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[post_content] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve patient health and safety.
As the 2024 FIP World Congress continues, Australian Pharmacist reports from Cape Town on some innovative services presented which are improving health across the globe.
South Africa: Improving access to HIV treatment and prevention
There are 7.9 million people in South Africa between the ages of 15 and 49 years living with HIV. Despite strides in treatments and preventative therapies, the rate of new infections remains high.
One project driven by pharmacists is aiming to change this, allowing community pharmacists to initiate high-risk young women and men onto HIV Pre-Exposure Prophylaxis (PrEP). In this implementation study, 10 pharmacies in Gauteng and the Western Cape (Cape Town) initiated high-risk individuals on combination tenofovir and lamivudine/emtricitabine for a period of 13 months. Patients were recruited inside and outside of the pharmacy.
Of the 838 potential participants, 88% (n = 737) were initiated on PrEP between June 2023 and January 2024. Risk assessment found most were sexually active, and more than three quarters (n = 595) engaged in sexual activity without a condom. Initial results from the study were positive, with further analysis to explore patient perceptions of PrEP initiation in community pharmacy.
Spain: Pharmacy reporting of stock shortages helps detect shortages sooner
The General Council of Pharmacists of Spain has developed two systems to prevent and mitigate medicine shortages.
The first is CisMED, a system that generates real-time information on supply incidents at a pharmacy level.
Over 10,000 pharmacies participated in this initiative in 2023 – over half of all pharmacies. CisMED reported a 30% increase in medicines that could not be supplied, with over half the alerts generated being for medicines not listed by their regulator, the Spanish Medicines Agency.
The second initiative, FarmaHelp, is a communication system which allows pharmacists to communicate with nearby pharmacies when a request for a medicine cannot be fulfilled. From the 10,000 pharmacies connected to the system, the number of medicines ‘found’ increased from 106,925 to 389,364. This meant 73.5% of the time, the pharmacist was able to offer a solution to the patient due to the FamraHelp system.
In combination, these digital systems have helped pharmacists both contribute to a more accurate and complete medicine shortage database, and allowed pharmacists to find more options to support access to scarce medicines to their patients more often.
The Netherlands: Palliative care kit improves access to care at end-of-life
The decision to initiate palliative care is often a time where medicines need to be prescribed and initiated at short notice, with a new and often complex regimen of medicines.
A project in The Netherlands led by the Royal Dutch Pharmacists Association, is trying to make this a smoother process for patients and their families through the introduction of a ‘palliative care kit’.
Based on the concept of a first-aid kit, the ‘palliative care kit’ contains everything patients will need to facilitate administration of medicines at end-of-life. This includes morphine and midazolam ampoules, syringes, needles, bandages and a urinary catheter with insertion set.
The kit is supplied by a pharmacy, which receives reimbursement for the medicines, and a professional fee for facilitating the supply of the kit.
The kit contains a permission document from the GP to use the supplies when necessary. The kit is delivered to the home of palliative patients when they enter the terminal phase at a time that can be planned. This allows a nurse to immediately use that kit when necessary.
The kit has reduced unnecessary time spent by community nurses, GPs and pharmacists in facilitating palliative care, particularly during evenings, nights and on weekends. Families report the presence of the kit reassuring because they know their loved one will be able to access the medicines they need instantly, should they experience acute deterioration.
Thailand: Medicine reviews for high-risk CKD patients
In Thailand, 30% of people with chronic kidney disease (CKD) use NSAIDs or other herbal medicines which may accelerate the progression of CKD. A pilot project has shown pharmacists can help reduce this.
In this pilot, a nurse at the CKD clinic referred patients (n = 23) with medicine problems to a pharmacy for medicine reconciliation, adherence checks and to review for potential causes of acute kidney injury. Importantly, the pharmacist also managed any problems identified and monitored kidney function for at least 3 months.
Half (52%) of patients stopped using NSAIDs, and kidney function improved from Stage 3 to Stage 2 in five patients within 3 months. While not statistically significant, the small pilot concluded the model of care appeared to reduce costs associated with medicines and CKD management.
Australian pharmacist on SA TV!
Meanwhile, Australian pharmacist and FIP President Paul Sinclair AM MPS has appeared on South African breakfast television to talk about the important role of pharmacists. Paul told SABC’s Expresso Show he was excited about the opportunities around the world for pharmacists.
[caption id="attachment_27480" align="aligncenter" width="507"]
FIP President Paul Sinclair AM MPS (left)[/caption]
‘Health care across the world is changing very quickly. It’s being driven by innovation, and pharmacists historically have embraced innovation and technology,' he said.
‘What excites me most about our profession at the moment is that we have the chance to do more. Our scope of practice is expanding rapidly, and with that comes opportunities to help more people deliver more outcomes and improve the health system.'
[post_title] => What are pharmacists doing in other countries?
[post_excerpt] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve health and safety.
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[post_content] => Syphilis cases have tripled in the last 10 years in Australia, leading to an ‘avoidable and unacceptable’ reemergence of congenital syphilis. This World Sexual Health Day (4 September), Australian Pharmacist explores pharmacists’ role in addressing this escalating issue.
When syphilis infections began to rise in Australia in 2011, the cases were primarily among men with male sexual partners, and young heterosexual persons in remote Aboriginal and Torres Strait Islander communities. However, there was a 500% increase in the rate of infectious syphilis among women aged 15 to 44 between 2011 and 2021, according to a report from the University of New South Wales’ Kirby Institute.
That means parent-to-child transmission is also on the rise - this is called congenital syphilis. There was a median of 4 cases per year in Australia between 2011 and 2019, skyrocketing to 17 cases in 2020, and 15 in 2021 and 2022. For the birthing parent of babies with congenital syphilis, the report’s authors found less than 40% were tested for syphilis during pregnancy.
Left untreated, congenital syphilis can lead to serious complications in more than 50% of cases, including miscarriage, stillbirth, neonatal death and permanent disability. Of all the cases of congenital syphilis in Australia between 2011 and 2021, 25% of babies were stillborn.
In Queensland, where cases of infectious syphilis have increased by 600% in 15 years, five babies contracted the disease in the womb in 2023, leading to 4 deaths. This is the largest number of Queensland deaths from congenital syphilis in a single year this century.
As a preventable and curable disease, Queensland Minister for Health Shannon Fentiman said the deaths ‘shouldn’t be happening’. It’s a message echoed by Australia’s Chief Medical Officer Professor Paul Kelly, who said health professionals need to ensure they’re up to date on information about syphilis testing and management.
‘Any baby losing its life is a tragedy. Any baby losing its life to a preventable illness is a responsibility for us all in our health system,’ he said in a video (below) recorded for the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).
https://vimeo.com/912435688
‘We must ensure everyone is tested for syphilis during pregnancy. All pregnant people should be tested at least once, and in many cases more … Once diagnosed, treatment is simple and effective.’
High-risk populations
In 2022, syphilis rates among Aboriginal and Torres Strait Islander peoples were more than five times higher than in non-Indigenous populations. Of the 15 congenital syphilis cases across the country in the same year, eight were among Aboriginal and Torres Strait Islander peoples.
‘Congenital syphilis diagnoses are 14 times as high among Aboriginal and Torres Strait Islander infants compared with non-Indigenous infants,’ said researcher Dr Skye McGregor, who led the Kirby Institute report.
‘All pregnant people should be tested for sexually transmitted infections (STIs) as part of pre- and antenatal health screening, but antenatal care is not always accessible. It is vital that comprehensive services are in place to ensure appropriate care is accessible for all pregnant people.’
Other high-risk populations include men who have sex with men and babies of mothers who have not had proper syphilis testing and treatment during pregnancy. However, ASHM Deputy CEO Jessica Michaels said it is important to recognise that syphilis can affect anyone.
‘In order to curb the rising syphilis epidemic, it is important that we take a “no wrong door’’ approach to testing,’ she said.
What to look out for
People presenting at a pharmacy with signs or symptoms of syphilis should be encouraged to test, Ms Michaels said, especially if the symptoms are otherwise unexplained.
‘Other instances when pharmacists can encourage patients to test for syphilis include people presenting with symptoms of any STI or an STI diagnosis, those asking about testing for STIs and/or blood-borne viruses, when people are assessed for post-exposure prophylaxis, and pregnant people who are not engaged in antenatal care.’
Symptoms and/or signs of syphilis can include:
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[post_content] => On 1 September the third and final 60-day dispensing tranche commenced, meaning patients can now access double the supply of almost 300 medicines for chronic conditions.
This includes more than 70 asthma inhalers that have been listed on the Pharmaceutical Benefits Scheme (PBS) with an option of a 60-day prescription – coinciding with the start of National Asthma Week (1–7 September) – including all asthma preventer inhalers.
Overall, the initiative is beneficial for patients living with asthma, said Associate Professor Debbie Rigby FPS, Clinical Executive Lead at the National Asthma Council Australia (NAC) and head of PSA’s Respiratory Care Community of Special Interest.
[caption id="attachment_22278" align="aligncenter" width="600"]
Debbie Rigby FPS explaining how to correctly use different inhaler devices[/caption]
‘We know that adherence to preventers is poor, and therefore asthma control can be poor, [with] cost being a barrier to people getting their preventers dispensed and using them as prescribed,’ she said.
‘So [60-day dispensing] will have a positive impact on people being able to afford their preventers, and that can, in turn, lead to better adherence and better asthma control.’
But while A/Prof Rigby said 60-day dispensing could work ‘very well’ for patients who have good asthma control and are stable, the NAC has expressed some concerns around patients receiving double supply of their inhalers.
‘Having a 12-month supply of medication removes the need to go back to the GP for a script at 6 months which means the patient misses out on a key opportunity for their GP to assess their asthma management,’ she said.
Australian Pharmacist explores these risks and what pharmacists can do to help mitigate them.
Medicine degradation can affect efficacy
When patients are dispensed double the supply of inhalers, it’s important to raise awareness that some have a shorter in-use shelf life than others.
‘Some inhalers come contained in a foil pack, usually with a desiccant or drying agent in them,’ said A/Prof Rigby.
‘They therefore have anywhere from 1–3 months in-use shelf life, which is different to the expiry date on the outer product [and] must be used within a specified timeframe to avoid reduced stability.’
This includes some dry powder inhalers, such as:
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[post_content] => Inequitable healthcare access, medicines shortages, antimicrobial resistance, and substandard and falsified medicines – all are challenges to be addressed by the pharmacy profession.
At today’s opening in Cape Town, South Africa of the 82nd annual congress of the International Pharmaceutical Federation (FIP), President Paul Sinclair MPS, the first Australian to be elected to the position, also highlighted the need for innovation in pharmacy to address public health challenges and disparities.
He cited pharmacy-based vaccination, which has expanded exponentially since the COVID-19 pandemic, as an example of an innovative approach that has had high impact.
‘Innovation is not just beneficial — it’s essential. Innovating pharmacy enhances patient care, improves therapeutic outcomes, addresses the dynamic challenges of health care, and propels the profession forward.’
The application of three principles — integrity, performance and passion — would help facilitate the advancement of the profession, Mr Sinclair told delegates from around the world.
FIP’s passion for pharmacy had led it to create its “Think Health, Think Pharmacy” campaign to advance the profession. Mr Sinclair urged pharmacists from around the world to support it.
‘Through this campaign, we’re raising awareness of the importance of pharmacies, and of pharmacists themselves, as an underutilised resource in the primary healthcare space, with the potential to deliver more for healthcare systems. We want everyone to think about pharmacy when they think about their health.
‘We want policymakers to think about universal pharmacy coverage when they think about universal health coverage. Promoting our professional identity will facilitate more pharmacy services with benefits for our communities,’ he said.
Australians in FIP awards
Australians Dr Shania Liu and Dr Sarah Dineen-Griffin were honoured at the presentation of the 2024 FIP Global Awards in Cape Town.
[caption id="attachment_27415" align="aligncenter" width="500"]
FIP award winner Dr Sarah Dineen-Griffin fourth from left[/caption]
Shania Liu received the Early Career in Pharmaceutical Practice Recognition Award. Presented every 3 years, the award recognises an educational program or innovation that promotes excellence in learning and teaching in any pharmacy discipline.
Dr Liu is the immediate past Chair of the Pain Management Leadership Committee of the Society of Hospital Pharmacists of Australia. Her research involved the improvement of the safe use of opioids before and after surgery.
Currently, she is a Postdoctoral Research Fellow in the Faculty of Medicine and Dentistry at the University of Alberta, Canada.
Sarah Dineen-Griffin was one of 10 new Fellows of FIP appointed at the Congress. FIP Fellowship recognises individual FIP members who have exhibited strong leadership internationally, distinguished themselves in pharmacy practice or the pharmaceutical sciences and who have contributed to the advancement of the practice of pharmacy or pharmaceutical sciences.
Dr Dineen-Griffin is a full-time teaching and research academic in the School of Biomedical Sciences and Pharmacy at the University of Newcastle. Currently she is Chief Investigator and Project Lead for the NSW/ACT Government Scope of Practice Pharmacy Trials. She is also the Vice President of the FIP Community Pharmacy Section.
[post_title] => FIP congress and two Australians honoured
[post_excerpt] => Find out what pharmacy topics are being discussed on the world stage at FIP, along with the Australians who received top honours.
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[post_content] => Earlier this year, a nation-wide news poll conducted by the Royal Australian College of General Practitioners (RACGP) found most General Practitioners (GPs) think patients would benefit from a multidisciplinary care team, including pharmacists, psychologists, and credentialed diabetes educators.
Allowing practices to grow their teams would improve access to care for all Australians, said RACGP President Dr Nicole Higgins.
‘Studies have shown having a pharmacist in the practice team improves the quality of prescribing and reduces costs for patients by supporting quality use of medicines and deprescribing initiatives,’ she said.
‘Some practices already employ practice-based pharmacists’ she said, recommending that there be dedicated funding in the Federal Budget 'to support more practices to do so'.
For those looking to enter this area of practice, Zachary Sum MPS FANZCAP (Derm., Surg.) – General Practice pharmacist (GP pharmacist) and member of the business development team at Melbourne's Eden Rise Family Clinic – has some sage advice.
Do some background research
For those considering a career as a GP pharmacist, Mr Sum advises immersion in the world of general practice.
A good place to start is subscribing to newsletters from:
‘These platforms provide pharmacists with inside news about how general practice and GPs function as a whole,’ he said.
Pharmacists can also gain insight into the challenges GPs are currently facing, including the long-standing Medicare rebate freeze and general decline in bulk billing practices.
‘This can help pharmacists think of new ideas for helping GPs solve their current industry challenges,’ Mr Sum said.
It would also be beneficial to consider how the skills you have as a pharmacist can benefit the community you intend to look after. This includes considering whether patients:
Queensland-based GP pharmacist Amy Gibson MPS[/caption]
‘There are the smaller, process-oriented, business-related tasks unique to each practice,’ said Mr Sum.
‘[Some of] the skills I’ve gained are more administrative, so I can help to make changes to the way the clinic’s administration is performed, how staffing is recruited, how we manage people, and how we manage and contact our patients.’
Remember, becoming a GP pharmacist is an iterative process, full of on-the-job learning and growing.
‘As you become more proactive in the role, you’ll create new services, alter your service delivery, change the type of services offered, or do something different altogether,’ he said. ‘The end goal is still to give value to the GPs and patients, and to support the community.’
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[post_content] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve patient health and safety.
As the 2024 FIP World Congress continues, Australian Pharmacist reports from Cape Town on some innovative services presented which are improving health across the globe.
South Africa: Improving access to HIV treatment and prevention
There are 7.9 million people in South Africa between the ages of 15 and 49 years living with HIV. Despite strides in treatments and preventative therapies, the rate of new infections remains high.
One project driven by pharmacists is aiming to change this, allowing community pharmacists to initiate high-risk young women and men onto HIV Pre-Exposure Prophylaxis (PrEP). In this implementation study, 10 pharmacies in Gauteng and the Western Cape (Cape Town) initiated high-risk individuals on combination tenofovir and lamivudine/emtricitabine for a period of 13 months. Patients were recruited inside and outside of the pharmacy.
Of the 838 potential participants, 88% (n = 737) were initiated on PrEP between June 2023 and January 2024. Risk assessment found most were sexually active, and more than three quarters (n = 595) engaged in sexual activity without a condom. Initial results from the study were positive, with further analysis to explore patient perceptions of PrEP initiation in community pharmacy.
Spain: Pharmacy reporting of stock shortages helps detect shortages sooner
The General Council of Pharmacists of Spain has developed two systems to prevent and mitigate medicine shortages.
The first is CisMED, a system that generates real-time information on supply incidents at a pharmacy level.
Over 10,000 pharmacies participated in this initiative in 2023 – over half of all pharmacies. CisMED reported a 30% increase in medicines that could not be supplied, with over half the alerts generated being for medicines not listed by their regulator, the Spanish Medicines Agency.
The second initiative, FarmaHelp, is a communication system which allows pharmacists to communicate with nearby pharmacies when a request for a medicine cannot be fulfilled. From the 10,000 pharmacies connected to the system, the number of medicines ‘found’ increased from 106,925 to 389,364. This meant 73.5% of the time, the pharmacist was able to offer a solution to the patient due to the FamraHelp system.
In combination, these digital systems have helped pharmacists both contribute to a more accurate and complete medicine shortage database, and allowed pharmacists to find more options to support access to scarce medicines to their patients more often.
The Netherlands: Palliative care kit improves access to care at end-of-life
The decision to initiate palliative care is often a time where medicines need to be prescribed and initiated at short notice, with a new and often complex regimen of medicines.
A project in The Netherlands led by the Royal Dutch Pharmacists Association, is trying to make this a smoother process for patients and their families through the introduction of a ‘palliative care kit’.
Based on the concept of a first-aid kit, the ‘palliative care kit’ contains everything patients will need to facilitate administration of medicines at end-of-life. This includes morphine and midazolam ampoules, syringes, needles, bandages and a urinary catheter with insertion set.
The kit is supplied by a pharmacy, which receives reimbursement for the medicines, and a professional fee for facilitating the supply of the kit.
The kit contains a permission document from the GP to use the supplies when necessary. The kit is delivered to the home of palliative patients when they enter the terminal phase at a time that can be planned. This allows a nurse to immediately use that kit when necessary.
The kit has reduced unnecessary time spent by community nurses, GPs and pharmacists in facilitating palliative care, particularly during evenings, nights and on weekends. Families report the presence of the kit reassuring because they know their loved one will be able to access the medicines they need instantly, should they experience acute deterioration.
Thailand: Medicine reviews for high-risk CKD patients
In Thailand, 30% of people with chronic kidney disease (CKD) use NSAIDs or other herbal medicines which may accelerate the progression of CKD. A pilot project has shown pharmacists can help reduce this.
In this pilot, a nurse at the CKD clinic referred patients (n = 23) with medicine problems to a pharmacy for medicine reconciliation, adherence checks and to review for potential causes of acute kidney injury. Importantly, the pharmacist also managed any problems identified and monitored kidney function for at least 3 months.
Half (52%) of patients stopped using NSAIDs, and kidney function improved from Stage 3 to Stage 2 in five patients within 3 months. While not statistically significant, the small pilot concluded the model of care appeared to reduce costs associated with medicines and CKD management.
Australian pharmacist on SA TV!
Meanwhile, Australian pharmacist and FIP President Paul Sinclair AM MPS has appeared on South African breakfast television to talk about the important role of pharmacists. Paul told SABC’s Expresso Show he was excited about the opportunities around the world for pharmacists.
[caption id="attachment_27480" align="aligncenter" width="507"] FIP President Paul Sinclair AM MPS (left)[/caption]
‘Health care across the world is changing very quickly. It’s being driven by innovation, and pharmacists historically have embraced innovation and technology,' he said.
‘What excites me most about our profession at the moment is that we have the chance to do more. Our scope of practice is expanding rapidly, and with that comes opportunities to help more people deliver more outcomes and improve the health system.'
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[post_content] => Syphilis cases have tripled in the last 10 years in Australia, leading to an ‘avoidable and unacceptable’ reemergence of congenital syphilis. This World Sexual Health Day (4 September), Australian Pharmacist explores pharmacists’ role in addressing this escalating issue.
When syphilis infections began to rise in Australia in 2011, the cases were primarily among men with male sexual partners, and young heterosexual persons in remote Aboriginal and Torres Strait Islander communities. However, there was a 500% increase in the rate of infectious syphilis among women aged 15 to 44 between 2011 and 2021, according to a report from the University of New South Wales’ Kirby Institute.
That means parent-to-child transmission is also on the rise - this is called congenital syphilis. There was a median of 4 cases per year in Australia between 2011 and 2019, skyrocketing to 17 cases in 2020, and 15 in 2021 and 2022. For the birthing parent of babies with congenital syphilis, the report’s authors found less than 40% were tested for syphilis during pregnancy.
Left untreated, congenital syphilis can lead to serious complications in more than 50% of cases, including miscarriage, stillbirth, neonatal death and permanent disability. Of all the cases of congenital syphilis in Australia between 2011 and 2021, 25% of babies were stillborn.
In Queensland, where cases of infectious syphilis have increased by 600% in 15 years, five babies contracted the disease in the womb in 2023, leading to 4 deaths. This is the largest number of Queensland deaths from congenital syphilis in a single year this century.
As a preventable and curable disease, Queensland Minister for Health Shannon Fentiman said the deaths ‘shouldn’t be happening’. It’s a message echoed by Australia’s Chief Medical Officer Professor Paul Kelly, who said health professionals need to ensure they’re up to date on information about syphilis testing and management.
‘Any baby losing its life is a tragedy. Any baby losing its life to a preventable illness is a responsibility for us all in our health system,’ he said in a video (below) recorded for the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).
https://vimeo.com/912435688
‘We must ensure everyone is tested for syphilis during pregnancy. All pregnant people should be tested at least once, and in many cases more … Once diagnosed, treatment is simple and effective.’
High-risk populations
In 2022, syphilis rates among Aboriginal and Torres Strait Islander peoples were more than five times higher than in non-Indigenous populations. Of the 15 congenital syphilis cases across the country in the same year, eight were among Aboriginal and Torres Strait Islander peoples.
‘Congenital syphilis diagnoses are 14 times as high among Aboriginal and Torres Strait Islander infants compared with non-Indigenous infants,’ said researcher Dr Skye McGregor, who led the Kirby Institute report.
‘All pregnant people should be tested for sexually transmitted infections (STIs) as part of pre- and antenatal health screening, but antenatal care is not always accessible. It is vital that comprehensive services are in place to ensure appropriate care is accessible for all pregnant people.’
Other high-risk populations include men who have sex with men and babies of mothers who have not had proper syphilis testing and treatment during pregnancy. However, ASHM Deputy CEO Jessica Michaels said it is important to recognise that syphilis can affect anyone.
‘In order to curb the rising syphilis epidemic, it is important that we take a “no wrong door’’ approach to testing,’ she said.
What to look out for
People presenting at a pharmacy with signs or symptoms of syphilis should be encouraged to test, Ms Michaels said, especially if the symptoms are otherwise unexplained.
‘Other instances when pharmacists can encourage patients to test for syphilis include people presenting with symptoms of any STI or an STI diagnosis, those asking about testing for STIs and/or blood-borne viruses, when people are assessed for post-exposure prophylaxis, and pregnant people who are not engaged in antenatal care.’
Symptoms and/or signs of syphilis can include:
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[post_content] => On 1 September the third and final 60-day dispensing tranche commenced, meaning patients can now access double the supply of almost 300 medicines for chronic conditions.
This includes more than 70 asthma inhalers that have been listed on the Pharmaceutical Benefits Scheme (PBS) with an option of a 60-day prescription – coinciding with the start of National Asthma Week (1–7 September) – including all asthma preventer inhalers.
Overall, the initiative is beneficial for patients living with asthma, said Associate Professor Debbie Rigby FPS, Clinical Executive Lead at the National Asthma Council Australia (NAC) and head of PSA’s Respiratory Care Community of Special Interest.
[caption id="attachment_22278" align="aligncenter" width="600"] Debbie Rigby FPS explaining how to correctly use different inhaler devices[/caption]
‘We know that adherence to preventers is poor, and therefore asthma control can be poor, [with] cost being a barrier to people getting their preventers dispensed and using them as prescribed,’ she said.
‘So [60-day dispensing] will have a positive impact on people being able to afford their preventers, and that can, in turn, lead to better adherence and better asthma control.’
But while A/Prof Rigby said 60-day dispensing could work ‘very well’ for patients who have good asthma control and are stable, the NAC has expressed some concerns around patients receiving double supply of their inhalers.
‘Having a 12-month supply of medication removes the need to go back to the GP for a script at 6 months which means the patient misses out on a key opportunity for their GP to assess their asthma management,’ she said.
Australian Pharmacist explores these risks and what pharmacists can do to help mitigate them.
Medicine degradation can affect efficacy
When patients are dispensed double the supply of inhalers, it’s important to raise awareness that some have a shorter in-use shelf life than others.
‘Some inhalers come contained in a foil pack, usually with a desiccant or drying agent in them,’ said A/Prof Rigby.
‘They therefore have anywhere from 1–3 months in-use shelf life, which is different to the expiry date on the outer product [and] must be used within a specified timeframe to avoid reduced stability.’
This includes some dry powder inhalers, such as:
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[post_content] => Inequitable healthcare access, medicines shortages, antimicrobial resistance, and substandard and falsified medicines – all are challenges to be addressed by the pharmacy profession.
At today’s opening in Cape Town, South Africa of the 82nd annual congress of the International Pharmaceutical Federation (FIP), President Paul Sinclair MPS, the first Australian to be elected to the position, also highlighted the need for innovation in pharmacy to address public health challenges and disparities.
He cited pharmacy-based vaccination, which has expanded exponentially since the COVID-19 pandemic, as an example of an innovative approach that has had high impact.
‘Innovation is not just beneficial — it’s essential. Innovating pharmacy enhances patient care, improves therapeutic outcomes, addresses the dynamic challenges of health care, and propels the profession forward.’
The application of three principles — integrity, performance and passion — would help facilitate the advancement of the profession, Mr Sinclair told delegates from around the world.
FIP’s passion for pharmacy had led it to create its “Think Health, Think Pharmacy” campaign to advance the profession. Mr Sinclair urged pharmacists from around the world to support it.
‘Through this campaign, we’re raising awareness of the importance of pharmacies, and of pharmacists themselves, as an underutilised resource in the primary healthcare space, with the potential to deliver more for healthcare systems. We want everyone to think about pharmacy when they think about their health.
‘We want policymakers to think about universal pharmacy coverage when they think about universal health coverage. Promoting our professional identity will facilitate more pharmacy services with benefits for our communities,’ he said.
Australians in FIP awards
Australians Dr Shania Liu and Dr Sarah Dineen-Griffin were honoured at the presentation of the 2024 FIP Global Awards in Cape Town.
[caption id="attachment_27415" align="aligncenter" width="500"] FIP award winner Dr Sarah Dineen-Griffin fourth from left[/caption]
Shania Liu received the Early Career in Pharmaceutical Practice Recognition Award. Presented every 3 years, the award recognises an educational program or innovation that promotes excellence in learning and teaching in any pharmacy discipline.
Dr Liu is the immediate past Chair of the Pain Management Leadership Committee of the Society of Hospital Pharmacists of Australia. Her research involved the improvement of the safe use of opioids before and after surgery.
Currently, she is a Postdoctoral Research Fellow in the Faculty of Medicine and Dentistry at the University of Alberta, Canada.
Sarah Dineen-Griffin was one of 10 new Fellows of FIP appointed at the Congress. FIP Fellowship recognises individual FIP members who have exhibited strong leadership internationally, distinguished themselves in pharmacy practice or the pharmaceutical sciences and who have contributed to the advancement of the practice of pharmacy or pharmaceutical sciences.
Dr Dineen-Griffin is a full-time teaching and research academic in the School of Biomedical Sciences and Pharmacy at the University of Newcastle. Currently she is Chief Investigator and Project Lead for the NSW/ACT Government Scope of Practice Pharmacy Trials. She is also the Vice President of the FIP Community Pharmacy Section.
[post_title] => FIP congress and two Australians honoured
[post_excerpt] => Find out what pharmacy topics are being discussed on the world stage at FIP, along with the Australians who received top honours.
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[post_content] => Earlier this year, a nation-wide news poll conducted by the Royal Australian College of General Practitioners (RACGP) found most General Practitioners (GPs) think patients would benefit from a multidisciplinary care team, including pharmacists, psychologists, and credentialed diabetes educators.
Allowing practices to grow their teams would improve access to care for all Australians, said RACGP President Dr Nicole Higgins.
‘Studies have shown having a pharmacist in the practice team improves the quality of prescribing and reduces costs for patients by supporting quality use of medicines and deprescribing initiatives,’ she said.
‘Some practices already employ practice-based pharmacists’ she said, recommending that there be dedicated funding in the Federal Budget 'to support more practices to do so'.
For those looking to enter this area of practice, Zachary Sum MPS FANZCAP (Derm., Surg.) – General Practice pharmacist (GP pharmacist) and member of the business development team at Melbourne's Eden Rise Family Clinic – has some sage advice.
Do some background research
For those considering a career as a GP pharmacist, Mr Sum advises immersion in the world of general practice.
A good place to start is subscribing to newsletters from:
‘These platforms provide pharmacists with inside news about how general practice and GPs function as a whole,’ he said.
Pharmacists can also gain insight into the challenges GPs are currently facing, including the long-standing Medicare rebate freeze and general decline in bulk billing practices.
‘This can help pharmacists think of new ideas for helping GPs solve their current industry challenges,’ Mr Sum said.
It would also be beneficial to consider how the skills you have as a pharmacist can benefit the community you intend to look after. This includes considering whether patients:
Queensland-based GP pharmacist Amy Gibson MPS[/caption]
‘There are the smaller, process-oriented, business-related tasks unique to each practice,’ said Mr Sum.
‘[Some of] the skills I’ve gained are more administrative, so I can help to make changes to the way the clinic’s administration is performed, how staffing is recruited, how we manage people, and how we manage and contact our patients.’
Remember, becoming a GP pharmacist is an iterative process, full of on-the-job learning and growing.
‘As you become more proactive in the role, you’ll create new services, alter your service delivery, change the type of services offered, or do something different altogether,’ he said. ‘The end goal is still to give value to the GPs and patients, and to support the community.’
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[post_content] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve patient health and safety.
As the 2024 FIP World Congress continues, Australian Pharmacist reports from Cape Town on some innovative services presented which are improving health across the globe.
South Africa: Improving access to HIV treatment and prevention
There are 7.9 million people in South Africa between the ages of 15 and 49 years living with HIV. Despite strides in treatments and preventative therapies, the rate of new infections remains high.
One project driven by pharmacists is aiming to change this, allowing community pharmacists to initiate high-risk young women and men onto HIV Pre-Exposure Prophylaxis (PrEP). In this implementation study, 10 pharmacies in Gauteng and the Western Cape (Cape Town) initiated high-risk individuals on combination tenofovir and lamivudine/emtricitabine for a period of 13 months. Patients were recruited inside and outside of the pharmacy.
Of the 838 potential participants, 88% (n = 737) were initiated on PrEP between June 2023 and January 2024. Risk assessment found most were sexually active, and more than three quarters (n = 595) engaged in sexual activity without a condom. Initial results from the study were positive, with further analysis to explore patient perceptions of PrEP initiation in community pharmacy.
Spain: Pharmacy reporting of stock shortages helps detect shortages sooner
The General Council of Pharmacists of Spain has developed two systems to prevent and mitigate medicine shortages.
The first is CisMED, a system that generates real-time information on supply incidents at a pharmacy level.
Over 10,000 pharmacies participated in this initiative in 2023 – over half of all pharmacies. CisMED reported a 30% increase in medicines that could not be supplied, with over half the alerts generated being for medicines not listed by their regulator, the Spanish Medicines Agency.
The second initiative, FarmaHelp, is a communication system which allows pharmacists to communicate with nearby pharmacies when a request for a medicine cannot be fulfilled. From the 10,000 pharmacies connected to the system, the number of medicines ‘found’ increased from 106,925 to 389,364. This meant 73.5% of the time, the pharmacist was able to offer a solution to the patient due to the FamraHelp system.
In combination, these digital systems have helped pharmacists both contribute to a more accurate and complete medicine shortage database, and allowed pharmacists to find more options to support access to scarce medicines to their patients more often.
The Netherlands: Palliative care kit improves access to care at end-of-life
The decision to initiate palliative care is often a time where medicines need to be prescribed and initiated at short notice, with a new and often complex regimen of medicines.
A project in The Netherlands led by the Royal Dutch Pharmacists Association, is trying to make this a smoother process for patients and their families through the introduction of a ‘palliative care kit’.
Based on the concept of a first-aid kit, the ‘palliative care kit’ contains everything patients will need to facilitate administration of medicines at end-of-life. This includes morphine and midazolam ampoules, syringes, needles, bandages and a urinary catheter with insertion set.
The kit is supplied by a pharmacy, which receives reimbursement for the medicines, and a professional fee for facilitating the supply of the kit.
The kit contains a permission document from the GP to use the supplies when necessary. The kit is delivered to the home of palliative patients when they enter the terminal phase at a time that can be planned. This allows a nurse to immediately use that kit when necessary.
The kit has reduced unnecessary time spent by community nurses, GPs and pharmacists in facilitating palliative care, particularly during evenings, nights and on weekends. Families report the presence of the kit reassuring because they know their loved one will be able to access the medicines they need instantly, should they experience acute deterioration.
Thailand: Medicine reviews for high-risk CKD patients
In Thailand, 30% of people with chronic kidney disease (CKD) use NSAIDs or other herbal medicines which may accelerate the progression of CKD. A pilot project has shown pharmacists can help reduce this.
In this pilot, a nurse at the CKD clinic referred patients (n = 23) with medicine problems to a pharmacy for medicine reconciliation, adherence checks and to review for potential causes of acute kidney injury. Importantly, the pharmacist also managed any problems identified and monitored kidney function for at least 3 months.
Half (52%) of patients stopped using NSAIDs, and kidney function improved from Stage 3 to Stage 2 in five patients within 3 months. While not statistically significant, the small pilot concluded the model of care appeared to reduce costs associated with medicines and CKD management.
Australian pharmacist on SA TV!
Meanwhile, Australian pharmacist and FIP President Paul Sinclair AM MPS has appeared on South African breakfast television to talk about the important role of pharmacists. Paul told SABC’s Expresso Show he was excited about the opportunities around the world for pharmacists.
[caption id="attachment_27480" align="aligncenter" width="507"] FIP President Paul Sinclair AM MPS (left)[/caption]
‘Health care across the world is changing very quickly. It’s being driven by innovation, and pharmacists historically have embraced innovation and technology,' he said.
‘What excites me most about our profession at the moment is that we have the chance to do more. Our scope of practice is expanding rapidly, and with that comes opportunities to help more people deliver more outcomes and improve the health system.'
[post_title] => What are pharmacists doing in other countries?
[post_excerpt] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve health and safety.
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[post_content] => Syphilis cases have tripled in the last 10 years in Australia, leading to an ‘avoidable and unacceptable’ reemergence of congenital syphilis. This World Sexual Health Day (4 September), Australian Pharmacist explores pharmacists’ role in addressing this escalating issue.
When syphilis infections began to rise in Australia in 2011, the cases were primarily among men with male sexual partners, and young heterosexual persons in remote Aboriginal and Torres Strait Islander communities. However, there was a 500% increase in the rate of infectious syphilis among women aged 15 to 44 between 2011 and 2021, according to a report from the University of New South Wales’ Kirby Institute.
That means parent-to-child transmission is also on the rise - this is called congenital syphilis. There was a median of 4 cases per year in Australia between 2011 and 2019, skyrocketing to 17 cases in 2020, and 15 in 2021 and 2022. For the birthing parent of babies with congenital syphilis, the report’s authors found less than 40% were tested for syphilis during pregnancy.
Left untreated, congenital syphilis can lead to serious complications in more than 50% of cases, including miscarriage, stillbirth, neonatal death and permanent disability. Of all the cases of congenital syphilis in Australia between 2011 and 2021, 25% of babies were stillborn.
In Queensland, where cases of infectious syphilis have increased by 600% in 15 years, five babies contracted the disease in the womb in 2023, leading to 4 deaths. This is the largest number of Queensland deaths from congenital syphilis in a single year this century.
As a preventable and curable disease, Queensland Minister for Health Shannon Fentiman said the deaths ‘shouldn’t be happening’. It’s a message echoed by Australia’s Chief Medical Officer Professor Paul Kelly, who said health professionals need to ensure they’re up to date on information about syphilis testing and management.
‘Any baby losing its life is a tragedy. Any baby losing its life to a preventable illness is a responsibility for us all in our health system,’ he said in a video (below) recorded for the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).
https://vimeo.com/912435688
‘We must ensure everyone is tested for syphilis during pregnancy. All pregnant people should be tested at least once, and in many cases more … Once diagnosed, treatment is simple and effective.’
High-risk populations
In 2022, syphilis rates among Aboriginal and Torres Strait Islander peoples were more than five times higher than in non-Indigenous populations. Of the 15 congenital syphilis cases across the country in the same year, eight were among Aboriginal and Torres Strait Islander peoples.
‘Congenital syphilis diagnoses are 14 times as high among Aboriginal and Torres Strait Islander infants compared with non-Indigenous infants,’ said researcher Dr Skye McGregor, who led the Kirby Institute report.
‘All pregnant people should be tested for sexually transmitted infections (STIs) as part of pre- and antenatal health screening, but antenatal care is not always accessible. It is vital that comprehensive services are in place to ensure appropriate care is accessible for all pregnant people.’
Other high-risk populations include men who have sex with men and babies of mothers who have not had proper syphilis testing and treatment during pregnancy. However, ASHM Deputy CEO Jessica Michaels said it is important to recognise that syphilis can affect anyone.
‘In order to curb the rising syphilis epidemic, it is important that we take a “no wrong door’’ approach to testing,’ she said.
What to look out for
People presenting at a pharmacy with signs or symptoms of syphilis should be encouraged to test, Ms Michaels said, especially if the symptoms are otherwise unexplained.
‘Other instances when pharmacists can encourage patients to test for syphilis include people presenting with symptoms of any STI or an STI diagnosis, those asking about testing for STIs and/or blood-borne viruses, when people are assessed for post-exposure prophylaxis, and pregnant people who are not engaged in antenatal care.’
Symptoms and/or signs of syphilis can include:
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[post_content] => On 1 September the third and final 60-day dispensing tranche commenced, meaning patients can now access double the supply of almost 300 medicines for chronic conditions.
This includes more than 70 asthma inhalers that have been listed on the Pharmaceutical Benefits Scheme (PBS) with an option of a 60-day prescription – coinciding with the start of National Asthma Week (1–7 September) – including all asthma preventer inhalers.
Overall, the initiative is beneficial for patients living with asthma, said Associate Professor Debbie Rigby FPS, Clinical Executive Lead at the National Asthma Council Australia (NAC) and head of PSA’s Respiratory Care Community of Special Interest.
[caption id="attachment_22278" align="aligncenter" width="600"] Debbie Rigby FPS explaining how to correctly use different inhaler devices[/caption]
‘We know that adherence to preventers is poor, and therefore asthma control can be poor, [with] cost being a barrier to people getting their preventers dispensed and using them as prescribed,’ she said.
‘So [60-day dispensing] will have a positive impact on people being able to afford their preventers, and that can, in turn, lead to better adherence and better asthma control.’
But while A/Prof Rigby said 60-day dispensing could work ‘very well’ for patients who have good asthma control and are stable, the NAC has expressed some concerns around patients receiving double supply of their inhalers.
‘Having a 12-month supply of medication removes the need to go back to the GP for a script at 6 months which means the patient misses out on a key opportunity for their GP to assess their asthma management,’ she said.
Australian Pharmacist explores these risks and what pharmacists can do to help mitigate them.
Medicine degradation can affect efficacy
When patients are dispensed double the supply of inhalers, it’s important to raise awareness that some have a shorter in-use shelf life than others.
‘Some inhalers come contained in a foil pack, usually with a desiccant or drying agent in them,’ said A/Prof Rigby.
‘They therefore have anywhere from 1–3 months in-use shelf life, which is different to the expiry date on the outer product [and] must be used within a specified timeframe to avoid reduced stability.’
This includes some dry powder inhalers, such as:
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[post_content] => Inequitable healthcare access, medicines shortages, antimicrobial resistance, and substandard and falsified medicines – all are challenges to be addressed by the pharmacy profession.
At today’s opening in Cape Town, South Africa of the 82nd annual congress of the International Pharmaceutical Federation (FIP), President Paul Sinclair MPS, the first Australian to be elected to the position, also highlighted the need for innovation in pharmacy to address public health challenges and disparities.
He cited pharmacy-based vaccination, which has expanded exponentially since the COVID-19 pandemic, as an example of an innovative approach that has had high impact.
‘Innovation is not just beneficial — it’s essential. Innovating pharmacy enhances patient care, improves therapeutic outcomes, addresses the dynamic challenges of health care, and propels the profession forward.’
The application of three principles — integrity, performance and passion — would help facilitate the advancement of the profession, Mr Sinclair told delegates from around the world.
FIP’s passion for pharmacy had led it to create its “Think Health, Think Pharmacy” campaign to advance the profession. Mr Sinclair urged pharmacists from around the world to support it.
‘Through this campaign, we’re raising awareness of the importance of pharmacies, and of pharmacists themselves, as an underutilised resource in the primary healthcare space, with the potential to deliver more for healthcare systems. We want everyone to think about pharmacy when they think about their health.
‘We want policymakers to think about universal pharmacy coverage when they think about universal health coverage. Promoting our professional identity will facilitate more pharmacy services with benefits for our communities,’ he said.
Australians in FIP awards
Australians Dr Shania Liu and Dr Sarah Dineen-Griffin were honoured at the presentation of the 2024 FIP Global Awards in Cape Town.
[caption id="attachment_27415" align="aligncenter" width="500"] FIP award winner Dr Sarah Dineen-Griffin fourth from left[/caption]
Shania Liu received the Early Career in Pharmaceutical Practice Recognition Award. Presented every 3 years, the award recognises an educational program or innovation that promotes excellence in learning and teaching in any pharmacy discipline.
Dr Liu is the immediate past Chair of the Pain Management Leadership Committee of the Society of Hospital Pharmacists of Australia. Her research involved the improvement of the safe use of opioids before and after surgery.
Currently, she is a Postdoctoral Research Fellow in the Faculty of Medicine and Dentistry at the University of Alberta, Canada.
Sarah Dineen-Griffin was one of 10 new Fellows of FIP appointed at the Congress. FIP Fellowship recognises individual FIP members who have exhibited strong leadership internationally, distinguished themselves in pharmacy practice or the pharmaceutical sciences and who have contributed to the advancement of the practice of pharmacy or pharmaceutical sciences.
Dr Dineen-Griffin is a full-time teaching and research academic in the School of Biomedical Sciences and Pharmacy at the University of Newcastle. Currently she is Chief Investigator and Project Lead for the NSW/ACT Government Scope of Practice Pharmacy Trials. She is also the Vice President of the FIP Community Pharmacy Section.
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[post_excerpt] => Find out what pharmacy topics are being discussed on the world stage at FIP, along with the Australians who received top honours.
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[post_content] => Earlier this year, a nation-wide news poll conducted by the Royal Australian College of General Practitioners (RACGP) found most General Practitioners (GPs) think patients would benefit from a multidisciplinary care team, including pharmacists, psychologists, and credentialed diabetes educators.
Allowing practices to grow their teams would improve access to care for all Australians, said RACGP President Dr Nicole Higgins.
‘Studies have shown having a pharmacist in the practice team improves the quality of prescribing and reduces costs for patients by supporting quality use of medicines and deprescribing initiatives,’ she said.
‘Some practices already employ practice-based pharmacists’ she said, recommending that there be dedicated funding in the Federal Budget 'to support more practices to do so'.
For those looking to enter this area of practice, Zachary Sum MPS FANZCAP (Derm., Surg.) – General Practice pharmacist (GP pharmacist) and member of the business development team at Melbourne's Eden Rise Family Clinic – has some sage advice.
Do some background research
For those considering a career as a GP pharmacist, Mr Sum advises immersion in the world of general practice.
A good place to start is subscribing to newsletters from:
‘These platforms provide pharmacists with inside news about how general practice and GPs function as a whole,’ he said.
Pharmacists can also gain insight into the challenges GPs are currently facing, including the long-standing Medicare rebate freeze and general decline in bulk billing practices.
‘This can help pharmacists think of new ideas for helping GPs solve their current industry challenges,’ Mr Sum said.
It would also be beneficial to consider how the skills you have as a pharmacist can benefit the community you intend to look after. This includes considering whether patients:
Queensland-based GP pharmacist Amy Gibson MPS[/caption]
‘There are the smaller, process-oriented, business-related tasks unique to each practice,’ said Mr Sum.
‘[Some of] the skills I’ve gained are more administrative, so I can help to make changes to the way the clinic’s administration is performed, how staffing is recruited, how we manage people, and how we manage and contact our patients.’
Remember, becoming a GP pharmacist is an iterative process, full of on-the-job learning and growing.
‘As you become more proactive in the role, you’ll create new services, alter your service delivery, change the type of services offered, or do something different altogether,’ he said. ‘The end goal is still to give value to the GPs and patients, and to support the community.’
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[post_content] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve patient health and safety.
As the 2024 FIP World Congress continues, Australian Pharmacist reports from Cape Town on some innovative services presented which are improving health across the globe.
South Africa: Improving access to HIV treatment and prevention
There are 7.9 million people in South Africa between the ages of 15 and 49 years living with HIV. Despite strides in treatments and preventative therapies, the rate of new infections remains high.
One project driven by pharmacists is aiming to change this, allowing community pharmacists to initiate high-risk young women and men onto HIV Pre-Exposure Prophylaxis (PrEP). In this implementation study, 10 pharmacies in Gauteng and the Western Cape (Cape Town) initiated high-risk individuals on combination tenofovir and lamivudine/emtricitabine for a period of 13 months. Patients were recruited inside and outside of the pharmacy.
Of the 838 potential participants, 88% (n = 737) were initiated on PrEP between June 2023 and January 2024. Risk assessment found most were sexually active, and more than three quarters (n = 595) engaged in sexual activity without a condom. Initial results from the study were positive, with further analysis to explore patient perceptions of PrEP initiation in community pharmacy.
Spain: Pharmacy reporting of stock shortages helps detect shortages sooner
The General Council of Pharmacists of Spain has developed two systems to prevent and mitigate medicine shortages.
The first is CisMED, a system that generates real-time information on supply incidents at a pharmacy level.
Over 10,000 pharmacies participated in this initiative in 2023 – over half of all pharmacies. CisMED reported a 30% increase in medicines that could not be supplied, with over half the alerts generated being for medicines not listed by their regulator, the Spanish Medicines Agency.
The second initiative, FarmaHelp, is a communication system which allows pharmacists to communicate with nearby pharmacies when a request for a medicine cannot be fulfilled. From the 10,000 pharmacies connected to the system, the number of medicines ‘found’ increased from 106,925 to 389,364. This meant 73.5% of the time, the pharmacist was able to offer a solution to the patient due to the FamraHelp system.
In combination, these digital systems have helped pharmacists both contribute to a more accurate and complete medicine shortage database, and allowed pharmacists to find more options to support access to scarce medicines to their patients more often.
The Netherlands: Palliative care kit improves access to care at end-of-life
The decision to initiate palliative care is often a time where medicines need to be prescribed and initiated at short notice, with a new and often complex regimen of medicines.
A project in The Netherlands led by the Royal Dutch Pharmacists Association, is trying to make this a smoother process for patients and their families through the introduction of a ‘palliative care kit’.
Based on the concept of a first-aid kit, the ‘palliative care kit’ contains everything patients will need to facilitate administration of medicines at end-of-life. This includes morphine and midazolam ampoules, syringes, needles, bandages and a urinary catheter with insertion set.
The kit is supplied by a pharmacy, which receives reimbursement for the medicines, and a professional fee for facilitating the supply of the kit.
The kit contains a permission document from the GP to use the supplies when necessary. The kit is delivered to the home of palliative patients when they enter the terminal phase at a time that can be planned. This allows a nurse to immediately use that kit when necessary.
The kit has reduced unnecessary time spent by community nurses, GPs and pharmacists in facilitating palliative care, particularly during evenings, nights and on weekends. Families report the presence of the kit reassuring because they know their loved one will be able to access the medicines they need instantly, should they experience acute deterioration.
Thailand: Medicine reviews for high-risk CKD patients
In Thailand, 30% of people with chronic kidney disease (CKD) use NSAIDs or other herbal medicines which may accelerate the progression of CKD. A pilot project has shown pharmacists can help reduce this.
In this pilot, a nurse at the CKD clinic referred patients (n = 23) with medicine problems to a pharmacy for medicine reconciliation, adherence checks and to review for potential causes of acute kidney injury. Importantly, the pharmacist also managed any problems identified and monitored kidney function for at least 3 months.
Half (52%) of patients stopped using NSAIDs, and kidney function improved from Stage 3 to Stage 2 in five patients within 3 months. While not statistically significant, the small pilot concluded the model of care appeared to reduce costs associated with medicines and CKD management.
Australian pharmacist on SA TV!
Meanwhile, Australian pharmacist and FIP President Paul Sinclair AM MPS has appeared on South African breakfast television to talk about the important role of pharmacists. Paul told SABC’s Expresso Show he was excited about the opportunities around the world for pharmacists.
[caption id="attachment_27480" align="aligncenter" width="507"] FIP President Paul Sinclair AM MPS (left)[/caption]
‘Health care across the world is changing very quickly. It’s being driven by innovation, and pharmacists historically have embraced innovation and technology,' he said.
‘What excites me most about our profession at the moment is that we have the chance to do more. Our scope of practice is expanding rapidly, and with that comes opportunities to help more people deliver more outcomes and improve the health system.'
[post_title] => What are pharmacists doing in other countries?
[post_excerpt] => Pharmacists present to the International Pharmaceutical Federation (FIP) on unique services in their country to improve health and safety.
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[post_content] => Syphilis cases have tripled in the last 10 years in Australia, leading to an ‘avoidable and unacceptable’ reemergence of congenital syphilis. This World Sexual Health Day (4 September), Australian Pharmacist explores pharmacists’ role in addressing this escalating issue.
When syphilis infections began to rise in Australia in 2011, the cases were primarily among men with male sexual partners, and young heterosexual persons in remote Aboriginal and Torres Strait Islander communities. However, there was a 500% increase in the rate of infectious syphilis among women aged 15 to 44 between 2011 and 2021, according to a report from the University of New South Wales’ Kirby Institute.
That means parent-to-child transmission is also on the rise - this is called congenital syphilis. There was a median of 4 cases per year in Australia between 2011 and 2019, skyrocketing to 17 cases in 2020, and 15 in 2021 and 2022. For the birthing parent of babies with congenital syphilis, the report’s authors found less than 40% were tested for syphilis during pregnancy.
Left untreated, congenital syphilis can lead to serious complications in more than 50% of cases, including miscarriage, stillbirth, neonatal death and permanent disability. Of all the cases of congenital syphilis in Australia between 2011 and 2021, 25% of babies were stillborn.
In Queensland, where cases of infectious syphilis have increased by 600% in 15 years, five babies contracted the disease in the womb in 2023, leading to 4 deaths. This is the largest number of Queensland deaths from congenital syphilis in a single year this century.
As a preventable and curable disease, Queensland Minister for Health Shannon Fentiman said the deaths ‘shouldn’t be happening’. It’s a message echoed by Australia’s Chief Medical Officer Professor Paul Kelly, who said health professionals need to ensure they’re up to date on information about syphilis testing and management.
‘Any baby losing its life is a tragedy. Any baby losing its life to a preventable illness is a responsibility for us all in our health system,’ he said in a video (below) recorded for the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).
https://vimeo.com/912435688
‘We must ensure everyone is tested for syphilis during pregnancy. All pregnant people should be tested at least once, and in many cases more … Once diagnosed, treatment is simple and effective.’
High-risk populations
In 2022, syphilis rates among Aboriginal and Torres Strait Islander peoples were more than five times higher than in non-Indigenous populations. Of the 15 congenital syphilis cases across the country in the same year, eight were among Aboriginal and Torres Strait Islander peoples.
‘Congenital syphilis diagnoses are 14 times as high among Aboriginal and Torres Strait Islander infants compared with non-Indigenous infants,’ said researcher Dr Skye McGregor, who led the Kirby Institute report.
‘All pregnant people should be tested for sexually transmitted infections (STIs) as part of pre- and antenatal health screening, but antenatal care is not always accessible. It is vital that comprehensive services are in place to ensure appropriate care is accessible for all pregnant people.’
Other high-risk populations include men who have sex with men and babies of mothers who have not had proper syphilis testing and treatment during pregnancy. However, ASHM Deputy CEO Jessica Michaels said it is important to recognise that syphilis can affect anyone.
‘In order to curb the rising syphilis epidemic, it is important that we take a “no wrong door’’ approach to testing,’ she said.
What to look out for
People presenting at a pharmacy with signs or symptoms of syphilis should be encouraged to test, Ms Michaels said, especially if the symptoms are otherwise unexplained.
‘Other instances when pharmacists can encourage patients to test for syphilis include people presenting with symptoms of any STI or an STI diagnosis, those asking about testing for STIs and/or blood-borne viruses, when people are assessed for post-exposure prophylaxis, and pregnant people who are not engaged in antenatal care.’
Symptoms and/or signs of syphilis can include:
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[post_content] => On 1 September the third and final 60-day dispensing tranche commenced, meaning patients can now access double the supply of almost 300 medicines for chronic conditions.
This includes more than 70 asthma inhalers that have been listed on the Pharmaceutical Benefits Scheme (PBS) with an option of a 60-day prescription – coinciding with the start of National Asthma Week (1–7 September) – including all asthma preventer inhalers.
Overall, the initiative is beneficial for patients living with asthma, said Associate Professor Debbie Rigby FPS, Clinical Executive Lead at the National Asthma Council Australia (NAC) and head of PSA’s Respiratory Care Community of Special Interest.
[caption id="attachment_22278" align="aligncenter" width="600"] Debbie Rigby FPS explaining how to correctly use different inhaler devices[/caption]
‘We know that adherence to preventers is poor, and therefore asthma control can be poor, [with] cost being a barrier to people getting their preventers dispensed and using them as prescribed,’ she said.
‘So [60-day dispensing] will have a positive impact on people being able to afford their preventers, and that can, in turn, lead to better adherence and better asthma control.’
But while A/Prof Rigby said 60-day dispensing could work ‘very well’ for patients who have good asthma control and are stable, the NAC has expressed some concerns around patients receiving double supply of their inhalers.
‘Having a 12-month supply of medication removes the need to go back to the GP for a script at 6 months which means the patient misses out on a key opportunity for their GP to assess their asthma management,’ she said.
Australian Pharmacist explores these risks and what pharmacists can do to help mitigate them.
Medicine degradation can affect efficacy
When patients are dispensed double the supply of inhalers, it’s important to raise awareness that some have a shorter in-use shelf life than others.
‘Some inhalers come contained in a foil pack, usually with a desiccant or drying agent in them,’ said A/Prof Rigby.
‘They therefore have anywhere from 1–3 months in-use shelf life, which is different to the expiry date on the outer product [and] must be used within a specified timeframe to avoid reduced stability.’
This includes some dry powder inhalers, such as:
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[post_content] => Inequitable healthcare access, medicines shortages, antimicrobial resistance, and substandard and falsified medicines – all are challenges to be addressed by the pharmacy profession.
At today’s opening in Cape Town, South Africa of the 82nd annual congress of the International Pharmaceutical Federation (FIP), President Paul Sinclair MPS, the first Australian to be elected to the position, also highlighted the need for innovation in pharmacy to address public health challenges and disparities.
He cited pharmacy-based vaccination, which has expanded exponentially since the COVID-19 pandemic, as an example of an innovative approach that has had high impact.
‘Innovation is not just beneficial — it’s essential. Innovating pharmacy enhances patient care, improves therapeutic outcomes, addresses the dynamic challenges of health care, and propels the profession forward.’
The application of three principles — integrity, performance and passion — would help facilitate the advancement of the profession, Mr Sinclair told delegates from around the world.
FIP’s passion for pharmacy had led it to create its “Think Health, Think Pharmacy” campaign to advance the profession. Mr Sinclair urged pharmacists from around the world to support it.
‘Through this campaign, we’re raising awareness of the importance of pharmacies, and of pharmacists themselves, as an underutilised resource in the primary healthcare space, with the potential to deliver more for healthcare systems. We want everyone to think about pharmacy when they think about their health.
‘We want policymakers to think about universal pharmacy coverage when they think about universal health coverage. Promoting our professional identity will facilitate more pharmacy services with benefits for our communities,’ he said.
Australians in FIP awards
Australians Dr Shania Liu and Dr Sarah Dineen-Griffin were honoured at the presentation of the 2024 FIP Global Awards in Cape Town.
[caption id="attachment_27415" align="aligncenter" width="500"] FIP award winner Dr Sarah Dineen-Griffin fourth from left[/caption]
Shania Liu received the Early Career in Pharmaceutical Practice Recognition Award. Presented every 3 years, the award recognises an educational program or innovation that promotes excellence in learning and teaching in any pharmacy discipline.
Dr Liu is the immediate past Chair of the Pain Management Leadership Committee of the Society of Hospital Pharmacists of Australia. Her research involved the improvement of the safe use of opioids before and after surgery.
Currently, she is a Postdoctoral Research Fellow in the Faculty of Medicine and Dentistry at the University of Alberta, Canada.
Sarah Dineen-Griffin was one of 10 new Fellows of FIP appointed at the Congress. FIP Fellowship recognises individual FIP members who have exhibited strong leadership internationally, distinguished themselves in pharmacy practice or the pharmaceutical sciences and who have contributed to the advancement of the practice of pharmacy or pharmaceutical sciences.
Dr Dineen-Griffin is a full-time teaching and research academic in the School of Biomedical Sciences and Pharmacy at the University of Newcastle. Currently she is Chief Investigator and Project Lead for the NSW/ACT Government Scope of Practice Pharmacy Trials. She is also the Vice President of the FIP Community Pharmacy Section.
[post_title] => FIP congress and two Australians honoured
[post_excerpt] => Find out what pharmacy topics are being discussed on the world stage at FIP, along with the Australians who received top honours.
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[post_content] => Earlier this year, a nation-wide news poll conducted by the Royal Australian College of General Practitioners (RACGP) found most General Practitioners (GPs) think patients would benefit from a multidisciplinary care team, including pharmacists, psychologists, and credentialed diabetes educators.
Allowing practices to grow their teams would improve access to care for all Australians, said RACGP President Dr Nicole Higgins.
‘Studies have shown having a pharmacist in the practice team improves the quality of prescribing and reduces costs for patients by supporting quality use of medicines and deprescribing initiatives,’ she said.
‘Some practices already employ practice-based pharmacists’ she said, recommending that there be dedicated funding in the Federal Budget 'to support more practices to do so'.
For those looking to enter this area of practice, Zachary Sum MPS FANZCAP (Derm., Surg.) – General Practice pharmacist (GP pharmacist) and member of the business development team at Melbourne's Eden Rise Family Clinic – has some sage advice.
Do some background research
For those considering a career as a GP pharmacist, Mr Sum advises immersion in the world of general practice.
A good place to start is subscribing to newsletters from:
‘These platforms provide pharmacists with inside news about how general practice and GPs function as a whole,’ he said.
Pharmacists can also gain insight into the challenges GPs are currently facing, including the long-standing Medicare rebate freeze and general decline in bulk billing practices.
‘This can help pharmacists think of new ideas for helping GPs solve their current industry challenges,’ Mr Sum said.
It would also be beneficial to consider how the skills you have as a pharmacist can benefit the community you intend to look after. This includes considering whether patients:
Queensland-based GP pharmacist Amy Gibson MPS[/caption]
‘There are the smaller, process-oriented, business-related tasks unique to each practice,’ said Mr Sum.
‘[Some of] the skills I’ve gained are more administrative, so I can help to make changes to the way the clinic’s administration is performed, how staffing is recruited, how we manage people, and how we manage and contact our patients.’
Remember, becoming a GP pharmacist is an iterative process, full of on-the-job learning and growing.
‘As you become more proactive in the role, you’ll create new services, alter your service delivery, change the type of services offered, or do something different altogether,’ he said. ‘The end goal is still to give value to the GPs and patients, and to support the community.’
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
