18 minute read
receives Honour
Favourable Opinion of Pharma Industry
More than half of people have a favourable opinion about pharmaceutical companies operating in Ireland, according to new research from Ipsos for the Irish Pharmaceutical Healthcare Association (IPHA), the representative organisation for medicines innovators.
The industry’s public favourability score, at 53%, is up from 44% since a similar poll was conducted in September 2018. When Ipsos measured sentiment towards the industry in June 2020 and in September 2021, the scores were 50% and 54%, respectively. Three in five people, or 60%, trust the industry in Ireland, almost twice the global average measured by an Ipsos survey of people across 29 countries.
More than four in five people, or 83%, believe that the industry makes an important societal and economic contribution. That figure is up slightly from 81% in 2018. Over half of people, or 55%, believe the industry focuses on what patients need. Almost nine in 10 people, or 89%, believe in the value of science in tackling unmet medical needs. More than four in five people, or 83%, believe the past five years has brought significant progress in the development of new medicines. About the same number recognise the link between medicines and better health outcomes.
Bernard Mallee, IPHA’s Director of Communications and Advocacy, said the survey shows the industry has high levels of public trust. “The public values science and the industry’s societal and economic impact. That innovator companies are spread across the regions, creating jobs and economic activity, is likely to strengthen that perspective. It is clear, too, that there is an appreciation of the positive health and quality of life impact of medicines. That the industry’s favourability rating has improved since before the pandemic may reflect heightened public awareness of science in tackling disease. With medicines innovation moving at pace, Ireland should be ready to take advantage of the jobs and health outcomes bonus that comes with the industry. That takes planning between industry, the State and wider stakeholders. We look forward to continuing that trend,” said Mr Mallee.
The next phase of Innovate For Life, the industry’s documentary campaign that tells the story of innovation in medicines, will be released in the coming weeks.
Honour for RCSI's First Female Microbiology Professor
The Department of Clinical Microbiology at RCSI University of Medicine and Health Sciences has renamed its laboratory in honour of the late Professor Ellen Moorhouse.
In a ceremony today at the RCSI Education and Research Centre at Beaumont Hospital, RCSI President Professor Laura Viani unveiled a plaque to mark the official naming of the 'Ellen Moorhouse Laboratory'. Professor Ellen C. Moorhouse was born in Dublin in 1928 and studied at RCSI before working in hospitals in Ireland and England. The RCSI Department of Clinical Microbiology was opened in 1965, and in 1967 Professor Moorhouse became the first Professor Ellen Moorhouse's son and daughter pictured at the event: Dr David Moorhouse, RCSI graduate and Consultant Neurologist at Bon Secours Hospital, and Kathryn Moorhouse, RCSI Library
female Clinical Sciences Professor at RCSI with her appointment as Chair of Microbiology. She continued working at RCSI and Beaumont Hospital until her retirement in 1995.
Today, Professor Moorhouse's portrait is displayed in RCSI's St Stephen's Green campus, and the Ellen Moorhouse Prize in Clinical Microbiology is awarded annually to an undergraduate medical student. RCSI President, Professor Laura Viani, commented: "It is my great honour to unveil the plaque officially naming the Ellen Moorhouse Laboratory at the RCSI Department of Clinical Microbiology at Beaumont Hospital. In the almost 30 years that Professor Moorhouse worked at RCSI, she taught and inspired countless generations of healthcare professionals. This is a fitting tribute to the lasting impact and influence our first female Clinical Sciences Professor has had at RCSI."
For 57 years, the RCSI Department of Clinical Microbiology has been committed to educating the next generation of doctors about sepsis, healthcare-associated infection and antimicrobial resistance and improving patient care through research into the prevention and control of healthcare-associated infections and antibiotic resistance /superbugs for better health outcomes.
Now led by Professor Fidelma Fitzpatrick, the team includes clinicians, other healthcare professionals and scientists, all of whom are actively involved in teaching, research, public engagement and advocacy, in addition to national health policy and health services leadership roles. Informed by its research and clinical activities, the RCSI Department of Clinical Microbiology contributes significantly to healthcare policy, national guidelines and national clinical programmes through membership of national and international committees.
EAHP Congress 2023
The 27th Annual European Association of Hospital Pharmacists Congress will take place from 22-24 March 2023.
The event will be held next year in Lisbon Congress Centre and will be entitled, ‘From Drug Design to Treatment Success – What Really Matters to Patients?’ Building on the success of previous meetings, EAHP decided to embrace new locations and a more diverse format for its in-person events, enabling the Association to host the annual congress in a new city: Lisbon. The scientific programme will encompass this wide horizon and provide an insight into these different and distinct, but also overlapping, subspecialities. I am sure that the Congress programme will effectively enable us all to grasp this rather complex landscape and to take home with us some valid answers. Find out more by visiting www.eahp.eu
Your patients, your profession, our passion.
ABBREVIATED PRESCRIBING INFORMATION: Consult the Summary of Product Characteristics for further information. Additional information is available upon request. Noradrenaline (Norepinephrine) Kabi 1mg/ml concentrate for solution for infusion. Active ingredient: 1ml concentrate for solution for infusion contains 1mg noradrenaline (norepinephrine) base equivalent to 2mg noradrenaline (norepinephrine) tartrate. Contains 3.4mg sodium per ml. Indications: In adults for use as an emergency measure in the restoration of blood pressure in cases of acute hypotension. Posology and method of administration: When diluted as recommended, each litre contains 40mg noradrenaline base equivalent to 80mg noradrenaline tartrate. If dilutions other than 40mg per litre are used, check infusion rate calculation carefully before starting treatment. Initial rate of infusion – 10-20ml/hour (0.16-0.32ml/min); equivalent to 0.4-0.8mg/hour noradrenaline base. Lower initial infusion rate of 5ml/hour (0.08ml/min); equivalent to 0.2mg/hour noradrenaline base may be preferred. Titration of dose – Once infusion has been established, titrate dose in steps of 0.05-0.1mcg/kg/min of noradrenaline base according to pressor effect observed (see SmPC for details). Continue infusion until adequate blood pressure and tissue perfusion maintained without therapy. Carefully monitor patient. Should only be administered by healthcare professionals familiar with use of noradrenaline and with appropriate monitoring facilities. Avoid abrupt infusion withdrawal; reduce infusion gradually. No experience in treatment of hepatic or renal impairment. Dose selection for an elderly patient should be cautious, starting at the low end of the dosing range. Safety and efficacy in patients less than 18 years old has not been established. Method of administration – Intravenous use only after dilution. Infuse at a controlled rate using either syringe pump, infusion pump or drip counter. Administer via a central venous catheter. If not using a central venous catheter administer into a large vein whenever possible, particularly an antecubital vein to minimize risk of ischemic necrosis. Avoid catheter tie-in technique if possible. Contraindications: Hypersensitivity to the active substance or to any of the excipients, hypotension due to blood volume deficit. Do not use with cyclopropane and halothane anaesthetics as this may cause serious cardiac arrhythmias including ventricular fibrillation. Special warnings and precautions for use: Do not use undiluted. Contraindicated in patients who are hypotensive from blood volume deficits except as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed. Should only be used in conjunction with appropriate blood volume replacement. If whole blood or blood plasma is indicated to increase blood volume, administer separately (e.g. use Y-tubing, individual containers). Prolonged administration may result in plasma volume depletion which should be continuously corrected by appropriate fluid and electrolyte replacement therapy. Frequently check blood pressure and rate of flow to avoid hypertension. Particular caution in patients with coronary, mesenteric or peripheral vascular thrombosis, hypotension following myocardial infarction, angina (particularly Prinzmetal’s variant angina), diabetes, hypertension or hyperthyroidism, major left ventricular dysfunction associated with acute hypotension (supportive therapy should be initiated simultaneously with diagnostic evaluation; reserve noradrenaline for patients with cardiogenic shock and refractory hypotension, in particular those without elevated systemic vascular resistance), liver failure, severe renal dysfunction, ischemic heart diseases and elevated intracranial pressure. Reduce dose if heart rhythm disorders occur during treatment. Cardiac arrhythmias may arise when used in conjunction with cardiac sensitizing agents and may be more likely in patients with hypoxia or hypercarbia. Elderly patients may be especially sensitive to the effects of noradrenaline. Not recommended in children. Where indicated, appropriate replacement therapy of blood or fluid together with adoption of the supine position with elevation of the legs, must be instituted and maintained prior to and/or during therapy with noradrenaline. During infusion, record blood pressure every two minutes from the time the administration started until the desired blood pressure is obtained and then every five minutes thereafter if infusion continued. Constantly watch flow rate and never leave patient unattended. Hypertension may eventually lead to acute pulmonary oedema, arrhythmia or cardiac arrest. Caution in patients receiving pressor amines with chloroform, enflurane or other halogenated anaesthetics (may cause serious cardiac arrhythmias) or any other cardiac sensitising agent or in patients who exhibit profound hypoxia or hypercarbia. Extreme caution in patients receiving monoamine oxidase inhibitors or within 14 days of cessation of such therapy and in patients receiving tricyclic antidepressants, adrenergic- serotoninergic drugs or linezolid. Overdoses or conventional doses in hypersensitive persons may cause severe hypertension with violent headache, photophobia, stabbing retrosternal pain, pallor, intense sweating and vomiting. The infusion site should be checked frequently for free flow. Care should be taken to avoid extravasation of noradrenaline tartrate into the tissues, as local necrosis might ensue due to the vasoconstrictive action of the drug (see SmPC for antidote for extravasation ischaemia). Blanching along the course of the infused vein warrants consideration of changing infusion site at intervals. Avoid administration via the veins of the leg in elderly patients or in those suffering from occlusive vascular diseases. Noradrenaline interacts with other medicinal products; some combinations are inadvisable or require additional precautions and close medical supervision – see SmPC. Undesirable effects: Anxiety, insomnia, confusion, weakness, psychotic state, transient headache, tremor, acute glaucoma, bradycardia, arrhythmia, electrocardiogram change, tachycardia, cardiogenic shock, stress cardiomyopathy, palpitations, increase in the contractility of the cardiac muscle resulting from the beta- adrenergic effect on the heart (inotrope and chronotrope), acute cardiac insufficiency, hypertension, peripheral ischaemia including gangrene of the extremities, plasma volume depletion with prolonged use, dyspnoea, respiratory insufficiency or difficulty, nausea, vomiting, paleness, scarification of the skin, bluish skin colour, hot flushes or skin redness, skin rash, hives or itching, retention of urine, extravasation, necrosis at injection site. Legal Category: POM Marketing Authorisation Number: PA2059/073/001 Marketing Authorisation Holder: Fresenius Kabi Deutschland GmbH; Else-Kröner Straße 1, 61352 Bad Homburg v.d.Höhe, Germany Further Information: See the SmPC for further details. Adverse events should be reported. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL - Dublin 2, Tel: +353 1 6764971, Fax: +353 1 6762517. Website: www.hpra.ie, E-mail: medsafety@hpra.ie. Adverse events should also be reported to Fresenius Kabi Limited via email Pharmacovigilance.GB@Fresenius-Kabi.com. Date of Preparation: January 2022 FPI-0041
Fresenius Kabi Limited Fresenius Kabi Ireland Unit 3B Fingal Bay Balbriggan, Co. Dublin Ireland Website: www.fresenius-kabi.com/ie/ Email: FK-enquiries.ireland@fresenius-kabi.com Phone: +353 (0)1 841 3030
Date of Prep: March 2022 Job Code: IE-IVF-2200006
Mental Health Impact on Hospital Workers
Findings from a research study exploring the mental health of Dublin’s general hospital staff during the COVID-19 pandemic revealed significant impacts on doctors, nurses and radiographers, including high levels of symptoms of posttraumatic stress disorder (PTSD), depression and suicidal thinking. The COWORKER Study, developed to investigate the mental health impact of the pandemic on Dublin general hospital staff and to help inform appropriate responses, involved researchers from Trinity College Dublin, St Patrick’s Mental Health Services and RCSI University of Medicine and Health Services. It was led by Declan McLoughlin, Research Professor of Psychiatry at Trinity and Consultant Psychiatrist at St Patrick’s Mental Health Services.
Staff in three large Dublin general hospitals (St James’s Hospital, Tallaght University Hospital and Beaumont Hospital) were invited to participate, with the study also aiming to provide an opportunity for doctors, nurses and radiographers to recognise if they have been experiencing mental health difficulties since the pandemic and to seek support if required. Among the key findings, which came from a cross-sectional anonymous survey of 377 Dublin healthcare staff during the third wave of the COVID-19 pandemic in early 2021, are: • 45% of respondents reported moderate or severe symptoms of post-traumatic stress disorder (PTSD)
• 52% of respondents reported low mood
• 13% of respondents reported thinking of ending their life over the previous week, and 5% reported planning to end their life.
The high levels of post-traumatic symptoms found in this study are higher than the current best international estimate for healthcare workers.
Staff also reported high levels of moral injury, which is the psychological distress experienced when one is forced to witness or perform acts that go against one’s ethical beliefs. This concept arose in military mental health research but has gained importance in research studying healthcare workers’ mental health due to COVID-19related scenarios. For example, healthcare workers may have had no option but to ration care when resources were scarce, or they may have had to stop family from visiting their loved ones due to restrictions.
Researchers also examined whether there were any differences in the levels of mental health difficulties between staff based on their roles. The findings show that doctors were significantly less likely to report symptoms of PTSD, low mood and moral injury than nurse or radiographers, while radiographers were significantly more likely to report low mood. Speaking about the impact of the findings, Declan McLoughlin, Research Professor of Psychiatry at Trinity and Consultant Psychiatrist at St Patrick’s Mental Health Services, said: “The pandemic has presented immense challenges for hospitals, their staff, patients and families. While there have been many studies internationally examining the psychological impact on hospital staff, this is the first to examine the impacts on those working in Dublin hospitals. “We hope that the study’s findings will highlight potential areas of concern for hospital management and staff so that they can address this and seek support as required.” Lead author of the study, Dr Conan Brady, Trinity College Dublin, said: “The results of the COWORKER study have shown the significant mental health impacts of the pandemic for those working in hospitals. While we do not know the full extent of the mental health experiences for hospital staff before COVID-19, there are many pandemic-related factors that may have impacted on this cohort’s mental health.
“In addition to the restrictions we’ve all faced, other reasons could be job stress or concerns about stigma from working in environments with high levels of COVID-19. There are few data on suicidal ideation in hospital staff internationally, and this warrants more investigation.” The results of the peer-reviewed study have been published as an Open Access paper in the Irish Journal of Medical Science.
Chickenpox Vaccine Schedule
The Health Information and Quality Authority (HIQA) has published the protocol for its newest health technology assessment (HTA) of the addition of the chickenpox (varicella) vaccine to the routine childhood immunisation schedule. The protocol describes the approach that HIQA's team will use to complete this piece of work. HIQA agreed to undertake this HTA following a request from the Department of Health. The request was supported by the National Immunisation Advisory Committee (NIAC). Varicella-zoster virus can cause two clinical syndromes: chickenpox, as a result of primary (initial) infection, and shingles, which typically occurs in later life due to reactivation of the virus. Chickenpox is a common infectious disease that mainly affects children; one case of chickenpox can potentially infect 10 to 12 people. Within EU/EEA countries, the annual incidence of chickenpox is typically equivalent to the birth cohort; the total number of births in Ireland annually is approximately 56,000. Dr Conor Teljeur, HIQA's Chief Scientist said: “A vaccine for chickenpox was first developed almost 50 years ago. Over the last 30 years, a growing number of countries around the world have added the chickenpox vaccine to their routine childhood immunisation schedules. In Ireland, the vaccine is currently recommended for non-immune individuals in certain risk groups. Our assessment will examine the impact of adding the vaccine to the childhood immunisation schedule.”
Waiting Lists Continue to Increase
The Irish Hospital Consultants Association (IHCA) has warned that the ongoing shortage of Consultants across many specialties in the North-East together with public hospital capacity deficits is restricting patients from accessing timely, high-quality medical and surgical care and is contributing massively to growing waiting lists and poorer health outcomes. New analysis from the IHCA shows that between the period May 2015 to May 2022, an additional 7,966 (+31%) people have been added to outpatient waiting lists across the NorthEast, with 33,468 now waiting for assessment. A further 2,742 patients are on inpatient/day case waiting lists and another 2,144 are waiting for GI endoscopies. This means there are 38,354 people across Counties Cavan, Monaghan, Louth and Meath waiting for public hospital inpatient/day case treatment, GI endoscopies or an outpatient appointment with a Consultant. Our Lady’s Hospital Navan has experienced the largest growth, with the main waiting lists there having almost doubled since 2015 to 8,700. The number of ‘long waiters’ at Navan have increased significantly, with 91 patients now waiting longer than a year for inpatient or day case treatment compared with zero patients seven years ago. The busiest hospital in the region, Our Lady of Lourdes in Drogheda, has seen its Outpatient waiting list increase by almost 3,500 (+30%) in the past seven years to almost 15,000. Drogheda consistently has one of the largest number of patients in any hospital who are medically fit for discharge but whose discharge is delayed. Patients presenting to its Emergency Department also faced a 9-hour average waiting time for admission in May.
The worst affected Specialties
Almost 4,500 additional people in the region waiting for an outpatient appointment with a hospital Consultant in four specialties, an increase of 41% since 2015, the analysis has revealed. The four specialties of Orthopaedics, Dermatology, Gynaecology and Rheumatology have some of the largest waiting lists and combined they account for close to half (46%) of all those waiting to be assessed by a hospital Consultant in the region. These patients run the risk of either a delayed diagnosis of skin and other cancers or may be living with increased pain while awaiting hip or knee surgery or treatment for arthritis.
These lists (seen below) have also seen some of the largest increases since 2015 - an average increase of 41%.
Orthopaedics alone accounts for 15% (5,064) of the entire Outpatient waiting lists at the four North-East hospitals. Louth County Hospital in Dundalk has seen a 127% increase in its Orthopaedic Outpatient waiting list, with an additional 833 people added since 2015, while Our Lady's Hospital, Navan and Our Lady of Lourdes, Drogheda have both seen a 28% increase over the same period. Many of these people will later go on separate inpatient waiting lists if they require hip or knee replacements. Commenting on the waiting lists, IHCA President Professor Alan Irvine, said, “The severe shortage of Consultants across the NorthEast is the main contributor to the unacceptable delays in providing care to patients. Growing waiting lists demonstrate the impact of years of Consultant shortages and underinvestment in capacity across these public hospitals. “We have a chronic recruitment and retention crisis with 22% of all approved Consultant posts nationally either vacant or filled on a temporary or agency – 838 posts in total. This increases to 26% in the North-East.
“The unprecedented level of Emergency Department presentations in recent months and the continued impact of the number of patients hospitalised with Covid-19 has meant further cancellations of surgical activity and outpatient appointments in the North-East and nationwide, which in turn will only increase the waiting lists further and lead to poorer clinical outcomes for patients. There were 281cancelled appointments in April alone at the four North East hospitals. “In addition, just 68 (8%) of the 829 additional acute beds that were provided nationally over the past two-and-a-quarter years were in the four hospitals in the North-East. Health service management needs to progress practical plans to significantly expand hospital capacity in the North-East, and throughout the country, at a much faster pace and without further delay. “The Government must make good on its promise to provide the extra beds, extra Consultants and extra facilities which are badly needed to meet the healthcare needs of the 38,000 people currently on waiting lists at hospitals in the North-East. “To achieve that end, the Consultant contract talks which resumed last week must honour the ‘unambiguous commitment’ made by the Minister for Health to end the pay discrimination imposed on Consultants contracted since 2012. This and more competitive terms and conditions are crucially important to recruit and retain the increased number of hospital Consultants required to provide timely care to the 902,000 people waiting for hospital care across the country.”
Dr Alan Irvine, President, Irish Hospital Consultant's Association
Specialty North-East Outpatient Waiting Lists May 2015 North-East Outpatient Waiting Lists May 2022 Change
Orthopaedics 4,023 5,064 +26%
Dermatology 3,487
Gynaecology 2,712
Rheumatology 664
Total 10,886 4,728
3,420
2,153
15,365 +36%
+26%
+224% - more than a 3-fold increase
+41%
