she said. Engaging children on their level is also crucial. “If they walk in with a superhero shirt on, you can say, “Who's your favourite superhero? What would Spider-Man do?’” she said.

      Tackling rising needlephobia among children

      While needlephobia is growing in prominence, there are ways to address, said Ms Brown – citing an example of a 6-year-old boy who was diagnosed with leukaemia 12 months earlier. ‘His mum gave us the heads up and said he is petrified of needles as a result of getting lots of chemo,’ she said. In such cases, the key is to empower the child. ‘We said, “this is how it’s going to feel compared to having blood taken or having an infusion”. He also understood how important it was for him to get vaccinated to protect his immune system.’ Post-vaccination, it’s important to debrief with the child to prime them for the next time around.  [caption id="attachment_17706" align="aligncenter" width="500"] Children after receiving their vaccinations at TerryWhite Chemmart Arana Hills, Brisbane. (Image: Karen Brown MPS)[/caption] ‘For example, you could say “remember for next time that you didn’t even feel me do it, and it’s not as bad as you thought”.’

      Building trust and long-term loyalty

      Childhood vaccination can be a powerful tool for pharmacies to build community trust. ‘That vaccine experience is a very good way to breed loyalty,’ Ms Brown said. ‘They will be customers of yours ongoing.’
      ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.' karen brown MPS 
      For hesitant pharmacists, she recommends administering your first vaccination to a child you’re familiar with – whether a family friend, someone from the local sporting club or a staff member’s child. ‘It’s almost like a trial,’ she said. ‘For example with COVID-19 vaccinations during the pandemic, my kids who were 7 and 8 years old at the time brought all their friends in, so they all did it together.’ And from there, it just gets easier. ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.’ There are several session dedicated to vaccination at PSA25, held in Sydney from 1–3 August. Register here to attend. [post_title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [post_excerpt] => Why this paediatrician is speaking out about low childhood vaccination rates as more kids become hospitalised. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician [to_ping] => [pinged] => [post_modified] => 2025-05-28 18:02:31 [post_modified_gmt] => 2025-05-28 08:02:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29491 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [href] => https://www.australianpharmacist.com.au/get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29497 [authorType] => )

      ‘Get the flu vaccine for your kids as soon as you…

      Vietnam
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                  [post_content] => Good morning, Vietnam!
      
      It was the late, great Robin Williams who immortalised the “good morning, Vietnam” phrase from the 1987 film of the same name. But 38 years later at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025, it was the mornings, afternoons and evenings that truly lived up to the greeting.
      
      Certainly, no surprise; the same successful format initiated at the first Offshore Refresher Course in 1977 has been continued – education each day from 8.30 am to 1.00 pm, then cultural activities, tours and social events.
      
      The Vietnam safari began in Hạ Long Bay, then to Hanoi, Hoi An and on to Ho Chi Min City. There were ‘Hs’ in abundance, although most of the locals still call Ho Chi Min City Saigon.
      
      This year, there were 37 hours of lectures and workshops in six locations – including the post-conference tour to Cambodia. Our four principal speakers were all experienced and popular Offshore Refresher Course presenters: Bruce Annabel (business management), Dr Phillip Artemi (dermatology), Dr Terri Foran (women’s health) and Dr Sepehr Shakib (pharmacology).
      
      And what social events! A highlight this year was the Vietnamese-themed dinner with apparently no time or expense spared by delegates to dress for the occasion. Of course, there was no shortage of tailor shops around town that could run up traditional men’s and women’s outfits in less than 24 hours.
      
      This kind of learning sure can be fun, but there’s plenty of hard work for the delegates as well. Many continue to deliberate long after the education sessions are over for the day – just to ensure they get correct answers to the questions in the ‘Jack Thomas Quiz’. The winner’s name engraved on the perpetual trophy is an incentive; and so is maximising your CPD points for the year.
      
      This year saw one of the closest Jack Thomas Quiz contests in Refresher Course history. Of
      the over 150 responses to the 75-question quiz, six delegates finished with a score of 97% – and placegetters were separated only by assessment of the written case study. First prize
      went to Johanna Bou-Samra, who works as Indigenous Outcomes Pharmacist with
      Queensland Health. Meredith Bell and former Jack Thomas Quiz winner Louise Braddock were joint runners-up.
      
      Skin has been a big thing at the conference this year – well, it is our biggest organ. Dermatology is a major part of our extended practice, so expertise in this area will help us take advantage of new opportunities. However, don’t despair if you missed out on the Offshore Refresher Course this year. Dr Phillip Artemi will also have a cameo role as part of the speaking faculty next year.
      
      Planning to attend the next Offshore Refresher Course? You should, and you should act now.
      
      Next year we celebrate the 50th Offshore Refresher Course in a very special way. The main conference in Japan will be on the luxury cruise ship Crystal Symphony. Bookings are filling fast, and we can’t take more than our cabin allocation will allow.
      
      So, it’s sayonara Saigon; Tokyo here we come.
      
      Find out more about what’s instore for 50th Offshore Refresher Course in Tokyo here.
                  [post_title] => PSA's Offshore Refresher wraps with style, and tailor-made outfits
                  [post_excerpt] => Clothes, culture and clinical learnings were in abundance at at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025.
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          [title_attribute] => PSA’s Offshore Refresher wraps with style, and tailor-made outfits
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      PSA’s Offshore Refresher wraps with style, and tailor-made outfits

      ACOP
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                  [post_content] => Since new cut-off dates were announced for pharmacists to comply with updating credentialing requirements, queries to PSA’s Pharmacist to Pharmacist Advice Line have surged.
      
      Here’s a round up of your top questions, answered.
      

      1. Why do I need to transition to a new credentialing system?

      After the Australian Association of Consultant Pharmacy (AACP) ceased operations in 2022, the Australian Pharmacy Council (APC) was charged with developing updated accreditation standards for Medication Management Review (MMR) and Aged Care pharmacist services. This process yielded two new credentials – the MMR Credential and the Aged Care On-site Pharmacist (ACOP) Credential. All pharmacists, whether originally accredited by the AACP or by another provider since its closure, must now transition to these new credentials. The primary change is the separation of MMR and ACOP into distinct credentials, each mandating dedicated training for pharmacists, said Bill Wallace MPS, PSA Pharmacist – Professional Support Adviser, who supports PSA members through the Pharmacist to Pharmacist Advice Line. ‘Those with prior experience in either area may apply for Recognition of Prior Learning (RPL) to receive credit toward their new credential(s), while others will need to complete additional education to fulfil the updated requirements,’ he said.

      2. How do I apply for MMR recognition of prior learning?

      Pharmacists who were accredited by AACP, PSA or ACP can submit proof of initial accreditation along with additional evidence as outlined in PSA’s RPL course page, Mr Wallace said. The performance outcomes not assessed by prior study are those relating to cultural competence (1.1) and individual quality improvement activities (4.2).  Examples of appropriate evidence to submit include:  
      • 1.1  – completing the free Deadly pharmacists foundation training course
      • 4.2 – establishing a personal quality-improvement plan that incorporates reflective practice or participation in a peer-review forum to receive feedback on your MMR work.

      3. What credentialing pathway do I need to take to work as an Aged Care Onsite Pharmacist?

      To work as an Aged Care Onsite Pharmacist , pharmacists need to have completed the MMR course and complete one of the following before 30 June 2026:
      • an ACOP credentialing course through PSA or other provider
      • the ACOP RPL process.
      ‘The ACOP RPL process is more comprehensive than the MMR RPL process, requiring the development of a detailed portfolio of evidence to demonstrate competency against each of the performance outcomes set by the APC,’ Mr Wallace said. Examples of ACOP performance competencies include:
      • Collaborative Practice: producing clear and concise clinical documentation using standardised communication tools and according to the RACF’s systems and preferences
      • Safe and Quality Use of Medicines: participating in the implementation and maintenance of clinical-governance systems to improve medicines-related safety and quality

      4. What’s the new deadline for transition arrangements for the MMR and ACOP credentials?

      From 1 January 2026, all MMR-credentialled pharmacists who wish to continue claiming for Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) services, or to participate in the ACOP Measure under transition arrangements must comply with the APC’s MMR standards.

      Medication Management Reviews

      The transition period for MMRs has been extended to 31 December 2025. The Department of Health and Aged Care has confirmed that there will be no further extensions.  This extension gives MMR-credentialed pharmacists additional time to complete an APC-accredited RPL or approved training program. The following MRNs will remain valid until 31 December 2025, or until they are replaced by an updated MRN issued upon completion of an APC-accredited RPL or training program, whichever comes first:
      • AACP MRNs held as of 31 December 2022 (i.e. those active and not lapsed before that date)
      • PSA MRNs
      • ACP MRNs
      • Advanced Pharmacy Australia (formerly SHPA) MRNs.

      ACOP Measure

      The ACOP Measure transition period has been extended until 30 June 2026. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date, provided they complete an APC-accredited ACOP training program by 30 June 2026. ‘If an MMR-credentialed pharmacist transfers to a different training provider and is issued a new MRN, they must use the new MRN when claiming HMRs/RMMRs or when participating in the ACOP Measure,’ Mr Wallace added.

      5. When do I need to get my RPL applications in by?

      Pharmacists should be looking at completing the RPL process prior to the extension deadlines, Mr Wallace said.  ‘The RPL process requires an assessor to examine the submitted evidence and provide feedback if required,’ he said.  ‘This process may take up to 4 weeks if there is no extra information or resubmission required.’ To ensure uninterrupted provision of medication review services, RPL evidence should be submitted at least 2 months prior to the deadline.

      6. Does RPL still count if I don’t meet the deadline?

      If pharmacists miss the deadline, they will lose eligibility to deliver medicine reviews and be unable to claim services under the Pharmacy Programs Administrator programs. In other words, you won’t get paid for services. ‘Pharmacists  can still apply for RPL, but if they do not meet the criteria for the RPL they may need to complete the full training program to regain the MMR credential,’ Mr Wallace said.

      7. How long does it take to become credentialed and what’s involved?

      For pharmacists who are working and have other commitments, completing both training programs takes roughly 6–12 months, Mr Wallace said. ‘If a pharmacist has more time to invest, it could be completed in 3–6 months,’ he said. ‘Assessors have up to 4 weeks to assess written submissions.’ The MMR Credential course is organised into four structured modules that progressively develop key competencies in medication reviews.  ‘Learners are evaluated through multiple-choice quizzes to verify understanding, a reflective exercise on providing culturally safe and inclusive care, and a peer-led discussion analysing an MMR report,’ he said. ‘They also participate in an AI-driven simulated patient encounter to practise medication history taking, and undertake a live online Objective Structured Interview to showcase their practical skills.’  The course also features a quality-improvement assignment, in which participants are required to review relevant policies and reflect on their own practice to drive ongoing enhancement. Meanwhile, the four-module ACOP credential course builds on the MMR Credential framework and begins with a similar assessment process. The course includes a supervised site visit to a residential aged-care facility, during which participants observe care delivery and critically reflect on both the environment and service quality, Mr Wallace said. ‘The course further incorporates a case-conference simulation; learners view a recorded interdisciplinary meeting and appraise their prospective roles and contributions,’ he said. ‘Then, a quality-improvement project tasks participants with conducting clinical audits and preparing governance reports to foster ongoing enhancements in aged-care settings.’ For advice on all things pharmacy, ring PSA’s Pharmacist-to-Pharmacist Advice Line between 8.30am to 5.00pm AEST on 1300 369 772. [post_title] => Countdown to new MMR and ACOP credential deadline [post_excerpt] => PSA's advice line has been flooded with questions from credentialed pharmacists on how to apply for MMR and ACOP recognition. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => countdown-to-new-mmr-and-acop-credential-deadline [to_ping] => [pinged] => [post_modified] => 2025-05-27 09:22:29 [post_modified_gmt] => 2025-05-26 23:22:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29462 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Countdown to new MMR and ACOP credential deadline [title] => Countdown to new MMR and ACOP credential deadline [href] => https://www.australianpharmacist.com.au/countdown-to-new-mmr-and-acop-credential-deadline/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29463 [authorType] => )

      Countdown to new MMR and ACOP credential deadline

      risperidone
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                  [post_content] => The Therapeutic Goods Administration (TGA) has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18.
      
      In 2024 alone, 22 adverse events as a result of overdose of risperidone oral solution were reported to the TGA – most cases involved accidental administration of 10 times the prescribed dose (for example, 5 mL instead of 0.5 mL). 
      
      Although no deaths were recorded, adverse effects led to hospitalisations in most cases.
      

      Why are dosing errors occurring?

      An investigation by the TGA unearthed several drivers for dosing errors of risperidone oral solution including:
      • misinterpreting dosing instructions
      • incorrect use of the dosing syringe
      • medicine administration by non-primary caregivers (e.g. babysitters or other relatives).
      And the TGA is not the only national health agency to raise concerns about risperidone dosing confusion. The Spanish Agency for Medicines and Health Products issued a public alert after discovering that paediatric caregivers misread decimal points when administering a dose of 1 mg/mL risperidone solution, often inadvertently giving ten times the intended dose. Most (74%) of these incidents were serious, with children suffering sedation, hypotension, tachycardia, extrapyramidal symptoms, QT prolongation and, in some cases, seizures. In Ireland, the Health Products Regulatory Authority echoed these concerns, reporting ten‐fold overdoses in children aged 3–15 –  urging prescribers and pharmacists to provide clear dosing-device instructions and educate caregivers on recognising and responding to overdose symptoms.

      What’s changing?

      To address the identified risk, the Product Information (PI) and Consumer Medicines Information (CMI) for Risperdal have been revised, and generic manufacturers are now required to update PIs and CMIs to mirror these changes. The new versions for Risperdal include more detailed dosing guidance and illustrative diagrams to support accurate administration including:
      • use the supplied pipette only: do not substitute with another measuring device
      • open the child-resistant cap: push down on the plastic screw cap and turn counter-clockwise, then lift off
      • insert and draw up dose: place the pipette in the bottle; hold the bottom ring and pull up the top ring to the mark matching the prescribed dose (e.g. 0.25 mL for 0.25 mg, 0.5 mL for 0.5 mg)
      • dose equivalence: 1 mL of Risperdal solution = 1 mg risperidone; graduations on the plunger are in 0.25 mL (0.25 mg) increments
      • administer in a drink: remove the pipette, slide the top ring down to expel the dose into a non-alcoholic beverage (e.g. water, juice, milk, coffee – avoid tea)
      • after use: close the bottle; rinse the pipette with cold water, let it air dry in its case; avoid detergents or vigorous wiping to preserve the printed graduations.
      While each generic product should cover the same key details, the syringe and instructions can vary by brand. So pharmacists are advised to always double-check the individual PIs.

      What do pharmacists need to do?

      Dosing instructions need to be clearly printed on the label. According to the Australian Commission on Safety and Quality in Health Care’s National standard for labelling dispensed medicines (Standard 6), label wording  should:
      • have digits for dosage amounts (e.g. ‘Take 1 tablet,’ not ‘Take one tablet’ or ‘Take ONE tablet’)
      • express dose ranges with words between numbers (e.g. ‘1 to 2,’ not ‘1-2’ which could be read as ‘12’)
      • spell out common fractions to avoid confusion (e.g. ‘quarter,’ not ‘0.25’ or ‘¼’)
      • for small paediatric liquid doses, match the numbers on the oral dispenser (e.g. ‘0.5 mL’).
      Presenting numbers as digits generally improves clarity among patients. However, fractions written symbolically (e.g. ½’) may be misread as ‘1 or 2’ and decimal points can be overlooked (e.g. ‘1.5’ read as ‘15’). That’s why, when counselling patients prescribed risperidone oral solution, pharmacists should:
      • verify that all caregivers understand the prescribed dosing regimen
      • demonstrate precisely how to measure the required volume using the provided oral syringe
      • instruct caregivers to review the dosing label before each administration and confirm their understanding, especially with those administering the medicine for the first time.
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      Paediatric risperidone errors prompt TGA safety update

  • People
    • Dr Ross Holland
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                  [post_content] => Australian and indeed international pharmacy has lost one of its true servants and pharmacy practice innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025) in Louisville Colorado, USA.
      
      Ross completed his pharmacy training in the late 1950s via the old apprenticeship and materia medica-based course at University of Sydney while working at Hallam’s ‘Chemists to Sydney since 1883’ Pharmacy in Pitt Street (with another of our pharmacy innovators Ted Crook of Chemdata fame) before moving to the Hunter Street Branch, and then managing the King’s Cross premises. 
      
      His early desire to make things better and easier for pharmacists in the practice of their profession saw Ross develop a unique algorithm-based stock control system to use in these pharmacies.
      
      This desire for improvement both professionally and personally saw him become closely involved with both hospital pharmacy and higher learning, resulting in his doctorates in educational training and development areas. How he applied this knowledge to the pharmacy sector, especially community pharmacy, created the basis of his lifelong commitment to the improvement of pharmacy practice – both in Australia and internationally.  
      
      His completion of the Society of Hospital Pharmacists of Australia Fellowship program kindled the flame of how this model could be applied to community pharmacy which, with the support of PSA led to the formation of the Australian College of Pharmacy Practice (ACPP) – with Ross being its ‘founding father’, Registrar and Dean. That the College will once again be back under the aegis of PSA was welcome news to Ross in his last days.
      
      [caption id="attachment_29498" align="aligncenter" width="500"] L-R: Col (Rtd) Bill Kelly FPS, Dr Ross Holland AM FPS, Warwick Plunkett FPS and Peter Carroll FPS[/caption]
      
      Ross’s vision of community pharmacists being able to undertake postgraduate studies in their chosen area of practice through distance learning created a wonderful opportunity undertaken by many in subsequent years, who were awarded Graduate Diplomas after having been subjected to the dreaded ‘Ross’s green pen’ marking comments.
      
      The advent of remunerated medication reviews for pharmacists in Australia again saw Ross and ACPP come to the fore with specially developed training and education support programs. Likewise, the introduction and development of pharmaceutical care further cemented in place Ross’s vision of the expanded and rightful role of pharmacists in patient care – an area in which he contributed to extensively both nationally and internationally. 
      
      A prolific writer, Ross authored books on pharmacology and drug information, a wonderful series of journal articles (with his wife Christine) in the American Society of Health Systems Pharmacy journal on Transitions in Pharmacy Practice, as well as reviewing and editing numerous other works. His excellent work When to Refer published by PSA in 1999 was prescient – given that Australian pharmacists are now embracing a wider scope of practice.
      
      Ross’s foray into the world of international pharmacy through both the International Federation of Pharmacy (FIP) and the Federation of Asian Pharmaceutical Associations (FAPA) saw his extensive contribution recognised with the awarding of his FIP Fellowship (2007) and the FAPA Ishidate Award (1988). His international training and development experience was also utilised to good effect with his involvement in Australian Government health-related aid programs in several South Pacific nations.  He was also a past faculty member of the World Health Organization Regional Teacher Training Program, contributing to the development of clinical pharmacy in South Korea.
      
      In recognition of his significant service to pharmacy practice, medical education and professional organisations, Ross was appointed a Member of the Order of Australia (AM) in 2019 and was also made a Life Fellow of PSA – reflecting his enduring impact on the profession.
      
      Ross was a true visionary in pharmacy and today’s pharmacists are benefitting greatly from his vision, energy and love of the profession to earn its rightful place in the delivery of patient care. 
      
      Ross is survived by his current wife, Christine, and children from his first marriage, Frederick, Adrienne, and Christopher. Ross is preceded in death by his first wife, Rosalind (Dec. 2001).
      
      He leaves grandchildren and great grandchildren in Australia, an extended family in the US, and many loving friends, both within and outside of pharmacy.
                  [post_title] => Vale Dr Ross William Holland AM FPS
                  [post_excerpt] => Pharmacy has lost one of its true servants and  innovators with the passing of Dr Ross Holland (6 May 1938 – 16 May 2025).
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      Vale Dr Ross William Holland AM FPS

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                  [post_content] => It’s no secret that Australia is bracing for one of the most intense influenza seasons in recent memory, with confirmed case numbers already reaching 89,165. And it’s not even winter yet – when influenza cases really start to take off.
      
      Alarmingly, influenza vaccination is also at its lowest in some time, particularly among young children. 
      
      According to Dr Anthea Rhodes, paediatrician and Director of the Royal Children’s Hospital National Child Health Poll, the convergence of early flu activity and low vaccination rates is creating a perfect storm for severe illness and hospitalisation.
      
      ‘We were really struck, in the latest National Child Health Poll, how much confusion there still is among parents about whether or not it's recommended for kids [and] whether or not it's worthwhile,’ said Dr Rhodes on 774 ABC Radio Melbourne.
      

      Why are the vaccination rates so low?

      There has been an uptick in the number of children hospitalised for influenza in Victoria, Dr Rhodes said. But one of the most troubling revelations this season is the low rate of flu vaccination among children under 5 years of age, with just 13.9% of children in this age cohort receiving the vaccine. ‘As a community, we still think about flu as being an older person's illness,’ she said. ‘But in fact, younger kids, between 6 months and 5 years are the group second most likely to be hospitalised … with complications of flu.’
      ONLY 3.9% of children < 5 years are up to date with flu vaccination.  
      Those complications include pneumonia –  one of the leading causes of hospitalisation among Australian children. Worryingly, many parents still view influenza as a mild illness in otherwise healthy kids, a perception Dr Rhodes says is both outdated and dangerous. ‘A third of parent respondents to the … poll indicated that they weren't aware that healthy kids can [get] seriously unwell from influenza,’ she said. ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.’ Compounding the problem is a widespread misunderstanding about the need for annual vaccination. ‘Because the flu virus … keeps changing and moving around the world, we have to have a vaccine each year to get the best match for the strain that's in the community,’ Dr Rhodes said. ‘And people aren't aware of that.’ The National Child Health Poll also uncovered psychological barriers to vaccination, with rising rates of needle phobia among children. ‘We found that in children over 4, nearly a quarter are described as having a severe fear of needles, and 13% had parents tell us that’s the reason why they couldn't have the flu vaccine,’ Dr Rhodes said.
      ‘Around half of serious cases are in previously completely well children. So this is a serious illness that can affect any child.' DR ANTHEA RHODES
      This fear often stems from a combination of anxiety and early negative experiences, such as those during the COVID-19 vaccine rollout. ‘Not everyone had a positive experience, [so] what we're seeing now is some of those kids coming back really fearful and avoiding having other vaccinations.’

      Filling in childhood vaccination gaps

      There is a naivety about the difference between a cold and the flu, said Karen Brown MPS, pharmacist at TerryWhite Chemmart in Arana Hills, Brisbane who regularly administers influenza vaccines to children 6 months and older. [caption id="attachment_29505" align="alignright" width="234"] Karen Brown MPS[/caption] ‘Even if they don't get sick enough to go to hospital, that parent doesn't have time to have a week off work to care for their child,’ she said. While there has consistently been a focus on herd immunity and protecting those most vulnerable, the cost of living pressures has brought a new variable to the equation. ‘It’s always been about protecting grandma and grandpa, but now they realise, particularly if they know people who have had influenza, that if you have a really sick child for a week, it has a huge impact on your life.’ Ms Brown has been at the forefront of paediatric flu vaccination ever since Queensland allowed pharmacists to administer the vaccine to young children. Her pharmacy has become a trusted destination for families due to its clear messaging and consistent availability. ‘We know what we're doing. We do every age group. There's no ‘will they won't they?’ They just know 7 days a week that they can walk in,’ Ms Brown said. ‘They know we'll always have the stock, we know the rules and the regulations, and they can walk in after school. We make it a really simple process.’ While infants and toddlers are a ‘piece of cake’ primary-school-aged children can be more challenging. ‘They know what's going on and they've got an opinion,’ she said. But Brown and her team use a combination of humour, distraction and engagement to ease anxiety, with the pharmacy’s  vaccination room decorated with caricatures of staff in a ‘Where’s Wally’-style poster to amuse their young patients ‘We’ll say to the kids, “Will I vaccinate you quicker than it takes for you to find my face?”’ she said. Engaging children on their level is also crucial. “If they walk in with a superhero shirt on, you can say, “Who's your favourite superhero? What would Spider-Man do?’” she said.

      Tackling rising needlephobia among children

      While needlephobia is growing in prominence, there are ways to address, said Ms Brown – citing an example of a 6-year-old boy who was diagnosed with leukaemia 12 months earlier. ‘His mum gave us the heads up and said he is petrified of needles as a result of getting lots of chemo,’ she said. In such cases, the key is to empower the child. ‘We said, “this is how it’s going to feel compared to having blood taken or having an infusion”. He also understood how important it was for him to get vaccinated to protect his immune system.’ Post-vaccination, it’s important to debrief with the child to prime them for the next time around.  [caption id="attachment_17706" align="aligncenter" width="500"] Children after receiving their vaccinations at TerryWhite Chemmart Arana Hills, Brisbane. (Image: Karen Brown MPS)[/caption] ‘For example, you could say “remember for next time that you didn’t even feel me do it, and it’s not as bad as you thought”.’

      Building trust and long-term loyalty

      Childhood vaccination can be a powerful tool for pharmacies to build community trust. ‘That vaccine experience is a very good way to breed loyalty,’ Ms Brown said. ‘They will be customers of yours ongoing.’
      ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.' karen brown MPS 
      For hesitant pharmacists, she recommends administering your first vaccination to a child you’re familiar with – whether a family friend, someone from the local sporting club or a staff member’s child. ‘It’s almost like a trial,’ she said. ‘For example with COVID-19 vaccinations during the pandemic, my kids who were 7 and 8 years old at the time brought all their friends in, so they all did it together.’ And from there, it just gets easier. ‘Kid’s consults can be way more fun than the adult ones. You can have a really good time. Some of them can be really cheeky, funny, sassy, and you get a lot of reward out of it.’ There are several session dedicated to vaccination at PSA25, held in Sydney from 1–3 August. Register here to attend. [post_title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [post_excerpt] => Why this paediatrician is speaking out about low childhood vaccination rates as more kids become hospitalised. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician [to_ping] => [pinged] => [post_modified] => 2025-05-28 18:02:31 [post_modified_gmt] => 2025-05-28 08:02:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29491 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [title] => ‘Get the flu vaccine for your kids as soon as you can’ warns paediatrician [href] => https://www.australianpharmacist.com.au/get-the-flu-vaccine-for-your-kids-as-soon-as-you-can-warns-paediatrician/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29497 [authorType] => )

      ‘Get the flu vaccine for your kids as soon as you…

      Vietnam
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                  [post_content] => Good morning, Vietnam!
      
      It was the late, great Robin Williams who immortalised the “good morning, Vietnam” phrase from the 1987 film of the same name. But 38 years later at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025, it was the mornings, afternoons and evenings that truly lived up to the greeting.
      
      Certainly, no surprise; the same successful format initiated at the first Offshore Refresher Course in 1977 has been continued – education each day from 8.30 am to 1.00 pm, then cultural activities, tours and social events.
      
      The Vietnam safari began in Hạ Long Bay, then to Hanoi, Hoi An and on to Ho Chi Min City. There were ‘Hs’ in abundance, although most of the locals still call Ho Chi Min City Saigon.
      
      This year, there were 37 hours of lectures and workshops in six locations – including the post-conference tour to Cambodia. Our four principal speakers were all experienced and popular Offshore Refresher Course presenters: Bruce Annabel (business management), Dr Phillip Artemi (dermatology), Dr Terri Foran (women’s health) and Dr Sepehr Shakib (pharmacology).
      
      And what social events! A highlight this year was the Vietnamese-themed dinner with apparently no time or expense spared by delegates to dress for the occasion. Of course, there was no shortage of tailor shops around town that could run up traditional men’s and women’s outfits in less than 24 hours.
      
      This kind of learning sure can be fun, but there’s plenty of hard work for the delegates as well. Many continue to deliberate long after the education sessions are over for the day – just to ensure they get correct answers to the questions in the ‘Jack Thomas Quiz’. The winner’s name engraved on the perpetual trophy is an incentive; and so is maximising your CPD points for the year.
      
      This year saw one of the closest Jack Thomas Quiz contests in Refresher Course history. Of
      the over 150 responses to the 75-question quiz, six delegates finished with a score of 97% – and placegetters were separated only by assessment of the written case study. First prize
      went to Johanna Bou-Samra, who works as Indigenous Outcomes Pharmacist with
      Queensland Health. Meredith Bell and former Jack Thomas Quiz winner Louise Braddock were joint runners-up.
      
      Skin has been a big thing at the conference this year – well, it is our biggest organ. Dermatology is a major part of our extended practice, so expertise in this area will help us take advantage of new opportunities. However, don’t despair if you missed out on the Offshore Refresher Course this year. Dr Phillip Artemi will also have a cameo role as part of the speaking faculty next year.
      
      Planning to attend the next Offshore Refresher Course? You should, and you should act now.
      
      Next year we celebrate the 50th Offshore Refresher Course in a very special way. The main conference in Japan will be on the luxury cruise ship Crystal Symphony. Bookings are filling fast, and we can’t take more than our cabin allocation will allow.
      
      So, it’s sayonara Saigon; Tokyo here we come.
      
      Find out more about what’s instore for 50th Offshore Refresher Course in Tokyo here.
                  [post_title] => PSA's Offshore Refresher wraps with style, and tailor-made outfits
                  [post_excerpt] => Clothes, culture and clinical learnings were in abundance at at the 49th PSA Offshore Refresher Course, held in Vietnam from 14–22 May 2025.
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          [title_attribute] => PSA’s Offshore Refresher wraps with style, and tailor-made outfits
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      PSA’s Offshore Refresher wraps with style, and tailor-made outfits

      ACOP
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                  [post_content] => Since new cut-off dates were announced for pharmacists to comply with updating credentialing requirements, queries to PSA’s Pharmacist to Pharmacist Advice Line have surged.
      
      Here’s a round up of your top questions, answered.
      

      1. Why do I need to transition to a new credentialing system?

      After the Australian Association of Consultant Pharmacy (AACP) ceased operations in 2022, the Australian Pharmacy Council (APC) was charged with developing updated accreditation standards for Medication Management Review (MMR) and Aged Care pharmacist services. This process yielded two new credentials – the MMR Credential and the Aged Care On-site Pharmacist (ACOP) Credential. All pharmacists, whether originally accredited by the AACP or by another provider since its closure, must now transition to these new credentials. The primary change is the separation of MMR and ACOP into distinct credentials, each mandating dedicated training for pharmacists, said Bill Wallace MPS, PSA Pharmacist – Professional Support Adviser, who supports PSA members through the Pharmacist to Pharmacist Advice Line. ‘Those with prior experience in either area may apply for Recognition of Prior Learning (RPL) to receive credit toward their new credential(s), while others will need to complete additional education to fulfil the updated requirements,’ he said.

      2. How do I apply for MMR recognition of prior learning?

      Pharmacists who were accredited by AACP, PSA or ACP can submit proof of initial accreditation along with additional evidence as outlined in PSA’s RPL course page, Mr Wallace said. The performance outcomes not assessed by prior study are those relating to cultural competence (1.1) and individual quality improvement activities (4.2).  Examples of appropriate evidence to submit include:  
      • 1.1  – completing the free Deadly pharmacists foundation training course
      • 4.2 – establishing a personal quality-improvement plan that incorporates reflective practice or participation in a peer-review forum to receive feedback on your MMR work.

      3. What credentialing pathway do I need to take to work as an Aged Care Onsite Pharmacist?

      To work as an Aged Care Onsite Pharmacist , pharmacists need to have completed the MMR course and complete one of the following before 30 June 2026:
      • an ACOP credentialing course through PSA or other provider
      • the ACOP RPL process.
      ‘The ACOP RPL process is more comprehensive than the MMR RPL process, requiring the development of a detailed portfolio of evidence to demonstrate competency against each of the performance outcomes set by the APC,’ Mr Wallace said. Examples of ACOP performance competencies include:
      • Collaborative Practice: producing clear and concise clinical documentation using standardised communication tools and according to the RACF’s systems and preferences
      • Safe and Quality Use of Medicines: participating in the implementation and maintenance of clinical-governance systems to improve medicines-related safety and quality

      4. What’s the new deadline for transition arrangements for the MMR and ACOP credentials?

      From 1 January 2026, all MMR-credentialled pharmacists who wish to continue claiming for Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) services, or to participate in the ACOP Measure under transition arrangements must comply with the APC’s MMR standards.

      Medication Management Reviews

      The transition period for MMRs has been extended to 31 December 2025. The Department of Health and Aged Care has confirmed that there will be no further extensions.  This extension gives MMR-credentialed pharmacists additional time to complete an APC-accredited RPL or approved training program. The following MRNs will remain valid until 31 December 2025, or until they are replaced by an updated MRN issued upon completion of an APC-accredited RPL or training program, whichever comes first:
      • AACP MRNs held as of 31 December 2022 (i.e. those active and not lapsed before that date)
      • PSA MRNs
      • ACP MRNs
      • Advanced Pharmacy Australia (formerly SHPA) MRNs.

      ACOP Measure

      The ACOP Measure transition period has been extended until 30 June 2026. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date, provided they complete an APC-accredited ACOP training program by 30 June 2026. ‘If an MMR-credentialed pharmacist transfers to a different training provider and is issued a new MRN, they must use the new MRN when claiming HMRs/RMMRs or when participating in the ACOP Measure,’ Mr Wallace added.

      5. When do I need to get my RPL applications in by?

      Pharmacists should be looking at completing the RPL process prior to the extension deadlines, Mr Wallace said.  ‘The RPL process requires an assessor to examine the submitted evidence and provide feedback if required,’ he said.  ‘This process may take up to 4 weeks if there is no extra information or resubmission required.’ To ensure uninterrupted provision of medication review services, RPL evidence should be submitted at least 2 months prior to the deadline.

      6. Does RPL still count if I don’t meet the deadline?

      If pharmacists miss the deadline, they will lose eligibility to deliver medicine reviews and be unable to claim services under the Pharmacy Programs Administrator programs. In other words, you won’t get paid for services. ‘Pharmacists  can still apply for RPL, but if they do not meet the criteria for the RPL they may need to complete the full training program to regain the MMR credential,’ Mr Wallace said.

      7. How long does it take to become credentialed and what’s involved?

      For pharmacists who are working and have other commitments, completing both training programs takes roughly 6–12 months, Mr Wallace said. ‘If a pharmacist has more time to invest, it could be completed in 3–6 months,’ he said. ‘Assessors have up to 4 weeks to assess written submissions.’ The MMR Credential course is organised into four structured modules that progressively develop key competencies in medication reviews.  ‘Learners are evaluated through multiple-choice quizzes to verify understanding, a reflective exercise on providing culturally safe and inclusive care, and a peer-led discussion analysing an MMR report,’ he said. ‘They also participate in an AI-driven simulated patient encounter to practise medication history taking, and undertake a live online Objective Structured Interview to showcase their practical skills.’  The course also features a quality-improvement assignment, in which participants are required to review relevant policies and reflect on their own practice to drive ongoing enhancement. Meanwhile, the four-module ACOP credential course builds on the MMR Credential framework and begins with a similar assessment process. The course includes a supervised site visit to a residential aged-care facility, during which participants observe care delivery and critically reflect on both the environment and service quality, Mr Wallace said. ‘The course further incorporates a case-conference simulation; learners view a recorded interdisciplinary meeting and appraise their prospective roles and contributions,’ he said. ‘Then, a quality-improvement project tasks participants with conducting clinical audits and preparing governance reports to foster ongoing enhancements in aged-care settings.’ For advice on all things pharmacy, ring PSA’s Pharmacist-to-Pharmacist Advice Line between 8.30am to 5.00pm AEST on 1300 369 772. [post_title] => Countdown to new MMR and ACOP credential deadline [post_excerpt] => PSA's advice line has been flooded with questions from credentialed pharmacists on how to apply for MMR and ACOP recognition. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => countdown-to-new-mmr-and-acop-credential-deadline [to_ping] => [pinged] => [post_modified] => 2025-05-27 09:22:29 [post_modified_gmt] => 2025-05-26 23:22:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29462 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Countdown to new MMR and ACOP credential deadline [title] => Countdown to new MMR and ACOP credential deadline [href] => https://www.australianpharmacist.com.au/countdown-to-new-mmr-and-acop-credential-deadline/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29463 [authorType] => )

      Countdown to new MMR and ACOP credential deadline

      risperidone
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                  [ID] => 29429
                  [post_author] => 3410
                  [post_date] => 2025-05-21 12:44:53
                  [post_date_gmt] => 2025-05-21 02:44:53
                  [post_content] => The Therapeutic Goods Administration (TGA) has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18.
      
      In 2024 alone, 22 adverse events as a result of overdose of risperidone oral solution were reported to the TGA – most cases involved accidental administration of 10 times the prescribed dose (for example, 5 mL instead of 0.5 mL). 
      
      Although no deaths were recorded, adverse effects led to hospitalisations in most cases.
      

      Why are dosing errors occurring?

      An investigation by the TGA unearthed several drivers for dosing errors of risperidone oral solution including:
      • misinterpreting dosing instructions
      • incorrect use of the dosing syringe
      • medicine administration by non-primary caregivers (e.g. babysitters or other relatives).
      And the TGA is not the only national health agency to raise concerns about risperidone dosing confusion. The Spanish Agency for Medicines and Health Products issued a public alert after discovering that paediatric caregivers misread decimal points when administering a dose of 1 mg/mL risperidone solution, often inadvertently giving ten times the intended dose. Most (74%) of these incidents were serious, with children suffering sedation, hypotension, tachycardia, extrapyramidal symptoms, QT prolongation and, in some cases, seizures. In Ireland, the Health Products Regulatory Authority echoed these concerns, reporting ten‐fold overdoses in children aged 3–15 –  urging prescribers and pharmacists to provide clear dosing-device instructions and educate caregivers on recognising and responding to overdose symptoms.

      What’s changing?

      To address the identified risk, the Product Information (PI) and Consumer Medicines Information (CMI) for Risperdal have been revised, and generic manufacturers are now required to update PIs and CMIs to mirror these changes. The new versions for Risperdal include more detailed dosing guidance and illustrative diagrams to support accurate administration including:
      • use the supplied pipette only: do not substitute with another measuring device
      • open the child-resistant cap: push down on the plastic screw cap and turn counter-clockwise, then lift off
      • insert and draw up dose: place the pipette in the bottle; hold the bottom ring and pull up the top ring to the mark matching the prescribed dose (e.g. 0.25 mL for 0.25 mg, 0.5 mL for 0.5 mg)
      • dose equivalence: 1 mL of Risperdal solution = 1 mg risperidone; graduations on the plunger are in 0.25 mL (0.25 mg) increments
      • administer in a drink: remove the pipette, slide the top ring down to expel the dose into a non-alcoholic beverage (e.g. water, juice, milk, coffee – avoid tea)
      • after use: close the bottle; rinse the pipette with cold water, let it air dry in its case; avoid detergents or vigorous wiping to preserve the printed graduations.
      While each generic product should cover the same key details, the syringe and instructions can vary by brand. So pharmacists are advised to always double-check the individual PIs.

      What do pharmacists need to do?

      Dosing instructions need to be clearly printed on the label. According to the Australian Commission on Safety and Quality in Health Care’s National standard for labelling dispensed medicines (Standard 6), label wording  should:
      • have digits for dosage amounts (e.g. ‘Take 1 tablet,’ not ‘Take one tablet’ or ‘Take ONE tablet’)
      • express dose ranges with words between numbers (e.g. ‘1 to 2,’ not ‘1-2’ which could be read as ‘12’)
      • spell out common fractions to avoid confusion (e.g. ‘quarter,’ not ‘0.25’ or ‘¼’)
      • for small paediatric liquid doses, match the numbers on the oral dispenser (e.g. ‘0.5 mL’).
      Presenting numbers as digits generally improves clarity among patients. However, fractions written symbolically (e.g. ½’) may be misread as ‘1 or 2’ and decimal points can be overlooked (e.g. ‘1.5’ read as ‘15’). That’s why, when counselling patients prescribed risperidone oral solution, pharmacists should:
      • verify that all caregivers understand the prescribed dosing regimen
      • demonstrate precisely how to measure the required volume using the provided oral syringe
      • instruct caregivers to review the dosing label before each administration and confirm their understanding, especially with those administering the medicine for the first time.
      [post_title] => Paediatric risperidone errors prompt TGA safety update [post_excerpt] => The TGA has tightened dosing advice for the antipsychotic risperidone after an alarming number of overdoses occurred in patients under 18. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => paediatric-risperidone-errors-prompt-tga-safety-update [to_ping] => [pinged] => [post_modified] => 2025-05-21 15:02:24 [post_modified_gmt] => 2025-05-21 05:02:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29429 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Paediatric risperidone errors prompt TGA safety update [title] => Paediatric risperidone errors prompt TGA safety update [href] => https://www.australianpharmacist.com.au/paediatric-risperidone-errors-prompt-tga-safety-update/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29433 [authorType] => )

      Paediatric risperidone errors prompt TGA safety update

AUSTRALIAN PHARMACIST Australian Pharmacist
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