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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 57: February 2007
Welcome to i2P in 2007.
This is the first edition for the year, and while Australia is just waking up after the annual holiday break, the writers for i2P are up and running.
While seeking a suitable publication to add to our global reading list, I found a quotation that I am thinking of adopting for i2P.
All Truth Goes Through Three Stages
· First it is ridiculed
· Then it is violently opposed
· Finally, it is accepted as self-evident
The writers at i2P have had many experiences of the above transition, but they still keep fronting for the only independent and not for profit publication available to pharmacists.
If anyone takes the time to research the archives (going back to 2000) you will note that many subjects we brought under the spotlight from that date onwards, are now accepted as “self-evident”.
We have helped to move the goal posts for many pharmacy issues.
Global Health News from the Internet - Pharmacy Related Links
This section of i2P aims to keep readers informed of global news that may affect pharmacy.
Readers are encouraged to share links to items of interest, by simply e-mailing the story link to the editor through the "Contact Us" panel located on the home page.
Topics can range from drug-related news, Information Technology, medical communications, medical research breakthroughs, management and marketing issues.
Because this news area is dynamic and changes daily, readers should immediately bookmark any links that they find interesting.
Response to any item is also encouraged through the "Letters (Your Say) " column.
By a Staff Writer - Publications to Note
This section of i2P is designed to be an experimental section to introduce other publications that have similarities to i2P, but are based in other countries.
The globalisation of Australian pharmacy started around the year 2000.
It has had minimal impact up to 2004, but that is now changing and i2P must reflect that change.
There are many aspects of globalisation not yet fully understood, but I think that to most of us, globalisation means that we must be quicker on our feet and have pharmacy practices with sufficient critical mass to withstand global pressures.
Depending on the model of pharmacy chosen, and its location, global pressures will vary.
As pharmacists we must begin to open up our minds to new ideas and innovative ways of delivering pharmacy practice.
By a Staff Writer - Conferences and Events
As part of our information service, i2P informs on Conferences, Workshops and Seminars or press releases that may be of interest to pharmacists. PSA information will continue to be published separately in the section reserved for PSA press releases. Pharmacy organisations may submit material for publication, preferably in digital format (Word document).
The Pharmacy 2007 Conference - organised by the Friendly Societies, this conference has gone from strength to strength each year to become the premier pharmacy conference.
Don't be disappointed - book now to ensure your reservation in Hobart this year.
New release - Therapeutic Guidelines Gastrointestinal 4 2006.
Order your copy to keep pace with current developments and guidelines.
Rollo Manning - A Regular Column Reporting the News Behind the News
* Co-payments increase sine a whimper
* Compliance programs is what it's called
* Scanning gains support
* THOUGHT FOR THE MONTH - The power of positive thinking
* For the disadvantaged we can offer a lot
Con Berbatis - A Pharmacy Researcher Perspective
Editor's Note: Over the past 100 years access to medical practitioners working in well organised primary care structures have become regarded as a cost-effective foundation of national health systems. But primary care differs between countries and GPs have declined markedly in the USA. Community pharmacies in developed countries are becoming regarded as important collaborative or individual contributors to primary care and self care where primary care resources are lacking.
Con Berbatis begins a series of reports which try to quantify community pharmacy’s current contribution and its future prospects in national health.
Neil Johnston - Management Consultant Perspective
Often, as we work our way through our business and professional life, we observe various happenings, events and developments without actually “seeing” them.
They are the “blind spots”, and we all experience them at one time or another.
It is not until you change your environmental mindset that you actually begin to notice things as other people may see them.
For this to happen you need to be removed from your own business environment, have associates that provide intellectual stimulation and an itinerary that involves searching for, or adapting from, that "something new" that will inevitably become obvious when you “see” it.
Stuart Adams B.App.Sc (Nutrition and Food) - From a Nutritional Activist Perspective
Editor's Note: Stuart Adams is a nutritional activist with a passion for evidence-based professional advice.
He has observed the quality of advice some pharmacists give in their daily practice when recommending nutritional supplements, and he finds it lacking.
Given that pharmacy has a commitment to excellence and has been diligently working to raise accreditation standards, what is going wrong in the nutritional advice area?
In a two-part series starting in this month's edition of i2P and finishing in the March edition, Stuart talks of his observations and first-hand experiences when working in a pharmacy environment.
You may disagree with him - that is your prerogative.
But if you catch a glimpse of your reflection within this well researched article, then please take this as an opportunity to raise the barrier.
If Stuart has found these "holes" within the pharmacy profession, others will have surely noticed, and the reputation of all pharmacists declines accordingly .
I value the reputation reported in past surveys of the Morgan Gallup Poll, measuring public opinion for the trust and integrity of pharmacists.
I believe that the ratings were justifiably earned over past years.
Please take this as a wake-up call and examine your professionalism against the following commentary.
Robert Forsythe - Globetrotting Community Pharmacist Perspective
Has Australian pharmacy lost its way?
That is sometimes how I feel when driving past one particular establishment where I live.
In fact - I find myself changing my route at times because of the way it makes me feel.
The PGA claims Australian pharmacy is ‘the best in the world’.
Yet, having traveled extensively I can honestly say that I have not seen pharmacies that look so tacky in any part of the developed or developing world.
Dr David More - From a Medical IT Perspective
In this article I am going to suggest that the race to maximise Government intrusion in citizens lives is presently being comprehensively won by the UK (with its multi-biometric compulsory national ID Card). Even worse, in the last day or so we learn from e-Health Insider that the UK Government wants to move to link many of its databases to simplify administration and reduce errors – to ensure not a single move you make goes unrecorded!.
The US is presently managing to come second in my view with the vagaries of the US Health Insurance Portability and Accountability Act (HIPAA) permitting large amounts of identified health information to move between service providers and payers with essentially no control on the part of the individual, almost daily leaks of identified information on the web or from mislaid lap-top computers and recently discovered privacy invasions such as warrantless wiretaps and covert house searches on the basis of perceived protection of “National Security”.
Sadly, however, we also now have our own Governments working out how best it can catch up and minimise the number of barriers that exist to a complete individually detailed dossier being built on all of us.
Garry Boyd - From an Intellectual Capital Perspective
The Losec case had more implications than the dispute between Astra and Alphapharm, and I dare say the implications gave rise to many prescriptions for the product.
The case itself involved Alphapharm having a crack at Astra on the basis that the Losec patent was obvious, therefore an inventive step had not been made.
Astra claimed the inventive step involved the combination of several compounds that interact with each other………..so far, so good.
A subcoating layer and an outer enteric coating comprising three elements follow the core compound, being the active ingredient.
The said invention involves the ability of the coatings to deliver the product where it is intended to be, being the intestine.
Alphapharm took exception to the patent and asked the Court to revoke it on the basis that it was not inventive.
Heather Pym - A Division of General Practice Perspective
When the Home Medicines Review option was initiated some six years ago it was difficult to rally prescribers to see the benefits or the need to refer patients for a review in our Division.
The Item 900 was introduced when GPs were coming to terms with using many other general practice initiatives and HMR was just another one to them AND they ‘did it anyway ‘.
However over the years and with much support and encouragement, the majority of GPs in the Division now know about it, many utilise HMR for their patients and we have a healthy average monthly count albeit not very large.
The good thing to note is that the figures are increasing and the HMR process is well bedded down.
Neil Retallick - A Friendly Society Perspective
The Federal Government claims that its intentions are good. It is only concerned about the welfare of the ‘average Australian’.
Its objective is to ensure every average one of us has access to the medicines we need at the lowest possible cost.
Over the last couple of years in particular we have seen a very determined Government lowering the price it pays to achieve this objective.
As it is, however, the Government is not alone in this system that delivers for the average Australian.
There was a time, not so long ago in the context of humanity, when doctors believed that to make an unwell patient better it was necessary to ‘bleed’ the illness out of the patient’s system.
It was a well regarded methodology, no doubt based in the best science of the day. Unfortunately, many patients died as a result of the cure when they might have been better off left to allow their own systems to fight for survival.
Ken Stafford - A Consultant Pharmacist Perspective
A piece in The West Australian newspaper last week about university cut off scores caught my attention.
It appears the WA boom economy has had an unexpected consequence, namely universities are finding it difficult to attract school leavers to what used to be prestige courses.
They would rather head “north” to earn huge salaries.
From the list of affected courses, only law seems to have maintained its TER score, which seems to give some indication of how young people perceive life in the big world.
Medicine didn’t get a mention, probably due to the difficulty of actually getting a place in medical schools, but pharmacy’s entrance score, in line with most of the other health profession courses, dropped this year to a TER of 88, down from 92 last year. (Law remained at 97)
Chris Wright - Dispensary Systems Perspective
Many of us speak of ‘change’ on these pages; after all, i2P is generally focused on change, innovation and progress.
It’s an interesting little verb (in this context), and one that we resist with great vigour most of the time.
I can’t remember a time when there was so much indecision and uncertainty behind closed doors.
Deregulation discussion, future models, to sell, or not to sell, generics & margins and plain old fear in the marketplace will make for a challenging 2007.
Barry Urquhart - International Conference Keynote Speaker
The available evidence and data on evolving trends indicates that the forthcoming calendar year will be one of consolidation and rationalisation for a number of sectors and entities, with an emphasis on cashflow.
Those precedents that were set during 2006 have been greatly influenced by the equity fund managers and leverage buyout specialists.
The disposal of the Myer department store national network by the then Coles-Myer Group in Australia is a case in point.
Upon acquisition the new owners and managers undertook an aggressive mass media stocktake sale campaign. Inventory was reduced by over $400 million (Australia).
The interest service costs on that sum alone represents an attractive enhancement to future annual profits.
Moreover, with the major competitor David Jones declaring that some 33% of its annual gross profit is generated by the store card and credit facilities, there are a lot of lessons for all retail oriented businesses.
A further point to ponder is the current true and meaningful answer to the long standing, standard question of external consultants:
“What business are you in?”
“Multiple revenue source supply chain management” may be an appropriate generic response.
Dr Andrew Byrne & Associates - A Harm-Minimisation Research Perspective
Editor's Note:Dr Byrne (and his associates) advocate for better policies which are proven to reduce risks for drug users and the general community under a framework in parallel with Australia's official policy of harm minimization. The findings of the New South Wales Drug Summit recommend better access to methadone, detoxification and other dependency treatments. It also advised investigating alternative services such as supervised injecting centres, leading to the opening of the Sydney Medically Supervised Injecting Centre in 2001. Dr Andrew Byrne has been involved in opioid treatments from a primary care background for 20 years at the same site in Redfern, an inner suburb of Sydney. He is recognised worldwide as a specialist in the addiction field and was involved in the seminal stages of the Chapter of Addiction Medicine, Royal Australasian College of Physicians. He received the Dole-Nyswander award from the American Association for the Treatment of Opioid Dependence in April 2006. A range of publications on pertinent strategies for harm-minimisation is available for dowloading at: http://www.redfernclinic.com/publications/ These e-publications may prove to be of practical interest to those pharmacists interested in dependence and addiction . This month we are pleased to publish a new conference report (APSAD Annual Scientific Conference. Cairns, Queensland) prepared by Dr Andrew Byrne. Dr Richard Hallinan has also had an interest in addiction medicine for about 20 years. Since joining the practice in 2000 he has published several key papers on subjects including hepatitis C and optimising methadone dose levels. He also has performed studies on hormones, mood disorders and related matters in dependency patients. Dr Hallinan also worked for years as a professional violinist in both Australia and in Austria.