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- Issue 81: April 2009
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- Issue 74: August 2008
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National Prescribing Service Press Releases

Katie Butt
From a Good Prescribing Perspective

Issue 74: August 2008
Page: 1 of 1 Author's Profile | Send to a Friend | Printer Version
The National Prescribing Service (NPS)is a valued independent resource for good and unbiased prescribing information and education.
Given the marketing pressures applied by global drug companies, Australia is blessed to have such a resource.
Pharmacists are moving closer to a prescribing role within the health system and it is appropriate that i2P promote the message of the NPS.
This Month:

 * Complementary therapies – jury is out on cold prevention

* Type 2 diabetes: an important health care topic for new-look NPS pharmacy activity

* Minimising birth defect risk for pregnant women with epilepsy


Complementary therapies – jury is out on cold prevention

If you want to avoid a cold over winter, your best chance to do so is to practice good hygiene techniques rather than take preventive medicines, according to the National Prescribing Service Limited (NPS) Common colds need common sense, not antibiotics campaign.

Executive Manager of Quality Use of Medicines (QUM) Programs for NPS, Karen Kaye, said many people take vitamins, mineral supplements and other herbal remedies at this time of year to avoid a cold.

“The evidence currently at hand seems to indicate that vitamin C supplements, zinc and echinacea do not assist in cold prevention,” she said. “In the case of echinacea particularly, the quality of these medicines can differ greatly and most have not been tested in good quality clinical trials.”

For treating colds she says an expert review of clinical studies of Vitamin C supplements, taken after symptoms show, did not give reliable effects in decreasing the duration or severity of symptoms. Zinc has not been shown to reduce the length or severity of a cold. Interestingly, a review of clinical studies published this year concluded that Echinacea purpurea, a specific variety of the plant, may be effective in the early treatment of colds in adults, but the results are unreliable. “A consistent problem is the quality of the clinical trials used to test these medicines,” she said.

Ms Kaye suggests basic hygiene practices such as washing hands frequently with soap; keeping your hands away from your eyes, nose and mouth; and, not sharing crockery and cutlery are the best ways to avoid catching one of the two to four colds that the average adult gets every year.

Cold symptoms usually begin one to two days after contact with the virus and you are most infectious in the early days of a cold. Symptoms usually improve in seven to 10 days.

And if you already have a cold? Rest, stop smoking and treat the symptoms. “Firstly, rest – give your immune system time to fight the cold,” Ms Kaye urged. She says drinking something soothing, gargling warm salty water or sucking on ice or a throat lozenge may provide relief from a sore throat. Saline (salt water) sprays or drops or inhaling steam from the shower will help clear mucus.

“Antibiotics won’t help your cold get better faster and won’t stop a cold from spreading to others because they simply don’t work on the viruses which cause common colds,” Ms Kaye said.

Remember that medicines include over-the-counter preparations, vitamins, mineral and herbal supplements as well as what is prescribed for you by your doctor. If you are contemplating taking a medicine, weigh up the clinical evidence before you make a purchase. Visit www.nps.org.au/commoncolds or ask your pharmacist or doctor for advice and always read the label. If your symptoms come on suddenly, are severe or last longer than usual, visit your doctor.

The NPS Common colds need common sense, not antibiotics campaign is the only Australia-wide strategy aimed at reducing the development and spread of antibiotic-resistant bacteria. For more information on treatment or the symptoms that should be seen by a doctor visit www.nps.org.au/commoncolds. For independent information about prescription, over-the-counter and complementary medicines call Medicines Line on 1300 888 763 to talk to a pharmacist between 9am and 6pm Monday to Friday, Eastern Standard Time (EST) for the cost of a local call (mobiles may cost more).

Type 2 diabetes: an important health care topic for new-look NPS pharmacy activity

More than 1,800 pharmacists and intern pharmacists have taken up the opportunity to extend the quality of care for patients with type 2 diabetes by enrolling in the National Prescribing Service Limited’s (NPS) new-look Pharmacy Practice Review counselling and action resource.

“The strong enrolments to date demonstrate that the review kit has been well received. Pharmacists say they are using the materials to better communicate with their patients, which is yielding positive results,” NPS Deputy CEO, Ms Karen Kaye said.

Of the enrollees to date, 658 are pharmacists and 1,171 are intern pharmacists and most - more than 1,100 - of enrolments were made via the NPS website. Enrolment remains open and those who complete the activity by 24 October 2008 will receive feedback in February 2009.

Designed to better support pharmacist-patient counselling and interaction, the new-look materials include tear-off pads with information to use in discussion with patients, an action checklist for pharmacists to work through with individual patients and the latest clinical information about best practice in drug use in type 2 diabetes.

Launched in 2001 as the Pharmacy Practice Audit and now called the Pharmacy Practice Review, it retains the self-audit component to help pharmacists keep up with best practice. Participants receive a feedback report that includes individual results, aggregated results of the total participating pharmacist group and provides expert commentary on the aggregate results.

Sydney-based community pharmacist Irene McMartin said the new approach has prompted her to think about the way she counsels patients.

“The focus is on me. It gets me to reflect on how well I did and how I can improve my service and level of care. It reminds me to ask people about their lifestyle,” Ms McMartin said.

South Australian-based community pharmacist Thelma Tantalos, says the reviews she has done have helped develop her communication skills and encourage more meaningful interactions with her patients.

“I would definitely recommend them to other pharmacists. They help us to optimise our counselling and achieve the best results for each of our customers. The review is now easier to follow and easier to apply with each patient,” she said.

David North, a New South Wales-based community pharmacist who is completing the current Pharmacy Practice Review ‘Enhancing patient care in type 2 diabetes’, said it helps him establish priorities when counselling patients and reminds him to also ask lifestyle questions.

“The presentation is much easier; it is more in-depth, it sets out points to encourage adherence to medication and it encourages us [pharmacists] to discuss lifestyle matters such as exercise,” Mr North said. “For instance, if they’re playing golf, we ask them, how’s your golf going? The review takes a more holistic approach and there have been flow-on effects. Our patients are now volunteering information so we’re receiving information about other aspects of their health, such as if they have a weight problem or if they smoke.”

The review package is a part of NPS’s broader vision to encourage quality use of medicines by enabling pharmacists and health professionals to deliver best-practice management care. The review uses best practice guidelines to help pharmacists and staff review current practice, consider introducing changes, review and reflect on these changes, and to monitor their progress.

The review allows pharmacists to self-assess their abilities against professional practice standards and core competencies, and current good practice in the management of diabetes, to determine their learning needs. It also demonstrates a commitment to provide patients with the best possible quality of care in medication.

To take part in the new Pharmacy Practice Review go to www.nps.org.au/healthpro, email info@nps.org.au or call 02 8217 8700 and return your forms to NPS when you have completed the activity. Those who returned their forms by 25 July 2008 will receive feedback in December 2008.

Minimising birth defect risk for pregnant women with epilepsy

Women taking antiepileptic drugs and planning a pregnancy are advised to prepare well ahead of conception to reduce the risk of birth defects, according to an article in the current edition of Australian Prescriber.

Associate Professor Cecilie Lander, Department of Neurology at the University of Queensland, states in the article that these women have two to three times more risk than other women of having a baby with a foetal abnormality. Taking more than one antiepileptic drug may carry a greater risk.

“Congenital heart disease, neural tube defects, urogenital defects and cleft lips or palates occur in about three to seven per cent of babies of women with epilepsy who are taking antiepileptic drugs,” Associate Professor Lander writes. In addition, there are concerns that children who have been exposed to these drugs in utero may develop problems such as language impairment and autistic disorders.

Associate Professor Lander therefore recommends pre-pregnancy counselling and a comprehensive management plan. “These women should be treated with the least teratogenic but most efficacious antiepileptic drug for their particular type of epilepsy, at the lowest effective dose,” she writes.

There are particular concerns with valproate. Associate Professor Lander says “valproate should be avoided if possible because of the risk of major malformations”. However, she says there is a delicate balance that clinicians and pregnant mothers must try to achieve when managing the risks of maternal epilepsy and trying to safeguard the health of the unborn child.

She also recommends that all potentially reproductive women with epilepsy take folate supplements, even if they are not currently contemplating pregnancy.

For the complete article visit the Australian Prescriber website www.australianprescriber.com.


For further information or interviews with the author contact Elayn James on 02 8217 8700 (bh), 0419 618 365 or ejames@nps.org.au


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