Welcome to the October edition of i2P (Information to Pharmacists).
A lot has been written about our ageing population and what strains it may place on the health system. The National Seniors Agency report that our ageing population will have as big an impact on our society as will climate change (see article in Aged Care section).
Pharmacy must plan appropriate strategies for an ageing population dealing with chronic health problems and major shifts in climate change simultaneously (see article in Climate Change section).
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Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
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Volume 2 Number 6
Volume 2 Number 7
Volume 2 Number 8
Volume 2 Number 9
Volume 2 Number 10
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Volume 3 Number 1
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Volume 3 Number 7
Volume 3 Number 8
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Volume 3 Number 11
Volume 4 Number 1
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Volume 4 Number 10
Volume 4 Number 11
Volume 5 Number 1
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Volume 5 Number 4
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.
25 Spetember 2009
The way forward for medicines use at the end of life
Deprescribing, opioid-phobia and disposal of unused medicines have been identified as significant issues in palliative care in a report prepared by the National Prescribing Service (NPS) and Palliative Care Australia (PCA).
The report, Achieving quality use of medicines in the community for palliative and end-of-life care, released today at the 10th Australian Palliative Care Conference, is the first to document a shared understanding of the barriers to the best use of medicines during the end stages of life.
Informed by submissions from more than 70 healthcare organisations and individuals, the report describes medicines use issues in palliative care and documents ways in which it can be improved.
Palliative Care Australia CEO, Donna Daniell says the report has helped prioritise areas for change.
“While everyone involved in palliative care has a responsibility to help improve medicines use, Palliative Care Australia will be leading the way,” Ms Daniell said.
“We will be talking to stakeholders about ways to strengthen clinical skills and the application of the current and emerging evidence base for medicines use at end of life. We will be working with practitioners to ensure safe and effective use of opioids for end-of-life care.”
The report identifies quality use of medicines issues including the need for clearer guidelines around deprescribing - when medicines should cease being prescribed to a patient at the end stages of life because they are no longer contributing to quality of life.
“Deprescribing, or ceasing medication where the evidence does not support its use in the current context of the patient, can be very difficult for medical practitioners. Doctors need clearer guidelines in this area so they can assess whether the evidence supports the continuation of a medicine,” NPS CEO, Dr Lynn Weekes said.
Opioid-phobia was also identified as a barrier to adequate pain management, with some health professionals lacking full knowledge about opioids including when and how to initiate them, management of breakthrough pain and understanding new formulations.
The report also identifies the need for comprehensive guidelines for consumers and carers around the safe use, storage and disposal of medicines in the home.
“Thanks to advances in medicines use, more patients are able spend their last days in the comfort of their home. However, medicines regimens may change frequently during their last weeks which can result in large amounts of unused medicines. This means the burden of medicine disposal lies with the family, and they are often left with medicines requiring careful storage including sedatives and opiates,” Dr Weekes said.
Other key findings in the report included:
* effects of polypharmacy on quality of life: tablet burden, adverse interactions, over prescribing
* lack of guidance for medicines use where evidence is not clear or is still emerging
* low access and utilisation of the Palliative Care Schedule on the PBS
* use of complementary medicines is not well understood or documented in palliative care
* identification of clinical skills gaps.
10 September 2009
Better use of medicines needed in palliative and end-of-life care
A report into appropriate, safe and effective medicines use in palliative care will be launched by the National Prescribing Service (NPS) and Palliative Care Australia at the 10th Australian Palliative Care Conference in September.
The report, Achieving quality use of medicines in the community for palliative and end-of-life care, is the first to document a shared understanding of the barriers to the best use of medicines during the end stages of life.
Informed by submissions from more than 70 healthcare organisations and individuals, the report identifies key issues affecting medicines use in palliative care and identifies opportunities for action and areas where further work is needed.
“This report is extremely significant for anyone involved in palliative care: doctors, pharmacists, nurses, patients, families and carers,” NPS CEO, Dr Lynn Weekes said.
“The principles of quality use of medicines are often forgotten during the end stages of life, when really this is the most critical time for best practice. Patients at the end of life are often taking a large number of medicines to manage pain and other symptoms, and the medicine regimen may change frequently within a short period of time.”
Palliative Care Australia CEO Donna Daniell says the report is an important first step in recognising unique medicines use issues in palliative care, the findings of which will help inform policy and practice direction.
“Medicines use has an even greater impact at the end of life than in any other area of therapeutics and as such, demands a greater level of precision and rigour. We know that today people at the end of life experience more pain and unrelieved symptoms than they should. The reality is that much of this can be prevented,” Ms Daniell said.
“Palliative care is finally being included in conversations about health care. It is increasingly recognised that for quality care at the end of life to be real, in all care settings including the home, improvements in quality use of medicines are imperative.”
The report will be presented by NPS program officer, Aine Heaney at the 10th Australian Palliative Care Conference in Perth on Friday 25 September.
10 September 2009
Promoting safe medicines use on RUOK? Day
More than 2000 Australians commit suicide each year; three-quarters of them are male. This is more than the number of people killed in car accidents each year.
RUOK? Day is being launched to bring Australians together in a bid to help prevent risk factors contributing to suicide. It will also promote awareness of information and support by raising the profile of existing organisations that provide these services.
As a provider of medicine information, the National Prescribing Service (NPS) is a unique supporter of RUOK? Day. Medicines and non-medicine treatments play a big part in helping people with depression, and the NPS is a trusted source of independent information for both health professionals and the general public.
The National Prescribing Service (NPS) is a non-profit organisation funded by the Department of Health and Ageing to promote the best use of medicines. We work with doctors, pharmacists, and other health professionals; government; industry; and consumers to identify and resolve challenges around the way medicines are used, to improve the health of all Australians.
Statement by Nicola Roxon, Minister for Health and Ageing.
3 September 2009
Get to know your medicines: ask your pharmacist!
During ‘Ask Your Pharmacist Week’ (31 August – 6 September), the National Prescribing Service Ltd (NPS) and the Pharmacy Guild of Australia are reminding Australians that generic medicines are an equal choice.
Australia has a comparatively low uptake of generic medicines compared to other countries in the western world, even though generic medicines contain the same active ingredient as original brand medicines and meet the same government standards. Only about 30 per cent of all Australian prescriptions are for generic medicines, compared to over 50 per cent in the US, 44 per cent in the Netherlands and 70 per cent in Denmark.
“Generic medicines work in the same way as brand name medicines. They contain the same active ingredient, even if they don’t always look the same,” acting NPS CEO, Karen Kaye said.
“Some prescription medicines have several different generic brands, and the consumer may not always receive the same one. For this reason it is vital consumers speak to their pharmacist or GP about their medicine so they learn how to identify their medicines.”
Kos Sclavos, National President of the Pharmacy Guild of Australia, says generic medicines can offer value for money, and people should learn the active ingredient in all their medicines.
“Generic medicines can be a good option for many consumers as they are usually less expensive than branded medicines. Your pharmacist is the best person to answer questions about your medicines, and can help you decide if switching to a generic is right for you.”
“If you are unsure about any of your medicines, ask your pharmacist to explain what each medicine is for, and which medicine the generic version replaces,” Mr Sclavos said.
Ms Kaye agrees and says getting to know your medicines can help reduce the risk of medicine-related problems.
“By being familiar with the active ingredient name, consumers are reassured that the medicine they are taking contains the active ingredient their doctor prescribed. From this, consumers can make informed decisions and reduce the risk of potential confusion and medicine misadventure,” Ms Kaye said.
To help people quickly identify the active ingredient in prescription medicines, NPS has developed the NPS Medicine Name Finder. When a PBS-listed medicine is entered into the online tool, the active ingredient name appears, and when the active ingredient is entered its brand names appear.
People are then prompted to record their medicine details on a downloadable Medicines List or print the information. A link is also provided to the Consumer Medicine Information (CMI) leaflet which contains more details about the medicine.
NPS Medicines Lists and the NPS Medicine Name Finder are available to download for free at www.nps.org.au/activeingredient
Katie Butt, NPS Media Adviser, 0419 618 365 or email@example.com
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