td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11356 [post_author] => 23 [post_date] => 2020-09-23 14:21:16 [post_date_gmt] => 2020-09-23 04:21:16 [post_content] => In the lead up to World Pharmacists Day on Friday, pharmacists around the country have expressed pride, passion and excitement for their work, the importance of which has been highlighted during a difficult year. The theme of this year’s World Pharmacists Day, held on 25 September, is ‘transforming global health’. The International Pharmaceutical Federation (FIP) encourages pharmacists to ‘use the day to organise activities that promote and advocate for the role of the pharmacist in improving health in every corner of the world’. Pharmacists are invited to use the World Pharmacists Day 2020 app to record special messages and spread the word about how the profession is transforming health through local networks. ‘We aim to show how pharmacists contribute to a world where everyone benefits from access to safe, effective, quality and affordable medicines and health technologies, as well as from pharmaceutical care services,’ said FIP President Dominique Jordan. Pharmacists can also get involved by adding a PSA frame to their Facebook profile picture, with the messages 'Pharmacists on the frontline' and 'Your medicine experts'. You can also follow PSA's social media channels to see updates from pharmacists throughout the day.
Reflections from Australian pharmacistsFrom bushfires to a pandemic, the valuable contributions Australian pharmacists make to their communities has been on show this year. Specialist pharmacist Christopher Hidayat MPS from Westmead Hospital Emergency Department in Sydney said this year’s theme was appropriate as pharmacists faced the challenges of COVID-19. Working closely with the emergency team, he ensures healthcare workers stay up to date with COVID-19 management information, while ensuring timely clinical review and continuity of care for patients presenting to the department. ‘The pandemic has changed the way we practice,’ he told Australian Pharmacist. ‘I have assisted in many ways, including helping establish the hospital's COVID-19 screening clinic and reviewing the way we administer high-risk drugs to COVID-19 patients. ‘Our impact and footprint on health care is growing, which makes it a very exciting time to be a pharmacist.’
Community supportCommunity pharmacists also stepped up in 2020, with Australians turning to their local pharmacy for health care and support more than ever in uncertain times. [caption id="attachment_10697" align="alignright" width="218"] Dimitra Tsucalas FPS[/caption] Dimitra Tsucalas FPS from Ascot Vale Pharmacy in Melbourne told AP that World Pharmacists Day had prompted her to reflect on her passion for the profession. ‘I love the work variety Australian community pharmacy now offers compared to even 10 years ago, let alone 30,’ she said. ‘A smile, a lightbulb moment, a healed wound, the look of pain relief or the sleep satisfied and rested CPAP client are just a few of the rewards I am honoured to receive.’ It had been a difficult year dealing with the COVID-19 lockdown, however. ‘The [quiet] roads and the absence of noise are like an old-fashioned long Sunday,’ she said. ‘Pharmacy staff inhale the fumes of 70% alcoholic sanitiser and pharmacy practice is punctuated by a revived fax machine, an energised email, a very overworked, tired telephone and exponential masked deliveries.’ Managing Pharmacist at Caremore Pharmacy Kippax in Canberra Andrew Kelly MPS had felt more connected to his community during the highs and lows of the year. ‘You become a part of people’s lives,’ he told AP, ‘and the trust and confidence they place in you is quite humbling.’ [caption id="attachment_11369" align="alignleft" width="215"] Andrew Kelly MPS[/caption] He reflected that pharmacists had played an important role in supporting their communities through the bushfires and again through COVID-19, by helping them process information and providing guidance and reassurance. ‘Working in community pharmacy, you soon realise that your role covers so much more than medicines and the counselling that goes along with it,’ he said. ‘I cannot think of many other professions where people intrinsically place their trust in you, not necessarily because of your name, or what you may have done for them in the past, but just the very fact that you are a pharmacist.’
A close connectionIn the coastal city of Bunbury, south of Perth, Kim Wallis MPS is also proud to be a pharmacist. ‘I never fail to walk into a situation with my peers and feel grateful for the incredibly compassionate and intelligent people that represent our profession,’ she said. Ms Wallis advocates for the inclusion of pharmacists in healthcare teams through her multiple roles as a hospital clinical pharmacist at Bunbury Regional Hospital, GP pharmacist at Brecken Health, and an accredited pharmacist offering personalised care in people’s homes. She also loves being part of the examination process for the new generation of pharmacists ‘to help maintain the high level of quality we are proud of’. Natasha Downing MPS is a consultant pharmacist and GP practice pharmacist at Goyder’s Line Medical in Jamestown, just north of Adelaide. She finds her role working closely with patients extremely rewarding. ‘I am able to … provide them with advice on their medicines they need, thereby decreasing hospital admissions and poor patient outcomes related to poor medicine use, management and knowledge,’ she told AP. ‘It’s a job that I truly love.’
Regional rolesIn the semirural town of Samford in the Moreton Bay region of south-east Queensland, Jacqui Hagidimitriou MPS is the manager and nutritionist at TerryWhite Chemmart Pharmacy. As a pharmacist and nutritionist in the community setting, she is an accessible healthcare professional with skills to be able to meet people ‘where they are at’ and encourage positive change. ‘There are a lot of conflicting messages out there about health and I see it as my role to provide a safe space for people to explore what good health means to them, by utilising diet, natural medicines and prescription medicines as a way for people to fulfil their health goals,’ she told AP. Ilwoo Park MPS also works in a rural location, having arrived in Oatlands, a historical village in the centre of Tasmania, 2.5 years ago. While she felt like an outsider at first, she joined local groups such as the Rotary Club in order to become a member of the community before she felt she could rightly be called a ‘community pharmacist’. Ms Park wants her patients to know that their health and safe use of medicines is her primary concern. She has won over initial sceptics, with doctors and customers alike appreciating her care and concern for the community. ‘Being in Oatlands is a fun package,’ she told AP. ‘My ultimate goal is [for] my community to know [me as their pharmacist].’
Outstanding pharmacists recognised[caption id="attachment_11370" align="alignright" width="182"] PSA SA/NT Branch Committee Member Adam Forrest celebrating in the lead up to World Pharmacists Day[/caption] In the lead up to World Pharmacists Day, PSA has announced three new Fellows in recognition of their outstanding contribution to the profession. Luke Kelly and Patricia Payne from New South Wales and Dr Tin Fei Sim from Western Australia were acknowledged for advancing pharmacy practice over an extended period of time. PSA National President Associate Professor Chris Freeman congratulated the new Fellows. ‘Fellowships of PSA are a prominent acknowledgement of those who have provided an outstanding contribution to the Society or the profession for an extended period of time,’ he said. ‘All three of these pharmacists have displayed a significant contribution to the profession and are worthy of being elevated to the status of Fellow.’ PSA will also announce the recipients of the PSA Symbion Excellence Awards – Pharmacist of the year, Early Career Pharmacist of the year and Lifetime Achievement award – and the PSA MIMS Intern Pharmacist of the Year, on Friday. Nominations for PSA's State and Territory awards will also open. To get involved on social media, use the following hashtags: #WPD2020 #onthefrontline #WorldPharmacistsDay #medicinesafety #medicineexpert #protectpharmacists #proudMPS and #pharmacistscantstayhome [post_title] => World Pharmacists Day 2020 [post_excerpt] => In the lead up to World Pharmacists Day on Friday, pharmacists around the country have expressed pride, passion and excitement for their work, the importance of which has been highlighted during a difficult year. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => world-pharmacists-day-2020-australia [to_ping] => [pinged] => https://www.australianpharmacist.com.au/assignments-exams-and-an-increased-workload-pandemic-pressure-hits-pharmacy-interns/ [post_modified] => 2020-09-25 15:51:04 [post_modified_gmt] => 2020-09-25 05:51:04 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=11356 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => World Pharmacists Day 2020 [title] => World Pharmacists Day 2020 [href] => https://www.australianpharmacist.com.au/world-pharmacists-day-2020-australia/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 11366 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11358 [post_author] => 235 [post_date] => 2020-09-23 14:13:35 [post_date_gmt] => 2020-09-23 04:13:35 [post_content] => Promoting antimicrobial stewardship, patient safety and digital health are just three of the new global goals for pharmacy launched by the International Pharmaceutical Federation (FIP) on Monday. The eight goals, which add to FIP’s 13 Pharmaceutical Workforce Development Goals released in 2016, will ‘support the transformation of the pharmacy profession around the world’, according to the Federation. FIP CEO Dr Catherine Duggan said the goals were a ‘logical next step’, following on from the existing workforce goals. ‘Having a clear and supportive, systematic and integrated global framework for the entire profession has many benefits,’ she said. ‘For example, the development goals can be used to facilitate applied research and evaluation in education and practice by universities and professional leadership bodies, respectively. ‘This framework can also be a basis for investment in pharmacy healthcare by governmental agencies and funding authorities, and for national planning and delivery of policy initiatives.’ [caption id="attachment_11359" align="alignright" width="1214"] The FIP Development Goals. (Image: FIP)[/caption] Newly appointed FIP Vice President and University of Sydney Pharmacy School Professor of Medicines Use Optimisation Parisa Aslani FPS said patient safety, in particular, had become a ‘global emergency’. Medicine safety and preventing medication-related harm was a large component of this, she said, particularly in relation to high-risk medicines and polypharmacy. PSA supported the development of the goals as a FIP Member Organisation, and there is strong alignment between FIP's aims and PSA's Pharmacists in 2023 report, including common goals, purpose and intent.
Uniting the professionLaunched as part of World Pharmacy Week (21–25 September), the goals align with FIP’s mission to support global health by enabling the advancement of pharmaceutical practice, sciences and education, and with the broader aims of the United Nations’ Sustainable Development Goals. The new goals cover:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11345 [post_author] => 1703 [post_date] => 2020-09-23 13:25:39 [post_date_gmt] => 2020-09-23 03:25:39 [post_content] => Psychotropic medicines are ‘overused and misused’ in the disability sector, consultant pharmacist Dr Manya Angley FPS told the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability yesterday. The sixth public hearing of the royal commission is examining the use of psychotropic medicines to address behaviours exhibited by people with disability. According to the royal commission’s issues paper on health care for people with cognitive disability, about 4.3 million Australians have some level of disability and, for 1 in 5 of these people, the main form of disability is mental or behavioural. This includes people with intellectual disability, autism, acquired brain injury or dementia. Antipsychotics were the riskiest of the psychotropic drugs prescribed to people with intellectual disabilities, Dr Angley told the hearing, with adverse effects ranging from liver problems to blood cell changes, movement disorders and abnormal cardiac effects that could lead to death. Dr Angley said she believed consultant pharmacists needed to be empowered to call out abuse or neglect. ‘If a person is prescribed a medication that is not an absolute last resort, then that person has been denied their right to have proper intervention and care,’ she said. ‘I also think that if they are solely prescribed because of their sedative effects, rather than addressing the underlying problems, then that is abuse. ‘It is neglecting to give [patients] the proper care they are entitled to as human beings.’ In a submission to the royal commission last month, PSA recommended that the government explore mechanisms for disability care recipients to regularly access pharmacist-delivered services to ensure appropriate and optimal medicine use and avoid harm from medication misadventure.
A right to proper careThe royal commission also heard a powerful story from a British mother whose son ultimately died as a result of psychotropic medicines. Oliver McGowan had mild hemiplegia, focal epilepsy, a mild learning disability and autism as a result of two episodes of meningitis. However, he was high functioning and had been told by a neurologist that he had a full life expectancy, Paula McGowan, who has recently moved to Australia, told the hearing. This changed after an incident in which Oliver was administered antipsychotic drugs in hospital, against his parents’ wishes, for what staff saw as challenging behaviour. He subsequently suffered a suspected neuroleptic malignant syndrome, a serious side effect of antipsychotic medications. ‘We were told that Oliver’s brain was now so badly damaged that he would be profoundly disabled, no speech, no understanding of language, no way of communicating,’ Ms McGowan said. After Oliver’s life support was turned off, he died at the age of 18. Ms McGowan had subsequently lobbied for mandatory training of support care workers in learning disability and autism, which will be rolled out in the United Kingdom next year, and continues to campaign for the same here.
Education and research neededSenior Counsel Assisting Kate Eastman SC told the royal commission it would hear evidence that becoming invisible, voiceless and without agency were some of the effects of inappropriate use of psychotropic medicines. The use of psychotropic medicines as a chemical restraint raised many concerns, she said, including:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11320 [post_author] => 1532 [post_date] => 2020-09-23 04:07:41 [post_date_gmt] => 2020-09-22 18:07:41 [post_content] => Pharmacists have adapted to life in the COVID-19 era, but what new practices should remain permanently? As Australia marks 6 months of disruption, uncertainty and pain from the coronavirus pandemic, pharmacy practice has changed irrevocably for many. And just as overt were problems in the aged care sector where accredited pharmacists faced challenges ensuring patients with complex and chronic disease remained focused on managing their conditions. This was especially so in states where RACFs were closed to all but staff but at a time when medicine reviews are more important than ever. Last month it was reported that more than 270 RACF residents aged 70–100+, most in Victoria, had died in the surge of cases and deaths that emanated from two quarantine hotels in Melbourne in May and June. Throughout, most pharmacists have never been busier as new regulations – from digital image prescriptions, to continued dispensing, to $25 million in funding from the federal government for home medicines deliveries – were adopted. Some hospital pharmacies moved to 24-hour operation and outpatient consultations moved to telehealth. While the COVID-19 era heralded a working life that at times was confronting, fraught and frantic for some Australian pharmacists, overseas pharmacists were in peril. According to the Federation of International Pharmacists (FIP) 43 pharmacists from Spain, Italy, the United Kingdom, Turkey, Belgium and China have died in the pandemic. In Australia, pharmacists have reconfigured workplaces for physical distancing, introduced vigorous cleaning regimes, juggled different prescription systems, fielded phone calls for deliveries, geared up for electronic prescriptions, conducted medicine reviews via telehealth, coped with severe stock shortages and dealt with anxious, sometimes abusive consumers. Some of the new pharmacy regulations were due to expire this month. But as a second surge of COVID-19 was activated by the Melbourne hotel quarantine debacle and the ensuing Crossroads Hotel cluster that spread in Sydney, the Home Medicines Service has been extended and telehealth will continue. As case numbers began to fall in mid-August, we asked eight pharmacists about the good, the bad and the ugly of Australian pharmacy practice during the pandemic and which of them they would prefer to be kept on permanently.
Top 10 worst-affected countries as at 21 August
WHAT SHOULD STAYSuzana Cukar: Electronic prescribing and face-to-face contact. James Buckley: Electronic prescribing – it’s the way of the future. Fiona Herbert: Electronic prescribing, hand sanitiser stations and sneeze screens. Patrick Tiong: Electronic prescriptions as a paperless tool to support medicines management. Kiely Hindmarsh: Fines for abusive customers. Hazel Matz: Zoom for meetings, webinars and information updates. Eva Quek: Electronic prescribing, sneeze guards, home delivery. Karen Starling: Telehealth consultations optional in certain circumstances (i.e. rural, remote, vulnerable), hand hygiene, improved collaboration between professions.
WHAT SHOULD GOEva Quek: Prescriptions that are faxed and emailed. Karen Starling: Faxes. Fiona Herbert: Faxed and emailed prescriptions and sneeze screens which make communication difficult with older patients. James Buckley: Perspex counter screens are a barrier especially for the hard of hearing. Suzana Cukar: Perspex screens, unless significantly more infections. Patrick Tiong: Perspex barriers bar effective voice communication. Kiely Hindmarsh: Perspex screens make it hard for the hearing-impaired. Hazel Matz: Relying so much on imported stock.
At the height of the pandemic, she was working up to 15 hours a day for 13 straight days, thanks to the volume of work from emails, faxes, stock issues, doctors’ phone calls, flu shots, deliveries and remaking the store to accommodate social distancing.
‘But the incessant abuse and hysteria has been the hardest to deal with,’ she said of the early days of the pandemic. ‘I have seen the absolute worst of the human race and it disgusts me.’
Not surprisingly, Ms Hindmarch is supportive of government fines introduced in NSW to deal with such patients though saddened it was necessary.
Image-based prescribing added to the burden, as she still had to manage the regular making of owing scripts and faxes, with little stock and copious phone calls to doctors to change drugs to accommodate the lack of medicines.
‘Then we had the government saying pharmacies can open 24 hours a day – with no staff or staff that require training on S2 and S3!’ said Ms Hindmarch.
‘We are the ones who have kept our community going in this health crisis, putting our own staff at risk. I personally have lost four staff members and I know of colleagues who wish to leave the profession after what they have experienced in this pandemic.’
The Toronto team introduced new filing systems to accommodate increased workloads, including a separate dispensing filing system for dates due that she will retain. By August, when a confirmed case of COVID-19 emerged in the area, masks were worn by staff (in line with NSW government recommendations). All the infection control was maintained, even during the lull before the second surge, including ‘on-the-hour cleaning’ which had become part of the daily pharmacy routine.
One upside is the deepening relationship with local doctors who have offered kind words of appreciation that have kept Ms Hindmarch going.
On the busy side, however, ‘the demand for home deliveries has more than quadrupled, so much so that we have a person on the road some days for more than 4 hours’, said Ms Hindmarch.
‘This is not sustainable.’
A delivery fee is under consideration, she said. ‘The problem is you need to service the community in these times and protect the most vulnerable. It’s just finding the balance.’
As owner of the Nedlands Terry White Chemmart, Hazel Matz has made it a top priority to absorb the latest information on COVID-19.
‘It was my duty to show strong, positive leadership when the staff were very anxious,’ said Ms Matz, whose pharmacy is close to the Sir Charles Gairdner Hospital where some cruise passengers infected with coronavirus were taken for treatment.
Technology has been the big timesaver for Ms Matz, who has become an enthusiastic user of the Zoom platform for meetings, webinars and information updates on an ever-changing situation.
‘I would like to continue using this technology long-term for meetings, CPD webinars and podcasts about new products post COVID-19.’
She is grateful to her small team which, coped admirably with long hours, shop alterations to manage hygiene and social distancing – and aggressive customers.
‘Luckily we were never threatened, but abusive behaviour in pharmacies needs to be dealt with by imposing fines,’ said Ms Matz.
Digital image prescriptions have been a challenge, resulting in extra work for already overloaded staff.
‘The problem is with the doctor’s surgery not providing enough information when sending over the script and my staff having to spend time following up,’ said Ms Matz.
Shortages of certain medicines have been a major issue, which she would like to see addressed through more local manufacturing and minimum stock levels being maintained in Western Australia.
‘I commend the wholesalers for working together to try to alleviate some of the shortages, but it has been a very trying situation,’ said Ms Matz.
|Date||Event||World deaths||Australian deaths|
|DEC 31||China informs WHO of new flu-like illness in Wuhan evident for weeks.|
|JAN 11||First death reported in China.||1|
|JAN 25||First Australian coronavirus cases recorded in Sydney and Melbourne. Arrivals from China now blocked.||56|
|JAN 31||WHO declares Public Health Emergency of International Concern. Flights from China, with 7,000+ cases, to be banned.||259|
|FEB 2||With most deaths in China, the first death elsewhere is reported in the Philippines (closely followed by Thailand).||362|
|FEB 11||WHO proposes COVID-19 as the official name for the disease caused by 2019n-CoV, later called SARS–CoV–2.||1,115|
|FEB 27||Federal Government activates Australian Health Sector Emergency Response Plan.||2,858|
|MAR 1||Australia’s first death, a Perth man, 78, evacuated from the Diamond Princess cruise ship in Japan. Virus now in 75+ countries.||3,050||1|
|MAR 11||Extra $25 million to fund home medicines service. Mean incubation period, 5.1 days, US study finds. Arrivals from Iran, Sth Korea, Italy now blocked.||4,630||3|
|MAR 21||Australian physical distancing rules effected. After self-isolation of all arrivals mandated, Australia closes its borders. World infections top 223,000.||13,126||7|
|MAR 25||NSW, other jurisdictions extend emergency dispensing special authority for 6 months.||21,779||11|
|APR 03||Global confirmed cases pass 1 million. Large cluster emerges from Ruby Princess cruise ship. $70 billion JobKeeper program to start.||61,855||28|
|APR 16||Most states have allowed digital image dispensing of prescriptions via fax, email or text. ACT and NT use existing regulations. World infections pass 2 million.||149,429||63|
|APR 23||Funded telehealth for HMRs and RMMRs allowed. Newmarch House aged care outbreak in NSW spreads with more resident deaths.||196,265||75|
|MAY 25||Quarantine hotel worker reports fever later linked to Victoria’s second surge. 19 dead from Newmarch House cluster.||355,565||102|
|JUN 30||Lockdowns in parts of Melbourne re-enforced after earlier restrictions fail to stop surge in cases. WA, SA, TAS, ACT, NT largely case-free.||519,248||104|
|JULY 15||WHO confirms aerosols in enclosed spaces could spread COVID-19. FIP updates its guidance.||447,598||111|
|JUL 23||Global coronavirus cases surge past 15 million. NSW Health, supported by PSA, recommends all health workers wear masks.||636,527||133|
|AUG 5||Melbourne enters 6-week Stage 4 lock-down on 2 Aug with Stage 3 now on in regional areas. A record 725 new infections detected.||709,361||247|
|AUG 11||Global cases pass 20 million. Russia first to approve vaccine. New Zealand’s 102-day run of 0 cases ends with 4 new cases – that spread.||743,578||331|
|AUG 17||After mandatory eye protection procedure rules introduced for VIC HCWs, a record 25 people die in that state in a single day.||777,216||421|
|AUG 19||Global cases pass 22 million as federal government announces AstraZeneca order for 25 million doses of Oxford Uni vaccine.||790,195||450|
|AUG 21||Infections pass 24,400 but marked decline of active cases in Australia and rate of new infections shows a definite slowing.||797,105||472|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11303 [post_author] => 235 [post_date] => 2020-09-16 13:57:28 [post_date_gmt] => 2020-09-16 03:57:28 [post_content] => Pharmacists from across the globe came together to share their experiences of the COVID-19 pandemic at the annual International Pharmaceutical Federation (FIP) congress – held virtually – this week. Panelists from Australia, Italy, Spain, Sweden, the United Kingdom (UK) and the United States (US) spoke about the challenges faced by pharmacists in their home countries in a session at FIP Virtual 2020. While the details of each situation were different, broad themes were common: a drastic increase in workload, uncertainty over new processes and legislation, and a commitment by pharmacists to serve their communities. To date, 52 pharmacists and pharmacy technicians from eight countries, chiefly Spain (19), Italy (11), Turkey and the United Kingdom (eight each), three from the US and one each from China, Belgium and Morocco, have died from COVID-19, according to FIP. [caption id="attachment_11306" align="alignright" width="232"] Ravi Sharma, Director for England of the Royal Pharmaceutical Society. (Image: FIP)[/caption] In the UK, pharmacy teams were upskilled quickly to enable them to work in areas such as critical care and mental health, said Ravi Sharma, Director for England of the Royal Pharmaceutical Society. ‘A lesson to come out of the pandemic is that we have gaps in our primary care integration – our healthcare system is not very joined up,’ he said. ‘There is now an opportunity to think about how pharmacy can become truly integrated into the healthcare system.’ Community pharmacies were a ‘pivotal part’ of the UK’s health response, Mr Sharma said, and the only healthcare service asked by the government to remain open. ‘Pharmacies are a gateway to the NHS [National Health Service] – we know 1 million consultations were happening in community pharmacies per week during the height of the pandemic,’ he said. ‘They were not only providing medicines but also health advice.’ Mr Sharma said the Royal Pharmaceutical Society had released an ethical decision-making framework to support pharmacists to make decisions about patient care. ‘This gave pharmacists the flexibility to use their clinical autonomy to make decisions in collaboration with other healthcare professionals in a safe and effective way,’ he said. Speaking from the US, CEO and Vice President of the American Society of Health-System Pharmacists Kasey Thompson said legislation held pharmacists back. 'One of the areas we’ve spoken about for so many years is making healthcare more convenient for patients and bringing healthcare to their homes,’ he said. ‘Something I was surprised about was how restrictive our laws and regulations were in regards to the provision of telehealth.’ Sonia Ruiz Moran, Director of International Affairs at the General Pharmaceutical Council of Spain, said the pandemic had increased the public’s understanding about the vital role of pharmacists. ‘Pharmacists have assisted 30 million people during the pandemic, which is about 60% of the entire population,’ she said. ‘There were 2.2 million people who received telehealth from pharmacists. More than 90% of Spaniards have an increased perception of pharmacy as an essential part of healthcare.’ FIP Community Pharmacy Sector President Lars-Ake Soderlund echoed these comments and said there had been a 'welcome reset' of the public's perception of the role of pharmacists.'When other healthcare facilities closed their doors, hospital and community pharmacies remained open,' he said.'We can conclude that pharmacists have once again shown that we are essential to the health of our communities and to the continued functioning of our health systems.'This goes for pharmacists in academia, science, educational activities, in industry, the supply chain, hospital and community pharmacy – we are all on the frontline in fighting this disease.'
Australian pharmacists at FIP[caption id="attachment_11304" align="alignright" width="249"] Parisa Aslani FPS is one of three new Vice Presidents of FIP.[/caption] Australia has been well-represented at the virtual congress, with University of Sydney Pharmacy School Professor of Medicines Use Optimisation Parisa Aslani FPS elected as one of three new Vice Presidents of FIP. PSA National President Associate Professor Chris Freeman said it was great to see Australian pharmacy represented on the world stage. ‘The honour of being named Vice President of the FIP follows significant dedication and leadership at the highest levels and presents a great opportunity to better connect Australian pharmacy practice to the rest of the world,’ he said. A/Prof Freeman also congratulated Monash University’s Faculty of Pharmacy and Pharmaceutical Sciences Dean Professor Bill Charman MPS on winning the inaugural Kamal K. Midha Award for Exceptional Leadership. Prof Charman was also one of eight pharmacists and pharmaceutical scientists to be made an FIP Fellow during the opening ceremony. ‘An FIP Fellowship recognises individual members of FIP who have exhibited strong leadership internationally and distinguished themselves in pharmacy practice or the pharmaceutical sciences,’ he said. ‘To also receive the very first Kamal K. Midha Award shows Professor Charman’s significant service and leadership in advancing the pharmacy profession.’ Professor Ross McKinnon from Flinders University was also named the new chair of the Board of Pharmaceutical Sciences. [post_title] => Pandemic dominates FIP 2020 [post_excerpt] => Pharmacists from across the globe came together to share their experiences of the COVID-19 pandemic at the annual FIP congress – held virtually – this week. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pandemic-dominates-fip-2020 [to_ping] => [pinged] => https://www.australianpharmacist.com.au/covid-19-digital-image-prescriptions/ [post_modified] => 2020-09-16 18:00:35 [post_modified_gmt] => 2020-09-16 08:00:35 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=11303 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pandemic dominates FIP 2020 [title] => Pandemic dominates FIP 2020 [href] => https://www.australianpharmacist.com.au/pandemic-dominates-fip-2020/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 11310 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11294 [post_author] => 23 [post_date] => 2020-09-16 13:16:44 [post_date_gmt] => 2020-09-16 03:16:44 [post_content] => The Therapeutic Goods Administration (TGA) has delivered an interim decision to down-schedule low dose cannabidiol from Prescription Only Medicine (S4) to Pharmacist Only Medicine (S3), with additional Appendix M controls, to allow greater access for patients.1 Stakeholders and companies in the cannabis industry have welcomed the move, but some say evidence to support the efficacy of low dose cannabidiol is lacking. Down-scheduling would apply to oral, oral mucosal and sublingual formulations of cannabidiol (CBD) products with requirements including a maximum recommended daily dose of 60 mg or less in packs containing 30 days’ supply or less, where CBD comprises at least 98% of the total cannabinoid content in the product. An additional condition specified in Appendix M, to allow it to be provided by a pharmacist, is that supply is limited to medicines on the Australian Register of Therapeutic Goods.1 PSA provided a submission in response to the proposed amendments, where it acknowledged that greater access to CBD was consistent with the current policy approach and reforms around medicinal cannabis availability and use in Australia.2 However, PSA did not support a separate proposal to exempt from scheduling cannabidiol as 98% or greater of total cannabinoid content, and 0.2% or less of tetrahydrocannabinol content, citing ‘significant concerns around safety implications for patients and carers, as well as the broader public’. 2 PSA National President Associate Professor Chris Freeman noted that the down-scheduling was not requested by the pharmacy profession. ‘Whilst low dose cannabidiol may be relatively safe, it is important that it has a therapeutic purpose and evidence behind the claims,’ Prof Freeman said. The submission also contended that evidence was limited in different indications and patient groups.2 The PSA believes additional Appendix M controls are needed, and did not support the inclusion of CBD in Appendix H (able to be advertised to the public).2 The published outcomes, however, are interim decisions and subject to further public consultation.
Stakeholder responseCBD is one of more than 100 compounds known as cannabinoids found in the cannabis (marijuana) plant, Cannabis sativa. It is the second most prevalent of the active ingredients in cannabis, but is not psychoactive, unlike tetrahydrocannabinol (THC). Brisbane community pharmacist and Executive Chairman and CEO of MedReleaf Australia Russell Harding has seen the benefits of CBD and combination CBD products for patients with many conditions since medicinal cannabis was legalised in 2016. Side effects have been generally mild, he told Australian Pharmacist. As with others working in the cannabis industry, he is eager to see greater accessibility of medicinal cannabis for the vulnerable and disadvantaged. However, he has reservations about the TGA decision. Although clinical trials are underway, Mr Harding believes there is little evidence to support a daily dose of 60 mg and thinks a more appropriate dose would be much higher – at least 200 mg daily. And even low-dose CBD would be cost-prohibitive without a government subsidy, ‘either as a mandated good manufacturing practice-compliant registration process or a new Aust-C category for medicinal cannabis’, he said. Mr Harding foresees the challenges in bringing a low-dose CBD product to market and to achieve ARTG listings with a whole plant medicine. He believes it will be a long time coming.
Challenges for pharmacistsDebbie Rigby FPS, well-known consultant clinical pharmacist, referred to the ‘hype, hope and hoops’ of CBD. ‘Down-scheduling will reduce the hoops, but would probably escalate the hype and hope,’ she told AP. Although down-scheduling would increase access for patients who are likely to benefit from its use, it would bring some challenges for community pharmacists. ‘I think the community’s expectations on the benefits of CBD are often unrealistic and influenced by media and anecdotal hype and false hope,’ Ms Rigby said. ‘A sound understanding of the evidence of benefit and absence of benefit would be essential for community pharmacists.’ ‘As an accredited pharmacist conducting Home Medicines Reviews, I have been asked about the use of CBD and usually spend some time discussing the evidence (or lack of) with patients, as well as considering the potential for drug interactions with the other medicines. We must remain evidence-based in our approach, whilst respecting the consumer’s rights and preferences.’ References
[post_title] => Should cannabidiol be down-scheduled to S3? [post_excerpt] => The Therapeutic Goods Administration (TGA) has delivered an interim decision to down-schedule low dose cannabidiol. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => should-cannabidiol-be-down-scheduled-to-s3 [to_ping] => [pinged] => [post_modified] => 2020-09-16 18:00:50 [post_modified_gmt] => 2020-09-16 08:00:50 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=11294 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Should cannabidiol be down-scheduled to S3? [title] => Should cannabidiol be down-scheduled to S3? [href] => https://www.australianpharmacist.com.au/should-cannabidiol-be-down-scheduled-to-s3/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 11300 )
- Australian Government Department of Health: Therapeutic Goods Administration. Notice of interim decisions to amend (or not amend) the current Poisons Standard. 2020. At: www.tga.gov.au/sites/default/files/notice-interim-decisions-proposed-amendments-poisons-standard-acms-and-joint-acms-accs-meetings-june-2020.pdf
- Pharmaceutical Society of Australia. Consultation: Proposed amendments to the Poisons Standard – Joint ACMS-ACCS meeting. 2020. At: www.tga.gov.au/sites/default/files/public-submissions-scheduling-matters-referred-acms-31-and-joint-acms-accs-25-meetings-held-june-2020-psa-01.pdf
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11249 [post_author] => 23 [post_date] => 2020-09-09 11:49:18 [post_date_gmt] => 2020-09-09 01:49:18 [post_content] => For the fifth year in a row, more than 2,000 Australians lost their lives to overdose in 2018, according to Australia’s Annual Overdose Report 2020 from Penington Institute. Opioids were the drug group most identified in unintentional overdose deaths, followed by benzodiazepines and stimulants, and alcohol was a contributing factor. The impact of the COVID-19 pandemic is yet to be determined, but is expected to be considerable.1 The 2018 overdose findings included1:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11182 [post_author] => 1703 [post_date] => 2020-09-02 11:43:49 [post_date_gmt] => 2020-09-02 01:43:49 [post_content] => The National Asthma Council Australia has released an updated version of its Australian Asthma Handbook, which includes a new treatment option for adults and adolescents (aged 12 years and over) with mild asthma.
For more information on the Australian Asthma Handbook Update, don’t miss PSA’s webinar on 30 September. For more information and to register, click here.[post_title] => New recommendations for patients with mild asthma [post_excerpt] => The latest version of the Australian Asthma Handbook includes a new treatment option for adults and adolescents with mild asthma. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => new-treatment-recommendations-patients-asthma [to_ping] => [pinged] => [post_modified] => 2020-09-02 17:27:16 [post_modified_gmt] => 2020-09-02 07:27:16 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=11182 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => New recommendations for patients with mild asthma [title] => New recommendations for patients with mild asthma [href] => https://www.australianpharmacist.com.au/new-treatment-recommendations-patients-asthma/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 11188 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11180 [post_author] => 23 [post_date] => 2020-09-02 11:23:18 [post_date_gmt] => 2020-09-02 01:23:18 [post_content] => Pharmacists, prescribers and patients have been told by the Therapeutic Goods Administration (TGA) to expect a shortage of Estradot (estradiol) hormone replacement therapy (HRT) transdermal products until July 2021. The shortages prompted the TGA to authorise five overseas-registered products, also named Estradot, in strengths 25, 37.5, 50, 75 and 100 microgram for import and supply until 1 August 2021 (unless lapsed earlier), under Section 19A of the Therapeutic Goods Act 1989. However, there is a delay in the supply of some of these authorised replacements. As a result, the TGA has issued Serious Shortage Substitution Notices for Estradot 25 and Estradot 100 patches. These notices allow pharmacists to replace prescriptions for the patches with the same strength of either Estraderm MX or Climara patches.1 Pharmacist Ruth Colwell MPS from Shaw Road Pharmacy in Brisbane’s inner north said she found the shortages frustrating. ‘Communicating with prescribers is time consuming and interrupts workflow,’ she told Australian Pharmacist. ‘Patients become frustrated when unable to source their intended product and can find it confusing coping with their potential side effects if their doctor then prescribes an alternative. ‘Hopefully this [TGA substitution] will make things a little easier both for the patient and the pharmacist.’ Under the TGA protocol for the Serious Shortage Substitution Notices issued for Estradot 25 and 100 patches1:
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11127 [post_author] => 23 [post_date] => 2020-08-26 12:50:31 [post_date_gmt] => 2020-08-26 02:50:31 [post_content] => Mandatory double-checking as it is currently performed does not reduce the incidence or severity of medication administration errors compared with single-checking, an Australian observational study conducted in a large paediatric hospital has found. Considering the time and cost involved, more effective safety measures may be warranted in modern clinical settings, according to the study authors.1 The global prevalence of medication errors in paediatric inpatients is high. Patients are vulnerable and have low physiological reserves to manage the effect of errors. As a measure to minimise errors and their associated harm, double-checking medication administration is recommended in paediatric hospitals and has been part of nursing practice for decades. Evidence to support its effectiveness is very limited, however.1 In this research, hospital policy required independent double-checking by registered nurses. This involved one nurse verifying in front of another nurse the medication order, correct dose for patient weight, time of last dose administration, medication and solvent/diluent when applicable, dose calculation, preparation and patient identification. The crucial aspect of double-checking is that it is independent and done without the administering nurse sharing information with the checking nurse. In contrast, if a nurse shares information (for example, the name of the drug to be checked), it could lead to two people making the same mistake i.e. confirmation bias. Sharing information beforehand is known as primed double-checking. Although nurses in the study believed that double-checking was necessary and they were highly compliant, it was rarely done independently. Primed double-checking was prevalent despite the hospital policy for independence. Checking was also considered less important for ‘safer’ medicines such as topical preparations, leading researchers to ask whether different checking was needed for different tasks. Little safety benefit was found with primed double-checking in addition to single-checking. The effectiveness of independent double-checking was unable to be determined, leaving this question unanswered. Continuation of the current practice seems questionable according to the authors, who posed questions about the value of clinical judgment rather than policy-mandated double-checking. Changes in technological developments, presentations, packaging and administration equipment over the past 50 years have added to the demands on nursing staff faced with preparation and administration of medicines, the authors concluded, and there must be updated, innovative checking processes for today’s clinical settings.
Lessons for pharmacistsWhile the research focused on nursing practice, lead author of the study and Director of the Centre for Health Systems and Safety Research at Macquarie University Professor Johanna Westbrook acknowledged the important role pharmacists play in promoting medicine safety in hospitals. She advised that pharmacists involved in double-checking medication supply in hospital or community pharmacy settings should continue to follow existing recommendations that promote the importance of independent double-checking until further research evidence was available. ‘This could be particularly relevant for double checks for dispensing controlled drugs, as well as packing medication dose administration aids,’ she told Australian Pharmacist. Prof Westbrook said the study demonstrated that medication errors remained a significant safety issue in hospitals, and that multiple strategies were likely to be required to address the problem. Reference
[post_title] => Double-checking does not always reduce medication errors [post_excerpt] => Mandatory double-checking as it is currently performed does not reduce the incidence or severity of medication administration errors compared with single-checking, an Australian study has found. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => double-checking-medication-administration-errors-study [to_ping] => [pinged] => https://www.australianpharmacist.com.au/a-tragic-medication-error/ [post_modified] => 2020-08-27 09:21:29 [post_modified_gmt] => 2020-08-26 23:21:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=11127 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Double-checking does not always reduce medication errors [title] => Double-checking does not always reduce medication errors [href] => https://www.australianpharmacist.com.au/double-checking-medication-administration-errors-study/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 11130 )
- Westbrook J, Li L, Raban M, et al. Associations between double-checking and medication administration errors: a direct observational study of paediatric inpatients. Qual Saf 2020;0:1–11.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11330 [post_author] => 3070 [post_date] => 2020-09-23 07:51:15 [post_date_gmt] => 2020-09-22 21:51:15 [post_content] =>
Case scenarioLoretta is a regular consumer at your pharmacy. Her husband recently had a stroke that resulted in a reliance on Loretta for assistance with daily activities. Loretta is struggling to adjust and often comes into the pharmacy distressed, with queries about managing her husband’s medication regimen. She has called the pharmacy a few times, unable to remember the advice provided and worried about administering his medications incorrectly. Loretta confides that she feels stressed, overwhelmed, tired, is suffering from frequent headaches and isn’t sleeping well. Recently a locum GP prescribed sleeping tablets; but she hasn’t filled the prescription as she thinks she can manage and is concerned she will be unable to wake to assist her husband in the night. Feeling that she can no longer cope with the demands of her job, Loretta tells you she remembers feeling this way when her son was born many years ago and she took a medicine (she can’t remember the name) that helped…
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
Case scenario continued…You suggest to Loretta that she sees her GP as she appears to be experiencing some symptoms of anxiety. Her GP eventually diagnoses her with generalised anxiety disorder and offers her the option of cognitive behavioural therapy or a trial of a medicine. Financial considerations and a lack of time lead Loretta to trial medicine. Loretta presents with a new prescription for sertraline 25 mg each morning and has a follow up appointment with her GP in 2 weeks’ time for review. You counsel Loretta on potential adverse effects, timeline to efficacy, likely duration of therapy and provide her with some information on lifestyle interventions, with a focus on sleep hygiene strategies to improve her sleep quality.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11275 [post_author] => 2983 [post_date] => 2020-09-16 04:27:39 [post_date_gmt] => 2020-09-15 18:27:39 [post_content] =>
Case scenarioJoe is 45 years old. Since he left school, he has worked in the construction industry. For the past 10 years Joe has worked in a joinery making timber windows and has experienced prolonged exposure to high levels of noise. Joe always talks very loudly when he comes into the pharmacy. He mentions that he has a constant ringing in his ears and asks your advice on how he can stop it.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
|SUBJECTIVE||Only the affected person can hear the sound (e.g. normal blood flow, sign of a tumour or blood vessel damage)|
|PRIMARY||No identified cause other than hearing loss if present|
|SECONDARY||Known specific cause|
|ACUTE OR RECENT ONSET||Apparent for <6 months|
|CHRONIC||Apparent for >6 months
|EXTERNAL EAR||Cerumen impaction Otitis externa|
|MIDDLE EAR||Otitis media Cholesteatoma|
|Do you find the tinnitus bothersome or non-bothersome?||
|When did the tinnitus begin?||
|Is the tinnitus constant or pulsatile?||
|Is the tinnitus unilateral or bilateral?||
|Is the tinnitus associated with otological (ear) symptoms (e.g. blocked ear sensation, ear pain, and vertigo)?||
|Is your hearing affected? If so, is the hearing loss sudden?||
|Do you think the tinnitus is due to prolonged exposure to noise, either occupational or social?||
|Are you taking any medicines?||
|How are you feeling? Depressed? Anxious?||
Case scenario continuedYou have known Joe for about 5 years. During this time, you have observed his increasing difficulty communicating. He tells you he is also experiencing difficulty participating in work activities as well as social events due to tinnitus. He has expressed sadness at his lack of personal relationships often because others do not understand tinnitus, which is adversely affecting his life. You refer Joe to his doctor, suggesting that he should have his tinnitus further investigated. A couple of months later, Joe returns to the pharmacy. On your advice, Joe had his tinnitus assessed. His GP sent him for an audiological assessment. It was found that Joe has significant hearing loss. As a result, Joe has hearing aids with a tinnitus masker fitted that he’s found beneficial. He has now been able to communicate better with his fellow workers and his family. However, Joe is still struggling to sleep. He asks if there’s something to help him sleep. You discuss this with Joe and acknowledge that many people with tinnitus experience poor quality sleep. When Joe leaves a noisy work environment for the quietness of his bedroom, the tinnitus is more noticeable. Joe also says he worries about the effects of not sleeping. You and Joe discuss sleep hygiene and the use of a sound generator during sleep to help improve his sleep quality. This background noise creates a background screen of noise, so that even if other noises occur in the environment or internally, such as with tinnitus, those noises are masked or screened out by the background or white noise. You also encourage Joe to seek the help of a tinnitus counsellor.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11214 [post_author] => 2903 [post_date] => 2020-09-09 03:41:34 [post_date_gmt] => 2020-09-08 17:41:34 [post_content] => [vc_row][vc_column width="2/3"][vc_column_text]Acute coronary syndrome significantly contributes to the morbidity and mortality of ischaemic heart disease, which remains the leading cause of death in Australia.1 It is estimated that 1.6% of Australians have experienced an acute myocardial infarction (MI),2 with an average of 157 people admitted to hospital for an acute MI each day in 2018.3 Acute coronary syndrome (ACS) refers to coronary ischaemia that presents with new or increasing symptoms.
|After reading this article, pharmacists should be able to:
|MODIFIABLE ISCHAEMIC HEART DISEASE RISK FACTORS||NON–MODIFIABLE ISCHAEMIC HEART DISEASE RISK FACTORS|
|COMMON SYMPTOMS OF ACS||LESS COMMON SYMPTOMS OF ACS|
|Aspirin||300 mg||Orally. Chewed or dissolved prior to swallowing if possible||Stat|
|Glyceryl trinitrate (GTN)||Spray||1–2 sprays (400–800 microgram)||Sublingually||Every 5 minutes as required for ongoing chest pain/discomfort, up to three doses*|
|Tablet||Half to one tablet (300–600 microgram)||Sublingually||Every 5 minutes as required for ongoing chest pain/discomfort, up to three doses*|
|Opioid analgesic||Fentanyl||25–50 microgram||Intravenously||Every 5–10 minutes as required for ongoing chest pain/discomfort|
|Morphine||2.5–5 mg||Intravenously||Every 5–10 minutes as required for ongoing chest pain/discomfort|
|RISK CLASSIFICATION||CLINICAL CHARACTERISTIC|
|Tenecteplase||30–50 mg (6,000–10,000 units) intravenous bolusa,b|
|Reteplase||10 units intravenous bolus, repeat once after 30 min|
|Alteplase||15g intravenous bolus, followed by intravenous infusion:
|DRUG||FIRST DOSE||REGULAR DOSE|
|Aspirin||300 mg orally (unless already administered as part of the management of chest pain of possible cardiac cause)||100–150 mg orally daily|
|PLUS (where indicated)|
|Ticagrelora||180 mg orally||90 mg orally twice daily|
|Prasugrelb||60 mg orally||10 mg orally daily|
|Clopidogrelc||STEMI: 600 mg orally STEMI and afibrinolysis: 300 mg orally NSTEACS: 300–600 mg orally||75 mg orally daily|
|Enoxaparin||1 mg subcutaneous injection, twice daily.|
|Enoxaparin (in patients who receive fibrinolytics)||30 mg intravenous bolus, then 1 mg subcutaneous twice daily|
|Unfractionated heparin||60 units/kg intravenous loading dose, then 12 units/kg/hour intravenous infusion, adjusted for APTT according to local protocol|
|Bivalirudin||0.1 mg/kg intravenous bolus, then 0.25 mg/kg/hour intravenous infusion|
|ASPIRIN: to prevent blood clots P2Y12 INHIBITOR: to prevent blood clots and stent thrombosis ACE INHIBITOR/ARB: to limit infarct size and reduce ventricular remodelling BETA BLOCKER: to maintain or improve ventricular function STATIN: to reduce blood cholesterol and stabilise arterial plaque NITRATE (SHORT-ACTING): to treat chest pain, as required|
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11162 [post_author] => 104 [post_date] => 2020-09-01 16:32:03 [post_date_gmt] => 2020-09-01 06:32:03 [post_content] =>
Case scenarioJordan, a young man in his early 20s, has come to ask what he can use for an itchy rash between his toes. The rash started about 1 week ago. He thinks it may be athlete’s foot. On inspection, you notice that the skin area between his fourth and fifth toes looks flaky. You also notice that he is wearing trainers. Jordan tells you that he wears trainers most of the time as he plays basketball in a local competition and trains often with his friends.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
|Tinea corporis, tinea cruris||Apply once or twice a day for 1–2 weeks||Apply once a day for 1 week||Apply once a day for 1 week||N/a|
|Tinea pedis||Apply once or twice a day for 1 week for interdigital type Apply for 2–4 weeks for plantar/ moccasin type||Apply once a day for 1 week||Apply once a day for 1 week for interdigital type Apply for 2–4 weeks for plantar/ moccasin type||Apply once only to both feet (interdigital) Wash off 24 hours later Not recommended for plantar/ moccasin type|
Case scenario continuedBased on the location and appearance of the rash, you agree with Jordan that he appears to have athlete’s foot (tinea pedis) between his toes. As the rash has been present for a relatively short time, and is restricted to the area between his toes, you recommend terbinafine cream. You advise him to apply a thin layer of the cream to the rash and surrounding skin daily after cleaning and drying the affected area. The cream should be applied to both feet, as both are often affected even though symptoms are not apparent on the other foot. Application should be done for 1 week and not ceased before that time if symptoms improve. If you think that compliance with therapy for one week may be unlikely, offer him the option of the liquid product, which is applied once only. You advise that Jordan should use a separate towel for the infected area. He should avoid wearing trainers except when playing sport, wear rubber thongs in change rooms and change his socks daily to avoid future infections. His trainers should be dried in the sun and dusted with tolnaftate powder or discarded if old. If the infection has not cleared in 2–3 weeks, he should see his doctor.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11104 [post_author] => 21 [post_date] => 2020-08-26 08:31:21 [post_date_gmt] => 2020-08-25 22:31:21 [post_content] =>
Case scenarioSuzanne is a 22-year-old university student who presents to your pharmacy with a prescription for mometasone furoate 0.1% ointment to be applied once daily to an unsightly rash on both her elbows. The rash started a few weeks ago, just as she was about to undertake her university examinations. She says that her doctor has diagnosed her with a skin condition called psoriasis, and she is quite concerned after being told that this is an incurable disease. Suzanne is currently on the combined oral contraceptive pill but is otherwise healthy with no known allergies. You reassure Suzanne that although psoriasis is incurable, the majority of cases are mild and can be managed well. You provide advice on the use of mometasone furoate ointment and explain that there are a number of treatment options available should the current treatment fail to be effective. Anxiety associated with her recent university examinations may have triggered the psoriasis. You further advise Suzanne about avoidance of potential triggers for the condition and the various nonpharmacological strategies which may be used in conjunction with her ointment.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
|SEVERITY OF PLAQUE PSORIASIS||PASI SCORE (0–72)||DLQI SCORE (0–30)|
|Mild to moderate||≤10||≤10|
|Severe||≤10 or >10||>10
≤10 and include involvement of:
|Severe||>10||≤10 or >10|
|DRUG AND FORMULATIONS||STRENGTHS AVAILABLE||GENERAL DIRECTIONS|
||Variable potencies and strengths:
|Coal tar –
|Salicylic acid –
||Short contact treatment – Start with low strength for 5–10 minutes daily, increase strength and application time according to response|
Case scenario continuedSuzanne returns to your pharmacy 3 weeks later and tells you that after using the mometasone ointment as directed, the rash on her elbows has almost cleared up. She has stopped using the ointment and is now applying a simple moisturiser (sorbolene cream with glycerin 10%) twice a day to the affected area, as recommended by you. She tells you that she now has a better understanding of psoriasis and is much less anxious about the management of her condition.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11283 [post_author] => 175 [post_date] => 2020-09-16 04:46:18 [post_date_gmt] => 2020-09-15 18:46:18 [post_content] => Gunnedah-based Karen Carter FPS loves making a difference to patients’ health and wellbeing. She always knew she wanted to own a pharmacy. Now she has two – and her children Justin and Wendy have followed her into the profession.
What led you to pharmacy?I enjoyed chemistry and biology at school which led to me choosing pharmacy over optometry. Wanting to help people and work in the health area, pharmacy allowed me to combine my passion for science and to make a difference to patients.
Can you describe your initial years?After 3 years of pharmacy study at the University of Sydney I added the Diploma of Hospital Pharmacy. During university holidays I worked at Colless’ Pharmacy in Narrabri and enjoyed working in a community pharmacy where the pharmacist knew the patients and offered lots of advice. This experience was invaluable. During my diploma year I enjoyed working at different hospitals, then worked in the intensive care and renal units at Prince Henry Hospital – an opportunity to work in a team environment, educate nursing staff and be involved in antibiotic and patient-controlled analgesia policies.
Where else have you worked? How did you wind up with two pharmacies?I also worked in community pharmacies in Marrickville, Baulkham Hills, Glebe and Bondi Junction in Sydney while working at the hospital gaining as much experience as I could because I wanted to own my own pharmacy and provide the best healthcare to patients. I left Sydney for country locums in Forbes, Wee Waa and Quirindi before joining a partnership in Gunnedah. I eventually bought the pharmacy and after a few years merged two pharmacies in 2001. In 2009 with my husband David, who has a banking background, an opportunity arose so we bought Narrabri Pharmacy.
What led to accreditation?I have always enjoyed lifelong learning and became an accredited pharmacist in 2003 while juggling work and raising two children. The review process allowed me to have closer contact with patients and make suggestions to improve their health. I now travel to Bourke, Walgett, Wee Waa and Boggabri to perform Home Medicines Reviews (HMRs) and Residential Medication Management Reviews (RMMRs). I travel in a two-seater plane to Bourke and Walgett with the physiotherapist from Narrabri who is the pilot!
Tell us about other areas of operation.We have been involved in research projects such as diabetes screening using HbA1c testing, asthma and sleep studies with the University of Sydney. In Gunnedah we were involved with the Indigenous Medication Review Service (IMeRSe) study allowing a closer relationship with our Aboriginal and Torres Strait Islander patients. This took me to Brewarrina and Skype interviews at Cooktown. I am studying a Graduate Diploma in Wound Care at Monash University and incorporating wound care services in both pharmacies.
How are the services offered in a regional town pharmacy different to those in other pharmacies?A one-stop service store with most of our pharmacists accredited for vaccinations. We do HMRs, RMMRs and in-store medication reviews, provide equipment and screening for sleep apnoea and aids for daily living. Six pharmacists are trained in mental health first aid. We have an extensive patient delivery service to Gunnedah and Narrabri for personal medication packs or medicines. We have a beauty therapist in both stores, and cosmetics and giftware offer a department-style store in these country towns. We have attended AgQuip with sleep apnoea equipment and advised on sleep apnoea screening. We sponsor local events and sporting teams. A dispensing robot and Webster robot in Gunnedah have allowed more pharmacist time.
And the next generation?Our son Justin interned with us in 2019 and is now one of our registered pharmacists while our daughter Wendy is currently in the 4th year of her pharmacy degree. Pharmacy is a fantastic career and the future is bright with opportunity.
A DAY IN THE LIFE of Karen Carter FPS, an accredited, rural community pharmacist owner in Gunnedah and Narrabri, NSW.7.30 am - A quick trip Drive 132 kilometres to a Wee Waa residential aged care facility (RACF). 9.00 am - On the ground in an RACF Deliver education and interview patients/care staff for RMMRs. Notice a new patient is taking amitriptyline (anticholinergic) and donepezil (cholinesterase inhibitor). Family agrees to an RMMR. Discover patient has been chewing Panadol Osteo and Duodart. Ring GP to discuss ceasing amitriptyline, change formula of paracetamol and organise RMMR referral as patient has swallowing issues. Duodart changed to prazosin after review. 11.00 am - Drop into Narrabri Pit stop at my pharmacy to check on team, referrals for HMRs, collect reports and roster and drive the hour home, making phone calls (hands free) to accountant or remembering to change our ad for the radio station. 12.00 pm - Back in Gunnedah At Karen Carter Chemist in Gunnedah, check latest sleep apnoea clinic patient results after setting up a CPAP trial on previous day. Patient has improved from 64 on apnoea/hypopnea index (severe sleep apnoea) to 4. She slept 7 hours (husband also slept well); feels better. 2.00 pm - Afternoon variety Dispensing, vaccination service and checking dose administration aids, dress a wound, discuss using a spacer and demonstrate use. Noticed a patient taking Galvumet only once daily rather than twice daily prescribed dose. Spoke to him about bringing in medicines for a MedsCheck. 4.00 pm - Report writing Write up RMMR report from the morning and fax to Wee Waa RACF and doctor. 6.00 pm - Home work Closing time and head home to family. After dinner write up RMMR/HMR reports, tackle an essay for my Graduate Diploma in Wound Care or attend a webinar on e-scripts.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11152 [post_author] => 227 [post_date] => 2020-09-01 05:08:53 [post_date_gmt] => 2020-08-31 19:08:53 [post_content] => Loan Pham MPS, a daughter of Vietnamese refugees, has spent 14 years at one pharmacy. She loves it so much, she’s hoping to buy it.
What set you on the path to a career in pharmacy?Growing up in Sydney I always had a passion to work in the health sector. During my last year of studying for a Bachelor of Medical Science I decided to study pharmacy because I felt it would be a rewarding profession to be able to help those in the community.
How did you find the course structure at your chosen university and did it affect your later decision-making?I was accepted into the Master of Pharmacy graduate degree course at the University of Sydney in 2004, the year it was introduced. It was a 2-year course that included clinical placement. This gave me firsthand experience working in hospitals, mental health clinics and community pharmacy. I particularly enjoyed community pharmacy, which allowed me to interact with consumers.
What lessons did you learn as an intern?I did my internship at Blooms the Chemist Leichhardt and learnt invaluable skills, including that in community pharmacy you need to be compassionate, genuine and to empathise with your patients and to build trust as a health professional. I’ve been here ever since.
What made you consider a future in community pharmacy?Community pharmacy allows you the face-to-face contact with your patient and these patients tend to become regular consumers. We form a trusted relationship with our patients that allows us to provide medicines and advise patients on how to take medicines safely and understand the impact of what they are taking.
What were some of the highlights in your 14 years as a community pharmacist?Firstly, one of the highlights would be the people whom I have worked with and met. They have helped shape me into the pharmacist that I am today. Secondly, seeing community pharmacy evolve from focusing largely on dispensing medicines and then moving to the forefront of providing early intervention to patients by assessing and providing risk assessment. The introduction of pharmacists’ providing vaccinations has also resulted in pharmacists expanding their role in health services and further changing patients’ perception of community pharmacy as more than just dispensing medicines. Also, the introduction of My Health Record and digital health has allowed us to access information that will help with adverse drug interactions and managing the multiple medicines and chronic conditions of some patients, and to collaborate with other health professionals.
What is your next likely career step?The next step in my pharmacy career is to soon go into ownership of this pharmacy. I have been thinking about this for the past few years and am looking forward to this next phase in my career.
Where do you see yourself in 5–10 years?I see myself running a successful business. With the ever-changing landscape of community pharmacy, it’s important to be open to change and to continue to remain relevant to patients and consumers by improving the pharmacist’s role in the delivery and management of healthcare.
A TYPICAL DAY for Loan Pham MPS, community pharmacist at Blooms the Chemist, Leichhardt. NSW.8.30 am - The morning rush Dispense and counsel patients on new medicines. Provide advice and recommendations. One regular customer had a new antidepressant prescription. I advised on the importance of a washing out period between mirtazapine and then swapping over to sertraline. 12.00 pm - Making medicine use safer More dispensing. One of our regular patients, who is visually impaired, came in with a prescription for a reducing dose of prednisone that was to taper over a month. She was confused about what to do. To put her at ease, I told her we would pack the reduced prednisone in a dose administration aid so it would be easier for her to remember when to take it. 2.00 pm - Vaccines, pick-ups and delivery Administering flu vaccines via either prior appointment or to walk-ins. Organising medicines for deliveries or pick-ups for customers who have called or emailed requests because of COVID-19 and cannot come into the pharmacy as they are vulnerable and have been required to isolate. 4.30 pm - Supplier challenges A doctor calls about ordering medicinal cannabis CBD oil for a patient. Our usual supplier is out of stock long term, so I have to contact other suppliers. It took several days to find a cost-effective, appropriate-strength product. The doctor was contacted and a new Special Access Scheme approval form was organised. 7.30 pm - Keeping up with change At home, I take time to read up on changes to opioid prescribing and the introduction of electronic prescriptions. Then I check through emails not able to be attended to during the day, for instance those arriving after closing time including updates from head office.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11101 [post_author] => 175 [post_date] => 2020-08-26 05:24:35 [post_date_gmt] => 2020-08-25 19:24:35 [post_content] => From compounding to COVID-19, Amanda Fairjones BPharm Hons AACPA, MPS can get answers for all your member queries.
Describe your work and the tasks involved on a typical day.As a member of the PSA membership team, I help answer queries that may be practice related, or ethical, technical, regulatory or registration questions. My priority each day is to answer telephone calls and emails from members – often straight away, but sometimes the questions are more difficult and require further research. The PSA employs a wide variety of pharmacists and other professionals with expertise in different areas who can assist me when needed.
What other roles have you held that make you an ideal person to provide practice advice?Most of my career to date has been spent in private hospital pharmacy. As the Director of Pharmacy for a large surgical hospital for 10 years and, more recently, in two small private mental health facilities, I have both experience and knowledge to answer member queries. I’ve also had experience as a pharmacy owner and in community pharmacy and hold accreditation for Medication Management Review Services.
What does your role involve?Providing advice to PSA members throughout the COVID-19 pandemic has been the most interesting aspect of my role so far. I started with PSA in March 2020 – at the beginning of the pandemic – and, like all pharmacists, had to quickly adjust to the rapidly changing pharmacy landscape. Colleagues were facing challenges never encountered before, and information and legislation was changing rapidly. Members relied on PSA for professional, up-to-date advice.
What are the strongest member concerns at present?The most common concern is the coronavirus and resulting changes to practice. Members have been particularly concerned and are asking questions about digital prescriptions. The new legislation for this was introduced on a state-by-state basis, which caused confusion. Digital prescriptions has meant pharmacies must change process and engage with prescribers about retaining original prescriptions – which has provided challenges. Members interested in diversifying their role often ask about further education. Many hope to expand their knowledge and I have provided them with information on becoming MMR-accredited, a diabetes educator or on training as a general practice pharmacist.
What have you learnt about pharmacy practice in the role?Members often call the advice line for further information or interpretation of pharmacy legislation. Providing advice nationally has helped me learn about pharmacy practice across all states and territories. This has assisted me to become more familiar with the differences in legislation and practice guidelines for all jurisdictions. The role has also expanded my knowledge around immunisation. Many pharmacists train to become qualified immunisers with PSA, and this role is constantly evolving. Members often call to confirm they are informed in relation to regulatory and training requirements.
How is PSA helping support members?PSA is interested to hear from members about any issues, questions or ideas. Members are able to ask PSA for professional practice support and can contribute to PSA policies and advocacy issues. Information and feedback received from members via telephone, email or other means is collated and reviewed across the organisation – particularly during the height of the COVID-19 restrictions.
Further resourcesPharmacist to pharmacist advice line (members only): 1300 369 772 8.30 am–5 pm (EST) weekdays. [post_title] => Guidance and advice: PSA’s new practice expert [post_excerpt] => From compounding to COVID-19, Amanda Fairjones BPharm Hons AACPA, MPS can get answers for all your member queries. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => guidance-advice-psas-new-practice-expert [to_ping] => [pinged] => [post_modified] => 2020-08-26 11:06:17 [post_modified_gmt] => 2020-08-26 01:06:17 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=11101 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Guidance and advice: PSA’s new practice expert [title] => Guidance and advice: PSA’s new practice expert [href] => https://www.australianpharmacist.com.au/guidance-advice-psas-new-practice-expert/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 11116 )
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 11028 [post_author] => 2662 [post_date] => 2020-08-19 11:21:02 [post_date_gmt] => 2020-08-19 01:21:02 [post_content] => The journey through the Australian healthcare system has been long and hard for this pharmacist patient.
I am one of the millions missing. One of the millions of people living with a rare disease for whom getting a correct diagnosis can take decades. We are a tribe of forgotten folks, who along the way are likely, at least once, to hear the comment: ‘It’s all in your head’.
I am a registered pharmacist. Yet I cannot perform my role due to chronic and debilitating illness. At 32, I was diagnosed by a clinical geneticist with Hypermobile Ehlers-Danlos syndrome (hEDS) a connective tissue disorder (CTD).
Chronic pain, extreme fatigue and neurological symptoms from brainstem compression resulted in my early departure from a career in pharmacy.
My first symptoms were a dislocation at 4 years of age. This should have been a red flag and led to some work-up by doctors. But of course, it did not.
Adolescence was full of migraines, orthostatic intolerance, generalised global body-wide aches and pain, soft tissue injury, chronic constipation and Raynaud’s phenomenon. But not one GP or specialist I consulted came remotely close to connecting the dots on these seemingly unrelated issues.
‘If you can’t connect the issues, think connective tissues.’ This is a phrase I would like all clinicians to know. I want it taught in medical, nursing, pharmacy and allied health faculties of learning. I strongly believe there are systemic failings that serve to delay or incorrectly diagnose patients with rare diseases, chronic illnesses and/or syndromes.
The biggest failing is that students are currently taught to look for horses, not zebras. This is a mistake and leads to delays such as mine. Recent research suggests that hEDS is not so rare after all. It has, perhaps, a prevalence of close to 1 in 500 – not 1 in 2,500 as previously determined.1,2 This misnomer, that zebras are rare, directly leads to many patient diagnoses being completely missed, while others are never able to shake the misdiagnoses they have been given.
My journey to diagnosis was filled with the likes of these phrases. ‘You’ve just got an achy body type… Hypermobility is benign… You just need to strengthen… A psychologist will help you.’ All the while my own research was telling me otherwise.
These dismissive statements play heavily on patients’ minds, undermining what they know to be true – that they are very ill.
Achieving my final and correct diagnosis from a clinical geneticist was extremely validating. But the path to get to this point was one of fighting the system, one that I had to drive from beginning to end. Misdiagnoses received along the way were fibromyalgia and myalgic encephalomyelitis, better known and stigmatised by the outdated term “chronic fatigue syndrome”.
While I now have a correct overarching diagnosis of CTD, my path to treatment continues. A lack of interest from clinicians who focus on CTDs and their comorbid conditions means I need to consult neurosurgeons in the United States.
I hope to change this is in future by engaging and educating clinicians from appropriate specialisations and via the establishment of a National Connective Tissue Disorder charity.
Hypermobile Ehlers-Danlos Syndrome is a heritable connective tissue disorder for which there is currently no genetic marker identified so diagnosis remains clinical.
A range of conditions including debilitating fatigue may also be present with loose, painful and unstable joints that can dislocate easily and frequently.
In Ms Linke’s case it has led to basilar invagination which has caused compression of her brainstem. She now needs to wear a neck brace.Janna Linke was recently re-registered on the APHRA pandemic sub-register to assist with the spread of COVID-19. She remains unable to work.
td_module_mega_menu Object ( [authorType] => [post] => WP_Post Object ( [ID] => 10925 [post_author] => 1925 [post_date] => 2020-07-29 11:26:06 [post_date_gmt] => 2020-07-29 01:26:06 [post_content] => Kurtis Gray, a final year Master of Pharmacy student at the University of Western Australia (UWA), is the 2020 PSA Mylan Pharmacy Student of the Year. Mr Gray believes his decision to study pharmacy was the best he has made. He beat a strong field from around the country to take the prestigious award this month, following in the footsteps of UWA colleague Alice Hashiguchi, who won last year. Each of the state finalists were presented with a patient via webcam who acted out a variety of symptoms. After a consultation and the opportunity to ask follow-up questions for more information, the finalists recommended a course of treatment and advice before a panel of judges. ‘It was a tough competition but a great opportunity for us to put into practice what we have learnt,’ Mr Gray said afterwards. ‘I really enjoy providing advice about medication to people who are unwell, and this competition enabled me to demonstrate this.’ The win came at a good time for Mr Gray, who is looking for an internship. But what to choose? ‘I love the clinical aspect of pharmacy, so I could see myself becoming a clinical pharmacist specialising in psychiatric medications,’ he told Australian Pharmacist. ‘Alternatively, I would love to somehow work in a community pharmacy which specialises in treating the homeless and people with mental health issues. ‘However, I could just as easily see myself being a general practice or a rural pharmacist, working with the Aboriginal Medical Services.’ Mr Gray believes he is joining the profession at the perfect time. ‘I think Australian pharmacists have been brilliant during the pandemic and have really stepped up. All the front line, essential health care workers have worked incredibly hard to facilitate effective healthcare during difficult times,’ he said. ‘I believe the work done will not be forgotten, and will make it easier for us future pharmacists to continue to expand awareness of our capabilities.’ Mr Gray hopes the recognition of pharmacists’ work will increase to the point where the term “pharmacist” is synonymous with “clinician”. ‘The hard work will make it easier for the new generation of pharmacists to continue to pioneer and expand the profession,’ he said. ‘The self-care fact cards that we can give out to patients are brilliant. When you have 10 patients all needing your time and attention, these cards are a good way to ensure that everything you say to a patient will, at the very least, make it home with them. I make a point to try and give these to as many patients as possible.’ Thomas Duong, from Monash University (VIC) took home the People’s Choice award. [caption id="attachment_10928" align="alignright" width="308"] Thomas Duong won the People’s Choice award[/caption] It was a huge opportunity and responsibility to represent Monash in such a major competition, Mr Duong said, and he is also now looking for an internship. ‘I’m interested in hospital pharmacy with its clinical dynamics,’ he said. ‘I am also interested in doing research so I may consider that pathway to higher study.’ PSA National President Associate Professor Chris Freeman congratulated both students. ‘We saw a very strong field line up this year and it is great to see such talented and passionate pharmacy students showcasing their skills and knowledge,’ he said. ‘This competition provides students with the opportunity to grow and learn with active listening, gaining patient insights and patient understanding important skills that support medicine safety and maximise patient outcomes. ‘It is heartening to see the future of our profession in good hands,’ A/Prof Freeman said, ‘and we were impressed with the overall level of knowledge from students during both the state and national finals.’ As his prize, Mr Gray will receive funding for pharmacy-specific education from Mylan. Mylan Australia Product Manager David Lai said the standard of students competing at this year’s PSOTY was impressive again. ‘It gives me great confidence to know the future of our pharmacy industry lies within the hands of these students,’ Mr Lai said. ‘They have excelled beyond my expectations.’ This year’s finalists:
Get your weekly dose of the news and research you need to help advance your practice.
Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.