Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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Neil Johnston

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Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

Some people create scrap-books or family photo albums to preserve memories or important hobby material.
I do similar exercises in a business and a professional sense whenever I find a good idea.
Some of these ideas, commonly found on the Internet, I catalogue for future use by researching all the potential applications that could absorb any new idea, and I write a concept paper about it.
Then, when something new appears that could provide enhancement, I revisit my concept paper and update it with this new information.
As a result, my desktop is littered with a large number of concept papers that are filed for future use, or amalgamated with other concepts as awareness builds for a meaningful project.
They are all projects in development.

At some point in time I will share a concept paper with a colleague who may have the capacity to expand on the subject just because they have a different perspective and background, and also because I have already adapted the idea to incorporate a pharmacy flavour.

When enough information-gathering has occurred I then look for an active partner to assist in the construction of what has now become a full-blown development project, ready for piloting..

This process obviously requires an investment in time and money, and often has a high failure rate because someone else first arrives at the point you are trying to move to, or is able to “muscle” you out because of access to a stronger and more aggressive political or marketing network.
Or the idea simply fizzles out because of some obvious flaw that emerges which was not originally apparent.
No matter, the pathway to a logical conclusion is both stimulating and satisfying, and keeps me focused within a profession that has many negative distractions.

My interests involve the whole gamut of pharmacy activity but I am most interested in a pharmacy direction involving fee-based services, in a marketplace where the majority of patients are rapidly ageing.
Not only ageing but are trying to co-exist in a health environment with a system designed for much younger people.
Ageing patients also consume a disproportionate share of health dollars in a health budget model that is totally inadequate both in budgeted dollars and available infrastructure.
This leads into, (without any major deductive power), to the fact that future health services will have to be administered in a patient’s home to conserve health dollars, yet still deliver a top health product..
That service would also need sophisticated communications systems delivering information from a patient’s environment to connected health professionals who are capable of reacting with appropriate decisions through such a network, at minimal cost.
Not an easy task and one that has already consumed $’s billions in resolving just some of the segments of the puzzle to an early stage of development.

What follows are three ideas that could play some part in a Pharmacy-in-the-Home model. Feel free to add comments at the foot of this article as a value-adding process.

3D Printers Could Be Used To Produce DIY Pharmaceuticals At Home

Researchers at the University of Glasgow have carried out a process for “printing” pharmaceutical compounds from numerous feedstocks, which could eventually allow people to produce their own medicines at home. Using a commercially-available 3D printer operated by computer-aided design software, the team has built what they call “reactionware,” tiny vessels in which chemical reactions can take place, but these vessels already have the chemicals that drive the reactions already built in. While this technique is common in large-scale chemical engineering, the development of reactionware makes it possible for the first time for custom vessels to be fabricated on a laboratory scale. The process has the potential to revolutionize healthcare in the developing world by allowing more efficient and economical access to treatments.

Similar printers are able to construct prototypes of objects from a CAD drawing, so developing small scale manufacture at a very sophisticated level is already a proven concept.
While I would not think that allowing a patient to manufacture their own drugs is an ideal process (particularly for an aged patient), there is no reason why a pharmacist could not be the intermediary to provide tailored compound dispensing to the aged care market. A very sophisticated service indeed.

New Bio-Sensor Uses Electrified Molecules For Instant Diagnostics

Researchers from University of California, Santa Barbara, have created a new Field-Effect-Transistor (FET) based sensor for ultra-sensitive instant diagnostics and detection of trace substances. The FET technique converts molecules into electrical switches that help send messages at a higher rate and are four time more sensitive than current diagnostics. This new technique shows tremendous potential for detecting biomolecules at ultra-low concentrations, from instant point-of-care disease diagnostics, to detection of trace substances for forensics and security.

Obviously, this product is a broad spectrum diagnostic tool that can deliver patient biometrics system in real time, and on a continuous basis, if required. I have already looked at wearable sensors attached to clothing, also near infrared as a measurement device.
These concepts could sustain a range of quite seriously ill patients in a home environment with a networked team support.
This type of system might also be able to be linked with a dose administration aid system.
There are major opportunities available in this field that would be well suited for the talents of pharmacists.

Wearable Fitness Monitor Lets Your Trainer Keep Tabs On Your Fitness Data

BodyMedia, a Pittsburgh-based medical and consumer technology company, has developed a wearable body monitoring system with remote software that allows doctors or trainers keep tabs on a person’s calorie burn, sleep habits and food intake. BodyMedia’s Fit Armband System monitors daily calories burned, steps taken, level of physical activity, and sleep patterns. Wearers can also enter their daily food intake into an online food log. With permission, the company’s ProConnect software will enable healthcare professionals to log on and chart an individual’s progress, leaving feedback and advice and helping people reach their goals.

There are some similarities in the objectives of this system as for the Bio-Sensor above.
While ageing is considered a disease state process, some researchers propose that active “anti-ageing” systems should be deployed on a wide front, thus delaying the onset of the various lifestyle disorders for as long as possible, after which more expensive aged care solutions need to be utilised.

It is estimated that if one lifestyle disease (Alzheimers) could be delayed in onset by 5 years, it could free up as much as 50% of nursing home accommodation plus free up enormous cash resources.
Current thinking is along the lines that if lifestyle can be equated with lifespan, much of the misery at the “end of life” could be avoided, with lifespan being productively extended in the process.
It can also prolong the range of skills in the workforce that suddenly disappear as people retire (and that in itself seems to be a trigger for speeding up lifestyle disorders such as Alzheimer’s).

Again, there are a range of opportunities in the mix of the above if pharmacists wish to apply themselves, rather than compete in retail discounting that serves no good purpose in today’s emerging health climate.
It will also need a robust approach to deflect the onslaught by Big Pharma to absorb as many health dollars as possible, by promoting drugs as the only form of treatment for an ageing patient.
Increasingly drugs have been found to be promoted with flawed evidence to support their claims. Savings in drug budgets could be more suitably deployed in nutritional and physical fitness health systems.

There is no magical solution that will emerge for Australian pharmacy unless it is home-grown and developed from the “bottom-up”.
If any readers are involved in developing similar projects, you might like to share your thoughts privately or publicise them through the pages of i2P.
Please make contact by email to: if there is interest.

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