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I2P | Page 354


23 Comments on

  1. Rollo Manning // August 9, 2014 at 1:30 am // Reply

    Are there any restrictions on the use of Ivermectin for scabies on the PBS?
    If “yes” what are they?
    Thanks
    Rollo

  2. Most even handed article from Ms Marron I have ever seen. Thank you. It has long been obvious that no one profession has all the answers for everyone. Generally people go to the people they trust first, their GP. When results are not obtained they look elsewhere, and when they find help, often instant, whether they understand or not,[ and who understands HOW antalgics or antibiotics work ], there is an increased chance they will return. The inference that ear problems are otitis media, which is an infection, to which the later connection of antibiotics is made, perpetuates the myth that ear problems are infections, when all the evidence indicates that in the vast majority of cases, there is NO INFECTION, hence the failure of antibiotics. AS well grommets also do NOT have evidence based support for their use. Being such an advocate of EBM I find it strange that Ms M. does not mention this, and may well be why a range of non-drug care gets patient satisfaction in what may well be a multi-factorial problem.

  3. Hygiene messages do not seem to be getting through. Still there are too many Medicos who buckle under the weight of patient’s requests for antibiotics.We need to push messages to promote hand-washing as very few people wash hands after toilet visits. Signs should be installed in toilets;sneezes need to be covered up;door handles are a source of infection;mask utilisation should be encouraged etc etc.

  4. I agree Gerald. As a consultant pharmacist I see inappropriate prescribing continued for years and the excuse given is “oh they are stable on that regime so I don’t want to change anything”. Quality of life is so important for our elderly, often more so than quantity. Even if they have been on something for years it is good to review and remember that what was started when they were in their 50′s or 60′s or 70′s may not be appropriate now they are in their 80′s or 90′s. However I also do not like to see them swallowing heaps of supplements which are expensive to buy and often of questionable value. Minimal medication focusing on quality of life is the way to go in my opinion.

  5. Mouhamad Zoghbi // August 19, 2014 at 10:36 pm // Reply

    Yes It is time!
    It is time to put the interaction before the transaction.
    It is time to put people’s health before the “cheaper brand”.
    I admire your work Gerald, because it is time we support pharmacists to dig deep and remember why they wanted to be a pharmacist? Mainly to support people’s lives and rarely for the money.
    What was the most trusted profession has significantly dropped simply because many pharmacies are placing their own interests before the communities.
    Finally, in a study I conducted with 133 pharmacy members I noticed that many pharmacy assistants usually in their teens or twenties found the elderly customers a pain to work with, they did not have the patience or the training to listen and understand their needs, this lead to frustration from both sides and a lack of care for the elderly.
    It really is time to bring back the community to pharmacy.
    Thanks Gerald.

  6. I have had preliminary discussions about forming “The Australian Integrative Pharmacists Association” as an offshoot of AIMA. This is a preliminary expression of interest, but I would be delighted to keep a record of any interest and liase with AIMA in time. I’m well aware that the Friends of Science and Medicine are infiltrating pharmacy circles, spreading their doctrine. Here’s an opportunity to be informed about complementary medicines in our practices, with an umbrella organisation protecting our opinions and interests.

  7. Keith Bastian // August 25, 2014 at 10:54 am // Reply

    Since the report in Europe some years ago, followed shortly thereafter by similar figures from US and Australia, of sales of non-pharmaceutical products for ‘health’ issues equaling or exceeding ‘mainstream’products, there was a ramp-up of the ‘unproven/unscientific’ claims by the spin doctors for Big Pharma. But immediately the buy-up of the companies producing nutritional products began, and very few are now independent. As this has happened, dosages of the active components has dropped, and many of the herbal ingredients are made from the less vital parts of the plant. So, by making weak products that are contrary to herbal protocols, they make money from less-discerning clients, and can then also say, ‘just as we told you,this stuff does not work’.

  8. To my knowledge, there are no known risk factors, and certainly no known causes, of MND. If the causes were known, researchers would have a better idea of how to treat it but there is no treatment available because causes/risk factors are unknown (except for 10% of cases where there is a family history). It is simply incorrect to provide a list of “actual causes” as you have done. What evidence do you have for these? This smacks of sensationalist journalism based on no evidence whatsoever to support your argument.

  9. This is so true. Good care involves empathy. Listening is all important. Treat the patient not just the disease.

  10. Glad to read this editorial this week. I would like to request you to uphold the need for patient centered care rather than anything else.

  11. Very poetic, very emotive: But hardly a case study with sufficient detail for a professional to make any judgment upon. Has this case study been published in a journal? I suspect a far more complicated scenario. Who established “cause and effect” ???

  12. You BELIEVE what you want, Ms Smartypants, but you haven’t disproven that the above have no effect and you haven’t told us how cancer works. It’s quite basic, really. Why don’t you put your intellect and skepticism to better use and instead of pandering to the establishment with your glib rhetoric, do some research. A good start would be the following websites. http://www.cancertutor.com
    http://www.lowdosenaltrexone.org/
    http://www.doctoryourself.com/riordan1.html
    http://www.health-science-spirit.com/no-one.htm
    http://www.greenmedinfo.com/disease/cancers-all
    http://www.doctorsaredangerous.com
    http://www.tbyil.com/cancer.htm

    P.S. And please get over your smug “I’m-a-skeptic-so-I-know-it-all” attitude. It does not become you (and you might ACTUALLY help people in need).

    P.P.s. The CAPTCHA box below is idiotic – the image has numbers, not words. Very indicative of this site’s bona fides. Oh and the “Preview comment” button does not work (ditto!)

  13. An important article. We spend many hours in our workplace and this can impact on long term health and well-being. In the same way that we invest in a good bed or a comfortable chair at home it is important to invest in a good quality ergonomic work environment.

  14. Yes, university has been undermined by many courses, and certainly their are chalratins taking advantage of the vulnerable already dealling with a mongrel of a disease, some terribly. A Current Affair is no pedigree though.

    I have seen quite a few pharmacists touting magic cures and the vitamin and herb aisles prove that expensive urine is a big money maker for pharmacies.

    However, caring and treating cancer patients is about holistic care, not just surgery, not weeks of radiotherapy or cytotoxics.
    The Cancer Council has a document for patients on complimentary therapies amd cancer treatment- puts a lot in perspective and discusses evidence. People cancer journey is what works for them, complimentary therapies are there for supporting the mainstream interventions, not replacing them. If it helps someone through a horrible journey, necuase traditional interventionist are great with the scalpel or filling out a prescription, but atrocious at ‘well being’ concerns.

    Exposing quackery is one thing. Punishing everyone else just becuase of your own cancer journey isn’t.

  15. Lesley Braun // October 7, 2014 at 2:45 am // Reply

    Interesting piece Mark, and an area in which I have a strong interest. The evidence has long supported the importance of nutritional supplements as an adjunct therapy to certain prescription medicines, and for pharmacists to recommend these when appropriate.
    Blackmores Institute has a strong commitment to working with pharmacists, researchers and education providers to grow the knowledge-base on integrative approaches such as this that will improve patient outcomes. You may be interested to read our editorial on the study you refer to: http://www.blackmoresinstitute.org/login/news-and-insights/Diuretics-proton-pump-inhibitor-to-hypomagnesemia

    http://www.blackmoresinstitute.org/login/news-and-insights/Proton-pump-inhibitors-and-magnesium-cause-for-concern

    Dr Lesley Braun, Pharmacist & Director of Blackmores Institute

  16. There are many of these stories happening after HPV vaccination and they are being documented by the US CDC adverse reaction database (VAERS) and the website – Safe, Affordable, Necessary and Effective Vaccines (www.sanevax.org). The public trusts that the clinical trials and post-vaccination surveillance are capable of determining cause and effect but this is not the case with HPV vaccines. The passive surveillance system used by all government regulators is inadequate for determining cause and effect (Ref: US CDC) and the clinical trials were also inadequate for establishing long-term cause and effect relationships. This information can be viewed in my article published in the journal Infectious Agents and Cancer (a link to this is on my website). Consequently there is inadequate knowledge of cause and effect even though many of the side-effects being observed after vaccination were identified in the clinical trials. Consequently the vaccine has been removed from the national programs in India and Japan due to the serious adverse events and court cases have started in Spain, France and India. Cause and effect should be established prior to the introduction of a vaccine into the community not after the event.

  17. Margaret Ford // October 14, 2014 at 2:34 am // Reply

    Tantalising editorial!

  18. I strongly support initiatives to increase research into primary health care in Australian community pharmacies, and have for many years. A fundamental step needed for this to succeed, and one which seems not to attract a lot of focus, is for proprietor and employee pharmacists to wholeheartedly embrace research in community pharmacies. A sustained campaign is needed from PSA and the Pharmacy Guild. In the 1980s in South Australia, in the 1990s in Perth and again in 2003 I undertook primary health care research in pharmacies in which I was working without any funding support. I did it because I knew it was important and I cared about the future of pharmacy. I am sure there are plenty of other pharmacists who feel as passionate about pharmacy as I was (and still am) when I did those studies. What is needed now is for those pharmacists to go looking for ways they can participate. Don’t stand back and wait. Become proactive. If PSA and the Guild can tap into this vast resource it will make a vast difference to our professional future. John Gibson

  19. The main issue being missed here is that there is no “generic” cannabis. I’ve had the privilege of spending a day in a cannabis nursery with a herbal grower outside Zurich. He grows a specific species of cannabis, rich in pain relieving properties, for the European medical market. To suggest that cannabis will add to the misuse of the current crop of opioid misbehaviour is an immature view. In my opinion, it smacks of protection of the existing market, and sweeps the value to the patient with intractable pain into the background. I’ve spoken to medical cannabis users. I’ve been overwhelmed at the improved quality of life in the scenarios of their particular use. So, don’t judge, just listen. And more especially, don’t leave decisions to the politicians!

  20. The Friends of Science (FSM) Pathology Recommendations was prepared by their Pathology Advisory Group which included distinguished pathologists from Australia and New Zealand. The report was supported by The Royal College of Pathologists of Australasia.
    It includes pathology tests that should be avoided.
    http://www.i2p.com.au/sites/i2p.com.au/files/Pathology-4.pdf
    (Full report http://www.scienceinmedicine.org.au/images/pdf/pathologyrecommendations.pdf)

    These tests are offered in some pharmacies by in-house naturopaths.
    http://www.i2p.com.au/article/naturopaths-pharmacies-whose-team-are-they

  21. The item claims that Complementary Medicine has the potential to produce a net economic benefit of $1.8 billion from 2015-2020.
    However, of the six treatments that were investigated, only one is complementary.
    The news report covers vitamin D and calcium supplementation for osteoporosis. Vitamin D and calcium supplementation is not complementary medicine, but conventional medicine, with the optimal doses and patient populations being worked out in clinical trials after basic research determined the mechanism of action of the hormone. Similarly, folic acid and omega fatty acids for cardiovascular disease are not complementary medicines, but conventional medicines. They were again discovered and developed by conventional research and clinical trials
    That something can be purchased over the counter without a prescription does not make it complementary, paracetamol would never be claimed as a complementary medicine. Being a vitamin does not make something a complementary medicine. Using vitamin C to treat Scurvy or folic acid to prevent neural tube defects is conventional medicine, while using vitamin C to treat colds is a complementary use (which is still promoted in the face of continued evidence that it is ineffective).
    The benefits of these regimes may be overestimated. The report did not examine some of the latest systematic reviews on omega fatty acids that have concluded there is no or minor effects. The review of the only actual complementary medicine, St. John’s Wort, does not factor in the life threatening drug interactions that it causes in the cost benefit analysis, and seems to be promoting self-medication for a significant illness.
    Claiming conventional medical treatments (such the vitamin D and calcium supplementation highlighted in the news article) show that complementary medicines have significant economic benefits is highly misleading.
    Yours sincerely
    Ian Musgrave
    Senior lecturer in Pharmacology University of Adelaide

  22. markanderson // October 31, 2014 at 4:20 am // Reply

    Glad to read this editorial. The thing is you have to understand your patients very well. I know you guys are great but you should be patient centered.

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