IPN 2020 April

April 2020 Volume 12  Issue 4 PHARMACYNEWSIRELAND.COM

THE INDEPENDENT VOICE OF PHARMACY

THANK YOU

In this issue: NEWS: Pharmacy stockpiling concerns Page 5

PROFILE: Pharmacy at the Forefront of COVID-19 Battle Page 9

BLOG: Listen to the Science on Covid-19 says IPHA Page 14

REPORT: The value of placements to Pharmacy students Page 20

CPD: Management of Sleep Disorders Page 35

To the Pharmacists, Pharmacy Technicians, Counter Assistants, Suppliers, Wholesalers and all Healthcare workers at the frontline of the COVID-19 Pandemic

OTC AWARDS: Winner details of the 2020 Awards Page 40

EDUCATIONAL: Working through Arthritis Page 66

Contains nicotine

“I quit smoking for her” Fergus O’Shea

Help smokers quit with an

unbeatable

combination* from

Mini ON THE GO CRAVING RELIEF

*Provides significant improvements in quit rates vs patch alone. Stead LF et al. 2012 Nicotine replacement therapy for smoking cessation, Cochrane Library.

IRE/NIQ/2019-001

Patch FOR 24 HOUR CONTROL

+

NiQuitin CLEAR 24 hrs transdermal patches are indicated for the relief of nicotine withdrawal symptoms including cravings as an aid to smoking cessation. Indicated in adults and adolescents aged 12 years and over. NiQuitin patches should be applied once a day, at the same time each day and preferably soon after waking and worn continuously for 24 hours. Apply a patch to non-hairy clean dry skin surface, a new skin site should be used every day. Therapy should usually begin with NiQuitin 21 mg/24 hrs and reduced according to the following dosing schedule: Step 1 NiQuitin Clear 21 mg/24 hrs transdermal patches first 6 weeks. Step 2 NiQuitin Clear 14 mg/24 hrs transdermal patches next 2 weeks. Step 3 NiQuitin Clear 7 mg/24 hrs transdermal patches last 2 weeks. Light smokers (e.g. those who smoke less than 10 cigarettes per day) are recommended to start at Step 2 (14 mg) for 6 weeks and decrease the dose to NiQuitin 7 mg/24 hrs for the final 2 weeks. Contraindications: Non-smokers, hypersensitivity, children under 12 years and occasional smokers. Precaution: Supervise use if hospitalised for MI, severe dysrhythmia or CVA, if haemodynamically unstable. Use with caution in patients with active oesophagitis, oral and pharyngeal inflammation, gastritis, peptic ulcers, GI disturbances, susceptible to angioedema, urticaria, renal/hepatic impairment, hyperthyroidism, diabeties, phaeochromocytoma, seizures & epilepsy. Discontinue if severe persistent skin rash. Pregnancy and lactation: Oral formats preferable to patches unless nauseous. Remove patches at bedtime. Side effects: Transient rash, itching, burning, tingling, numbness, swelling, localised pain urticaria, hypersensitivity reactions. headache, dizziness, tremor, sleep disorders, nervousness, palpitations, tachycardia, dyspnoea, pharyngitis, cough, nausea, vomiting dyspepsia, upper abdominal pain, diarrhoea, constipation, dry mouth, sweating, dermatitis, photosensitivity, arthralgia, myalgia, asthenia, malaise, influenza-type illness, fatigue, seizures and anaphylaxis. Legal classification: GSL: PA 1186/18/4, PA 1186/18/5 & PA 1186/18/6. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland. http://www.medicines. ie/medicine/12136/SPC/NiQuitin+CLEAR+7+mg+24+hours++transdermal+patch/ http://www.medicines.ie/medicine/12137/SPC/NiQuitin+CLEAR+14+mg+24+hours+transdermal+patch/ http://www. medicines.ie/medicine/12138/SPC/NiQuitin+CLEAR+21+mg+24+hours+transdermal+patch/ NiQuitin Mini 1.5mg/4mg Mint Lozenges are used for the treatment of tobacco dependence by relief of nicotine withdrawal symptoms and cravings. Indicated in adults and adolescents aged 12 years and over. NiQuitin Mini 1.5 mg are suitable for those who smoke who smoke 20 cigarettes or less a day.

NiQuitin Mini 4 mg are suitable for smokers who smoke more than 20 cigarettes a day. Place a lozenge in the mouth whenever there is an urge to smoke, allow to dissolve completely. Do not chew or swallow whole. Abrupt cessation: Use a lozenge whenever there is an urge to smoke, maximum of 15 lozenges a day. Continue for up to 6 weeks, then gradually reduce lozenge use. Gradual cessation: Use lozenges whenever there is an urge to smoke in order to reduce the number of cigarettes smoked for up to 6 weeks, followed by abrupt cessation. Adolescents (12-17 years): Only with advice from a healthcare professional. Contraindications: Hypersensitivity to nicotine or any of the excipients, children under the age of 12 years and non-smokers. Precaution: Supervised use in dependent smokers with a recent myocardial infarction, unstable or worsening angina pectoris including Prinzmetal’s angina, severe cardiac arrhythmias, uncontrolled hypertensions or recent cerebrovascular accident. Use with caution in those with; stable cardiovascular diseases, diabetes mellitus, susceptiblity to angioedema & urticaria renal/hepatic impairment, phaeochromocytoma & uncontrolled hyperthyroidism, GI disease & seizures.

Side effects: Nausea, mouth/throat and tongue irritation, irritability, anxiety, sleep disorders, dizziness, headaches, cough, sore throat, dyspnoea, vomiting, diarrhoea, GI discomfort, flatulence, hiccups, heartburn, dyspepsia, nervousness, depression, palpitation, rash, angioedema, pruritus, erythema, hyperhidrosis, fatigue, malaise chest pain, anaphylactic reactions, hypersensitivity, tremor, dysgeusia, paresthesia mouth, seizures & epilepsy, dysphagia, eructation, salivary hypersecretion, pharyngitis. http://www.medicines.ie/medicine/14493/SPC/NiQuitin+Mini+1.5mg+mint+lozenges/#PRODUCTINFO http://www.medicines.ie/medicine/14492/SPC/NiQuitin+Mini+4mg+mint+lozenges/ Legal classification: GSL: PA 1186/18/11 & PA 1186/18/12. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland.

3

Contents

Foreword

Page 5: Collaboration is Key to Covid-19

Ireland's community pharmacists are at the frontline in the fight against the novel coronavirus disease (COVID-19) and they are doing everything in their power to support their patients and to support their allied healthcare professionals.

Page 6: Ireland's wholesalers working together on supply Page 9: Pharmacy at the coalface of COVID-19 Page 12: How is Industry tackling Covid-19?

Page 14: Trust the Science says Bernard Mallee Page 18: Pharmacies taking the right steps in Covid-19 battle Page 40: Winners of the OTC Retail & Pharmacy Product Awards 2020

5 #OurPharmacy

#OurPharmacy Heroes Heroes

9

Page 69: New appointment at IPHA

PUBLISHER: IPN Communications Ireland Ltd. Clifton House, Fitzwilliam Street Lower, Dublin 2 00353 (01) 6690562

32

40

ADVERTISING EXECUTIVE Amy Evans: amy@ipn.ie

DESIGN DIRECTOR Ian Stoddart Design PHARMACYNEWSIRELAND.COM @Irish_PharmNews IrishPharmacyNews

On page 12 we detail all the investments and innovations being carried out by the pharmaceutical industry in the fight against COVID-19. These are numerous and varied and demonstrate ongoing dedication in this field, whilst on page 14 Bernard Mallee of the Irish Pharmaceutical Healthcare Authority says, "The pandemic is a lesson in many things. Among them is how interdependent we are. When all this is over, we will need to look at how embedded is the cooperation and how structured is the collaboration between industry and policy leaders."

Award-winning start-up, e-learning specialist and IPN Training Partner, 4FrontPharmacy.ie has created a solution to overcome the various barriers being presented by COVID-19 and enable pharmacies safely respond to this unprecedented global crisis.

Through its online training platform. Turn to page 68 for this Business Continuing Professional Development Module.

On page 32 we detail how a team of researchers at NUI Galway is examining an existing study of interventions for patients with community acquired pneumonia which is rapidly being repurposed to examine COVID-19 patients. This study is being revised and repurposed to enable healthcare professionals to offer novel emerging therapies to the sickest patients.

EDITOR Kelly Jo Eastwood: 00353 (87)737 6308 kelly-jo@ipn.ie

CONTRIBUTORS Rachel Dungan, MPSI Amy Oates, MPSI David McLean

Some of Ireland's leading pharmacy chains have said they are taking steps to maintain safe and steady supply of medicines and healthcare services . Prescription ordering services through a mobile app have also doubled in the past two weeks.

CarePlus Pharmacy says it has seen a sharp increase use of its App Prescription Ordering Services, as communities across Ireland stick to social distancing.

Pharmacy students are also being called to the frontline to help out in their communities, and the PSI is curently investigating ways in which they can regulate this. On page 16, Lauren O'Reilly from the Irish Pharmacy Students Association talks to readers about the value of community pharmacy workplace learning.

MANAGING DIRECTOR Natalie Maginnis n-maginnis@btconnect.com

ADVERTISING DIRECTOR Debbie Graham: 00353 (87) 288 2371 debbie@ipn.ie

In this difficult situation it is important to maximise the use of community pharmacy practice to meet patients’ needs and maintain continuity of services. Community pharmacists should be enabled to offer rapid, effective and safe solutions related to the ongoing and possible worsening of shortages of medical equipment and medicines.

Irish Pharmacy IRISH News is PHARMACY circulated to all NEWS independent, multiple Pharmacists and academics in Ireland.

All rights reserved by Irish Pharmacy News. All material published in Irish Pharmacy News is copyright and no part of this magazine may be reproduced, stored in a retrieval system or transmitted in any form without written permission.

IPN Communications Ltd. has taken every care in compiling the magazine to ensure that it is correct at the time of going to press, however the publishers assume no responsibility for any effects from omissions or errors.

In other news, we feature the winners from the 2020 OTC Pharmacy & Retail Product Awards. Whilst we were disappointed not to be able to hold our annual Award event, our entrants were delighted with the results, turn to page 40 for all the details of the OTC products leading the way in their respective categories.

Until the next isue, keep safe and Thank You to all the pharmacists, technicians, counter assistant, suppliers and healthcare workers tirelessly working on the ground to protect the health of the nation!

Regulars FEATURE: INHALER TECHNIQUE

P28

EDUCATIONAL: ARTHRITIS

P33

CPD: SLEEP DISORDERS

P35

BUSINESS: BUSINESS CPD

P66

4

News

Pharmacy changes working practice

HPRA Covid-19

Many community pharmacies across Ireland are changing their working practices in the face of the COVID-19 outbreak.

The vast majority of HPRA staff are currently working remotely.

This is in line with government advice which aims to slow down the spread of the infection.

Dave McFadden Pharmacist, McFadden's Pharmacy Dublin

our teams the time to advance prepare prescriptions and replenish stock, so that we can continue to serve your local communities.”

Perspex shields are also being brought into stores across the country in order to protect staff and customers.

"We are rolling these out as fast as we can to protect our staff and our customers,” they add.

OTC Sales

Smal changes are being implemented across many stores to allow for social distancing measures and opening times.

Boots stores across the country are operating with different opening hours and small health alterations due to the pandemic.

A spokesperson said, "Currently all our stores are open but some stores may have altered their usual opening hours." Customers are being urged to observe social distancing, particularly during busy periods, to try and limit the spread of coronavirus (COVID-19).

They have also set a limit on nine types of products including pain relief, tissues and cough/ cold products.

A dramatic increase in sales of over the counter medications such as paracetamol and ibrupofen as people became “spooked” by the coronavirus outbreak has eased and supplies remain solid, pharmacists and producers have said.

“We saw a big spike in sales of over the counter medication in the 10 days up until last Monday,” said Tony McEntee, Managing Director of the McCauley Health & Beauty Pharmacy Group.

“There was a bit of panic buying.

People were definitely spooked a bit and every time there was a bit of bad news we saw a spike but that demand has been sated and we are back to normal,” he said.

“Our level of over the countrer medications in stock yesterday was no different to the same day last year. And I am not aware of any shortages coming down the line.”

All McCabes pharmacies are operating on different opening hours.

Pharmacist Dave McFadden, who owns a shop on Prussia Street in Dublin, said “things are holding up fine” and “it is just a matter of people not panicking.

A spokesperson said, "During this time of National Emergency our stores will open a little later or close a little earlier, to allow

“Wholesalers are keeping the flow going and we are getting our normal two deliveries a day,” he said.

“There was a bit of panic buying. People were definitely spooked a bit and every time there was a bit of bad news we saw a spike but that demand has been sated and we are back to normal” A spokewoman for GlaxoSmithKline, which makes Panadol, said the company had “experienced an increase in demand for some of our products.”

However, she said the company had plans in place “which includes measures to help secure reliable supply, such as holding strategic stock and dual sourcing.”

She said GSK took “the resilience and continuity of our supply chains very seriously, and we draw on our extensive experience to try and mitigate issues affecting supply.”

David Delaney of Medicines for Ireland, the representative body for the Irish pharmaceutical trade sector, said the country was well stocked and there was no need for people to stockpile or overpurchase.

He said planning for Brexit in recent times meant the sector was well placed to cope with the pandemic.

He also added that it was business as usual for the sector and there was no evidence to suggest that Ireland would face any general medicine supply issues.

Calling all Pharmacists The Irish Pharmacy Union is asking any pharmacist who is willing to make themselves available for emergency cover to pharmacies, who may be short staffed as a result of Covid-19, to send them a message with your name, PSI number, phone number and email address. They will then include you on a list to their members.

PHARMACYNEWSIRELAND.COM

During this period, please correspond with them by e-mail using existing HPRA staff e-mail contacts or via relevant mailboxes. Please also see additional details, including emergency contacts, on their website.

Until further notice, their main contact phone number is unavailable. They also request that you do not correspond with them by post as they will have limited access to physical mail sent to their offices.

HPRA have implemented business continuity measures to maintain HPRA operations and ensure minimal disruption to services. Their focus is to continue to operate business as usual, where possible, while protecting the health of their staff and stakeholders.

A limited number of staff will be present at our offices to ensure continuity of critical business processes which have to be performed on site. Since last week, all face-to-face meetings have been cancelled and will be conducted by phone where possible.

Our plans are being continually reviewed and we will update you as the situation develops.

For the latest COVID-19 regulatory advice and information relating to health products, see hpra.ie/covid19.

Meanwhile, pharmacists should remind remind patients and their carers of the Emerade product recall from September 2019.

Emerade is a medicine used for the emergency treatment of severe acute allergic reactions (anaphylaxis).

The recall is necessary as some Emerade pens may fail to produce an injection when used, due to failure of the pen to activate and the potential for a blocked needle.

The company, Bausch Health, has informed the HPRA that not all pens impacted by the recall have been returned to pharmacies as requested in September last year.

The recall relates to all in-date batches of: Emerade 150mcg pre-filled pens Emerade 300mcg pre-filled pens Emerade 500mcg pre-filled pens

News Pharmapod partner with IPU In support of pharmacies and their teams and to safeguard patients at this busy time, Pharmapod has partnered with the Irish Pharmacy Union to provide free access to Pharmapod's Incident Management solution for pharmacies in Ireland throughout the COVID-19 pandemic.

Pharmacists can register by visiting: https://go.pharmapodhq. com/l/478652/2020-03-20/f4h9v Pharmapod’s solution is deployed virtually and your pharmacy can be up and running in minutes. Cloud-based, it can be accessed from the pharmacy or from home - and it helps with team collaboration in the same or multiple locations.

This initiative includes access to: - Medication Incident Management; - Near-miss reporting; - Pharmacy Incident and case management; - Analytics and benchmarking - Training & onboarding for pharmacy teams; - On-going customer success support and live chat; - Membership of a growing community of pharmacy professionals around the globe pooling their learning and driving change.

A statement from Pharmapod says, “We would like to take this opportunity to thank pharmacists and their teams for their dedication and commitment to providing such an exemplary service to the public at this time and always.”

The Pharmapod Solution is a smart, intuitive and professionspecific platform designed to facilitate effective compliance with pharmacy legislation and complement the workflow within the pharmacy, reducing the risk of litigation through error prevention.

It enables pharmacists to systematically record medication-related incidents and risks in practice and carry out effective root-cause analysis.

The system analyses the collated data and disseminates the learning back to the profession and to key stakeholders internationally, preventing recurrence of patient harm.

5

Collaboration key in combatting Covid-19 In what has already been dubed 'Year of the Mask' Covid-19 hit Ireland with a bang. As Irish Pharmacy News went to press, there were 1329 confirmed cases. Further details on this are detailed on page 10.

Meanwhile, many thoughts have been shared on ways of working within healthcare to help combat the spread. One suggestion, IPN has learned, was from a former senior health official which details greater collaboration between GPs and Pharmacists..

The proposal was that as an emergency measure, pharmacists should be empowered to issue repeat prescriptions for people.

The case is made that it would save many patients, especially the elderly, having to contact their GP to get a repeat prescription,

especially if nothing has really changed medically for them.

of course abiding by the social distancing rules.

The Irish Pharmacy Union support the idea, which has already been approved for medical card holders.

It is also believed that efforts are under way for wider roll-out of an electronic prescription service, involving GPs and pharmacists.

Under the Irish health system, GPs share patient care with pharmacists. This change to allow pharmacists issue repeat scripts during a time of emergency could also increase social interaction especially for older people, getting repeat prescriptions filled, as some of these would be delivered to their homes, with everyone

During this emergency new ways of working are inevitable and have already happened. Redeployment is under way, retired staff are coming back to help in this hour of need, as are medical and nursing students. It is one of the more encouraging aspects of the Covid-19 crisis and part of the legendary Irish spirit.

Increasing violence against pharmacy Interim guidance from the HSE has asked community pharmacists to consider asking patients with respiratory complaints to wait in their car while a prescription is filled out and to place a phone in consultation rooms in light of the coronavirus pandemic.

Pharmacies across Ireland like McGreals Blessington - pictured here - are employing strict hygiene measures for the safety of their staff and customers Irish Pharmacy news has learned of increasing numbers of reports that pharmacy staff are experiencing abuse, disorder and even violence at the hands of some of the members of the public they are trying to help.

Darragh O’Loughlin of the Irish Pharmacy Union says, "Abuse of pharmacy staff is never acceptable. Pharmacy is a key part of the national response and its workforce are entitled to be treated with the same respect as other key healthcare professionals.

“This is an especially challenging time for the pharmacy profession and we condemn any abuse.

“Pharmacies and pharmacy professionals are working on the frontline, under significant pressure, to support the public and patients during the Covid-19 pandemic.”

Since the start of the pandemic, some pharmacy staff have been verbally abused when telling patients they were not able to source a certain product for them, a pharmacist working near Lucan who wishes to remain anonymous told IPN. Patients complain, for instance,

when “they’ve been told to go and pick up the prescription from the pharmacy but there’s no prescription in the pharmacy because it hasn't arrived.”

The IPU also said that “many pharmacy teams have reported an increase in abuse, violence and aggression from some members of the public.”

Issued by the HSE and Health Protection Surveillance Centre, the guidance asked pharmacists to consider how they can limit the exposure of other customers without causing “undue distress or embarrassment” to a potential patient.

Pharmacists have been asked to consider how they might rapidly identify and direct individuals who present with respiratory complaints and who ask for a consultation.

The advice says that consideration should be given to asking patients with respiratory tract infection to wait in their car while their prescription is being filled, if they travelled by car.

The advice also says that there should be a “clearly designated area” for consultations and that pharmacists should check if that area allows for a physical separation of one metre.

“If possible consider having a telephone available in the room so that consultation can be carried out over the phone.”

Consideration should also be given to texting customers advising those with a relevant travel history or respiratory symptoms not to attend the pharmacy in person but to call in advance.

PHARMACYNEWSIRELAND.COM

6

News

Wholesalers working to meet demand During the beginning of the outbreak, wholesalers say they struggled to keep up with demand from pharmacies.

Ger Rabbette, Group CEO, Uniphar

centres, additional transport capacity to our distribution network, some redeployment of sales and administrative teams to assist with operational activities and recruitment of temporary staff across a range of customer facing roles.

'We will continue to review all aspects of our operations in an effort to further improve our service levels and offering.'

However they have been working tirelessly to overcome the obstacles. Medicines wholesaler United Drug has said that throughout the crisis they have experienced unprecedented demand for the supply of prescription and OTC medicines.

They told Irish Pharmacy News, 'Whilst volumes were almost double our normal levels, we expect activity levels will reduce over the coming weeks. Our stock levels are steadily improving and we continue to work hard to further improve the situation and support our customers.

Paul Reilly CEO of United Drug added, “We are committed to maintaining continuity in the supply and distribution of medicines across Ireland at this challenging time. Meeting the needs of patients and customers remains our number one priority. Our operations and the wider support teams are working tirelessly to ensure the continuity of critical medicine supplies.

'Our focus has been on ensuring an equitable service and supplies to Retail Pharmacies and Hospitals and whilst we had to impose some restrictions on a range of sensitive, Ethical and OTC products, the vast majority of the allocations have now been removed.

'New measures have been put in place to meet the increased demand including additional and extended shifts in all distribution

"All of the sites remain fully operational. The wellbeing of staff across warehouses, and offices is critically important and measures have been put in place to maintain a healthy business operations and work environment. We are working closely with the HSE, Department of Health and the Health Products Regulatory Authority to adhere to latest guidelines and protocols.

We have control measures in place to mitigate the risk of COVID-19 infection and have issued PPE to staff, where appropriate, for their health and safety.”

Uniphar said that it has seen a significant spike in demand across all of its three divisions as the government and the wider healthcare sector ramp up preparations to deal with the forecasted increase in patients across Europe in the coming weeks. In a trading update, the Irish pharmaceuticals group said its business performance is ahead of its expectations and there has been limited disruption from the Covid-19 outbreak to its business up to now.

Uniphar said that as it prepares for the full impact of the Covid-19 crisis in the next 12 weeks, it expects to continue to see increased volumes across the group, with likely increases in cost to serve as it invests in additional resources to manage significantly higher volumes, while at the same time dealing with reduced availability of manpower due to potential sick leave or self-isolation/quarantine situations arising.

Paul Reilly, CEO, United Drug in Ireland

PMI Digital Series All of the current Pharmaceutical Managers Institute in-person events are postponed just now while everyone works remotely and does their bit to flatten the curve.

However they have said, "We still need to keep in touch with what's happening in the industry and hear directly from stakeholders. The PMI have you covered!

Next week we'll be launching our brand new series: PMI Digital. These will be in the same format as our breakfast meetings, just held online. Full details will be going to out to our members very shortly."

PHARMACYNEWSIRELAND.COM

Medicine Shortages The Health Products Regulatory Authority has been notified of a shortage of the following products: Becotide 50mcg Evohaler – PA1077/042/006 Cozaar Comp 100mg/12.5mg Film Coated Tablet – PA1286/001/001 Creon 25000 Gastro-Resistant Capsule – PA2010/008/002 Folinic acid 10mg/ml Solution for Injection (50mg/5ml presentation) – PA0822/198/003 Frisium 10mg Tablet – PA0540/043/001 Hypnovel 10mg/2ml Solution for Injection – PA2239/007/001 Pneumovax 23 Solution for Injection in Prefilled Syringe – PA1286/055/002 Prozamel 20mg Capsule – PA0126/110/001 Rifadin 150mg Capsule – PA0540/066/001 Rifadin 300mg Capsule – PA0540/066/002 The following shortage has been resolved and supply has resumed to the Irish market: Ancontil 2.5g/250ml Solution for Infusion – PA2010/048/001 Caverject 10mcg Powder and Solvent for Solution for Injection – PA0822/115/002 Ciproxin 750mg Tablet – PA1410/028/014 Efexor XL 37.5mg Prolonged Release Capsule – PA0822/072/001 Frumil 40mg/5mg Tablet – PA0540/101/002 Gerax 0.25mg Tablet – PA0577/010/001 Logynon Tablet – PA1410/005/001 Noxafil 300mg/ml Concentrate for Solution for Infusion – EU/1/05/320/004 Temodal 100mg Capsule – EU/1/98/096/015

Genuair -has it ‘clicked’ yet? ®

The ONLY prefilled inhaler with visual and audible feedback for confirmed dose delivery 1-4

Genuair - a simple to use inhaler for patients with COPD 4

LAMA + LABA

LAMA Abbreviated Prescribing Information Eklira® Genuair® 322 micrograms inhalation powder. Please consult the Summary of Product Characteristics (SPC) for the full prescribing information. Presentation: Inhalation powder in a white inhaler with an integral dose indicator and a green dosage button. Each delivered dose contains 375 µg aclidinium bromide equivalent to 322 µg of aclidinium. Also, contains lactose. Use: Maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD). Dosage: For inhalation use. Recommended dose is one inhalation of 322 micrograms aclidinium twice daily. Patients should be instructed on how to administer the product correctly as the Genuair inhaler may work differently from inhalers used previously. It is important to instruct the patients to read the Instructions for Use in the pack. No dose adjustments are required for elderly patients, or those with renal or hepatic impairment. No relevant use in children and adolescents.

Contraindications: Hypersensitivity to aclidinium bromide or to any of the excipients. Warnings and Precautions: Stop use if paradoxical bronchospasm occurs and consider other treatments.

Do not use for the relief of acute episodes of bronchospasm. Use with caution in patients with myocardial infarction in the previous 6 months, unstable angina, newly diagnosed arrhythmia within the previous 3 months, or hospitalisation within the previous 12 months for heart failure functional classes III and IV. Dry mouth, observed with anticholinergic treatment, may be associated with dental caries in the long term. Use with caution in patients with symptomatic prostatic hyperplasia or bladder-neck obstruction or with narrow-angle glaucoma. Do not use in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.

Interactions: Do not administer with other anticholinergic-containing medicinal products. No other interactions expected. Please consult the SPC for more details. Fertility, pregnancy and lactation: No data on use in pregnancy. Risk to newborns/infants cannot be excluded. Consider risk-benefit before using during lactation. Unlikely to affect fertility at the recommended dose. Side-effects: Common (1-10%): Sinusitis, nasopharyngitis, headache, cough, diarrhoea, nausea. Uncommon (0.1- 1%): Dizziness, blurred vision, tachycardia, palpitations, dysphonia, dry mouth, stomatitis, rash, pruritus, urinary retention. Rare (0.01-0.1%): hypersensitivity. Not known: angioedema, anaphylactic reaction. Pack sizes: Carton containing 1 inhaler with 60 unit doses. Legal category: POM Marketing Authorisation Number: EU/1/12/778/002 Marketing Authorisation holder: AstraZeneca AB, SE151 85 Södertälje, Sweden. Marketed by: A. Menarini Pharmaceuticals Ireland Ltd., Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin A96 T924. Further information is available on request to A. Menarini Pharmaceuticals Ireland Ltd. or may be found in the SPC. Last updated: May 2018

This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions to: 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 A. Menarini Pharmaceuticals Ireland Ltd. Phone no: 01 284 6744.

Date of item: October 2019. IR-BRI-17-2019

References:

1. MIMS Ireland October 2019 2. Eklira Genuair Summary of Product Characteristics, last updated February 2018 3. Brimica Summary of Product Characteristics, last updated August 2019 4. Magnussen, H et al. COPD. 2019 Apr;16(2):196-205

Abbreviated Prescribing Information Brimica® Genuair® 340 micrograms/12 micrograms inhalation powder. Please consult the Summary of Product Characteristics (SPC) for the full prescribing information. Presentation: Inhalation powder in a white inhaler with an integral dose indicator and an orange dosage button.

Each delivered dose contains 396 µg aclidinium bromide (equivalent to 340 µg of aclidinium) and 11.8 micrograms of formoterol fumarate dihydrate. Also, contains lactose. Use: Maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD). Dosage: For inhalation use. Recommended dose is one inhalation of 340 µg/12 µg twice daily. Patients should be instructed on how to administer the product correctly as the Genuair inhaler may work differently from inhalers used previously. It is important to instruct the patients to read the Instructions for Use in the pack. No dose adjustments are required for elderly patients, or those with renal or hepatic impairment. No relevant use in children and adolescents.

Contraindications: Hypersensitivity to the active substances or to any of the excipients. Warnings and Precautions: Do not use in asthma. Stop use if paradoxical bronchospasm occurs and consider other treatments. Do not use for the relief of acute episodes of bronchospasm. Use with caution in patients with myocardial infarction in the previous 6 months, unstable angina, newly diagnosed arrhythmia within the previous 3 months, or hospitalisation within the previous 12 months for heart failure functional classes III and IV. Discontinue if increases in pulse rate, blood pressure or changes in ECG occur. Use with caution in patients with a history of or known prolongation of the QTc interval or treated with products affecting the QTc interval. Use with caution in patients with severe cardiovascular disorders, convulsive disorders, thyrotoxicosis and phaeochromocytoma.

Hypokalaemia may occur, is usually transient and supplementation not needed. In patients with severe COPD, hypokalaemia may be potentiated by hypoxia and concomitant treatment. Use with caution in patients with symptomatic prostatic hyperplasia, urinary retention or with narrow-angle glaucoma. Dry mouth, observed with anticholinergic treatment, may be associated with dental caries in the long term. Do not use in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Interactions: Do not administer with other anticholinergic and/or long-acting β2-adrenergic agonist containing medicinal products.

Caution in use with methylxanthine derivatives, steroids, non-potassium-sparing diuretics, β-adrenergic blockers or medicinal products known to prolong the QTc interval. Please consult the SPC for more details. Fertility, pregnancy and lactation: No data on use in pregnancy. Consider risk-benefit before using during lactation. Unlikely to affect fertility at the recommended dose. Sideeffects: Common (1-10%): Nasopharyngitis, urinary tract infection, sinusitis tooth abscess, insomnia, anxiety, headache, dizziness, tremor, cough, diarrhoea, nausea, dry mouth, myalgia, muscle spasms, peripheral oedema, increased blood creatine phosphokinase. Uncommon (0.1- 1%): Hypokalaemia, hyperglycaemia, agitation, dysgeusia, blurred vision, tachycardia, electrocardiogram QTc prolonged, palpitations, angina pectoris, dysphonia, throat irritation, stomatitis, rash, pruritus, urinary retention, increased blood pressure. Rare (0.01-0.1%): Hypersensitivity, bronchospasm, including paradoxical.

Not known: anaphylactic reaction, angioedema. Pack sizes: Carton containing 1 inhaler with 60 unit doses. Legal category: POM Marketing Authorisation Number: EU/1/14/963/001 Marketing Authorisation holder: AstraZeneca AB, SE-151 85 Södertälje, Sweden. Marketed by: A. Menarini Pharmaceuticals Ireland Ltd., Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin A96 T924. Further information is available on request to A. Menarini Pharmaceuticals Ireland Ltd. or may be found in the SPC. Last updated: October 2019 This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. 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 A. Menarini Pharmaceuticals Ireland Ltd. Phone no: 01 284 6744.

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News

Pharmacy taking 'right measures' in Covid battle Pharmacies taking steps to maintain safe and steady medicines supply, whilst some pharmacies have had to close their doors.

Some of Ireland's leading pharmacy chains have said they are taking steps to maintain safe and steady supply of medicines and healthcare services as COVID-19 crisis looms.

Prescription ordering services through a mobile app have also doubled in the past two weeks.

CarePlus Pharmacy says it has seen a sharp increase use of its App Prescription Ordering Services, as communities across Ireland stick to social distancing.

The numbers using the app, which was released in 2015 and has over 600 established regular users, have shot to more than 1,200 over the past fortnight.

Customers can send new or repeat prescriptions directly to their pharmacy through the app who they can then contact to organise collection of their medication.

Lee-Ann Hyland, Head of Marketing from CarePlus Pharmacy said: “Using technology like our App means that we can reduce the number of face-to-face transactions, and reduce the risk of spreading COVID-19.

“Community Pharmacy has an important role to play, and our CarePlus Pharmacists, along with other community Pharmacists, will not be found wanting.

“The increase in the number of App users means that people are

quickly adapting to this technology, and we encourage as many customers as possible to consider ways to minimise contact and still get the prescriptions they need.”

As people are stocking up on painkillers and hand sanitisers pharmacies have seen a surge in customers, forcing many to ration supplies.

“You might have noticed that we’ve set a limit on the number of certain items you can buy. Thank you for supporting us and appreciating these limits as we try to help as many people as possible,” Bernadette Lavery, Managing Director Boots Ireland said in a statement.

Bernadette said the chain continues to have stock in the supply chain of hand sanitisers and other high demand products like children’s medicine, pain relief and hygiene products. Hand sanitisers are being sent to stores each day to meet the “exceptional demand,” he added.

Boots will also offer free delivery of prescriptions for their online repeat prescription service.

In a separate statement, James appealed to the public to desist from panic buying.

“We ask our customers to speak to our teams for ways they can proactively manage their prescriptions if they are in self

Bernadette Lavery, Managing Director Boots Ireland isolation; and to only buy the medicines they need now so we can make sure as many people as possible can access the products they need,” he said.

in Parnell Street, Dublin., had to close its doors.

The pharmacy took to Facebook to let their customers know the news and tell them they would still be taking phone calls to assist in whatever they can.

Toby Anderson, Chief Executive of LloydsPharmacy parent McKesson UK, said the company has processes in place with suppliers and manufacturers to help minimise the impact of shortages and ensure a consistent supply of critical products.

A spokesperson said: “Unfortunately we have had to close our doors until 29/3/20 due to a positive COVID19 test result.

“Life Pharmacy beside Aldi at the ILAC Centre have generously offered to help look after any of our patients who need their medications during this time.

“Our priority is to make sure that everyone has access to the medication that they need, when they need it, so we are doing everything we can to ensure availability, despite increasing demand and supply challenges,” he said in a statement.

“I would like to apologise to all our patients for any inconvenience caused but it was our only option at this time.

Pharmacy Closure

“We will still be taking phone calls on 018746972 and will help in any way we can.”

Meanwhile, Irish Pharmacy News has learned that Foley's Pharmacy

IRISH PHARMACY AWARDS POSTPONED In light of the ongoing health crisis brought about by COVID-19, the decision has been taken by IPN Communications to postpone to 2020 Irish Pharmacy Awards.

The Awards were due to take place on May 23rd in the Clayton Hotel, Dublin but with the safety and health of our guests paramount and in light of the uncertain times faced by the nation, we have decided to postpone until later in the year.

For more than eight years, the Irish Pharmacy Awards have celebrated excellence in community pharmacy in Ireland. Now, more than ever, we are thankful and grateful of our hardworking and dedicated community pharmacies.

It is our greatest hope that we

can all come together later in the year to show our appreciation to them, their supply chains, the manufacturers and all concerned in delivering healthcare to our nation.

IPN Communications are working with event partners and suppliers to reschedule the event for a later date, precise timing and venue still to be determined based on the Covid-19 pandemic development and on venue.

Clonmel Corporate Ad 210x297mm_(new version).pdf

Not only will the event celebrate pharmacy teams and pharmacists, it will be an opportunity to say

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a huge thank you for all the hard work and support in these challenging times.

Deadline for applications to enter the awards is now extended until further notice and can be downloaded by visiting www. pharmacynewsireland.com.

28/02/2019

12:11

More details will follow in due course. Keep up to date with IPA announcements on our social media channels.

Twitter: @Irish_PharmNews Facebook: @IrishPharmacyNews

Profile

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Community Pharmacy at the COVID Coalface While Ireland remains in the grip of the global COVID-19 Pandemic, community pharmacies, pharmacists and their staff are at the facing battle on a daily basis.

Pharmacies across the country are remaining open and medicines continue to be available to treat patients.

There are 1,900 community pharmacies in Ireland, all working at the frontline of the health service in the fight against Covid-19. Pharmacists will continue to perform their vital role as a first point of contact for people with our health care system.

#OurPharmacy Heroes

The Irish Pharmacy Union has issued the following advice for pharmacists to give to patients:  Do not stockpile any medicine or purchase medication you do not need. One month’s supply of prescription medicines is the maximum quantity allowed by the HSE under the GMS or other Community Drug Scheme.  Individuals who require medication on a regular basis should ensure their prescriptions are up to date.  Patients or carers are asked, if possible, to phone the pharmacy in advance to request that their prescription be dispensed for a particular time/date so that the pharmacy can have it ready when they come in.  Check with elderly family members and neighbours to make sure they have their medicines and, if necessary, help them to contact the pharmacy if they need advice or information.  People who have been to an affected place in the last 14 days, or who have had contact with someone with coronavirus, or who are exhibiting fever, cough or other respiratory symptoms of Covid-19 should NOT attend at a pharmacy or GP clinic. Instead, they should stay at home and phone their GP or local HSE helpline without delay.

As Irish Pharmacy News went to press, the Health Protection Surveillance Centre was reporting that 17 patients diagnosed with COVID-19 in Ireland have died.

 8 deaths located in the east, 3 in the south, 3 in the north-west and 3 in the west of the country  Patients included 4 females and 13 males  Median age of these reported deaths is 84  8 patients were reported as having underlying health conditions There have now been 71 COVID-19 related deaths in Ireland.

The Health Protection Surveillance Centre has been informed of 325 new confirmed cases of COVID-19 in Ireland, as at 1pm, Tuesday 31 March.

There are now 3,235 confirmed cases of COVID-19 in Ireland.

Pharmacy Practices Community pharmacies have been putting a range of new working practices in motion over the last number of weeks. These

include aids for social distancing measures, perspex screens in front of shop and allowing only a select number of customers in the store at any one time.

Some of the largest pharmacy retail chains have rolled out new measures aimed at supporting vulnerable customers while limiting the need for physical contacts and ensuring people will not be left without essential medicines.

McCauley Health & Beauty Pharmacy has launched a smartphone app service to facilitate existing customers who wish to order medicines for home delivery. It will also allow doctors and new customers upload prescriptions directly to pharmacists. As we have already reported, CarePlus have also witnessed a huge increase in the numbers of consumers using their App. Meagher’s Pharmacy Group has started a helpline to deliver prescriptions nationwide to people

in need as “a direct result of listening to the fear in our elderly population these past two weeks”.

The pharmacists will aim to video calling patients “so that they see a human face who can offer them the expert advice and reassurance they need at this very lonely and worrying time for them”.

Customers will also be able to get prescriptions filled remotely by sending photographs of their prescriptions to local branches who organise delivery, along with other items including toiletries, vitamins and hand sanitisers.

Many other smaller pharmacies have also been delivering to their vulnerable customers since the scale of the crisis became clear in recent weeks.

Manufacturing of Medicines Across the country, the manufacture of medicines for global supply, as well as for patients here, continues.

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Profile For the health and safety of colleagues and customers, Hickey's Pharmacy Group have introduced a number of new measures to help during this unprecedented time

to stop the virus from replicating; anti-inflammatories that treat the lungs after the immune system is overwhelmed; and antibody-based treatments for seriously ill patients.

Manufacturing sites are operating, and the distribution and supply chains that bring medicines to patients continue to function.

In that sense, medicines manufacturing during COVID-19 is an ‘essential business’. This message has been relayed to the Government and it has been echoed in statements by the Taoiseach, the Minister for Business, Enterprise and Innovation and others.

The industry is working closely with the health authorities to closely monitor the supply chain.

There are no reports of shortages or supply disruptions caused by the pandemic. The industry fully supports the Government’s efforts to stop the spread of COVID-19.

Locally, companies are engaging with hospitals and charities to

identify ways they can help on a practical level.

Globally, biopharmaceutical innovators are searching for a vaccine and a treatment. A vaccine would protect people from the virus in the future. A treatment would help people who have it to get better. Usually, a vaccine takes an average of 2.5 years to develop. But the industry is working hard to have one much sooner than that. Vaccines save up to 3 million lives every year.

They protect people from often fatal diseases such as polio, measles, diphtheria, thyphoid and rubella. They have even eradicated smallpox. We want to add COVID-19 to that list.

Scientists are investigating three main types of drugs: antivirals

The industry globally is involved in collaborative research to fast-track the development of therapeutics and diagnostics for COVID-19. Many of these research and development efforts are in partnership with public health programmes like the Innovative Medicines Initiative, as well as with institutions like the European Medicines Agency and the World Health Organisation (WHO).

Here is a snapshot of how some companies are supporting efforts in the detection, prevention and treatment of COVID-19.

Pfizer, in partnership with BioNTech SE, is aiming to accelerate the development of BioNTech’s potential first-inclass COVID-19 mRNA vaccine programme, BNT162, which is expected to enter clinical testing by the end of April. In Italy, Pfizer pledged to make available for free medicines worth around ¤2.5 million.

GSK is donating US$10 million to the WHO and the UN Foundation’s COVID-19 Solidarity Response Fund to help prevent, detect and manage the pandemic. The company is expanding vaccines collaborations and evaluating existing medicines to determine whether any could be used beyond current indications.

Johnson & Johnson is searching for a vaccine, making existing antivirals available for testing,

'Take Good Care' has always been the motto at Meaghers and the importance of this is highlighted during these difficult times. Some of the measures introduced to help them include requesting that customers phone or email ahead for prescriptions, respect social distancing and cough/sneeze etiquette, reduce face-to-face interactions and order online where possible

PHARMACYNEWSIRELAND.COM

The fantastic team at Hayes & Hayes totalhealth Pharmacy, Portumna, who like many more totalhealth teams around the country, have implemented new protocol in store, to help curb the spread of infection and doing it all with a smile!

collaborating with industry partners to screen a library of antiviral molecules, working with health authorities and institutions on research platforms, and providing tools and personal equipment where it can.

MSD has donated a supply of interferon beta-1a (Rebif) to the French Institut National de la Santé et de la Recherche Médicale following a request for use in a clinical trial. The company has supported China’s fight against COVID-19 with multiple donations in cash and in kind to local charities.

Novartis is providing US$20 million in grants to support public health initiatives that help communities manage the pandemic. The company is involved in collaborative research efforts, as well as making available compounds from its libraries that are suitable for invitro antiviral testing.

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The team at Mangans Pharmacy Newbridge helping customers with a smile during these difficult times

You can hardly see it, but McCabes Pharmacy have perpex screens in front of all their tills

authorities as an experimental option to help tackle the outbreak there. The company is working with the World Health Organisation on a coordinated global response effort.

The team at McCartans Pharmacy are liaising with the local volunteers of Maynooth to ensure that the more vulnerable members of society are well looked after during this pandemic

The team at McCabes Pharmacy have been receiving written notes of thanks from their customers

Eli Lilly has partnered with AbCellera Biologics to codevelop antibody products for the treatment and prevention of SARS-CoV-2, the virus that causes COVID-19.

capabilities to scale up screening while research and development teams are working to identify monoclonal antibodies to progress towards clinical trial evaluation.

AstraZeneca is donating 9 million face masks to support healthcare workers around the world as they respond to COVID-19. The company is accelerating the development of diagnostic testing

Bayer has partnered with other manufacturers in the COVID-19 Therapeutics Accelerator Initiative, initiated by the Bill and Melinda Gates Foundation, to find and develop effective novel compounds against the virus.

AbbVie donated US$2 million worth of Aluvia to Chinese heath

The pharmacy staff in Allcare Perrystown and Rathfarnham Pharmacies getting deliveries ready for their local customers.

Allcare are providing a free local delivery service nationwide with priority given to self-isolating, at-risk and elderly people.

Sanofi Pasteur, the vaccines global business unit of Sanofi, is leveraging previous development work for a SARS vaccine as part of efforts to unlock a pathway for developing a COVID-19 vaccine.

Sanofi is using its recombinant DNA platform to produce a novel COVID-19 vaccine candidate.

Roche and Genentech, part of Roche, are providing scientific expertise and research and development advice to the WHO and other stakeholders.

The company is working with Chinese health authorities and the government to help provide screening and health care, including supporting local health officials and hospitals in the Hubei Province.

Takeda is initiating the development of a plasma-derived therapy, designated TAK-888, with the potential to treat hospitalised COVID-19 patients and to prevent infection in frontline healthcare workers.

Boehringer Ingelheim is working to develop neutralising antibodies against the SARS-CoV-2 spike protein. It is investigating existing pipeline and inmarket compounds, as well as compounds from former HIV and HCV research activities. The company has a joint fast-track call for project submissions to develop therapies and diagnostic tools initiated by the Innovative Medicines Initiative.

PHARMACYNEWSIRELAND.COM

12

News

How is Industry tackling COVID-19?

As COVID-19 spreads, biopharmaceutical innovators are at the heart of the fightback against the pandemic. The industry’s efforts are global.

In Ireland, the focus is in four main areas: 1. Ensuring the secure and continued supply of medicines to patients; 2. Securing business continuity in medicines manufacturing; 3. Helping the Government to manage the response through information-sharing; and, 4. Contributing to the search for a vaccine and a treatment.

Globally, biopharmaceutical innovators are searching for a vaccine and a treatment. A vaccine would protect people from the virus in the future. A treatment would help people who have it to get better. Usually, a vaccine takes an average of 2.5 years to develop.

But the industry is working hard to have one much sooner than that.

Vaccines save up to 3 million lives every year. They protect people from often fatal diseases such as polio, measles, diphtheria, thyphoid and rubella. They have even eradicated smallpox. We want to add COVID-19 to that list.

Scientists are investigating three main types of drugs: antivirals to stop the virus from replicating; anti-inflammatories that treat the lungs after the immune system is overwhelmed; and antibody-based treatments for seriously ill patients.

Here is a snapshot of how some companies are supporting efforts in the detection, prevention and treatment of COVID-19.  Pfizer, in partnership with BioNTech SE, is aiming to accelerate the development of BioNTech’s potential first-inclass COVID-19 mRNA vaccine programme, BNT162, which is expected to enter clinical testing by the end of April. In Italy, Pfizer pledged to make available for free medicines worth around ¤2.5 million.  GSK is donating US$10 million to the WHO and the UN Foundation’s COVID-19 Solidarity Response Fund to help prevent, detect and manage the pandemic. The company is expanding vaccines collaborations and evaluating existing medicines to determine whether any could be used beyond current indications.  Johnson & Johnson is searching

for a vaccine, making existing antivirals available for testing, collaborating with industry partners to screen a library of antiviral molecules, working with health authorities and institutions on research platforms, and providing tools and personal equipment where it can.  MSD has donated a supply of interferon beta-1a (Rebif) to the French Institut National de la Santé et de la Recherche Médicale following a request for use in a clinical trial. The company has supported China’s fight against COVID-19 with multiple donations in cash and in kind to local charities.  Novartis is providing US$20 million in grants to support public health initiatives that help communities manage the pandemic. The company is involved in collaborative research efforts, as well as making available compounds from its libraries that are suitable for in-vitro antiviral testing.  Eli Lilly has partnered with AbCellera Biologics to co-develop antibody products for the treatment and prevention of SARS-CoV-2, the virus that causes COVID-19.  AstraZeneca is donating 9 million face masks to support healthcare workers around the world as they respond to COVID-19.

The company is accelerating the development of diagnostic testing capabilities to scale up screening while research and development teams are working to identify monoclonal antibodies to progress towards clinical trial evaluation.  Bayer has partnered with other manufacturers in the COVID-19 Therapeutics Accelerator Initiative, initiated by the Bill and Melinda Gates Foundation, to find and develop effective novel compounds against the virus.  AbbVie donated US$2 million worth of Aluvia to Chinese heath authorities as an experimental option to help tackle the outbreak there. The company is working with the World Health Organisation on a coordinated global response effort.  Sanofi Pasteur, the vaccines global business unit of Sanofi, is leveraging previous development work for a SARS vaccine as part of efforts to unlock a pathway for developing a COVID-19 vaccine.

Sanofi is using its recombinant DNA platform to produce a novel COVID-19 vaccine candidate.

PHARMACYNEWSIRELAND.COM

 Roche and Genentech, part of Roche, are providing scientific expertise and research and development advice to the WHO and other stakeholders.

The company is working with Chinese health authorities and the government to help provide screening and health care, including supporting local health officials and hospitals in the Hubei Province.  Takeda is initiating the development of a plasmaderived therapy, designated TAK-888, with the potential to

treat hospitalised COVID-19 patients and to prevent infection in frontline healthcare workers.  Boehringer Ingelheim is working to develop neutralising antibodies against the SARS-CoV-2 spike protein. It is investigating existing pipeline and inmarket compounds, as well as compounds from former HIV and HCV research activities. The company has a joint fast-track call for project submissions to develop therapies and diagnostic tools initiated by the Innovative Medicines Initiative.

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e in ¹Cetrine Allergy7 1mg/ml Oral Solution, and available in 200ml bottle and launched 28 in November 2019. Cetrine Allergy 10mg FCT available in 7 and 30 packs, Lorat 10mg Tablets available in 7 and 28 C packs, or Rhinex Relief 50 micrograms/actuation to Nasal report spray, suspension, available as 1 x 60 doses. Medicinal products not subject to medical prescription. For further information, SPC or to report CF adverse drug reactions, No: contact the Marketing Authorisation 22863 Holder: Rowex Ltd., Bantry, Co. Cork. Ireland. Freephone: 1800 304 400. Fax: 027-50417. Date of preparation: (01-20) CCF No: 22863

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News

Together, let’s fight COVID-19 and place our trust in science A blog by Bernard Mallee, Director of Communications and Advocacy, IPHA

There is much at stake now for human health - and for the global economy. The COVID-19 pandemic has created anxiety in homes and communities. Jobs are vanishing fast, first in vulnerable sectors and soon beyond them. Hospitals are bracing for the surge in patients.

Bernard Mallee, Director of Communications and Advocacy, IPHA

Initiative to fast-track collaborative research, identifying assets in their libraries that could be used to develop diagnostics and treatments in the fight against COVID-19.

The industry is providing financial support and in-kind donations to organisations on the ground, as well as working closely with health authorities on shared solutions.

The Taoiseach this week sounded a rallying call to us all to fight the virus by changing our behaviours and looking out for others. His words will be heeded for the hope they offered, as well as for the realistic assessment of the bleakness we face.

agreements or expanding existing ones to mine science for a breakthrough. Companies are pairing with partners and government agencies to pool money, knowhow and people in coming up with ways to prevent or treat the disease.

As COVID-19 spreads, the job of the biopharmaceutical industry is help. That means developing vaccines and treatments and maintaining the integrity of the medicines supply chain.

Pfizer this week announced that it has signed a deal with Germany’s BioNTech SE to co-develop a potential vaccine. Eli Lilly and Canada’s AbCellera are to work together on antibody products.

Across the industry, companies are establishing new partnership

Companies are working through Europe’s Innovative Medicines

PHARMACYNEWSIRELAND.COM

Developing a vaccine from scratch takes years. But what has been learned from previous efforts could shorten the development timeline. Sanofi Pasteur is re-visiting previous work on SARS and a well-established recombinant technology platform as part of efforts to develop a vaccine. Sanofi and Regeneron are, together, exploring whether an existing therapy approved to treat rheumatoid arthritis could be used as treatment for COVID-19.

Remember that vaccines, when they do come, are among the most successful and cost-effective public health interventions ever.

They have ridded the world of smallpox, almost eradicated polio, and eliminated measles, diphtheria and rubella in many parts of the world. The World Health Organisation estimates that vaccines save 3 million lives every year.

Patients will understandably be worried about whether they will still be able to get their medicines during the pandemic. The Health Products Regulatory Authority and the European Medicines Agency oversee reporting and information from the industry about medicines shortages. No reports of shortages or supply disruptions due to COVID-19 have so far been received. Companies build resilience into their supply chains.

They have contingency plans in place. They are keeping a close watch on the supply chain globally and making adjustments where needed. The industry is urging patients to avoid ‘stockpiling’ medicines because that could cause shortages.

It is vital the Government recognises the importance of medicines manufacturing, just as it sees the value of continuity of care in the health services. Some critical functions need to stay operational during COVID-19 - and medicines manufacturing is among them.

We must ensure all manufacturing teams stay safe and well doing their jobs. The same goes for their suppliers. As much of the country closes due to the pandemic, manufacturing will stay open.

Business continuity is key.

The pandemic is a lesson in many things. Among them is how interdependent we are. When all this is over, we will need to look at how embedded is the cooperation and how structured is the collaboration between industry and policy leaders. There really is no more time for silos, either within governments or between governments and industry. This is a shared space in a hyperconnected world.

For now though, the priority is to slow the spread of the virus, to flatten the curve of new infections, and to support doctors and nurses who are putting themselves at risk to help others.

This is no time for the tranquilising drug of gradualism. It is a time for fierce, urgent effort by all of us.

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Report

Self-Care Advice in Coping with Covid-19 Those at the lowest risk from COVID-19 are the young, who therefore have the least incentive to take precautions. They might even benefit from developing immune protection against future coronavirus mutations. However, the more young people infected, the greater the risk they pose to the elderly or those with multiple health risks.

Peter Conry, Pharmacist

Here, Peter Conry, Pharmacist, outlines his advice in effective self-care techniques for consumers strengthening their immunity.

There are three types of precautions: 1. Preventing inward infection from others 2. Preventing outward infection of others 3. Boosting the body’s ability to fight/beat the infection The aim here is to slow the spread of the disease so that there are medical facilities available for those that need them – up to 20% of cases (and this doesn’t exclude the young). These are standard safety precautions to minimise the chance of contact with infectious droplets from others in the air or on surfaces and other items: 1. Preventing outward infection of others Masks – preferably tight-fitting (e.g. with metal strip to bend around nose or with foam rubber or silicon edging (to achieve the same). The best would meet FFP2 or FFP3 EU guidelines. Failing that US-standard N95 masks would do.

Ignore the recent disinformation - Proper masks, properly worn, work. But “masks” aren’t all equal. You want to get face-fitting

masks and so-called respirators.

However, if there’s no choice, any mask is better than no mask – you just have to try and eliminate gaps.

If your glasses fog up, it’s not tightly fitted!

Wear an outdoor “uniform” e.g. light, easily removable, easily washable coat for work or shopping. Think of it as your version of the surgical gowns or scrubs worn in hospitals. This coat shouldn’t come into the inside of the home (e.g. leave at door, in the car, or at work) and should be frequently washed. Try to handle the (safe) inside of the coat rather than the outside. Same policy for shoes, bags & anything else that has outside contact. Thorough hand-washing after contact with anyone or anything. By now, you know how!

Gloves, especially disposable, form an additional barrier if regular hand-washing isn’t feasible. When removing, avoid contact with the outside of the gloves. Use one glove to remove the other.

Then grab the top inside of the remaining glove and pull it over the first glove, sealing any infectious material inside. And still wash hands afterwards.

Only touch what you have to touch. I recently witnessed two schoolgirls in Pettit’s, the local Gorey SuperValu branch. One picked up a pack of crisps at the

PHARMACYNEWSIRELAND.COM

till, then decided against it and put it back. Her friend said “now you’ve got to wash your hands”.

Any item on a shelf or in a shop is a potential reservoir of infectious material. Don’t touch or fondle groceries.

Wipe down and disinfect surfaces and items. Milton Solution (sodium hypochlorite, known as Chlorox in the US) diluted 1 in 10 is the standard. Otherwise 70% isopropyl alcohol or alcowipes with 70% isopropyl alcohol will do. Even Dettol was shown to kill the Ebola virus.

Where relevant or possible, avoid unnecessary visits to risk areas.

This includes GP practices. It will usually be possible to collect the next 6 months of prescriptions from the GP. And pharmacies can prepare prescriptions in advance of collection once informed by telephone. Ensure all family contacts know and follow the

same safety protocol when, for example, visiting parents. Studies on health workers during the last Ebola outbreak in West Africa showed that people drop their guard around friends and family, or when tired. Or while starting to get used to the new protective measures.

2. Preventing outward infection of others These are measures to safeguard others. You start from the assumption that you ARE a potential source of infection (e.g. if there’s even a 5% chance, such as mild symptoms of a cold). To protect those around you, take precautions at that stage. You can always relax precautions later. But don’t wait till you’re bad enough to ask for a test: Masks: Here the quality can be lower than for prevention of inward infection. Even a DIY mask made

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from a fan-folded paper tissue with stapled elastics is better than nothing. If you run out of masks, while re-use is generally a no-no you may have no choice. Only re-cycle the better, more durable FFP2, FFP3 or N95 masks. Soak and mix thoroughly in Milton’s Solution (known in the US as Chlorox) diluted 1 in 10. Wear gloves or use a stick! Then rinse and allow to dry. Don’t ever soap or machine wash!

like their childhood home.

Don’t bring the outside in!

Maximize safety.

Manage physical contacts so as to minimize possible transfer of infection. This includes everything from your hand-washing routine to removal of outer layer of clothes before or at the door when visiting. In a 2015 WHO report on avoidable infections amongst health workers, they explained how there was a tendency to ease up on precautions in trusted locations

There are a number of measures that may boost the body’s ability to handle and manage a COVID-19 infection.

Set and follow a common safety protocol, including choice of clothing, footwear (to be left at door) etc. If you do become ill, remember that most people have mild symptoms and recover well.

3. Boosting the body’s ability to fight/beat the infection

Ensure Vit D levels are adequate.

This is proven to reduce susceptibility to viral or bacterial infection. If Vit D levels weren’t tested, assume levels are low as this is the norm in Ireland, esp in Feb/March. Supplements should

be in the order of 2,000 IU daily.

Get levels tested once during the next 3 months, but 2,000 IU/day is a safe dose for 12 weeks. For children and younger teens, this can be reduced to 1000-1500 IU. If supplements come in different strengths than you need then calculate the weekly requirement e.g. 2,000 x 7days = 14,000 IU/wk. Taking 3000 IU daily on 5 days a week (=15,000) will be close enough.

Echinacea (a herbal antiviral, commonly used during colds) was tested during the 2003 SARS outbreak and showed promise.

Unfortunately, when SARS was controlled many planned studies were shelved, so there’s only limited data, but there’s enough to suggest it’ll help.

Elderberry (sambucus) is a traditional remedy for respiratory

viruses and may be useful Highdose Vitamin C injections are currently being trialled in China.

You won’t get enough absorption with normal Vit C supplements (too much causes diarrhoea, or it gets peed out), but Vitamin C in the form of liposomal preparations may get closer to injectable blood levels. Liposomes are fat droplets with Vit C hidden in them, so it gets sneaked into the blood. You can get a local brand made in Bray, Co. Wicklow from Porebski Liposomes (also known as Sunflower Liposomes) or in sachet single-dose form as Altrient C. Not cheap, but if ever there was a time to try it....

Liquorice extract – available in health stores. Showed promise in the SARS studies. Zinc lozenges: Preferably Zinc Acetate.

They may coat the throat and make infection more difficult.

Having adequate Zinc is also important in maintaining a fit immune system. Or you could eat oysters... However, as with other micronutrients, don’t overdo it either as this could have the opposite effect.

Possibly L-Lysine: It’s an amino acid (present in meats), available as a supplement. It’s used by distance athletes during their peak training season to avoid cold sores as it seems to make it difficult for the herpes virus to invade new cells. Arginine, on the other hand, another amino acid, seems to do the opposite. Arginine would be found in nuts and beans e.g. cocoa bean (chocolate) or peanuts.

The product I have stocked up on is SuperLysine+ Immune Support, available from iherb.ie or iherb. com. It contains Lysine, Echinacea, Liquorice root, Propolis and a few other useful ingredients with antiviral potential.

If there’s any risk of being deficient

PHARMACYNEWSIRELAND.COM

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Report

in minerals and vitamins e.g. low B12 due to eating a vegan diet, then take B Complex for a few weeks only. A vegan needs constant B12 as it’s involved in making white blood cells which fight infection. Some medications reduce B12 absorption, so it would be especially important to supplement with B12 (ideally the under-the-tongue spray) in people with Type II Diabetes if they are being treated with the drug metformin (Glucophage) or people taking daily acidblocking medicines like Nexium (esomeprazole, Emazole), Losec (omeprazole), Zoton (lansoprazole) and the like. Without adequate stomach acid your absorption of B12, but also iron and possibly other micronutrients will be compromised. If you’re taking the higher strength of these medicines, discuss with your health providers if you could try reducing the strength (e.g. instead of getting 28 x Nexium 40mg, have it dispensed as 56 x Nexium 20mg and experiment a bit). More importantly, cut the foods that are (usually) provoking the problem in the first place.

If your diet has been poor recently, you may be low in some of the B Vitamins. So try taking a course of B Complex vitamins for a few weeks, just to top up. Do the same again when your reserves have been depleted. Don’t go mad on them and take overdoses excess micronutrients can often cause similar problems to not having enough!

Note: Many big-brand multivits have lots of ingredients but only the bare minimum (RDA) of each.

B Complex tend to be bigger tablets. Alternatively, add some organ meats into your diet – foods we used to eat in previous generations e.g. liver, kidney and heart. Why? Because these are some of the most vital and busy parts of the body and have higher content of micronutrients.

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Don’t overdo it though. Once or twice a week would be enough and if you take these, skip the multivitamin. If pregnant, drop this to once a month.

Avoid foods that are difficult for the (your!) body to handle. Specifically sugar and alcohol. And, if you suffer from food intolerances that you cover up by taking, for example, acid-blocking medicines, look instead at avoiding these foods, Replace them by better options, ideally a greater variety of vegetables. Foods that are bad for you are less of an issue when the body has reserves, but don’t carry a weakness into a battle with a powerful virus. And don’t forget garlic and leeks!

Learn Buteyko Breathing.

Konstantin Buteyko – a Russian scientist – got the idea from yoga.

A clinical trial in NZ found that the method could reduce use of Ventolin inhalers by about 90%.

Here’s my abbreviated version: oBreathe nasally. The most popular book on Buteyko is titled “Close your Mouth”. oIn addition to using the organ we were given to breathe with (the nose), you need to breathe like a baby and slow the rhythm right down. This is difficult until you master it. The best time to practice is in bed at night. How you breathe when falling asleep is also how you’ll wake up. oBreathe in with the nose as usual (normal breaths, not especially deep). But when you exhale, hold the lungs empty and count the heartbeats till you inhale again. oIncrease the number of heartbeats (with empty lungs) gradually to 25-30 beats, or whatever point you notice that you are no longer forcing the pace but are perfectly comfortable and relaxed. Take as long as you need.

Don’t rush it. You may find that you push too hard and have to shorten the number of beats a few times.

Don’t worry, or give up. Just keep at it. One more beat. Gently but firmly. Once you reach that babybreathing rhythm with long gaps between inhalations, you’ll know.

Nappy Rash?

Time to ecommend Caldesene.

Caldesene prevents and treats nappy rash.

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For topical use only. Cleanse and dry the affected area before applying. A copy of the summary of product characteristics is available upon request. The active ingredient in Caldesene Medicated Powder is Calcium Undecylenate 10% w/w, 20g, 55g, 100g pack size. For supply through general sale. PA 126/152/1 PA Holder: Clonmel Healthcare Ltd., Waterford Road, Clonmel, Co. Tipperary. Date Prepared: October 2019. 2019/ADV/CAL/112H

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Pharmacy Learning

Pharmacy Students called to the Frontline

Pharmacy students across Ireland have been assisting their pharmacy colleagues in the midst of the current COVID-19 outbreak. Irish Pharmacy News understands that many members of the Irish Pharmacy Students Association (IPSA) are already working in the community and supporting pharmacies; working to have their studies more flexible to coincide with the pandemic.

It is also believed the committee is awaiting guidance from the HEI on how pharmacy students can best support the community. Many pharmacies across the country are desperately in need of additional help across both the dispensary and within their OTC sections.

The Adrian Dunne Pharmacy Group also put out a call for help to all pharmacy students.

"Calling all 3rd, 4th & 5th year pharmacy students and trainee technicians," the statement says.

"During these unprecedented times, we are continuing to focus on the health and wellbeing of our local communities. It’s likely we will need your valuable skills in our busy dispensaries to assist with dispensing medication to our customers.

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"We have 12 branches throughout Leinster. If you are interested in helping out, please email careers@dunnepharmacies.ie with details of your location and availability."

Proposed Changes to Study The Pharmaceutical Society of Ireland is proposing changes to the existing statutory rules which set out the education and training

requirements for the five-year integrated Masters degree in pharmacy (MPharm). This is being done as a part of current initiatives to meet potential and real challenges arising in the context of the COVID-19 emergency for individual students.

The PSI states, "We are required to consult on the introduction of, or changes to, any PSI

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For babies, infants most adverse situation that For babies, infants "The comes to mind is the one we are and children currently facing - Covid-19. We and children can learn from adversity; about from 0+ months from 0+ months MyPro Kolicare is a clinically MyPro a clinically provenKolicare probioticisformula that proven probiotic formula that effectively prevents and treats effectively prevents indications and treats of the early childhood the early childhood indications of Colic, whilst promoting a healthy Colic, whilst promoting a healthy digestive system for baby. digestive system for baby.

what works and what does not, and can apply our learnings in future practice."

The amendment would apply to students who commenced their fifth year placement prior to 1 March 2020.

The amendment is proposed to mitigate circumstances that may reasonably arise for individual students in light of the exceptional circumstances presenting during the COVID-19 emergency. Those circumstances may include: a student, a preceptor, or both, being required to self-isolate, selfquarantine, or because of illness being unable to continue with the placement or where a pharmacy may have to close for a defined period of time, which will impact the experiential learning placement.

You can find out more about this at the PSI website: www.thepsi.ie In the below article, Lauren O’Reilly Vice President of Public Relations wth the Irish Pharmaceutical Students’ Association looks at the value of part-time work within community pharmacy to students.

The value of a part-time job in community pharmacy to the pharmacy student

statutory rules. In light of current circumstances, the consultation period is short and we appreciate all those who can share their considered feedback with us between 26 and 31 March 2020. The PSI is engaging directly with all those who may be particularly affected by the proposed changes."

Under the current PSI (Education and Training) (Integrated Course) Rules 2014, a student must undertake eight consecutive L LY P R months in a Ipatient-facing CA experiential learning placement A L LY P R in their fifth year I C that is to be completed as part of the MPharm.

CLICLI N N

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been and will be necessary to make changes to deal with real and potential challenges that are evolving and arising.

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• 100% natural • 100% natural • 5 drops a day • 5 drops a day In the context of the current • Easy to use COVID-19-pandemic, the proposes an amendment The PSI along with other • andEasy to use PSI to the Rules that will reduce regulatory public bodies • Allergen is examining how it carries outfree the legislative requirement placement to a period of its regulatory functions during • Allergen free for six months in exceptional this unprecedented time. It has

circumstances and within the period of eight consecutive months provided for in the higher education institutions’ calendar.

Whilst time is precious when studying a full-time course, like pharmacy, working in community pharmacy part-time, alongside your studies, is priceless. Since first year, I have always been fortunate enough to be employed in community pharmacy, and can see the benefits of this, as I am now in fourth year preparing for all-encompassing OSCE examinations.

It is not just examinations that this experience prepares you for however, there are many reasons why a part-time or seasonal job in a pharmacy produces a wellrounded student.

Confidence: Many pharmacists will agree that one of the greatest

For more information please contact: t: 4602 e: info@pharmed.ie For(044) more933 information please contact: t: (044) 933 4602 e: info@pharmed.ie

assets you can have, alongside your pharmacy education, is the confidence to give the evidencebased advice which you have studied, and to have faith in your own professional and ethical judgement in practice. Whilst working in community pharmacy, the student is given the opportunity to observe the pharmacist, and ask questions. I have yet to meet a pharmacist who is not happy that their staff ask questions and show a willingness to learn! Over time, being immersed in the pharmacy environment and learning from pharmacists, technicians and experienced OTC staff, students can gain confidence in their own abilities to give sound health advice and will develop their own style of doing so. I have noticed my own confidence, looking back, has evolved massively since my first Saturday working in community pharmacy.

Education: In college we learn the theory behind pharmacy practice and engage in workshops, OSCEs and have lecturers who practice, however the additional valuable learning occurs when actually in the community pharmacy setting and a patient is asking you about their rash, their cold or whatever the issue at hand may be. The greatest part of this experience is that you either know the answer and feel empowered to help the patient, or you can ask the pharmacist and learn for the next time you come across this condition or illness. We get to learn from experience, as well as from lectures!

Mentorship: In my experience working in community pharmacy, I have always been fortunate enough to be able to ask the pharmacist any queries I may have had, whether it was about the job, the course, or the future career.

It is so beneficial to speak to someone who has come through the whole MPharm programme and understands the demands

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Pharmacy Learning

of the course. I always found it very motivating to have a mentor like this who understands that you want to learn and shows you anything of interest which they come across such as drug recalls, new products on the market, calculations, PSI correspondence or even just something as simple as making up an antibiotic and calling the student over to show them how it’s done, for the first time. A pharmacist may have engaged in additional training courses or completed an additional Masters programme, which a student can earmark for future reference. They have a wealth of knowledge and experience to learn from!

customer service situation can help a student to feel more empowered and well-equipped, when it comes to experiential placement or even upon registry as a pharmacist.

Team-work: In every pharmacy, there is a team of people working there, even if there might only be an OTC assistant and the pharmacist at any one time in a quieter pharmacy. Learning about team dynamics, efficiency, task delegation… is all invaluable experience. I think from working as part of a team I’ve also learnt that when times are stressful, such as now during the coronavirus outbreak, it becomes even more important to be able to smile or have a laugh together. This is the value of a team!

Observation of how pharmacies handle adverse situations. I am certain that the most recent, ever-evolving adverse scenario that comes to mind is COVID-19!

We can learn from adversity about what works and what does not, and can apply our learnings in future practice. The range of different issues that affect community pharmacy, which can arise over a 5-year period whilst a student is in college, are widely varying, and enable the student to be able to deal with these issues competently, rather than coming across them for the first time when qualified, and in a position of greater responsibility.

Customer-service: Gaining experience in dealing with the public is absolutely invaluable.

Observing how a pharmacist, manager or experienced staff member deals with a difficult

Training opportunities, development opportunities, responsibility: Many pharmacies will offer their staff the opportunity to do either internal or external training, to further their knowledge and skills. Students are often entrusted with their own responsibilities within a pharmacy also, which may include anything from cash handling, purchasing/ sending orders, to liaising with sales representatives and even training of new staff.

Balance: Believe it or not, a part time job is often a welcome distraction from exams,

assignments and everything else going on in college. Working alongside a friendly team can really be something to look forward to after a long week in lectures and the library. A change of scene, and knowing you are working X amount of hours means your other hours, by default, have to be more productive! There is simply no room for procrastination.

Making life-long connections in the industry: The connections made in community pharmacy, whilst working either in a chain or for an independent pharmacy, are invaluable, and will stand to students once they qualify. When pharmacy students work part time, they often work weekends, and this can mean (as it did for me), meeting many different locum pharmacists, as well as having a strong relationship with the supervising/support pharmacists.

Of course pharmacy placements are part of the course itself, but early and regular exposure to the profession, and the evolving field of pharmacy, will stand to students. Qualifying and suddenly being responsible for everything happening in the pharmacy, on a given day (in a lot of circumstances), is a daunting thought for many, and is a mental challenge to overcome. I think exposing ourselves to the way that different pharmacists approach this responsibility, and asking them about their experiences when they first qualified, can really

help budding pharmacists see the light. Having several pharmacist role models to speak to about your future career plans as a pharmacy student is reassuring and motivating. There is so much support out there for pharmacy students looking for part-time or seasonal work in pharmacies, and I would urge any pharmacy student considering applying to eat the frog!

Lauren O’Reilly Vice President of Public Relations, Irish Pharmaceutical Students’ Association

News Extreme Stress for Pharmacy Students

Event Postponments

Almost one-in-five students across a range of medical third level courses suffer extreme stress according to a new study, with an academic supervisor claiming stress during training can help once they are working in frontline fields.

Irish Pharmacy Awards 2020 - The Irish Pharmacy Awards have been postponed from May 23rd, 2020 due to the impact of the COVID-19 pandemic.

The study, titled, 'Perceived stress experienced by undergraduate healthcare professional students throughout their degree,' surveyed 205 students at University College Cork across a range of courses, led by general nursing and pharmacy and also including medicine and dentistry.

It found more than 64% of students experienced moderate stress with 18.7% experiencing high stress.

The study was conducted by members of the Pharmaceutical Care Research Group at the

School of Pharmacy in UCC and the Department of Pharmacy at Cork’s Mercy University Hospital.

One of the academic supervisors, Dr Kevin Murphy of UCC's School of Pharmacy, said the study found that there were differences in the level of stress reported by some students in different courses.

“What our study did show was that the students broadly named the same two aspects as the biggest causes of stress: Summer exams and overall workload throughout the year,” he said.

PHARMACYNEWSIRELAND.COM

The Awards, celebrating their eight year, will now be held on January 16th in the Clayton Hotel, Burlington Road, Dublin.

Award Categories are still open for entry by visiting www. pharmacynewsireland.com or by contacting Events Organiser Aoife Jackson at: aoife@ipn.ie United Drug Pharmacy Show The United Drug 2020 Pharmacy Show, scheduled to take place on Sunday 19th and Monday 20th April in Citywest Convention Centre, Dublin, has been postponed.

The Pharmacy Show will now take place on September 6th and 7th in the same venue.

Advertorial

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Hay Fever - Key Market Trends Key market trends in the Child and Babycare Category identified and discussed by Anne-Sophie Martin, Brand manager for GP number 1 recommended, 100% natural sea water nasal spray brand STÉRIMARTM. How to Make the Most of the Hay fever Sub-category?

Anne-Sophie Martin says, “Pharmacies should present themselves as the convenient destination for informative advice and products that will address symptoms quickly and effectively.

It also presents an opportunity to not only drive sales on treatments but also support this as upsell of products with preventative properties, or natural products that can complement their existing treatment choice for more efficient management of symptoms.

According to Mintel reports, not only do a quarter of parents in the UK who have children between the ages of 0 to 2 like to use natural alternatives to personal care products on their children, but one fifth are worried their children are sensitive or allergic to certain ingredients in personal care products.

This means that many parents now not only want to know that products are effective, and ‘more natural’ but also they are becoming much more aware of what the different ingredients are in the products they are using, investigating that their full ingredient list is completely safe before believing brand and packaging claims.

This is a trend that is predicted to grow throughout the healthcare market in general, as shoppers become more conscious about what they are putting in their own and especially their children’s bodies, opting for products that they perceive to be the ‘healthier alternative’ with minimal or no risk of potential side effects. It is not enough for brands to just state their natural qualities anymore, they need to be able to prove it with ‘nothing to hide’ ingredients and straightforward claims clearly stated on pack.

But while they are becoming more savvy, research conducted on behalf of STÉRIMARTM towards the end of 2016 showed that while parents are open to trying new products if they think they will

work and are recommended by peers, they are still looking to GP’s as a first port of call for advice on treatment. This is mainly due to the fact that they think the childcare category can be confusing and hard to navigate themselves, with many products lacking clear benefits and reasons to believe.

This is a great opportunity for Pharmacies to bridge the gap between GP advice and peer recommendation, helping parents to navigate through the array of products available. By ensuring that staff are knowledgeable* about which products are not only effective, but also the ones that are most often recommended by GPs and which are completely natural, will help position them as a trusted and convenient destination for parents to get advice and treatment recommendation for their children. This can be coupled with ensuring that the childcare products are well categorized at shelf to make it easy for parents to navigate at point of sale. If possible, products could be grouped by ailment and put in age suitable order.

Opportunities for pharmacy businesses with the Stérimar™ children’s range According to Kantar Worldpanel and Nielsen Scantratck data 28.01.2017, the Nasal Spray category is a growing

area within healthcare. In 2016 the Nasal Spray market grew by 10.3%, attracting 91k more shoppers than the previous year, with the average price rising by £0.25.

New launches and higher price points play a key role in contributing to the growth in this area, mainly driven by decongestants, although hay fever is also a strong subcategory.

STÉRIMAR™ range of natural sea water based nasal sprays is one of the brands that has helped drive the growth of the Nasal Spray category. Last year, Stérimar grew by 18.3% and attracted an impressive 77k more shoppers.

Stérimar is now standing as the 7th largest brand in the whole nasal treatment market with the second largest percentage value growth. The brand is also thriving across the sub-categories becoming the 6th biggest brand in the decongestant sector, the 4th biggest brand in the children’s sector and the 3rd biggest brand in the overall hayfever sector.

This is supported by the fact that it is the UK’s GP number 1 recommended brand as well as the fact that the products in the children’s range contain only natural sea water and purified water with some additional copper salts for Stérimar Kids.

These gentle yet effective products tick several of the key boxes for parents who are seeking healthier alternatives.

Stérimar hay fever products have a base of 100% natural purified sea water and can be used alongside a nasal congestion medication and antihistamines based on medical advice. This means that pharmacists are able to up sell and widely recommend Stérimar in the knowledge that it is safe to use and will not cause any rebound congestion.

Customers should also be educated on the relevance of preventative solutions when tackling hay fever symptoms. As the first line of defence against pollen, it is essential to keep your nose as healthy as possible to help protect from the symptoms of hay fever. Washing your nose daily with an isotonic solution will simply wash away contaminants and debris trapped in the nose while helping prevent the onset of allergic reactions and ensuring the nasal lining is kept moistened.

Advise your customers to start using Stérimar nasal sprays well in advance and a couple of weeks before they usually start experiencing symptoms and to keep using it regularly throughout the season to keep symptoms at bay.

For more information, samples and pricing please contact your Pemberton Representative on 01 4632424

Listen out for the Pollen Count brought to you by Sterimar April to July

Getting Under the Skin of Allergies

L

ike an unwelcome guest, many allergens arrive with little warning. Their most common effects are all too familiar to the millions suffering from allergies: itchy nose, eyes, and roof of the mouth; runny or stuffy nose; watery eyes; sneezing; ear fullness and popping; hives; cough; and sinus headache. Allergies are either seasonal (eg, caused by tree and plant pollen) or nonseasonal (eg, caused by dust). Mold, animal dander, dust, and pollen are the most common allergens.

Despite a significant rise in awareness of allergies in recent years, plenty of confusion still surrounds them. The mechanism behind allergy is complex but is best described as the negative reaction that the body has to a particular substance.

Very often these substances are foods (e.g. egg, shellfish and nuts), although a person can be allergic to pretty much anything.

Common allergens other than food include Latex, bee and wasp stings, and a number of medicines (e.g. antibiotics, NSAIDs, aspirin, chemotherapy drugs).

Symptoms are broad and range from a runny nose, sneezing, skin rashes and worsening of asthma and eczema, through to the swelling of the lips and throat that is seen in severe reactions.

There are various theories as to why allergy incidence is increasing so rapidly. These include: • Hygiene hypothesis. This argues that, if we are not exposed to bacteria and endotoxins in early childhood, our immune systems

don’t develop as they should and therefore overreact when exposed to allergen challenges • Excessive use of antibiotics • Air pollution • Eating more processed food • Increase in stress • Insulation and double-glazing, which have created more of an allergy challenge within people’s homes.

Offering Pharmacy Advice Patients often self-treat mild to moderate allergies, asking pharmacists for guidance about which OTC antihistamines, decongestants, combination products, or nasal sprays work best. Effective advice must be patient specific; however, there are tips that apply to all patients, including parents with children experiencing allergies.

Identify the culprit Although most people are aware of seasonal allergies, many cannot pinpoint the culprit. Keeping a

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log regarding symptom onset, time of day, and environmental surroundings helps narrow the list. Patients’ symptoms often vary in intensity from day to day, further complicating assessment.

Patients with ongoing allergies should see a specialist, even if symptoms are mild. The intensity of current allergic reactions does not necessarily predict the intensity of future attacks.

Review things that can worsen symptoms Although patients may attempt to avoid allergens’ triggers, they may be unaware of exacerbating environmental conditions, including aerosol sprays, air pollution, cold temperatures, humidity, irritating fumes (including perfume), tobacco and wood smoke, and poor housekeeping Educate patients on the difference between food intolerance and food allergies Many people confuse food allergies with more common food intolerances. Allergies involve an immune reaction; food intolerances

stem from the inability to digest certain foods. Symptoms are similar, but milder: gastrointestinal problems, hives, itching, or eczema. Although avoiding specific foods is the recommended strategy, patients should be evaluated by an allergist.

Discuss anaphylaxis Those with severe reactions have increased risk for anaphylaxis.

Inform patients they need to go to A&E if: • acute symptoms occur within minutes or hours involving respiratory compromise, tongue swelling, or hypotension • skin tone is flushed or pale (almost always present with anaphylaxis) • nausea, vomiting, or diarrhea begins • dizziness or fainting, or a weak or rapid pulse, occurs.

Certain medications (especially penicillin); foods like peanuts, fish, shellfish, milk, and eggs; and insect stings are common triggers for anaphylaxis.

Emphasize to parents that a history of mild reactions does not preclude the child from having a future anaphylactyic reaction. Treatment starts with epinephrine, followed by antihistamines or corticosteroids.

COMMON ALLERGIC SKIN DISEASES Eczema Eczema (atopic dermatitis) is a disease characterised by a faulty skin barrier, which causes the skin to lose moisture and allows infection to enter, resulting in inflammation, intense itching, redness, dryness, blistering and scaling. The itching can promote scratching and skin damage, leading to cracked, weeping skin, which, in turn, creates more irritation and can cause the sufferer to become trapped in an itch-scratch cycle.

red weals on the skin that may itch or cause a burning sensation and are often accompanied by angioedema. Urticaria has various causes and only around 20 per cent of cases are connected with allergy. Other possible triggers include infection, physical pressures and food intolerance.

Polymorphic light eruption Polymorphic light eruption (PLE) is a common skin problem that usually occurs during exposure to the first strong sunlight of the year or while on a sunny holiday. It is not clear why certain individuals are affected by PLE, although it is thought to involve a delayed reaction to an allergen produced in the body in response to ultraviolet (UV) radiation. The problem usually subsides as the skin adapts to stronger UV levels.

Allergic dermatitis

Insect bites and stings

Allergic dermatitis also causes irritation, itching and inflammation.

Unlike irritant dermatitis, which is caused by repeated exposure to harsh chemicals, allergic dermatitis involves an immunological response and requires a sensitisation period. Key triggers are either contact (e.g. plants, cosmetics, fabric, jewellery) or environmental (e.g. food, sunlight and medicines).

Most insect bites and stings clear up within 24 hours but systemic reactions involve the airways and require immediate medical attention as they can lead to lifethreatening anaphylaxis.

Urticaria Also known as nettle rash or hives, urticaria is characterised by raised

Antihistamines Antihistamines are the mainstay of allergy management. They work by blocking the action of histamine, a chemical mediator released by the body as part of the immune response. Histamine widens blood vessels to increase the supply of white blood cells to the affected

26 | PHARMACYNEWSIRELAND.COM

area. This results in inflammation or oedema in the surrounding tissue and can also cause narrowing of the airways. Histamine release will result in itching and irritation.

Antihistamines are most effective in advance of allergen exposure but can still be highly beneficial if taken during a reaction. In addition, antihistamine creams can sometimes be used to soothe insect bites and stings (although are not generally recommended), while nasal sprays and eye drops containing azelastine can relieve irritation in the nose or eyes. Nasal antihistamines have the advantage of a rapid onset of action, although they do not control as many symptoms as oral antihistamines.

Corticosteroids Intranasal corticosteroid sprays or drops alleviate and prevent both immediate nasal allergy symptoms (e.g. sneezing and watery discharge) as well as late phase symptoms, such as congestion, irritation and sinus pain, which occur later in the allergy cascade as a result of additional chemicals released from mast cells. Corticosteroids suppress inflammation in the nasal passages by reducing mast cell activity.

Cromoglicate Cromoglicate works by blocking histamine release during an allergic reaction by stabilising mast cells. It should ideally be administered before contact with

the allergen and can take several weeks to have full effect, so is preventative in nature. Patients who are particularly troubled by eye symptoms, for example, should therefore be encouraged to persevere with treatment. Sodium cromoglicate nasal sprays can help to alleviate hayfever symptoms in children, for whom nasal corticosteroids are unsuitable.

Decongestants Decongestants provide short-term relief from nasal congestion associated with allergic rhinitis. They work by increasing vasoconstriction in the blood vessels of the nasal passages, which results in reduced inflammation and mucus production. Intranasal decongestants containing ephedrine or xylometazoline should not be used for longer than five to seven days as prolonged administration can lead to rebound congestion.

Saline Saline nasal washes or sprays are an effective alternative to decongestants that can be used all year round and are safe for use in children. They help to wash allergens out of the sinus passages and provide gentle relief from nasal irritation and congestion.

In addition, sterile saline eye drops are a simple, gentle and effective alternative for dealing with seasonal allergic conjunctivitis.

News First ‘drive thru’ warfarin clinic The arrival of the coronavirus pandemic has changed the way medicine is practised with a lot of services coming up with new ways to care for patients in a safe and secure manner. One such service is the anticoagulation and atrial fibrillation clinics in Tallaght University Hospital, which has established Ireland’s first drive thru warfarin clinic.

In an effort to reassure patients and ensure they continue to come to the clinic to have their regular INR levels checked, the anticoagulation and atrial fibrillation service in Tallaght University Hospital has devised a system where patients of the hospital can phone in advance and get an appointment for their check-up.

However, instead of having to attend the clinic in the hospital they can simply drive up to the entrance of the day hospital where they are met by staff in the who preform a finger prick blood test to check their warfarin levels.

Commenting on the new service Professor Rónán Collins, Consultant Geriatrician and National HSE Clinical Stroke Lead said it was developed first of all to reassure patients that they could safely be monitored as normal if they needed to or preferred to stay on warfarin or be switched over to the newer drugs if they preferred.

“The anticoagulation nurse staff do a finger prick test from the window of the patient’s car in full Personal Protection Equipment (PPE). We will ring the patient later that day with their INR and recommend the next dose of warfarin and time of next test, or should they wish to switch to a newer agent, recommend a best choice for them and explain to them how to move to the new drug and then email the prescription to their pharmacy,” he explained.

There are currently 1,000 patients on warfarin who attend Tallaght University Hospital and on average they would need it monitored every six weeks or so but some people need to attend more or less frequently.

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Boots launch Online Prescription Ordering In the face of COVID-19, the priority for Boots Ireland continues to be supplying all patients with the prescriptions, advice and medicines that they need.

Dawson Street pharmacy staff

As the pharmacy chain is seeing an increased demand for services, they want to ensure all patients get their medication in a timely manner in line with government advice regarding minimising the spread of the virus.

The Boots Prescription Ordering Service enables patients to pre-order their prescriptions through the Boots app before going in to their chosen Boots to collect their medication. This helps to reduce the wait time in stores, so that patients can pick up their prescriptions as quickly as possible, avoiding long queues and to further enable social distancing.

Caoimhe McAuley, Director of Pharmacy at Boots Ireland, “We are constantly striving to offer our patients the best quality service. In light of the current circumstances and in line with

government advice, giving our patients the ability to pre-order their prescriptions will ensure they spend less time queuing for their medication, which will further enable social distancing and help us protect our patients and colleagues.”

The Boots Prescription Ordering service is a feature of the Boots

app that allows customers to digitally transmit their prescriptions ahead of visiting their chosen pharmacy. Repeat prescription requests can also be sent and managed via the service.

Once the order is placed through the app, Boots will let cusomers know when they’ve received the order and when the prescription is ready to collect.

Vaccine 18 months away Scientists are making progress in the search for a vaccine for COVID-19 - but it is still likely to be a year or 18 months before one is available, according to the Irish Pharmaceutical Healthcare Association (IPHA) which represents the research-based international biopharmaceutical industry.

During World Immunisation Week, IPHA says a vaccine is the only way to protect the world’s population against new waves of COVID-19 infection.

While a medicine would treat the disease, a vaccine would stop people getting it in the first place. Scientists across industry, universities, and health and research organisations are working around the clock in searching for vaccines and treatments. In many cases, biopharmaceutical companies are turning to their libraries of approved drugs or compounds that are in early testing and screening to see whether any of them can take down the virus.

Most experts believe it will take a year to 18 months to develop, test, approve and manufacture a vaccine.

Vaccines take time to develop years, if not decades. But, due to the urgency of the pandemic, the timetable is being shortened.

But scientists know that there can be no short-cuts on the testing needed to ensure a vaccine, or a treatment, is safe and effective.

Several biopharmaceutical companies have potential medicines in various stages of development, and some existing medicines are in late phase clinical trials. Various collaborative projects, some of them guided by programmes such as Europe’s Innovative Medicines Initiative, are exploring vaccine technologies for early phase clinical trials.

Johnson & Johnson expects to start human clinical trials on

a lead vaccine candidate by September, with the first batches available for emergency use by early next year. Pfizer has signed a deal with Germany’s BioNTech to co-develop a potential vaccine while Eli Lilly and AbCellera are working together on antibody products. AbbVie has announced it is donating US$35 million to COVID-19 relief efforts, as well as exploring the potential of an antiretroviral therapy for HIV to treat COVID-19. Scientists at MSD are assessing antiviral and vaccine assets to see whether any could be applied in the treatment of COVID-19. GSK and Sanofi are combining efforts to develop an adjuvanted COVID-19 vaccine. The plan is to have it available in the second half of next year. There are many other examples.

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Respiratory - Optimising Inhaler Technique sthma is a serious global health-care issue, affecting an estimated 300 million individuals of all ages, with prevalence ranging from 1% to 18% in different countries.

In Ireland, it affects over 470,000 adults and children.

Pharmacists can be instrumental in providing patients with valuable resources to educate them about pharmacologic agents for treating and managing asthma.

Pharmacists can educate patients about the proper use of inhalation devices, especially newly diagnosed patients who may be overwhelmed with diagnosis and treatment plans.

As more treatment options and patient resources become available for controlling asthma, a collaborative effort between health care professionals and patients, coupled with patient education and stressing the importance of patient adherence, is fundamental for effectively controlling asthma.

For successful management of asthma, it is important that patients be thoroughly educated about their condition, know the warning signs of asthma attacks, know the factors that may trigger an attack, know how to manage attacks, adhere to their asthma plan, and know how to properly use the prescribed treatment.

Results from various studies show that increasing awareness and promoting education about asthma can reduce the numbers of asthma-related hospitalisations, emergency department visits, missed days at school and work, and deaths.

to remember that this is not a complete list and a sufferers own personal triggers may fall outside of these categories.

The final goal of asthma treatment is to achieve optimal asthma control and to maintain this control thereafter.

 Physical activity, including exercise

Taking controller medication as prescribed and keeping asthma controlled are important parts of trigger management. Many asthma patients find they're less sensitive to triggers when their asthma is well controlled.

 Exposure to cold air or sudden changes in temperature

Often, it may not be just one trigger that sets off an episode of asthma but a mixture of several triggers. For this reason, it is important to suggest sufferers keep an asthma diary to monitor their symptoms and help pin point their triggers.

Below is a list of some of the most common triggers, it is important

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Table 1: Possible Triggers of Asthma Attacks  Respiratory infection

 Stress

 Exposure to irritants such as cigarette smoke, air pollution, chemicals, dust, or aerosol sprays  Allergens such as mold, pollen, dust mites, and pet dander  Pharmacologic agents such as aspirin, nonsteroidal antiinflammatory drugs, and nonselective beta-blockers Inhaler Technique Many effective inhaled medications are found on the market, yet poor asthma control still exists with poor

inhaler technique being one of the main determinants.

Various formulations and designs of metered dose inhalers (MDIs) and dry powder inhalers (DPIs) are available; however, incorrect inhalation techniques are still demonstrated by health-care professionals and their patients Just last year, it was revealed that of three of Ireland’s 470,000 people with asthma may be unknowingly aggravating their condition simply by not using their inhalers correctly.of three of Ireland’s 470,000 people with asthma may be unknowingly aggravating their condition simply by not using their inhalers correctly.

The news led to the Minister for Health, Simon Harris, the Asthma Society of Ireland and the Irish Pharmacy Union (IPU) launching an ‘Inhaler Technique’ awareness campaign to encourage people with asthma to ensure that they are using their inhaler device correctly.

Daragh Connolly, President of the Irish Pharmacy Union (IPU),

said, “Pharmacists, as healthcare professionals, are ideally positioned to provide advice and assistance to people with asthma to help them gain control over their condition.

Having the correct inhaler technique is absolutely essential for those who have asthma to get the most out of their medicines and pharmacists are available to provide the support and advice necessary to ensure that this happens. We would encourage people with asthma to bring their inhalers to their local pharmacy and the pharmacist will be able to provide them with the practical advice they need for using their inhalers properly.”

Ireland has the fourth highest incidence of asthma in the world; one in 10 adults and one in five children have the disease. Inhalers are one of the most common devices used to treat asthma yet research shows as many as 2 in 3 people may be using their inhaler incorrectly.

However, when taught the correct technique, people are able to use their inhalers more effectively with substantial benefits for their asthma control and overall health. People with asthma are advised to have the inhaler technique checked by a healthcare professional at every opportunity.

Recent research carried out in the UK, showed that 27.4% of patients had never been shown how to use their inhalers by any healthcare professional.

In the study, pharmacists and pharmacy technicians attended a two-hour training session and were provided with a resource box that included placebo inhalers, training aids and patient information leaflets.

Overall, 35 pharmacies recruited a total of 380 patients with a diagnosis of asthma or COPD, and carried out more than 500 assessments between May 2018 to June 2019.

Of the 380 patients, 50.0% used one inhaler, 46.1% used two inhalers and 3.9% used three inhalers. A mixture of aerosol and dry powder inhalers (DPIs) requiring different inhalation techniques were prescribed for 56.8% of patients.

The most commonly prescribed inhalers were metered-dose inhalers (59.5%), Ellipta (24.5%) and Turbohaler (8.4%).

The researchers were surprised to find out that 27.4% of patients had never been shown how to use their inhalers by any healthcare professional before they attended the pharmacy inhaler technique service.

On arrival, significantly more patients were assessed as having good DPI inhaler technique (defined as having no critical or serious errors) than aerosol inhaler technique (77.8% vs. 49.2%;

P<0.05). However, after training from a pharmacist or pharmacy technician, this increased by 19.5% and 46.4%, respectively, to 97.3% and 95.6% of inhaler devices assessed.

The researchers concluded that a dedicated service provided by community pharmacy staff was effective at improving inhaler technique for almost all patients.

However, they highlighted that uptake at many pharmacies was low and only 11 of the patients received the service at weekends.

Choosing the correct inhaler Selecting the correct device for an individual patient from the many that are available is not easy. There seem to be new combination compounds being released all the time and, of course, the new ones are likely to replace the old ones.

Another level of complexity is added by the wide choice of inhaler device and concerns regarding whether the patient can use one type of inhaler more easily than another. If a patient is unable to master the required inhalation technique for a specific delivery device, there are usually other choices for inhalers delivering equivalent drug doses and providing the same clinical efficacy.

The most common types of inhaler device available are: 1. Dry powder inhalers (DPI)

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2. Pressurised metered-dose inhalers (MDI or pMDI)

 Switching to ultrafine particle inhaler

3. Breath-actuated MDI (BApMDI)

Common errors by dry powder inhaler users

4. Aerosol holding chamber (commonly called a ‘spacer’ is often prescribed for use with pMDI inhalers, especially with ICS medicines) Each type of device requires a different pattern of inhalation for optimal drug delivery to the lungs.

Common errors by metereddose inhaler users  Not exhaling fully before inhaler user  Inhaling too fast  Not inhaling fully  Inhaling through the nose  Not inhaling for over 5 seconds  Firing before inhaling (good co-ordination not critical on inhalation but dose has to be released within 1s after the start of the inhalation)

 Inadequate acceleration on inhalation  Not inhaling long enough (inhaling too fast)  Not inhaling all the dose (If the dose is supplied in a capsule then two inhalations may be required to empty the dose) Some ways of solving these common problems  Proper demonstration and training  Using a mobile phone video to show and correct errors  Using a sophisticated tester/ trainer device to ascertain the patient’s inspiratory acceleration Table 2: Factors Affecting Asthma Control • Appropriate medications

 Stopping inhalation when cold spray hits the throat

• Patient’s willingness to use medications

Some ways of solving these problems

• Developing a written asthma action plan to guide patients in self-management

 Proper demonstration and training  Adding a spacer (spacers score low in patient preference)  Switching to breath-actuated MDI

• Identifying asthma triggers • Implementing environmental measures to control allergies, irritants, and pollution when feasible

• Treating comorbid conditions that may exacerbate asthma, such as allergic rhinitis, gastroesophageal reflux disease, obesity, and sleep apnea • Educating patients about their asthma treatment plan and how to manage their asthma • Stressing the importance of patient adherence to the selected treatment plan • Routine monitoring of therapy, response to therapy and follow-up • Adjusting therapy when warranted.

Advice and Education In offering education and advice, patients and caregivers of children with asthma should be educated on the basics of asthma; the goals of treatment; how to manage triggers; how to properly use metered-dose inhalers; the importance of adhering to therapy, refilling prescriptions on time, and carrying rescue medications at all times because attacks may occur without warning; and how to use maintenance and rescue medications.

Because patients with asthma are at an increased risk for developing respiratory complications from infections such as influenza and pneumonia, patients should be encouraged to obtain a yearly inactivated influenza vaccination.

Although asthma is a chronic condition, it can be successfully managed through patient education and adherence, with effective therapy, patients can lead normal, healthy lives.

Asthma Vs COPD Currently there are 500,000 people with COPD in Ireland. COPD is mainly due to damage caused by

smoking, while asthma is due to an inflammatory reaction. COPD is a progressive disease, while allergic reactions of asthma can be reversible. Initial symptoms can be similar in both diseases, for example, shortness of breath, chest tightness, wheezing, and cough, which can lead to confusion or misdiagnosis. Both diseases can have severe, dangerous signs and symptoms, for example, a bluish discoloration of the skin, and respiratory distress. Death may even occur. Initial treatments of COPD include bronchodilators, while initial treatments for asthma include inhaled corticosteroids while initial treatments. COPD usually develops after age 40 and often becomes a chronic disease of lung function. Asthma may develop in people of almost any age.

Women with chronic obstructive pulmonary disease (COPD) experience a worse quality of life, are more likely to be symptomatic and are at greater risk of frequent and severe acute exacerbations than men, according to a study presented during the recent American Thoracic Society International Conference.

The study analysed baseline characteristics of 1,832 participants in the Subpopulations and Intermediate Outcome Measures in COPD study; of these, 42 per cent were women. Age, smoking status, race and lung function (assessed as forced expiratory volume in 1 second as a percentage of predicted) were similar in women and men, but women reported significantly fewer smoking pack-years than men (mean 48 and 56 respectively).

After adjusting for confounders, women reported greater impairment of respiratoryspecific (St George’s Respiratory

Questionnaire score 4.48 points higher) and general (Short Form-36 score 17.47 points lower) quality of life than men.

COPD Key Facts

Women also showed 31.4 meters shorter six-minute walk distance and were 89 per cent more likely than men to show hypoxemia during or after the test. Women were also 63 per cent more likely to experience COPD symptoms and 75 per cent more likely to experience at least two acute exacerbations a year than men.

Between 50 and 60% of people don’t use their inhaler sufficiently well to benefit

Moreover, women were 25 per cent more likely to have suffered a severe acute exacerbation that needed treatment in an emergency department or hospitalisation during the year before the study.

The Asthma Society of Ireland has urged people who suffer with the condition and/or chronic obstructive pulmonary disease (COPD) not to stockpile medicines during the coronavirus crisis.

In a statement the group said it wanted to assure people that there was no national shortage of asthma and COPD medication and is advising people to continue taking their preventative medication as prescribed.

Currently there are 380,000 people who have asthma and 500,000 people with COPD in Ireland.

The group has also warned people with asthma and COPD to only trust reputable sources for advice on their condition.

Sarah O’Connor, CEO of the Asthma Society of Ireland, said: “The Asthma Society has been liaising closely with the IPU, the HSE, the Department of Health and with various pharmaceutical companies who have reassured us that there is a good stock of asthma and COPD medications in Ireland.

Management of stable COPD should be individualised based on symptoms and exacerbation risk

Pharmacists should check that the medication dose is right and discuss if a spacer would help Several drugs aid COPD management including shortacting bronchodilators, inhaled corticosteroids (ICS), long-acting beta agonists (LABA) and longacting muscarinic agonists (LAMA).

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), which has published guidelines covering diagnosis, management and prevention since 2001, management of stable COPD should be individualised based on symptoms and exacerbation risk.

For example, patients in group B who experience persistent breathlessness while using a LABA or LAMA should receive combination treatment with both classes. No evidence supports LABA over LAMA or vice versa for initial symptomatic treatment. The choice depends on the patient’s perception of benefit.

There are now a large number of inhalers and pharmacists can help people find the right one for them. For instance, many people with COPD have co-morbidities, which might influence the choice.

People with arthritis might not have the dexterity to use some inhalers. Indeed, between 50 and 60% of people don’t use their inhaler sufficiently well to benefit.

By encouraging good inhaler technique, pharmacists can make a huge difference to patients’ health and wellbeing.

News NUI Galway Refocusing Research to Fight COVID-19 NUI Galway has begun a comprehensive review of its existing healthcare research to repurpose it to help fight the spread of COVID-19.

A team of researchers at NUI Galway is examining an existing study of interventions for patients with community acquired pneumonia which is rapidly being repurposed to examine COVID-19 patients. This study is being revised and repurposed to enable healthcare professionals to offer novel emerging therapies to the sickest patients.

A new working group has been established to give healthcare professionals the ability to quickly profile the immune response of severely ill patients with a view to guiding therapeutic options. The working group comprises of the

University’s top academics in the fields of haematology, immunology and ID. The University’s critical care researchers are working with the Irish critical care trials group and international pandemic research consortia to develop and rapidly implement Clinical Trials in patients with COVID-19 Severe Respiratory Failure in order to test and gain access to novel therapies as they emerge.

President of NUI Galway, Ciarán Ó hÓgartaigh said, “NUI Galway exists for the public good. The Irish people have answered the

Government’s call to combat the spread of Covid 19, and the University is mobilising all its academic capabilities to join this global action. While we’re also repurposing our research to combat this crisis, I’d like to pay particular tribute to our medical community, staff and student doctors and nurses who are on the frontline saving lives in our hospitals, nationally and internationally. They making a great contribution throughout the world and our impact is at its most profound through them and their commitment to others. We are deeply grateful to them.”

Healthcare students at NUI Galway are playing a vital role in the provision of healthcare- in their clinical placement and through volunteering, both in contact tracing and at various testing centres across the city.

A new website called www.covidmedsupply.org has been created by NUI Galway and the University of Limerick to offer essential aid in the fight against the coronavirus pandemic. The new global platform is designed to help local organisations, such as industry, businesses, universities and labs provide available personal protective equipment.

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News

Recycling Campaign First for Ireland Dr Cara Augustenborg, Environmental Scientist and broadcaster, launched the first national respiratory inhaler recycling initiative on behalf of Teva Pharmaceuticals Ireland (Teva).

Teva's Speciality Medicines Director Clodagh Kevans, Sarah O'Connor, CEO of the Asthma Society of Ireland and Dr Cara Augustenborg, Environmental Scientist and broadcaster

Teva are the first in the Irish pharmaceutical industry to take this significant step in playing an active role in addressing the recycling of inhalers and providing people living with respiratory-related illnesses with environmentally, sustainable treatment.

The launch took place at O’Connor’s Pharmacy, Dublin 4 and is part of a nationwide pilot scheme which aims to encourage people living with respiratoryrelated illnesses to recycle their used or out of date inhalers.

There are an estimated 560,000 people in Ireland currently living with a respiratory-related illness and in 2019 alone, 4.4 million inhalers used which is a rising number on previous years. Until today, no free public recycling facility has been made available to dispose of used inhalers in Ireland.

Currently, in Ireland, people living with respiratory-related illnesses are encouraged to return their used inhalers to their local pharmacy, where they are then disposed of with other medical waste through incineration.

However, it’s unclear how many Irish consumers dispose of their inhalers correctly. When inhalers aren’t disposed of correctly, they are sent to landfill which is harmful to the environment both in plastic material waste and in greenhouse gas emissions as the residual gas from canisters may be released to the atmosphere. Both are damaging to Ireland’s environment and ecosystem.

In a first for the Irish pharmaceutical industry, Teva is today launching a pilot initiative which will empower people living with respiratory-related illnesses to recycle their used inhalers.

Teva has partnered with global recycling group TerraCycle to bring its Zero Waste Box scheme to 100 Irish pharmacies across Ireland in a 12-month recycling pilot scheme. TerraCycle’s Zero Waste Box is a cardboard box that collects, and stores used inhalers until they are collected

by TerraCycle and then recycled to help make new products including playground materials and garden equipment.

In the same way as recycle ‘green’ bins are used in households every day, Teva’s new recycling initiative provides a convenient way for people living with respiratoryrelated illnesses to recycle their used or out-of-date inhalers. The Zero Waste Box can be used by pharmacy goers when they are collecting prescriptions or a new inhaler, making it convenient for their lifestyle.

People living with respiratoryrelated illnesses can find out where their nearest participating pharmacy is located by visiting www.inhalerrecycling.ie

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Teva’s campaign to raise awareness of the initiative includes support from the Asthma Society of Ireland, representing the 380,000 people with asthma in Ireland, and people who live with asthma and COPD. The aim of their support is to highlight the importance of this scheme and to encourage people across Ireland to get behind it.

Teva’s Speciality Medicines Director Clodagh Kevans said: “Teva is an environmentally conscious company and we are continuously taking steps towards improving our impact on the environment. One of those steps is this new pilot programme which will provide pharmacists and people with respiratory-related illnesses the opportunity to recycle their inhalers for the first time in Ireland.

“We at Teva Ireland realise that our work and contributions to creating healthy communities are essential for leading a responsible business. We also know that in all areas of life, consumers are increasingly supportive of environmentally sustainable initiatives.

“We’re excited to launch this pilot with the Asthma Society of Ireland, and we hope that with their support, with buy-in from our pharmacy partners and people living with respiratoryrelated illnesses, this pilot programme can make a difference.” she added.

Emphysema Explained Emphysema occurs when the normal lung is destroyed either by smoking or, in 15% of cases, other causes including genetically linked diseases. The space left behind is filled with trapped air that causes the lung to hyperinflate over time, pushing the chest wall out and the diaphragm down. All this trapped air limits air flow in and out, causing debilitating breathlessness. If badly affected, it is like trying to breathe through a straw.

As a form of air hunger, patients complain by saying ‘I just cannot get a deep breath in or out’. Symptoms progress over time and, eventually, everyday activities such as walking or getting dressed become difficult.

Often, patients will have trouble feeling confident leaving their home. The implications can be devastating for both the patient and their loved ones.

The substantial burden There are currently half a million people aged 40 years and over suffering with emphysema or chronic obstruction pulmonary disease (COPD) in Ireland.

As the third leading cause of death globally in 2010, the age standardised death rate for COPD in 2011 was 27.87 per 100,000 for Ireland, compared with 18 per 100,000 for the WHO European region. In other words, the burden of disease is substantial, with models of care being proposed by advisory groups within the Health Service Executive.

Treatments include smoking cessation, medical therapy, vaccinations and pulmonary rehabilitation, and in extreme cases single or double lung transplantation. Innovation in medical technology has led to surgical lung volume reduction options, either endobronchial valves or robotic surgery.

Zephyr Valves for example, are tiny valves placed in the airways to block a diseased part of the lungs and reduce hyperinflation.

This makes room for the healthier parts of the lungs to expand and lifts pressure off the diaphragm, thereby making breathing easier.

When successful, treated patients breathe more easily, are more active, and enjoy a better quality of life. Indeed, some outcomes exceed all expectations for those patients most in need. Funding of regional treatment centres with COPD specialists will soon be required to deal with what will be an overwhelming demand for this level of care.

Educational

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Get Moving on Arthritis

Arthritis Week: This year, National Arthritis Week took place from 20-26 April.

The theme of the week was ‘Movement is the best medicine’, which looks to underscore the importance of physical activity for joint health. While the major focus was on physical activity for people with arthritis, the campaign also highlighted the importance of exercise and movement as a preventative measure.

Educational: Physical activity is proven to be a vital part of managing arthritis.

As well as reducing pain and inflammation, keeping active improves joint support and lubrication, helps with weight control and has many other health benefits.

National Arthritis Week 2020 creates awareness and understanding around the importance of physical activity in managing arthritis, to launch the movement is the best medicine campaign, to provide people with information and exercise resources, and ultimately to change people’s behaviour and get people with arthritis moving.

There are a number of different arthritis conditions: Ankylosing spondylitis (AS) is a form of inflammatory arthritis, which mainly affects the spine, but can also cause pain and/or swelling in the shoulders, hips, knees, heels, chest/ribs and small joints of the hands and feet.

Fibromyalgia is a syndrome associated with widespread pain and fatigue. There are no outward signs of the condition but fibromyalgia symptoms include severe pain, fatigue and stiffness.

Gout is a very painful form of arthritis. It is a long term, chronic condition that, if not properly managed, can affect sufferers for their whole life.

Juvenile idiopathic arthritis (JIA) is the name given to several forms of arthritis in children and teenagers under 16. It is an auto-immune condition, and while it principally affects the joints, it may also affect other organs including the eyes.

Systemic lupus erythematosus (SLE or lupus) is systemic disease, that can affect many different parts of the body. Cells and antibodies, which are in the

blood to defend the body against infection, begin to attack it instead and cause inflammation.

Osteoarthritis (OA) is the most common of all types of arthritis.

It usually develops gradually, over several years, and affects a number of different joints.

The cause is unknown, but it does appear more in females than males.

Polymyalgia rheumatica (PMR) is an inflammatory condition affecting the muscles in and around the shoulder and upper arm areas, buttocks and thighs.

Psoriatic arthritis (PsA) is a form of arthritis that in most cases affects the skin and the joints. Most people with PsA will develop the condition following the onset of psoriasis, however, not all people with psoriasis develop PsA. Raynaud’s disease or Raynaud’s phenomenon is a condition which affects the extremities, predominantly the fingers and toes. Symptoms include painful sensation of cold and a whitening or reddening of the fingers and/ or toes.

Rheumatoid arthritis (RA) is a very common type of inflammatory disease. The body’s natural defences (the immune system) attacks certain parts of the body instead of protecting it. This autoimmune reaction occurs mainly in the joints, but can affect vital organs too.

Scleroderma Scleroderma is a rare disorder of the body's connective tissues.

It damages the cells that line the walls of the smaller arteries, such as those in the fingers and toes. Systemic scleroderma can damage the organs, while local scleroderma tends to affect the hands and face.

Sjogren's Syndrome Sjogren's syndrome is an autoimmune condition, where the body's natural self-defence system, gets confused and attacks the body's healthy tissues. White blood cells attack the body's tear and saliva glands, reducing the amount of saliva and tears produced, and causing a dry mouth and dry eyes, along with other related symptoms.

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Pharmacist-led inhaler training A new study carried out by Irish pharmacy resarchers, has found that community pharmacist–delivered inhaler training informed by a digital technology improves adherence and health status.

Susan O'Dwyer, Superintendent Pharmacist, Boots Ireland and School of Pharmacy, TCD placed to deliver personalized inhaler education."

The study, entitled, 'Personalised Biofeedback on Inhaler Adherence and Technique by Community Pharmacists: A Cluster Randomized Clinical Trial' was carried out by Susan O'Dwyer, Superintendent Pharmacist with Boots Ireland and also from the School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, The University of Dublin, Dublin, Ireland along with colleagues.

It states, "Guidelines recommend that patients treated with inhalers receive adherence counseling and device training. Digital technologies that assess both inhaler adherence and technique have been developed. Using these technologies community pharmacists, who have regular contact with patients, are well

The objective was to determine the impact of a pharmacist intervention, informed by digital technology, on inhaler technique and adherence of patients with asthma in the community.

A cluster randomised, parallelgroup, multisite pharmacy study was conducted over 6 months.

All study groups had an electronic device (inhaler compliance assessment device) attached to their maintenance inhaler.

A biofeedback group received personalized inhaler training informed by data recorded by the device. The demonstration group received inhaler training, by physical demonstration with a placebo inhaler. The control group received usual care. The primary outcome was inhaler adherence, which was classified as “actual adherence” and expressed as the proportion of expected drug accumulation if adherence and technique had been perfect. Secondary outcomes were

quality-of-life scores as measured by the St George's Respiratory Questionnaire, symptoms, and exacerbations.

A total of 152 participants (n = 74 biofeedback, n = 56 demonstration, and n = 22 control) were recruited.

Asthma was the predominant condition among participants (n = 83), with chronic obstructive pulmonary disease (n = 55) and asthma/chronic obstructive pulmonary disease overlap also reported (n = 8). In intention-totreat analysis, adherence in the biofeedback group during month 2 was 62%, 18% higher (95% CI, 6 to 30) than that in the demonstration group (P = .004) and 24% higher (95% CI, 9 to 40) than that in the control group (P = .003). During month 6, adherence was 14% higher (95% CI, ?1 to 30; P = .07) in the biofeedback group than in the demonstration group and 31% higher (95% CI, 13 to 48; P = .001) than in the control group. At the end of the study, the biofeedback group had a sustained fall in St George's Respiratory Questionnaire from baseline, ?6.1 (95% CI, ?9 to ?0.4; P = .04) and had significantly improved daily respiratory symptoms.

New Guidelines for Pharmacy Global guidance for pharmacists in community, hospital and clinical biology on coronavirus/COVID-19 has been updated by the International Pharmaceutical Federation (FIP).

The document replaces FIP’s first coronavirus guidance issued last month. “The situation has developed rapidly and an urgent update was necessary as, around the world, we are learning more about this new virus,” said Mrs Jane Dawson, chair of FIP’s Emergency Taskforce, who is also secretary of FIP’s Military and Emergency Pharmacy Section and director of health policy for the New Zealand Defence Force.

The updated guidance document takes into account newly available evidence and recommendations.

In particular, around: • Modes of transmission and incubation period • Pharmacy operations and facilities: ensuring safety and continuity of service • Preventive measures, including the use of masks • Pharmacy interventions and patient counselling

• Treatment guidelines and medicines that may need to be stocked • Progress in medicines and vaccines development • Laboratory testing for COVID-19 in suspected human cases • Cleaning and disinfection products and procedures Travel advice The guidance also addresses opinions on the safety of the use of ibuprofen, ACE inhibitors, angiotensin receptor blockers and corticosteroids during the coronavirus/COVID-19 pandemic, which suggest an increased risk of infection or increased severity of disease. FIP has issued a position statement on this issue today, available on the federation’s website.

“Since COVID-19 was declared a pandemic by the World Health Organisation just over a week

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ago, and with some countries going into lockdown, we have seen an even greater reliance on pharmacists as the first point of contact with the health system.

FIP has been hearing from colleagues around the world who have been stepping up to get their communities through this challenging time for our health services. We thank them for the amazing work that they are doing under increased pressure and hope that this updated guidance will support them in their practice,” Mrs Dawson said.

FIP’s Coronavirus Emergency Taskforce is made up of experts from several countries, including China, and representing different regions around the world. FIP is collaborating with its member organisations and other partners to make this guidance available in different languages for maximal dissemination and use.

Study on Methadone A new study, led by RCSI researchers, has found that patients receiving methadone treatment are most at risk of overdosing in the month following the end of methadone treatment and during the first four weeks of treatment.

However, the study did not observe transfers between services as high risk periods, with no deaths occurring following a transfer. This suggests that the current structures in Ireland promote a smooth transition of patients between services.

The study was funded by the Health Research Board and was a collaboration between the School of Pharmacy and Biomolecular Sciences in RCSI, HRB Centre for Primary Care Research in RCSI, the HSE Addiction Services, Trinity College Dublin and the HSE National Social Inclusion Office.

People with opioid dependence have more than 10 times the risk of premature death than the general population.

The researchers analysed data from 2,899 people who were prescribed and dispensed methadone in addiction services between January 2010 and December 2015. They observed 154 deaths, and 55 (35.7%) of those were identified as drug-related poisonings.

The rate of drug-related poisoning deaths was more than four times higher in the month following the end of treatment and over three times higher in the first four weeks of treatment when compared to the remaining time in treatment. These findings are consistent with growing evidence from other international studies.

No deaths were observed in the first month following transfer between treatment providers.

Transfers between addiction services and primary care are facilitated by GP Coordinators employed by the addiction services. The GP Coordinator provides all relevant clinical details on the patient being transferred to the new treatment provider. The provision of opioid substitution treatment is also available in Irish prisons; if a prisoner is in treatment prior to incarceration, their treatment is continued in prison.

CPD: Management of Sleep Disorders in Pharmacy

Continuing Professional Development

CPD

35

This module is suitable for use by community pharmacists as part of their Continuing Professional Development. After reading this module, in the magazine or online, complete the post-test on our website at www.pharmacynewsireland.com and include in your personal CPD ePorfolio.

Author - Amy Oates qualified from the Robert Gordon University Aberdeen with a Master in Phamacy in 2011. She then undertook a pre-registration year with Gordons Chemists in Edinburgh. After registration she moved back home and worked for Johnstons Pharmacy in Longford Town, Lanesborough and Ballygar, Co. Galway. She has also completed a Cardiology in Clinical Pharmacy Practice module with Trinity College Dublin.

Management of Sleep Disorders in Pharmacy 60 Second Summary Whether they are caused by a health problem or by too much stress, sleep disorders are becoming increasingly common. Depending on the type of sleep disorder, people may have a difficult time falling asleep and may feel extremely tired throughout the day.

Sleep apnea is characterized by pauses in breathing during sleep. This is a serious medical condition that causes the body to take in less oxygen. It can also cause you to wake up during the night.

Allergies, colds, and upper respiratory infections can make it challenging to breathe at night which can then cause sleeping difficulties. Stress and anxiety often have a negative impact on sleep quality. It can be difficult for you to fall asleep or to stay asleep. Nightmares, sleep talking, or sleepwalking may also disrupt your sleep.

Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis. Whether they are caused by a health problem or by too much stress, sleep disorders are becoming increasingly common.

Depending on the type of sleep disorder, people may have a difficult time falling asleep and may feel extremely tired throughout the day. The lack of sleep can have a negative impact on energy, mood, concentration, and overall health.

Symptoms can differ depending on the severity and type of sleeping disorder. They may also vary when sleep disorders are a result of another condition.

General symptoms of sleep disorders include: •

Difficulty falling or staying asleep

•

Daytime fatigue

•

Strong urge to take naps during the day

Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.The way you feel while you're awake depends in part on what happens while you're sleeping.

•

Irritability or anxiety

•

Lack of concentration

•

Depression

Treatment for insomnia and sleep disorders can be categorized into pharmacological and non-pharmacological treatments.

Pharmacological treatments must achieve a balance between hypnotic and adverse effects. Hypnotics are indicated in psychophysiological insomnia for occasional intermittent use or short-term administration for up to two weeks. Benzodiazepine usage can result in impaired sleep quality, residual sedation, memory or functional impairment the day following drug administration, or rebound insomnia. Non-benzodiazepine hypnotics, such as Zolpidem or zopiclone have hypno-sedative action similar to the benzodiazepines.

This refers to the inability to fall asleep or to remain asleep. It can be caused by jet lag, stress and anxiety, hormones, or digestive problems. It may also be a symptom of another condition. Insomnia can be very problematic for your overall health and quality of life, potentially causingdepression, difficulty concentrating, irritability, weight gain and impaired work or school performance.

Common sleeping disorders include: Insomnia

Sleep Apnea Sleep apnea is characterised by pauses in breathing during sleep. This is a serious medical condition that causes the body to take in less oxygen. It can also cause you to wake up during the night.

Reflection - Is this area relevant to my practice? What is your existing knowledge of the subject area? Can you identify any knowledge gaps in the topic area?

Planning - Will this article satisfy those knowledge gaps or will more reading be required? What resources are available?

Action - After reading the article complete the summary questions at www. pharmacynewsireland.com/cpdtraining and record your learning for future use and assessment in your personal log.

Evaluation - How will you put your learning into practice?

Have I identified further learning needs?

Published by IPN. Copies can be downloaded from www.irishpharmacytraining.ie Disclaimer: All material published is copyright, no part of this can be used in any other publication without permission of the publishers and author.

Restless Leg Syndrome Restless leg syndrome (RLS) also called Willis-Ekbom Disease, causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them. This urge is sometimes accompanied by a tingling sensation in the legs. While these symptoms can occur during the day, they are most prevalent at night.

As symptom severity is increased during the night, it could become difficult to fall asleep or return to sleep after waking up. Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops.

Narcolepsy This is characterised by “sleep attacks” that occur during the day. This means that you

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CPD: Management of Sleep Disorders in Pharmacy

will suddenly feel extremely tired and fall asleep without warning. The disorder can also cause sleep paralysis, which may make you physically unable to move right after waking up. Although narcolepsy may occur on its own, it is also associated with certain neurological disorders, such as multiple sclerosis.

Allergies, colds, and upper respiratory infections can make it challenging to breathe at night which can then cause sleeping difficulties. Stress and anxiety often have a negative impact on sleep quality. It can be difficult for you to fall asleep or to stay asleep.

Nightmares, sleep talking, or sleepwalking may also disrupt your sleep.

All of the above disorders and other factors can lead to sleep deficiency. Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death. Sleep deficiency occurs if you don't get enough sleep, you sleep at the wrong time of day, you don't sleep well or get all of the different types of sleep that your body needs, your sleep disorder that prevents you from getting enough sleep or causes poor quality sleep.

Sleeping is a basic human need, like eating, drinking, and breathing. Like these other needs, sleeping is a vital part of the foundation for good health and well-being throughout your lifetime. Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death.

It can help to understand how sleep works and why it's important.

Stages of sleep Sleep can be divided into two categories: 1) Rapid eye movement (REM) sleep usually occurs around 90 minutes after falling asleep; during REM sleep, brain activity increases and dreaming occurs; a number of periods of REM can occur during a night’s sleep (usually three to five episodes) 2) Non-rapid eye movement (NREM) sleep is made up of four different stages. One sleep cycle may consist of several stages of NREM sleep followed by a period of REM sleep.

There are four different stages of NREM sleep.

Stage 1-drowsiness -may last 5 to 10 minutes, during which time your muscles relax and you may be easily disturbed. You may also feel as if you are falling, which causes a muscle contraction known as hypnic myoclonia or ‘sleep jerks’.

Stage 2 - light sleep: eye movements stop during this stage, your heart rate slows down and your body temperature decreases as your body prepares itself for deep sleep.

Stages 3 and 4 - deep sleep: these two stages are deep sleep. Stage 4 is more intense than stage 3. During these stages, your physical energy levels are restored and your immune system is strengthened. If woken, you may feel disorientated for a few minutes. Around 90

minutes into this sleep cycle you will begin to have REM sleep.

Importance of Sleep Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.

The way you feel while you're awake depends in part on what happens while you're sleeping.

During sleep, your body is working to support healthy brain function and maintain your physical health. In children and teens, sleep also helps support growth and development.

Your immune system relies on sleep to stay healthy. Ongoing sleep deficiency can change the way in which your immune system responds. If you are sleep deficient, you may have trouble fighting common infections.

Sleep disorders and deficiency can affect people of all ages, races, and ethnicities. There are certain groups of people who may be more likely to be sleep deficient: • Those who have limited time available for sleep, such as caregivers or people working long hours or more than one job • People who have schedules that conflict with their internal body clocks, such as shift workers, first responders, teenagers who have early school schedules, or people who must travel for work • Make lifestyle choices that prevent them from getting enough sleep, such as taking medicine to stay awake, abusing alcohol or drugs, or not leaving enough time for sleep • Have undiagnosed or untreated medical problems, such as stress, anxiety, or sleep disorders • Have medical conditions or take medicines that interfere with sleep • Certain medical conditions have been linked to sleep disorders. These conditions include heart failure, heart disease, obesity, diabetes, high blood pressure, stroke or transient ischemic attack, depression, and attentiondeficit hyperactivity disorder (ADHD).

Treatment Options GPs can diagnose insomnia and other sleep disorders by asking questions about sleep schedules and habits and by gathering information from sleep partners or parents.

They will also rule out other medical problems that might interfere with sleep.

Treatment for insomnia and sleep disorders can be categorized into pharmacological and non-pharmacological treatments.

Pharmacological treatments must achieve a balance between hypnotic and adverse effects.

Hypnotics are indicated in psychophysiological insomnia for occasional intermittent use or short-term administration for up to two weeks.

Benzodiazepine usage can result in impaired sleep quality, residual sedation, memory or functional impairment the day following drug administration, or rebound insomnia. Other problems may include increased rates of falls, drowsiness, dizziness and cognitive impairment. Non-benzodiazepine hypnotics, such as Zolpidem or zopiclone have hypno-sedative action similar to the benzodiazepines. The side effect profile of these drugs is more favourable, preserving psychomotor tasks and memory capacities better than benzodiazepines and they do not possess respiratory depressive side effects.

Treatment should be limited for the lowest possible dose for the shortest possible time.

Over-The-Counter Sleep Aids Nytol One A Night Nytol is a sleep aid medication that is clinically proven to help relieve temporary difficulties getting to sleep. Nytol works quickly and helps ensure that your sleep is undisturbed. Nytol Tablets contain the active ingredient Diphenhydramine Hydrochloride 50mg.Diphenhydramine should be used for the shortest possible duration as tolerance or dependence can develop with continuous use.

Nytol should not be used for more than seven consecutive nights without consulting a doctor.

If sleeplessness persists patients should visit their GP, as insomnia may be a symptom of an underlying medical illness.

Age

Recommended Amount of Sleep

Infants aged 4-12 months

12-16 hours a day (including naps)

Children aged 1-2 years

11-14 hours a day (including naps)

Children aged 3-5 years

10-13 hours a day (including naps)

Children aged 6-12 years

9-12 hours a day

Teens aged 13-18 years

8-10 hours a day

Adults aged 18 years or older

7–8 hours a day

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When to recommend Nytol One A Night Diphenhydraminehydrochloride is an antihistamine thatcauses sleepiness or drowsiness. It can be recommended as a sleep aid for temporary sleep difficulties. Problems in getting a goodnight's sleep can be caused by many factors such as stress, jet lag orpersonal problems such as bereavement.

In sleep problems of this type, Nytol has beenshown to help people to fall asleep fasterand have a longer and deeper sleep.

Suitable for patients aged over 18 years and recommended only for short term use. It is important that patients are advised not to drive or operate machinery for at least 8 hours after taking Nytol.

Use in the elderly is not recommended due to the greater risk of adverse reactions. Nytol should not be recommended for use in elderly patients withconfusion.The elderly are more prone to the side effects of confusion and

paradoxical excitation - increased energy, restlessness and nervousness.

Use with Caution Nytol One-A-Night 50mg Tablets should be used with caution in patients withasthma, bronchitis and chronic obstructive pulmonary disease, myastheniagravis, epilepsy or seizure disorders, narrow-angle glaucoma, prostatic hypertrophy and urinaryretention.

Diphenhydramine has also been associated with prolongation of the QT interval.

May increase the effects of alcohol, therefore alcohol should be avoided.Avoid use of other antihistamine-containing preparations, including topicalantihistamines and cough and cold medicines whilst taking Nytol One-ANight50mg Tablets.

Use in pregnancy and breastfeeding Nytol One A Night is not recommended for use during pregnancy.There is not adequate

data from the use of diphenhydramine in pregnant women.Diphenhydramine crosses the placental barrier and has been reported to causejaundice and extrapyramidal symptoms in infants whose mothers received the drugduring pregnancy.Use of diphenhydramine during the first trimester of pregnancy has been associatedwith an increased risk of fetal abnormalities.Use of sedating antihistamines during the third trimester may result in reactions in thenewborn or premature neonates.

Nytol One-A-Night 50mg Tablets are not recommended whilst breastfeeding withoutmedical advice. Diphenhydramine has been detected in breast milk, but the effect of this on breastfedinfants is unknown.

If administered during breastfeeding there is an increased risk ofadverse effects of antihistamines, such as unusual excitation or irritability in infants.

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CPD: Management of Sleep Disorders in Pharmacy

Side Effects

Pharmacist Counselling

Common side effects include sedation, drowsiness, disturbance in attention, unsteadiness, dizziness and dry mouth.

Elderly patients are prone to side effects of confusion and paradoxical excitation - increased energy, restlessness and nervousness.Diphenhydramine also has a major influence on the ability to drive and use machines.Diphenhydramine is a hypnotic and will produce drowsiness or sedation soon after thedose has been taken. It may also cause dizziness, blurred vision, cognitive andpsychomotor impairment. It is not recommended to drive or operate machineryfor at least 8 hours after taking the tablet.

There are many lifestyle adjustmentsthat can greatly improve sleep quality and can be discussed with your patients. If your patientsstruggle to fall asleep at nightadvise some lifestyle adjustments such as:

Pharmacist Monitoring The onset of signs or symptoms raising abuse should be monitored by the pharmacist. Cases of abuse and dependence have been reported with diphenhydramine in adolescents or young adults for recreational use. Cases of abuse can also be prevalent in patients with psychiatric disorders or with a history of abuse disorders.

Monitor for signs of overdose. Signs can be similar to the side effects of the medication, but additional symptoms may include mydriasis, fever, flushing, agitation, tremor, dystonic reactions, hallucinations and ECG changes, such as QT prolongation and torsades de pointes. Large overdose may cause rhabdomyolysis, convulsions, delirium, toxic psychosis, arrhythmias, coma and cardiovascular collapse.

Melissa Dream This is natural solution to stress and sleep disorders. Contains natural ingredients to keep calm during the day and to prepare for a good deep sleep. Melissa Dream works to effectively calm and fights stress and works to induces sleep and promote deep sleep. This supplement is non drowsy and non-addictive.

Melissa Dream contains 3 main ingredients: Lemon balm is considered a "calming" herb used to reduce stress and anxiety, promote sleep, and ease discomfort associated with digestion. Several studies have found that lemon balm combined with other calming herbs such as chamomile can help to reduce anxiety and promote sleep.

Chamomile has long been used, mostly in teas, as an effective calming agent. Studies indicate that low doses of chamomile relieve stress and anxiety, while higher doses promote sleep.

L-theanine is an amino acid found in green tea leaves. Research has proven that L-theanine creates a sense of relaxation in approximately 30-40 minutes. The amino acid directly stimulates the production of alpha brain waves, creating a state of deep relaxation and mental alertness similar to what is achieved through meditation. Further, L-theanine is involved in the formation of GABA, which influences the levels of serotonin. This produces the key relaxation effect.

• incorporating more vegetables and fish into diet, and reducing sugar intake

S

Self-Appraisal WHAT I intend to learn and why When I completed the PSI Pharmacy Assessment System, two of the ‘areas for improvement’ identified from the ‘Management and Supervision’ section and the ‘Sale and Supply of Non-Prescription Medicines’ Section related to providing evidence that all staff are trained and competent in their role. I realised that I have no formal method of standardising or demonstrating staff training and I want to address this.

P

• reducing stress and anxiety by exercising • creating and sticking to a regular sleeping schedule • drinking less water before bedtime • limiting caffeine intake, especially in the late afternoon or evening • decreasing tobacco and alcohol use • eating smaller low carbohydrate meals before bedtime Improving sleep habits also plays a vital role in promoting sleep. For patients struggling to fall asleep, or for those who wake at night and can’t get back to sleep, recommend some ways to improve their sleep habits, such as: • Going to bed and waking up at the same time every day. For children, have a set bedtime and a bedtime routine.

• Keeping the same sleep schedule on weeknights and weekends. Limit the difference to no more than about an hour.

Staying up late and sleeping in late on weekends can disrupt your body clock's sleep–wake rhythm.

• Use the hour before bed for quiet time. Avoid strenuous exercise and bright artificial light, such as from a mobile phone,TV or computer screen. The light may signal the brain that it's time to be awake.

• If you wake up and can't fall back to sleep within 20 minutes or so, get out of bed. Go to another room and read or do other quiet activities until you feel sleepy.

Personal Plan HOW I intend to learn it I plan to research training options available in Ireland.

I plan to ask my staff to bring in their course completion certificates.

I plan to speak to staff at performance appraisal to explore their learning needs.

A

Action What I actually did I reviewed IPU OTC off-site training and distance learning.

I read OTC related articles in pharmacy magazines such as IPN. I spoke to my staff about their qualifications and training needs.

I contacted www.4FrontPharmacy.ie for a demo of their online Pharmacy Training Programme.

D

Document What I have learned specifically Three key realisations • Training staff to manage OTC sales of medicines is a core part of the Medicines Supply Chain.

• The true cost of off-site training, taking into account the training fee, travel expenses, overnight and food expenses, pharmacy cover, day’s wages for person attending the training.

• The value of online team training extending beyond the expertise, to include leveraging and implementing whole team learning with marketing and sales activities, for the sake of patient care.

E

Evaluate ONE example of how I put my learning into practice • By using an online programme designed by pharmacists for pharmacy teams, at the tip of a button, I can demonstrate my team’s up-to-date training and meet PSI training guidelines.

• I can now concentrate on leveraging the expanded team skill base to extend my pharmacist service offering.

• My time is now used for higher value activities that ONLY a pharmacist can do, and I am confident that OTC sales conducted by my staff, will be referred appropriately.

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Dispensing errors and near misses in a community Dispensing errors and misses in community pharmacy setting in near the Republic ofaIreland: pharmacy setting in and the Republic Ireland: Incidence, type, causes, reporting of compliance Incidence, type, causes, and reporting compliance Martin, S1, Murphy, K2

BACKGROUND • Majority of complaints to the Pharmaceutical Society of Ireland (PSI) are BACKGROUND related to dispensing errors (DEs)(1) • Only 66% of pharmacies maintain accurate error logs(2) • Majority of complaints to the Pharmaceutical Society of Ireland (PSI) are • DE incidence has been found to range from 0.01% - 22% of total dispensed related to dispensing errors (DEs)(1) items(3), translating into 7,500 – 16.5 million DEs/year in Ireland(4) • Only 66% of pharmacies maintain accurate error logs(2) • Wrong strength, wrong quantity, wrong drug, and labelling error have been • DE incidence has been found to range from 0.01% - 22% of total dispensed found to be the main DE categories(3) 7,500misreading – 16.5 million DEs/year insound-alike, Ireland(4) look •items(3), Amongsttranslating the causesinto of DEs, the prescription; • Wrong strength, wrong quantity, wrong drug,have andbeen labelling been alike drugs (SALAD); and computer errors, founderror to behave the most found to be the main DE categories(3) prevalent(3).

• •Amongst thecircumstances causes of DEs, misreading prescription; look Regarding associated withthe DEs, pharmacistssound-alike, have associated alike drugs (SALAD); errors, have been to be the most an increased workloadand withcomputer an increased perceived rate found of DEs(5) prevalent(3).

• Regarding associated with DEs, pharmacists have associated AIMScircumstances / OBJECTIVES an increased workload with an increased perceived rate of DEs(5) • Assess the reporting incidence of DEs and near misses (NMs) in a community setting in the Republic of Ireland AIMS / pharmacy OBJECTIVES • Identify the different types and causes of DEs, and their associated circumstances • Assess the reporting incidence of DEs and near misses (NMs) in a •community Evaluate the self-perceived compliance in recording pharmacy setting in the Republic of Ireland DEs and NMs, and reasons the for lack of compliance • Identify different types and causes of DEs, and their associated circumstances METHODS • Evaluate the self-perceived compliance in recording DEs and NMs, and reasons for lack of compliance • All community pharmacies in the Republic of Ireland (n=1688) were invited

2 S1, Pharmacy, Murphy, KDublin 1 St. James Martin, Late Night School of Pharmacy, University College Cork2 St. James Late Night Pharmacy, Dublin1 School of Pharmacy, University College Cork2

Circumstances associated with DEs Workload (67.2%)

Circumstances associated with DEs

Workload (67.2%) Distractions (44.8%) Distractions Interruptions (44.8%) (25.9%) Interruptions (25.9%)

to complete online survey. Participants were questioned regarding general METHODS pharmacy information; DEs and NMs reported between 1/1/2019 – types and causes of Republic DEs; perceived circumstances associated • All30/6/2019; community pharmacies in the of Ireland (n=1688) were invited DEs; perceived reasons for not reporting DEs and NMs; and for their towith complete online survey. Participants were questioned regarding general self-perceived compliance in recording DEs and NMs pharmacy information; DEs and NMs reported between 1/1/2019 – • A DE was defined as any error detected after the medication had been given 30/6/2019; types and causes of DEs; perceived circumstances associated to the patient or their representative with DEs; perceived reasons for not reporting DEs and NMs; and for their • A NM was defined as any error that was detected before the patient or self-perceived compliance in recording DEs and NMs patient’s representative was handed the dispensed prescription • A DE was defined as any error detected after the medication had been given to the patient or their representative RESULTS • A NM was defined as any error that was detected before the patient or patient’s representative was handed the dispensed prescription

RESULTS

Top DEs reported by Irish Community Pharmacies Wrong Strength (32.1%)

Top DEs reported by Irish Community Pharmacies Wrong Drug Wrong Strength (16.7%) (32.1%) Wrong Quantity Wrong Drug (13.5%) (16.7%)

Wrong Quantity (13.5%)

CONCLUSION •In Ireland, similarly to other countries, DEs happen at much lower rate than NMs •Pharmacists are aware of under-reporting of DEs and NMs CONCLUSION •Pharmacists and pharmacy staff can learn from well documented •In and Ireland, to other countries, happen at much lower DEs NMs,similarly and a better reporting strategyDEs is needed rate than NMs •More studies are necessary to identify strategies to prevent DEs in a community pharmacy setting •Pharmacists are aware of under-reporting of DEs and NMs •Pharmacists and pharmacy staff can learn from well documented References available on request.

DEs and NMs, and a better reporting strategy is needed Acknowledgments: •More studies are necessary to identify strategies to prevent DEs in a We would like to thank all community pharmacists that completed the survey, as without their help, this project would not have been possible community pharmacy setting CONTACT: For more information on the content of this poster, please contact Sergio Martin, St. James Late Night Pharmacy; sergio.martin.moran@gmail.com References available on request.

Acknowledgments:

We would like to thank all community pharmacists that completed the survey, as without their help, this project would not have been possible CONTACT: For more information on the content of this poster, please contact Sergio Martin, St. James Late Night Pharmacy; sergio.martin.moran@gmail.com

OTC Pharmacy & Retail Product Awards 2020 As the situation around the COVID-19 outbreak was gathering momentum, alongside enforced restrictions on large social gatherings, the OTC Pharmacy & Retail Product Awards were cancelled. This decision was taken in order to protect our guests. All of the entrants and finalists were incredibly understanding of this decision, and we are very grateful for their support with this.

The OTC Pharmacy & Retail Product Awards are one of the largest events in Ireland’s retail pharmacy sector with an anticipated over 250 of Ireland’s retail professionals and leading OTC manufacturers expected to be in attendance.

Natalie Maginnis, Managing Director of IPN Communications, organisers of the event said, “While an incredible amount of work went into planning this year’s OTC & Retail Pharmacy Product Awards, and all of our entrants and finalists have put immense time and energy into their applications and presentations, it has reached a point with COVID-19 where we felt it was absolutely necessary to cancel the annual event in order to protect the health and safety of attendees.

“We believe that cancelling this years’ event is the ethical to do when we have a large gathering of people in an enclosed environment with a risk of spread. Given that a large number of these guests work in healthcare, dealing with those that are amongst the sickest people of society.”

The OTC & Pharmacy Retail Awards are the only industry awards that specifically recognise and reward the companies and their products within the OTC market.

Created in 2015, they recognise Ireland’s best OTC and retail pharmacy products. The awards applaud the investment by these companies, both large and small, into product development, training, marketing initiatives and promotional campaigns.

They were judged by an expert judging panel, which includes independent retail pharmacy owners, OTC buyers from pharmacy chains, symbol groups, co-operatives and buying groups.

The winners across our 22 categories were contacted by the IPN team with the news and feedback and had their certificates posted out. Over the following pages we have featured the winners within our categories which ranged from Best Beauty Product and Best Baby Product to Best Marketing Campaign and Best Launch.

40 | PHARMACYNEWSIRELAND.COM

Best Baby Product Elave Paediatric Sensitive Sun SPF 50+ The Best Baby Product for 2020 was won

by Elave Paediatric Sensitive Sun SPF 50+

by Irish company Ovelle.

Elave sensitive Sun Paediatric SPF 50+ offers very high broad spectrum UVA/UVB infrared (IR) thermal protection.

Paediatrician approved from newborn, helps shield delicate skin from harmful UVA/UVB rays that cause sunburn.

This water resistant sunscreen protects without irritating the skin. A lightwight non greasy formula which doesn't clog pores. Hypoallergenic and free from worrying chemicals.

Product innovation, attractive packaging, impact to the customer, unique selling point, and manufacturer support are all important if a baby product is to be successful in an already saturated marketplace.

Niamh Fennell, Ovelle Pharmaceuticals

Some aspects of the babycare market have slipped away from pharmacies, as supermarkets entice parents with cut-price promotions and big brand offerings. However, infant and child health is still an important category, with newparents relying on their local Pharmacy for care and support.

SUN SITIVE 0+ N E S 5 ELAVE ATRIC SPF I D PAE

Best Baby Product – The Finalists Product Company Calpol Vapour Plug & Nightlight Johnson & Johnson Baby VitD3 Drops Valeo Healthcare Milton Baby Care Primeline Mustela Vitamin Barrier Cream 1 2 3 GA Distribution

Judges Comments: "Fantastic product loved by mums and families all over Ireland. Proud to support this as an Irish product that is clearly dominating its market. Great communication from Ovelle to all pharmacy teams also."

CALPOL® Vapour Plug & Nightlight

BabyVitD3 Drops

Milton Baby Care

Mustela Vitamin Barrier Cream 123

Best Natural Product Alflorex

Alflorex® is a groundbreaking product for Irritable Bowel Syndrome (IBS), a condition that affects up to 1 in 7 people in Ireland every day.

Its innovation led to it being chosen as the winner of the Best Natural Product in the 2020 OTC Retail & Pharmacy Product Awards.

More and more consumers are in search of natural solutions to their ailments, including both homeopathic remedies and supplements supportive of a healthier lifestyle.

Driven by consumer interest in all things natural, the market for natural products available over-the-counter has increased over the last number of years. Consumers are purchasing these for both prevention and immune boosting properties as well as to help aid healing when they are sick.

Alflorex® is taken daily to manage and prevent recurrence of all of the main IBS symptoms.

The bacterial culture in Alforex, 35624®, was discovered and developed in Ireland by small Irish company, PrecisionBiotics.

It is one of the bestselling IBS products in pharmacies in Ireland (IQVIA Value Share Nov 2019), consistently praised and purchased by Irish consumers.

Judges comments: "This product is really excellent, it sells well and is trusted by consumers all over Ireland. It has had a huge impact on those who have tried it and has gathered a large following in use due to its efficacy."

Multi-Mam Compress

Just Balm

One Nutrition B12-Max

Colm O’Sullivan, Head of Communications, Sara Beltoise, Marketing Director, Aishling Forde, Careline Advisor & Business Support, PrecisionBiotics Group

ZinCuFlex®

Best Natural Product – The Finalists Product Company Multi-Mam Compress Ocean Healthcare Just Balm Nia Natural Beauty One Nutrition B12-Max Naturalife ZinCuFlex PPC Galway

Best Beauty Product Solgar Collagen Hyaluronic Acid Complex Solgar Collagen Hyaluronic Acid Complex by Nature's Bounty won the highly coveted Best Beauty Product at the OTC & Retail Pharmacy Product Awards 2020.

Solgar® understands that good nutrition is the foundation of beautiful skin. That’s why they created their Collagen Hyaluronic Acid Complex to nourish the skin from within.

This unique complex includes a patented ingredient BioCell Collagen ll®, a unique and highly absorbable complex of hydrolysed collagen type II, hyaluronic acid, and chondroitin.

With hyaluronic acid, clinically shown to reduce new lines and wrinkles, increase skin hydration, and increase collagen content in the dermis to support skin structure and elasticity.

Innovation continues to be a significant factor in the continued growth of the beauty OTC market in Ireland. With the category remaining highly competitive, innovation is just one way to maintain consumer interest in brands.

Julie Crest, National Sales Manager UK & Ireland, Solgar

This category was open to retail products available within community pharmacy within the key category of Beauty.

Judges Comments: "Solgar is the Rolls Royce supplement for beauty from the inside. Our customers really love this product. The value to the customer makes this a joy to sell within our pharmacy."

Gosh Chameleon Foundation

Perfectil Hair Crush Gummies

RONIC HYALU N E G COLLA D COMPLEX C A I

Jenny Glow

Best Beauty Product – The Finalists Product Company Gosh Chameleon Foundation Gosh Beauty Perfectil Hair Crush Gummies Valeo Healthcare Jenny Glow Jenny Glow

Best Digestive Product Bio-Kult At the OTC & Retail Product Awards, Bio-Kult by Scope Healthcare won the Best Digestive Product.

Bio-Kult is a scientifically developed multispecies, multi-strain supplement with 14 strains of beneficial bacteria. This means that Bio-Kult can deliver high concentrations of beneficial bacteria to the colonisation sites in the gut and therefore be able to help a more diverse range of digestive disorders.

2020

Showcasing product excellence

Bio-Kult has been proven to survive the high acidity of the stomach. It does not need to be refrigerated, is gluten free and suitable for children and pregnant women.

Winner Best Digestive Product

This category was open to all OTC products available in Ireland for the treatment of digestive orders for enhancing gut health. These products included those for heartburn, upset stomach, diarrhoea, constipation and bloating.

Bio-Kult Advanced (SCOPE)

The judging panel considered products which demonstrated targeted and effective relief, as well as an appreciation of the impact these digestive disorders have on the sufferer.

ULT BIO-K CED N ADVA

Judges Comments: "Bio-Kult is competitively priced with a great product range. We receive great support from the company and great feedback from customers who find them better than similar products on the market. We find Bio-Kult is easy to sell, with worthwhile and valuable training and support provided to pharmacy teams."

Alflorex®

Best Digestive Product – The Finalists Product Company Alflorex Precision Biotics Digest Gold Valeo Healthcare One Nutrition Gluten Shield Naturalife

Digest Gold™

One Nutrition Gluten Shield

Best Children & Baby Product Bronchostop Junior Bronchostop Junior offers fast acting relief for cough in children from one year. Bronchostop soothes the cough in stages of both dry and productive chesty cough by covering the cough receptors with a protective layer of marshmallow extract and honey.

2020

Showcasing product excellence

Baby care and child specific products have an important role to play in pharmacy particularly in Ireland as birth rates here are currently higher than the EU average.

The birth rate in Ireland remains relatively high this year with 14.4 babies born per 1,000 residents compared to an average of 10.1 in the rest of the EU.

Winner Best Children and Baby Product Bronchostop Junior

By offering good advice from birth onwards, pharmacy teams can play a vital role in helping parents deal with the many self-limiting ailments that occur during childhood. These conditions range from colic to paediatric cold and flu.

Judges comments: "This product wins hands down! Often it's so good that we have difficulty getting our hands on it as it sells out so quickly but this is testament to how effective it is in dealing with paediatric cough. Really successful product that hit the ground running on launch."

Calpol 120 mg/5 ml Sugar Free Infant Oral Suspension

MyPro™ Kolicare

RELIFE Relizema spray&go

(Perrigo)

OSTOP H C N BRO NIOR JU

WellKid Soft Jelly Pastilles

Best Children & Baby Product – The Finalists Product Company Calpol 120mg/5ml Johnson & Johnson MyPro Kolicare Pharmed RELIFE Relizema Spray & Go A Menarini WellKid Soft Jelly Pastilles Valeo Healthcare

Best Living Aid/Device Product - Scholl InBalance Pain Relief Insoles Retail pharmacy is not only limited to offering OTC medicines and cosmetics; this new category for 2020 highlights those living aid and medical device products available to purchase in community pharmacies across Ireland.

2020

Showcasing product excellence

Winner Best Living Aid/Device product

These products assist with enhancing and improving consumer health and wellbeing and can include sport supports, electronics and non-medicated therapies.

The winner for this new category in 2020 was Scholl InBalance Pain Relief Insoles.

Scholl Inbalance Pain Relief Insole

These help to relieve lower body pains from being on the feet all day.

Developed with a team of biomechanic experts, they have a Motion Control Structure and have been designed to work in three ways: Shock absorption, pressure redistribution and stabilisation.

(Reckitt Benckiser)

Lower Back Pain relief insole comes with a heel cup to reduce stress transfer to the lower back. It is a full length insole to support the position of the entire foot and prevent high pressure areas, distributing the load more evenly.

E PAIN C N A INBAL INSOLE F RELIE

Judges Comments: "This is a well known brand with terrific consumer loyalty and therefore has a great following. I would frequently recommend this product over other brands we stock due to its renowned efficacy and value to the customer."

Lombastab Lumber Support

Best Living Aid/Device Product – The Finalists Product Company Lombastab Lumber Support New Vision Healthcare Duracell EasyTab Hearing Aid Battery Primeline Epitact Flexible Bunion Corrector Pharmed

Duracell EasyTab Hearing Aid Battery

Epitact Flexible Bunion Corrector

Best Eye Care Product Hy-Opti

Hy-Opti Eye Drops won the second category for Rowex.

Increased screen time is having a negative impact on consumers’ eyes, which often dry out and become sore.

Innovation is likely to also fuel growth over the coming years. Many Irish consumers suffer from eye conditions such as blepharitis, where the eye lid becomes blocked and enamed.

Furthermore, Ireland experienced a prolonged period of hot weather last year, with temperatures soaring above average and partial drought conditions being experienced across most of the country. This had a positive impact on overall sales of allergy eye care in particular as demand increased due to the high pollen count in the country.

Hy-Opti Eye Drops are a moisturising ophthalmic solution available in 10ml and 20ml containing sodium hyaluronate.

Hy-Opti Eye Drops are preservative free and provide soothing relief from the effects of dry-eye. The unique selling points for Hy-Opti include: • Fast acting moisturising ophthalmic solution.

• Available in 10ml and 20ml.

• Hy-Opti Eye Drops are preservative free and provide soothing relief from the effects of dry-eye. The product is innovative as we offer two strengths, 10ml and 20ml at a lower cost than the brand leader.

Judges comments: "This product has the edge over competitors due to its value to the consumer. Customers love this product, it is well priced and looks well stocked on the pharmacy shelves. We get great support and training from Rowex also which is an added benefit."

Optrex Pro Vision

OPTASE® TTO Eye Lid Cleansing Gel

Mr. Joe Keane, General Manager of Rowa Pharmaceuticals Ltd.

PTI HY-O OPS R EYE D

Macu-SAVE™

Best Eye Care Product – The Finalists Product Company Optrex Pro Vision Reckitt Benckiser Optase TTO Eye Lid Cleansing Gel Scope Macu-SAVE Pharmed

Best Hair, Nail & Scalp Product Naturigin Simply Natural Naturigin, winner of the 2020 Best Hair, Nail & Scalp Product category, was founded by husband and wife Mette and Stig From Denmark.

In the search for quality natural organic sustainable hair colour the family started their journey to create a healthier alternative to chemical hair colour.

Naturigin was born, available in 19 shades.

Manufactured in Denmark using windfarm energy.

It is derived from 98.2% natural ingredients containing 12 organic Ingredients.

Consumers are becoming more confident in asking for advice about hair and scalp problems. There has been much media coverage about imminent ‘cures’ for baldness but this media speculation proves that the hair and scalp category is an important area for shoppers.

2020

Showcasing product excellence

Winner Best Hair, Nail and Scalp Health Product Naturigin (Simply Natural)

The category has witnessed new product development over the last 12 months and this is expected to continue.

Judges comments: "This is a vegan-certified product and offers a great price point and excellent value for money. I love the background to this product, the packaging and design. I have to offer top marks to this product that sits so well within community pharmacy."

NATUR

IGIN Phyto Novathrix

Best Hair, Nail & Scalp Product – The Finalists Product Company Phyto Novathrix GA Distribution Nourkrin Woman Wholefoods Nailner Treat & Colour for Fungal Nails Brandshapers

Nourkrin® Woman

Nailner Treat and Colour for Fungal Nails

Best Oral Health Product CB12

Winner of the Best Oral Product for 2020 is CB12.

CB12 mouthwash is different. Thanks to its unique, patented formula of Zinc and Chlorhexidine, it is clinically proven to actively neutralise bad breath for 12 hours.

Oral hygiene (and gum protection) is set to be an important trend among consumers as many younger consumers are aware of the effectiveness of introducing good oral hygiene to their oral care routine.

Kelly Jackson, Sales & Marketing, Mylan

Growth within the oral care market was been slower in 2019 compared to previous years due largely to a decline in demand for mouth fresheners and a falling need for dentures.

Judges comments: "This product has a large following with consumers. The support is there and it is an attractive and strong product within the oral and dental market."

TePe® Interdental Brush

Colgate Total

VirtueBrush

CB12 Marvis

Best Oral Health Product – The Finalists Product Company Tepe Interdental Brush Ocean Healthcare Colgate Total Primeline VirtueBrush Diamond Head Floss Tip Toothbrush VirtueBrush Marvis Toothbrush Barbers & Groomers

Discover

Mouthwash Actively neutralises bad breath for 12 hours1

BrSeaptrhay

Chewing Gum

Toothpaste

Discover the range of CB12 in pharmacies nationwide References 1. Thrane PS, Jonski G, et al. Zn and CHX mouthwash effective against VSCs responsible for halitosis for up to 12 hours. Dental Health 2009; 48(3): 8-12.

Mylan IRE Healthcare Ltd, Newenham Court, Northern Cross, Malahide Road, Dublin 17, Ireland. www.mylan.ie Job code: CB12-2019-0161 Date of preparation: June 2019

Best Women’s Product Triumph® Monthly Cycle Supplement Made in Ireland, Triumph scooped the Best Women's Health Product for 2020.

Created by women for women, Irish made Triumph® Monthly Cycle Supplement is ‘The Ultimate All-InOne Beauty, Energy, Hormonal Activity & Immune System Support Supplement.’ This is the first product in the world that’s designed around the three phases of the monthly cycle.

Containing a months supply of 30 sachets and 30 tablets, all numbered, colour coded and easy to take.

Self-care health issues and care strategies for women’s health is far more wide-reaching than just pregnancy and gynaecology. Research has shown that increased global focus on women’s health disorders and an overall ageing female population are helping to drive growth of the women’s health products over-the-counter.

Today’s women are much more well informed with consumers leaning towards self-care and self-medication and thus the outlook has been witnessing a dramatic transformation in recent years.

Judges Comments: "This is a great product innovation within the female health market. It is attractively packaged with some beneficial and interesting unique selling points. The value of this product to both the pharmacy and the consumer is fantastic."

Relactagel

Proceive® Women

Vagisil Crème

Active Iron & B Complex Plus for Women

Renee O'Shaughnessy, Co Founder & Director, Triumph

HLY ® MONT H P M TRIU UPPLEMENT S CYCLE

Best Women's Product – The Finalists Product Company Relactagel Kora Healthcare Proceive Women Ocean Healthcare Vagisil Crème Brandshapers Action Iron & B Complex Plus for Women Solvotrin

Most Innovative Product Bio-Kult Migrea It is imperative for many business to differentiate themselves in a packed market whilst addressing customer needs and focusing on what they can do differently.

2020

Showcasing product excellence

Winner Most Innovative Product

This category was won by Bio-Kult Migréa, which helps to tackle head discomfort and is the latest addition to the Bio- Kult range.

It is the first live bacteria supplement designed to target the head.

Bio-Kult Migréa is an advanced multi- action live bacteria formulation that targets

Bio-Kult Migréa

both the digestive tract and the head and has been formulated with magnesium and vitamin B6, both of which contribute to normal functioning of the nervous system, and reduction of tiredness and fatigue.

Vitamin B6 contributes towards the normal function of the immune system and has been shown to help protect against in ammation.

Vitamin B6 also has the added bene t of contributing to the regulation of normal hormonal activity.

Few markets aren't crowded these days, with competition coming not only from local companies but, thanks to e-commerce, overseas too.

In a connected world, services are no longer limited to our local high street. Standing out in a crowded market isn't easy, but innovation can help businesses attract the customers they need to stay ahead of their market competition.

(SCOPE)

Judges Comments: "This product is certainly innovative and competitively priced within its category. It is easy to sell and consumers frequently return so it has a large loyal following."

ULT BIO-K ÉA MIGR Zenflore®

Best Innovative Product – The Finalists Product Company Zenflore Precision Biotics RELIFE Relizema Cream A Menarini Epitact Flexible Bunion Corrector Pharmed

RELIFE Relizema cream

Epitact Flexible Bunion Corrector

Best Tanning Product TanOrganic Facial Tan Oil TanOrganic Facial Tan Oil won the Best Tanning Product category for 2020.

TanOrganic Facial Tan Oil is a luxurious self-tan specially formulated for the delicate skin on the face that absorbs quickly without leaving a greasy layer to reveal a radiant natural golden tan.

Showcasing product excellence

2020

Made wholly from natural and organic ingredients that are super nourishing, it will leave skin looking and feeling hydrated for up to 7 days. It is suitable for sensitive skin, eczema-prone, acne or psoriasis.

This product is a world fist ecocertified, vegan -certified, organic and cruelty-free self-tan. Along with being the highest-rated self-tan on trust pilot, it is also the only tan with a 100% score with ethical association; only 6 other cosmetic brands in the planet have such a score.

Winner Best Tanning Product Facial Tan Oil (TanOrganic)

The self-tanning market is still booming, not just in Ireland but globally. With an increase in the number of cases of nonmelanoma skin cancer, consumer awareness around long-term sun exposure is increasing and, along with it, the willingness to use self-tanners.

As the lines between self-tanning and skincare categories continue to blur, innovation in formulation and product ranges will remain paramount to the success of the selftanning market, say market research reports.

Judges comment: "This product scores really highly within product innovation and value. Being vegan-certified and ecocertified is such a big positive in todays world where these issues are ever more important to so many consumers."

Professional Fast Tanning Mousse

WHITE to BROWN Self Tanning Water Medium

Perfect Fade Vegan Self-Tan Oil

Magic Mousse à Bronzer

L FACIA

TAN OIL

Best Tanning Product – The Finalists Product Company Professional Fast Tanning Mousse St.Moriz Self Tanning Water Medium White to Brown Perfect Fade Vegan Self-Tan Oil Cocoa Brown Payot Magic Mousse a Bronzer GA Distribution

Best Pharmacy Only Product Nexium Control Nexium Control won the category for Best Pharmacy Only Product 2020.

The brand has continued to innovate introducing the mini capsule in 2018 which is an easy to swallow capsule in a convenient bottle format.

Nexium Control is Ireland’s leading pharmacy-only heartburn treatment without prescription* and is one of the fastest growing brands in the GI category.

2020

Showcasing product excellence

Since its launch in 2014, it has grown from strength to strength and now accounts for 39% value market share and continues to experience double digit growth of 14% year ending December 2019.

Winner Best Pharmacy Only Product

While more is being done to promote awareness regarding the importance of the safety and appropriate use of OTC drugs, pharmacists are still the patients best resource in the proper selection of OTC products.

Moreover, while it is important for all patients to properly use OTC products, individuals of advanced age, individuals with preexisting medical conditions such as diabetes, those currently using prescription drugs and those requiring pharmacy-only products must always consult their pharmacist when considering the use of OTC drugs to avoid possible contraindications, drug interactions, and/or dosing errors.

Nexium Control (Pfizer)

ONT C M U NEXI

A high level of continued marketing support above and below the line is driving its’ overall success together with continued pharmacy support from the Pfizer Consumer Healthcare representative team.

ROL

Judges Comments: "This excellent product sells really well within our pharmacy. It has huge product innovation.

Nexium is a useful trusted and effective product marketed with a good point of sale rapport."

Voltarol Emulgel Extra Strength 2% w/w Gel

Best Pharmacy Only Product – The Finalists Product Company Voltarol Emulgel Extra Strength 2% w/w Gel GSK Nurofen Rapid Relief Liquid Capsules Reckitt Benckiser Benylin Day & Night Tablets Johnson & Johnson

Nurofen Rapid Relief Liquid Capsules

BENYLIN® Day & Night Tablets

Best Irish Pharmacy Brand Product Revive Active Revive Active won the Best Irish Pharmacy Brand category for 2020.

Revive Active is an award-winning super supplement with 26 active ingredients working together, helping put back what life takes out.

This super supplement is delivered in individual daily sachets which are added to water or juice offering higher bioavailability as vitamins and minerals dissolved in liquid form are absorbed in the body more easily than in tablet or capsule form.

The unique blend of vitamins and minerals provide a multitude of health benefits which include naturally sustained energy, without the use of sugar and caffeine, as well as contributing to a normal immune system and heart health.

With the unique combination of CoEnzymeQ10 and L-Arginine along with the 24 other active ingredients each sachet delivers multiple benefits.

In an increasingly borderless world, many consumers are favouring Irish pharmacy brand products. Research has shown that a brand’s country of origin can be as important as other purchasing criteria such as price and quality with many Irish pharmacy shoppers wanting to support local businesses, finding local more trustworthy and more attuned to their needs and wants.

Judges comments: "Everything about this is ideal, great pricing, support and marketing. The product really works and has a fantastic following from my customers. The marketing involved here competes with global product lines currently on the shelves. I really sell this with confidence."

Active Iron

Panadol

Ovelle Emollients

Solpadeine

Dáithí O’Connor, Founder and MD of Revive Active

E REVIV

ACTIVE

Best Irish Pharmacy Brand Product – The Finalists Product Company Active Iron Solvotrin Panadol Extra Soluble GSK Ovelle Emollients Ovelle Solpa-extra Soluble Tablets Perrigo

TWO WINS FOR IRISH SUPPLEMENT BRAND AT OTC & RETAIL PHARMACY AWARDS 2020 REVIVE ACTIVE AWARDED BEST PHARMACY BRAND PRODUCT

ZEST ACTIVE AWARDED BEST VMS PRODUCT

“As an Irish company Revive Active are delighted to win such prestigious awards in two highly competitive categories. To receive such accolades from the Irish Pharmacy industry is a great honour and reflects on the trojan work put in by our team in every area of the company.”

Daithi O’Connor Founder and Managing Director Call: 091 769803 | Email: info@reviveactive.com | Web: reviveactive.com

Best Cough, Cold & Flu Product Benilyn Day & Night Tablets One of the most contested categories this year was for the Best Cough, Cold & Flu Product. This segment represents a huge market within community pharmacy.

Showcasing product excellence

2020

It was won this year

by Benilyn Day & Night Tablets.

Benilyn Day and Night tablets are the only day & night tablets for 24 hour cold and flu relief. Each white tablet contains 500mg Paracetamol and 60mg Pseudoephedrine hydrochloride. Each blue tablet contains 500mg Paracetamol and 25mg Diphenhydramine hydrochloride. During the day the white tablet relieves fever and decongests the nose. During the night the blue tablet helps relieve cold symptoms for a better night sleep.

The cold and flu season represents one of the biggest revenue generators for the over the counter products market.

Winner Best Cough, Cold and Flu Product Benylin® Day & Night Tablets (Johnson & Johnson)

It is a huge market, but players also face stiff competition and have a limited window of opportunity to generate these sales.

This puts huge pressure on marketing, sales and distribution teams to maximise category management and secure the right “share of shelf,” or risk losing their market potential.

Judges Comments: "This product is a staple favourite amongst consumers. It does exactly what it says, is attractively packaged and offers great value for money and point of sale within the community pharmacy."

AlchemLife PhytoRelief-CC™

Lemsip

Y N® DA ETS I L Y BEN T TABL H & NIG

Otrivine

Best Cough, Cold & Flu Product – The Finalists Product Company AlchemLife PhytoRelief-CC Pharmed Lemsip Reckitt Benckiser Otrivine Adult Mucus Relief Menthol 0.1% w/v Nasal Spray GSK

Best Pharmacy Training Initiative Uriage Uriage Training scooped the Best Pharmacy Training Initiative of the Year for 2020.

Excellence in training initiatives is a crucial component for many pharmaceutical companies in the promotion of their OITC offering, whether it be for an existing or a new product and/or service.

2020

Training presents a prime opportunity to expand the knowledge base of your audience, ensuring consumers enjoy a consistent experience and background knowledge.

Showcasing product excellence

Winner Best Pharmacy Training Initiative of the Year

Uriage, the pharmacy only dermo-cosmetic brand, is one of the leading thermal water brands on the international market. Uriage products respond to the needs of all skin types including the most sensitive.

Uriage Thermal water cannot be compared to others sold in Ireland.

Uriage is committed to providing ongoing training to ensure that all pharmacy staff are confident they can offer the best possible advice and service to customers. Uriage 360 training comprises of onsite training of pharmacy staff, monthly off site training in key locations nationwide, online training support. Uriage invested in a knowledge based competition over several months resulting in over 13 pharmacies being represented on a trip to France for an experiential trip to the Uriage Thermal Centre.

Uriage (GA Distribution)

URIAG

Judges comments: "Within our pharmacy we have witnessed tremendous support from GA Distribution, from across the whole team. Their training is thorough, comprehensive and invaluable for us in providing advice and education to consumers. Well deserved win in this category."

E

Solgar & Nature’s Bounty Training THE SOLGAR® ACADEMY LEARNING HUB

Best Pharmacy Training Initiative Product – The Finalists

Product Solgar & Nature's Bounty Training Kelo-Cote 4FrontPharmacy.ie

AC A D E M Y

EARN GET TS & POIN RDED REWA R FO NING TRAI

Company Nature's Bounty Alliance Pharmaceuticals 4Front Pharmacy

24/7 Access to the Best Training and Education Resources: Webinars, E-Courses, Training Manuals & Nutrition News REGISTER NOW at www.solgaracademy.co.uk to enrol in courses, complete assessments and earn great rewards For more information contact your Solgar® Territory Account Manager or call 01442 890 355 Food supplements should not be used instead of a varied balanced diet and a healthy lifestyle. Solgar® is a registered trademark.

KELO-COTE®

4FrontPharmacy.ie

Best Skincare Product RELIFE Relizema cream

RELIFE Relizema Cream by A Menarini, won the Best Skincare Product for 2020.

This innovative product helps to manage conditions like eczema, dermatitis and dry and sensitive skin. It is the first RELIFE product range to be rolled out in pharmacies nationwide. Ireland is the first country in the world outside of Italy to launch RELIFE as a dermatology (over-the- counter OTC) brand.

The Relizema product range, which consists of six products, is aimed at managing eczema, dermatitis and dry and skin conditions in adults and children using a three-pronged approach – ‘Treat, Protect and Cleanse’.

RELIFE’s Relizema cream helps to treat the symptoms of itching and redness, which are associated with dermatitis. Due to its derma- protective action, it helps maintain and restore the physiological skin barrier and its formulation protects and moisturises the skin with a soothing effect.

The quest for youth is expected to continue among both male and female consumers. The global skincare market is fast growing and expansive, vast and evolving quickly with forecasts that indicate a global market of ¤81.9 billion in 2028, growing signi cantly from ¤44.1 billion in 2018.

Judges comments: "This is a great product and a new innovation for the Irish market within the skincare category. It is still relatively new and in its infancy with regards to roll-out here but feedback from consumers has been excellent and a I predict a large following."

Bio-Oil Dry Skin Gel

PoxClin® Shingles Body Mousse

Elave Rejuvenating Cleansing Treatment

MooGoo's Irritable Skin Balm

Johnny Murphy, Head of Consumer Health, A.Menarini Pharmaceuticals Ireland Ltd

Best Skincare Product – The Finalists Product Company Bio-Oil Dry Skin Gel Ocean Healthcare PoxClin Shingles Body Mousse Pharmed Elave Rejuvenating Cleansing Treatment Ovelle MooGoo's Irritable Skin Balm MooGoo

NEW Relizema™ ECZEMA DRY & SENSITIVE SKIN BABY CARE

A unique range of Italian emollients and cleansers, which includes products developed for eczema, dermatitis, baby care, dry and sensitive skin.

All products are dermatologically tested

Distributed by: A.Menarini Pharmaceuticals Ireland Ltd, Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin. www.relife.ie IE19019 IR-REL-22-2019 Date of item April 2019

Best Launch of the Year Bronchostop Junior

When launching a new product there are several steps to success that are crucial for any business, taking time and careful planning. These include understanding your target audience and how to reach them effectively, looking at what makes your product innovative or different and unifying the product team across all channels, whether it’s marketing, social media or sales.

2020

Showcasing product excellence

Winner Best Launch of the Year Product

This year, the category was won by Bronchostop Junior.

Bronchostop Junior offers fast acting relief for cough* in children from one year. Bronchostop soothes the cough reflex in stages of both dry and productive chesty cough by covering the cough receptors with a protective layer of marshmallow extract and honey.

Bronchostop Junior (Perrigo)

Traditionally, productive and non- productive coughs have been managed differently but the ingredients in Bronchostop Junior work in synergy to relieve both dry and chesty coughs.

Judges comments: "This product wins hands down! Often it's so good that we have difficulty getting our hands on it as it sells out so quickly but this is testament to how effective it is in dealing with paediatric cough. Really successful product that hit the ground running on launch."

Emazole Control

Triumph® Monthly Cycle Supplement

OSTOP H C N BRO NIOR JU

RELIFE Relizema Range – Consumer Campaign 2019

Best Launch of the Year – The Finalists Product Company Emazole Control Rowex Triumph Monthly Cycle Supplement Vitropics RELIFE Relizema Range Consumer Campaign 2019 A Menarini

Best Marketing Campaign Spotlight Oral Care - Harm Free Oral Health Spotlight was the winner of the Best Marketing Campaign 2020.

Marketing campaigns are the perfect way to reach customers, clients, and leads. They can be the game- changing move.

Producing campaigns with a series of touchpoints will grab someone’s attention better than a single advertisement. With a need to break through the clutter when promoting a product, an effective marketing campaign can do that.

Spotlight is a new range of toothpastes, created by two Galway based dentists in response to the potentially harmful ingredients found in most other brands.

Research showed we all take it for granted that our toothpaste ingredients are safe. So the aim of the launch campaign was to wake consumers up about what’s actually in their existing brand and get them to reconsider what they're putting into their mouths, one of the most absorbent parts of the body.

Focusing on the toothpaste’s unique formulation, the TTL campaign which featured Spotlight’s creator’s Dr Lisa and Dr Vanessa Creaven, was extremely effective in not only raising awareness of this new challenger brand but also in driving engagement, increasing site traffic and improving sales.

Siobhan Lavery, Siobhan Lavery Consulting

SPOTLI

RAL GHT O

Best Marketing Campaign – The Finalists Product Company Durex Valentine's Campaign Reckitt Benckiser NiQuitin Perrigo Perrigo Cold & Flu Products Perrigo Solgar Campaigns Nature's Bounty

CARE

Judges Comments: "Fantastic marketing and support. The advantage for Spotlight is it's owners are dentists, which in turn means it is led, developed and endorsed professionally which has contributed to really raising its profile amongst community pharmacy."

Durex Valentines Campaign

NiQuitin

Perrigo Cold & Flu Products

Solgar Campaigns

NEW

Stay well this winter with Ultibio Immune Scientifically proven ingredients to balance and maintain the immune system* *See pack for details. Food supplements should not be used instead of a varied balanced diet and a healthy lifestyle. Solgar® is a registered trademark.

cutter.indd 1

22/12/2014 09:46

Best Pain Relief Product Brupro Max

Brupro Max 400mg from Rowex won the Best Pain Relief category, making it a double win for Rowex within the 2020 OTC & Pharmacy Retail Product Awards.

Brupro Max 400mg Film-coated tablets work where they’re needed - at the site of pain. They quickly relieve pain, reduce in ammation and lower temperature.

Brupro Max provides fast and effective relief from areas of pain such as headache, dental pain, muscular pain and cold and flu symptoms.

The pain relief market within Ireland is consistently rising.

Pain relief products will continue to be in strong demand, with consumers leading busier and more stressful lifestyles, and seeking analgesics for pain relief, particularly from tension and headaches.

More active consumers are also likely to require more pain relief for injuries.

OTC analgesics used to treat pain can sometimes be particularly difficult for patients to self-manage. Community pharmacists and their teams have an opportunity to educate and advise within this area.

Judges comments: "This is an excellent product within pain relief, which comes with amazing support from Rowex.

These tables are easy to swallow and at an ideal price point."

Nurofen Rapid Relief Liquid Tablets

Argicalm

Mr. Joe Keane, General Manager of Rowa Pharmaceuticals Ltd.

RO BRUP MAX

Voltarol Emulgel Extra Strength 2% w/w Gel

Best Pain Relief Product – The Finalists Product Company Nurofen Rapid Relief Liquid Tablets Reckitt Benckiser Agricalm New Vision Healthcare Volatrol Emulgel Extra Strength 2% w/w Gel GSK

Best VMS Product Zest Active There was much competition around the Best VMS Product category, which was won by Zest Active.

This product scored highly with the judges for its impact on customers, value of product to the pharmacy and unique selling points.

2020

Showcasing product excellence

Increasing numbers of people are taking a proactive approach to their health and the wellbeing trend is sweeping the nation. Keeping up with consumers or even getting a bit ahead of their desires is the name of the game. In the ever-changing and extremely fickle vitamins, minerals and supplements (VMS) category, it is even more vital to stay on pace or ahead of the curve with those visiting their local pharmacy.

Winner Best VMS Product Zest Active (Revive Active)

According to latest market research reports, vitamins sales are expected to continue growing as consumers increasingly look towards preventative measures over cures. A growing number of consumers are expected to monitor their health through blood tests, which will result in greater awareness of vitamin and other deficiencies.

AC ZEST

TIVE

Judges Comments: "Great support has been given by the team behind Zest Active. We have received fantastic customer feedback once this product was purchased with repeat customers.

I now actually use this product myself!"

Aqua Biome

Best VMS Product – The Finalists Product Company Aqua Biome Valeo Healthcare Seven Seas Joint Care Supplex & Tumeric Brandshapers Eskimo Brain 3.6.9 PPC Galway

Sevens seas Jointcare Supplex & Tumeric

Eskimo Brain 3.6.9

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Business CPD

COVID19 KEY MESSAGES #COVID-19 #FirstDoNoHarm #StaySafe #SaveLives IPN’s Pharmacy Business Excellence Series is for community pharmacists committed to growing their professional and business knowledge and skills to overcome challenges and thrive as a community pharmacist.

LEARNING OUTCOMES At the end of article, you will be able to…

• Outline the purpose of the IPN/4Front Pharmacy Business Excellence Series • Assess the risks of the status quo • Describe key changes community pharmacists must navigate to survive and thrive • Recognise opportunities to be cutting edge community healthcare leaders • Showcase examples of pharmacy business excellence in action • Reflect on what is possible for you

Summary: Never before has there been such a need for the entire pharmacy workforce to have fast, accurate and timely training. Yet, simultaneously, never have there been so many barriers to achieving this goal.

• Pharmacies are at the frontline, supplying essential medicines and pharmaceutical care in a time of heightened fear and high demand. There is no time for the pharmacist to individually train staff.

• Off-site, face to face training is not possible, both because the staff is required in a patientfacing capacity AND because all such training is not possible due to the social (physical) distancing required to contain the spread of the coronavirus.

• All staff, bar none, require immediate training in a timely manner.

Award-winning start-up, e-learning specialist and IPN Training Partner, 4FrontPharmacy.ie has created a solution to overcome

these barriers, and enable pharmacies safely respond to this unprecedented global crisis. Through its online training platform, in just 60-90 minutes, you and your pharmacy team will be able to - Describe how Coronavirus COVID-19 is spread - Outline specific actions they can take immediately to #StaySafe in a pharmacy setting - Communicate clear public health messages to patients Who is it for?

• Pharmacists • Pharmacy Owners

• Pharmacy Technicians • Pharmacy Front Of Shop Staff • Temporary Pharmacy Staff and Volunteers • Pharmacy and Pharmacy Technician Students • Pharmacy Office Staff What pharmacy workers are exempt?

Nobody. Coronavirus knows no county boundaries, no role distinctions, no hierarchy.

Should I wait until my employer asks me to do this training?

As a pharmacy worker, it is your personal responsibility to yourself, your family, your team, your patients and the pharmacy business you work for to ensure you have the knowledge and skills to minimise the risk of contracting or transmitting coronavirus infection.

I am not directly patient-facing.

Is Coronavirus training relevant for me?

As a pharmacy worker, you are at the front line. You provide essential services for the most vulnerable in our society. None of us is immune to this coronavirus.

If you or any member of your team contracts COVID-19, or are a close contact of a confirmed case, self-isolation and self-quarantine means you will be unavailable to work for at least 14 days. You could also inadvertently infect team members. #StaySafe

PHARMACYNEWSIRELAND.COM

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Coronavirus COVID-19

If you feel unwell with cough or fever: please phone your doctor for medical advice or please phone the pharmacy for a supply of your medicines or advice about your medicines.

This helps to protect you, other people and staff visiting the pharmacy today.

Phone us first

Tel:

I am a pharmacy ‘reserve’ worker or ‘volunteer’ helping out. Is Coronavirus training relevant for me?

will be unavailable to work for at least 14 days. You could also inadvertently infect family, patients or team members. #StaySafe

As a pharmacy worker, you are at the front line. You provide essential services for the most vulnerable in our society. None of us is immune to this coronavirus.

If you or any member of your team contracts COVID-19, or are a close contact of a confirmed case, self-isolation and self-quarantine means you will be unavailable to work for at least 14 days. You could also inadvertently infect family, patients or team members. #StaySafe

On whose information is the Coronavirus COVID-19 Certified Pharmacy Training programme based?

I am a very experienced pharmacist and I already have extensive infection control training. Is Coronavirus training relevant for me?

SARS-CoV-2 is a novel coronavirus, which was unknown in humans until 31st Dec 2019.

While your infection control training and experience as a pharmacist is a valuable strength to be leveraged, none of us knows it all regarding this pandemic. As a pharmacist, you are at the front line. You provide essential services for the most vulnerable in our society. None of us is immune to this coronavirus. If you or any member of your team contracts COVID-19, or are a close contact of a confirmed case, self-isolation and self-quarantine means you

The Coronavirus COVID-19 Certified Pharmacy Training Programme is distilled, by pharmacists, from reputable sources such as the Health Service Executive, Health Protection Surveillance Centre, World Health Organisation, Department of Foreign Affairs, Pharmaceutical Society of Ireland and Irish Pharmacy Union.

Why should every Pharmacy Worker complete the Coronavirus COVID-19 Certified Pharmacy Training immediately?

In order to: - Protect yourself and your Family - Protect your Team - Protect your Patients - Protect your Business How will a Supervising or Superintendent Pharmacist know who has completed the training?

After watching the audio-visual lesson and reading the assigned resources (e.g. from HSE), you need to complete a multiple choice

For more information visit hse.ie or phone HSElive on 1850 24 1850

quiz and attain at least 80% in order to generate a certificate of completion. This certificate of completion is emailed to each person who successfully completes the training. It can be printed from the 4FrontPharmacy site. It is also recorded in the person’s ‘Learner Dashboard.’

Staff members who are free 4FrontPharmacy members can forward a copy of their certificate to their HR department, supervising and superintendent pharmacist to add to their training record. (Pharmacies who are ‘Paid’ 4FrontPharmacy members also have integrated management oversight of employee completion records).

How can we use our training to demonstrate our professionalism to our patients?

Some pharmacies are printing, laminating and displaying their Certificates of Completion to further reassure the public and their colleagues of their professionalism, COVID-19 competence and their ongoing commitment to patient safety.

How often is the programme updated?

The Coronavirus COVID-19 lesson is reviewed and updated each week in line with national developments.

What does the Coronavirus COVID-19 Certified Pharmacy Training programme involve? www.4FrontPharmacy.ie has made its online Coronavirus COVID-19 Certified Pharmacy Training programme available for free to all pharmacy staff with immediate effect.

The online programme comprises of four video lessons: 1. What Causes Infections; 2. Managing Infections 3. Coronavirus COVID-19 – The Facts 4. Protecting Staff & Patients from Infections in Community Pharmacy, How much time does it take to complete the programme?

Each lesson takes just 15-30

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Business CPD Ensure ALL pharmacy staff (pharmacists, technicians, front of shop, door staff, delivery staff, office staff etc) have signed up and completed the free Coronavirus COVID-19 Certified Pharmacy Training programme as soon as possible.

Don’t delay. In a pharmacy setting, we are on the front line. We are exposed to each other and to our patients. We share work surfaces.

We touch common tools such as key boards, phones, door handles.

- Poor practice will cause pharmacy closures.

- Poor practice will infect colleagues and patients.

- Poor practice, will cost lives.

If you have already signed up. thank you.

Remember, Coronavirus is a new virus. There is emerging guidance on a daily basis. Therefore refer back to the course at least weekly to ensure you stay up to date.

Rachel Dungan CEO 4Front Pharmacy, practising social distancing during an interview with Elaine Crowley about pharmacy and COVID-19 on The Elaine Show, Virgin Media One TV, 18th March 2020

minutes to complete and the entire programme can be completed in 60-90 minutes. It is specifically designed for all staff working in Community Pharmacy, from pharmacists to front-of-shop staff.

This is one of the most important 90 min investments of your life. Implementing the lessons in your pharmacy practice WILL save lives.

DOES 4Front Pharmacy only offer COVID-19 Training?

No. In addition to training on COVID19 there are over 80 other courses and products allowing training to be completed on multiple topics.

Do I need a computer to do the programme?

No. Once you have ‘signed up’ and ‘logged in,’ you can complete this programme from any device with speakers and an internet connection, such as a phone, tablet, lap-top or computer. For viewing on a phone, hold the phone in a horizontal position to view the videos.

Why has www.4FrontPharmacy.ie made the decision to release this module free of charge?

Commenting on the decision to make the programme available without charge to the wider pharmacy community, co-founder of 4Front Pharmacy, David McLean, said “In the absence of an available vaccine, our best defense against the spread of infection is to educate all employees with accurate information about the disease, proven methods to prevent infection, and link this to the latest national advice. This is the right thing to do at the right time – for pharmacies, their staff and their customers.”

Co-Founder Rachel Dungan MPSI added:

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“While pharmacy staff are already highly competent and well-trained with regard to infections, the emergence of COVID-19 has generated unprecedented levels of queries and understandable concern among pharmacy workers and the general public. The need for accurate, comprehensive communication and best practice action is critical for every single staff member. The coronavirus pandemic is a new health, business and personal threat.”

Rachel Dungan MPSI added: “I have been a pharmacist for 25 years and have always been a passionate advocate for pharmacy. Coronavirus is the biggest threat we have faced in our lifetime. I want all my pharmacy colleagues to survive to tell the tale. I want our families and our patients to get through this unscathed. I want our businesses to stay open to serve our communities in their time of greatest need. That is why at www.4FrontPharmacy.ie , we have put 100% of our resources into making our online COVID-19 Certified Pharmacy Training available free of charge to ALL pharmacy staff, with immediate effect.”

First Do No Harm Primum non nocere is a Latin phrase that means "first, do no harm." Non-maleficence, which is derived from the maxim, is one of the principal precepts of bioethics that all medical students are taught in school and is a fundamental principle throughout the world.

‘First Do No Harm’ comes sharply into focus when dealing with this global viral pandemic.

We are required to ensure that every member of our team is engaged, empowered, equipped, enabled to work in a way that ‘first, does no harm.’ #StaySafe by ensuring you and every member of your pharmacy team completes this online training AND takes the actions required to keep you, your family, your team, your patients and your business safe.

If you or any member of your pharmacy team has not yet signed up, you can‘sign up’ for 4FrontPharmacy’s free Coronavirus COVID-19 Certified Pharmacy Training programme at www.4FrontPharmacy.ie If you have any difficulty registering, please email either David.McLean@4FrontPharmacy.ie or Rachel.Dungan@4FrontPharmacy.ie 4FrontPharmacy’s goal is to engage, empower, equip, enable you to protect yourself, protect your family, protect your team, protect your patients and protect your pharmacy, and in doing so #StaySafe and #SaveLives.

AUTHOR: Rachel Dungan MPSI, ACC. Community Pharmacist. Award-Winning Medical and Leadership Coach and CEO of www.4FrontPharmacy.ie, a leading-edge online training platform for pharmacies, proven to drive patient safety, staff engagement, and increased sales, through raising the quality of pharmacy / patient interactions. Known as ‘The Pharmacist Coach,’ Rachel worked for 20 years as a supervising and superintendent pharmacist. Rachel’s entire career has focused on developing and applying professional and business excellence to enable pharmacy teams to deliver exceptional results.

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Over ¤100,000 raised by 100Minds McCabes Pharmacist and Perrigo Pharmacy Intern Glenn Ryan has recently completed his part in 100minds, which raises vital funds for the Temple Street Foundation.

This year the team collectively raised ¤115,123 a staggering amount.

Glenn says, "I would like to thank every family member, friend, colleague, classmate, student, lecturer, customer, patient, and connection who kindly donated and helped me to play a small role in this incredible achievement. Their donations will have a great impact on the children and families who receive such wonderful care from Children's Health Ireland at Temple Street Children's University Hospital."

The team managed to smash their ¤100k target in providing the funds needed to facilitate the development of a new radiology ultrasound room and sedation facilities.

"It was an unbelievable experience to work with a team of altruistic individuals who each volunteered and accepted the challenge to make a difference in the lives of the most vulnerable children in Ireland, sick children who need great care right now," he added.

New Appointment at IPHA The Irish Pharmaceutical Healthcare Association (IPHA) has announced the appointment of Jim McGrath to the role of Director of Commercial Policy.

Mr McGrath has spent the last three years as Public Affairs Director with the corporate advisory firm Teneo, where he has provided policymaking and strategic support to many of Ireland’s leading businesses including in the healthcare and pharmaceutical sectors.

Mr. McGrath also has over eight years senior-level policymaking experience having previously been advisor across three separate Government departments - the Department of Business, Enterprise and Innovation, the Department of Environment and the Department of Transport. He also worked as an adviser in the European Parliament and is a former journalist.

Connecting Pharmacy to Effective Coaching Connect a Coach was founded to offer coaching to ALL frontline and emergency services staff. It is a free service for nurses, doctors, first responders, health care assistants, pharmacists and emergency services, essentially anyone on the frontline dealing with the impact of COVID 19.

As Leo Varadkar said on St. Patrick’s Day, ‘never will so many ask so much of so few’. It was this statement that got Ailbhe Harrington and Karen Hayes mulling over how they could give to those who are being asked to give so much. Ailbhe, a Master Certified Coach and Coach Trainer, and her co-founder Karen Hayes, Associate Certified Coach brainstormed how they could answer the ‘Be on Call for Ireland’ initiative. Over the course of a week they put the call out to their network of qualified coaches, and so Connect a Coach was born.

It is a very simple process with no paperwork requirement, no approvals process and no long waiting times. Simply visit www.connectacoach.org , where you will find a directory of coaches.

From there, you select a coach, and are brought into their online calendar where you can book a 45-minute slot. The coach will confirm the slot within 2 hours and send you details for your virtual or phone session. There are a large number of coaches working with Connect a Coach allowing them to guarantee coaching availability between 7am and 9pm, 7 days a week. There are up to 4 sessions available, entirely free. If you wish to continue coaching beyond the fourth session, you can engage with your coach separately.

So how does it all work?

Harrington says ‘Our frontline

Pharmacists currently working at the frontline during Covid-19 are being offered access to a free coaching service which aims to offer assistance as a key resource.

staff are working in very changed conditions, on many levels, in remote testing centres, with new colleagues, dealing with an illness we haven’t known much about until now. Our frontline staff are human, and, dealing with all of this can be challenging. Now more than ever, they need to be fully resourced. That’s where coaching can help’.

Both Ailbhe and Karen spoke to us about the rigour that has been applied in selecting the panel of coaches. ‘They needed to all fulfil certain eligibility criteria so that Connect a Coach could guarantee quality of service and a strict adherence to confidentiality, supervision and ethics. Also, we are grateful to be supported

by HSE staff, who will take all coaches through an understanding

and awareness of psychological first aid.” Says Harrington Having spoken at length with Ailbhe and Karen, it’s very clear that this is a voluntary operation that has been mobilised at breakneck speed, because that’s the requirement now.

There’s a considerable degree of professionalism behind it, but the piece that stands out here is empathy. There’s huge acknowledgment of the mammoth task being taken by our frontline workers right now, Connect a Coach are waiting in the wings to help pick you up when you might fall, to help keep you resourced, or to just listen, when you most need to be heard. We wish Ailbhe, Karen and the wider team at Connect a Coach the very best of luck with this initiative!

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