Negar Almassi MPS[/caption]
Dr Brian Chia MPS[/caption]
COPD is significantly underdiagnosed
Associate Professor Debbie Rigby FPS[/caption]
Nicolette Ellis MPS[/caption]
A national education program for pharmacists funded by the Australian Government under the Quality Use of Diagnostics, Therapeutics and Pathology program.[/caption]
Both these disorders can occur separately, but if they co-occur, this is termed COMISA. Approximately 30–50% of people with OSA have comorbid insomnia, and 30–40% of people with chronic insomnia have comorbid OSA.9,12 A recent population-based study reported that 11% of Australian adults report symptoms of COMISA.13
The ‘gold standard’ measure of OSA presence and severity is an overnight sleep study (Table 1).25 The most common single metric to determine OSA presence and severity is the apnoea-hypopnoea index (AHI), representing the average number of airway narrowing and closure events occurring per hour of sleep.24 Identifying the most appropriate management approaches for OSA also requires consideration of lifestyle factors, symptoms and consequences, occupation, chronic conditions, and other sleep conditions. Self-report questionnaires may be used to screen for a high-risk of OSA and identify patients suitable for referral and consideration of overnight sleep study assessment (Table 1).24
Although evidence-based guidelines unanimously recommend avoiding long-term use of hypnotics, they are indicated for a minority of patients that present with severe acute insomnia that is causing significant psychological distress or functional impairment.29 Most people who experience short-term insomnia symptoms (1–2 weeks) can be reassured that sleep will return to ‘normal’ after the underlying precipitant has subsided, without targeted treatment (i.e. hypnotic medicines).29,33 For those who experience persistent insomnia, cognitive behavioural therapy for insomnia (CBTi) is the first-line treatment. Pharmacotherapy may be considered in patients with severe insomnia that is causing significant impairment or distress (e.g. times of acute work/exam stress, bereavement).34
Tailored recommendations for non-CPAP therapies may also be provided to patients with different levels of OSA severity and presenting features.17 For example, weight management advice where indicated, positional devices (in the presence of supine-predominant OSA), mandibular advancement splints (in patients with mild-to-moderate OSA), and upper airway surgery are effective treatments that may be tailored to each individual patient.24
Dr Alexander Sweetman (he/him) PhD
Senior Program Manager, and chair of the psychologist education subcommittee at the Australasian Sleep Association.
Associate Professor Sutapa Mukherjee (she/her) MBBS, FRACP, PhD
Respiratory and sleep physician, Associate Professor of Respiratory and Sleep Medicine at Flinders University and past President of the Australasian Sleep Association.
Professor Garun Hamilton (he/him) MBBS, FRACP, PhD
Respiratory and sleep physician, clinical professor at Monash Health and Monash University and President of the Australasian Sleep Association.
Professor John Turnidge AO[/caption]
Topical corticosteroids are used for various dermatological conditions such as eczema and psoriasis.
Learning objectives
After reading this article, pharmacists should be able to:
Describe common misconceptions and misunderstandings of topical corticosteroids
Identify current evidence and recommendations on the safety...
Pharmacists have a new oncology-focused tool for the evaluation and assessment of adverse drug events in oncology.
French researchers have developed a trigger tool to evaluate the prevalence, harm, and preventability of adverse drug events (ADEs) in oncology using a...
Community pharmacists are well-placed to help people with hypersensitive airways, according to allergist and APP18 presenter Dr Jessica Tattersall.
Australia has some of the highest rates of allergy in the world, with 1 in 5 affected with some form such...
Accredited pharmacist and Credentialed Diabetes Educator Angelica Rostov details how pharmacists can advance their diabetes education.
The following changes are now in place for those who are either undertaking or considering undertaking the diabetes educator qualification.
To become a Pharmacist Diabetes...
Achieving better outcomes for rheumatoid arthritis patients requires successful collaboration between specialists, GPs and pharmacists.
A new NPS MedicineWise education program has highlighted the importance of successful collaboration between rheumatologists, general practitioners (GPs) and community pharmacists in the early diagnosis...
The PSA guidance document Guidance for provision of a Pharmacist Only medicine–Short-acting beta₂ agonists (salbutamol and terbutaline)2 assists in responding appropriately to a request for an inhaler and/or relief of bronchospasm.
Learning objectives
After reading this article, pharmacists should be...
Vegan diets are becoming increasingly popular among teenagers and youth, especially females, due to the perceived health benefits of a plant-based diet.
Learning objectives
After reading this article, pharmacists should be able to:
Describe the principles and philosophy of...
Pharmacists when co-locating with GPs play a valuable role in reducing over-prescribing in older patients.
Over 12 months, pharmacists in an ACT-based pilot study recommended deprescribing in several cases where older patients were unnecessarily taking medicines for a range of...
A commonly-used treatment for Alzheimer's disease could reduce the risk of stroke among people with dementia.
The Australian-Swedish study, co-authored by Monash University researchers, focussed on the effect of acetylcholinesterase inhibitors (AChEIs), which are commonly prescribed to relieve symptoms of...
The feet and toenails are prone to a variety of infections, as they are frequently exposed to a moist environment through the regular use of footwear.
Learning objectives
After reading this article, pharmacists should be able to:
Recognise the signs...
