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Welcome to the first homepage edition of i2P for 2012.
In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011.
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We apologise to all those potential subscribers who were unable to register with us in the second half of 2011, but if you try once more you should have no problem.

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NPS Media Releases January 2010

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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.

The National Prescribing Service (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.

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General practice keen to improve prescribing practice

Twenty three general practice networks from around Australia have been selected as demonstration sites for an innovative pilot project which aims to give general practitioners (GPs) feedback on their prescribing practices.

The Prescribing Data in General Practice Demonstration (PDGPD) Project – run by the National Prescribing Service (NPS) in conjunction with the Australian General Practice Network (AGPN) – is a quality improvement activity aimed at improving prescribing practice in patients with hypertension and chronic heart failure.

“Following a significant number of expressions of interest we selected 23 general practice networks to participate in the demonstration project,” said AGPN CEO Mr David Butt.

”This project offers GPs immediate feedback on their prescribing patterns and show how their prescribing compares to other GPs in their practice.”

“We are delighted with the number of practices that want to take part in the pilot, which shows the value of this type of project,” Mr Butt said.

The project uses the Canning data extraction tool so GPs can receive immediate feedback on their prescribing practices against clinical indicators.

“Until now use of electronic prescribing data extraction for the purposes of quality improvement and manual extraction for indicator calculations for prescribing indicators has been very time-consuming and complicated,” NPS CEO Dr Lynn Weekes said.

“To make this feasible, the Canning data extraction tool has been modified to automatically extract relevant prescribing data and calculate eight clinical prescribing indicators.”

The data extraction tool provides results for both individual GP and the whole practice. It also identifies, for the treating GP, individual patients who may benefit from a change in prescribing to optimise management.

“As well as receiving instant feedback, GPs will be able to reflect on their prescribing practices through discussions with practice peers and a PDGPD Project Facilitator.”

The pilot project focuses on chronic heart failure and hypertension. Both these conditions have well-established treatment guidelines but studies show under-prescribing of first-line recommended treatments.

The pilot project will run for two years and involve approximately 180 practices over that time.

For further information visit

www.agpn.com.au/programs/quality-use-of-medicines-qum/prescribing-data-in-general-practice

Health professionals warned about risks of quinine

Doctors continuing to prescribe quinine for purposes other than malaria are putting people’s health at risk, warns the National Prescribing Service (NPS).

Quinine sulphate or bisulphate tablets (Quinate or Quinbisul) had previously been approved for the prevention of muscle cramp, however approval was withdrawn by the TGA in 2004 because the risk of thrombocytopenia (decreased platelet count) outweighs quinine’s modest efficacy. It is now a streamlined authority PBS item, subsidised only for use in malaria.

“More than 100,000 prescriptions for quinine tablets continue to be dispensed each year, which is far in excess of the quantity required to treat cases of malaria,” NPS acting CEO, Karen Kaye said.

Although total annual prescription numbers are falling (from 246,923 in 2005-06 to 154,511 in 2008-09), these figures suggest the drug is still being prescribed for leg cramps. Also of note is that PBS/RPS prescription numbers have increased over the last two years, coinciding with the streamlining of the authority item (increasing from 3863 scripts in 2006-07, the first year after streamlining, to 6395 scripts in 2008-09).

“Prescribers are reminded of the lack of efficacy of quinine in leg cramps, the risk of harm and that the only TGA-approved indication for quinine is malaria,” Ms Kaye said.

As of 2004, ADRAC had received 228 reports of thrombocytopenia involving quinine, six of which resulted in death. Typically, cases occur within the first few weeks of starting quinine although intermittent dosing may result in a longer time to onset. Symptoms can be severe, requiring hospitalisation and platelet transfusion.

“We strongly encourage doctors to ask patients to stop taking quinine for muscle cramps. While some patients may be reluctant, there is no evidence for its long-term efficacy or safety for preventing or treating leg cramp,” Ms Kaye said.

“Stretching exercises may be of benefit to some patients. While there is little evidence to support their efficacy in prevention, stretching does encourage self care and is unlikely to cause adverse effects.”

Underlying causes of cramp should also be investigated and may include electrolyte disturbance (particularly sodium and calcium deficiency), peripheral vascular disease or motor neurone disease. Possible drug causes of cramp include calcium-channel blockers, beta2-agonists and diuretics.

To assist prescribers a fact sheet on the benefits and harms of using quinine for leg cramps has been prepared and can be accessed at www.nps.org.au/news_and_media/factsheets.

Mixing medicines, alcohol and sun can be a recipe for trouble

It’s easy to forget about daily routines while on holidays but if you’re one of the hundreds of thousands of Australians with a chronic health condition, forgetting to take your medicines or not taking them properly can have serious consequences.

Over the holiday season Australians are urged to think about lifestyle factors that can reduce the effectiveness of medicines including drinking alcohol and spending time the sun.

“Holidays might mean a break from your daily routine but unfortunately our health doesn’t get a break. Any medicines that you normally take on a regular basis should be continued along with lifestyle habits like eating a healthy diet and getting regular exercise,” NPS CEO, Dr Lynn Weekes said.

“Alcohol can increase side effects of many medicines in particular antidepressants, sleeping tablets, some pain medicines and some antihistamines and come cough and cold medicines. It can also worsen some conditions that may be treated with medicines, such as depression and anxiety.”

“Stop and think before consuming alcohol and read the consumer medicines information. If drowsiness will be increased by alcohol most prescription medicines will have a red sticker on the package.”

A few medicines can increase sensitivity to the sun. These include the antibiotic doxycycline, some anti-epileptic medicines and immunotherapies, and most acne treatments.

“If you’re using medicines that can increase sensitivity to the sun avoid spending large amounts of time outdoors. If you are outside ensure you wear sunscreen and protective clothing as your skin is likely to burn much faster than normal,” Dr Weekes warned.

“Canapés, big lunches and dinners and alcohol are hard to avoid during the festive season but people with diabetes will need to watch what they eat. Be aware of what you’re being served and how much you’re eating, and plan your medicines and meal times,” Dr Weekes said.

For more information about whether your medicines interact with alcohol or increase sun sensitivity download the consumer medicine information leaflet from www.nps.org.au/cmi or ask your doctor or pharmacist.

Think about your medicines as you prepare for the holidays

Australians travelling over the holiday break are urged to think about their medicines when preparing to go away, especially if they are going overseas.

CEO of the National Prescribing Service, Dr Lynn Weekes said forgetting to pack your medicines or not storing them properly can have serious consequences.

“There are three things to consider about your medicines when preparing to go away – do you have enough for the duration of your holiday or repeat prescriptions that can be filled, do your medicines need to be stored in special conditions while you’re travelling, and do you have the right documentation if you’re going overseas,” Dr Weekes said.

“Most medicines need to be stored under 25°C as exposure to heat and sunlight can cause chemical reactions in some medicines and reduce their effectiveness. If you’re going to be driving long distances or you’ll be somewhere without electricity (e.g. camping) ensure any medicines are kept cool in refrigerated bags.”

“If you are taking a friend or relative out of an aged care facility or hospital for leave over the holiday period check with the nursing staff that you have been given any medicines they may need and written instructions for dosages and timings. Ask for any special instructions such as avoiding particular foods that you may need to know as their carer.”

“If you’re going overseas make sure you’ve had the necessary immunisations and have enough of any medicines you take regularly for the time you’re away with a few days extra supply in case you get delayed,” Dr Weekes said.

When taking medicines out of Australia always keep your medicines in their original packaging and carry your prescriptions and a letter from your doctor explaining what the medicines are for. Some countries may not allow you past immigration without this documentation if you’re carrying medicines, especially if you have needles for injectible medicines.

“Crossing time zones can mess up daily medicine regimens so speak to your doctor or pharmacist before you leave about how you can manage the time differences,” Dr Weekes said.

For advice on how to store your medicines while travelling ask your pharmacist or visit www.nps.org.au/consumers/publications/medicines_talk/mt24/

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