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Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.

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NPS Media Releases April 2012

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	NPS Spokesperson articles by this author...
Regular information provided by NPS – Better choices, better health - NPS enables people to be medicinewise.

NPS is a valued independent resource for accurate, evidence-based prescribing information and education.
Given the marketing pressures applied by global drug companies, NPS plays a vital and unique role across the healthcare sector.
For more information please contact Stephanie Childs on (02) 8217 8667 or 0419 618 365 or schilds@nps.org.au

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26 APRIL 2012

GOVERNMENT MUST TAKE THE LEAD IN TACKLING ANTIBIOTIC RESISTANCE: NPS BOARD CHAIR DR JANETTE RANDALL ADDRESS TO THE NATIONAL PRESS CLUB

NPS Board Chair Dr Janette Randall today called on the government to take the lead on a cross sectoral approach towards tackling the antibiotic-resistance crisis facing the Australian community.

In an address to the National Press Club in Canberra, Dr Randall said the issue of antibiotic resistance is not restricted to the health sector with veterinary, agriculture and manufacturing all having their part to play.  Leadership is needed to ensure efforts are coordinated and cost effective.

“Government needs to take the lead and recognise where cooperation across portfolios is required,” said Dr Randall.

“Industry and health researchers must be supported to invest in R&D and the development of new antibiotics.  New mechanisms to fund drug development and bring new antibiotics to market through innovative reimbursement models are urgently needed.

“We need to take action at all levels – individuals, health professionals, communities, media, industry and government. We must act strongly, and we must act now.”

Dr Randall also previewed a world without antibiotics, warning that we risk not only returning to an era before antibiotics were discovered, but an even more daunting post-antibiotic era where the bacteria are smarter, more virulent and cause nastier and more complex infections.

“Data shows that the timeline between a new antibiotic becoming available and the development of resistance to that antibiotic is getting shorter and shorter.”

“We are facing a world where infections from something as simple as a scratch have the potential to kill and where common illnesses once again become serious or untreatable and carry a higher risk of complications and death,” Dr Randall said.

The speech coincides with the launch of new consumer campaign from NPS to address the misuse and overuse of antibiotics in the Australian community.

“We are asking all Australians to become resistance fighters and join the fight against antibiotic resistance and we are supporting this campaign with other tools and resources to help change attitudes and behaviours towards antibiotic use,” Dr Randall said. 

“We have an ambitious goal to reduce antibiotic prescribing by 25% in five years. This will bring Australia in line with the OECD average of defined daily dose of antibiotics per capita/per day and give us a real chance to reduce the incidence of antibiotic-resistant bacteria in the Australian community.

“To help us achieve this, we are working with GPs, pharmacists, nurses and other health professionals to promote the use of best-practice guidelines for infections, encourage symptomatic management of colds and flu, and to facilitate better patient conversations when discussing antibiotic resistance and the correct use of antibiotics,” said Dr Randall.

A full copy of Dr Janette Randall’s speech is available via the NPS website at http://www.nps.org.au/news_and_media

To become an antibiotic resistance fighter, login to Facebook and visit www.facebook.com/NPSmedicinewise

 

24 APRIL 2012

SIGN UP TO BE AN ANTIBIOTIC RESISTANCE FIGHTER AT FACEBOOK.COM/NPSMEDICINEWISE

NPS has launched a new Facebook page for Australians to sign up and become antibiotic resistance fighters at www.facebook.com/NPSmedicinewise

Created as part of a new campaign to tackle antibiotic resistance in the community, NPS is asking Australians to pledge to take three simple steps to combat the development and spread of this global problem. If 35,000 people sign up, Australians could significantly reduce antibiotic resistant bacteria.

NPS clinical adviser Dr Danielle Stowasser says antibiotic resistance fighters are everyday Australians who take action to safeguard the health of the whole community by making sure antibiotics remain effective into the future.

“Antibiotics were one of the most important advances in modern medicine, but because we have been misusing these medicines, more and more bacteria are becoming resistant to treatment.  With very few new antibiotics being developed, the harsh reality is that if we don’t change the way we use antibiotics now, by the time our children are adults we could run out of effective antibiotics. By 2030 we could be back to the pre-antibiotic era.”

“The good news is we can actually curb, and even reverse the development of antibiotic-resistant bacteria if we take action now.  Every individual can contribute and make a difference to our future health and the future health of our children.

“This is why we are encouraging all Australians to sign up via Facebook and become an antibiotic resistance fighter.  If 35,000 Australians were to join the fight, this would help bring our antibiotic usage as a nation in line with the average of other OECD countries,” Dr Stowasser says.

The mass media component of the campaign also launches this week with a series of advertisements on television, in print and online, featuring everyday Australians donning ‘Resistance fighter’ t-shirts and taking simple actions to curb antibiotic resistance.

“There are some simple steps we can all take to become antibiotic resistance fighters,” says Dr Stowasser,

·         Firstly, don’t expect or ask for antibiotics from your doctor if you have a cold or flu, as these are caused by viruses which antibiotics cannot and do not treat.

·         Secondly, if you are prescribed antibiotics for an infection, take them exactly as directed by your doctor, and know that not doing so increases antibiotic resistance.

·         Finally, always practice good hygiene to stop the spread of germs and encourage others to become resistance fighters too.

To sign up to become an antibiotic resistance fighter, login to your Facebook page and go to www.facebook.com/NPSmedicinewise.  Fighters are also encouraged to invite their friends to sign up with the person who gets the most of their friends to join to receive a prize* including

·         An iPad pre-loaded with a Medicines List app and other helpful medicinewise tools

·         A magazine subscription of your choice to either Prevention Magazine, Practical Parenting or Women’s Health

·         $1000 worth of books for a school or day care centre of your choice

·         Your chance to meet Mel Doyle in Sydney, thanks to a donation from one of our resistance fighter partners.

For more information about the NPS antibiotic resistance fighter campaign and to view the advertisements online visit http://www.nps.org.au/bemedicinewise/antibiotic_resistance

* Full terms and conditions at www.facebook.com/NPSmedicinewise.

 

23 APRIL 2012

“BACK TO THE FUTURE – LIFE WITHOUT ANTIBIOTICS”: NATIONAL PRESS CLUB ADDRESS ON 26 APRIL

National Press Club address by Dr Janette Randall, Chair, NPS Board

"Back to the future - life without effective antibiotics"

11.30am - 1.30pm, Thursday 26 April 2012

It’s hard to believe 100 years ago, a simple scratch could kill.  In the days before antibiotics were discovered, people had little defence against bacterial infections so a festering wound or a bout of tonsillitis could often turn life-threatening. Now the world is on the brink of returning to the pre-antibiotic era because of the overuse and misuse of antibiotics globally. In fact in 2011 the World Health Organization issued an ominous warning: act now or risk losing these miracle drugs forever.  

What would a world without antibiotics look like?  What are the solutions?  And whose responsibility is it to act? The good news is we have the tools and knowledge to make a better future if we can change the patterns of today.

Dr Janette Randall, chair of the NPS Board, will address the National Press Club in Canberra this Thursday 26 April.

Please join us for this important event. For more information and to reserve tickets visit http://www.npc.org.au/speakers/dr-janette-randall.html or telephone the National Press Club on (02) 6121 2199.

About Dr Janette Randall

Janette is a general practitioner in Brisbane. She has worked in general practice since 1994, obtaining her General Practice Fellowship in 1996. She has a special interest in mental health issues, as well as women’s health and paediatrics.

From 1997 to 2006 Janette was significantly involved in the Divisions of General Practice Program holding various roles locally and at a state level in Queensland. 

Janette was appointed a director of NPS, a not-for-profit, independent organisation for a medicinewise Australia, in May 2006 and has held the position of Chair of the NPS Board since August 2007. For the past three years she has been a member of the National Medicines Policy Executive committee advising the government on issues relating to medicines policy and program implementation.

 

19 APRIL 2012

1 IN 5 AUSTRALIANS EXPECT ANTIBIOTICS FOR COUGHS OR COLDS: NEW NPS CAMPAIGN

1 in 5 Australians expect their doctor to prescribe antibiotics for themselves and/or their child when they have a cough or cold, new research from NPS has found.

Of the 1013 Australians surveyed nationwide*, 4 in 5 also said they expect a prescription from their GP when they have an ear, nose, throat or chest infection, with more than half (51%) saying they would ask their GP for one. 

Requests for antibiotics to treat their child’s cold or cough were double that of parents who would ask for one themselves (14% vs 6%), with fathers more likely to ask than mothers (22% vs 9%).

The survey also revealed a plethora of misconceptions when it comes to antibiotics with only half of respondents knowing that bacteria are becoming resistant to antibiotics. Only 40% knew antibiotics should not be taken for viruses and many (40%) did not know that taking antibiotics when they’re not needed contributes to antibiotic resistance.  More than half did not know resistance increases when you don’t complete the course as directed and in general, the youth audience had less knowledge.

Released to coincide with the launch of a new NPS campaign against antibiotic resistance, NPS clinical adviser Dr Danielle Stowasser says these results indicate people may be thinking about or taking antibiotics even when they don’t really need them.

“Since antibiotics were first used in treatment, they have become one of our most important weapons against bacterial infections.  But over time, because we have been overusing and misusing these medicines, bacteria have built up resistance to antibiotics, meaning infections caused by these bugs are becoming harder and harder to treat,” says Dr Stowasser.

“If we don’t act now to combat the development and spread of antibiotic-resistant bacteria, we risk returning to an era where an infection from something as a simple as a scratch could cause serious complications, or even death.  In fact, the World Health Organization has labelled antibiotic resistance as being one of the greatest threats to human health today.”

The new NPS campaign encourages all Australians to become antibiotic ‘resistance fighters’ and join the fight against antibiotic resistance. 

“Australians are amongst some of the highest users of antibiotics in the developed world, with around 22 million prescriptions written every year.  If at least 35,000 Australians pledge to join the fight against antibiotic resistance this will help bring our use in line with the average of other OECD countries,” says Dr Stowasser.

NPS has set up a Facebook page — www.facebook.com/NPSMedicinewise — where from Monday 23 April people can pledge to take some simple actions to help fight antibiotic resistance. 

“The first thing an antibiotic resistance fighter does is not expect antibiotics for colds and the flu, as these are caused by viruses which antibiotics cannot treat,” says Dr Stowasser.

“The second pledge an antibiotic resistance fighter makes is to always take antibiotics exactly as directed by their doctor if they are prescribed them, knowing that not doing so contributes to the development and spread of antibiotic-resistant bacteria.”

“Finally, an antibiotic resistance fighter always practices good hygiene – such as washing their hands and covering their mouths when they cough or sneeze – to help stop the spread of infection caused by both viruses and bacteria,”  Dr Stowasser concluded.

A variety of resources, tools and information to help consumers learn more about becoming an antibiotic resistance fighter are now available on the NPS website.  For further information, visit www.nps.org.au/bemedicinewise/antibiotic_resistance

 

16 APRIL 2012

Asthma treatment still inadequate in Australia 

The treatment of asthma in Australians remains inadequate, and could be improved by tailoring individuals’ asthma treatment and educating patients on inhaler technique, a leading asthma expert has warned.

Writing in the latest edition of Australian Prescriber, Associate Professor Helen Reddel, research leader at the Woolcock Institute of Medical Research says many people are prescribed higher doses than necessary. Most people do not use their inhalers correctly, leading to poor clinical outcomes and wasted medicines.

“Deaths from asthma have dramatically fallen in recent years, so it is often perceived as a commonplace and rarely serious condition. However, treatment of asthma in Australia is not optimal,” says Dr Reddel.

“Many patients are still under-treated. More than half of people with asthma aged 15–34 years are dispensed preventive medications only once in a year, which indicates many people are not taking enough of these medicines to reduce the risk of asthma flare-ups.”

“On the other hand, many patients are being over-treated. The majority of preventer prescriptions for asthma in Australian adults are for the highest potency combination of an inhaled corticosteroid and long-acting beta2 agonist rather than a low-dose inhaled corticosteroid which alone should be sufficient for most patients. People with asthma should have their asthma control and risk factors reviewed once or twice a year, and have their treatment adjusted if necessary. Patients may also make short term adjustments for worsening asthma in accordance with their written action plan.”

Current guidelines are based on assessment of the patient’s level of asthma control - the extent to which the effects of asthma have been reduced or removed by treatment. The level of current control (how the patient’s asthma is at present) is determined by the frequency of symptoms, use of reliever inhalers and activity limitation over the last month, and spirometry. The patient’s future risk of adverse outcomes, particularly exacerbations and adverse drug reactions, should also be considered when deciding how to manage their asthma.

Dr Reddel, who is also Chair of the GINA (Global Initiative for Asthma) Science Committee, recommends that treatment should be stepped down when asthma is stable to minimise the (small) risk of adverse effects, such as osteoporosis and cataract, with treatment stepped up only after dealing with other factors contributing to poor control.

When symptoms are worse, other causes should be considered such as rhinitis, cardiac failure or vocal cord dysfunction. Inhaler technique should be reviewed by watching the patient demonstrate how they use it. Videos showing correct inhaler technique are available on the National Asthma Council website. Taking asthma medications as prescribed can be difficult, and Dr Reddel discusses ways to help. A second article by Dr Reddel on written asthma action plans will be published in the June issue of Australian Prescriber.

To read the full article and others visit www.australianprescriber.com

Individuals with questions about their medicine can call the Medicines Line (1300 MEDICINE or 1300 633 424), Monday to Friday 9am to 5pm AEST

 

12 APRIL 2012

INFLUENZA VACCINE RECOMMENDED BUT SELECT THE APPROPRIATE VACCINE

Further to advice issued by the RACGP and the Chief Medical Officer, NPS is encouraging health professionals to offer their patients influenza vaccination, especially for those at risk, but to be aware that the choice of influenza vaccine is important, especially for children.

NPS Head of Programs, Ms Karen Kaye, says that as the influenza season approaches, it is important for health professionals to advise patients that even healthy people can get severe influenza and vaccination is the single best way to protect against the disease.

“In Australia there are on average 85 deaths and over 4,000 hospitalisations recorded due to influenza illness each year,” says Ms Kaye.

“Health professionals should let their patients know that despite there being no new strains of influenza identified in 2012, people who were vaccinated in 2011 still need to be vaccinated this year to ensure continuing protection.

“This advice is valid for everyone, but especially for those at risk of complications of influenza, including those with pre-existing medical conditions, such as chronic lung and heart disease, the elderly and pregnant women.

“Previous concerns about influenza vaccination side effects have been fully investigated and the recommendations for the 2012 influenza season have taken these into account. Selecting the appropriate vaccine will ensure patient confidence.”

Data collected during the 2010 influenza season showed that the Fluvax vaccine was associated with febrile reactions in up to 1 in 100 children under the age of 5 years. The new recommendations are that Fluvax must not be administered to children under the age of 5 and should only be used in children between 5 and 10 if one of the other alternative vaccines is not readily available. The other recommended vaccines (Agrippal, Fluarix, Influvac and Vaxigrip) may be used in anyone over 6 months of age.

For people eligible to receive free vaccination under the National Immunisation Program, Fluarix and Vaxigrip are available for those over 6 months of age and Fluvax for those over the age of 10.

NPS has prepared information for health professionals seeking more information about influenza vaccination.

The NPS information explains that while there have been some reports of safety concerns in the media, on the whole the benefits of having an influenza vaccine outweigh the risks for the majority of Australians.

“We encourage health professionals to advise patients receiving influenza vaccines that some may experience mild reactions, such as redness and swelling at the injection site, but if they are worried they should contact their doctor,” says Ms Kaye.

A report published in February 2012 by the Australian Technical Advisory Group on Immunisation (ATAGI) and the TGA on the safety in adolescents (over 10 years old) and adults of seasonal influenza vaccines found that the risk for adverse events from an injection with Fluvax was likely to be modestly higher than with either Vaxigrip or Influvac – the main adverse event being a reaction at the site of the injection.

However, the report emphasised that the absolute rate of adverse events following injection in adolescents and adults with Fluvax was within an acceptable range, and concluded that the risk-benefit profile for Fluvax justified its continued use in all adults over 65 years and those over the age of 10 who are at risk of contracting influenza (due to other concurrent diseases or conditions which may predispose to infection).

Health professionals can read more about flu vaccines for the 2012 influenza season and access resources about immunisations at www.nps.org.au/health_professionals/vaccines.

NPS also offers unbiased, evidence-based information for patients about vaccines at www.nps.org.au/medicines/vaccines_immunisation

 

3 APRIL 2012

ENTRIES NOW OPEN FOR NATIONAL MEDICINEWISE AWARDS

Health professionals, consumers and industry organisations are invited to enter projects or activities that address quality use of medicines in the broader community in the new 2012 National MedicineWise Awards.

The awards, which build on the past Quality Use of Medicines Awards, recognise the many successful programs that address medicines use issues and will be presented by NPS: Better choices, Better health as part of the 2012 National Medicine Symposium (NMS).

NPS Head of Programs Ms Karen Kaye said the awards acknowledge at the highest level efforts to improve medicines use and patient outcomes.

“Achieving a medicinewise community requires a combination of initiatives across the many areas that contribute to medicines safety, awareness and practice. The National MedicineWise Awards recognise the important role of each of these areas and set new standards for achievement and innovation,” Ms Kaye said.   

Award categories cover the key areas contributing to quality use of medicines and include:

·         Building a medicinewise community: consumer programs

<$100,000 budget

>$100,000 budget

·         Education for health professionals to build quality use of medicines skills

<$100,000 budget

>$100,000 budget

·         Excellence in labelling and packaging

·         Best e-health resources

·         Best media report of a medicines story

The National MedicineWise Awards also include awards for the best NMS abstracts. Accepted abstracts will automatically be considered under the following categories:

·         Best student abstract for NMS

·         Best abstract for NMS

·         Best poster

·         People’s choice poster

Anyone who has submitted an abstract and wishes to be considered for the non-abstract categories of the National MedicineWise Awards will need to complete a separate nomination form.

Nominations for the National MedicineWise Awards close Friday 20 April 2012. All winners will be announced at the NMS 2012 dinner on Thursday 24 May. For more information go to www.nps.org.au/topics/nms/awards 

 

2 APRIL 2012

Latest edition of Australian Prescriber out now  

The April edition of Australian Prescriber is out now and looks at the following topical issues:

Freedom of expression under threat: complaints about medicines

There needs to be protection for people who make genuine complaints about medicines, writes Dr John Dowden, Editor-in-Chief of Australian Prescriber, in the publication’s April edition. The editorial cites the recent case of Dr Ken Harvey being sued for questioning the efficacy of a complementary medicine, and explores whether freedom of expression may be under threat in Australia from companies using legal action, or the threat of it, to try to silence their critics.

High blood pressure and cholesterol in Australian children

Cardiovascular risk factors such as high blood pressure and cholesterol levels are on the increase in Australian children, particularly those who are overweight or obese, write Dr Julian Ayer, Children’s Hospital at Westmead, and Associate Professor Gary Sholler, University of Sydney. These risk factors are often overlooked in children, but they play an important role in adult cardiovascular health. Improving diet and increasing exercise within the whole family are central to the non-drug treatment of hypertension. The authors give drug treatment options for children with secondary hypertension or children with end organ damage who have not responded to lifestyle measures. The article also looks at recommendations on when to treat children with statins

Hypertensive disorders in pregnancy

Hypertensive disorders in pregnancy are common, according to Dr Peter Donovan of Princess Alexandra Hospital, Brisbane, and range from chronic and gestational hypertension to eclampsia. These disorders are associated with an increased risk in pregnancy. Dr Donovan warns that there are limited data about the safety of many hypertensive drugs in pregnancy, so certain medicines such as ACE inhibitors and angiotensin receptor blockers should be avoided. The article also looks at the various manifestations of hypertensive disorders in pregnancy, the suggested approach to care, and postpartum management and secondary prevention. The increased cardiovascular risk for women who have had any hypertensive disorder in pregnancy also means that long-term follow-up is needed, writes Dr Donovan.

Safe use of adrenaline autoinjectors

Adrenaline autoinjectors enable non-medical people – including patients – to treat anaphylaxis, but as there are two different brands of the device in Australia, patients and carers need to be trained in their use. Sandra Vale, Jill Smith and Clinical associate professor Richard Loh, of the Australasian Society of Clinical Immunology and Allergy (ASCIA), outline how to use the two different devices. The authors emphasise the importance of trainer devices for patients and carers, and summarise prescribing and dosing guidelines for adrenaline autoinjectors. They also look at common adverse effects and important precautions, as well as the importance of patient action plans.

Other articles in this edition of Australian Prescriber include

Rational prescribing for ongoing management of asthma in adults

Home sleep studies for investigating sleep apnoea

To read the full articles and more visit www.australianprescriber.com

 

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