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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 for May 2009

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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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5 May 2009
Antiviral guidelines and rapid tests for diagnosing influenza available on NPS website

Health professionals are urged to follow guidelines issued by the Department of Health and Ageing when prescribing antivirals for the treatment of swine influenza (H1N1).

The National Prescribing Service Ltd (NPS) made these guidelines available on its website last week, along with links to information from the US Centers for Disease Control, World Health Organisation and other industry organisations.

Current recommendations for the treatment of swine influenza using oseltamivir (Tamiflu®) or zanamivir (Relenza®) are only in the event of:

 

• Close contacts of confirmed or probable cases, in consultation with the local Public Health Unit, within 48 hours of contact

• Suspected cases, in consultation with the local Public Health Unit, if started within 48 hours of onset of symptoms, until influenza A is excluded or an alternative diagnosis is made.

 

There is no current recommendation for oseltamivir to be used as a prevention by travellers visiting affected countries, apart from Mexico.

These recommendations are in line with those issued by the US Centers for Disease Control (CDC), which can be accessed at www.cdc.gov/swineflu/recommendations.htm.

An article ‘Rapid tests for the diagnosis of influenza’ from the June edition of Australian Prescriber has been released early and can also be accessed via the NPS website.

The article, written by Microbiology Registrar Hong Foo and Clinical Professor of Medicine, Dominic Dwyer, from the Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, outlines rapid influenza tests based on viral antigen detection with point-of-care tests and immunofluorescence, how they work and their limitations.

It is not expected that the Australian seasonal influenza vaccine will provide protection against this new strain of influenza virus. However, people over 65 and other vulnerable groups should still be encouraged to be vaccinated as this will provide protection against seasonal influenza.

Community pharmacists can access more detailed information through The Pharmacy Guild of Australia and Pharmaceutical Society of Australia websites.

 

Doctors and other prescribers can access further information through the AMA and RACGP websites.

 

12 May 2009
Funding boost acknowledges importance of quality use of medicines

The National Prescribing Service Ltd (NPS) has welcomed a funding enhancement from the Federal Government to expand on our quality use of medicines work.

NPS will receive additional funds over the next four years to continue programs that improve medicines use among Australians.

“This announcement acknowledges NPS’ role in providing accurate, independent information to health professionals and consumers. It also reflects the Government’s commitment to integrative and preventative health measures that benefit all Australians,” NPS CEO, Dr Lynn Weekes said.

“This was not an easy Budget for the nation, but through our continued work promoting the safe and effective use of medicines, NPS will contribute to long term savings.”

It was also announced in the Budget that NPS will receive funding to run a national diagnostic requesting service to promote best clinical practice for efficient use of diagnostic imaging and pathology tests.

“We are yet to determine the details with the Department of Health and Ageing but it is likely to reflect our successful quality use of medicines program model,” Dr Weekes said.

This includes decision support tools, implementation of evidence-based guidelines, peer feedback and educational programs designed to assist health professionals and consumers make the best health decisions.

“Diagnostic imaging and pathology programs are a logical expansion of our current work with health professionals. Ultimately we hope to run synergistic programs that link diagnostics with medicines, ensuring tests are used efficiently and result in the best outcomes for patients.”

“We look forward to working closely with industry stakeholders in this new and interesting area for NPS,” Dr Weekes said.

The additional funding includes an additional $21 million over four years to enhance its existing work and $9.4 million over four years for the new diagnostics work.

Further detail about the work NPS will be doing over the next four years is expected to be announced in coming weeks.

14 May 2009
New medicine evaluation tools for aged care facilities

Two new Drug Use Evaluation (DUE) tools have been developed by the National Prescribing Service Ltd (NPS) to assist health professionals working in aged care facilities with optimal drug therapy relating to laxative use, and hypnotics.

The NPS DUE toolkits provide localised activities to compare current drug use against best practice and guide health professionals in their decision making to achieve the best outcomes for patients.

“Laxatives are one of the most frequently used medicines in long term aged care facilities - up to half of nursing home residents have reported experiencing constipation and 74% are receiving at least one laxative preparation[1],” NPS Education and Quality Assurance Program Manager, Judith Mackson said.

“But despite their widespread use, it is often difficult to assess the efficacy of laxatives. The inappropriate treatment of constipation can have a significant impact on the resident’s quality of life and increase the cost of care. The Laxative use for chronic constipation DUE will support health professionals to ascertain if current practice is at odds with best practice,” Ms Mackson said.

Benzodiazepine and non-benzodiazepine hypnotics for insomnia is the first electronic DUE toolkit to be available as a downloadable application for health professionals. The tool is a standalone data collection and analysis tool which is a valuable addition to the DUE resources.

This eDUE examines the appropriate use of medicines to manage insomnia in aged care facilities. The new electronic format contains fewer questions than other DUE tools, offers an intuitive interface and a variety of drop down menus. It also has a ‘save as you go’ mechanism, recognises appropriate dosage quantities and provides automatic feedback.

There are now four DUE toolkits available from NPS:

1. Benzodiazepine and non-benzodiazepine hypnotics for insomnia (NEW eDUE version)

2. Laxative use for chronic constipation (NEW)

3. Antipsychotics for behavioural and psychological symptoms of dementia

4. Analgesics for persistent pain

Participation in these DUE activities will assist the aged care facility to meet components of the Residential Care Standards issued by the Aged Care Standards and Accreditation Agency and comply with the Australian Pharmaceutical Advisory Council Guidelines for medication management in Residential Aged Care Facilities.

These DUE activities are also recognised by a number of health professional bodies as contributing to continuing education and professional development. To be eligible for professional development points, enter your details on the DUE access page on the NPS website.

The NPS DUE toolkits are downloadable at www.nps.org.au/due. For more information about DUE in aged care facilities, contact Aine Heaney at NPS on (02) 8217 8700 or aheaney@nps.org.au.

[1] 1. Harari D, Gurwitz JH, Avorn J, et al. Bowel habit in relation to age and gender: findings from the National Health interview Survey and clinical implications. Arch Int Med 1996;156:315-20.

2. Williams SG, DiPalma JA. Constipation in the long-term care facility. Gastroenterol Nurs.1990;12:179-82.

3. Woodward M, Moran J, Elliot R, et al. Constipation in older people Pharmacological Management Issue. J Pharm Pract Res 2002;32:37-43.

 

20 May 2009
Pharmacy Practice Review – improving quality care

The National Prescribing Service Ltd (NPS) has developed a new Pharmacy Practice Review to support pharmacists to deliver best practice care for patients prescribed proton pump inhibitors (PPIs).

The Pharmacy Practice Review – a counselling and action resource: Quality use of prescription Proton Pump Inhibitors (PPIs) is part of the broader vision of NPS to encourage quality use of medicines. It is one of the activities of the 2009 NPS therapeutic program on prescribing and use of PPIs for health professionals.

“The NPS Pharmacy Practice Reviews allow pharmacists to self-assess their practice against pharmacist competencies and professional practice standards to determine training and development needs,” NPS Deputy CEO, Karen Kaye said.

“Last year 1500 pharmacists and interns completed the NPS ‘Enhancing patient care in type 2 diabetes’ review. Pharmacists participating in NPS activities are committed to providing patients with best-practice care.”

“Feedback we have had from both hospital and community pharmacists has been largely positive. Most acknowledge that by the time they complete two or three reviews, they can see improvements in the way they communicate with patients which benefits the whole relationship,” Ms Kaye said.

Participating in the activity assists pharmacists to identify counselling points and provide appropriate lifestyle advice for patients prescribed PPIs as well as allowing pharmacists to reflect on individual episodes of care. Pharmacists completing the Review will be in a better position to identify patients for referral to their GP.

The Pharmacy Practice Review includes a tear-off pad with information to give to patients, an action checklist for pharmacists to work through for each patient and current clinical information on the use of PPIs.

By participating in this Review, pharmacists can earn continuing professional development points:

• Australian Association of Consultant Pharmacy (AACP) — 8 points

• Pharmaceutical Society of Australia (PSA) CPD&PI program — 8 points

• Pharmacy Board of South Australia — up to 8 ENRICH credits

• Society of Hospital Pharmacists of Australia (SHPA) CPD Program — 8 hours of content as a group 2 activity

To participate in the Pharmacy Practice Review and ensure feedback will be provided in late November, pharmacists must enrol by 26 June 2009. Visit www.nps.org.au/pharmacy_practice_reviews.

The NPS publication, Prescribing Practice Review (45) Proton pump inhibitors: step-down to symptom control is available at www.nps.org.au/health_professionals.

 

29 May 2009
Managing acute post-operative pain in hospital

Health professionals caring for patients with acute post-operative pain can improve pain management with a new drug use evaluation toolkit developed by the National Prescribing Service Ltd (NPS).

The Acute postoperative pain drug use evaluation (DUE) toolkit can be used by hospitals to assess practices and ensure interventions lead to improvements in a patient’s experience of pain. It is designed to support surgical, anaesthetic, pharmacy and nursing staff in public and private hospitals to manage acute pain after surgery and assist hospitals to review practice when new drugs become available.

“Health professionals, hospital and day surgery services that choose to use these resources will be able to audit the quality of acute postoperative pain management by measuring key quality indicators, provide real-time reporting and feedback data in a format that supports educational quality improvement strategies,” Ms Mackson said.

The DUE toolkit was developed following a national quality improvement project on management of acute postoperative pain in 62 Australian public and private hospitals in 2006 and 2007 and includes an electronic data collection tool (e-DUE) and educational resources.

The e-DUE audit tool is a standalone windows application that provides a streamlined method of data entry and reporting of clinical measures that ensures both hospital and patient confidentiality. It measures 13 quality indicators including pain assessment, sedation scores and management of acute pain post-discharge.

The educational resources include:

• a PowerPoint feedback presentation for hospital staff;

• wall posters on pain assessment and prescribing of analgesia;

• pain scales, assessment and a discharge checklist;

• a patient brochure; and

• a summary to be used in one-on-one education with clinical staff.

“The technology allows for improved functionality and can be used more than once to store data in order to show comparisons between data collections.” Ms Mackson said.

The educational resources in the toolkit were developed in consultation with the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine for the acute postoperative pain project.

The electronic DUE toolkit is free and can be downloaded from

www.nps.org.au/health_professionals/drug_use_evaluation_due_programs/due_kit_for_hospitals

 

For more information contact NPS on (02) 8217 8700.

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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