td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8736 [post_author] => 23 [post_date] => 2019-11-20 09:01:07 [post_date_gmt] => 2019-11-19 23:01:07 [post_content] => Almost 10% of residents in aged care facilities were prescribed an antimicrobial, mostly commonly cefalexin and clotrimazole, but the majority had no documented signs of infection, The 2018 Aged Care National Antimicrobial Prescribing Survey has found. Published early ahead of World Antibiotic Awareness Week this week, the survey data was collected on 20,030 aged-care residents from 407 facilities around the country.1 On the day of the survey, almost 10% of residents in participating facilities were prescribed at least one antimicrobial. Two-thirds of those recently prescribed were for residents with no documented signs or symptoms of infection, and more than a quarter of antimicrobials had been prescribed for longer than 6 months. Over one-third of antimicrobials prescribed were topical preparations. Skin, soft tissue or mucosal infections (18%), cystitis (16%) and pneumonia (9%) were the most common indications presumed or documented for prescribed antimicrobials. The authors recommended that documentation of start, stop and review dates for antimicrobials was needed, given the incomplete documentation found during the survey.1 To mark Antibiotic Awareness Week for 2019, Professor Brendan Murphy, Australian Government Chief Medical Officer and Dr Mark Schipp, Australian Chief Veterinary Officer have released a joint statement on how Australians can reduce antibiotic resistance. The joint statement is published on the Australian Government’s AMR website. As Australia is one of the highest users of antibiotics in the developed world, pharmacists and all Australians need to heed the call: It’s time to take antibiotic resistance seriously.2 The World Health Organization warns that antibiotic resistance is one of the greatest threats to human health today, but pharmacists can be part of the solution by helping preserve the effectiveness of antibiotics.2
What can pharmacists do?Pharmacists can help patients understand when to, and when not to, use antibiotics, and how to use them. They can advise on other treatments to manage symptoms and how to prevent infections and their spread (e.g. vaccination, good hygiene and handwashing).3 Taking an antibiotic stewardship role, a pharmacist can check the prescribed indication against the therapeutic guidelines to clarify the duration of therapy required, and the timeframe for when a referral is warranted if there is an inadequate response to therapy.3 Patients should be advised to return unused and expired antibiotics to the pharmacy for safe disposal through the National Return and Disposal of Unwanted Medicines program to reduce their entrance into the environment.3
Advice when dispensing antibiotics‘Some antibiotic pack sizes contain more dosage units than required for a course of therapy,’ Claire Antrobus MPS, PSA Manager, Practice Support, said. She advises that ‘it’s a good idea to ask patients if the prescriber has told them for how many days they need to take their antibiotics’. Re-consider the instruction ‘Continue until all taken’ if appropriate. Be on the lookout for signs of inadequate patient response to therapy and refer promptly.5 Prescribing data has indicated that around 25% of repeat antibiotic prescriptions were dispensed more than 4 weeks after the initial dispensing. This indicates potential inappropriate antibiotic use in the community.4 Ms Antrobus reminds us of the PSA Choosing Wisely recommendation – Do not dispense a repeat prescription for an antibiotic without first clarifying clinical appropriateness.5 Pharmacists can update their knowledge by completing Australian Pharmacist CPD: Antimicrobial stewardship and pharmacy and Antimicrobial resistance – Evidence in patient care.
Other Antibiotic Awareness Week activities:Antimicrobial resistance. Australian Government. Antibiotic Awareness Week. NPS MedicineWise. Antibiotic Awareness Week. Australian Commission on Safety and Quality in Health Care. References
[post_title] => World Antibiotic Awareness Week 2019 [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => world-antibiotic-awareness-week-2019 [to_ping] => [pinged] => [post_modified] => 2019-11-20 14:08:22 [post_modified_gmt] => 2019-11-20 04:08:22 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8736 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => World Antibiotic Awareness Week 2019 [title] => World Antibiotic Awareness Week 2019 [href] => https://www.australianpharmacist.com.au/world-antibiotic-awareness-week-2019/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8745 )
- Dowson L, Rajkhowa A, Buising K, et al. The 2018 Aged Care National Antimicrobial Prescribing Survey: results show room for improvement. Aust Prescr 2019. Epub 2019. Nov 14.
- Antibiotic Awareness Week. NPS MedicineWise: www.nps.org.au/antibiotic-awareness
- Department of Health: www.amr.gov.au/what-you-can-do/pharmacy
- PSA media release. New medicines advice: Prescribing cascades, polypharmacy, homeopathy. 2018. At: www.psa.org.au/new-medicines-advice-prescribing-cascades-polypharmacy-homeopathy
- Campbell C, Page A, Edwards S, et al. Choosing wisely: Antibiotics. Australian Pharmacist 2019;38(5):20–21. Choosing Wisely Recommendations – Pharmaceutical Society of Australia. At: www.choosingwisely.org.au/recommendations/pharmaceutical-society-of-australia
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8740 [post_author] => 175 [post_date] => 2019-11-20 08:28:42 [post_date_gmt] => 2019-11-19 22:28:42 [post_content] => The Royal Australian College of General Practitioners (RACGP) has supported PSA’s call for better dispensing authorities without prescriptions for people with chronic disease during natural disasters and emergency situations. Asked if it was in favour of pharmacists having greater autonomy to dispense a month’s supply of medicines during disasters, the president of the RACGP, Dr Harry Nespolon, said any changes ‘must be approached very carefully’. He welcomed discussions with PSA and the federal government on 'any proposals that aim to ensure those impacted by emergencies such as bushfires have the support and care they need’. Any changes made should only apply ‘where absolutely necessary’, he told Australian Pharmacist yesterday. As 50 fires (fewer than last week) continue to rage through New South Wales (NSW) ahead of more predicted heatwave conditions, 20 of them remained uncontained and air quality in Sydney from nearby fires this week was equivalent to those of some of the world’s most polluted cities. Rural and remote areas in parts of the state faced similar conditions. The first ‘catastrophic’ fire risk rating issued for NSW last week prompted the federal Health Department to highlight the current three-day emergency supply rule that applies to pharmacists under which they can dispense medicines without a prescription. In its advice for approved pharmacists, the department specified that the advisory notice was in effect until ‘at least 30 December’. It included provisions for pharmacists needing emergency relocation of their business – with their Pharmaceutical Benefits Scheme (PBS) pharmacy approval number remaining the same for temporary relocations. PSA National President Associate Professor Chris Freeman has said that forced evacuations ahead of fires showed how pharmacists required greater freedom to dispense critical medicines to patients in need. ‘PSA has long proposed that pharmacists should have the ability to provide at least a month’s supply of medicines, especially those medicines for chronic disease when a patient has run of our their current supply. It’s when these disasters occur that these issues come to the fore,’ he told AP. ‘Pharmacists unfortunately in these bushfire hit regions will be actually impeded by state and territory legislation as well as PBS legislation in ensuring continuity of medicines supply. ‘This needs to be fixed as a matter of priority.’ Yesterday, Dr Nespolon said: ‘We would welcome discussion with government and the Pharmaceutical Society of Australia on any proposals that aim to ensure those impacted by emergencies such as bushfires have the support and care they need. ‘However, any such changes must be approached very carefully and should only apply where absolutely necessary,’ he said. ‘Ensuring a patient’s continuity of care with their GP will always be a key imperative.’
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8727 [post_author] => 235 [post_date] => 2019-11-19 16:04:55 [post_date_gmt] => 2019-11-19 06:04:55 [post_content] => Brad Butt MPS has been named the 2019 UTS Most Innovative Pharmacist for his pioneering work in men’s health. Mr Butt established Men’s Health Downunder at his pharmacy in Cooleman Court, Canberra in 2013. With prostate cancer the second-most diagnosed cancer in Australian men, Mr Butt said he wanted to address the lack of support for men recovering from a prostatectomy. The program has since expanded into other urological issues, including Peyronie’s disease, incontinence and erectile dysfunction, as well as a website where men and their partners can access health information. ‘I am very proud to say that Men’s Health Downunder is now the largest men’s health pharmacy clinic in Australia,’ Mr Butt said. ‘While many of our patients are referred by GPs, urologists and sexual health clinics, we are finding more and more patients self-referring for additional advice and support.’ An initial consultation with a Men’s Health Downunder pharmacist generally runs for about 45 minutes and includes gathering a patient’s medical history and making sure they have the appropriate medicines. Much of the subsequent consultations involve counselling patients about the safe use of medicines and setting milestones so patients know what to expect. [caption id="attachment_8730" align="alignright" width="1000"] UTS Professor Kylie Williams, Warwick Plunkett FPS, Brad Butt MPS and Liz Chatwin from AstraZeneca.[/caption] Accepting the award at the UTS Pharmacy gala dinner earlier this month, Mr Butt said the program was helping to reduce the stigma around this area of men’s health. ‘In the last 12 months, we have seen over 1,000 patients and their partners who would otherwise have had little to no further support with their urological health issues,’ he said. ‘This has an immeasurably positive impact on patient mental health.’ Men’s Health Downunder also runs an annual allied health practitioner conference, a GP education event and a patient forum, and Mr Butt said he plans to hold masterclasses in the future to reach as many men as possible. Chair of the Industry Advisory Board for Pharmacy at UTS, Warwick Plunkett FPS said Butt’s initiative embodies the spirit of the awards, which were established to recognise pharmacists who share UTS’ passion for embracing innovation, implementing professional services and redefining the profession in the process. [caption id="attachment_8732" align="alignright" width="268"] UTS students and PSA Prize for Excellence in Pharmacy winners Joshua Thompson and Malu Katz.[/caption] ‘Despite many excellent nominations, the judges felt that Men’s Health Downunder was the most innovative,’ Mr Plunkett said. ‘It is a highly original service in a therapeutic area that is often shrouded in ignorance, which is the epitome of the award’s overriding objective.’ Several UTS Pharmacy students also received awards at the gala dinner, including first-year student Malu Katz and second-year Joshua Thompson, who both received the PSA Prize for Excellence in Pharmacy. Mr Thompson said he was honoured to accept the award. ‘Pharmacy is such an exciting profession because it is expanding so much in Australia,’ he said. ‘The course at UTS has been great, particularly the placements. I’ve got a real kick out of applying my theoretical knowledge to the fast-paced hospital environment.’ [post_title] => The pharmacy service improving men’s health down under [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => the-pharmacy-service-improving-mens-health-down-under [to_ping] => [pinged] => [post_modified] => 2019-11-20 14:08:43 [post_modified_gmt] => 2019-11-20 04:08:43 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8727 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => The pharmacy service improving men’s health down under [title] => The pharmacy service improving men’s health down under [href] => https://www.australianpharmacist.com.au/the-pharmacy-service-improving-mens-health-down-under/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8728 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8709 [post_author] => 175 [post_date] => 2019-11-13 11:23:16 [post_date_gmt] => 2019-11-13 01:23:16 [post_content] => State and federal health departments have advised of options available to pharmacists in parts of NSW and Queensland affected by this week’s catastrophic-level fires. Under the existing three-day emergency supply rule they can dispense medicines without a prescription until ‘at least 30 December’ if satisfied of an immediate need, the federal Department of Health advice for approved pharmacists stated. These include provisions for pharmacists needing emergency relocation of their business – with their Pharmaceutical Benefits Scheme (PBS) pharmacy approval number remaining the same for temporary relocations. The NSW Ministry of Health advised yesterday when parts of greater Sydney and NSW were deemed at ‘catastrophic’ fire risk, that pharmacists wanting temporary relocation should contact the Pharmacy Council of NSW on 1300 197 177. Queensland’s Chief Health Officer, Dr Jeanette Young, advised of a State of Fire Emergency across 42 Local Government Areas in the state at the weekend following a period of significantly heightened fire weather conditions expected to continue this week. But PSA National President Associate Professor Chris Freeman said forced evacuations ahead of fires showed how pharmacists require greater freedom to dispense critical medicines to patients in need. ‘PSA has long proposed that pharmacists should have the ability to provide at least a month’s supply of medicines, especially those medicines for chronic disease when a patient has run of our their current supply. It’s when these disasters occur that these issues come to the fore,’ he told Australian Pharmacist. ‘Pharmacists unfortunately in these bushfire hit regions will be actually impeded by state and territory legislation as well as PBS legislation in ensuring continuity of medicines supply. ‘This needs to be fixed as a matter of priority. It prevents pharmacists from caring for their patients in an effective way. Enough is enough.’ Early today, according to the NSW Rural Fire Service, 73 fires were burning across the state with 37 of them uncontained. ‘Pharmacists seeking to temporarily relocate their approved pharmacy due to damage from bushfire affected areas should send an email to email@example.com or phone 1800 316 389 quoting the name of the affected pharmacy, its current PBS approval number, addresses of the current and temporary premises, and expected timeframe for return to the approved premises,’ the federal Department of Health advice stated. The Pharmacists’ Support Service (PSS) advised this week it can offer a listening ear and someone to talk through the impact of the fires on pharmacists and how they are feeling. PSS is available on 1300 244 910 every day of the year between 8.00 am and 11.00 pm AEDT. [post_title] => Catastrophic fire ratings highlight need for better emergency dispensing provisions [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => emergency-relocation-and-dispensing-rules-in-place-to-new-year-nsw-and-qld [to_ping] => [pinged] => [post_modified] => 2019-11-13 18:39:01 [post_modified_gmt] => 2019-11-13 08:39:01 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8709 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Catastrophic fire ratings highlight need for better emergency dispensing provisions [title] => Catastrophic fire ratings highlight need for better emergency dispensing provisions [href] => https://www.australianpharmacist.com.au/emergency-relocation-and-dispensing-rules-in-place-to-new-year-nsw-and-qld/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8710 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8693 [post_author] => 235 [post_date] => 2019-11-13 11:07:24 [post_date_gmt] => 2019-11-13 01:07:24 [post_content] => Pharmacist salaries in rural and remote areas are on the rise as the demand for professionals in community and hospital roles increases. According to the 2019 Raven’s Recruitment Pharmacy Market Report, released last week, demand for pharmacists in the past 12 months has increased in all sectors. Shortages, however, are most critical outside the metropolitan areas. While a pharmacist in Sydney can expect to earn $68,000 to $84,000 per year before superannuation, a colleague in the same position in the ACT could expect $74,000 to $82,000, according to the report. This salary jumps to between $89,000 and $101,000 in the Northern Territory. The same discrepancies are shown in the report between pharmacist manager and intern pharmacist roles in city and regional areas. For instance, an intern pharmacist in Melbourne, Perth and Brisbane can expect a salary of between $48,500 and $54,000. In regional and rural Victoria and Tasmania the range is $52,000 to $63,000, but in rural Queensland and the Northern Territory, including Darwin, the salary range is between $58,000 and $64,000. Pharmacist manager annual salaries [table id=5 /] Source: 2019 Raven’s Recruitment Pharmacy Market Report Raven’s Recruitment General Manager Heidi Dariz said increasing numbers of pharmacists, particularly those in community pharmacy, had been leaving the profession due to pay and working conditions. While the Fair Work Commission’s decision to increase pharmacists’ pay by 5% over this year was welcome, Ms Dariz said, ‘many in the industry share the opinion that the Community Pharmacy Award is still irrelevant to the actual cost of recruiting and retaining quality staff’. ‘Whilst we have seen an overall increase in the salaries pharmacy employers have been offering this year, many employees have felt that the increases are too low for the responsibilities and workload the role entails,’ she added. She pointed to PSA’s Pharmacists in 2023: Roles and Remuneration report, which advocates for an increase in remuneration across the pharmacy sector, both to fund more patient-focused professional activities and to fund an increase in pharmacists’ salaries. PSA also developed a new remuneration model for pharmacists, based on the Advanced Practice Framework, which takes into account a pharmacists’ years and area of experience. ‘The [PSA report] highlighted the fact that remuneration for pharmacists did not reflect their skills, training, expertise or responsibility in the healthcare system, with the average hourly pay rate for community pharmacists well below that of professions with comparative levels of professional responsibility and training,’ Ms Dariz said. ‘To counter the effect on attraction and retention, employers will need to look at investing in training programs, offer career development pathways and offer genuine work-life balance initiatives if they are to retain valued staff and not lose them to other industries.’ Ms Dariz said she has also seen more pharmacists looking outside the traditional career path, rather than leaving the profession altogether. ‘We have had an increasing number of candidates interested in other career paths within pharmacy, including working in the pharmaceutical industry, within aged care and as pharmacists in GP clinics, and we expect this trend to continue into the future, she said. [post_title] => Pharmacists’ demand highest in rural and remote areas [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacists-demand-highest-in-rural-and-remote-areas [to_ping] => [pinged] => [post_modified] => 2019-11-13 16:30:40 [post_modified_gmt] => 2019-11-13 06:30:40 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8693 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pharmacists’ demand highest in rural and remote areas [title] => Pharmacists’ demand highest in rural and remote areas [href] => https://www.australianpharmacist.com.au/pharmacists-demand-highest-in-rural-and-remote-areas/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8707 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8690 [post_author] => 23 [post_date] => 2019-11-13 09:54:04 [post_date_gmt] => 2019-11-12 23:54:04 [post_content] => With increasing overdose deaths from both prescription opioids and heroin, naloxone nasal spray – now listed on the Pharmaceutical Benefits Scheme – is a life-saving and easy-to-use opioid reversal agent to stock in your pharmacy. And pharmacists this week have been urged to re-think social attitudes to reduce the stigma of drug use, addiction and overdose to ensure easy access to naloxone nasal spray. Guidance for provision of naloxone is now available in the PSA document Guidance for provision of a Pharmacist Only medicine – Naloxone for the treatment of opioid overdose.1 As John Jackson, Chair of PSA’s Harm Minimisation Committee told Australian Pharmacist: ‘Naloxone is not a new drug. It has been used extensively in a parenteral form, especially in hospitals where pharmacists have a sound knowledge of its use as a narcotic antagonist.’ But there is growing recognition of its potential benefit for suspected opioid overdose in the community. Deaths due to illicit drug overdose (e.g. heroin or diverted fentanyl) commonly occur in the presence of another person. There may be a reticence to call an ambulance because of possible police involvement. Broader availability of naloxone among users, their family and friends can save lives. The potential for overdose also exists with opioids prescribed for chronic pain (e.g. oxycodone), particularly when used with other central nervous system depressants such as alcohol and benzodiazepines. Australian research has found that most chronic pain patients prescribed opioids either expect to be offered naloxone or would appreciate it.2
Human storiesThe director of the Australian Research Centre in Sex, Health and Society at LaTrobe University, Professor Suzanne Frazer, led a recent research project into why naloxone was not accessed more widely. Researchers interviewed 37 health professionals and also 46 people in New South Wales and Victoria who take opioids and found that many were either unaware of how to obtain the reversal agent or were too embarrassed. Yesterday (Tuesday) the experiences and stories collected through that research were shared on Overdoselifesavers.org, a website launched at the Australasian Professional Society on Alcohol and Other Drugs conference in Hobart. ‘Many people we interviewed were keen to know about naloxone, and access it, but were concerned about confidentiality when speaking to pharmacists, or didn’t want to bring it up with their GP in case it affected their relationship in the future,’ Professor Frazer said. ‘We need to rethink our social attitudes to opioid consumption and overdose if naloxone programs are to fully achieve their life-saving potential,’ she said yesterday.
Role of the pharmacistExperience with naloxone may be limited in the community, but pharmacists are uniquely placed to identify people at risk of opioid toxicity and provide them with a reversal agent. Being alert for the signs of opioid overdose, and then facilitating access to naloxone and training for family and friends, presents a good opportunity for pharmacists to undertake early intervention. And naloxone is safe with no abuse potential. Australian and international studies have demonstrated that supplying naloxone for a layperson to administer is safe, feasible and cost-effective.2 ‘In the nasal formulation, a simpler, more convenient preparation is able to be readily administered without extensive training,’ Mr Jackson said. Naloxone is a competitive antagonist at opioid receptors with a fast onset of action and a short half-life. When administered in the presence of an opioid, it displaces the opioid at the receptor and reverses its effects – importantly respiratory depression which can be fatal. It works for all opioids, e.g. heroin, morphine and oxycodone as well as opioid substitution therapies such as methadone. It is also safe in nonusers. When given to healthy volunteers with no recent exposure to opioids, naloxone showed no adverse effects.2 In 2016, naloxone injection 400 microgram/mL became available as a Schedule 3 medicine, available over-the-counter (OTC) and on prescription. It is approved for intramuscular, intravenous and subcutaneous use in Australia, and has been used by ambulance and paramedical staff to treat overdose for over 40 years.2 Naloxone nasal spray, 1.8 mg/actuation, became available OTC and on prescription (PBS subsidised on 1 November), earlier this year. Mr Jackson said that ‘pharmacists need to develop the capability to identify and assess high-risk individuals in a non-stigmatising manner’. From the PSA guidance document, pharmacists can identify high-risk factors (e.g. high opioid dose (>100 mg morphine equivalents/day)), long-acting form (e.g. methadone) or extended-release preparation). The person may have a respiratory condition, or smoke or take other central nervous system depressants, or may be part of a methadone or detoxification program. Pharmacists should discuss with patients/carers the risks associated with opioids, and supply naloxone where appropriate. Also, ensure the person has been provided with an emergency opioid overdose protocol.2 ‘In training people to recognise the symptoms of opioid overdose and how to administer the nasal spray, pharmacists should ensure [they] understand it is not a substitute for professional medical care, and further doses of naloxone may be required,’ Mr Jackson warned. Although the nasal spray contains two single dose devices, ‘emergency assistance should be sought whenever an opioid overdose is suspected and the spray administered’, he added. ‘The [nasal] spray can be administered even if the person is not breathing.’ Inform users that ‘each device contains only one spray and should not be pumped or “primed” before use.’ Be mindful that naloxone has a half-life <1 hour, which is shorter than all the opioids. Observe the patient for 2–3 hours after naloxone administration for relapse. This is particularly important following methadone or controlled-release opioids, where narcosis may persist for >24 hours.3
ResourcesRefer to the PSA guidance document for the use of naloxone nasal spray in children, pregnancy and while breastfeeding, where the infant needs to be monitored for opioid withdrawal symptoms. Also, refer to the recommendations when supplied to a third party and follow–up advice.1 A training resource is available at: www.penington.org.au/programs-and-campaigns/resources/cope-overdose-first-aid Although the nasal spray formulation is expensive at present, Mr Jackson said we can expect to see a price reduction, especially as multiple brands are available overseas. References
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- Pharmaceutical Society of Australia. Guidance for provision of a Pharmacist Only medicine: Naloxone. Canberra: PSA; 2019.
- Jauncey ME, Nielsen S. Community use of naloxone for opioid overdose. Aust Prescr 2017;40:137–40.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8675 [post_author] => 27 [post_date] => 2019-11-12 13:51:58 [post_date_gmt] => 2019-11-12 03:51:58 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text]As regulatory bodies restrict or ban carisoprodol, the highly addictive but effective muscle relaxant still dominates the US prescription drug market. Carisoprodol, marketed in the United States1 as Soma and Vanadom, was one of the first anxiolytic drugs sold on the market. Soma was developed in 1950 by Frank Berger and Bernard John Ludwig at Carter Products. The team at Carter Products also developed meprobamate (Early Elixirs, September) and felbamate, used in the treatment of epilepsy.2 In 1959 the US Food & Drug Administration approved carisoprodol for use and throughout the next two decades concerns about abuse of the drug spread.3 But it wasn’t until an explosion in its use in the 1990s and early 2000s that it was classified in America as a Schedule IV drug with a potential for abuse in 2012.4 Between 1996 and 2005 the number of emergency department visits caused by carisoprodol in the US increased from 6,569 to 19,513 with the drug listed as one of the 25 most dangerous in the country. Despite restrictions, carisoprodol is still widely prescribed with over 3 million prescriptions (a drop from the 10 million written in 2008) written in the US in 2016.5
How it worksThe exact method of action of carisoprodol is unclear but laboratory studies on animals show the relief of painful musculoskeletal conditions is associated with changes in the interneural activity of the spinal cord and the descending reticular formation in the brain. Carisoprodol’s effects are felt within 30 minutes and last for approximately six hours, bringing on feelings of drowsiness and mild to strong euphoria – albeit short-lived due to the rapid rate at which it is metabolised. The drug has powerful reactions with many opioids and analgesics (especially codeine) reducing the amount of the opioid required for effect.6 Researchers have described carisoprodol as producing an effect in users similar in some ways to alcohol intoxication.5 Prolonged use of carisoprodol can lead to physical dependence and withdrawal can be life threatening for high-dose users. Patients suffering from physical withdrawal can be given long-acting benzodiazepines such as diazepam or clonazepam as the dosage of carisoprodol is slowly reduced.6 Used illicitly, carisoprodol is mixed with opioids and benzodiazepines to accentuate a user’s high. This practice is referred to as ‘The Holy Trinity’. A typical dose of carisoprodol is 350–700 mg but some take up to 1050 mg or more, per day.5
Use in AustraliaCarisoprodol is no longer a licenced product in Australia but can be accessed via the Special Access Scheme. Globally, it has been removed from sale by authorities or heavily restricted in Norway, Sweden, the European Union, Indonesia and Canada.5 References
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- Drug Enforcement Administration, Diversion Control Division, Drug & Chemical Evaluation Section. CARISOPRODOL (Trade Name: Soma®) 2019. At: www.deadiversion.usdoj.gov/drug_chem_info/carisoprodol/carisoprodol.pdf
- Tone A. The Age of Anxiety: A History of America’s Turbulent Affair with Tranquilizers. New York: Basic Books; 2009. At: https://www.amazon.com/Age-Anxiety-Americas-Turbulent-Tranquilizers/dp/046502520X
- Fass J. Carisoprodol legal status and patterns of abuse. Ann Pharmacother 2010;44(12):1962–7. At: https://www.ncbi.nlm.nih.gov/pubmed/21062909
- Reeves RR, Burke RS, Kose S. Carisoprodol: update on abuse potential and legal status. South Med J 2012;105(11):619–23. At: https://www.ncbi.nlm.nih.gov/pubmed/23128807
- The Drug Classroom. Carisoprodol 2016. At: https://thedrugclassroom.com/video/carisoprodol/
- US National Library of Medicine. PubChem. Compound summary, carisoprodol 2019. At: https://pubchem.ncbi.nlm.nih.gov/compound/Carisoprodol
- Fudin J. The perfect storm: opioid risks and ‘The Holy Trinity’. Pharmacy Times 2014. At: www.pharmacytimes.com/contributor/jeffrey-fudin/2014/09/the-perfect-storm-opioid-risks-and-the-holy-trinity
- Australian Government, Federal register of legislation. Poisons standard February 2017 made under paragraph 52D(2)(a) of the Therapeutic Goods Act 1989. At: www.legislation.gov.au/Details/F2017C00665
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8505 [post_author] => 23 [post_date] => 2019-10-30 09:51:30 [post_date_gmt] => 2019-10-29 23:51:30 [post_content] => When medication charting involves a pharmacist as well as a doctor, medication error rates in hospital admissions are significantly reduced, according to a new study.1 Researchers from Monash University’s Centre for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences and Alfred Health evaluated the model of collaborative medication-charting in public hospitals in Victoria. Over 8,500 patients in general medical wards were included in the study, making it the largest of its kind.1 Generally, a doctor charts a patient’s medications on admission, after which a pharmacist reviews and reconciles the medication list. However, delays and review omissions can occur. This increases the risk of medication errors, potentially leading to patient harm and increased duration of hospitalisation. The 2016 study aimed to see whether timely, collaborative care as soon as possible after admission would reduce medication errors. Patients who had partnered pharmacist medication charting (known as PPMC) were found to have a reduced hospital stay from 4.7 (IQR* 2.8-8.2) days to 4.2 (IQR 2.3-7.5) days (p<0.001); a reduction of half a day on average.1 Also, the number of medication errors detected within 24 hours of admission was significantly reduced. Medications charts that had at least one error was reduced from 66% to 3.6%.The number-needed-to-treat to prevent one error was 1.6 (95% Cl:1.57-1.64).1 The PPMC model involved a pharmacist taking a medication history, reconciling medications, assessing risk of venous thromboembolism (VTE), collaboratively making decisions with the admitting medical officer and charting the medication. A second pharmacist took the role of independent assessor, reviewing all medications charted by a pharmacist within 24 hours, to provide a second check and identify any medication errors. A limitation of the study was that pharmacists were only available during normal working hours during the intervention phase, whereas in the pre–intervention phase all admitted patients were included in the study, no matter what time of day or night. The Deputy Director of Pharmacy at Alfred Health, Erica Tong, praised the collaborative work with the medical team at the point of admission, and believes the partnered pharmacist model around the clock should be evaluated. ‘Implementation of this model to other clinical areas such as surgical and oncology services should be considered, and evaluation of the impact on electronic prescribing systems on this model should also be investigated,’ Ms Tong said.1 The Acting Director of Pharmacy Services at Brisbane’s Princess Alexandra Hospital (PAH) and Associate Professor at the University of Queensland’s School of Pharmacy, Michael Barras, welcomed the study findings and fully supports this model of care. ‘Prescribing is not currently in a pharmacist’s scope of practice, unless under a research framework, so that task remains with the medical officer,’ he added. Although not providing 24-hour care, Emergency Department pharmacists are available until 8.00 pm daily. 'Models of care like this pharmacist-led medicines charting initiative need to become normal care for all patients in all hospitals if we are serious about medicine safety. Whatever Australian hospital a patient is in, they deserve to receive access to high quality pharmacist care like this,' according to PSA National President Associate Professor Chris Freeman. 'We welcome this research as it adds further weight to PSA’s call in Pharmacists in 2023 for hospital pharmacists to be available at comparable levels regardless of location, timing or nature of stay to make patients in Australian hospitals safer.' The Monash study on minimising medication errors on admission builds on a previous study conducted by Erica Tong and colleagues – Reducing medication errors in hospital discharge summaries: a randomised controlled trial. The study involved pharmacists completing the medical discharge summary, resulting in a reduction of medication errors from 60% to 15%. This study was published in the Medical Journal of Australia (MJA) and was independently judged to be the best paper published by the MJA in 2017.2 *IQR = interquartile range, or middle 50% – used as a measure of statistical spread of results References
[post_title] => Patient outcomes improve when pharmacists chart medications [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => patient-outcomes-improve-when-pharmacists-chart-medications [to_ping] => [pinged] => [post_modified] => 2019-10-30 14:22:56 [post_modified_gmt] => 2019-10-30 04:22:56 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8505 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Patient outcomes improve when pharmacists chart medications [title] => Patient outcomes improve when pharmacists chart medications [href] => https://www.australianpharmacist.com.au/patient-outcomes-improve-when-pharmacists-chart-medications/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8515 )
- Tong EY, Mitra, B, Yip, G, et al. Multi‐site evaluation of partnered pharmacist medication charting and in‐hospital length of stay. Br J Clinl Pharmacol 2019. Epub 2019 Oct 21.
- Tong EY, Roman C, Mitra B, et al. Reducing medication errors in hospital discharge summaries: a randomised controlled trial. Med J Aust 2017;206:36–39.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8450 [post_author] => 23 [post_date] => 2019-10-22 12:13:03 [post_date_gmt] => 2019-10-22 02:13:03 [post_content] => In a move aimed at reducing antibiotic resistance, the Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that four of the most widely prescribed antibiotics in Australia have the default repeat options removed. Amoxycillin, amoxicillin–clavulanic acid, cephalexin and roxithromycin are the four antibiotics with the highest volume of repeats. Pharmacists need to be prepared for consumer queries. With the right advice, fears can be allayed and changes can be seen in a positive light for both individuals and the community. Australia's Chief Medical Officer, Professor Brendan Murphy said earlier this month that the federal Health Minister, Greg Hunt, was likely to endorse the changes. 'The Minister has to make a decision on the recommendation of the PBAC but the Minister has indicated he is supportive of these changes,' he told the ABC. Antibiotic resistance is a growing problem, acknowledged by health professionals and increasingly understood by the public. However, this doesn’t always translate into individual expectations for an antibiotic when a patient believes one is needed. At its latest meeting in August, the PBAC considered changes to listings of certain antibiotics to encourage antimicrobial stewardship (collective strategies to improve appropriateness and minimise adverse effects of antibiotic use). The outcome was a recommendation to change antibiotic listings for high use items on the PBS with repeat prescription options.1 Specifically, the PBAC recommended: ‘The removal of repeat options for a range of listings where no repeats were deemed necessary as per the Therapeutic Guidelines. The PBAC also recommended aligning the listings for specific indications to the Therapeutic Guidelines where increased quantities are clinically indicated. The PBAC considered that the recommended changes, aligned as best possible with the current version of the Therapeutic Guidelines (version 16), would support antimicrobial stewardship and quality use of medicines as well as assist in the reduction of antimicrobial resistance.’1 Angus Thompson MPS, Lecturer in Therapeutics and Pharmacy Practice at the University of Tasmania, is a passionate advocate of antimicrobial stewardship in the community and for pharmacist involvement. He sees the proposed changes to repeat options for those antibiotics as an important step forward for individual patient safety and broader action on antibiotic resistance, which has been a long time coming. Mr Thompson recalls a patient admitted to hospital after a course of amoxicillin-clavulanic acid for a diabetic foot ulcer. When the ulcer hadn't improved after 5 days, she had the repeat dispensed. After 9 days she presented to her GP, who arranged for an urgent hospital admission due to the significant risk of foot amputation. If a clinical review had taken place at Day 5, earlier intervention may have prevented such a critical outcome. Mr Thompson says that while changes to repeats are welcome, other issues including changes to pack sizes to better align with course lengths recommended in Therapeutic Guidelines are necessary. He added: 'Most women taking trimethoprim for a UTI need a 3–day course so do not need to be given 7 days’ supply, as this means any remaining tablets could be used inappropriately down the track without clinical review. We also need more judicious use of the advice to complete the course, especially when pack sizes and recommended course durations often align poorly.' 'The proposed change to automatic repeats presents a huge opportunity for pharmacists at the first dispensing to advise patients – if symptoms haven't improved by the end of the first pack they need to consult with their GP, unless the GP has advised otherwise', Mr Thompson said. ‘Consistency in messages is important.' He would like to see GPs write the recommended duration of therapy on scripts so pharmacists can reinforce that instruction. PSA recently convened a meeting to discuss improvements in antibiotic labelling and counselling by pharmacists, including a review of the instruction ‘until all taken’. The meeting was chaired by Emeritus Professor Lloyd Sansom, and representative stakeholders from a number of medical, government, pharmacy and consumer organisations attended the meeting. PSA representative Claire Antrobus said that ‘a communications strategy is being developed to relay the outcomes of the meeting to medical, allied health and pharmacy professionals and to consumers’. Jack Muir Wilson MPS, pharmacist at Wilkinson’s Pharmacy in Burnie, Tasmania, also welcomes the proposed changes, although in his small community there can be difficulties getting in to see the GP promptly. Mr Muir Wilson would like to see some flexibility in the changes, to allow for prolonged courses of antibiotics when needed for chronic conditions. He thought expiry dates on antibiotic scripts would be useful, as well as new PBS Streamline codes for high–use antibiotics. Also, 'health literacy can be a problem in some rural areas, so education for patients on when antibiotics are needed would be useful, along with education for prescribers on the importance of antimicrobial stewardship', Mr Muir Wilson said. Pharmacists are urged to work collaboratively with prescriber colleagues to help improve antimicrobial stewardship in the community, where the vast majority of antibiotics are used. Reference
[post_title] => Changes to PBS antibiotic prescribing [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => changes-to-pbs-antibiotic-prescribing [to_ping] => [pinged] => [post_modified] => 2019-10-24 08:54:34 [post_modified_gmt] => 2019-10-23 22:54:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8450 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Changes to PBS antibiotic prescribing [title] => Changes to PBS antibiotic prescribing [href] => https://www.australianpharmacist.com.au/changes-to-pbs-antibiotic-prescribing/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8457 )
- August 2019 PBAC meeting – other matters. PBS. Commonwealth of Australia. At: www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/pbac-outcomes/recommendations-made-by-the-pbac-august-2019
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8416 [post_author] => 235 [post_date] => 2019-10-16 09:51:45 [post_date_gmt] => 2019-10-15 23:51:45 [post_content] => The National Asthma Council has highlighted the vital role community pharmacists can play in identifying at-risk patients, following a drop in overall asthma deaths since 2016. Australian Bureau of Statistics figures released last month show there were 389 asthma-related deaths recorded in Australia last year, down from 411 in 2017 and 457 in 2016.1 Those aged 75 years and over continue to account for nearly two-thirds of deaths. Deaths in children remain uncommon, with seven recorded child asthma deaths in 2018. While the statistics show the number of asthma deaths in women fell by about 20% between 2016 and 2018, there was just a 4% reduction in male deaths. It is not known why there is such a large discrepancy between the two, but National Asthma Council CEO Siobhan Brophy said the overall reduction in deaths could be attributed to several factors. These include increased patient awareness following the epidemic thunderstorm event in Melbourne and Geelong in 2016, in which 10 people died from asthma.2 ‘The development of new ways to manage severe asthma is also having an impact,’ Ms Brophy said.3 ‘Biological agents are improving patients’ lives, while increased management and review protocols surrounding their potential [use] are providing greater opportunities to optimise patient care.’ Ms Brophy said pharmacists can play a vital role in identifying and helping those at risk of uncontrolled asthma to better manage their condition. This includes identifying people whose poorly controlled asthma could be due to poor adherence, as well as discussing inhaler technique, triggers and the potential for reliever overuse. [caption id="attachment_8434" align="alignright" width="300"] Luke Vrankovich MPS[/caption] With male asthma-related deaths decreasing at a lower rate, Luke Vrankovich MPS, Managing Pharmacist at Amcal Castletown in Townsville, Queensland said pharmacists in a primary care setting can help inform patients about the importance of seeing a GP to discuss their condition to ensure their asthma is being appropriately managed. ‘It’s possible compliance is an issue or they’re not using a spacer,’ Mr Vrankovich said. Inhaler technique should also be reviewed. Mr Vrankovich said community pharmacists are perfectly placed to have these conversations with patients. ‘We have really good scheduling laws in Australia that allow [salbutamol] and other relievers to be accessed over the counter, which is amazing,’ he said. ‘But as pharmacists we could potentially be doing more in terms of having a conversation with people about why preventers are so important for ongoing management of their asthma.’ Mr Vrankovich said the most important thing – whether consumers are male or female – is to get out from behind the counter and build a rapport with them. ‘If you build that relationship with someone then what you say carries more weight,’ he said. ‘We can also switch from asking questions like, “How often do you use your reliever?” to “How often do you have asthma flare-ups where you feel you need some relief?” ‘This makes it more about the patient [rather than] their disease state.’ For information on severe asthma diagnosis and management, check the Australian Asthma Handbook. For National Asthma Council how-to videos and checklists on inhaler technique, go to www.nationalasthma.org.au References
[post_title] => Australian asthma deaths fall, mostly in women: ABS [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacists-have-a-role-to-play-in-preventing-asthma-deaths [to_ping] => [pinged] => [post_modified] => 2019-10-21 13:18:28 [post_modified_gmt] => 2019-10-21 03:18:28 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=8416 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Australian asthma deaths fall, mostly in women: ABS [title] => Australian asthma deaths fall, mostly in women: ABS [href] => https://www.australianpharmacist.com.au/pharmacists-have-a-role-to-play-in-preventing-asthma-deaths/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 8422 )
- Australian Bureau of Statistics. Australia’s leading causes of death, 2018. 25 September 2019. At: www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3303.0Main+Features12018?OpenDocument
- National Asthma Council Australia. Epidemic thunderstorm asthma. National Asthma Council Australia, Melbourne, 2017. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/thunderstorm-asthma
- Press release. Asthma Council welcomes drop in asthma deaths but warns against complacency. 14 October, 2019. At: www.nationalasthma.org.au/news/2019/asthma-council-welcomes-drop-in-asthma-deaths-but-warns-against-complacency
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 7962 [post_author] => 42 [post_date] => 2019-09-24 09:30:23 [post_date_gmt] => 2019-09-23 23:30:23 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text]I want to implement SafeScript in my pharmacy. What do I do, and how long does the process take? SafeScript is an initiative by the Victorian Government which has established a clinical decision-making tool in the form of a real-time record of all prescriptions for specific medicines. SafeScript draws data from Prescription Exchanges Serivces (PES) when prescriptions for monitored medicines are issued or dispensed. Monitored medicines include all Controlled Drugs, all benzodiazepines, zopiclone, zolpidem, quetiapine and products containing codeine. The service is available to all pharmacists in Victoria, and will be compulsory from April 2020. While not yet compulsory, pharmacists should be using this system now. One of the effects evident in the 13 months of activity following its roll-out in April 2018, is that 11,000 clinicians have begun utilising the service and SafeScript has helped those clinicians identify 15,000 instances of a person visiting more than four health providers for monitored medicines within the specified time period. SafeScript also helped to identify 13,000 people who were prescribed doses that could be excessive, or in combinations that could increase risks. There is a clear advantage for a pharmacist to have access to this information when making a decision about the appropriateness or safety of supplying a medicine at a specific point in time, especially from the perspective of assisting a person to access different services that may be relevant to their circumstances.
RegistrationThe process of registering for SafeScript is relatively simple, and requires two specific activities to be completed:
Every pharmacist registers through the SafeScript portal at www.safescript.vic.gov.au. This will require your AHPRA registration, date of birth, and contact details for the pharmacy at which you will access SafeScript.
- Individual registration:
Visit vic.health1 for instructions on downloading SafeScript software for each terminal used within the pharmacy. You will also find instructions for ‘manual’ access via the portal for systems that do not yet have integrated software solutions.
- Enabling software:
Implementation tipsImplementing SafeScript in isolation from your colleagues is less than ideal. A discussion in the workplace about the ease of implementation and wealth of clinical information SafeScript provides can help to ensure that all staff within the pharmacy are aware of the role of SafeScript, correct processes for accessing a person’s record, and how to proceed in the instance where a pharmacist identifies a request to dispense what they consider unsafe. Importantly, each pharmacist needs to register individually for SafeScript – accessing a person’s medical information under another heath professional’s credentials is not permitted. Pharmacists should familiarise themselves with referral pathways for allied health, specialist pain treatment options, specialist substance use disorder options, and the use of motivational counselling to overcome dangerous health choices.
Other statesThe Federal Government has committed to a national Real Time Prescription Monitoring (RTPM) service, interoperability between state and territory systems. Most states and territories are now actively working towards implementing RTPM systems in their jurisdictions. The impact of SafeScript as a clinical tool on medicine safety is clear. RTPM cannot come soon enough to the rest of Australia’s prescribers and pharmacists.
|Lodge your own question at firstname.lastname@example.org|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 7431 [post_author] => 10 [post_date] => 2019-08-28 01:12:30 [post_date_gmt] => 2019-08-27 15:12:30 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text] Conducting research can be a daunting prospect. But by choosing a mentor and working intelligently, pharmacists can research and have their work published. A study published earlier this year in the Journal of Pharmacy Practice and Research found that pharmacists have a keen interest in conducting research.1 Yet these same pharmacists had comparatively low levels of research confidence and experience. The lack of confidence is understandable, as research and publication can be a formidable, lengthy undertaking. Thankfully, no one expects early career pharmacists (ECPs) to launch straight into a randomised control trial by themselves. But while practising pharmacists may not always seem themselves as researchers, leading academics say the opposite is true. ‘Pharmacists working in clinical practice are in an ideal position to identify opportunities to change health care for the better,’ says Professor Simon Bell MPS, Director at Monash University’s Centre for Medicine Use and Safety. ‘Doing research is a way to explore those opportunities for change, to generate evidence that’s necessary to bring about change in clinical practice or health policy.’ So picture an ECP at work, wanting to get involved in research, with the distant goal of publishing work – where do they start? ‘Simple audit processes of the way you do things in your clinical practice is important research, and that can lead on to publications,’ says John Coutsouvelis, Senior Oncology and Haematology Pharmacist at Alfred Health, and a Senior Lecturer at Monash University. ‘It could be clinical, it could be a process. Start with audits and drug usage evaluations in hospitals. If you’re in community pharmacy, start with an audit of customer satisfaction with services. It’s all simple research, but starts you thinking about how to set up a study and what you’re measuring.’ Meredith Wiseman, a Senior Lecturer at Monash University, also encourages practising pharmacists to start with their own scope of practice. ‘Question what you see around you, and if you have a question, raise it with the people you work with – that’s often the start of more discussion around potential research projects,’ she says. Discussing practice with colleagues and seniors is not only useful in mapping out a research question, but often yields potential opportunities for participating or collaborating with other projects and researchers. ‘Researchers are passionate about what they do and are happy to discuss research opportunities with any pharmacist,’ says Professor Bell. ‘Make an appointment with academic staff at your university, or if you’re working in a hospital, approach the director of pharmacy for advice. Universities and hospitals often have ongoing research projects that pharmacists can get involved in. This is a great way to gain experience.’ Mr Coutsouvelis also recommends that those who are looking to conduct research attend conferences in their field. ‘They’re a great way to start understanding what you need to put in an abstract and the things that reviewers look for.’ When it comes to developing a research question, Ms Wiseman encourages pharmacists to read academic literature. ‘It provides a good background. Read, read, read, talk with collaborators, get involved, and put yourself out there,’ she says. ‘Hospitals and other institutions often run journal clubs that can be a great resource for keeping abreast of current research.’ Reading naturally leads into the next step of research – a literature review. ‘It’s important to understand what’s already been published,’ says Professor Bell. ‘Often people come up with good ideas, but when they look further into the research literature they find several other studies have covered the area. It’s important to think about what your research will add.’
Determining methodsAfter identifying a research topic, pharmacists need to determine the research methodology for their study. For those new to research, this can be the most daunting stage of a study. ‘People often want to do complex research, but it’s more important to pick a methodology that is suitable to your question and that may mean a simpler methodology,’ says Mr Coutsouvelis. Professor Bell says one common reason studies are rejected for publication is due to concerns over methodological quality. ‘I would encourage people to have a discussion with their research mentor about the most appropriate methods before they start doing their research,’ he says. ‘That way, the time and resources they invest will produce the best returns on investment and a high-quality piece of evidence at the end.’ Looking at past research can also help. ‘Go back to the literature and see how people have studied a similar topic in a different area, or a similar thing with a different drug, and try and map your methodology out that way,’ says Mr Coutsouvelis.
Finding that journalWhen it comes to publishing research, finding the right journal can be a challenge. ‘There are many different scientific journals out there, with different readerships,’ says Professor Bell. ‘It’s important to keep your readership in mind when writing your article and selecting a target journal. Work is often rejected because it’s outside the scope of the journal, so you need to target your work to the right readership.’ A good place to start, says Ms Wiseman, are the professional journals. ‘Australian Pharmacist, the Journal of Pharmacy Practice and Research – they’re obviously going to be good links.’ She also advises close collaboration with experienced researchers. ‘Work with them to identify the best journal, and then read those journals yourself to ensure they fit your theme.’ When it comes to identifying and submitting to journals, Professor Bell says an experienced research mentor can save time, avoid needless rejections, and help optimise the impact of your work. ‘Regardless of where you choose to publish your research, it’s important to have a good research mentor who can guide you through that process. Publishing doesn’t have to be a daunting experience. ‘It’s fantastic when a student or pharmacist comes to us with an idea for research – it’s the kind of innovation and enthusiasm we need. But it’s important to take the time to work with a research mentor to help ensure that your proposed work is novel and the methods are rigorous before getting started.’
Dealing with rejectionWhen it comes to the final step of publishing their work, should new researchers expect to be knocked back by journals? ‘Even experienced researchers have their papers rejected,’ says Professor Bell. ‘The good journals only accept a small percentage of the articles they receive. If you do receive a rejection, that doesn’t mean that the work wouldn’t be suitable to be published in another journal. It can be easy to feel disappointed when a manuscript is rejected, but people shouldn’t lose heart if that happens.’ Having a research mentor is important as they can help identify more suitable journals to submit work to, and it requires patience. ‘ECPs sometimes expect something straight away, which is not a criticism. But to really get a good paper published can sometimes take a year,’ says Mr Coutsouvelis. Reaching publication is a consultative process between researchers, publishers and reviewers. ‘Any article will go through several rounds of peer review and editing before it’s submitted for publication, so don’t get disheartened,’ he says. References
- Waddell J. Research confidence, interest and experience of an Australian hospital pharmacy population. Journal of Pharmacy Practice and Research. May 2019. doi.org/10.1002/jppr.1480. At: https://onlinelibrary.wiley.com/doi/abs/10.1002/jppr.1480
|Submit your research to AP at email@example.com|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 7509 [post_author] => 196 [post_date] => 2019-08-12 13:17:30 [post_date_gmt] => 2019-08-12 03:17:30 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text] It’s no longer plain sailing in Australian community pharmacy. Bruce Annabel helps navigate in this, the fourth instalment of our Future Health series. Most have heard the saying, ‘You cannot direct the wind, but you can adjust the sails.’ The nautical analogy is helpful. Pharmacy has sailed along propelled by the winds of regulation; the exclusive distribution of PBS pharmaceuticals and scheduled medicines have generated patient visits and profit. In return, consumers have received a reliable, accessible medicine distribution network. But in an era of tectonic change, is that sufficient to maintain pharmacy’s financial returns and relevance in the health spectrum? The winds of change are blowing hard on the traditional business model, requiring owners, peak bodies, industry and the profession to assess where community pharmacy now stands. Initiatives are needed to harness these forces, beginning with the forthcoming Seventh Community Pharmacy Agreement (7CPA).
Winds of change
1. Market and technologyThe key to community pharmacy success has been location, maximising script throughput, and operating efficiently as a business. However, fundamental change in the competitive and technological landscape has resulted in flat script volumes and falling patient visits pressuring profitability and viability. One of the biggest concerns is falling patient visits, down 3.8% during the last five years including 1.9% last year,1 reflecting the reduced market relevance of the traditional business model. Therefore, historical success factors have become ‘hygiene’, and it’s getting worse because few are responding appropriately to the changes.
2. Blown off courseUnfortunately, price discounting is the result, financed by cutting wages and pressuring suppliers for deals that no longer exist. Something has to change – net profit is down 22% compared with five years ago, while return on investment has fallen to 14% compared with 25% just 10 years ago.1 Pharmacists clinging to the script-processing role means ‘pharmacist professional service’ is inconsistently delivered to patients, who are left to interact with pleasant assistants. That is referred to as ‘service’, which is now a ‘hygiene’ factor too. But even though it has been blown off course, the old model is chugging along, made possible by dispensing profitability sufficient to hold the bottom line together … for the time being.
3. CommoditisationBecause of price discounting and wage cuts, pharmacists are working even harder processing scripts with less time for advice and professional services. The result is that patients and the community have been trained to value pharmacies based on price instead of health benefits i.e. an industry focused on ‘selling to customers’ instead of ‘helping patients’. The majority of new medicines being listed on the PBS are highly specialised, usually high cost, and mostly delivered to patients in hospital or specialist practices. Pharmacy has been left primarily dispensing cheap off -patent pharmaceuticals with an average cost of $25.1 Many of these medicines have become commoditised by competing for market share through price discounting in a flat market.
4. Federal governmentPBS script volume fell by 2 million between 2013/14 and 2017/18 and net outlays have been flat in nominal terms for 10 years. That policy will continue, evidenced by the April 2019 budget forecasting expenditure of $9.7 billion in 2022/23 compared with the 2018/19 estimate of $9.6 billion. So the government expects costly new medicines to be paid for by the industry, manufacturers, distributors and perhaps even pharmacy. Perhaps that was the motivation behind the proposed extended 60-day script supply for 143 drugs. The proposal could resurface!
5. Cyclonic windsWinds of change may turn cyclonic as the Fourth Industrial Revolution gathers pace. It has been written: ‘During the next three years, the Fourth Industrial Revolution will really take hold as technologies in the physical, digital and biological spheres begin to come together under the impetus of ‘the internet of things’, artificial intelligence, robotics and additive manufacturing.’2 Immunotherapy, gene and cell therapy, along with technological convergence, will fundamentally reshape the industry.
Adjusting the sailsThere is much support for pharmacist-only ownership, although it should be capitalised on by utilising their skills and trust with patients. Innovation in the quality of the patient offer is the key to a non-price competitive value equation aimed at holding existing patients, attracting new ones and giving them great reasons to return. Some pharmacies have done this by offering patients innovative services. This includes minor ailments, mental health, medication management and condition management in addition to script supply and advice. These innovative pharmacies outperform the industry standard in most measures, including earning professional services income over $100,000 pa, some $300,000 pa, compared with the average of a touch above $30,000.1 Virtually every pharmacy is capable of operating that model but they lack the incentive and/or implementation assistance. The innovators model should be adopted as the industry framework. The key elements are:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 5170 [post_author] => 82 [post_date] => 2019-05-16 09:13:50 [post_date_gmt] => 2019-05-15 23:13:50 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text] Faye McMillan is a pioneer, paving the way for other Aboriginal and Torres Strait Islander people who want to work in the pharmacy profession. When she’s not busy winning awards, she works as a community pharmacist, university lecturer and is a founding member of Indigenous Allied Health Australia.
Why did you decide to become a pharmacist?Over 20 years ago, I was working as a pharmacy assistant in my hometown of Trangie (NSW) when I thought to myself, ‘I actually want to be the pharmacist.’ The pharmacist I was working with at the time was extremely supportive and encouraged me to apply to study. I ended up being part of the inaugural cohort of students when Charles Sturt University introduced their pharmacy program in Wagga Wagga, NSW in 1997.
What’s the main focus of your practice?I’m a community pharmacist, and I also teach in the area of Indigenous health, mental health and pharmacy at CSU. But the main focus of my work is patient-centred care, and ensuring that I’m working with people, so that they feel engaged. That’s what really drew me to pharmacy in the first place – an opportunity to have a relationship and help people as they navigate their health journey.
You’re passionate about recruiting Indigenous Australians into healthcare. What work do you do in this area?As a founding member of Indigenous Allied Health Australia (IAHA), we strive to recognise Aboriginal and Torres Strait Islander people in the allied health workforce. I sat on the board from its inception in 2009 until 2017 and I was also the chair from 2010–2016. We started with just seven members, now we have 1,500. IAHA is seen as one of the key bodies representing Aboriginal and Torres Strait Islander people to government and was involved in the development and implementation of the National Aboriginal and Torres Strait Islander Health Plan. We also work with universities to ensure that when Aboriginal and Torres Strait Islander students undertake allied health courses, they are being provided with support, mentors and networking opportunities. But at IAHA, it’s not just about how we recruit people, it’s how we retain them. We work to ensure they feel engaged, not just in their profession but as a part of their community in the form of a trained healthcare professional.
You were Australia’s first registered Indigenous pharmacist and won the 2019 NSW Aboriginal Woman of the Year Award. How do you feel about being a role model?It didn’t sit comfortably at first, but I think I’ve settled into it and recognised that people do need role models. When I was starting out I looked around for role models, and I appreciated the journeys of the people who I looked up to. If I’m that to someone else, then that’s a wonderful thing. Sometimes you’re able to use the platform of being an award recipient to give a nuanced opinion or view, and we need people to take up those positions.
You’re also a member of PSA’s National Aboriginal Community Controlled Health Organisation Leadership Group. Why is pharmacist intervention in Indigenous health so important?Pharmacists play an integral role in the lives of so many people, whether clinically, in the community, or in hospitals – there are so many touch points where pharmacists can be included to provide insight into the health of Aboriginal and Torres Strait Islander people. The knowledge and skills that pharmacists have through their education, their life experiences and by being a consistent presence in the community means that they are able to provide a point of reference for other health professionals. The Leadership Group is making significant contributions by ensuring people have access to a highly skilled and trained workforce, as well as providing education around the medicines that are needed in these communities, while ensuring they are accessible and affordable.
What’s the next big project that you’re working on?I’m putting the final touches on a mental health app that I’ve been developing over the past 18 months. I wanted to create something that would provide meaningful support to people – not in place of trained mental health professionals, of course. The app is an extension of an existing self-awareness app that keeps you connected with people you’ve identified in your contact list as your ‘caring community’. It assesses where people are sitting on the scale of mental wellness, followed by contact from someone who will reach out and have a conversation with you. It’s all about having real conversations – listening out for warning signs such as changes in the timbre of the voice, and pauses, things that are easily masked in social media use. Get more news at www.australianpharmacist.com.au [/vc_column_text][/vc_column][vc_column width="1/3"][/vc_column][/vc_row] [post_title] => Pushing boundaries: the pioneer pharmacist [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pushing-boundaries-the-pioneer-pharmacist [to_ping] => [pinged] => [post_modified] => 2019-05-16 11:27:59 [post_modified_gmt] => 2019-05-16 01:27:59 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=5170 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pushing boundaries: the pioneer pharmacist [title] => Pushing boundaries: the pioneer pharmacist [href] => https://www.australianpharmacist.com.au/pushing-boundaries-the-pioneer-pharmacist/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 5171 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 4455 [post_author] => 20 [post_date] => 2019-03-07 21:35:04 [post_date_gmt] => 2019-03-07 11:35:04 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text] A range of apps enable pharmacists and patients to see and/or manage their medical information. As the benefits of My Health Record (MHR) become more widely known, its uptake and usage can be expected to grow. As pharmacists, we are well positioned to take a leadership role and guide patients on this topic, given our status as the most digitally enabled of all health professionals. It is important for patients who wish to play an active role in their healthcare, or carers of vulnerable patient groups (e.g. children, disabled, elderly, mentally impaired), to understand what information is available to them and how they can access and control access to clinical documents (shared health summary, discharge summary, pathology, diagnostic imaging), prescriptions (prescriptions issued and dispense uploads), consumer documents (patient health summaries, patient notes) and Medicare documents (e.g. immunisation register, organ donor status, Medicare benefits).
How do patients access their MHR?There are two ways for patients to access their My Health Record. 1. WEB PORTAL (myrecord.ehealth.gov.au) This site:
|Using a great smartphone app with your patients? Share your insights with your colleagues. Email firstname.lastname@example.org and tell us about your experience and the results you’ve seen.|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8507 [post_author] => 23 [post_date] => 2019-10-30 08:49:54 [post_date_gmt] => 2019-10-29 22:49:54 [post_content] => Megan Tremlett MPS and Sue Carson MPS are two pharmacists forging new roles outside the norm in pharmacy. At PSA Queensland’s Annual Therapeutic Update this month, participants heard how they are following their dreams by pursuing work that was not available to them when they graduated more than 25 years ago. They are making a difference to peoples’ lives, and their passion is infectious. Based on the Sunshine Coast, Ms Tremlett is co–ordinating the Aboriginal integrating pharmacists within Aboriginal Community Controlled Health Service (ACCHS) to improve chronic disease management project (IPAC). Ms Carson is working as a pharmacist in the Community Transition Care Program at the Brighton Health Campus of the Metro North Hospital and Health Service in Brisbane. Ms Tremlett loves contributing to the evolution of an alternative career path for pharmacists, one that is much needed in the Aboriginal and Torres Strait Islander health sector. She also finds it rewarding to contribute to research needed to support the value of this emerging role for pharmacists. She works collaboratively with project partners, which extends her knowledge of research methodology. ‘It is immensely rewarding to coordinate 20 inspirational pharmacists doing the pioneering “on the ground” work to provide, not only a relatively new clinical service but also to collect extensive project-related data,’ she told Australian Pharmacist this week. ‘Hearing numerous testimonials from patients, doctors and others positively impacted by their work has been very satisfying.’ In Ms Tremlett’s 28-year career, she has deliberately sought job variety and new challenges to progress her professional capabilities, including hospital pharmacy (both in Australia and the United Kingdom), community pharmacy, and as an accredited pharmacist conducting RMMRs and HMRs. Due to her previous work in the Northern Territory, and her ongoing interest in new clinical roles for pharmacists, she was approached by PSA for the role of IPAC Project Coordinator. ‘I have been extremely fortunate to share this role with a wonderful colleague, Hannah Loller, who is equally passionate about the health of Aboriginal and Torres Strait Islander Australians.’ Ms Tremlett wants to encourage pharmacists to consider participating in research to use their extensive skills and push existing boundaries in care delivery. ‘In particular,’ she added, ‘I am optimistic that the role of pharmacists working with Aboriginal Health Services will continue to gain momentum thanks to a combination of research projects such as IPAC and IMeRSe, and the shared experience of a number of pharmacists who have already been working in this sector for many years.’ ‘While there are challenges associated with becoming integrated into a new practice setting, the rewards of being a valued member of a multidisciplinary team and making a genuine difference to patient care are limitless. For pharmacists who like to travel, I would urge you to seek a new adventure in regional or remote Australia,’ Ms Tremlett said. Sue Carson jumped at the opportunity to work in a community transition care program with registered nurses, enrolled nurses, speech pathologists, physiotherapists, dieticians, occupational therapists and social workers using her skills as an accredited pharmacist. ‘It is very rewarding to see a client of community transitional care gain independence in their own home after an admission to hospital. The other health professionals value my knowledge as a pharmacist, and we learn from each other every day.’ She has ‘never felt so valued in my career in pharmacy’ because in the transitional care setting, pharmacists are greatly needed as a significant number of hospital readmissions occur due to medication errors at transitions of care. ‘There are an increasing number of opportunities for pharmacists to work in multi-disciplinary teams as we [not only] have pharmaceutical knowledge but also communication skills. So pharmacists should seek out the opportunities that our professional training can lend itself to,’ Ms Tremlett said. ‘As PSA is impressing upon government and medical professionals [and as highlighted in the Royal Commission into Aged Care Quality and Safety] pharmacists need to be involved wherever and whenever medicines are used.’ PSA’s Pharmacists in 2023 report encourages pharmacists to be embedded wherever medicines are used, and unlock their potential to improve healthcare access and outcomes for Australians and reduce variability in care.1 Reference
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- Pharmaceutical Society of Australia. Pharmacists in 2023: For patients, for our profession, for Australia’s health system. Canberra: PSA; 2019.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 8301 [post_author] => 11 [post_date] => 2019-10-06 00:22:36 [post_date_gmt] => 2019-10-05 14:22:36 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text]The pharmacovigilance inspector role is fairly new to Australia. It requires tact, tenacity, excellent time management and travel. Sarah May became the Therapeutic Goods Administration’s first pharmacovigilance inspector in 2015.
How did you become a pharmacovigilance inspector?It was by accident really. I moved to London for a one-year working holiday. Over there it wasn’t possible to work in my field as a hospital pharmacist as my Australian registration was not directly transferable. As an alternative, I ended up in the pharmaceutical industry in medical affairs and pharmacovigilance. I then applied for – and secured – a role as a pharmacovigilance inspector with the UK Medicines and Healthcare products Regulatory Agency.
How did you end up at the TGA?We were thinking about moving back from the UK when the TGA advertised a position for someone to establish a pharmacovigilance inspection program in Australia. At the time I was probably the only Australian with experience as a pharmacovigilance inspector. So began my career in setting up Australia’s Pharmacovigilance Inspection Program.
What role does your job play in supporting medicine safety in Australia?I ensure Australian sponsors of medicines are complying with Australian Pharmacovigilance requirements1 (and that) they are monitoring the risk-benefit balance of medicines in Australia, collecting and reporting adverse drug reactions to the TGA and communicating identified risks as required. This can involve physically inspecting medicines companies (sponsors), reviewing adverse drug reactions, reviewing periodic safety update reports and databases, requesting records of ongong monitoring activities inspecting quality management systems and reviewing contracts and agreements with partners.
POINTERSSarah May’s pointers for a career as a pharmacovigilance inspector.
AN INSPECTION DAY IN THE LIFE of Sarah May7.00 am: Travel preparation After waking at 6am and grabbing a taxi to the airport, join other inspectors and squeeze in some pre-flight breakfast. 8.30 am: Arrrive for inspection After landing, travel to the inspection site – the company headquarters, a manufacturing site, shop or home office – the site of their pharmacovigilance system. 9.30 am: Set up and preparation Sign into the site, set up computers and documents. Start inspection with introduction to team, discussion about inspection and methods. 11.00 am: Collect data Undertake the first pharmacovigilance inspection session. Generally it’s an interview session on how the sponsor is collecting adverse drug reactions data and submitting cases to the TGA. 12.30 pm: Documentation Write up a list of documents required from the sponsor to corroborate interviews and compliance with legislation. Through a working lunch, start review of documents provided so far – often in the hundreds in the course of an inspection. 2.30 pm: Shift in focus Second pharmacovigilance inspection session. Focus could be ongoing monitoring, post registration regulatory commitments, quality management systems, maintenance of reference safety information, contracts and agreements with partners and contractors. 4.00pm: Database reviews Ask for more documents, review databases before hotel check-in and quick team dinner later. 8.00 pm: More work Back to the hotel for more document reviews and initial findings on non-compliance issues. Prepare for inspection day two.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 7520 [post_author] => 82 [post_date] => 2019-08-15 13:49:41 [post_date_gmt] => 2019-08-15 03:49:41 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text] Deirdre Criddle FPS is a complex care coordinator pharmacist at Sir Charles Gairdner Hospital in WA, and also a senior pharmacist steering professional services and development. It keeps her busy – and inspired.
Can you tell us what your complex care role entails?It’s quite new. In 2012, an inter-disciplinary team of advanced practitioners – nurses, social workers, occupational therapists, physiotherapists – were charged with improving health system navigation for complex patients. They asked Bruce Williamson, an experienced clinical pharmacist, if he could upskill them. Bruce tried to draft a program, but basically said, ‘You don’t need upskilling – you need a pharmacist embedded in your team.’ So he started this journey and I have been fortunate enough to follow in his footsteps since 2014. It’s now three days a week in an inter-disciplinary team. I do a lot of intensive work in medication management for patients who are medically complex. It’s a fantastic position, I love it, and it’s growing. I think there’s a huge opportunity for progression in that area – hospitals are facing such difficulty with patients becoming more complex, and pharmacists are an integral part of the solution.
What got you started in hospital settings?I’ve had a varied journey. I started as a hospital pharmacist, then was with NPS MedicineWise for 14 years as an educational visiting pharmacist, which was invaluable. I branched into being an independent accredited pharmacist doing medicines reviews, and I hoped to make a career of that. But the cap came along in 2014, and that killed it. That’s when I came back into hospital pharmacy at Sir Charles Gairdner. And I heard Bruce talking at a clinical pharmacy meeting about his role, and I just thought, ‘Oh, I so want that job.’ Everything that I had done to that point was consolidated in that role. That’s what brought me back. But I’m a bit of a jack-of-all-trades. I see the value in every aspect of our profession. It’s not like this role is better than that role. I would never dream of doing anything else.
You’re also a Director of the Society of Australian Hospital Pharmacists (SHPA). What are today’s biggest challenges in hospital settings?It’s a very challenging environment. The need to prioritise is paramount, and that’s a difficult thing. In my role as a care coordinator pharmacist you are dealing with stressed patients, and also stressed staff. They’re working with insufficient resources, staffing levels are not what they should be, patient complexity is increasing ... basically, they’re working in a very stretched system. If you’re spending all your time with your nose to the grindstone, there’s no opportunity to do the reflection to ask, ‘How can I do my job better?’ That can only come if you’re given room to breathe. Trying to get those in power to understand the value pharmacists bring to complex systems, especially to reduce medicine-related harm across the patient journey, that’s where we need to go.
How would you like to see pharmacists’ roles in complex care develop?For my first two years in this role, people would say, ‘What’s a pharmacist doing in a complex care coordination team?’ My dream now is that everyone will say, ‘Where’s the pharmacist?’ There are people like me all across Australia, and that is so exciting. Sometimes you think you’re alone, but I can guarantee you you’re not. If we have mechanisms to network, and to improve the collaboration and sharing across our profession, especially in these emerging areas of practice, it can only be a good thing.
A DAY IN THE LIFE of Deirdre Criddle, hospital pharmacist8.00am: The day begins Connect with the cardiology pharmacist, who updates the team on new guidelines. Take a phone call from a clinical pharmacist concerned about a patient. 9.00am: Stopovers Visit a ward with a family, telephone interpreter in tow. Consent gained for a visit with an on-site interpreter in two days. 10.00am: Drive by Home visit with a patient who is confused by medicine changes. I make a phone call to his GP and General Medicine Consultant to discuss. Arrange a visit with patient at GP clinic the following day to trial a dose administration aid. 12.30pm: Meetings Meet with Head of Pharmacy Gillian Babe and Clinical Pharmacist David Lui to discuss the results of the Medicines Management Mapping Project about facilitating early post discharge using community and hospital pharmacists. 2.00pm: More meetings Catch up with the clinical nurse leads for the Cognitive Impairment Committee to discuss content development for an education package dedicated to antipsychotics prescribed in the hospital setting. 3.00pm: And another ... Multidisciplinary team meeting with CoNeCT social worker, pain consultant and addiction specialist to discuss concerns for a patient. 4.00pm: Check in What’s new in the email inbox? Check new referrals, and plan visits for the coming week. Phone patients scheduled for an outreach visit. 9.00pm: Moonlighting Teleconference with the International Pharmaceutical Federation (FIP) Working Group, based in the Netherlands. Final review of The pharmacist’s role in beating noncommunicable diseases. High fives all round as we agree to final edits and submit to the FIP Council for approval.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 7523 [post_author] => 82 [post_date] => 2019-08-05 13:56:33 [post_date_gmt] => 2019-08-05 03:56:33 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text] Luke Vrankovich MPS, a former locum and one half of the Roaming Pharmacist duo, gained an online following living life on the road. So how is pharmacy ownership working out?
Can you describe the ethos of The Roaming Pharmacist?It was started by Liam Murphy a few years ago. It was a way, using social media, to show how you can be a locum and travel at the same time. It was also a way to educate the public on some key ideas that are important to Liam, such as harm minimisation through pill testing at festivals. I came on board and began locuming around the country, incorporating my passion into my work, which is mental health. Ethos? I’d say sharing our adventures and educating along the way.
What are some of the most interesting places that your work as a locum has taken you?I’ve been all over. I took a road trip down the coast of New South Wales (NSW) and Victoria – I ended up rock climbing in Arapiles. One of my favourite places was Broome in Western Australia (WA) – really interesting work and a good group of people. Another favourite was Merimbula in NSW – a great sense of community. The pharmacy staff made me feel very welcome.
How did you adapt to the different legislation when moving between states?It required a bit of brain power to look out for the differences, mainly with the scripts on file and Schedule 8 medicines. The easiest way to adapt was to do some research beforehand so I would have a rough idea of how things worked, but I also leaned on the other pharmacists around me. I didn’t necessarily need to know everything in intricate detail before I got there, it was more about knowing what questions I needed to ask when certain situations arose.
You now own a pharmacy in Townsville. Why did you make the switch?Just over a year ago I was on a six-month trip around Australia, but I only made it to Carnarvon in WA when I got a call from my former boss in Coffs Harbour about an opportunity to run a pharmacy in Townsville. I thought it might be a while before another opportunity presented itself, so I took the plunge. It’s a very different lifestyle to working as a locum and comes with its own set of challenges, but I’ve always wanted to own my own pharmacy so I could prepare myself and my family for the future.
You’re a former mental health first aid facilitator. Do you use these skills a lot in your pharmacy practice?I use them every day. What’s great about mental health first aid is that it teaches you how to pick up on signs and approach conversations with more confidence. In a busy pharmacy, it’s easy to get caught in the cycle of receiving a repeat prescription for escitalopram, for example, and just dispense it. But the training empowers you to want to have that conversation with every person that comes through who takes an antidepressant – whether it’s new or continued. It’s important to ask how it’s been working for them, and if they’ve been on it for a while, if they are happy with the results. Sometimes this leads to deeper conversations around efficacy and adherence, which almost always turns to treatment recommendations or referrals.
Do you think other pharmacists would benefit from training in mental health first aid?A lot of pharmacists lack confidence to approach the conversations around mental health, particularly if a person has suicidal thoughts and they are voicing that within the pharmacy. It’s definitely not an easy situation to be in and it takes its toll. Nothing will ever fully prepare you, but the confidence you develop through training, along with the knowledge about the right referral points, particularly in acute situations, certainly helps.
You’re a former ECP of the Year, in 2017. Where do you see pharmacy practice going in the future?I see pharmacists specialising in one way or another. PSA is doing great work with pharmacists in general practice and pharmacist vaccination services have also been expanding. A lot of pharmacies try and be everything to everyone, but it’s not sustainable for community pharmacies to be across all areas of health care. I think the profession will branch out further into specialties and that the pathways will become more official.[/vc_column_text][/vc_column][vc_column width="1/3"][/vc_column][/vc_row] [post_title] => From locum to pharmacy owner [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => locum-pharmacy-owner-roaming-pharmacist [to_ping] => [pinged] => [post_modified] => 2019-08-15 17:37:19 [post_modified_gmt] => 2019-08-15 07:37:19 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=7523 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => From locum to pharmacy owner [title] => From locum to pharmacy owner [href] => https://www.australianpharmacist.com.au/locum-pharmacy-owner-roaming-pharmacist/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 7525 )
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.