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Welcome to the first homepage edition of i2P for 2012.
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NPS Media Releases June 2009

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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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9 June 2009

Review finds errors occurring at all stages of medication process

A literature review of medication safety in the community, conducted by the National Prescribing Service Ltd (NPS), has found adverse drug events* and medication errors are a significant problem in Australia.

The study, which cites more than 300 articles from Australia and overseas, is the first comprehensive review of medication safety issues and possible solutions in the community setting.

It explores the prevalence, contributing factors, and outcomes of adverse drug events and medication errors in the community. It also considers the impact of methods to improve medication safety including medication reviews, medication reconciliation, patient education and e-health interventions.

“This review confirms that medication errors continue to occur at all stages of the medication process - prescribing, supply, administration, monitoring and documentation. Up to 73% of these events are preventable, meaning patient safety is being jeopardised and avoidable burdens are being placed on our health system,” NPS CEO, Dr Lynn Weekes said.

Some key findings from the report include:

* Those at high risk of adverse events associated with medicines are older people, those with serious health conditions, those taking multiple medications, those using high risk medicines and those being transferred between community and hospital care.

* Around 6% of hospital admissions in Australia are associated with adverse drug events, with almost one third of admissions for the elderly associated with adverse events.

* Consistently high error rates occurred during transfer of care between hospital and community settings; and

* 10% of general practice patients in Australia report experiencing an adverse drug event; while 25% of high risk patients reported adverse events associated with medicines.

The most commonly reported contributing factor of medication errors and adverse events was poor communication, which is highlighted when patients are transferred between hospital and community settings.

The review also found that while many interventions do not have a significant impact on patient outcomes, those that take a comprehensive approach to managing specific disease states such as heart failure and include medication reviews, home visits and/ or telephone follow ups, do show positive patient outcomes.

“For medication management to be effective it must involve the patient and/ or their carer, and all members of their health care team. Interventions should be monitored, assessed and if necessary, revised. To address medication issues that arise during the transfer of care a systems-based approach must be developed and implemented nationally,” Dr Weekes said.

* Adverse drug events are any incidents involving a medicine that cause harm to the patient. They include harm that results from known adverse drug reactions, medication errors or system failures associated with the manufacture, distribution or use of medicines.

29 June 2009
Managing patient expectations of antibiotics

Health professionals are being given clear guidelines for prescribing particular antibiotics in different diagnostic scenarios in the latest National Prescribing Service (NPS) education program, Management of specific respiratory tract infections.

The therapeutic program aims to address inappropriate antibiotic use, particularly for treating acute bronchitis, sore throat and other respiratory tract infections, but also gives prescribers the facts to be confident prescribing symptomatic treatments.

“Prescribing for antibiotics in acute bronchitis continues, even though the illness is usually viral and antibiotics are only appropriate when a cough is the result of pneumonia or an exacerbation of chronic obstructive pulmonary disease (COPD),” NPS Deputy CEO, Karen Kaye said.

“GPs have told us they often feel pressured by patients to prescribe something but they aren’t confident to only recommend rest, saline solution, steam inhalation*, and analgesics if the patient has pain and fever,” Ms Kaye said.

Acute sore throat is usually viral and clinical features that distinguish a sore throat requiring antibiotics include fever over 38°C, exudate on the tonsils, tender cervical lymphadenopathy and the absence of cough. These features indicate infection by group A Streptococcus and require antibiotics.

Management of specific respiratory tract infections reinforces the following:

· Antibiotics are only appropriate in acute cough if a chest X-ray suggests pneumonia or in exacerbations of chronic obstructive pulmonary disease (COPD) with sputum purulence, plus increased sputum volume and/or dyspnoea

· Antibiotics are only appropriate in sore throat if all four diagnostic criteria (fever, exudate, lymphadenopathy and absence of cough) for streptococcal infection are present

· Use penicillin V for 10 days in uncomplicated sore throat that appears to be streptococcal

· Reserve macrolides when treating respiratory tract infections for those with pertussis or those hypersensitive to penicillin

· Cough and cold medicines have limited efficacy

· Provide advice to patients on appropriate symptomatic relief

“Home remedies such as honey and lemon, rather than a cough medicine which has limited efficacy, are the simplest and cheapest treatment options for uncomplicated acute coughs,” Ms Kaye said.

As part of the therapeutic program, NPS provides health professionals with:

· Case study (58): Antibiotics and respiratory tract illness – thinking of patient-centred care

· GP Clinical Audit: Management of specific respiratory tract infections (enrol by 7 August 2009)

· Prescribing Practice Review (46): Management of specific respiratory tract infections

· NPS News (63): Managing expectations for antibiotics in respiratory tract infections

The GP clinical audit is recognised by the RACGP Quality Assurance & Continuing Professional Development Program, total points 40 (category 1) and in the ACRRM Professional Development Program, 30 points (extended skills). It also qualifies as an activity for QPI of the PIP (Quality Prescribing Initiative of the Practice Incentives Program), year ending April 2010.

To enrol in the clinical audit visit www.nps.org.au/health_professionals.

*steam inhalation should not be used by children

Media enquiries to Katie Butt, Media Adviser, 0419 618 365 or kbutt@nps.org.au

The National Prescribing Service Limited (NPS) is an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.

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