IPN December 2024 Digital

December 2024 Volume 16  Issue 12 PHARMACYNEWSIRELAND.COM

Dynamic 100 Issue THE INDEPENDENT VOICE OF PHARMACY

In this issue: NEWS:

NEXIUM CONTROL GETS TO WORK IN

Calls for Integrated Women’s Health Plan Page 6

1 HOUR

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*FULL EFFECT MAY TAKE 2 – 3 DAYS

MEDICINES: Shortages Deepen across Ireland Page 8

AWARDS: Chanel is The People’s Pharmacist Page 14

REVIEW: Medicines for Ireland Manifesto Page 20

CPD: Management of Pain Page 43

24HR HEARTBURN PROTECTION WITH JUST ONE PILL

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This Publication is for Healthcare Professionals Only

CONFERENCE: Irish College of Ophthalmology Page 48

DYNAMIC: Pharmacy’s Dynamic 100 Page 64

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Contents

Foreword

Page 7: Boots open destination store in Cork

In one of our lead news stories this month, Pharmacists across Ireland are calling on all political parties to back a bold new proposal for an integrated Women’s Health Plan. This transformative initiative would provide seamless, comprehensive care for women at every stage of life, from their teenage years through menopause, by uniting the existing Free Contraception and the proposed Hormone Replacement Therapy (HRT) schemes.

Page 10: Life Pharmacy Raises ¤27,450 Page 12: Pharmacy of the Year Title for McCabes

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Whilst mentioning the proposed Hormone Replacement Therapy (HRT) schemes, on page 8 we reveal that the roll-out is increasingly threatened by the ongoing shortages in HRT medicines, an industry expert has said. The comments come as latest figures show that 333 medicines are currently out-of-stock, with 283 of these medium to high-risk medicines.

Page 14: Chanel wins the Vote for People’s Pharmacist 2024 Page 24: United Drive driving excellence Page 32: Landmark Year for Cardiac Health

12

Page 40: Viatris Team show support for Irish Wheelchair Association

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

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

Finally, may I take this opportunity on behalf of the entire IPN team to wish all our readers and supporters a very Merry Christmas, and a prosperous New Year. See you in 2025!

SALES MANAGER Amy Evans | amy@ipn.ie 0872799317

DESIGN DIRECTOR Ian Stoddart Design PHARMACYNEWSIRELAND.COM @Irish_PharmNews IrishPharmacyNews

Chanel was nominated by members of her local community recognising her exceptional dedication and impact as a community pharmacist. Known for consistently going above and beyond in her role, Chanel is celebrated as a true pillar of her community, offering invaluable support, care, and expertise to those she serves.

Of course no December issue would be complete without our annual Dynamic 100 – detailing those innovative and dedicated professionals making their mark on the sector. It is fair to say the dedication, passion and innovation behind the profession is never lacking.

MANAGING DIRECTOR Natalie Maginnis n-maginnis@btconnect.com

CONTRIBUTORS Ruth Morrow Colm Moore Michele O’Brien Amy Kelly Chris Macey

Among the notable shortages is HRT medication which continues to experience serious supply problems with just weeks to go until the roll-out of the new free HRT scheme recently announced by government. Commenting, Sandra Gannon, Azure CEO said, “Any new HRT programme is going to struggle to take-off if the relevant products experience limited or no availability. There is a real concern across the pharmacy community that the scale of the supply challenges with HRT is not fully appreciated.”

On page 14 of this issue we feature the winner of the 2024 People’s Pharmacist Award, in association with Panadol, Chanel Geoghegan of Hickey’s Pharmacy in Clones. During September, members of the public were encouraged to nominate their local pharmacist whom they thought should be recognised for going the extra mile. After receiving a wealth of nominations – over 400 – across the country, eight deserving shortlisted finalists have been chosen. Chanel beat some stiff competition to scoop the title with over 11,000 votes cast in total and a reach across social media of 350,000.

Page 64: Annual Dynamic 100 of Pharmacy

EDITORIAL/ EVENTS & MARKETING EXECUTIVE Aoife Hunter: aoife@ipn.ie

The plan aims to revolutionise women’s healthcare, removing barriers and ensuring every woman in the country has access to the care she needs without interruption or additional cost. You can read more about this on page 6.

40 Irish Pharmacy News is circulated to all 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.

IRISH PHARMACY NEWS

Regulars FEATURE: WINTER FIRST AID

P34

FEATURE: WINTER SKIN

P36

CPD: PAIN

P43

FINANCE: PENSION LEGISLATION

P52

TEAM TRAINING: COLD AND FLU

P56

PHARMACYNEWSIRELAND.COM

6

News

Pharmacists Call for Integrated Women’s Health Plan Pharmacists across Ireland are calling on all political parties to back a bold new proposal for an integrated Women’s Health Plan. This transformative initiative would provide seamless, comprehensive care for women at every stage of life, from their teenage years through menopause, by uniting the existing Free Contraception and the proposed Hormone Replacement Therapy (HRT) schemes.

Kathy Maher, Chair of the IPU’s Pharmacy Contractors Committee

limit the scheme's success. Our integrated Women’s Health Plan would address this by combining the HRT and Free Contraception schemes into one streamlined service, eliminating unnecessary hurdles and ensuring consistency in care."

The plan aims to revolutionise women’s healthcare, removing barriers and ensuring every woman in the country has access to the care she needs without interruption or additional cost.

Kathy Maher, Chair of the IPU’s Pharmacy Contractors Committee said: "We welcome the Minister for Health’s commitment to women’s health through the provision of HRT. However, the budget allocation to fund only the medication while excluding professional pharmacy dispensing fees creates a gap that could

“Dispensing data shows that there has been a doubling of demand for HRT over the past two years.

The treatment is now seen as an entirely standard part of managing menopause and perimenopause.

Given the importance of HRT within women’s healthcare eliminating all costs would be of significant benefit.

This integrated approach would ensure that reproductive health needs are fully supported, offering women cost-free HRT at pharmacies as part of a holistic, accessible healthcare service.”

"Our members, representing thousands of pharmacies across the country are uniquely positioned to lead

this transformation," Ms Maher continued. "We are on the front line, seeing firsthand the challenges women face in accessing healthcare. By providing a single, cohesive service, we can make a significant impact on women’s lives, ensuring no woman has to navigate fragmented care at crucial stages of her health journey."

The Free Contraception Scheme has already proven its value by removing financial and logistical barriers for women. Extending its framework to include HRT, the use of which has doubled in the last two years, would provide similar benefits for older women, ensuring continuity of care from age 17 through to menopause.

As Ireland enters a new era in women’s healthcare, the IPU is urging all political parties to champion this proposal in their health policies.

"This plan is a game-changer," Ms Maher concluded. "By integrating these services, we can deliver seamless, cost-free healthcare that supports women throughout their lives. We look forward to working with the Department of Health to make this vision a reality and urge political leaders to join us in transforming women’s health."

School of Pharmacy Quercus College Scholarships The Quercus College Scholarships acknowledge the academic achievement of students who have achieved top marks in the College of Medicine and Health (CoMH) examinations of Summer 2024.

This year, 37 recipients across the College of Medicine and Health at University College Cork were awarded Quercus College Scholarships, including three recipients from the School of Pharmacy: • Sabhdh Ryan (BPharm2) • Olga Andriyashchenko (BPharm4) • Catherine McGann (MPharm) Professor Helen Whelton, Head, College of Medicine and Health, Professor Stephen Byrne, Deputy President and Registrar of UCC and Professor Brendan Griffin, UCC School of Pharmacy

PHARMACYNEWSIRELAND.COM

The School congratulates its three Quercus College Scholars on their fantastic achievement.

Cervical Cancer Elimination Plan The HSE has launched the Cervical Cancer Elimination Action Plan 2025-2030, which sets out the steps we will take to make cervical cancer rare in every community.

The plan recognises milestones reached so far, highlights the challenges ahead and sets out the work we will do in the HSE and with our partners, to make cervical cancer rare in every community. Elimination of cervical cancer does not mean zero cases of cervical cancer; we are aiming to reach the WHO target for elimination of 4 cases per 100,000 women by 2040.

Eliminating cervical cancer will be achieved through the joint effort of the HSE’s vaccination, cervical screening and treatment services, in partnership with communities.

Dr Colm Henry, HSE Chief Clinical Officer, said: “For most people, cervical cancer is preventable. We know it is caused by HPV in over 90% of cases. We have the tools in HPV vaccination and cervical screening to prevent it. The falling level of cervical cancer in Ireland demonstrates the impact of the HSE’s CervicalCheck programme since it began in 2008 and, more recently, the HPV vaccination programme as vaccinated people continue to reach adulthood.

“The success of our plan in achieving our shared vision of making cervical cancer rare in every community depends on building greater integration across the HSE. This will mean our services are more patientcentred by making them more joined up and easier to navigate.

Changes to health service structures under the new HSE Health Regions offer us more opportunities to integrate than ever, and we are committed to working together to connect, develop shared solutions, and deliver this plan in collaboration with our communities. Success will mean we make history, by making a cancer rare in every community.”

News AMR Roadmap for Pharmacy Six “Antimicrobial Resistance (AMR) Roadmaps”, one for each of the World Health Organisation regions, that define and prioritise major milestones towards mitigating AMR for the period 2024 to 2028, are published by the International Pharmaceutical Federation (FIP) recently.

The roadmaps were developed

by FIP in collaboration with its regional pharmaceutical forums and, for the European Region, with FIP member organisations in Europe as there is no FIP regional pharmaceutical forum in the European region.

The new roadmaps have been developed to follow roadmaps for 2020-2024. The new publication also presents various activities against AMR that have been undertaken in countries of each region.

Antimicrobial resistance (AMR) is a serious global health problem, threatening the effective prevention and treatment of a growing number of infections caused by bacteria, parasites, viruses, and fungi that have become resistant to commonly used medicines.1 Although the patterns of AMR have considerable variation globally,2 AMR should be a concern for every country.

According to the World Health Organisation (WHO), every country should have a national action plan on AMR, to include avoiding overuse and misuse of antibiotics and increasing healthcare professionals' awareness and understanding of AMR while providing effective communication, education and training.3 At the 79th United Nations General Assembly (UNGA) High-Level Meeting on AMR in 2024, countries committed to ensuring that at least 70% of antibiotics used for human health are from the WHO Access Group Antibiotics, which have relatively minimal side effects and a lower potential to cause AMR. The International Pharmaceutical Federation (FIP) also focuses on this issue while considering pharmacists' contribution to combating AMR. Therefore, FIP Development Goal 17: Antimicrobial Stewardship is one of the 21 FIP Development Goals as a primary sole focus.

FIP has developed AMR regional roadmaps for 2020-2024, aiming to drive AMR actions in a new decade.

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Pharmacy Opportunities Including Funding Must be Prioritised by the Next Government The Irish Pharmacy Union (IPU) is urging the next government to prioritise significant opportunities to enhance community-based healthcare. The IPU has outlined five key areas where progress should be made to improve patient care in its election manifesto issued today ahead of the upcoming general election.

The top priority, according to the IPU, is addressing the underfunding of pharmacies. IPU President Tom Murray stated, “In Ireland, significant political attention is paid to healthcare, yet community pharmacies, which are the most accessed healthcare providers, are often overlooked.”

“Pharmacies deliver essential state funded healthcare services through community drug schemes, but fees for these services have been frozen since 2009, while operating costs have soared. Currently, one in ten pharmacies is loss-making, and without swift government action, pharmacy closures could become a reality. To prevent this, the IPU

is calling for an increase in the dispensing fee to ¤6.50 per item of medicine dispensed, a modest adjustment seeing reinstatement to the 2009 rate.”

In the past year, progress has been made in governmental policies to provide for expanding healthcare services in pharmacies.

Mr Murray highlighted, “The foundations for more efficient care have been laid through the work of the Expert Taskforce and new legislation. Opportunities for independent autonomous pharmacist prescribing are now within reach but require continued support from the Minister for Health after the election.”

The IPU is also advocating for a more proactive approach to managing pharmaceutical care of our citizens. “The state spends nearly ¤2.5 billion on medicines annually, yet there is no cohesive national strategy to ensure the safe and effective use of these medicines, leading to challenges like medicine shortages and delayed treatments, affecting patient care, Mr Murray said. “A Chief Pharmaceutical Officer, as recommended by the Expert Taskforce, should be appointed promptly within the Department of Health to oversee policy development to ensure high standards of pharmaceutical care for all citizens.”

A New Era for Beauty in Cork Boots is thrilled to announce the grand opening of its first-ever destination store in the heart of Cork City, a game-changer for the Irish beauty landscape.

Shoppers flocked to Half Moon Street today to be among the first to explore the new store.

Members of the Boots Ireland Leadership Team pictured with Store Manager Shane Doocey (centre) as he cuts the ribbon at the official unveiling of the Best of Boots Destination Store on Half Moon Street in Cork City.

Pic. Robbie Reynolds This flagship store is a beauty lover’s paradise, showcasing an unparalleled collection of global beauty powerhouses and cult favourites, including MAC, Too Faced, Benefit, Fenty, Milk, R.E.M., Urban Decay, Kylie Cosmetics, Huda Beauty, Sol de Janeiro, and many more. Discover skincare innovations from brands like Kiehl's, Dr Jart+, and The Ordinary, and indulge in luxury offerings from YSL, Chanel, Armani, Lancôme, Estée Lauder, Clinique, Clarins, and Liz Earle.

Haircare enthusiasts will be spoilt for choice with a curated selection from Kerastase, Quai, Redken, Matrix, Pureology, Philip Kingsley, Shu Uemura, L’Oréal Pro, and Bumble and Bumble.

Elevating the immersive beauty experience, the store features the No7 Pro Derm Scan, a revolutionary

skin analysis tool from Boots' best-loved skincare brand. Beyond beauty, the store continues to provide a seamless healthcare experience with a focus on easy navigation and expert advice.

Stephen Watkins, Managing Director of Boots Ireland, said: "I’m incredibly proud to bring our first-ever best of Boots destination store to Cork. Our investment in our Half Moon Street store is

about providing customers in Cork and beyond with an unmatched selection of iconic beauty, skincare, and haircare brands, all in one extraordinary space.

We know our customers appreciate choice and quality, and we're thrilled to offer such a comprehensive range right in the heart of the city. I can’t wait to welcome everyone to experience all that this unique store has to offer."

PHARMACYNEWSIRELAND.COM

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News

Medicine Shortages Deepen The roll-out of the recently announced free HRT scheme is increasingly threatened by the ongoing shortages in HRT medicines, an industry expert said today. The comments come as latest figures show that 333 medicines are currently out-of-stock, with 283 of these medium to high-risk medicines.

Sandra Gannon, CEO, Azure Pharmaceuticals

Among the notable shortages is HRT medication which continues to experience serious supply problems with just weeks to go to the rollout of the new free HRT scheme recently announced by government.

The analysis, published by leading pharmaceutical company, Azure Pharmaceuticals. Commenting, Sandra Gannon, Azure CEO said: “Any new HRT programme is going to struggle to take-off if the relevant products experience limited or no availability. There is a real concern across the pharmacy community that the scale of the supply challenges with HRT is not fully appreciated.”

Azure also published another round of findings from polling it commissioned of pharmacists, carried out by Ireland Thinks.

Research found that 61% of community pharmacists noted increased workload as the biggest change faced by pharmacists over the past decade, with medicine shortages also impacting pharmacists and patient care.

The findings come as negotiations between pharmacy representatives and the Department of Health on the roll-out of new pharmacy powers commence.

68% of pharmacists expressed dissatisfaction over the level of support and guidance issued in response to shortages. The most common impacts of medicine shortages reported by pharmacists include increased workload (36%) and delayed or interrupted patient treatment (31%).

Although pharmacists are most directly impacted, patients are also affected by these issues.

With 42% of pharmacists reporting that patients express frustration and anger when a medicine is unavailable and a further 36% say patients express concern and anxiety.

The research findings also found that 80% of Irish pharmacists have experienced verbal or physical abuse over the past year.

Commenting on the findings, Ms Gannon said, “Pharmacists are facing increasingly stressful working environments and patient presentations, compounded by medicine shortages, administrative burdens, and outdated fee models. The ongoing shortages issue is giving rise to agitation and confusion among patients, particularly as this is giving rise to increasing use of unlicensed, more expensive alternative medicines. The normalisation of unlicensed medicines is alarming.

In some cases, people can’t access medicines needed for their treatment at all.

“For four years now, pharmacists have grappled with medicine shortage issues, with little meaningful consideration of how we collectively meet this challenge.

Ireland’s response remains out-ofsync with other countries.”

There continues to be a rise in use of unlicensed medicines, known as an Exempt Medicinal Product (EMP). Many of these products do not contain an English translation of the original patient information leaflet, leading to potential confusion on dosages, or interactions with other medicines, foods or alcohol or allergies a patient may have.

86% of pharmacists say there should be additional requirements accompanying the prescription of EMPs, such as an English language patient information leaflets and a database verifying their origin.

Throat and Mouth Inflammation in Pharmacy A report of a digital event and an insight board discussion, held by the International Pharmaceutical Federation (FIP) on managing throat and mouth inflammation in community pharmacy is published by FIP. Community pharmacists play a pivotal role in guiding individuals through self-care approaches to this condition, providing non-prescription medicines and essential advice for symptom management. In some parts of the world, however, community pharmacists may face challenges in managing of throat and mouth inflammation, including inappropriate antibiotic prescribing, a limited regulatory landscape, or the lack of availability or authority to conduct point-of-care testing. As part of its work on self-care, FIP organised an advisory insight board in November 2023 with frontline community pharmacists, policy experts, educators and researchers to explore the role of pharmacists globally in the effective management of throat and mouth inflammation and to obtain information on the different strategies and challenges faced by pharmacists in this area.

This was followed by a FIP digital event in October 2024 at which speakers shared approaches for managing sore throat and mouth inflammation.

PHARMACYNEWSIRELAND.COM

Antibiotic Resistance Antibiotics are losing their effectiveness at an unforeseen pace, caused by the overuse and misuse of antibiotics. The health impact of antibiotic-resistant infections is comparable to that of influenza, tuberculosis and HIV/AIDS combined.

This European Antibiotics Awareness Day (EAAD), the HSE is reminding everyone how valuable antibiotics are and how important it is that we only use them when needed. Antibiotics cannot help if the infection is caused by a virus.

Dr Eimear Brannigan, HSE National Clinical Lead for Antimicrobial Resistance and Infection Control (AMRIC) says, “Antibiotics are lifesaving drugs when used appropriately to treat bacterial infections, and are usually very safe for us. We have become reliant on antibiotics being effective to treat or prevent infection during many of our routine operations, treatments and for critical surgery such as organ transplants, cancer treatment and many illnesses.

“Unfortunately, over the last 100 years or so a lot of antibiotics have been used in people, animals and crops, often when they were not always appropriate. Because of this antibiotic use, many bacteria have adapted so that antibiotics no longer work as well as they did 20 years ago. Bacteria or bugs become resistant to different types of antibiotics.

These are sometimes called superbugs. So, antibiotics that once worked well to treat an infection may no longer work as well as before or, do not work at all. This is known as antibiotic resistance.”

Everyone is responsible and can make a difference in addressing this growing threat. Prudent use of antibiotics is important; • use antibiotics only when prescribed and as prescribed • use good infection prevention control practices to prevent infections spreading.

EAAD is a European Centre for Disease Prevention and Control (ECDC) annual event which coincides with World Antimicrobial Awareness Week (WAAW).

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News

Life Pharmacy Raises ¤27,450 Life Pharmacy, part of Uniphar Group, is proud to announce that it has raised €27,450 for Jack and Jill Children’s Foundation as part its Life100 campaign. Thanks to the remarkable efforts of Life Pharmacy staff and customers across the country, these funds will go directly to supporting in-home nursing care and respite for families of children with severe neurological conditions.

Mairead Reen, Reens Life Pharmacy and Chair of the Life Pharmacy Board and Michaella McMahon, Corporate Fundraising Manager, Jack & Jill Children’s Foundation

cycle-thons, cake sales, and raffles encouraging customers and community members to donate along the way.

Reen's Millstreet in Co. Cork raised the highest amount at ¤3,754 and proudly led the cheque presentation to the Jack and Jill Children’s Foundation on behalf of Life Pharmacy.

Throughout the month of August, the Life100 campaign saw Life Pharmacy teams take part in various fundraising activities in their local communities, including sponsored walks,

The funds raised will help the Jack and Jill Children’s Foundation continue to provide the gift of time to families caring for children with life-limiting conditions, offering crucial support that makes a real difference in their everyday lives.

Every ¤18 raised provides one hour of in-home nursing care to Jack and Jill, making the ¤27,450 raised a significant lifeline for families supported by the Foundation.

“We are incredibly proud of our Life Pharmacy teams and the communities that came together and rallied around this important cause,” said Mairead Reen, Chair of Life Pharmacy. “It’s heartwarming to see how our local stores and customers can make such a tangible difference for the Jack and Jill Foundation. Reen's Millstreet, along with our other top fundraising stores, have set a wonderful example of community spirit.”

Deirdre Walsh, CEO, Jack and Jill Children’s Foundation said, “We are very grateful to Life Pharmacy and its incredible teams for their tireless efforts in raising ¤27,450 for Jack and Jill through the Life100 campaign.

This generous contribution will directly fund over 1,525 hours of vital in-home nursing care for families across Ireland, providing them with the precious gift of time and support during some of their most challenging moments. The dedication of Life Pharmacy and all the communities involved, is truly inspiring, and we are proud to have worked alongside Life Pharmacy in achieving our goal of providing care and respite for families in need.”

Knowledge of ‘Pneumo’ Falls Short Less than half of Irish people aware that Pneumococcal disease, or ‘Pneumo’ is vaccine-preventable Newly released research has highlighted that 56% of people in Ireland are unaware that pneumococcal is a vaccinepreventable disease. The research carried out by Ipsos B & A, on behalf of MSD Ireland, examined the awareness and knowledge of pneumococcal disease, also known as ‘Pneumo’, and showed that awareness levels of the disease and related vaccination programmes remain quite low in Ireland.

Invasive pneumococcal disease, more generally known as 'pneumo', is a major cause of illness and death in Ireland, particularly among the very young, older people and those with a weakened immune system. A pneumococcal infection can cause many types of illness that range from mild to very severe, including

pneumonia, meningitis, sinus, ear, bone, and blood infections.

Emphasising the low awareness levels, less than 1 in 4 people said that they have some understanding of Pneumo disease (24%). (20% say they have little knowledge and just 3% say they know a lot).

In contrast, 41% say they have no awareness of the disease at all, while 36% say that they have heard about it, but don’t know anything about it. (77% net lack of awareness).

Awareness of Pneumo increases with age, yet overall awareness still remains low across all ages.

28% of those polled over the age of 65 said they had at least a little knowledge about Pneumo, while just 19% of those aged 25-34 said they have at least a little knowledge about the disease.

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Over 800,000 people aged 65 and older are at risk of contracting pneumococcal disease in Ireland each year, but despite this, almost 3 in 4 people surveyed (73%) have not heard of the national vaccination programme for pneumococcal disease.

The pneumococcal vaccine is free of charge as part of the National Immunisation Programme for the over 65s and at-risk groups, such as people with diabetes, heart disease or respiratory conditions and patients receiving chemotherapy.

Of those who develop an invasive infection: 1 IN 4 will get Pneumonia, 1 IN 4 will get Meningitis, and 1 IN 10 will die.

Speaking about the importance of contacting a GP for information

about pneumococcal disease, General Practitioner and Clinical Lecturer, Dr. Sumi Dunne said: "Streptococcus pneumoniae ‘pneumo’ is the most common bacterial cause of communityacquired pneumonia. Globally, and here in Ireland, it is a major cause of illness and death in Ireland, particularly among the very young, the elderly and those with a weakened immune system.

Pneumo disease is currently compounding the problems of our already overburdened hospitals and increasing dependence on medicines, like antibiotics. I would strongly encourage those with a weakened immune system, or anyone over the age of 65, to protect themselves and their loved ones over the next few weeks and months, and to focus on the prevention of Pneumo disease.”

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News

Pharmacy of the Year for McCabes McCabes Pharmacy Citywest were recently crowned ‘Pharmacy of the Year’ at the 2024 Retail Excellence Awards.

McCabes Pharmacy Jackie O’Reilly and Chloe Masterson with Awards host and team

and mystery shopper audits, this Award is really coveted. My heart bursts for our Citywest team who have claimed the title of REI National Pharmacy of the Year 2024. Congratulations to the incredible pharmacy team who deliver the McCabes Way consistently.”

This distinguished honour celebrates McCabes Citywest's exceptional healthcare service, outstanding customer care, and commitment to community wellness.

Sharon McCabe, CEO at McCabes Pharmacy and LloydsPharmacy Ireland commented, “Validated by the highest levels of independent and third party scrutiny, inspection

McCabes also scooped a second Award winning the Ecommerce Team of the Year. This prestigious accolade recognises the exceptional achievement of a team that has successfully transformed their business into an omnichannel presence in 2024

Ensuring Medicines Equity University College Cork (UCC) research has received a grant to use modern computational methods to develop critical medicines for improving global health and equality.

A team of researchers at UCC has received ¤950,000 in funding from the Bill & Melinda Gates Foundation to use artificial intelligence (AI) and machine learning (ML) to accelerate the development of medicines for conditions that impact those in developing countries.

Access to life-saving medicines in developing countries is often fraught with obstacles. For major pharmaceutical companies, the financial incentive to develop treatments for smaller, underserved populations simply isn’t there. Local manufacturers, meanwhile, often grapple with a lack of technical expertise and resources needed to navigate the rigorous process of bringing a drug to market. The challenges are compounded by inadequate infrastructure and harsh climatic conditions, making the path to accessible medicines even steeper.

Addressing this issue, a team from University College Cork’s School of Pharmacy - led by Professor Brendan Griffin, Dr Patrick O’Dwyer, and Dr Harriet BennettLenane - is driving forward the "Advancing Global Health Drug

(L-R): Professor Brendan Griffin, Dr Patrick O’Dwyer and Dr Harriet BennettLenane. Photos by Ruben Martinez (UCCTV) Formulation Development Using ML and AI" project. Their mission is to develop Artificial Intelligence (AI) and machine learning tools that can accelerate the creation of medicines for conditions that disproportionately affect those in developing countries, such as malaria and other tropical diseases.

The tools they are building will be made freely accessible via an open-source, web-based platform, ensuring that this technology can be leveraged worldwide. This ambitious project aligns to the UCC

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Futures thematic areas of Future Medicines and AI & Data Analytics.

Professor Brendan Griffin said: "We're building on the School of Pharmacy's strong foundation in AI and machine learning with this exciting project, which has the potential to reshape how medicines are developed for patients in developing countries.

It ties in with our goal of using pharmaceutical innovation to create a more sustainable and accessible medicine supply for everyone."

Iron Deficiency in Pregnancy Four out of five pregnant women in Ireland are iron deficient by their third trimester, a University College Cork (UCC) study reveals. Researchers at the Irish Centre for Maternal and Child Health (INFANT) and School of Food and Nutritional Sciences in UCC have shown that over 80% of women are iron deficient by their third trimester.

The findings raise concerns as the participants in the study were a low-risk and generally healthy cohort.

This study is the largest of its kind globally and was conducted in collaboration with the University of Minnesota and the Masonic Institute of the Developing Brain. Led by UCC’s Dr Elaine McCarthy, the study was published in the prestigious American Journal of Clinical Nutrition.

The study analysed data collected from 641 women in Ireland who were pregnant with their first baby and had a successful delivery. Blood samples were taken from the women throughout pregnancy, at 15, 20 and 33 weeks to determine iron status. "In Cork, which is a high-resource setting,” the authors found that “iron deficiency defined by a variety of markers was very common during pregnancy, despite the mothers being generally healthy. Interestingly, despite these high rates of iron deficiency, none of the study participants were anemic in the first trimester.”

In this study, almost threequarters of the participants took an iron-containing supplement that contained the Irish/ European recommended daily iron allowance of 15-17mg. The authors did note that "ironcontaining supplements (mainly multivitamins) taken pre/early pregnancy were associated with a reduced risk of iron deficiency throughout pregnancy, including the third trimester." The study did not have information on maternal diet, so it was not possible to investigate other dietary or lifestyle practices that were protective.

2024

r e n n i W

Chanel is The People’s Pharmacist 2024 Irish Pharmacy News, Ireland’s leading pharmacy publication has announced Chanel Geoghegan, Pharmacist at Hickey’s Pharmacy Clones as the winner of The People’s Pharmacist 2024, in association with Panadol.

Chanel was nominated by members of her local community recognising her exceptional dedication and impact as a community pharmacist. Known for consistently going above and beyond in her role, Chanel is celebrated as a true pillar of her community, offering invaluable support, care, and expertise to those she serves.

This nomination highlights Chanel's commitment to enhancing the health and well-being of her patients and customers, exemplifying the highest standards of service in her field. Her compassionate approach and tireless efforts have made her a trusted and respected figure, embodying the

role of a community leader and healthcare advocate.

This recognition not only shines a spotlight on the pharmacy's contributions to the community but also underscores the value of teamwork and commitment in making a meaningful impact, even in rural areas.

For this pharmacist, it’s clear that the heart of her success lies in collaboration, passion, and unwavering support for their community.

During September, members of the public were encouraged to nominate their local pharmacist whom they thought should be recognised for going the extra mile. After receiving a wealth of nominations – over 400 – across the country, eight deserving shortlisted finalists have been chosen.

Chanel beat some stiff competition to scoop the title with over 11,000 votes cast in total and a reach across social media of over 350,000.

With over 2 million Irish people visiting a community pharmacy every month, pharmacists are ideally placed to be the first port of call before a visit to the local GP Surgery.

“Chanel is a true pillar of her community, consistently going above and beyond in her role as a pharmacist,” said one nominee.

“From personally delivering medications to patients’ homes to traveling to administer flu vaccines and checking in on elderly clients, Chanel’s dedication is unwavering.

For families going through palliative care, she provides her personal mobile number, making herself available 24/7—even taking calls on her days off.

Balancing her demanding role with raising three young boys, Chanel continues to put her patients first, never taking extended holidays and often putting others’ needs before her own.

“Her commitment to patient care is seen not only in her actions but also in her priorities. When medications are in short supply, Chanel often sources them from

Marie-Laure Bruckert with Pharmacist, Chanel Geoghegan

14 | PHARMACYNEWSIRELAND.COM

alternate wholesalers. She is deeply committed to her patients' well-being, valuing their health over profit margins—a rare trait in any business owner.

“Chanel’s compassion, dedication, and integrity have made her a true standout in her profession—a unicorn in the world of pharmacy owners. Her community is not only grateful but also inspired by the exceptional care and kindness she brings to every aspect of her work.”

The People’s Pharmacist Award seeks nominations from across the country, giving patients the opportunity to recognise and salute their local pharmacist.

Through this Award, we are enabling the public to have a voice in recognising the unwavering support and spirit that makes pharmacists the backbone of our health service in every community across Ireland.

As the scope and prominence of this Award has increased with each passing year, it has added even more value to the profession of pharmacy; through the strong and positive messages, not to mention, recognition given to the vital and impressive work being done by all the nominees, in their communities.

Chanel commented on her win, “I was so pleasantly surprised to be recognised by our community for the role we play in pharmacy.

Being patient-facing is truly my favourite part of the job I

The People’s Pharmacist 2024, Chanel Geoghegan love being able to help people when they need it most. It’s also important to recognise that this is a team effort. I have a fantastic team behind me, and none of this would be possible without their support.”

She continued, “Helping people through tough times is genuinely fulfilling. Community pharmacists are uniquely positioned to support the most vulnerable, whether

they’re local families or patients who’ve lived here their entire lives.

Having grown up here myself, I feel deeply connected to the community and understand the needs of both younger and older generations alike.

Chanel highlighted the significance of this milestone not just for herself, but for the entire pharmacy team.

She emphasised that the achievement reflects the collective effort of the dedicated team working behind the scenes. "I have a brilliant team of girls around me, and I see this very much as a win for all of us," she added.

Receiving recognition offers more than just personal pride— it provides an opportunity to showcase the critical role that pharmacies play in local communities.

"For me, this is a fantastic opportunity to promote my small business and to shine a light on the important role of pharmacies in local communities," says Chanel.

"Any support the government can give our sector will be wide-

Marie-Laure Bruckert, with the Pharmacy team Olivia Cadden, Chanel Geoghegan, Melissa Rossiter, Larrissa Leigheo and Deborah Gunn. Others on the team that were not present are: Natalie Connolly, Ciara Holland, Lisa Mccusker, Bronwyn Cassidy, Erin Reilly and Sarah Lovett

reaching and invaluable," she noted, underscoring how such assistance could help strengthen the vital contributions pharmacies make to public health.

“We are a close-knit community, I have known most of my patients for years, this drives me to give the best care possible. We are highly valued by our patients; pharmacists are on the frontline and give critical care to local families that need it. Providing advice and support to my hard working team also motivates me.

It is a real team effort.

The 2024 People’s Pharmacist Finalists were:  Martin Kelly, Kelly’s StayWell Pharmacy, Dundalk  Deirdre O’Rourke, Adrian Dunne Pharmacy, Kilbarrack  Keith Brennan, Brennan’s Pharmacy, Ballyfermot  Ultan McKeon, Quinn’s Pharmacy, Bray  Paul Burns, Dargle Valley Pharmacy, Bray  Brian Fitzgerald, Mari Mina Pharmacy, Toomevara  Laura Reynolds, LloydsPharmacy, Rathmines

PHARMACYNEWSIRELAND.COM | 15

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News

LloydsPharmacy rebrands to McCabes- the largest rebrand in Irish Pharmacy The pharmacy landscape in Ireland is undergoing an exciting transformation Castletroy SC store manager Maria McBrearty and Assistant Manager Shane Curtin, along with Sharon McCabe CEO McCabes, Jan Pieter Hallerma MD McCabes and Brian Okeefe Retail Director

all 110 pharmacies nationwide and their customer base and local communities.

All this work is being done at top speed while working on normal day to day projects using current team resources so great praise goes to all involved for the huge effort and commitment to help create this “bigger and better” pharmacy operation.

Celebrating with the Community, establishing McCabes Pharmacy

In April 2024, PHX Ireland, via its subsidiary LloydsPharmacy, acquired McCabes Pharmacy, and over the past few months, have been bringing together the operations of two of the best known and most trusted retail pharmacy brands in the country, creating the largest retail pharmacy brand in Ireland under one trusted name: McCabes. This strategic move not only strengthens McCabes Pharmacy position as Ireland's largest and most patient centric pharmacy network but also expands the reach and commitment to exceptional healthcare services across the country. Led by Sharon McCabe as CEO, McCabes Pharmacy will be more accessible to local communities across Ireland, while also serving as a professionally exciting place for healthcare colleagues and teams to work and build meaningful careers.

Since September and within a tight 14 week timeframe, the 80 Lloyds Pharmacies across Ireland have been rebranded with the final pharmacies expected to be completed in early December offering customers and local communities a more

enhanced customer experience and refreshed in store layout.

The extensive list of customer touchpoints including internal and external store signage, phone answer machines, dispensary bags, TIL receipts and colleague name badges, to name a few all required new design and artwork that needed to be created and produced under very tight timelines to align with the store rebrand roll out for a consistent and unified customer branding and experience.

However, the rebrand is not just about the physical rebranding of the stores but a wider project to offer an integrated multi-channel customer service and customer experience across the 110 pharmacies from delivering brand and customer experience training, aligning processes and systems, selecting product and category ranges, pricing and promotions,

Ashleaf SC Pharmacy team along with Sharon McCabe CEO and Alannah and Aleigha Murphy, the Crumlin twin boxers who live local to the Ashleaf SC Pharmacy

PHARMACYNEWSIRELAND.COM

as well as moving towards a single platform website and app. It also includes aligning the internal and store operational processes and compliance for stores, HR policies and IT systems integration to name a few.

The revamped McCabes website and app will be live late January 2025 along with key digital tools like appointment booking, online prescription ordering and click and collect to accommodate

Customer and GP awareness of the rebrand was and remains a key priority. The Marketing team started a dual branding strategy from August, one month before the start of the rebrand to make local communities aware of what was coming. The team were super busy as this involved creating new materials to communicate across all our external channels (radio, social, email, website, app notifications, customer leaflets and digital screens) with the tagline, We’re changing our name. We’re still the same people you know and trust. It was key that customers and patients were reminded that the same great people they know and trust would still be there to support and advise them. The pharmacy teams played a pivotal role in communicating this key message out across their customer and community networks.

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Laura Reynolds Pharmacy Manager Rathmines and Aisling O'Connor, Pharmacy Manager Glasnevin

Members of the Pharmacy team from Castletroy Shopping Centre

Since pharmacies have been rebranded, we’ve been celebrating with launch parties across the country to mark this momentous occasion. From Dublin to Limerick, Cork to Dungarvan, we've welcomed communities to come visit the same teams at the same location but under the new name, showcasing everything McCabes Pharmacy has to offer.

The McCabes Marketing team have worked with Pharmacy teams locally to invite media, influencer and customers to their opening events with senior leadership teams attending for the ribbon cutting. With entertainers, delicious snacks, live demonstrations from suppliers to tailored skin and health consultations, and not forgetting the generous goodie bags, the attendees have enjoyed a truly memorable customer experience.

What Sets McCabes Pharmacy Apart?

The focus of the teams is always on the patient to ensure the best quality customer experience, along with quick and easy prescriptions and medications are consistently available across all 110 pharmacies.

• Unwavering Commitment to Personalised Patient Care: Our dedicated team of pharmacists and healthcare professionals are passionate about providing you with the highest level of personalised care, addressing your specific needs and concerns.

• Comprehensive Product Range: We offer a wide selection of medicines, vitamins, and skincare brands to cater to all your health and wellness needs.

Store manager Ber O’Reagan at The Lough, Cork presenting Sharon McCabe with a “welcome to Cork” bouquet of flowers

• Enhanced Services for Evolving Needs: McCabes Pharmacy constantly evolves to stay ahead of the curve and meet your evolving healthcare needs. We offer cutting-edge digital health innovations, personalised preventative care programs, and integrated health services, ensuring a holistic approach to your well-being.

• Award-Winning Convenience at Your Fingertips: We understand the importance of convenience. Our user-friendly online store and app allow you to manage your health effectively. Book appointments, order prescriptions, and enjoy fast and efficient home delivery options – all from the comfort of your own home.

• Familiar Faces, Trusted Network: While the name has changed, the friendly faces you know from your local LloydsPharmacy haven't gone anywhere. They're now part of a wider network, ensuring a consistent

experience and exceptional service across Ireland.

Sharon McCabe, CEO of McCabes Pharmacy, spoke on her enthusiasm for this new chapter: "The McCabe's national rollout is in full swing, and we're thrilled to be serving more communities across Ireland as we become the country's largest and most patientfocused pharmacy brand. With the rebranding soon to be complete across communities nationwide, customers have greater access to our renowned patient care."

As we move forward under the McCabes name, we remain dedicated to providing exceptional customer service with a personal touch, with the best quality preventative health care advice, the largest online health platform and most comprehensive range of services. Our aim is to make every visit to McCabes Pharmacy both welcoming and supportive, convenient and efficient to every customer, every time.

The Bluebells Trio- singing group bringing in the festive cheer to the Nutgrove SC rebrand event

PHARMACYNEWSIRELAND.COM

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News

Scientists reveal MRSA's double defence against antibiotics Scientists from the University of Sheffield and University College Dublin (UCD) have discovered how the hospital superbug MRSA can grow and divide in the presence of antibiotics. The findings published in Science today pave the way for new approaches to control infectious disease.

Methicillin Resistant Staphylococcus aureus (MRSA) is an antimicrobial resistance superbug that causes over 120,000 deaths per year. Given the urgent need for new, more effective antibiotics and a lack of MRSA vaccines, understanding and combating the superbug is crucial.

The study reveals MRSA has a double defence mechanism against antibiotics - this new insight offers hope in treating the life-threatening superbug and other infectious diseases. Dr Rebecca Corrigan, Assistant Professor

at UCD School of Medicine and author on the paper said, “This discovery is important because it helps us to understand how bacteria can survive antibiotic treatment. It is only through understanding this that we can develop new ways to treat MRSA infections in our efforts to tackle the antimicrobial resistance crisis.”

Bacteria, such as MRSA, have mesh like cell walls around them that require enzymes to knit them together. The enzymes are the targets for antibiotics such as

penicillin and methicillin. This type of antibiotic has saved millions of lives over the decades.

It has been known for many years that in order to be resistant, MRSA has acquired a new cell wall enzyme that allows it to survive exposure to antibiotics. However, the researchers have found that this alone is insufficient for survival. Their study shows MRSA has also evolved an alternative division mechanism that allows it to replicate in the presence of antibiotics. This previously unknown

mechanism is essential for MRSA resistance. By understanding the details of this process, researchers are working towards developing inhibitors that can target MRSA’s novel survival strategy.

The next step for this research is to determine how MRSA is able to grow and divide in the presence of antibiotics using the new mechanism that has been discovered. The research involves a multidisciplinary collaboration led by the University of Sheffield and is funded by Wellcome and UKRI.

Save the date - IIOP parallel session as part of RCSI Charter Week 2025!

Thursday, 6 February 2025 - The IIOP is delighted to announce that it will be hosting a session entitled ‘Next Generation Pharmacy’ on Thursday 6 February 2025 from 14.45-16.45 as part of the RCSI Charter Meeting 2025.

The session will bring together important contributors from across the healthcare system to present and take part in a panel discussion aimed at providing a forum for sharing perspectives. Academic researchers, pharmacists across primary and secondary care, policy makers and next generation pharmacists will present at this IIOP session which will include a number of perspectives including workforce planning, IT infrastructure, personalised medicines, sustainability in pharmacy practice and insights from a next generation pharmacist.

IIOP competition: invitation for submission for pharmacists and next generation pharmacists!

We are adding an exciting new feature to Charter Day for 2025!

All pharmacy students and pharmacists are invited to make a submission themed around their vision of what a pharmacists’ role will be in 25 years’ time…. the year 2050. The submission may take the form of any multimedia format e.g. video, audio, gaming, blog, text, art, infographic, poster, letter, poem…etc. When thinking about your submission, you may wish to reflect upon....'who, what, when, where and why'...in developing your thinking around the communication of your vision of the role.

Good luck to all entrants and please spread the word among next generation pharmacists!

RCSI CHARTER DAY 2025 ‘NEXT GENERATION PHARMACY’ COMPETITION!

How to make a submission?

To read the guidelines for submission and also to submit your entry, click here . Individual and group submissions are welcome. Closing date for submissions is 10 January 2025.

There will be two ¤200 prizes – one for the winning pharmacist and one for the winning pharmacy student and prizes will be presented at the IIOP session on 6 February.

Registration for the session Registration details for the IIOP session, programme of events, speaker bios and other RCSI Charter Meeting details will be issued closer to the event. Keep an eye on the IIOP website and our social media accounts for further details and updates. Registration for the IIOP event will be free for IIOP members and pharmacy students wishing to attend the IIOP session only. For anyone wishing to attend other events during RCSI Charter Week 2025, please visit the RCSI website What is RCSI Charter Week?

The Royal College of Surgeons in Ireland (RCSI) Charter Meeting is an annual event, celebrating the

PHARMACYNEWSIRELAND.COM

As part of RCSI Charter Day, 6th February 2025, IIOP invite you to make a submission themed around your vision of what a pharmacists’ role will be in 25 years’ time, the year 2050...

SUBMISSION DEADLINE: 10th JANUARY 2025 Submissions may be made using any multimedia format e.g. art, letter, poem, video, gaming recording, audio, short essay, poster, etc. Individual and group submissions welcome PRIZES TO BE PRESENTED AT CHARTER DAY SUBMIT HERE For more information visit iiop.ie

vision 2050 granting of a Royal Charter and founding of the College in 1784.

It is a multidisciplinary event, welcoming each of the facilities and speciality groups in RCSI.

The Charter Meeting will take place, in person, from Tuesday 4 February to Saturday 8 February 2025 in RCSI with the theme ‘Next Generation Surgery’.

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End of Year Review Medicines for Ireland unveils General Election Manifesto Suppliers of generic, biosimilar, and value-added medicines call on political parties to ensure fair competition through patent reform, which could potentially saving the State millions.

Chairperson of Medicines for Ireland Paul Neill transparency and efficiency in the medicines reimbursement process and collaborate with EU counterparts to address medicine shortages through a European Critical Health Act.

As Ireland prepares for the upcoming general election, Medicines for Ireland (MFI) has launched its comprehensive General Election Manifesto, setting out the critical need to ensure patient access to affordable, lifesaving, and lifeenhancing medicines.

MFI calls on all political parties to prioritise investments in medicines and systems that deliver value for patients and the State. The manifesto underscores the critical importance of a resilient and sustainable generics, biosimilars, and value-added medicines industry, especially in light of rising medicine costs, an ageing population, and the increasing burden of chronic diseases.

In its manifesto, MFI is calling for: 1. Patent reform for fair competition: Address barriers to early market entry for offpatent companies to ensure the State can recover overpayments when patents are invalidated and encourage the HSE to engage early in court cases to recover losses. In one example known to MFI, the State could have saved over ¤26 million in just eight months had the patent been invalidated and the HSE been a party to the preliminary injunction proceedings.

2. Access to essential and affordable medicines: Guarantee the availability of vital medicines at accessible prices, implement the recommendations of the Mazars report to enhance

3. An Industry fit for the Green, Digital Era: Embrace sustainability and digital innovation in the healthcare sector, support the use of technologies to improve efficiency, reduce waste, and enhance patient care and engage with the off-patent industry to ensure environmental policies do not hinder the availability of essential medicines.

accessibility and affordability of essential medicines. Our manifesto outlines a clear path to achieving this by addressing the barriers to early market entry for generics and biosimilars. By implementing these reforms, we can ensure that Irish patients have timely access to the treatments they need, while also delivering significant cost savings to the State.

“Our manifesto emphasises the need for patent reform and greater market competition to drive down costs and improve access to essential medicines.

We are committed to working with policymakers to create a healthcare system that is both efficient and equitable for all Irish citizens.”

Medicines for Ireland urges all political representatives to engage with MFI and its members to deliver on the untapped potential Chairperson of MFI, Paulfor NeillIreland’s Medicines withinpriorities the off-patent industry. By said, “As we approach afor critical prioritising the measures outlined in Medicines Ireland’s priorities juncture in Ireland’s healthcare the manifesto, Ireland can ensure a landscape, we must prioritise the healthier future for all its citizens.

Vice-Chair of MFI, Deirdre Kelly says, “The future of healthcare in Ireland lies in embracing sustainability and digital innovation. Our manifesto calls for a collaborative approach to integrating green practices and advanced technologies within the pharmaceutical industry. By doing so, we can enhance efficiency, reduce waste, and ultimately improve patient care. We urge political leaders to support these initiatives, ensuring that our healthcare system is both resilient and forward-thinking.

“The escalating costs of managing chronic diseases and long-term care are placing an unsustainable burden on our healthcare system.

By prioritising the use of generics and biosimilars, we can alleviate this pressure and ensure that all patients have access to the medicines they need. Our manifesto provides a roadmap for achieving this, and we call on all political parties to support these vital reforms.”

Medicines for Ireland’s priorities

Medicines for Ireland’s priorities Patent reform to ensure fair competition Address barriers to early market entry for off-patent companies caused by the current and Patent the reform to ensure fair competition

developing landscape originator pharmaceutical companies, leading to significant Address thelegal barriers to earlyfavouring market entry for off-patent companies caused by the current and overspending by landscape the Irish State and delayed access to cost-effective generics. developing legal favouring originator pharmaceutical companies, leading to significant overspending by the Irish State and delayed access to cost-effective generics.

Patent reform to ensure fair competition

Address the barriers to early market entry for off-patent companies caused by the current and developing legal landscape favouring originator pharmaceutical companies, leading to significant Patent reform to ensure fair competition overspending by the Irish State and delayed access to cost-effective generics.

Address the barriers to early market entry for off-patent companies caused by the current and developing legal landscape favouring originator pharmaceutical companies, leading to significant overspending by the Irish State and delayed access to cost-effective generics.

Access to essential and affordable medicines Guarantee availability of vital medicinesmedicines at prices that are accessible to all, supporting public Access tothe essential and affordable health and the delivering valueoftovital patients and the healthcare system.

Guarantee availability medicines at prices that are accessible to all, supporting public health and delivering value to patients and the healthcare system.

Access to essential and affordable medicines

Guarantee the availability of vital medicines at prices that are accessible to all, supporting public health and delivering value to patients and the healthcare system.

Access to essential and affordable medicines

Guarantee the availability of vital medicines at prices that are accessible to all, supporting public health and delivering value to patients and the healthcare system.

An industry fit for the green, digital era The future of healthcare lies in embracing and digital innovation. We urge political An industry fit for the green, digitalsustainability era

parties to actively engagelies with off-patent industry toand avoid any unintended consequences The future of healthcare in the embracing sustainability digital innovation. We urge political when thatthe drive environmental MFI calls onconsequences political partiessupporting to activelyinitiatives engage with off-patent industryresponsibility. to avoid any unintended representatives accelerate thedrive use environmental of technologiesresponsibility. to improve efficiency, waste, and when supportingtoinitiatives that MFI callsreduce on political An industry fitto for the green, digital era enhance patient care. representatives accelerate the use of technologies to improve efficiency, reduce waste, and The future of healthcare enhance patient care. lies in embracing sustainability and digital innovation. We urge political parties to actively engage with the off-patent industry to avoid any unintended consequences when supporting initiatives that drive environmental responsibility. MFI calls on political representatives to accelerate the use of technologies to improve efficiency, reduce waste, and Anenhance industry fit for patient care.the green, digital era

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End of Year Review Advocating for those with Asthma The Asthma Society of Ireland advocates for the well-being of the 450,000 people in Ireland currently with asthma and the 890,000 affected at some point in life. Its vision is for all individuals with asthma to live symptom-free, with a mission to reduce asthma deaths and improve lives. The Society empowers patients, raises awareness, influences policy, and collaborates with healthcare, research, and education professionals. It actively supports all levels of care, working closely with the National Clinical Programme Respiratory (NCPR).

Written by Ruth Morrow, Respiratory Nurse Specialist, Asthma Society of Ireland

use but has greater impact with repeated engagement.

Asthma Adviceline: 1800 44 54 64

Achievements In 2024 the Asthma Society has been working hard to advocate, care, inform and educate those with asthma, their carers and health care professionals. Our patient services consist of Asthma/COPD Adviceline, and the WhatsApp nurse messaging service part of which is the webinar series. We also support healthcare professionals with resources in the form of written and electronic resources. In addition, the website is very often the first port of call for clients seeking information on their condition.

Patient Services WhatsApp Nurse messaging Service: 086 059 0132 The WhatsApp nurse messaging service supported 395 new patients in 2023, surpassing that number by mid-November 2024. Each new admission has approximately 10 interventions.

Over 4,000 interventions are expected by year-end. This nurse-led service enables asthma and COPD patients, their families, and carers to confidentially message respiratory nurses for disease management advice, access health tools, and receive referrals. Insights show the service is effective for one-time

By mid-November 2024, the Asthma/COPD Adviceline surpassed 2023 figures with over 4,000 consults. This free call back service offers 30-minute consultations with asthma nurses, providing education, self-management support, and healthcare signposting, with follow-ups as needed. In partnership with COPD Support Ireland, the COPD Adviceline helps patients understand and manage their condition while connecting them to COPDSI services and support groups.

Webinars Webinars are held regularly to support self-management and provide education to patients, carers and healthcare professionals. Expert speakers present on topical subjects alongside an ASI respiratory nurse followed by a Q&A session.

Subjects this year included: Smoking & Vaping, Women & Asthma, Allergic Rhinitis & Asthma, Back2School for parents, carers, teachers and SNAs and Winter Wellness. Between 200 and 300 people registered for each webinar and on average 130 attended.

People can avail of webinar recordings to watch back on our website and through our monthly e-zine communication.

Safe school’s Programme

22 | PHARMACYNEWSIRELAND.COM

E referral An e referral for health care professionals to refer their patients to the Adviceline has been developed. Patients can also self-refer. The referral is available on the website. Simply fill in the referral form and submit.

The administrative staff will then contact the client and give them an appointment at a time that suits.

This e referral has become popular with integrated hubs and GP practices. We welcome referrals from all health care professionals who feel their patients would benefit from the Asthma society augmenting their care Resources The Asthma Society provides vital patient education, distributing over 10,000 resources annually.

Updated booklets, such as Asthma and Allergy, Take Control of Your Asthma, Asthma and your Child and Asthma and Pregnancy are now more literacy-friendly, featuring larger fonts, fewer words, and more graphics, approved by the Medical Advisory Group. New

infographics are also available for the WhatsApp service, social media, and the website. A key 2024 resource, developed with the HSE National Clinical Programme Respiratory, is the MART Asthma Action Plan for patients using Maintenance and Reliever Therapy, accessible on the website.

Campaigns and Communication In 2024 the ASI ran a number of successful campaigns throughout the year. Campaigns aim to raise awareness amongst key stakeholder groups about the seriousness of asthma or hayfever and encourage people and their carers to take action towards proactive disease management Asthma Awareness Week Asthma Awareness Week took place during the first week of May. The focus this year was ‘Asthma Education Empowers’ which aimed to empower people with asthma with the appropriate education to manage their disease, and to recognise when to seek medical help when their asthma worsens.

Hayfever Campaign This year the Asthma Society conducted a very successful Hayfever campaign. Every opportunity was taken to share expert advice on managing this condition. A top tips release with practical tips was shared with key broadcast, print and online media. Numerous national and regional interviews took place with Respiratory Nurse Specialist Ruth Morrow and Prof Marcus Butler as well as sharing the personal stories of patients with asthma who experience severe hayfever symptoms. The campaign continued throughout the summer months.

Asthma Safe School Programme The aim of this program is to train one teacher per school in PHECC (Pre Hospital Emergency Care Council) approved and certified basic life support and administration of Salbutamol for emergency treatment of adults and children with an acute asthma attack.

This program enables school staff to identify what to do in the case of an acute asthma attack, to encourage schools to provide a supportive environment for students with asthma, to create better public awareness of the 5 Step Rule and how to recognize and manage an asthma attack.

Part of the programme included an Asthma Safe School webinar, free for all principals, teachers and SNAs in September.

Oral Corticosteroid Tablet use This campaign was based on research conducted by IQVIA and Irish company specialising in analytics and clinical research services to the life sciences industry. Longitudinal retail pharmacy prescription data was used and then reviewed by the Asthma Society of Ireland’s Medical Advisory Group. The research showed that almost 1 in 5 patients were dispensed multiple courses of steroid tablets within a 12 month period. Steroid tablets are associated with significant adverse side effects and should be prescribed at the lowest possible dose for the shortest possible time. This media relations campaign addressed the concerns surrounding the overuse of oral

Training days on the safe schools programme

steroids in asthma management while highlighting best practices for treatment Advocacy and research Towards Optimal Severe Asthma Care report During 2024, the Asthma Society of Ireland undertook research to examine the standards of care for severe asthma in Ireland.

Following a literature review a survey was conducted of patients with severe asthma that revealed new insights on the existing gaps in the Irish healthcare system.

This was explored in further detail with a focus group of patients and carers of children living with severe asthma. Both research projects showed inconsistencies in care standards, diagnostic hurdles, significant financial strain on patients and a lack of understanding and awareness from healthcare professionals, employers and the general public. These findings were then presented at a roundtable of experts who were in agreement with the challenges and potential solutions raised by patients. The experts underlined the need for government to allocate funding to support the introduction and maintenance of a severe asthma registry.

Tobacco 21 Alliance We wholeheartedly welcome the Public Health (Tobacco) (Amendment) Bill 2024, which will raise the legal age of the sale of tobacco products from 18 to 21. Once officially passed, the Tobacco 21 Alliance, of which we are an active member, will issue a short statement welcoming the bill and showing our support for it to reduce smoking among young people. The Act will come into operation on 1 February 2028.

Other important groups the Asthma Society is a member of include; • Climate change and air pollution working group • The HSE inhalers action group

• Irish lung health alliance and the International Respiratory Coalition • Physical activity for chronic conditions working group • Tobacco stakeholders group Challenges The Asthma Society faces challenges on behalf of those it represents. Asthma severity is often underestimated, delaying diagnosis and treatment.

Socioeconomic and geographic disparities hinder access to care, medications, and diagnostic tools.

Educating patients on medication adherence and trigger avoidance remains a persistent issue.

Funding is needed for research to address care gaps, raise climate change awareness, and advocate for supportive health policies.

Winter illnesses like flu, COVID-19, and RSV exacerbate difficulties for respiratory patients, as reported via WhatsApp and Adviceline services. Additional challenges include inflation, GP access issues, and financial constraints forcing patients to skip GP visits or asthma medications.

The cost-of-living crisis also affects those requiring oxygen or nebulised medication.

Looking to 2025 The Asthma Society looks forward to planning growth within the organisation in 2025. We will endeavor to measure our impact using data that reflects what

we do and allows us to review our activities.

A new website will be launched in the New Year that will have a new architecture and be easier to navigate. Information will be updated on an ongoing basis for the website and for all educational resources.

The ASI strategy 2020 -2025 is complete next year. A project to develop a new strategy will begin.

A research proposal to review the impact of the ASI patient services activities has been developed and funding dependent this research will be carried out in 2025.

We have a number of campaigns, events and webinars in the plan for next year so follow us on social media, print media and broadcasting media or go onto our website and join our emailing list to keep updated.

We strive to reach out further to those who need our services and build relationships with stakeholders. Along with patient services, the Asthma Society will build on its advocacy and research work to meet the needs of people with asthma.

Acknowledgments The author would like to acknowledge the help of Mary McDonald, Patient Services Manager and Caroline Reilly, Patient Services Coordinator for their assistance with this article.

PHARMACYNEWSIRELAND.COM | 23

End of Year Review United Drug - Driving Excellence and Innovation Reflecting on 2024’s progress and achievements for United Drug. With a steadfast commitment to supporting pharmacists and advancing the industry, we have celebrated numerous milestones that demonstrate our dedication to quality, innovation, and collaboration.

Connecting with the Community at HPAI 2024 This year, the United Drug team attended the Hospital Pharmacists Association of Ireland (HPAI) Conference 2024. The event brought together hospital pharmacists from across the country, providing invaluable opportunities to network, share research, and engage with experts.

From discussing best practices to exploring new innovations, the conference exemplified the importance of collaboration in shaping the future of pharmacy.

Adding value and support to our customers through new sales structure As part of our continued commitment to improve focus and support for our customers we have restructured our regional coverage and have expanded our sales team. This allows us to provide a tailored and personalised offering to our valued customers.

Transforming Retail with Profitlines Plus -easier ordering for Pharmacies

the art cutting machine enables us to cut an average of 10,000 bags per week.

The launch of Profitlines Plus marked another major milestone for United Drug. This innovative platform integrates wholesale and consumer offerings, creating a seamless solution for Pharmax customers. By bridging the gap between front-of-shop retail and wholesale products, Profitlines Plus sets a new standard for efficiency and customer experience.

Celebrating Excellence and Collaboration of our teams

Delivering best in class Customer Care and Product Range in Ostomy & Urology United Drug Ostomy & Urology division continues the tradition of excellence in customer service and strives to help healthcare professionals deliver better product and services to their ostomy patients. We continually improve and invest in ostomy and the addition of our second, state of

Enhanced processes within Supply chain to drive efficiencies Through continuous review of our internal processes, we have explored new and more efficient management of the supply chain operations and stock management to maintain high levels of service to our valued customers.

United Drug Quality team celebrate successful audit

At the Analytics Summit, United Drug Distributors Director David Keyes shared insights into

At United Drug we are committed to being our customers’ unlicensed sourcing partner.

Offering a swift and efficient service for supplying and sourcing Exempt Medicine products we continue to provide best in class product and pricing, instilling peace of mind in our customers.

Supporting the Next Generation of Pharmacists Investing in the future of pharmacy is a core value for United Drug.

This year, we continued our tradition of sponsoring lab coats for Pharmacy and Pharmaceutical Science students at Trinity College Dublin. This initiative represents our ongoing commitment to nurturing the next generation of pharmacy professionals.

United Drug Consumer had a successful weekend at the Pregnancy and Baby Fair, showcasing the dedication to meeting the needs of families and expecting parents. The event allowed us to connect with consumers and bring them the essentials on their healthcare journey.

Looking Ahead focused on supporting the future of Irish Healthcare

Expanding Knowledge through UD Talks Podcast series Building on the success of the Knowledge Hub webinar series, United Drug launched its first podcast series, UD Talks.

This exciting platform provides pharmacists with accessible, insightful conversations on industry trends, innovations, and strategies.

With a focus on delivering valuable knowledge, UD Talks is quickly becoming a trusted resource for pharmacy professionals.

Advancing Data-Driven Decision Making

Elements Exempt Medicine Sourcing and Supply

Engaging with our Family, and Mum and Baby Communities

Maintaining Quality and Standards for best-in-class supply chain Our commitment to quality was further affirmed with excellent results in the ISO9001:2015 recertification audit. This achievement underscores our dedication to maintaining and exceeding the highest standards across our operations.

The year also highlighted the outstanding efforts of our teams and colleagues. United Drug Wholesale’s Operations Managers team was honoured with the Collaborative Award at the PHX Ireland Awards, recognising their commitment to operational efficiency and teamwork. Meanwhile, Christine Flynn of United Drug Consumer received the Ambitious Award, showcasing her dedication and drive. These accolades reflect the incredible talent and spirit within our organisation.

how data-driven strategies are transforming our supply chain decision-making. His presentation underscored our investment in analytics to enhance efficiency and service excellence, ensuring pharmacists can rely on a robust and responsive supply chain.

United Drug Consumer attend the Pregnancy and Baby Fair

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As we reflect on a year filled with accomplishments, we remain committed to supporting pharmacists and the communities they serve. Whether through innovation, collaboration, or education, United Drug is proud to be at the forefront of shaping a stronger, more connected pharmacy sector. We stand united with our suppliers, manufacturers and customers as we strive for a healthier Ireland and together, we are aligned on our purpose and mission to “deliver health”.

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JointCare supports your active lifestyle1

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Vitamins C & D

Vitamin D

Vitamin C

Manganese

Vitamin D contributes to the maintenance of normal bones and normal muscle function. Manganese contributes to the normal formation of connective tissue. Vitamin C contributes to normal collagen formation for the normal function of bones and cartilage. *Source ©2024 NIQ data, Value and Units, Vitamin & Minerals (Client defined), 52 w/e 28.09.24, Total UK. Verify at https://seven-seas.co.uk/ Food supplements are not intended as a substitute for a varied and balanced diet and a healthy lifestyle.

End of Year Review Fractures ARE Preventable in most people Our vision in the Irish Osteoporosis Society is for the amount of people affected by bone loss to dramatically decrease. The charity is committed to increasing the awareness of this Silent disease, which is preventable in the majority of people. Prevention should start in schools with physical education being made mandatory, which long term will not only reduce the risk of bone loss in later life but also multiple other conditions such as obesity, diabetes, heart disease etc.

Written by Michele O’Brien, Irish Osteoporosis Society

• A survey in 2023 showed 1 in 5 adults have fractured since turning 40. Over 1/3 reported to have had a fragility fracture, which is a broken bone from a trip and fall or less, which if a person had healthy bones, they would not have fractured.

The rate of fragility fractures was highest amongst 40 to 54 year olds.

• Research does show that most broken bones (fractures) occur within a T score of -1. 5 to -2.49, which is the moderate to marked Osteopenia range.

In order for our vision to be successful, we need your support to spread awareness of this disease and the charity itself. www.irishosteoporosis.ie This disease has no signs or symptoms warning a person they are losing bone; and it is causing pain, disability and premature death, daily in Ireland.

2024 for the Irish Osteoporosis Society was spent increasing awareness of the many myths regarding this disease, which has always been one of our major challenges. It is quite shocking, the fact that we are not a 3rd world country, yet so much misinformation is in the public and health care domain regarding this disease.

• Why monitoring of bone loss is essential.

• Why Bone loss is different to most diseases.

• The importance of normal vitamin D levels.

• More men pass away from Osteoporosis than get prostate cancer, which is why it is essential for men to see if they have risk factors for this silent disease.

• More women pass away from Osteoporosis than from the combined deaths of cancer of the ovaries, uterus and cervix.

Lung cancer is the only cancer that supersedes Osteoporosis in deaths, which is why all women should be making their bone health a major priority for 2025.

• Anyone with bone loss needs their bone health monitored closely due to the fact that there are NO signs or symptoms of bone loss occurring or improving.

Why the Irish Osteoporosis Society does not recommend Yoga The concept of yoga is wonderful, but the reality is that it is not appropriate for most people, especially senior citizens. The reasons are that many of the stretches contain excessive flexion of the spine which puts excessive stress on the anterior aspect of the vertebrae, as well as the discs between them and the sciatic nerve. Stress on the vertebrae, when a person has bone loss, can and has caused vertebral fractures.

Excessive stress on the discs and sciatic nerve can cause a herniated disc/s which causes radiating pain down a person’s leg.

• Osteoporosis is preventable Touching toes while in the sitting position or standing position, e and treatableyour in the majority of people; we have 80+ year bells, yoga, jumping olds who have improved their off boxes, stopping your feet when walking, tram bone health. Check out Kays videos on the Irish Osteoporosis Society Facebook page.

• Women over 65 (Caucasian and Asian) are the highest risk group, however Osteoporosis effects 50% of women and 25% of men 50+, and all age groups can be affected.

The following are the main messages that the charity highlighted throughout this past year • Yoga/forward flexion should not be done by anyone with bone loss.

• Calcium and Vitamin D supplements are not treatments.

• Anyone who has broken a bone from a trip and fall or less should be assumed to have Osteoporosis unless proven otherwise.

• Osteopenia should not be considered a “touch of bone loss”.

26 | PHARMACYNEWSIRELAND.COM

• Anyone who is on any medication or treatment for other diseases such as Chemotherapy, Radiation, Arimidex, Aromatase inhibitors, proton pump inhibitors, Depo-Provera, progesterone only contraceptives and corticosteroids, are high risk.

Written by Michele O'Brien, CE

World Osteoporosis Day – Time for a Check With World Osteoporosis havin

Society are asking everyone to

Why prevention of Fractures Written by Michele O'Brien, CEO, Irish Osteoporosis Society of appropriate monitoring will Vitamin D can cause aches and

Worldwide, up to 37 million frag of Fibromyalgia. my Vitamin D equivalentWhat oflevel 70should fractures per m be for bone health? thlabs considerbones Some a “normal” that if on the20 persons With World Osteoporosis having taken place October, thewere Irish Vitamin D level of 30 or 50nmol/L With Cardiac issues a patient will to 125nmol/L. develop signs or symptoms Society are asking everyone tousually check to see if they have risk factors fo that there is an issue, the same place people at risk of fracturing.

The Irish Osteoporosis Society have never heard of a diabetic patient been told “Come back in 5 years”, so why this trend is occurring is baffling.

with Diabetes. With bone loss being silent and having no signs or symptoms, the only signs will be of people fracturing, leaving many losing their independence and others facing premature death.

pains, which mimic the symptoms

The Irish Osteoporosis Society recommend a Vitamin D level of between 70 to 125nmol/L for bone health.

Why prevention of Fractures is common sense as well as econom Normal bone Image Normal bone Image Worldwide, up to 37 million fragility fractures occur annually in people o People are encouraged to prevent Diabetes and cancer to name equivalent of 70 fractures per minute.

A fragility fracture is a broken bo a few but with bone loss those are proactive are now being that if the persons bones werewho healthy, theabsolutely fracture would not have occ discouraged, it makes no sense.

The Irish Osteoporosis Society (IOS) does not recommend yoga/ chair yoga for anyone, as many of the stretches contain excessive forward flexion stretches.

important is to ensure that you are taking enough of both but also to check that you are not taking too much of either of them.

Normal bone Image

The images show the positions those with bone loss and senior citizens should avoid, as many senior citizens have undiagnosed vertebral fractures and bone loss.

Unfortunately the Irish Osteoporosis Society receives a significant number of calls from people who have developed disc and sciatic nerve problems, as well as fractured vertebrae doing forward flexion stretches.

Did you know that calcium and vitamin D supplements are not “Osteoporosis treatments”?

Did you know that research shows that the majority of fractures (broken bones) occur in the moderate to marked Osteopenia range?

Most people are not aware that Osteopenia should not be considered a “touch of bone loss”. Research shows that most broken bones occur in the Moderate to marked Osteopenia range, which is a T score of -1.5 to -2.49. It is essential that when a person is diagnosed with bone loss that a plan to prevent further bone loss is put in place and the causes of their bone loss are investigated and addressed.

Most hospitals, due to patient volume have difficulty accessing initial and repeat DXA scans, which is why our health service should invest in more DXA scans for hospital settings, as prevention of fractures have been proven to be cost effective.

Bone image with bone Bone image with bone loss

1 in 2 women over age 50 will e 50, even though research show With most diseases people are recent survey in Ireland show taking a medicationA to slow down the progression of the disease or to help with relieving symptoms of experienced a fragility fracture. it. With Osteoporosis treatments, the prescribed medication/ expected/assumed by most pe treatments help to either slow Do you know why treating Osteopenia or Osteoporosis is very different to treating other diseases out there?

down bone loss or increase bone formation which improves bone quality and helps to reduce the risk of fractures.

The Irish Osteoporosis Society depends significantly on donations to help achieve its goals. Could you, your friends or coworkers help raise funds for this small (2 employees to cover Ireland!) but dedicated charity? Could you consider Payroll giving, which is an easy and efficient way for people to donate to our work directly from their monthly salary?

food, as well as assisting the immune system. The bones are the depository for calcium. In the event someone cannot absorb calcium, the body is programmed to take it from the bones, resulting in bone weakening.

increase awareness of this Silent disease. You can request to be emailed fact sheets, as well as female and male questionnaires that help find causes of bone loss from the charity by emailing info@irishosteoporosis.ie OR by just passing on the National helpline phone number 01 637 5050 would make a significant difference in helping to reduce the amount of people suffering from this treatable disease.

There are some in Ireland who 1 in 2 women over age 50 will The experience osteoporosis fractures, and 1 Answer: Taking the daily importance ofolder, Vitamin D, as they are the highest ri recommended amounts of especially in the winter months Did you know that Osteoporosis 50, even though research shows that most fractures are preventable. survey was highest amongst 40 Calcium and Vitamin D are very is a Silent disease With winter arriving and especially important but they are not actual since wethat really didover not have one a The fact isin no one feels bone showed A recent Ireland third of Irish adults ove Osteoporosis treatments.

There survey common sense, but financially sunny summer, it is essential that loss. It is essential that a person’s appears to be a small amount of protect not onlyof theirfractures bone response to their Osteoporosis a fragility fracture.people The level in the wou people who do experienced need a calcium living Thissurvey is to help health but their overall health. in Ireland. treatment is monitored. A person’s Our hope for 2025 is that all of and Vitamin D supplement, due bone health may be declining youthe reading this pieceage will make to not liking milkexpected/assumed etc. Both should by most people toessential beindependence amongst older groups Vitamin D is for the without anyone’s knowledge, and a conscious effort totheir help to care co be taken preferable through absorption of calcium from food, if this is not possible, then through a supplement. Many just need a Vitamin D supplement, in conjunction with a bone health plan to prevent fractures or a prescribed Osteoporosis medication if the person has fractured or is very high risk to fracture.

which is why it is essential their repeat DXA scans are performed to monitor their status.

There are some in Ireland who believe that should only be TheDXA Irish scans Osteoporosis Society Did you know that the Irish older, as they are the raterisk of fragilit Osteoporosis Society,highest who are the risk group.aConsidering person who the is high to fra national experts in bone loss, do ever recommend a person wait 40 to 54-year-olds shows that prevention survey was not highest amongst member who suffered from Ost 5 years to be rescanned?

NOTE: Those diagnosed with butis afinancially for ourshould health the overall Why not email common sense, Fibromyalgia have theirservice Currently there new trend health.

Thereand wasfor a person in I info@irishosteoporosis.ie for a Vitamin D levels checked, as a regarding DXA scanning. Some living Ireland.

This to help person prevent people high risk ending up dic copy of our Vitamin D and in calcium may be taking it but not DXA clinics are now is recommending left, theatperson said that they rescanning every 5 years. Lack calculator. The reason this is so fully absorbing it. Low levels of independence and their care costing farWe more €120 to do a DX arethan not the a third world countr

should neverinoccur. | 27 PHARMACYNEWSIRELAND.COM The Irish Osteoporosis Society who are situation the National experts Osteop

End of Year Review Crohn’s & Colitis Ireland As we reflect on 2024, Crohn’s & Colitis Ireland (CCI) celebrated it’s 40th anniversary and has continued to support and empower individuals living with Inflammatory Bowel Disease (IBD), building on our mission to improve daily life and foster resilience. This year has been one of both challenges and remarkable achievements, from gaining critical insights through our IBD Patient Survey to launching impactful initiatives that reached thousands of people. In November 2024, we proudly launched our 200 page IBD Diet Information & Recipe Book.

Written by Amy Kelly, COO, Crohn’s & Colitis Ireland services, as we strive to ensure that the voices of those living with IBD are heard and acted upon.

Helpline and Support Services

IBD Patient Survey 2024 – A Window into the Lived Experience of IBD One of our most significant undertakings this year was the IBD Patient Survey, which ran from February to March 2024.

With over 1,500 responses, the survey provided invaluable insight into the lived experience of those with Crohn’s disease and ulcerative colitis. The data revealed startling statistics that underscore the pressing need for more comprehensive and accessible care for IBD patients in Ireland: • 47% of patients waited over a year before seeking medical help.

• 33% went to A&E once or more before receiving a diagnosis.

• A staggering 85% reported that their mental health was not addressed in clinical settings.

• 68% lacked access to diet and nutrition support.

• 68% were never asked about non-gut complications of IBD. • 62% of respondents said IBD care placed a financial burden on them.

• 35% experienced stigma or unfair treatment.

• 44% stated that IBD impacts their daily tasks, and 69% weren’t asked about fatigue.

• Over 50% of patients reported not having regular care reviews.

• 70% shared that they have struggled to cope with their IBD in the past year.

The full report is available on our website, where it serves as a valuable resource for policymakers, healthcare professionals, and the public. The survey has also reinforced the need for CCI’s continued advocacy for better

This year, our helpline saw a 47% increase in demand compared to 2023, illustrating the growing need for our support services.

We have remained committed to providing practical and emotional support through various channels, including online support meetings, four patient days in Dublin, Cork, Carlow, and Sligo, and speaking at three medical student events.

We also delivered two webinars: one focused on diet and IBD, and another on living with an ostomy.

World IBD Day Media Campaign – Raising Awareness Our World IBD Day (19th of May) campaign, themed “It Takes Guts,” showcased the courage and resilience of people living with IBD. The campaign garnered significant media attention, with coverage from over 120 outlets, including national and local radio, TV, print, and digital platforms. The widespread exposure helped raise awareness and destigmatise IBD, encouraging empathy and understanding.

Partnership with Cork Airport This year, we collaborated with Cork Airport to address an issue that has been a growing concern for many IBD patients: the detection of stomas by airport scanners. In partnership with the airport, we are training security staff to handle passengers with stomas with dignity and respect.

We are also creating educational content to help passengers understand the process and know what they can request for a more comfortable journey. We are excited to expand this initiative to Dublin, Shannon, Knock, and Kerry airports in the near future, further improving the travel experience for IBD patients.

Gutcast – Empowering Through Stories Our award-winning podcast Gutcast continues to be an

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essential platform for sharing lived experiences and expert advice. This year, the episode featuring patient advocates Victoria Spillane and Ciarán Davis, along with IBD nurse Angela Mullen, provided listeners with personal insights into life with IBD and the evolution of care over the past 40 years. With over 30,000 listens, Gutcast remains a vital resource for patients and healthcare professionals alike, offering practical advice, emotional support, and an open dialogue on the challenges faced by those living with IBD. Clinical Referral Programme – Supporting Newly Diagnosed Patients We introduced a new service in 2024, the Clinical Referral Programme, which aims to provide timely support for those newly diagnosed with Crohn’s or colitis.

In collaboration with the Mercy Hospital, the IBD nurse team referred patients to our service, providing them with tailored information, time to answers all their questions, and an introduction to the full range of CCI’s services.

This bespoke service empowers patients by offering them the tools and support they need to manage their condition from the outset.

Boo4Poo – Engaging the Next Generation In response to the concerning rise in paediatric IBD diagnoses, CCI launched the Boo4Poo campaign, a Halloween-themed colouring competition aimed at educating and engaging primary school students about IBD. The campaign not only raised awareness but also fostered empathy for children living with the condition. With over 100 entries, Boo4Poo has proven to be a highly successful initiative, and we look forward to expanding it in 2025.

IBD Diet Information & Recipe Book – A New Resource for Patients In November 2024, we proudly launched the IBD Diet Information & Recipe Book, a comprehensive resource designed to help individuals with IBD manage their diet and improve their overall health. According to our 2024 patient survey, 68% of respondents

reported a lack of access to specialised diet and nutrition support, highlighting the need for this resource. The book, written by dietitian Lorraine Cooney and reviewed by a panel of experts, contains over 60 IBD-friendly recipes and expert advice. It covers a range of topics, from managing flare-ups and remission to navigating social events and dining out.

Looking Ahead to 2025 – Continued Progress and Advocacy As we look toward 2025, CCI remains committed to building on the momentum of 2024. Our advocacy efforts will continue to focus on raising awareness and effecting systemic change, particularly in light of the upcoming general election. We aim to ensure that IBD patients’ voices are heard in the new government, advocating for policies that address the gaps in care and support revealed by our patient survey.

We will also expand our network of support services, working closely with healthcare providers to ensure that IBD patients have access to the care, support, and information they need to live well. Through initiatives like our helpline, patient days, and online support meetings, we will continue to provide a vital safety net for those navigating the complexities of living with IBD. In addition, we are excited about the continued development of our collaborations with airports and other organisations to improve the quality of life for IBD patients. The success of the Boo4Poo campaign and the IBD Diet Information & Recipe Book demonstrates the power of education and empowerment, and we look forward to creating more resources that support IBD patients in the year ahead.

2025 promises to be another year of progress, and we are deeply grateful for the unwavering support of our members, partners, and supporters. We will continue to fight for better care, increased awareness, and an improved quality of life for all those diagnosed with Crohn’s disease and ulcerative colitis in Ireland.

End of Year Review Migraine Ireland With 2024 being Migraine Ireland’s 30th Anniversary, the team has worked incredibly hard on making it a year to be remembered. Arguably our biggest year yet, Migraine Ireland has received national recognition through its nomination for the Irish Healthcare Awards. The project entitled, “In Their Words” was a first-of-its-kind video series dedicated to exploring migraine through the lived experiences of migraineurs themselves. It’s the stories such as theirs that drive this team of five to continue its mission of advocacy, education and patient support.

Written by Naomi Oziel, Individual Giving, Donor and Grants Development Officer, Migraine Association of Ireland

Rewinding to the beginning of the year, Migraine Ireland presented a talk at Trinity College Dublin to an audience of doctors and nurses on the effectiveness of Compassion Focused Therapy (CFT) for migraine. This informative session presented collaborative findings of Migraine Ireland, Sláintecare and the Department of Psychology of Beaumont’s 6-week trial of CFT and found that most patients cited moderate to significant improvements in their migraine management as a result of their participation. Delivering this news to a large audience of PhDs in such an esteemed academic establishment helps to further validate and advocate for migraineurs across the nation.

Mid-year saw the introduction of a brand-new role in Migraine Ireland through the hiring of an Individual Giving, Donor and Grants Development Officer,

“Next year, in 2025, we intend to add and highlight our schools programme, our Healthcare professional Guide for GPs and Pharmacists, and will continue to bring interesting speaker from all over the world to give as much insight into migraine as possible” marking a continued period of growth in the organisation. Around the same time, the team travelled to LinkedIn headquarters here in Ireland to provide an in-person workplace talk on migraine and

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how to manage it in the office.

Opening with an articulate explanation of the phases of migraine, the presenters later shift into exploring small yet effective adjustments that employers could make in their workplaces to help their employees who live with migraine. This talk marked a large step towards migraine education on a larger scale corporate level.

Moving into the final quarter, Migraine Ireland launched fundraising events of which the funds go right back into providing services for the migraine community. The positive impact which results from these events is what drives this organisation continue organising ones such as the Autumn Cycle Challenge and the current Winter Lapland Quest, which is still live through Dec 31st.

The teams look forward to the year ahead and bringing our best to the team and to you!

Next year, in 2025, we intend to add and highlight our schools programme, our Healthcare professional Guide for GPs and Pharmacists, and will continue to bring interesting speaker from all over the world to give as much insight into migraine as possible.

Throughout the year, as all these talks and events take place, Migraine Ireland does significant work which may be

lost in the noise of its more outwardly ambitious activities.

Our membership management and communication is key to engaging with our support base.

Migraine Ireland has logged over 200 contacts with its Infoline service users to date. These interactions are so important to the organisation and represents the voice of the person living with migraine in Ireland on a daily basis. Listening to and being trusted with the stories of people living and fighting every day with migraine is what informs our work and our objectives.

Over the year we have had our biweekly group conversations.

This informal peer to peer support represents the beauty of people who understand each other supporting each other. Often people living with migraine face stigma, misunderstanding and social isolation. Being present at those conversations is a privilege and an inspiration.

Migraine Ireland has been on the same mission for its thirty-year lifespan and while this mission will never change, we are constantly exploring new paths and avenues to achieve it. This year has been one of change, creativity and recognition for us and as we look to the year ahead, we hope that our efforts will continue to pay off as we increase the visibility of migraineurs in Ireland.

Over 600,000 people in Ireland live with Migraine, and as the only not-for-profit organisation in the country dedicated to migraine and other primary headache disorders we are really privileged and proud to represent their interests.

We can be contacted via email on info@migraine.ie or see out website at www.migraine,ie

PREVENT

THE DISRUPTION OF MIGRAINE1 The only oral once-daily

calcitonin gene-related peptide (CGRP) receptor antagonist for both episodic and chronic migraine patients1,2

Tablet not actual size.

Typical characteristics of migraine are headache of unilateral location, pulsating quality, moderate or severe intensity, aggravation by routine physical activity and association with nausea and/or photophobia and phonophobia.3 ABBREVIATED PRESCRIBING INFORMATION. AQUIPTA®▼ (atogepant) 10 mg tablets; 60 mg tablets. Please refer to the Summary of Product Characteristics (SmPC) before prescribing.

PRESENTATION: Each tablet contains: 10 mg atogepant in 10 mg tablet, 60 mg atogepant in 60 mg tablet. INDICATION: Prophylaxis of migraine in adults who have at least 4 migraine days per month. DOSAGE AND ADMINISTRATION: The recommended dose is 60 mg taken orally once daily with or without meals; swallowed whole and not split, crushed or chewed. Missed dose to be taken as soon as it is remembered. If forgotten for an entire day, missed dose to be skipped and next dose taken as scheduled. Dose Modification: The recommended dosage of atogepant with concomitant use of strong CYP3A4 inhibitors or strong OATP inhibitors is 10 mg once daily. Special Populations: Elderly (≥65 years): No dose adjustment of atogepant is needed in elderly patients.

Renal impairment: In patients with severe renal impairment (creatinine clearance [CLcr] 15-29 mL/ min), and in patients with end-stage renal disease (ESRD) (CLcr <15 mL/min), the recommended dosage of atogepant is 10 mg once daily. For patients with ESRD undergoing intermittent dialysis, atogepant should preferably be taken after dialysis. No dose adjustment is recommended for patients with mild or moderate renal impairment. Hepatic impairment: Avoid use of atogepant in patients with severe hepatic impairment. No dose adjustment is recommended for patients with mild or moderate hepatic impairment. Paediatric Population: The safety and efficacy of atogepant in children (< 18 years of age) have not yet been established. CONTRAINDICATIONS: Hypersensitivity to active substance or any of the excipients. SPECIAL WARNINGS AND PRECAUTIONS: Atogepant 60 mg tablets contain 31.5 mg sodium per tablet; this is equivalent to 1.6% of the WHO recommended maximum daily intake of 2 g sodium for an adult. Atogepant 10 mg tablets contain less than 1 mmol sodium (23 mg) per dose, that is to say essentially ‘sodium-free’. Atogepant has no or negligible influence on the ability to drive and use machines. However, if affected by somnolence, patients should exercise caution before driving or using machinery. FERTILITY, PREGNANCY AND LACTATION: Pregnancy: Atogepant is not recommended during pregnancy and in women of childbearing

potential not using contraception. Breast-feeding: It is unknown whether atogepant is excreted in human milk. A decision must be made whether to discontinue breast-feeding or to discontinue/ abstain from therapy taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman. Fertility: No human data on the effect of atogepant on fertility are available. Animal studies showed no impact on female and male fertility with atogepant treatment.

UNDESIRABLE EFFECTS: Common (≥ 1/100 to <1/10): Decreased appetite, nausea, constipation, fatigue/somnolence, weight decreased. Refer to Section 4.8 of the SmPC for details of other side effects, and for further information. ▼ 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; website: www.hpra.ie.

LEGAL CATEGORY: POM (S1B). MARKETING AUTHORISATION NUMBERS: EU/1/23/1750/001 AQUIPTA 10 mg tablets in blisters, in cartons of 28 tablets; EU/1/23/1750/003 AQUIPTA 60 mg tablets in blisters, in cartons of 28 tablets. MARKETING AUTHORISATION HOLDER: AbbVie Deutschland GmbH & Co. KG, Knollstrasse, 67061 Ludwigshafen, Germany. Further information is available on request from: AbbVie Limited, 14 Riverwalk, Citywest Business Campus, Dublin 24. DATE OF REVISION: October 2023. PI/1750/001.

References: 1. AQUIPTA® Summary of Product Characteristics, available at www.medicines.ie. 2.

Morena-Ajona D, et al. J Clin Med. 2022;11(6):1656. 3. Ferrari MD, et al. Nat Rev Dis Primers. 2022;8(1):2.

IE-AQP-230001 | Date of preparation: May 2024

End of Year Review A Landmark Year for Cardiovascular Health In some ways 2024 was a landmark year for the cause of cardiovascular health in Ireland. But many concerns and frustrations also remain over the lack of priority given to minimising preventable death and disability from heart disease and stroke in Ireland.

Written by Chris Macey, Director of Advocacy and Patient Support, Irish Heart Foundation services that support patients almost literally from the hospital gates for as long as they need us. A great many describe these practical, social and emotional supports as their lifeline.

In terms of the Irish Heart Foundation’s agenda, the highlights were the first ever national funding for community support services for stroke survivors and heart patients in Ireland, along with the restoration of Ireland’s credentials as a world leader in tobacco control.

On the downside, another year passed without publication of the National Review of Specialist Cardiac Services and without an overarching National Cardiovascular Health policy. This represents not so much a gaping hole as a chasm in Ireland’s health services given that cardiovascular disease is responsible for almost 30% of all-cause mortality here.

It has to be recognised, however, that funding provided in the recent Budget for the Irish Heart Foundation’s national stroke and heart support services will have a life-changing impact on many thousands of patients in every corner of the country.

Cardiovascular patients represent a huge portion of Ireland’s population, in the region of 600,000 people.

And there are as many as 80,000 discharges of heart and stroke patients from Irish hospitals each year – the equivalent of one every seven minutes.

They are changing a deep sense of abandonment among stroke survivors caused by the chronic dearth of community rehabilitation.

They are also helping to tackle the revolving door syndrome of a 90 day hospital readmission rate among heart failure patients that has been estimated at 30%, often for the want of basic information and support.

Over one in three stroke survivors returning home nationally are being referred in to the services, which also support thousands more patients across a broad range of cardiac conditions. And the recurrent funding championed

by Minister for Health Stephen Donnelly provides the basis for long term sustainability for support that can continue to grow in scale and depth in line with stroke survivor needs.

Until recently Ireland had lost its way in terms of tobacco and nicotine addiction. Youth smoking rates had risen for the first time in a generation; we were one of the last countries in Europe to ban the sale of vapes to under 18s; and we remained around half a million smokers short of reaching the Tobacco Free Ireland target of a 5% smoking rate by 2025.

When the pandemic struck, the Irish Heart Foundation set up a phone-based check-in service in collaboration with the national heart and stroke programmes to support patients who couldn’t attend hospital appointments or were being discharged home earlier than usual to free up space for Covid patients.

However, the Irish Heart Foundation-led campaign for legislation to make Ireland the first EU country to increase the legal age of sale of tobacco to 21 has breathed new life into tobacco control in Ireland. We know this measure will be effective from its success in the US where it was made federal law by President Donald Trump in 2019. And through our own experience when the age of sale in Ireland was increased here from 16-18, reducing smoking in that age group by 30%.

This provided the basis for the development of a pathway of phone, online and face to face

Perhaps most importantly it sets Ireland on a path to the total phasing out of legal tobacco

32 | PHARMACYNEWSIRELAND.COM

sales, as is in train in the UK – a move supported by 83% of the Irish public in a poll for the HSE. Unlike in the UK, this must be accompanied by a gradual process of denicotinisation of cigarettes to reduce their addictive nature and therefore demand for them over time.

National Cardiac Services Review with a robust and fully funded implementation plan, and prioritise the publication of a new National Cardiovascular Policy and Strategy, also with a commitment to full multi-annual funding.

In addition to the ¤1 budget increase on a pack of cigarettes, the imposition of a specific tax on e-cigarette liquid imposed for the first time will act as a deterrent to young people taking up vaping.

And whilst legislation to protect young people from nicotine addiction following the explosion in youth vaping could not be passed before the general election, there is broad cross-party consensus that tough action is needed.

- Full implementation of the National Stroke Strategy 20222027 with an overall investment of ¤36 million and a subsequent plan with guaranteed multi-annual funding that places a far greater emphasis on the community services and supports that enable survivors to make the most of life after stroke.

But nor can the negative impact of the absence of a national plan for cardiovascular disease since the previous policy expired in 2019.

The absence of a policy framework for the prevention, detection and treatment of cardiovascular disease, along with services and supports that maximise patients’ health and wellbeing in the community is preventing the development of lifesaving services.

This is resulting in preventable death, disability and loss of quality of life on a significant scale.

It should be acknowledged that there was some funding in the Budget for implementation of the National Stroke Strategy and for the development of a new cardiovascular plan.

However, this is against the background of a lack of comprehensive national cardiac registries providing health planners with vital real-time data; restricted access to cardiac diagnostics is resulting in long waiting lists; and an urgent need for investment in cardiac imaging, including echocardiography, cardiac CT and cardiac MRI. The incoming President of the Irish Cardiac Society, Prof Brendan McAdam said at a recent hearing of the Oireachtas Health Committee that due to such deficits the cardiovascular community was currently unable to deliver care at a level consistent with international guidelines.

The incoming Government should urgently publish the

Our other priorities include:

- Priority for implementing the model of care for cardiac rehabilitation, which can reduce deaths from heart disease by at least a fifth. Services in many parts of the country are at crisis point with staffing down 63% since 2009 in the face of a major population increase and waiting times in some instances in excess of two years.

- We need a firm commitment on legislation to tackle Ireland’s obesity crisis, including protection for children from junk food marketing – with teenagers seeing around three ads for unhealthy food and beverages every ten minutes they are online. This saturation level of exposure is a key driver of Ireland’s childhood obesity crisis which the State’s own research predicts will cause the premature deaths of 85,000 of this generation of children in Ireland.

- We should also build on the success of the Sugar Sweetened Drinks Tax, which reduced sugar intake from soft drinks by a quarter in its first year by incentivising product reformulation. A tax on high sugar food products, coupled with programmes to increase consumption of fruit and vegetables, would reduce the national waistline and promote healthier diets.

- Other crucial evidence-based measures to tackle childhood obesity include no fry zones near schools and restrictions of price promotions and in store marketing.

- Completion of legislation to protect children from vaping put forward by the outgoing Government.

The end of erectile problems?

Touch wood.

Available over the counter. No prescription required.

Always read the leaflet. Available in a 4 or 8 pack.

ABBREVIATED PRESCRIBING INFORMATION Product Name: Sidena 50 mg Tablets.

Composition: Each tablet contains, 50 mg sildenafil (as citrate) .

Description: Light blue, round, slightly dotted tablets. Cross breaking notch on one side and marked ‘50’ on the other side. Can be divided into equal quarters. (Only two quarters of the 50 mg is covered by posology).

Indication(s): Treatment of men with erectile dysfunction, which is the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance.

Dosage: Adults and elderly: 50 mg taken as needed approximately one hour before sexual activity. Dose may be decreased to 25 mg. Max dose: 50mg once daily. Impaired renal and hepatic function: Sildenafil clearance is reduced in hepatic and severe renal impairment. Consider a dose of 25 mg. Dose may be increased step-wise to 50 mg if tolerated. Children and adolescents below 18 years of age: Contraindicated. Use in patients using other medicines: Starting dose of 25 mg with CYP3A4 inhibitors (not advised to use with ritonavir). To minimise postural hypotension in patients receiving and alpha-blocker, stabilise patient first on the alpha blocker and use a starting dose of 25 mg sildenafil.

Contraindications: Hypersensitivity to sildenafil or any of the excipients. Concomitant with ritonavir, nitric oxide donors or nitrates in any form, guanylate cyclase stimulators e.g. riociguat.

In patients that sexual activity is inadvisable (e.g. severe cardiovascular disorders such as a recent (6 months) acute myocardial infarction (AMI) or stroke, unstable angina or severe cardiac failure). Refer these patients to a doctor. Patients with loss of vision in one eye due to NAION. Known hereditary degenerative retinal disorders. Severe hepatic impairment. Hypotension.

Anatomical deformation of the penis. Not intended if no erectile dysfunction. Women.

Warnings and Precautions for Use: First diagnose erectile dysfunction and determine potential underlying causes (e.g. hypertension, diabetes mellitus, hypercholesterolaemia or cardiovascular disease), before considering pharmacological treatment. Consider the cardiovascular status of patients, since there is a degree of cardiac risk associated with sexual activity.

Serious cardiovascular events, including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, cerebrovascular haemorrhage, transient ischaemic attack, hypertension and hypotension have been reported post-marketing in temporal association with the use of sildenafil. Most, but not all, of these patients had pre-existing cardiovascular risk factors. Sildenafil has vasodilator properties, resulting in mild and transient decreases in blood pressure. Caution: Patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie’s disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell anaemia, multiple myeloma or leukaemia). Advise patients that in case of priapism, prolonged erections (longer than 4 hours) or sudden visual defect, they should stop taking sildenafil and consult a physician immediately. Administer to patients with bleeding disorders or active peptic ulceration only after careful benefit-risk assessment, as there is no safety information available.

Interactions: See SPC for detailed information. Inhibitors of the cytochrome P450 (CYP) isoforms 3A4 (major route) and 2C9 (minor route) isoenzymes such as CYP3A4 inhibitors: Itraconazole, ketoconazole, erythromycin, cimetidine, HIV protease inhibitor saquinavir: May reduce sildenafil clearance and increase sildenafil plasma levels. Consider a starting dose of 25 mg. Strong CYP3A4 inducers e.g. rifampicin may increase sildenafil clearance and decrease sildenafil plasma concentrations. Grapefruit juice: May give rise to modest increases in plasma levels of sildenafil. Nicorandil (Hybrid of potassium channel activator and nitrate): Due to the nitrate component it has the potential to have serious interaction with sildenafil. Sildenafil potentiates the hypotensive effect of nitrates. Alpha blocker: Concomitant administration of sildenafil may lead to symptomatic hypotension in a few susceptible individuals. Patients should be hemodynamically stable on alpha-blocker therapy prior to initiating sildenafil treatment. Sildenafil potentiates the antiaggregatory effect of sodium nitroprusside in vitro. Not recommended in patients with a history of bleeding disorders or active peptic ulceration. Not recommended to use with other pulmonary arterial hypertension treatment containing sildenafil. Caution when sildenafil is initiated in patients treated with sacubitril/valsartan. May result in a increase of bosentan availability.

Ability to Drive and Use Machinery: Minor influence, dizziness and altered vision were reported. Patients should be aware of how they react to sildenafil before driving or using machinery. Undesirable Effects: Very common: Headache. Common: Dizziness, visual disorders, visual colour distortion, vision blurred, flushing, hot flush, nasal congestion, nausea, dyspepsia. See SPC for more adverse effects.

Marketing Authorisation Holder: Rowex Ltd, Bantry, Co. Cork. Marketing Authorisation Number: PA 0711/170/002. Further information and SPC are available from: Rowex Ltd., Bantry, Co. Cork. Freephone: 1800 304 400 Fax: 027 50417 E-mail: rowex@rowa-pharma.ie Adverse events should be reported. Reporting forms and information can be found on the Legal Category: Not subject to medical prescription.

HPRA website (www.hpra.ie) or by emailing Rowex pv@rowa-pharma.ie Date of Preparation: Jan 2024 Date of preparation: (10-24) CCF: 26643

Supply status: Supply through pharmacies only.

34

Winter Health

Focusing on Winter First Aid Whether you love it or hate it, winter brings with it a number of health and safety considerations. As winters get increasingly cold, the importance of proper preparation becomes even greater. Get ready for outdoor activities with appropriate first aid provisions and take precautions to stay warm whenever you face the elements. time, every home should have tweezers, gauze pads, bandages, and antibiotic ointment.

Here are some steps that pharmacists should tell patients to follow in treating cuts at home: • Rinse a cut with cool water • Wash around the cut with soap; avoid getting soap into the wound • Remove dirt and debris from the wound with tweezers; clean the tweezers with rubbing alcohol before using them • Apply direct pressure with a clean gauze pad to a bleeding cut • Treat the cut with antibiotic ointment • Cover the cut with a bandage (deeper cuts may require a butterfly bandage) • Do not pick at a scab while a cut is healing Treating Bruises Taking precautions to keep warm during the winter helps to prevent colds and the flu and can even help to prevent more serious health problems like strokes, heart attacks, pneumonia and depression.

• Review their knowledge of First Aid in case of an emergency

Some people are more at risk in cold weather. These are:

Hypothermia is a serious decrease in body temperature below 35°C (normal body temperature is approximately 37°C). It is a medical emergency that requires hospital treatment.

• Low-income individuals

Signs of hypothermia include:

• Individuals with a disability

• People over the age of 65

• Shivering, cold and pale skin which may turn blue or grey on dark skin tones (particularly visible on palms and soles of the feet)

• Children under the age of 5

• Slurred speech

• Those with a mental health condition

• Slow breathing

• Those suffering from long-term health conditions

• Pregnant people

• Fatigue and confusion

• Take the necessary precautions to keep warm when out in the cold

Other signs of hypothermia can include loss of coordination, clumsiness, memory problems, and a decrease in the body’s overall energy. Hypothermia can be caused by a number of factors, such as not wearing sufficient clothing in cold weather, remaining outdoors for too long, falling into cold water, having wet clothes, or living in a cold house – particularly those living alone.

• Be aware of any potential weather-related risks, such as hypothermia or frostbite

Cuts, scrapes, and bruises are among the most common injuries, and no family member is safe from

To help customers make sure they, and their First Aid kit are ready for winter, here are some things to consider: • They should have a First Aid kit on hand that is stocked with the appropriate items

PHARMACYNEWSIRELAND.COM

minor accidents. Fortunately, these injuries usually can be treated at home without a doctor visit.

Pharmacists need to be able to advise patients on how to treat these injuries if medical attention is not necessary, as well as to counsel patients as to when they should seek medical attention.

Scrapes (or abrasions) are wounds in which layers of skin are scraped or torn. The most common sites for scrapes are the hands, elbows, and knees. These injuries often are the result of a fall. Although the scrapes may ooze blood, bleeding does not always occur. Objects penetrating the skin cause cuts (or lacerations). Depending on the depth, cuts often will bleed.

Bruises are the result of hard contact with a person or an object.

The impact causes an injury to the tissue beneath the skin, and blood from the injury settles near the skin. Bruises usually start out looking red, then within a few hours turn blue or purple, and finally appear yellow as they fade.

Treating Cuts and Scrapes Minor scrapes and cuts are easily treated at home with basic wound-care or first-aid supplies.

Because cuts can happen at any

Although bruises can be painful, treatment is limited. The best care for bruises involves rest and ice.

Ice stops blood flow to the injury site, thus limiting the size of the bruise. Rest allows the site to heal.

Here are some further guidelines for patients for treating bruises at home: • Apply ice packs or cold compresses as soon as possible • Reapply ice packs every hour for 10-15 minutes during the first day, if needed • With bruised legs or feet, elevate the legs as much as possible during the first day • Take acetaminophen, if needed, for pain; do not take aspirin • With large bruises, limit activity during the first day • Use heat packs after 48 hours to promote healing Here are some signs that bruises need medical attention: • The bruise swells • The bruise does not start to fade within a week • The bruise occurs easily or for no obvious reason

Have a very

Christmas

Listen out for our Christmas ad on

Our Medicare range of breathable plasters to treat minor cuts and scrapes include fabric, waterproof, spot, blister, burns and blue detectable plasters.

Medicare plasters are hypoallergenic, latex-free and air-permeable making them ideal for those with sensitive skin.

Don’t let a gift-wrap mishap ruin your festive cheer, stock up on Medicare Plasters for quick, reliable protection this holiday season!

Scan our QR code to browse our Medicare Home Woundcare Range.

For support and further information

EMAIL: pharmacy@flemingmedical.ie • FREEPHONE: 1800 307777

Winter-Proof Skin Sales in your Pharmacy Dry Skin If the skin’s water content drops below 10%, the enzymes responsible for corneocyte desquamation no longer function properly. The corneocytes shrink reducing levels of NMF and the lipid lamellae appears broken (analogous to crumbling mortar in an old brick wall).

These will create breaches in the skin’s barrier, allowing for greater water loss.

Clinically, xerotic skin appears rough and flaky, with white patches (which represent adherent corneocytes due to reduced desquamation) that is both uncomfortable and pruritic. Dry skin is commonly seen on the lower legs, the trunk, forearms, hands and face. The feet are normally less prone to dryness, being protected by socks and tights, but dryness can be problem for those who walk barefoot or wear sandals.

Left untreated, xerotic skin becomes red, dull and rough, and ultimately starts to crack. These cracks deteriorate over time and can bleed, providing an entry portal for irritants and bacteria that can lead to infections.

To prevent dry skin, customers should be advised to maintain skin hydration through adequate fluid intake, avoid hygiene products that dry out the skin, reduce full-body bathing to every other day, and avoid long, hot showers. To treat dry skin, there are several suggestions pharmacists can offer. Patients can apply oil-based emollients (eg, petrolatum and mineral oil) after bathing, or they may use colloidal oatmeal or bath oil while bathing to enhance skin hydration. Humectants, such as glycerin, draw water into the skin. More serious cases of dry skin may require a urea- or lactic acid containing product.

Managing Eczema The words eczema (which comes from the Greek word meaning ‘to boil’) and dermatitis (meaning inflammation of the skin) are often used interchangeably to describe several conditions that cause the skin to become dry, itchy, inflamed or irritated.

There are a number of different types of eczema but the term is most often used to refer to atopic eczema (also called atopic dermatitis).

The word atopic refers to hypersensitivity reactions to something in the environment.

Atopic eczema is a very common, noncontagious, chronic (long-term) inflammatory skin condition. While the exact cause is not known, certain factors are thought to be important in its development, these include an inherited (genetic) predisposition to have a weakened skin barrier, as well as altered inflammatory and allergy responses. Atopic eczema most frequently begins in infancy

but may also develop for the first time in adulthood. It affects approximately 1 in 5 children and 1 in 12 adults in Ireland.

For most children affected, the disease is mild.

However, often those who have seemingly outgrown the condition will continue to have life-long sensitive skin and may have recurrences of eczema following long symptom-free spells.

Itching stimulates more scratching

Stimulates nerve ending to trigger itch

Itching

Scratching

Atopic eczema can run in families and frequently occurs alongside other atopic conditions, including hay fever and asthma.

Symptoms include red, dry, itchy skin, which can sometimes weep, become blistered, crusted and thickened. However, the appearance of eczema and the locations of the body affected can vary greatly depending on the age of the person affected.

Atopic eczema has been described as the ‘itch that rashes’. Itch is an unpleasant sensation which activates the desire to scratch. The desire to scratch can be so intense that people can sometimes scratch until the skin becomes painful and bleeds. Occasionally, this can lead to cuts, abrasions and skin infections.

Scratching is a behaviour used to relieve itching, but sometimes it can also be prompted by emotion, or it can become habitual.

Some people scratch when they are stressed or anxious. Some people scratch through subconscious repeated behaviour, and can get stuck in the itch scratch cycle. When they feel itchy they scratch – when they scratch chemicals are released that causes more itch.

Alongside conventional management and treatments for atopic eczema some simple techniques may help to relieve the itch.

36 | PHARMACYNEWSIRELAND.COM

Pain, swelling and redness

Release inflammatory chemicals

Habit reversal is a behaviour modification technique that can be beneficial in helping to replace an old habit with a new one.

To stop scratching, the person first needs to become aware of the desire to scratch and the action of scratching. However, people living with eczema can get fed up of family saying “stop scratching!”, so it may help by developing a code word to provide encouragement instead. Maybe gently ‘pinch’ or ‘tap’ or count the number of times scratching is observed to create awareness of the action.

Some people choose to use a tally counter.

The main aim is to improve symptoms and achieve long-term control. In atopic eczema, the skin’s protective barrier is weakened which allows moisture to be lost, and irritants and allergens to pass through the skin more easily.

Some common everyday substances e.g. soap, contribute to the weakening of the skin’s barrier and should be avoided.

The Irish Skin Foundation’s ‘Living with Atopic Eczema’ survey, which over 450 people living with eczema or caring for someone with eczema responded to between September 2018 – April 2019 showed that the cost of eczema treatments and doctor’s appointments needed to manage the condition can be a significant financial burden.

The survey revealed that 42% of carers of children and 49% of adults reported cutting back on household expenses due to the cost of managing atopic eczema. The figures suggest that one quarter of you spend at least €2,300 annually on doctor’s fees, overthe-counter management products and prescription treatments.

Rosacea Gusty winds during the winter and the dry air in overheated rooms cause the skin of patients with rosacea to become more sensitive. Rosacea is defined as a chronic, relapsing, inflammatory condition that affects the central portion of facial skin. More frequently seen in fair-skinned individuals of Celtic or Northern European heritage, rosacea occurs more commonly in women (although men tend to experience more severe disease) and in those between 30 and 50 years of age.

Chapped Lips

Use of Emollients

Chapped lips can occur in any season of the year, although they are particularly common during the winter months. Chapped lips can be painful, embarrassing, and uncomfortable.

They may sometimes cause difficulty in talking, eating, and drinking. Understanding the causes, treatments, and prevention can help pharmacy teams advise sufferers on how to reduce or avoid the occurrence of chapped lips.

Emollient (moisturiser) therapy is often used to manage a number of skin conditions, such as eczema and psoriasis. However, with such a wide variety of emollients available on the market today, it is important you and your team are aware about which products are the best fit for people who need to use emollients regularly.

The skin on the lips is much thinner and more delicate than that on other parts of the body. The lips are also exposed to the elements, including the sun and cold, dry air, making them prone to dryness, cracking, flaking, and peeling.

The lips lack oil glands and so cannot produce their own moisture, but natural moisturisers can help. Whilst the winter conditions most often cause chapped lips, there are other causes such as:  Smoking  Dehydration  Repeatedly licking the lips  Skin disorders such as eczema

Self-Care Tips for Rosacea

 Allergic reactions to certain skin care products or cosmetics

These are some of the most important things sufferers need to know about rosacea and how they can best manage it themselves.

 Use of certain medications such as anti-acne products

1: Identify the triggers: If possible, identify and avoid any lifestyle or environmental factors which trigger or exacerbate symptoms.

Examples of common triggers can include alcohol, hot beverages, spicy foods, and extremes in temperatures.

Sometimes it may help to keep a written record of flare-ups to identify any trigger.

2: Choosing products: Individuals with rosacea, often have sensitive, easily irritated skin. Therefore it is important to select mild, non-irritating, fragrance-free, alcohol-free, skin care products.

Advise on the use a moisturiser which is fragrance free and “non-comedogenic” or “oil free”, on a regular basis to improve skin hydration and skin barrier function 3: Cleansing: Avoid vigorous washing and scrubbing as this can irritate the skin. Wash the skin with a gentle skin cleanser or a soap substitute, use lukewarm water and pat skin dry.

4: Shave carefully: Electric shavers may be more comfortable for men with rosacea.

Avoid any shaving creams or lotions that burn or sting.

Those with chapped lips may experience dryness, redness, tenderness and sensitivity, cracking, splitting, or peeling and pain.

A variety of OTC products are available for treating or preventing chapped lips. These products typically contain ingredients that assist in healing, such as skin protectants, moisturisers, pain relievers, and sunscreens.

Emollients are moisturisers that come in the form of lotions, creams and ointments. They repair and protect the skin barrier. They hydrate and trap moisture in the skin. Emollient therapy improves symptoms resulting in decreased dryness, flaking, cracking, scaling, resulting in reduced itch and inflammation.

Emollients are used in two ways: Leave on emollient or wash emollient. A leave-on emollient is applied directly to the skin to moisturise and trap moisture. Wash emollient comes in the form of a soap substitute as an alternative to soap, emollient body wash in place of shower gel, or emollient bath additive or bath oil instead of bubble bath. Soaps, shower gels and bubble-bath should be avoided as they contain detergents, which strip away the natural oils and dries out the skin.

Finding the right emollient is often a matter of trial and error, but the best emollients are ones customers prefer to use and will continue to use every day.

Practical tips for emollient therapy  Establish a good daily skin care routine and try to stick to it.  Don’t stop moisturising when the skin is clear.  Apply emollients in a smooth, downward motion, in the direction of the hair growth.  Never stick fingers into a tub of emollient – Remember to use a CLEAN spatula, spoon or a pump dispenser to apply so it does not become contaminated.  A child with inflamed skin often requires a minimum of 250g of ‘leave-on’ emollient per week, while an adult may need approximately 500g – 1000g per week.  Bathwater should be a lukewarm temperature. 5 minutes with an emollient bath additive is sufficient.  Remember – avoid soap, bubble bath and shower gel.  After bathing or showering, gently pat skin dry and apply emollient all over when the skin is still slightly damp.

5: Use medications as directed: Use prescribed topical preparations and oral rosacea medications as directed; e.g. take them at the correct time of day, as often as prescribed, at the right dose.

6: Be patient! Unfortunately, patience is necessary; rosacea treatment may take time to take effect.

Depending on the individual and type of treatment (topical or oral), some studies have suggested it may take 6 – 12 weeks before any particular therapy is changed for another.

7: Are the eyes affected? If a sufferers eyes are affected, they should consult with their doctor.

For mild eye symptoms (which may include dryness or a gritty feeling in the eyes) washing the eyes twice daily with warm water and using artificial tears may be beneficial.

PHARMACYNEWSIRELAND.COM | 37

38

Advertorial

Biotech Alternatives to Corticosteroids: Novel oral and topical approach to treating mild to moderate atopic dermatitis (eczema) Atopic dermatitis, or eczema, is a chronic skin condition wherein the skin barrier is disrupted leading to a cycle of inflammation, redness, pruritus, and scratching. These symptoms further weaken the skin barrier increasing trans-epidermal water loss (TEWL) and triggering de-hydration and inflammation.

Written by Barbara Paldus, Codex Labs

genes that can activate IL-13, thereby reducing itching.7 Novel Anti-Inflammatory Oral Treatment for AD

BiaComplex 2.0 is comprised of plant stem cell extracts as well as hyaluronic acid and NP ceramides. 1% colloidal oatmeal was included to meet USA FDA OTC Monograph M016.

The plant-biotech stem cells selected to repair and fortify the skin barrier include: • Calendula officinalis: antioxidant, anti-inflammatory and wound healing benefits2

L-histidine, an amino acid, supports skin barrier integrity through filaggrin formation and has been found to significantly reduce AD severity and flare-ups: children taking 0.8 grams of L-histidine daily for 12 weeks experienced 49% reduced AD severity;8 adults taking 4 grams of L-histidine daily for 8 weeks experienced 34% reduced AD severity.9 The Antü Skin Barrier Support supplement combines 4 g of L-histidine and three antioxidant, gut barrier supporting plants (M3Complex):

improved by day 56: 78% hydration increase, 40% TEWL decrease, and 65% desquamation index decrease.

The second study used the soap and lotion as well as the oral supplement on 35 subjects with moderate AD (average SCORAD 34.6). By day 56, in 100% of subjects, SCORAD decreased by 93% (p < 0.0001) and pruritus decreased by 97% (p < 0.0001) compared to day 0 baseline. All skin parameters improved by day 56: 117% hydration increase, 29% TEWL decrease, and 83% desquamation index decrease.

The test subject feedback fully supported the measured data with 100% reporting their skin condition improved and felt soothed, while 97% reported less itch and less dryness.

• Symphytum officinale: allantoin promotes desquamation; rosmarinic acid increases ceramide formation3 and inhibits itch-causing S. aureus

• Matico (Buddleja globosa): stigmasterol helps protect gut mucosa and reduces gut inflammation10

• Haberlea rhodopensis: myconoside stimulates extracellular matrix synthesis4

• Maqui (Aristotelia chilensis): anthocyanins and flavonoids help neutralize free radicals

• Padina pavonica thallus: laminarins and alginic acids moisturize and support wound healing.5

• Murta (Ugni molinae): gallic acid, quercetin, and kaempferol enable strong antioxidant activity against lipid peroxidation.

Increased intestinal permeability (IP) is also known as leaky gut.

Eczema is often correlated with leaky gut, and gut inflammation like irritable bowel syndrome (IBS) or Crohn’s-like symptoms.

Studies have found that children with AD have increased IP, and one study reported a correlation between a marker of increased IP and the Scoring Atopic Dermatitis (SCORAD) index.1

The use of sunflower oil as a carrier enables the bioactive compounds to penetrate skin without synthetic penetration enhancers. Its high concentration of linoleic acid (>60%) helps maintain skin barrier integrity, serves as an emollient, and reduces TEWL. It is safe for those with tree nut allergies, which are common in AD.

The M3Complex antioxidant activity was compared to ascorbic acid (vitamin C), curcumin, black tea and green tea EGCG. In four laboratory methods, M3Complex showed comparable if not superior antioxidant capacity. It also showed the highest quercetic and phenolic equivalents.

M3Complex is an effective option for reducing gut and systemic inflammation in AD.

References

Novel Biotech topical treatment for AD

Inflammatory skin disorders such as AD are also characterized by intense pruritus, leading to significant discomfort and distress. Particularly in children, interleukin-13 (IL-13), a cytokine that regulates immune responses and inflammation, can promote intense itch. Research has shown that elevated levels of IL-13 are present in the skin of individuals with AD.6

Clinical Test Results

5. https://journals.tubitak.gov.tr/ veterinary/vol41/iss1/16/

Conventional AD treatments include topical corticosteroids alongside skincare routines with emollients/moisturizers and gentle cleansers. Integrative dermatology considers the role of the skin-gut axis in AD: in addition to topicals, it also addresses gut dysbiosis and systemic inflammation.

Eczema Skin-Gut Axis

The topical regimen discussed here consists of Bia™ unscented soap and Bia eczema relief lotion, made with the patented biotech BiaComplex 2.0.

The soap is cold processed to yield excess glycerin, so it does not strip moisture, sebum, or the microbiome from the skin. This is essential in maintaining skin barrier integrity and supporting the native skin microbiome to prevent S. aureus infections.

Treatment of Pruritus

Gene expression studies of the BiaComplex 2.0 applied to epidermal tissues demonstrated downregulation of IL-4 cytokine

PHARMACYNEWSIRELAND.COM

Two clinical trials were performed at Eurofins in Poland. The results are comparable to corticosteroids (e.g. triamcinolone or betamethasone) and have been submitted for publication.

The first study used only the soap and lotion on 34 subjects with mild AD (average SCORAD 29.8).

By day 56, in 100% of subjects, SCORAD decreased by 99% (p < 0.0001) and pruritus decreased by 93% (p < 0.0001) compared to day 0 baseline. All skin parameters

This initial data demonstrates conclusively that it is possible to leverage plant-biotech actives to achieve comparable performance in AD severity and pruritus reduction to traditional corticosteroids, but without the known side effects, allowing long-term use.

1. https://pubmed.ncbi.nlm.nih. gov/3745938/ 2. https://pmc.ncbi.nlm.nih.gov/ articles/PMC10142266/ 3. https://www.mdpi.com/14220067/23/7/3910 4. https://pubmed.ncbi.nlm.nih. gov/22023081/

6. https://pmc.ncbi.nlm.nih.gov/ articles/PMC10151557/ 7. Paldus B, Cornell, M. United States patent application 18/900,196; granted Nov 2024.

8. https://pubmed.ncbi.nlm.nih. gov/33000160/ 9. https://pubmed.ncbi.nlm.nih. gov/29042806/ 10. https://doi.org/10.3389/ fimmu.2021.741934

40

News

Viatris Team Showcase Court Skills Viatris colleagues demonstrate their court and team skills, while supporting Irish Wheelchair Association Enis Otuk, Country Manager Ireland, Viatris and Paul Ryan, Irish Wheelchair Association Sports National Operations Manger

event. This is the second time we've had the pleasure of working with Viatris on this fantastic initiative, hosted at Sports Campus Ireland, and their support is truly making a difference. These events are a wonderful way for colleagues to come together to raise vital funds for Irish Wheelchair Association’s work across Ireland.

“Viatris' donation will help sustain our IWA Multi Sports Clubs across the country, as well as our vital work in IWA Community Centres keeping our members active and Viatris Inc. (NASDAQ: VTRS) colleagues in Ireland joined the Irish Wheelchair Association last month in the Sport Ireland Campus, Blanchardstown, Dublin, for a fast-paced and entertaining wheelchair basketball event. The experience raised over ¤10,000 for the registered charity, which runs corporate team building days with the underlying aims of changing attitudes, facilitating access to sports, and supporting facilities for people with disabilities. The event is part of a pan-European #BuildingHealthierCommunities initiative at Viatris, a global healthcare company, which aims to engage employees and local healthcare communities across Europe to support social and environmental projects. The unique, fun-filled experience was enjoyed by over 100 employees from Ireland and across Europe, including members of Viatris’ Leadership team.

our employees. We aim for these partnership efforts to make a real difference in the local community.

These collaborations also influence our employees, helping them not only understand the challenges of the communities we live and work in but also embrace our many differences and realise our own potential. I am proud to be part of an organisation that has community and diversity in mind.

As the Viatris motto goes, we are ‘Stronger Together’.”

Ann-Marie O'Grady, Chief Executive Officer, Irish Wheelchair Association added, "We are incredibly grateful for Viatris' continued partnership - now in its second year - and their generous donation of ¤10,000 euro towards, and participation in, this unique Corporate Wheelchair Basketball

Enis Otuk, Country Manager - Ireland, explained, “We’re honoured to join Irish Wheelchair Association today to experience adapted physical activity through wheelchair basketball. At Viatris, we believe diverse perspectives drive innovation and our ability to make an impact in the world.

Today’s event is a celebration of diversity and inclusion.” Enis went on to say, “In Ireland we support approximately 30 Irish charities and organisations each year, nominated and chosen by

Viatris Ireland employees and employees from the Irish Wheelchair Association

PHARMACYNEWSIRELAND.COM

engaged through sports like boccia and other community activities.

For people with disabilities, these services are more than just recreational—they're a lifeline.

They help combat loneliness and isolation, empowering our members to stay connected, active and involved in their communities and support their physical and mental wellbeing.

“Together with partners like Viatris, we can continue to make a lasting impact on the lives of people with disabilities, ensuring they can live the life they choose."

Enis Otuk, Country Manager Ireland and Ann-Marie O’Grady Chief Executive Officer, Irish Wheelchair Association

Legal Category: Not subject to medical prescription. Supply through pharmacies only. Marketing Authorisation Number: PA23055/016/001 Marketing Authorisation Holder: Upjohn EESV, Rivium Westlaan 142, 2909 LD Capelle aan den IJssel, Netherlands. Full prescribing information available on request from: Viatris, Dublin 17. Phone 01 8322250 Date of Revision of Abbreviated Prescribing Information: 01 Feb 2024 Reference Number: IE-AbPI-ViagraConnect-v004

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Reporting of adverse reactions: Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Website: www.hpra.ie. Adverse reactions/events should also be reported to the marketing autorisation holder at the email address: pv.ireland@viatris.com or phone 0044(0)8001218267.

tablets

50 mg

LITT

Indications, Dosage and Administration: Indications: For erectile dysfunction in adult men. Dosage and Method of use: Adults: one 50 mg tablet taken with water approx. one hour before sexual activity. The maximum dosing frequency is once per day. The onset of activity may be delayed if taken with food. Patients should be advised that they may need to take Viagra Connect a number of times on different occasions (max of one 50 mg tablet per day), before they can achieve a penile erection satisfactory for sexual activity. If patients are still not able to achieve a sufficient penile erection they should be advised to consult a doctor. Elderly: no dosage adjustments required (≥ 65 years old).

Renal Impairment: No dosage adjustments for patients with mild to moderate renal impairment.

Dosage adjustments required for those with severe renal impairment, see SmPC. Hepatic Impairment: Dosage adjustments required for those with mild-moderate hepatic impairment, see SmPC. Viagra Connect is contraindicated for patients with severe hepatic impairment (see contraindications). Presentation: Film-coated tablets containing sildenafil citrate equivalent to 50 mg of sildenafil. Contraindications: Hypersensitivity to the active substance or to any of the excipients. Co-administration with nitric oxide donors (such as amyl nitrite), nitrates, ritonavir, guanylate cyclase stimulators (such as riociguat) is contraindicated. Agents for the treatment of erectile dysfunction, including sildenafil, should not be used by those men for whom sexual activity may be inadvisable, and these patients should be referred to their doctor. This includes patients with severe cardiovascular disorders such as a recent (6 months) acute myocardial infarction (AMI) or stroke, unstable angina or severe cardiac failure. Sildenafil should not be used in patients with severe hepatic impairment, hypotension (blood pressure < 90/50 mmHg) and known hereditary degenerative retinal disorders such as retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases). Sildenafil is contraindicated in patients who have loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy (NAION), regardless of whether this episode was in connection or not with previous PDE5 inhibitor exposure. Viagra Connect should not be used in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease). Viagra Connect is not indicated for use by women. The product is not intended for men without erectile dysfunction. This product is not intended for men under 18 years of age. Warnings and precautions: Erectile dysfunction can be associated with a number of contributing conditions, e.g. hypertension, diabetes mellitus, hypercholesterolaemia or cardiovascular disease. As a result, all men with erectile dysfunction should be advised to consult their doctor within 6 months for a clinical review of potential underlying conditions and risk factors associated with erectile dysfunction (ED). If symptoms of ED have not improved after taking Viagra Connect on several consecutive occasions, or if their erectile dysfunction worsens, the patient should be advised to consult their doctor. Cardiovascular risk factors: Since there is a degree of cardiac risk associated with sexual activity, the cardiovascular status of men should be considered prior to initiation of therapy. Agents for the treatment of erectile dysfunction, including sildenafil, are not recommended to be used by those men who with light or moderate physical activity, such as walking briskly for 20 minutes or climbing 2 flights of stairs, feel very breathless or experience chest pain. For a list of patients who are considered at low cardiovascular risk from sexual activity see SmPC. Patients previously diagnosed with the following must be advised to consult with their doctor before resuming sexual activity: uncontrolled hypertension, moderate to severe valvular disease, left ventricular dysfunction, hypertrophic obstructive and other cardiomyopathies, or significant arrhythmias.

Sildenafil has vasodilator properties, resulting in mild and transient decreases in blood pressure.

Patients with increased susceptibility to vasodilators include those with left ventricular outflow obstruction (e.g. aortic stenosis), or those with the rare syndrome of multiple system atrophy manifesting as severely impaired autonomic control of blood pressure. Priapism: Patients who have conditions which may predispose them to priapism (such as sickle cell anaemia, multiple myeloma or leukaemia), should consult a doctor before using agents for the treatment of erectile dysfunction, including sildenafil. Prolonged erections and priapism have been occasionally reported with sildenafil in post-marketing experience. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. Concomitant use with other treatments for erectile dysfunction is not recommended. Effects on vision: Patients should be advised that in the event of any sudden visual defect, they should stop taking Viagra Connect and consult a physician immediately. Concomitant use with CYP3A4 inhibitors: patients should be advised to consult a doctor before taking Viagra Connect as a 25 mg tablet may be more suitable for them. Concomitant use with alpha-blockers: Caution is advised when sildenafil is administered to patients taking an alpha-blocker, as the co-administration may lead to symptomatic hypotension in a few susceptible individuals.

This is most likely to occur within 4 hours post sildenafil dosing. In order to minimise the potential for developing postural hypotension, patients should be hemodynamically stable on alpha-blocker therapy prior to initiating sildenafil treatment. Thus, patients taking alpha blockers should be advised to consult their doctor before taking Viagra Connect. Treatment should be stopped if symptoms of postural hypotension occur, and patients should seek advice from their doctor on what to do. Effect on bleeding: the use of sildenafil is not recommended in those patients with history of bleeding disorders or active peptic ulceration, and should only be administered after consultation with a doctor. Hepatic impairment: Patients with hepatic or renal impairment must be advised to consult their doctor before taking Viagra Connect, since a 25 mg tablet may be more suitable for them.

Lactose: The film coating of the tablet contains lactose. Viagra Connect should not be administered to men with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Sodium: This medicinal product contains less than 1 mmol sodium (23 mg) per tablet. Patients on low sodium diets can be informed that this medicinal product is essentially ‘sodium-free’. Use with alcohol: Drinking excessive alcohol can temporarily reduce a man's ability to get an erection. Men should be advised not to drink large amounts of alcohol before sexual activity.

Interactions with other medicinal products and other forms of interaction: Individuals receiving concomitant treatment with CYP3A4 inhibitors must be advised to consult their doctor before taking Viagra Connect, dosing adjustments may be required, see SmPC. Patients receiving alpha blocker treatment should be stabilised on therapy prior to initiating sildenafil treatment and must be advised to consult their doctor before taking Viagra Connect as dosing adjustments may be required, see SmPC. Caution when sildenafil is initiated in patients treated with sacubitril/valsartan, see SmPC. Fertility, pregnancy and lactation: There was no effect on sperm motility or morphology after single 100 mg oral doses of sildenafil in healthy volunteers. Viagra Connect is not indicated for use by women. Undesirable effects: Very common (≥1/10): headache. Common (>1/100, <1/10): dizziness, visual colour distortions, visual disturbance, vison blurred, flushing, hot flush, nasal congestion, nausea, dyspepsia. For details of uncommon, rare and very rarely reported adverse events and those of unknown frequency, see SmPC.

Viagra Connect (sildenafil) 50 mg film-coated tablets

E

PI

Viagra Connect (sildenafil) 50 mg film-coated tablets Please refer to Summary of Product Characteristics (SmPC) before prescribing

TH

ABBREVIATED PRESCRIBING INFORMATION

BLUE

For more information please contact Viatris or refer to the SmPC for full prescribing information VIAC-2024-0035. DOP: February 2024

www.viagraconnect.ie

Not all topical diclofenac products are the same. Formulation Matters.1

Voltarol Emulgel Extra Strength Gel is clinically proven to demonstrate deep tissue penetration into the joint 2

Learn more about the formulation of Voltarol Emulgel Extra Strength Gel Diclofenac diethylammonium

For all-day relief from joint pain†

† apply once, morning & evening

References: 1. Derry S et al. Cochrane Database Syst Rev 2015; 6: CD007402. 2. Seefried et al. Ther Adv Musculoskel Dis (2020) Vol 12: 1-13.

Product Information: Please consult the Summary of Product Characteristics for full product information.

Voltarol Emulgel 1% w/w Gel (diclofenac) and Voltarol Emulgel Extra Strength 2% w/w Gel (diclofenac). Indications: For the local symptomatic relief of pain and inflammation in trauma of tendons, ligaments, muscles and joints, localised forms of soft tissue rheumatism. Dosage: Adults and adolescents 14 years and over: Voltarol Emulgel 1% w/w Gel: 2-4g of gel, applied topically 3-4 times daily. Maximum treatment duration is 7 days. Voltarol Emulgel Extra Strength 2% w/w Gel: 2-4g of gel, applied topically 2 times daily – morning and evening. Maximum treatment duration is 14 days. All gels: Patients should consult their doctor if the condition does not improve within 7 days, or worsens. Contraindications: Patients with or without chronic asthma in whom asthma, angioedema, urticaria or acute rhinitis are precipitated by aspirin or other non-steroidal anti-inflammatory agents. Hypersensitivity to diclofenac, acetylsalicylic acid, other non-steroidal anti-inflammatory drugs, or any other ingredient in the gel. Use in third trimester of pregnancy. Use in children and adolescents aged less than 14 years. Warnings and precautions: Apply only to intact, non-diseased skin and not to skin wounds or open injuries. Do not smoke and avoid naked flames. It should not be used with occlusion, allowed to come into contact with the eyes or mucous membranes or ingested. Application over extensive areas for prolonged periods or application in excess of recommended dosage may give rise to systemic effects. Discontinue if rash develops. Use with caution in patients with a history of peptic ulcers, gastrointestinal bleeding, hepatic or renal insufficiency, or bleeding diathesis, or intestinal inflammation. Voltarol Emulgel 1% w/w Gel: Contains propylene glycol and benzyl benzoate, which may cause skin irritation. Voltarol Emulgel Extra Strength 2% w/w Gel: Contains propylene glycol and butylhydroxytoluene which may cause skin reactions or irritations, and fragrance limonene and linalool which may cause allergic reactions. Side effects: Very rare: rash pustular, hypersensitivity (including urticaria), angioedema, asthma, photosensitivity reaction. Rare: Dermatitis bullous. Common: Dermatitis (including contact dermatitis), rash, erythema, eczema, pruritus. MA Holder: Haleon Ireland Limited, 12 Riverwalk, Citywest Business Campus, Dublin 24, Ireland. MA Number: Voltarol 1% w/w Gel: PA 678/140/2.

Voltarol 2% w/w Gel: PA 678/140/3. Legal Category: 1%: GSL, 2%: Pharmacy only. Text revised: July 2023. Further information available on request.

Contains diclofenac diethylammonium. Always read the label/leaflet.

Trade marks are owned by or licensed to the Haleon group of companies. PM-IE-VOLT-23-00025.

CPD: Pain

43

AUTHOR: Donna Cosgrove PhD MPSI Continuing Professional Development

CPD 60 Second Summary The reason we experience pain is to notify the body of a stimulus in order to avoid further tissue damage. It is usually proportional to the severity of the injury, and resolves when the tissue heals fully. Acute pain lasts for less than 3 months and is most commonly caused by musculoskeletal conditions. Chronic pain persists beyond the tissue healing time, or beyond three months. Prolonged pain which lasts for longer than the expected period of healing can be caused by an inappropriate increase of afferent input into the dorsal horn (DH), leading to central sensitisation.

In pain perception, three main stages generally occur, firstly pain sensitivity, then pain transmission from the periphery to the DH, and finally, transmission of these signals to the higher brain, e.g cortex, through nerves in the central nervous system (CNS).

Pain can be grouped into three different classifications: nociceptive, neuropathic, and inflammatory. Pain is strongly associated with self-care management and acute pain is responsible for consumption of large quantities of over the counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDS).

Pharmacist-led management of pain, including the identification of the cause and knowledge of the treatments available, helps optimise outcomes in self-medicating people.

A review of the comparative effectiveness of opioid, nonopioid pharmacologic, and non pharmacologic therapy in acute pain conditions was conducted.

Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of short-term adverse events.

There are no specific clinical guidelines that provide information on how to manage acute pain with OTC analgesics, but there are a few available that are still relevant such as the NICE management of acute postoperative pain, and several indication specific guidelines for e.g headache, back pain, dysmenorrhoea, and sprains and strains.

Donna graduated with a BSc in Pharmacy from the Royal College of Surgeons in Ireland.

She then returned to university to complete a MSc in Neuropharmacology. This led to a PhD investigating the genetics of schizophrenia, followed by a postdoctoral research position in the same area. Currently Donna works as a pharmacist in Galway, and as a clinical writer.

1. REFLECT - Before reading this module, consider the following: Will this clinical area be relevant to my practice?

knowledge gap - will this article satisfy those needs - or will more reading be required?

2. IDENTIFY - If the answer is no, I may still be interested in the area but the article may not contribute towards my continuing professional development (CPD). If the answer is yes, I should identify any knowledge gaps in the clinical area.

4. EVALUATE - Did this article meet my learning needs - and how has my practise changed as a result? Have I identified further learning needs?

3. PLAN - If I have identified a

5. WHAT NEXT - At this time you may like to record your learning for future use or assessment. Follow the

4 previous steps, log and record your findings.

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.

HALEON has no editorial oversight of the CPD programmes included in these modules.

Management of Acute Pain in Pharmacy Introduction Pain is a distressing sensation, as well as an emotional experience.1 The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. IASP expand further with these points to put the definition in context:2  Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.  Pain and nociception are different phenomena: pain cannot be inferred solely from activity in sensory neurons.  Through their life experiences, individuals learn the concept of pain.  A person’s report of an experience of pain should be respected.  Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.  Verbal description is only one of several behaviours to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain.

The reason we experience pain is to notify the body of a stimulus in order to avoid further tissue damage. It is usually proportional to the severity of the injury, and resolves when the tissue heals fully. Acute pain lasts for less than 3 months and is most commonly caused by musculoskeletal conditions. Chronic pain persists beyond the tissue healing time, or beyond three months (3).

Prolonged pain which lasts for longer than the expected period of healing can be caused by an inappropriate increase of afferent input into the dorsal horn (DH), leading to central sensitisation.1 Types and Causes of Pain The experience of pain occurs through the activation of receptors in the primary afferent fibres: the unmyelinated C-fibre and myelinated Aδ fibre. These receptors are only activated in the presence of noxious stimulus and are normally quiet. Three types of neurons that exist in our body are sensory neurons (afferent neurons), interneurons (which relay the signals between afferent and efferent neurons) and motor neurons (efferent neurons).

In pain perception, three main stages generally occur, firstly pain sensitivity, then pain transmission from the periphery to the DH, and finally, transmission of these

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signals to the higher brain, e.g cortex, through nerves in the central nervous system (CNS).

This pathway carrying the signal to the brain is the ascending pathway, and the nerves that connect the brain to e.g. muscles involved in reflex are the descending pathway.1  Transduction occurs initially.

The painful stimulus is converted to chemical tissue events, then chemical tissue and synaptic cleft events are converted into electrical events in the neurons, and finally electrical events in neurons are transduced as chemical events in the synapses.  Transmission then occurs, i.e. the propagation of electrical events along the neuronal pathways and across synapses.  Modulation then takes place at all levels of nociceptive pathways through the primary afferent neuron, DH and higher brain centres, up or downregulating the sensation.

There are multiple types of nerve fibres in the body that have different roles. Based on the velocity of a conducted impulse, axon’s diameter, and function of an axon, the sensory (afferent) neurons are classified into three main groups—Group A, B and C.

44

CPD: Pain Figure 1. Signal pathways for nociception summary4

propagated from other peripheral nerves.  Inflammatory: This is a normal biological response to harmful stimuli that is required to start tissue repair. Neutrophils are usually the first cells to gather at the site of injury. Redness and swelling at the site of injury is due to the increased blood flow and increased vascular permeability, which can also induce pain. Chemical inflammatory mediators including 5-HT, kinins, histamine, nerve growth factors (NGF), adenosine triphosphate (ATP), prostaglandins (PGs), glutamate, leukotrienes and nitric oxide (NO) are produced from the necrotic tissues during inflammation, and interact to activate nociceptors within the inflamed area.

Hyperalgesia is the natural occurrence of enhanced pain perception at the site of injury due to the lowered pain threshold to thermal/mechanical pain stimuli.

PGs are the main culprits for receptor sensitisation. Some inflammatory mediators activate receptors outside the trauma site, covering a larger area than is actually injured.

 Aα nerve fibres are the thermal and mechanical nociceptors.

They are also the smallest myelinated nerves, with a relatively fast conduction velocity.  Aδ fibres are responsive towards short-lasting and pricking pain.  Group B nerve fibres are mainly nociceptive in function with moderate conduction velocities, and include those of the autonomic nervous system (ANS) and general visceral afferent fibres.  Group C nerve fibres are unmyelinated and have a relatively slow conduction velocity. They are polymodal, activated by thermal, mechanical and chemical stimuli. The activation of C-fibres gives rise to poorly

localised sensations, such as burning sensation of the skin.

Motor (efferent) neurons carry the impulses of motor signals out from the spine to the peripheral effector organs, the skeletal muscle and smooth muscles.

Once the nociceptive signal from the ascending pathway reaches the somatosensory cortex, the descending pain modulation pathway is triggered. Descending pain control pathways can be facilitatory as well as inhibitory: facilitatory pathways enhance pain perception whereas inhibitory pathways suppress pain perception.4 Pain can be grouped into three different classifications: nociceptive, neuropathic, and inflammatory:

 Nociceptive: Aδ and C-fibres are mostly found in superficial organs, such as the skin, whereas deeper structures such as muscles and joints are mainly supplied with C-fibres.

There is an additional nociceptor type called silent nociceptors.

These are located in the viscera and are usually insensitive to mechanical stimuli, but can be sensitised by the chemical mediators produced during inflammatory reactions.  Neuropathic: this type of pain generally serves no purpose.

It is commonly described as nerve injury or impairment and is associated with allodynia (central pain sensitisation).

Nerve neurochemistry can be damaged after compression, stretching, or hyperexcitability

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Allodynia describes central sensitisation that leads to a pain response from a stimulus that normally does not provoke pain, such as a light touch.

Both hyperalgesia and allodynia occur due to the increase of prostaglandin E2 (PGE2) in the inflamed tissue after activation of the COX pathway in the DH of the spinal cord.

There are a range of endogenous compounds responsible for the generation of pain:1  Tachykinins (substance P, neurokinins A and B) are neuropeptides produced in the periphery that bind to neurokinin type receptors, NK1, 2 and 3, to elicit excitation.  Calcitonin Gene-Related Peptide (CGRP) is a peptide in both the CNS and PNS. CGRP receptors (calcitonin receptorlike receptors) are found in

45 the nucleus accumbens, meaning that CRGP mediated pain transmission is controlled centrally.  Bradykinin, produced locally at the site of inflamed tissue, binds to the bradykinin receptors (B1 or B2). It initiates production of other inflammatory mediators, as well as being responsible for nociceptor sensitisation to heat stimuli.  Cytokines are released following degradation of e.g. mast cells during inflammation. Platelet activating factor (PAF) causes 5-HT production, which leads to plasma extravasation and pain.

Histamine is also produced after mast cell granulation, adding to inflammation. Cytokines like interleukin 1β (IL-1β) and tumour necrosis factor α (TNFα), strong proinflammatory molecules that promote hyperalgesia, are also present.  Prostaglandins are produced from the action of cyclooxygenase (COX) on arachidonic acid (AA). PGE2 (from COX 2, binds to prostaglandin E2 receptors 1-4) and PGI2 (from COX1, binds to prostaglandin receptor IP) are two major PGs that lead to afferent sensitisation.  Leukotriene B4 is produced within the leukocytes, and is responsible for recruiting neutrophils to the site of tissue damage, as well as promoting cytokine production.  Adenosine triphosphate (ATP) is an intracellular messenger released locally by damaged tissues and directly stimulates its receptors.  Nerve Growth Factor is a neuropeptide released at the site of injury causing rapid onset of hyperalgesia after activation of the NGF receptor, widely expressed in primary afferent neurons. It also causes further mast cell degranulation.  Glutamate is the most common excitatory neurotransmitter, and is released by the sensory afferents to modulate nociception.

The following mediators act to mitigate the sensation of pain:  GABA is the most widely distributed inhibitory neurotransmitter. It can inhibit the sensation of pain.

 Opioid peptides (enkephalin and dynorphin) bind to mu, delta and kappa opioid receptors, widely distributed throughout the body.

These inhibit the release of excitatory neurotransmitters, reducing pain sensation.  Cannabinoids (most notably tetrahydrocannabinol, THC) bind to CB1 (brain and spinal cord) and CB2 receptors (predominantly in the immune system). They result in a reduction of neuronal excitation and mast cell degranulation.

Pharmacy Role in Acute Pain Management Pain is strongly associated with self-care management and acute pain is responsible for consumption of large quantities of over the counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDS). Pharmacist-led management of pain, including the identification of the cause and knowledge of the treatments available, helps optimise outcomes in self-medicating people.5 It is important to initiate conversations with patients about what they have taken before and how in order to help improve efficacy and safety.

The underlying cause of pain should be treated where possible, and the full therapeutic dose tried before switching to an alternative analgesic. For this reason, combination analgesics should not be used as the first line in some cases to allow independent titration of single constituent medicines and assessment of efficacy.

The aims of pain management should be discussed with each individual, but may include some or all of the following:3  Reducing the intensity of pain  Enhancing physical functioning  Improving psychological functioning  Promoting return to work or school and/or role within family and society  Improving health-related quality of life Ibuprofen is the most frequently used OTC analgesic in Europe.5 A Cochrane review investigating the effects of analgesics/analgesic combinations (given as single doses postoperatively) concluded that there is evidence supporting the efficacy of these OTC drugs that are available without

prescription, with ADRs generally not different from placebo.6 There are risks associated with OTC NSAID intake in certain groups such as pregnant women, older people, and people taking additional medications although data suggests overall that the risk of severe ADRs from OTC analgesics remains low. Improving safety relies on increasing consumer awareness of risks, which is done by pharmacists, pharmacy technicians and OTC staff on a daily basis.5 Over-the-Counter Analgesia and Evidence A review of the comparative effectiveness of opioid, nonopioid pharmacologic, and non pharmacologic therapy in acute pain conditions was conducted. Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of shortterm adverse events.7 Evidence on nonpharmacological therapies was limited, but heat therapy, spinal manipulation, massage, acupuncture, acupressure, a cervical collar, and exercise were effective for specific acute pain conditions. Authors of a separate Cochrane review on the efficacy of OTC analgesics in acute pain made the following observations.6  There was evidence to show that simple, inexpensive, readily available analgesics give good pain relief to many patients with acute pain, such as toothache, sprains and strains.  The most effective OTC drugs used were ibuprofen/ paracetamol combinations in 400mg/1,000mg and 200mg/500mg doses; respectively, providing relief to 70% of people, and with a NNT of less than 2.  Fast acting ibuprofen formulations were effective in over 50% of patients, with a NNT of 2 to 3.  Paracetamol alone helped about 40% of patients and had a NNT of between 3 and 5, which was dose dependent.  Of particular note was an absence of evidence to support efficacy of low-dose codeine preparations in acute pain.  The authors also question the standard advice supplied with

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ibuprofen and other NSAIDs to take them with food: the absorption of these drugs is faster on having an empty stomach which increases efficacy. Some ibuprofen product PILs have in fact been changed to reflect this advice e.g. the PIL for Nurofen Express Maximum Strength Tablets advises to “take the tablets by mouth only with a glass of water”; no mention of food.8 In a Cochrane review specifically looking at the efficacy of topical NSAIDs for musculoskeletal conditions, authors found that.9  Topical NSAIDs provided good levels of pain relief in acute conditions such as sprains, strains and overuse injuries, probably similar to that provided by oral NSAIDs.  Formulations of topical diclofenac, ibuprofen, and ketoprofen in particular demonstrated significantly higher rates of clinical success (more participants with at least 50% pain relief) than matching topical placebo.  For diclofenac, the Emulgel formulation had the lowest NNT of 1.8 for at least 50% pain intensity reduction.

Diclofenac plasters (except fhr the brand Flector) also had a low NNT of 3.2.  Ketoprofen gel had an NNT of 2.5 (but less well defined outcomes).  Ibuprofen gel had an NNT of 3.9 as measured by outcomes of marked improvement or complete remission.  Data was insufficient to make comparisons between individual topical NSAIDs or against the same oral NSAID.  Local skin reactions were generally mild and transient, and did not differ from placebo, and very few systemic adverse events.

Notably, etofenamate topical preparations were not included in this review.

In terms of specific nonpharmacological approaches, review authors7 found that heat therapy was probably associated with moderate decrease in pain compared to usual care or placebo, particularly for lower back pain.

Further evidence for the use of non-

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CPD: Pain

pharmacological measures in this review were not robust enough to make recommendations, however.

Non-Steroidal Anti-inflammatories Ibuprofen is the first line treatment recommendation for a range of aches and pains including lower back pain, period pain and toothaches. Although aspirin can also be used for many aches and pains, other NSAIDs like ibuprofen tend to be better tolerated, so are the preferred option.3 Nonsteroidal anti-inflammatory drugs work through mediation of prostaglandin and thromboxane A2 production through reversible inhibition of the enzyme cyclooxygenase (COX). Prostaglandins mediate many physiological functions including inflammatory and nociceptive processes; also maintaining the gastric mucosal barrier, regulating renal blood flow and endothelial tone.6 These medicines should not be taken in people with active gastrointestinal bleeding/ulcers, previous hypersensitivity to NSAIDs, severe heart failure, or severe liver or kidney impairment.3 Paracetamol This is a great first line choice for mild to moderate pain. It has no known GI, renal or cardiac adverse effects at the usual OTC and prescribed doses; however, the patient should be reminded of the maximum daily dose over 24 hours to reduce the risk of accidentally exceeding this. Paracetamol appears to inhibit COX 1 and COX 2, although it does not inhibit COX in peripheral tissues. It is for this reason that paracetamol has no peripheral anti-inflammatory effects like traditional NSAIDs.10 Codeine Codeine and paracetamol combination products should only be offered for e.g. managing acute lower back pain if an NSAID is not suitable or has been ineffective.3 Opioids are not suitable to recommend for acute treatment of tension type headaches or migraines. Tolerance and dependence can occur with use of weak opioids, so caution should be used. The codeine and paracetamol OTC products are not suitable in acute ulcerative colitis, or conditions that may include abdominal distension or inhibition of peristalsis as a symptom. Peripheral receptor

binding can cause nausea, vomiting and constipation.6 Caffeine Caffeine does not have any pain relieving effect itself, but rather is added as an adjuvant to ibuprofen, aspirin and/or paracetamol products to enhance their analgesic effects. It is a competitive antagonist of adenosine A1 and A2 receptors, so it is possibly the disruption of normal adenosine signalling responsible for any enhanced analgesia.11 Pain Management Guidelines There are no specific clinical guidelines that provide information on how to manage acute pain with OTC analgesics, but there are a few available that are still relevant such as the NICE management of acute postoperative pain, and several indication specific guidelines for e.g headache, back pain, dysmenorrhoea, and sprains and strains.3 These guidelines should be considered along with the ever changing evidence base, particularly important if there is a few years since the guidelines were updated.

The WHO analgesic ladder, published in 1986, provided guidance on how to provide adequate pain relief in cancer.

It has gone through several modifications since its initial appearance, and is now used for the treatment of pain in additional types of conditions like degenerative disorders, musculoskeletal diseases, neuropathic pain, and other types of chronic pain.12 The original version was unidirectional, starting with NSAIDs or paracetamol as step 1, and heading up to weak (step 2) and strong (step 3) opioids, with or without adjuvants, depending on the patient’s level of pain. It has been suggested that step 2, which recommends the use of weak opioids, be eliminated, as there is little evidence that these offer much for pain control. Instead, reduced doses of strong opioids may be more useful. However, opioids aside, one main limitation of the original pain ladder was lack of inclusion of non-pharmacological approaches into the pain treatment path. Subsequently, a fourth step has been added to the pain ladder. This integrates non-pharmacological evidence based interventions like epidural anaesthesia, intrathecal

administration of analgesia, neurosurgical procedures, neuromodulation strategies, nerve blocks, and ablative procedures (the removal or destruction of a body part or tissue or its function), among others. There is more of a focus on quality of life with the updated WHO pain ladder, with a bidirectionality that offers de-escalation if pain improves as well as stepwise escalation for worsening pain. Some of the main elements are:  Oral dosing of drugs whenever possible.  Around-the-clock administration for pain control rather than on-demand.  Analgesics must be prescribed according to pain intensity as evaluated by a scale of pain severity. For this purpose, a clinical examination must combine with an adequate assessment of the pain.  Individualised therapy (including dosing) addresses the concerns of the patient.

This method presupposes that there is no standard dosage in the treatment of pain, maybe the biggest challenge in pain management, as the dose must be continuously adapted to the patient, balancing analgesic effects with potential side effects.  Proper adherence to pain medications, as alteration in the dosing can lead to a recurrence of pain.

With evidence that pharmacistled management of pain helps to optimise outcomes in selfmedicating people, pharmacy teams have a very important role in the acute management of pain. Using up to date research evidence and guidelines can help pharmacy teams with the provision of the most effective treatment strategies. Advice on appropriate OTC analgesia tailored to each patient, considering age, medical conditions and other medications can be offered, as well as advice about topical vs. oral administration. Appropriate referral to a GP for stronger medication can be made if necessary.

References 1. Yam, M. F., Loh, Y. C., Tan, C. S., Khadijah Adam, S., Abdul Manan, N., & Basir, R. (2018). General pathways of pain sensation and the major

Continuing Professional Development supported by

neurotransmitters involved in pain regulation. International journal of molecular sciences, 19(8), 2164.

2. International Association for the Study of Pain. (2021). IASP announces Revised Definition of Pain. Available https://www.iasppain.org/publications/iasp-news/ iasp-announces-revised-definitionof-pain/ 3. Youssef, S. (2019). Clinical guidelines and evidence base for acute pain management. Pharm J, 303(7929), 44-48.

4. (Physiopedia. (n.d.) Pain Facilitation and Inhibition. Available https://www. physio-pedia.com/Pain_Facilitation_ and_Inhibition) 5. Perrot, S., Cittée, J., Louis, P., Quentin, B., Robert, C., Milon, J. Y., ... & Baumelou, A. (2019). Selfmedication in pain management: The state of the art of pharmacists’ role for optimal Over-The-Counter analgesic use. European Journal of Pain, 23(10), 1747-1762.

6. Moore, R. A., Wiffen, P. J., Derry, S., Maguire, T., Roy, Y. M., & Tyrrell, L. (2015). Non-prescription (OTC) oral analgesics for acute pain-an overview of Cochrane reviews.

Cochrane Database of Systematic Reviews, (11).

7. Chou, R., Wagner, J., Ahmed, A. Y., Blazina, I., Brodt, E., Buckley, D. I., ... & Skelly, A. C. (2021). Treatments for acute pain: a systematic review.

Available https://europepmc.org/ article/nbk/nbk566506 8. Reckitt Benckiser Healthcare International Ltd. (2020). Nurofen Express Maximum Strength 400mg Tablets Patient Information Leaflet.

Available https://www.medicines. ie/medicines/nurofen-expressmaximum-strength-400mgtablets-33157/patient-info 9. Derry S., Moore R.A., Gaskell H., McIntyre M., Wiffen P.J. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD007402. DOI: 10.1002/14651858.CD007402.pub3.

10. Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, Chang Z, Woolsey J. Drugbank: a comprehensive resource for in silico drug discovery and exploration.

Available: https://www.drugbank.ca/ drugs/DB00316.

11. Derry, C. J., Derry, S., & Moore, R. A. (2014). Caffeine as an analgesic adjuvant for acute pain in adults.

Cochrane Database of Systematic Reviews, (12). Available https:// www.ncbi.nlm.nih.gov/pmc/articles/ PMC6485702/ 12. Anekar, A. A., & Cascella, M. (2021).

WHO analgesic ladder. In StatPearls [Internet]. StatPearls Publishing.

GETTING YOU THERE ONE TRY AT A TIME. AN UNBEATABLE WAY TO QUIT NICOTINE*

Don’t quit trying. *By Combining NiQuitin clear patch with one Oral format provides significant improvement in quit rate vs patch alone.

NiQuitin Clear 24 hrs Patches are indicated for the relief of nicotine withdrawal symptoms including cravings as an aid to smoking cessation in adults and adolescents aged 12 years and over. Contains Nicotine. Should be applied to a new skin site once a day to a non-hairy clean dry skin surface and worn continuously for 24 hours.

Therapy should 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 – Light smokers (less than 10 cigarettes per day) are recommended to start at Step 2 for 6 weeks, Step 3 NiQuitin Clear 7 mg/24 hrs transdermal patches last 2 weeks. NiQuitin patches may be used in combination with a nicotine oral format (refer to the package leaflet for dosingguidance). 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, diabetes, 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: sleep disorders, abnormal dreams, insomnia, headache, dizziness, nausea, vomiting, application site reactions, nervousness, palpitations, dyspnoea, pharyngitis, cough, dyspepsia, upper abdominal pain, diarrhoea, constipation, dry mouth, sweating, localised pain, urticaria, hypersensitivity, tremor, nervousness, palpitations, tachycardia, contact & allergic dermatitis, photosensitivity, arthralgia, myalgia, asthenia, malaise, influenza-type illness, fatigue, chest or limb pain, pain, seizures and anaphylaxis. Product not subject to medical prescription. PA 1186/018/004, PA 1186/018/005, PA 1186/018/006. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland. Date of preparation: Oct 2024. SPC: https://www.medicines.ie/medicines/niquitin-clear-7-mg-24-hours-transdermalpatch-33085/spc https://www.medicines.ie/medicines/niquiti n-clear-14-mg-24-hours-transdermal-patch-33083/spc https://www.medicines.ie/medicines/niquiti n-clear-21-mg-24-hours-transdermal-patch-33084/spc NiQuitin Mini 2mg / 4mg Mint Lozenges are indicate for the treatment of tobacco dependence by relief ofnicotine withdrawal symptoms and cravings. in adults and adolescents aged 12 years and over. ContainsNicotine. NiQuitin Mini 2mg are suitable for those who smoke 20 cigarettes or less a day. NiQuitin Mini 4 mgare suitable for smokers who smoke more than 20 cigarettes a day. Use whenever there is an urge tosmoke, allow to dissolve completely. Do not chew or swallow whole. Adults (+18 years): Abrupt cessation: Use a lozenge whenever there is an urge to smoke, maximum of 15 lozenges a day. Continue for up to 6weeks, then gradually reduce lozenge use. Gradual cessation: Use lozenges whenever there is an urge tosmoke in order to reduce the number of cigarettes smoked for up to 6 weeks, followed by abrupt cessation.NiQuitin Minis may be used in combination with NiQuitin patches (refer to the package leaflet for dosing guidance). Adolescents (12-17 years): only with advice from a healthcare professional. Should not quit witha combination NRT regime. 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 cardiacarrhythmias, uncontrolled hypertensions or recent cerebrovascular accident. Use with caution in those with;stable cardiovascular diseases, diabetes mellitus, susceptibility to angioedema & urticaria, renal/hepaticimpairment, phaeochromocytoma & uncontrolled hyperthyroidism, GI disease & seizures. Side effects: Nausea, mouth/throat and tongue irritation, irritability, anxiety, insomnia, sleep disorders, dizziness,headaches, cough, sore throat, vomiting, diarrhoea, upper abdominal pain, GI and oral discomfort, flatulence,hiccups, heartburn, dyspepsia, dry mouth, constipation, ulcerative stomatitis, pharyngitis, pharyngolaryngeal pain, nervousness, depression, palpitations, heart rate increased, dyspnoea, rash, angioedema, pruritus, erythema, hyperhidrosis, urticaria, fatigue, malaise, asthenia, chest pain, anaphylactic reactions, hypersensitivity, tremor, dysgeusia, paraesthesia mouth, seizures & epilepsy, dysphagia, eructation, salivary hypersecretion, influenzalike illness. Product not subject to medical prescription. PA 1186/018/017, PA 1186/018/012.

MAH: ChefaroIreland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland. Date of preparation: Oct 2024. SPC: https://www.medicines.ie/medicines/niquitinmini-2mg-mint-lozenges-35237/spc https://www.medicines.ie/medicines/niquiti n-mini-4mg-mint-lozenges-33091/spc MAT-5246

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Conference

ICO host Winter Meeting 2024 The Irish College of Ophthalmology held their annual Winter Conference recently. Discussions focused on the evolving landscape of public and private practice in Ireland with presenters and panelists sharing their impressions of the changing ownership and funding models, and how the development of medicine as a business with the entrance of investment capital, impacts the delivery of care.

Keynote speakers and panelists Dr Shane McKeogh, ICGP/HSE GP Integrated Care Lead for Adult Respiratory Disease and Principle GP, Solas Medical Centre, Dublin, Mr Sean Gallagher, Entrepreneur and ICO Board Member, Mr James O'Reilly, Consultant Ophthalmic Surgeon, UPMC Aut Even Hospital, Kilkenny and Whitfield Hospital, Waterford, Mr John Doris, President, ICO and Consultant Ophthalmic Surgeon, University Hospital Waterford, Mr Richard Comer, Consultant Ophthalmic Surgeon, Bon Secours Hospital, Galway, Mr Aidan O'Reilly, Interim Secretary General, Irish Hospital Consultant Association and Professor Robert Scott, Consultant Ophthalmologist, St John and St Elizabeth Hospital, London The meeting took place on Friday, 15 November at the Albert Lecture Theatre, Royal College of Surgeons in Ireland, Dublin.

Annual Montgomery Lecture 2024 Professor Scott is a former Royal Air Force Lead Military Consultant Ophthalmologist at the Birmingham and Midland Eye Centre (BMEC) and Royal Centre for Defence Medicine (RCDM) at Queen Elizabeth Hospital in Birmingham, sub-specialising in eye trauma, advanced cataract and vitreoretinal surgery. His lecture, titled "Traumateyesed: Coping with Major Ocular Injuries", offered a unique and invaluable clinical learning perspective on the management of severe ocular trauma, as well as practical guidance for ophthalmologists dealing with similar eye trauma cases in civilian healthcare settings.

During his lecture, he told the audience of ICO members and trainees, "All ophthalmologists, like myself, will be expected to deal with severe eye trauma. If you are not managing such patients day to day, it can be difficult to find a framework to work from. Eye injury is a disaster with life-changing functional, social and cosmetic effects. The role of the eye surgeon is to manage the patient, their family and the injury. Management should be staged with the aim of doing as little as is effective at any stage, initially aiming to stabilise the eye and then offering secondary management of longerterm complications. Eye protection prevents the worst effects of ocular injury and should be encouraged at a personal and legislative level.

Eye injury patients require life-long monitoring and patients must know this.

for retrobulbar haemorrhage immediately if required. Take a detailed Log of history and examination with timings for any insurance or legal reports that will be required in the future. Make sure that systemic Antibiotics are prescribed if there is an open globe injury. Ensure that an appropriate Scan is performed, s-ray, CT scan or ultrasound ‘B’ scan. Perform a primary closure of the globe often with a Suture. Do not neglect communication with the patient’s family, and sort any general Issues that they might have, that is what the hospital welfare department is for. Ensure your patient is in a Comfortable and quiet environment

to minimise stress and reduce potential Charles Bonnet syndrome.

Follow these guidelines and you can handle the worst eye trauma that presents to you."

Professor Scott also participated in the ICO Winter Meeting session earlier that day on the topic, “What Might the Future of Practice Look Like?" where he shared further expertise on ophthalmology healthcare delivery and discussed evolving management models for the specialty in light of his experience of the evolution of the UK healthcare system.

L-R Mr Richard Comer, Consultant Ophthalmic Surgeon, Bon Secours Hospital, Galway (ICO Winter Meeting Chair and Moderator) photographed with Mr Sean Gallagher, Entrepreneur and ICO Board Director

“For ease of memory, I organised the initial management of eye trauma cases into the acronym CLASSIC as follows. Perform a lateral Canthotomy and cantholysis

Professor Robert Scott (right), Consultant Ophthalmologist at St John and St Elizabeth Hospital, London, who delivered the Annual Montgomery Lecture 2024 at the Irish College of Ophthalmologists Winter Meeting on Friday, November 15th, is pictured with Mr John Doris, ICO President and Consultant Ophthalmic Surgeon, University Hospital Waterford

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L-R Mr Richard Comer, Consultant Ophthalmic Surgeon, Bon Secours Hospital, Galway (ICO Winter Meeting Chair and Moderator) photographed with Mr Sean Gallagher, Entrepreneur and ICO Board Director, Professor Robert Scott, Consultant Ophthalmologist, St John and St Elizabeth Hospital, London and Mr Aidan O'Reilly, Interim Secretary General, Irish Hospital Consultant Association

Starts to relieve cravings in * 30 seconds *based on 2 x 1mg spray Nicorette QuickMist 1 mg/spray, oromucosal spray, solution. One spray delivers 1 mg nicotine in 0.07 ml solution. 1 ml solution contains 13.6 mg nicotine. Excipient with known effect: Ethanol (less than 100 mg of ethanol/spray). Propylene glycol, Butylated hydroxytoluene. Pharmaceutical form: Oromucosal spray, solution. A clear to weakly opalescent, colourless to yellow solution. Indications: For the treatment of tobacco dependence in adults by relief of nicotine withdrawal symptoms, including cravings, during a quit attempt (or to cut down smoking before stopping completely.

Permanent cessation of tobacco use is the eventual objective. Nicorette QuickMist should preferably be used in conjunction with a behavioral support program. Dosage: Subjects should stop smoking completely during the course of treatment with Nicorette QuickMist. Adults and Elderly: The following chart lists the recommended usage schedule for the oromucosal spray during full treatment (Step I) and during tapering (Step II and Step III). Up to 4 sprays per hour may be used. Do not exceed 2 sprays per dosing episode and do not exceed 64 sprays (4 sprays per hour, over 16 hours) in any 24-hour period. Step I: Weeks 1-6: Use 1 or 2 sprays when cigarettes normally would have been smoked or if cravings emerge. If after a single spray cravings are not controlled within a few minutes, a second spray should be used. If 2 sprays are required, future doses may be delivered as 2 consecutive sprays. Most smokers will require 1-2 sprays every 30 minutes to 1 hour. Step II: Weeks 7-9: Start reducing the number of sprays per day. By the end of week 9 subjects should be using HALF the average number of sprays per day that was used in Step I. Step III: Weeks 10-12: Continue reducing the number of sprays per day so that subjects are not using more than 4 sprays per day during week 12. When subjects have reduced to 2-4 sprays per day, oromucosal spray use should be discontinued. To help stay smoke free after Step III, subjects may continue to use the oromucosal spray in situations when they are strongly tempted to smoke. One spray may be used in situations where there is an urge to smoke, with a second spray if one spray does not help within a few minutes.

No more than four sprays per day should be used during this period. Regular use of the oromucosal spray beyond 6 months is generally not recommended. Some ex-smokers may need treatment with the oromucosal spray longer to avoid returning to smoking. Any remaining oromucosal spray should be retained to be used in the event of sudden cravings.

Gradual cessation through progressive reduction in smoking: For smokers who are not willing or ready to quit abruptly. The oromucosal spray is used between periods of smoking in order to prolong the smoke-free intervals and with the intention to reduce smoking as much as possible. The patient should be aware that an incorrect use of the spray may enhance adverse effects. A cigarette is replaced with one dose (1-2 sprays) and a quit attempt should be made as soon as the smoker feels ready and no later than 12 weeks after start of treatment. If a reduction in cigarette consumption has not been achieved after 6 weeks of treatment, a healthcare professional should be consulted. After quitting smoking, gradually reduce the number of sprays per day. When subjects have reduced to 2-4 sprays per day, oromucosal spray should be discontinued. Regular use of the oromucosal spray beyond 6 months is not recommended. Some ex-smokers may need treatment with the oromucosal spray longer to avoid returning to smoking. Any remaining oromucosal spray should be retained to be used in the event of sudden cravings. Paediatric population: Do not administer this medicine to persons under 18 years of age. There is no experience of treating adolescents under the age of 18 with this medicine. Method of administration: After priming, point the spray nozzle as close to the open mouth as possible. Press firmly the top of the dispenser and release one spray into the mouth, avoiding the lips. Subjects should not inhale while spraying to avoid getting spray into the respiratory tract. For best results, do not swallow for a few seconds after spraying. Subjects should not eat or drink when administering the oromucosal spray. Behavioural therapy advice and support will normally improve the success rate. Contraindications: Hypersensitivity to nicotine or to any of the excipients. Children under the age of 18 years. Those who have never smoked. Special warnings and precautions for use: This medicine should not be used by non-smokers. The benefits of quitting smoking outweigh any risks associated with correctly administered nicotine replacement therapy (NRT). A risk-benefit assessment should be made by an appropriate healthcare professional for patients with the following conditions: Cardiovascular disease: Dependent smokers with a recent myocardial infarction, unstable or worsening angina including Prinzmetal’s angina, severe cardiac arrhythmias, recent cerebrovascular accident and/or who suffer with uncontrolled hypertension should be encouraged to stop smoking with non-pharmacological interventions (such as counselling). If this fails, the oromucosal spray may be considered but as data on safety in this patient group are limited, initiation should only be under close medical supervision. Diabetes Mellitus. Patients with diabetes mellitus should be advised to monitor their blood sugar levels more closely than usual when smoking is stopped and NRT is initiated as reduction in nicotine induced catecholamine release can affect carbohydrate metabolism. Allergic reactions: Susceptibility to angioedema and urticaria. Renal and hepatic impairment: Use with caution in patients with moderate to severe hepatic impairment and/or severe renal impairment as the clearance of nicotine or its metabolites may be decreased with the potential for increased adverse effects. Phaeochromocytoma and uncontrolled hyperthyroidism: Use with caution in patients with uncontrolled hyperthyroidism or phaeochromocytoma as nicotine causes release of catecholamines. Gastrointestinal Disease: Nicotine may exacerbate symptoms in patients suffering from oesophagitis,

gastric or peptic ulcers and NRT preparations should be used with caution in these conditions. Seizures: Use with caution in subjects taking anti-convulsant therapy or with a history of epilepsy as cases of convulsions have been reported in association with nicotine. Paediatric population: Danger in children: Doses of nicotine tolerated by smokers can produce severe toxicity in children that may be fatal. Products containing nicotine should not be left where they may be handled or ingested by children. Transferred dependence: Transferred dependence can occur but is both less harmful and easier to break than smoking dependence. Stopping smoking: Polycyclic aromatic hydrocarbons in tobacco smoke induce the metabolism of drugs metabolised by CYP 1A2 (and possibly by CYP 1A1). When a smoker stops smoking, this may result in slower metabolism and a consequent rise in blood levels of such drugs. This is of potential clinical importance for products with a narrow therapeutic window, e.g. theophylline, tacrine, clozapine and ropinirole. The plasma concentration of other medicinal products metabolised in part by CYP1A2 e.g. imipramine, olanzapine, clomipramine and fluvoxamine may also increase on cessation of smoking, although data to support this are lacking and the possible clinical significance of this effect for these drugs is unknown. Limited data indicate that the metabolism of flecainide and pentazocine may also be induced by smoking. Excipients: This medicine contains about 7 mg of alcohol (ethanol) in each spray which is equivalent to 97 mg/ml. The amount in one spray of this medicine is equivalent to less than 2 ml beer or 1 ml wine. The small amount of alcohol in this medicine will not have any noticeable effects. This medicinal product contains less than 1 mmol sodium (23 mg) per spray, i.e. essentially ‘sodium- free’. This medicine contains 12 mg propylene glycol in each spray which is equivalent to 157 mg/mL. Due to the presence of butylated hydroxytoluene, Nicorette QuickMist may cause local skin reactions (e.g. contact dermatitis), or irritation to the eyes and mucous membranes. Care should be taken not to spray the eyes whilst administering the oromucosal spray. Undesirable effects: Effects of smoking cessation: Regardless of the means used, a variety of symptoms are known to be associated with quitting habitual tobacco use. These include emotional or cognitive effects such as dysphoria or depressed mood; insomnia; irritability, frustration or anger; anxiety; difficulty concentrating, and restlessness or impatience. There may also be physical effects such as decreased heart rate; increased appetite or weight gain, dizziness or presyncopal symptoms, cough, constipation, gingival bleeding or apthous ulceration, or nasopharyngitis. In addition, and of clinical significance, nicotine cravings may result in profound urges to smoke. This medicine may cause adverse reactions similar to those associated with nicotine given by other means and these are mainly dose-dependent. Allergic reactions such as angioedema, urticaria or anaphylaxis may occur in susceptible individuals. Local adverse effects of administration are similar to those seen with other orally delivered forms.

During the first few days of treatment irritation in the mouth and throat may be experienced, and hiccups are particularly common. Tolerance is normal with continued use. Daily collection of data from trial subjects demonstrated that very commonly occurring adverse events were reported with onset in the first 2-3 weeks of use of the oromucosal spray, and declined thereafter. Adverse reactions with oromucosal nicotine formulations identified from clinical trials and during post-marketing experience are presented below. The frequency category has been estimated from clinical trials for the adverse reactions identified during post-marketing experience. Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1 000 to <1/100); rare (≥1/10 000 to <1/1 000); very rare (<1/10 000); not known (cannot be estimated from the available data). Immune system disorders Common Hypersensitivity Not known Allergic reactions including angioedema and anaphylaxis Psychiatric disorders Uncommon Abnormal dream Nervous system disorders Very common Headache Common Dysgeusia, paraesthesia Not known – Seizures (Cases of seizures have been reported in subjects taking anti-convulsant therapy or with a history of epilepsy). Eye disorders Not known Blurred vision, lacrimation increased Cardiac disorders Uncommon Palpitations, tachycardia Not known Atrial fibrillation Vascular disorders Uncommon Flushing, hypertension Respiratory, thoracic and mediastinal disorders Very common: Hiccups, throat rritation Uncommon Bronchospasm, rhinorrea, dysphonia, dyspnoea, nasal congestion, oropharyngeal pain, sneezing, throat tightness Common: cough Gastrointestinal disorders Very common Nausea Common Abdominal pain, dry mouth, diarrhoea, dyspepsia, flatulence, salivary hypersecretion, stomatitis, vomiting Uncommon Eructation, gingival bleeding, glossitis, oral mucosal blistering and exfoliation, paraesthesia oral Rare Dysphagia, hypoaesthesia oral, retching Not known Dry throat, gastrointestinal discomfort, lip pain Skin and subcutaneous tissue disorders Uncommon Hyperhidrosis, pruritus, rash, urticaria Not known Erythema General disorders and administration site conditions Common Burning sensation, fatigue Uncommon Asthenia, chest discomfort and pain, malaise. MAH: JNTL Consumer Health I (Ireland) Ltd. Block 5, High Street, Tallaght, Dublin 24, Ireland, Ireland. PA Number: PA23490/019/013 Date of revision of text: December 2023. Product not subject to medical prescription. Supply through pharmacy and non-pharmacy outlets. Full prescribing information available upon request.

IE-NIC-2024-76107 | Nov 2024

50

News

Reducing Risk of Type 2 Diabetes Ahead of World Diabetes Day (14 November), the HSE has highlighted the range of supports and services for people at risk of type 2 diabetes, as well as for people living with type 2 diabetes so they can manage their condition and live a healthy life. There are approximately 270,000 people living with type 2 diabetes in Ireland today.

Dr Sarah O’Brien, HSE National Clinical Adviser and Group Lead for Chronic Disease

• 75% of people with pre-diabetes on the HSE National Diabetes Prevention Programme lost weight and 50% managed to bring their blood glucose levels back to within the normal range.

• There were significant improvements in outcomes for people with a new or existing diagnosis of type 2 diabetes on the HSE DISCOVER DIABETES programme, a free course, including management of blood glucose, body weight, body mass index and levels of diabetes distress associated with living with diabetes.

Professor Derek O’Keeffe, Clinical Lead for the HSE National Clinical Programme for Diabetes, said, “A person living with pre-diabetes or diabetes requires time and support to understand what the condition is, how to treat and manage it, and

the serious nature of the condition if not treated. The HSE diabetes programmes aim to empower people, providing them with the knowledge, skills and confidence required to engage in changes that will benefit their health for the long term. Participants learn how to self-care and manage the condition in partnership with their GP and healthcare teams, which helps avoid serious health complications.”

Data from pilot phases of the programmes show very positive results:

GP programme identifies 16,000 patients with pre-diabetes The HSE delivers person-centred, integrated, accessible care to patients living with diabetes and other chronic diseases as close to home as possible. The Structured Chronic Disease Management (CDM) Programme, has had a positive impact for people with chronic diseases, including diabetes.

Dr Sarah O’Brien, HSE National Clinical Adviser and Group Lead for Chronic Disease, said, “In the

first two years of the Opportunistic Case Finding Programme, over 16,000 patients were identified as having pre-diabetes and over 2,800 patients were newly diagnosed with type 2 diabetes and enrolled onto the Chronic Disease Management Treatment and Preventive Programmes, as appropriate. Eligible patients have scheduled reviews with their GP and Practice Nurse, with a focus on lifestyle health behaviour improvements and/ or medical management of diabetes and associated risk factors.”

Earlier this year, a new Diabetes in Pregnancy model of care was launched, to support the estimated 7,000 women in Ireland a year who develop gestational diabetes and/ or pre-eclampsia.

Women diagnosed with gestational diabetes from 1 January 2023 are eligible for the Chronic Disease Management Programme and are being supported through an annual review with their GP and a care plan aimed at reducing their risks.

More information on pre-diabetes and type 2 diabetes is available at the HSE website: www.hse.ie/diabetes.

Encouragment to Join in ‘Flunion’ this Winter In a recent survey, commissioned by the Irish Patients Association, it has been revealed that 56% of Irish parents stated that their children have missed school days in the past year due to flu or flu-like conditions, which has an negative impact on their children’s learning opportunities and has forced 1 in 5 parents to rely more on grandparents for childcare when their children are ill.

Almost half of parents (49%) stated that the biggest impact of missed school days was their children missing learning opportunities and 24% cited that missing school activities was an issue too.

However, it seems that many parents are hesitant to get the winter flu vaccine for their children, with 53% of those surveyed revealing they hesitated to get their children the winter flu vaccine in the last year. This has increased from survey results in 2023, which found that 44% hesitated to get the vaccine. While the research indicates that hesitation has increased this year this seems to be driven by time constraints on parents with 17% of those surveyed admitting that a lack the time was one of the reasons why

they hesitated in getting their child vaccinated last year.

The Irish Patients Association is urging parents & guardians to avail of the free nasal flu vaccine for their children and is asking them to join in ‘Flunion’ in the battle against the flu this winter. In getting the free vaccine parents & guardians are not only protecting their children but they are also protecting the wider community too. It can also help to alleviate missed school days too!

The survey also found that half of respondents saw their GP up to 3 times as a result of flu-like symptoms in the past year and 1 in 10 admitted they had to visit their GP 4+ times over this period. Also,

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noted was the delay with being able to access a GP appointment with 49% of respondents experiencing delays of at least a day or more.

Speaking about the research, Consultant in Emergency Medicine & Prehospital Doctor, Dr. Lisa Cunningham, commented, “It’s encouraging to see that there is an increase awareness among parents as to the seriousness of the influenza virus, including the complications it can cause. What we would encourage is for parents to avail of the many opportunities to get the influenza nasal spray protection. Pharmacists are the corner stone for community influenza vaccination for children, with appointments in many

community pharmacies easier to access for parents. The schools are rolling out the influenza programme also which is currently underway. Of course, GPs are also providing this free service.”

Stephen McMahon of the Irish Patients Association, said, “The research shows that families are greatly impacted by flu and flu like condition and that an issue for parents when it comes to vaccination is time constraints.

Therefore, we want to make it as easy as possible for parents and guardians to access the vaccination. It is very quick and easy to receive and free from local GPs or pharmacies, so parents / guardians can arrange an appointment at a time that works for them.”

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52

Finance

Employer Sponsored PRSA’s - The Finance Act giveth and the Finance Act taketh away There is nothing like a change of legislation that removes an excellent tax planning and cash extraction tool to focus attention. This change included in Finance Act 2025 that changed how PRSAs can be funded has certainly done that. So what is the big deal? Why is there so much talk about this and what does it all mean going forward?

Written by Kieran Moore QFA, SIA Kieran is a Director of Moore Wealth Management. He has been advising the pharmacy community for 20 years and can be contacted via kieran@mwm or 086-3801868 www.mwm.ie

Pensions Simplification For many years in Ireland we are supposedly in the process of pension simplification, though from an adviser perspective it’s the opposite as you will see.

It’s long acknowledged that there are too many structures, differing contributing levels and tax treatments for employees, directors and the self-employed.

The PRSA Change Let’s start with the changes in the PRSA legislation. The 2023 Finance Act attempted to create a level playing field between the standard executive pension or Retail Master Trust (RMT) as it’s now known and the alternative option the Personal Retirement Savings Account (PRSA).

To do this it removed the primary barrier to the use of a PRSA as an employer-funded pension which was the fact that employer contributions would trigger benefit in kind tax for an employee when they went above an age related limit. This was in contrast to the RMT as exempt from BIK. On the face of it a sensible move to balance out the attractiveness of both options. But, when doing this the government in their wisdom went a step further. There are now no salary and service criteria that would normally limit employer contributions to a PRSA .

A strange omission while leaving these same restrictions in place for the RMT option. This meant that an employer could now theoretically put up to ¤2 Million in one go into a pension for an employee which this is the current Standard Fund Threshold (SFT) regardless of that employee's length of service or salary.

This did not level the playing field between the two options, it made one substantially more attractive than the other.

For example, a business owner aged 54 who employed themselves at a salary of ¤80,000 and their spouse at a salary of 30k with no existing pension funds could previously have put a maximum (based on current revenue rules) of about 100% of salary each year into a company pension for both.

So ¤110,000 could be used each year in this regard. There would also be credit for back service which would allow a lump sum to cover those years.

With these changes they could now use a PRSA and subject to the cash being there put up to ¤2 Million for each of them into a PRSA. Clearly the playing field is no longer level especially for those looking to fund pensions for spouses who are not on high salaries. The anomaly that was flagged and highlighted before the finance act was signed off came into effect. We wrote about it at the time and many of you benefited from the change. Now however the Department of Finance has decided this option will no longer apply from Dec 31st 2024.

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The unrestricted level of contribution for employer funded PRSAs will close at the end of this year and be replaced by a maximum contribution of 100% of salary in the year of contribution.

Any contribution in excess of annual salary will now attract BIK. This in itself is more equitable but for a PRSA there is no provision for funding back service which is a strange omission.

This now puts the RMT back as the best option for certain people with more attractive funding limits if you have significant unfunded back service. Those who take out a company paid PRSA will not be able to fund for back service through that structure but if they had salaries like my earlier example and 15 years back service then up to ¤700,000 could be contributed to a Retail Master Trust. All clear?

Two Finance Acts in a row have attempted to equalise the market for employer sponsored pensions.

Both have failed miserably and this only adds a layer of complexity to those looking to set up employer paid pensions for themselves, family or staff. For those looking to fund under current legislation time is running out. Clearly as you will see proper advice has never been as important.

The government has also made important changes to other areas.

Increased Standard Fund Threshold (SFT) The SFT was initially introduced in December 2005 to place a lifetime limit on the total capital value of pension benefits that an individual could draw from tax relieved pension products. It was ¤5.4 Million at its highest level. However over the years of austerity this was reduced to ¤2 Million by 2014 and has not increased since. With inflation factored in over time there has been a significant decrease in real terms as between 2014 and 2023 Irish wage inflation was 34%.

This alone merits an increase in the SFT to ¤2.68 million.

Where an individual breaches the lifetime cap at retirement, the excess is subject to penal taxation

at an effective income tax rate of up to 68% - of which 40% is incurred upfront, with the remaining balance collected on drawdown.

Inflation, increased final salaries and therefore increased final pensions for those in top public sector jobs put pressure on the government to increase the limits for private pensions again for the appearance of equity between both systems. You will recall the resignation of many garda sergeants and the inability to appoint to top posts in An Garda Siochana which was a direct consequence of the SFT limit and when civil servants are impacted; This year the government announced that the standard fund threshold will be increased as follows; • In 2026 to ¤2.2 million • In 2027 to ¤2.4 million • In 2028 to ¤2.6 million • In 2029 to ¤2.8 million These changes are welcome but you have to ask why wait until 2026.

Auto Enrolment Auto Enrolment first proposed 25 years is coming. Initially expected to be here 2023, then in 2024 , it is now finally set to take effect on 30th September 2025. So what will this look like for employers and employees?

Any employee in non-pensionable employment will be required to be a member of a company pension plan where both employer and employee must make contributions. Those without a pension scheme who earn more than ¤20,000 per year and are aged between 23 and 60 will be automatically enrolled into the new system.

The National Automatic Enrolment Retirement Savings Authority (NAERSA) will administer the autoenrolment scheme, leaving minimal administrative work for you as an employer to do. NAERSA will act as the caretaker of the employee’s interests and savings. NAERSA will determine which employees are

53 eligible for auto-enrolment using Revenue payroll data and it will enrol them.

It will collect all employee, employer and state contributions, and invest the money on your employee’s behalf. A default investment strategy will be in place.

NAERSA will allocate any investment returns to their savings pot. Employees will keep one savings pot as they move from job to job – this is known as the ‘pot-follows-member’ approach.

NAERSA will operate an online portal for employees, to manage employee opt-outs, opt-ins, suspension of contributions and re-enrolment. It will also operate an online portal for employers, to facilitate the payment and monitoring of contributions.

Mandatory Contribution levels The contribution rates for auto-enrolment will be phased in over the first 10 years of

the operation of the scheme: Employer contributions will start at 1.5% of gross pay matched by the employee contribution with an extra 33% of the employee contribution being contributed by the state. The table below shows how the increases will be phased in over ten years.

There are many concerns in the industry about Auto Enrolment. In principle trying to protect people from a dramatic decrease in income in their older years is a good thing. Retirement planning is important but not a priority for many, the government has decided

to force employers and employees to face this issue head on. But in doing and offering products that are likely to be less attractive than those available currently in terms of investment options and flexibility on contributions. In addition the state contribution of 33% of your own contribution is less attractive than the current 40% tax relief currently on offer to those in the higher tax rate.

If you can avoid the auto enrolment pension you should, especially those paying tax at 40%. Setting up a company pension for staff in advance of October next year

Employee

Employer

State

Year 1 to 3

1.5%

1.5%

0.5%

Year 4 to 6

3%

3%

1%

Year 7 to 9

4.5%

4.5%

1.5%

Year 10+

6%

6%

2%

would mean you take control of the situation. You can control how much you contribute, you can create the goodwill of doing it on your own terms and everyone could benefit from better contracts, better investment choices and enhanced tax relief for those on the higher tax rate.

Everyone’s circumstances are different so some thought is needed before you decide if you want to avoid auto enrolment by acting early or if you want to let the government make those decisions for you. You will be funding pensions as an employer in less than12 months the only question is will it be on your terms?

The consequences of decisions in the area of retirement planning have become more pronounced with every year and finance act.

Make sure you seek professional advice to find the best options for you and your business.

News Pharmacy Winter Conferring RCSI is celebrating the 2024 winter conferrings with more than 1,470 health science graduates and two honorary doctorates conferred across five ceremonies.

The first ceremonies took place on 20 November at the RCSI campus on St Stephen’s Green, where over 130 candidates graduated with primary healthcare degrees including BScs in Pharmacy and Physiotherapy.

Candidates were presented by the Vice Chancellor of RCSI, Professor Cathal Kelly, and conferred by RCSI President, Professor Deborah McNamara.

During the afternoon Postgraduate Academic Awards Degree ceremony, a further 82 candidates graduated, receiving awards including Postgraduate Diploma in Health Professions Education, Master of Science (MSc), Degree of Doctor of Medicine (MD), and Doctor of Philosophy (PhD).

Professor Mary Dixon-Woods, Director of THIS Institute and The Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge, was awarded an Honorary Doctorate during this ceremony. Professor Dixon-Woods' evidence-based insights, focused

Pictured (l-r): New RCSI Physiotherapy and Pharmacy graduates Robert Staunton, Sonia Ciuciu and Ashley Ajie

on safety and quality in healthcare, have contributed significantly to healthcare policy, inquiries and reports in the UK and beyond.

The ceremonies continued on Monday 25 November with three events at the Convention Centre Dublin. The morning ceremony saw 336 candidates conferred with masters degrees from the RCSI School of Nursing and Midwifery, as well as MScs in areas of healthcare management and leadership, healthcare ethics and law, neurology and gerontology, advanced clinical practice and loss and bereavement.

The Postgraduate Academic Awards conferring in the afternoon will celebrate 285 graduates. This ceremony will mark the inaugural graduation of candidates from

RCSI’s new MSc in Positive Health Coaching programme.

Degrees awarded will include Master of Pharmacy (MPharm), MSc in Technologies and Analytics in Precision Medicine;

professional diplomas in clinical leadership, leading digital health transformation and positive health; and postgraduate diplomas in loss and bereavement, positive health coaching and human factors in patient safety.

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News

Second Action Plan for Men’s Health (2024 – 2028) The HSE and partners encouraged men to engage in their health and wellbeing ahead of International Men’s Health Day (November 19th). While men’s health overall has improved, men still have a lower life expectancy than women and higher mortality rates for the leading causes of death such as heart disease, cancer and suicide. There are also significant disparities between different subpopulations of men.

The HSE, Men’s Health Forum in Ireland, the Men’s Development Network and the National Centre for Men’s Health in SETU, launched the second National Men’s Health Action Plan, Healthy Ireland – Men (HIM) (2024 – 2028) at a Men’s Health webinar.

Key Insights: • Although life expectancy for men in Ireland has improved in recent years, it is still 3.6 years lower than female life expectancy (80.5 and 84.1 respectively).

• Life expectancy at birth for men living in the most deprived areas is 79.4 years, compared with 84.4 years for those living in the most affluent areas (a difference of 5 years).

• Cancer is now the primary cause of death in men in Ireland, accounting for 30.8% of all male

deaths. The risk of dying from cancer is 34% higher for men than for women.

• 16.7% of men aged 40 – 44 have issues with their mental health.

• Men are more likely than women to report being overweight or obese (63% v 50%), while the gap in the proportion of men and women reporting a normal weight widens with age.

• 16% of men aged 15 – 24 are either daily or occasional users of e-cigarettes.

• In 2023 37% of men reported that they binge drink.

• Men are less likely than women to seek preventive care and undergo regular health screenings.

• Men made up 78% (144) of all road fatalities in 2023.

men’s health practice in Ireland in recent years.

Dr Philip Crowley, National Director of Wellbeing, Equality, Climate and Global Health in the HSE said: “Measures designed to improve men’s health can impact not just on men’s lives, but can have a positive influence on the lives of women and children, and on society as a whole. By promoting preventive care, engagement with screening programmes, awareness of signs and symptoms of disease, and encouraging help-seeking in men who may have symptoms, it may be possible to achieve early detection and improved outcomes from diseases such as cancer and circulatory diseases.

“Ireland was the first country in the world to adopt a National Men’s Health Policy, and while other countries have built on the pioneering work and practical learning from the Irish experience, there is a clear need to sustain and continue to build upon the existing body of work, particularly with regard to addressing health inequalities.”

“The second Action Plan for Men’s Health marks another important step in continuing the momentum and excellent progress that has been achieved in the area of

The plan calls for an increased focus on healthy masculinities, as the basis for boys and men to be more actively engaged in their health and wellbeing and in the pursuit of gender equality.

Actions seek to build on a relational approach to gender, which is mutually beneficial in terms of women’s and men’s health and wellbeing.

Transferring COPD Care World COPD day took place last month, Wednesday 20th November. It aims to raise awareness, share knowledge and discuss ways to reduce the burden of COPD worldwide.

Janet Given star of Virgin Media’s ‘Gogglebox’

assessment and management clinics which offer diagnostic testing to include spirometry.

COPD is a common, preventable and treatable disease that is characterised by ongoing breathing difficulties, usually caused by significant exposure to noxious particles or gases. Major risk factors for developing COPD are tobacco smoking or exposure to occupational, outdoor and indoor air pollution.

There are an estimated 380,000 people living with Chronic Obstructive Pulmonary Disease (COPD) in Ireland, with over 15,000 people requiring admission to hospital with this condition annually.

The Respiratory Integrated Care Team (RICT) in Donegal provide a range of services for people living with COPD. These include

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Patients with exacerbating COPD often require multiple admissions and readmissions to hospital for their care. A newly developed alternative care pathway called the CARE Virtual Ward has been available to people living with COPD in Donegal since November 2023, with 192 admissions to the virtual ward to date. This has resulted in a 22% decrease in overall admissions to Letterkenny University Hospital, with a presenting condition of COPD. The Community and Acute Respiratory Excellence (CARE) Virtual Ward (CVW) is an

alternative care pathway to hospital admission for patients with COPD in Donegal. The CVW provides 20 beds and is delivered by the Respiratory Integrated Care Team under the governance of the respiratory consultant in Letterkenny University Hospital.

The Virtual Ward allows monitoring and care for patients experiencing an exacerbation of their COPD while remaining in their own home instead of hospital admission.

The virtual ward is available for people with COPD throughout Donegal. It can be accessed by referral from GPs and through Consultants and Respiratory Specialist nurses in Hospital.

Patients are educated to recognise early deterioration of their condition and avail of prompt treatments and interventions.

Rescue prescriptions are provided recommending the appropriate medications and patients are instructed on when and how they are to be used.

CARE Virtual Ward team in Donegal have released a video showing the patient’s experience.

Topic Team Training – Cold and Flu Following on from the November issue Continuing Professional Development on the Pharmacy Role in the Management and Treatment of Cold and Flu, this 5-Minute Learning Module is designed to enhance the community pharmacy team understanding and ask further questions as to how you can support and advise patients. techniques and vaccination reduces transmission of viral infections and therefore reduces inappropriate prescribing of antibiotics.

Antihistamines: First-generation antihistamines such as brompheniramine and chlorpheniramine have been shown to provide some symptomatic relief. This involves a reduction in symptoms such as sneezing and nasal discharge, as well as a reducing the duration of symptoms.

Community pharmacy is often the first port of call for patients when they have symptoms of cold or flu. Most symptoms can be effectively treated by using over the counter (OTC) medicines from community pharmacies.

Both the common cold and flu are contagious respiratory illnesses but are caused by different viruses; flu is caused by different influenza viruses and the common cold can be caused by coronaviruses, rhinoviruses, adenoviruses and parainfluenza viruses. The incidence of the common cold and flu is subject to seasonal variation, with a higher incidence in winter compared to summer.

Symptoms of cold are usually limited to the upper respiratory tract (nose and throat) and flu symptoms generally affect more than just the upper respiratory tract, with symptoms of flu usually much more severe than those of

a cold. Symptoms of a cold can include blocked or runny nose, sneezing, cough, sore throat and fever. Symptoms of flu can include fever, fatigue, body aches, headache, difficulty sleeping, loss of appetite, dry cough and nausea.

Runny nose and sore throat are also possible, but less common than with the common cold.

The common cold and flu are generally self-limiting in healthy individuals and usually will resolve within two weeks. However, flu and complications of flu can lead to serious illness. In children, otitis media (middle ear infection) and respiratory complications including croup and bronchiolitis are most common. Rarer complications in children can include myocarditis, pericarditis, encephalopathy, encephalitis and Reye’s syndrome.

Effective consultations between pharmacy staff and patients are fundamental to ensure appropriate

Consider:  Is the pharmacy team confident in informing pharmacy customers on the recommended treatment?  Is the pharmacy team educated and knowledgeable on the dosage and contra-indications for all cold and flu medicines?  Am I/my team familiar with the current lifestyle tips on dealing with the cold/flu such as drinking plenty of fluids and avoiding infecting others?  Am I/my team aware of those at-risk of flu and who should be referred?

56 | PHARMACYNEWSIRELAND.COM

recommendations are made and desired patient outcomes are achieved. Optimal management of these consultations require effective information gathering from the patient, with proper use of a framework essential for retrieving information.

Treatment Antibiotics are not effective in treating viral infections such as the common cold and influenza and therefore should not be used in the treatment of these illnesses.

Pharmacists can play an important role in antimicrobial stewardship, particularly in the context of cold and flu. Encouraging hand hygiene

Key Points: Check your pharmacy team are aware and understand the following key points:  The main routes of infection  Recognising the specific symptoms of both cold and flu and how they differ  Lifestyle and hygiene tips and advice on reducing infection  Recognising which symptoms warrant urgent and non-urgent referral  The recommendations for children and those aged under 6

Decongestants: These have been shown to have clinical effectiveness in reducing symptoms of rhinorrhoea, nasal congestion and sneezing. Pseudoephedrine and Phenylephrine are two decongestants that are licensed for OTC use in those aged 12 years and older in Ireland. Potential side effects can include agitation, hypertension, tachycardia, nausea and dysrhythmia. Decongestants can also be used in combination with a first-generation oral antihistamine.

Actions:  Prior to recommending OTC products, pharmacists should ascertain whether self-treatment is appropriate  Include POS with associated conditions relating to this category  Ensure efficient sign posting and shop floor management with associated ailments linked for maximum cross aisle merchandising  Ensure there is a discreet area in which staff can assist with advice and product selection  Dedicated window displays will improve the shoppers experience and highlight the pharmacy as a centre for seasonal ailments  Update the team’s knowledge of available remedies by type/cause, indications and doses to ensure appropriate product selection for each customer  Train the team to meet all the above considerations

COLD & FLU SYMPTOMS

ONLY TRIPLE ACTIVE FORMULATION Solpa Cold & Flu Multi Relief Max Powder for Oral Solution, Paracetamol 1000 mg, Guaifenesin 200 mg, Phenylephrine Hydrochloride 12.2 mg.

For the relief of symptoms of colds and flu and the pain and congestion of sinusitis, including aches and pains, headache, blocked nose and sore throat, chills, lowering of temperature, and to loosen stubborn mucus and provide relief from chesty coughs. Adults, the elderly and adolescents aged 16 years and over: One sachet every 4-6 hours as required to a maximum of 4 sachets (4 doses) in a 24-hour period. Do not give to children and adolescents under 16 years. Not to be continued for over 3 days without consulting a doctor. Contraindications: Hypersensitivity to any of the ingredients, severe hepatic impairment, hyperthyroidism, hypertension, diabetes, cardiovascular disease, those taking tricyclic anti-depressants or beta-blockers or other antihypertensive agents, patients who are taking or have taken monoamine oxidase inhibitors within the last two weeks or those currently receiving other sympathomimetics, phaeochromocytoma, closed angle glaucoma, and porphyria. Precautions: circulatory disorders, chronic alcoholism, urinary retention or prostatic hypertrophy, gilbert’s syndrome, concomitant treatment with flucloxacillin and medicinal products affecting hepatic function, glucose-6-phosphate dehydrogenase deficiency, haemolytic anaemia, glutathione deficiency, dehydration, chronic malnutrition, elderly, adults and adolescents weighing less than 50kg, may act as a cerebral stimulant. Use with paracetamol-containing products. Do not take with alcohol. Pregnancy and lactation: Not to be taken during pregnancy or whilst breast feeding without medical advice. Side effects: Thrombocytopenia, agranulocytosis, anaphylaxis, severe cutaneous hypersensitivity, bronchospasm, hepatic dysfunction, acute pancreatitis, angioedema, angle glaucoma. See SmPC for full list of side effects and further information. Product not subject to medical prescription.

PA1186/021/003. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland. Date of preparation: Feb 2023.

MAT-4747 SPC: https://www.medicines.ie/medicines/solpa-cold-flu-multi-relief-max-powder-for-oral-solution-35312/spc#tabs

ONLY FROM PHARMACY

IRISH PHARMACY NEWS

JANUARY

FEBRUARY

 Minister for Health Stephen Donnelly announced an additional ¤20m in funding for new medicines.

 Proposed legislation was announced for an enhanced role for pharmacists. The proposed measures signalled a positive step in patient care.

 Marking the International Day for the Elimination of Violence Against Women, the Irish Pharmacy Union issued a reminder that there were over 1,000 ‘Safe Pharmacies’ available to offer support for people in domestic abuse situations.

 It was announced that a cross-border project reviewing patients’ use of medicines (polypharmacy) improved the safety of patients by reducing adverse drug reactions. The evaluation report was produced for the Isimpathy Project.

 Navi Group presented their latest offering, dispenSense, the latest breakthrough technology, designed to revolutionise and simplify the dispensing process and workflow.

 Operation Transformation in partnership with the Irish Pharmacy Union hosted a National Blood Pressure Day amongst local pharmacies.

 34 pharmacies across Dublin were revealed to be receiving medicine deliveries from a new all-electric delivery van, as part of NovoNordisk’s environmental strategy, Circular to Zero, to eliminate company C02 emissions by 2030.

 LloydsPharmacy released key Health Insights for 2024, revealing a range of trends and preferences amongst Irish adults regarding their health and wellness habits, including a strong preference for seeking guidance from healthcare professionals.

 Meaghers Pharmacy Group added a tenth pharmacy to their Group, taking over the Bhagwans Pharmacy in Ballinteer.

 The finalists were announced for the 2024 OTC & Retail Pharmacy Product Awards.

2024 & Retail Pharmacy Product Awards

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YEAR END REVIEW

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MARCH  Osteoporosis, antimicrobial-resistant infections and several types of cancer were among the ailments that were scheduled to be tackled by seven drugs newly approved by the HSE.  The Pharmaceutical Manufacturers’ Institute raised an incredible 10,340 for LauraLynn with their annual Christmas Charity Lunch.  The Annual Guaranteed Irish Pharmaceutical Forum, hosted by Guaranteed Irish took place where insights were shared around the theme of ‘Innovation in the Community – Positioning Ireland to Deliver Best Patient Care.’  Sharing the Vision – National Mental Health Conference took place at Dublin Castle, providing stakeholders with the opportunity to discuss developments in national mental health policy and delivery.

APRIL  It was announced that from the beginning of March, the maximum legal validity of prescriptions was extended from 6 to twelve months. The new measures provided greater flexibility for patients, reduced demand on primary care services and utilised the expertise of community pharmacists.  The Irish Pharmaceutical Healthcare Association (IPHA) released new data indicating continuing length timelines of two years or more for the reimbursement of new life-enhancing medicines.  The Medical Council published its 2022 Workforce Intelligence Report.

Its data showed the growing number of female doctors registering with the Medical Council for the first time.  After a length period of transition and inspiration drawn from the mission of statement from their parent company, PHOENIX Group, PHX Ireland unveiled their new company values.

MAY  Chemist Warehouse opened their tenth store at Cornmarket Centre, Cork City.  The Finalists were announced for the 2024 Irish Pharmacy Awards  Medicines for Ireland published a new five-year vision, Looking Forward: Building on the Framework for a sustainable generic biosimilar and value-added medicines industry in Ireland.  Popular consumer brand, Clonmel Healthcare announced the completion of the construction of a brand new 2m warehouse facility in Clonmel.

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YEAR END REVIEW

JUNE  Pharmacists across Ireland welcomed the Digital Health Framework for Ireland 2024-2030. The new framework highlighted a critical step forward in addressing Ireland’s outdated technologies and the inefficiencies that have impacted the health system.  It was stated by Irish Pharmacy Union President Tom Murray, that a funding model for Ireland’s pharmacies was long overdue and should be implemented as a matter of urgency. Mr Murray was addressing the annual conference.  Fox’s Pharmacy in Birr were able to gain an extra day in the pharmacy, thanks to the introduction of new shelf labels.  It was revealed that 83% of Irish consumers signal price as a key consideration when purchasing OTC medicines, according to a nationwide poll by Azure Pharmaceuticals.

JULY  Tanaiste Micheál Martin joined Cork company, PrecisionBiotics to mark a decade of success for their flagship product, Alflorex. The event was held at the Glucksman Gallery in UCC last month, to celebrate Alflorex which was launched in 2014 and is now sold in 22 countries worldwide.  The Irish College of Ophthalmologists hosted their Annual Conference 2024 at the Knockranny House Hotel in Westport, Co Mayo from Wednesday 15th to Friday 17th May. Over 200 ophthalmologists gathered for the three-day scientific conference to hear the latest clinical and scientific developments in the specialty from eye experts at home and abroad.  As part of their added value Knowledge Hub and CPD learning programme, United Drug recently hosted an informative webinar on the topic of HPV Vaccination. The webinar specifically focussed on the role of the pharmacist in the vaccination process, leading to a reduction in Cervical Cancer.  For the first time ever in Ireland a conference focusing on diabetes technologies was held recently in Dublin and a new healthcare professional (HCP) group “Diabetes Technology Network Ireland (DTN IRL)” was launched.

AUGUST  Ireland needs to take action to reduce the amount of medicines being inappropriately disposed of, it was announced by pharmacy bodies.

The IPU called for a nationwide Disposal of Unused Medicines Properly (DUMP) scheme to be established.  According to a new study, community pharmacies in Ireland are providing higher levels of healthcare than ever before. The study also found close to universal support for expanding pharmacy services into new treatment areas.  We published the annual IQVIA Top 100 over-the-counter pharmacy products in Ireland featuring an exclusive interview and in-depth look into the market with General Manager Gwynne Morley  Pharmacist Michelle O’Hagan of The Pharmacy Hub Killinarden gave readers an overview of the Digestive Health market in Ireland  Life Pharmacy celebrated welcoming its 100th Pharmacy in Killeagh, Co Cork with a nationwide fundraising campaign to raise vital funds for the Jack and Jill Children’s Foundation.

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SEPTEMBER  Welcomes abounded to the news that pharmacists will be able to prescribe, starting with prescribing for a range of common conditions. An initial list of eight conditions was revealed.  Boots Ireland were recognised as one of the most reputable organisations in Ireland, securing third spot in 2024 in the Ireland RepTrak® 2024 Study.  This issue witnessed the first step in McCabes Pharmacy’s journey to becoming Ireland’s largest pharmacy brand with the official rebranding of their LloydsPharmacy Ashleaf Store in Dublin to McCabes Pharmacy.  A first-of-its-kind study from St Patrick’s Mental Health Services and University College Cork explored preferences and needs of those with lived experiences of weight gain from anti-psychotics.

OCTOBER  The Irish Institute of Pharmacy collaborated with the National Cancer Control Programme to develop a Cancer Care Hub, intended to be a resource for all pharmacists.  The Irish Pharmaceutical Healthcare Association announced Shane Ryan as their new President and published its General Election Manifesto, asking the next Government to commit to a continuous and faster flow of new life-enhancing medicines.  Professor Helena Kelly was appointed as the new Head of School of Pharmacy at RCSI.  McLernons launched their updated MPS Retail, revolutionising the pharmacy retail experience.  Pharmacists expressed concern that Budget 2025 failed to provide the necessary clarity that was expected on how the chronic underfunding of the community pharmacy sector will be addressed.

NOVEMBER  The HSE published the PCRS 2023 Statistical Analysis of Claims and Payments Report. It provides an overview of over ¤4bn in reimbursements and payments made in 2023, representing a ¤260m increase over 2022.  In the ever-evolving world of healthcare, United Drug’s new podcast series, UD Talks, is a timely and much needed initiative. Hosted by Denis O'Driscoll, Superintendent Pharmacist for LloydsPharmacy Ireland, the podcast sets out to address some of the most pressing topics in community pharmacy.  We announced the Finalists for the 2024 People’s Pharmacist Award.  The Asthma Society of Ireland released research into the dispensing of steroid tablets across Irish retail pharmacies.  A new research paper titled “The Top Ten Priorities in Adults Living with Type 1 Diabetes in Ireland and the United Kingdom – A James Lind Alliance Priority Setting Partnership” has been published, shedding light on the most pressing concerns and priorities of adults living with Type 1 diabetes.

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Dynamic 100: Women Trailblazers

Women have long been making remarkable contributions to the healthcare arena, as caregivers, pioneers, and leaders. From pharmacists to researchers, industry giants and entrepreneurs, women continue to shape the future of public health, often overcoming significant challenges along the way.

Their dedication and innovation have transformed the healthcare and pharmacy landscape in Ireland. Whether working on the frontlines of patient care, advancing groundbreaking research, or advocating for community health, women in healthcare embody resilience, compassion, and excellence.

Below we highlight the achievements of some of the most influential women in pharmacy healthcare in Ireland whose work continues to inspire future generations and ensure the well-being of communities everywhere.

Hillary Collins Chief Human Resources Officer for PHX Ireland Currently serving as the Chief Human Resources Officer for PHX Ireland, part of the Country Board, overseeing People and Culture strategy for 2,000 employees across multiple business units in supply care, homecare healthcare, and retail pharmacy. A proven and dynamic leader in reducing employee turnover by creative and intuitive talent acquisition and organizational design, with a focus on value-based people strategies across diverse, multilingual teams. Hillary holds prior experience working at the Pan-European and global level in multi-language and IR jurisdictions.

Key accomplishments in her career to date include implementing a talent management and leadership development program with over 80% of participants graduating, improving internal promotions by 15% year-on-year. She has also developed and rolled out corporate values and behaviours across Irish and European jurisdictions, driving an increase in employee alignment with company culture, measured through post-implementation surveys.

Through her facilitation skillset Hillary led an initiative that kickstarted the reduction of locum spend in retail pharmacy by engaging with pharmacists, creating life stage benefit packages to attract and retain teammates, developing a European partnership with Spanish university to develop Erasmus programme for early career, partnerships with Irish university and delivery an authentic tone of voice on Linkedin for employee attraction campaigns Over the past year, PHX Ireland has completed the acquisition of McCabes Pharmacy, adding 30 stores and 450 employees to their existing 80-pharmacy footprint. Hillary spearheaded a comprehensive people and culture strategy, grounded in six pillars: supporting, developing, representing, including, hearing, and recognizing our people across all business units which has retained >80% of all key talent.

Elaine Condon, Managing Director, TCP Homecare Elaine Condon, Managing Director of TCP Homecare, Ireland's largest private Clinical homecare provider of ‘direct to patient services.’ Part of the country board for PHX Ireland.

TCP Homecare was first established in 2000 as a logistics company to deliver temperature sensitive pharmaceutical products to hospitals, GPs and patient homes in a patented fleet of temperature controlled vans. As Managing Director of TCP, which is part of PHX Ireland group, Elaine Condron has led the rapid expansion of TCP over this time to a position today where they employ 215 experienced healthcare professionals, who uniquely provide the dispensing and distribution of pharmaceutical products, an extensive range of homecare nursing services and sharps waste management and facilitate a unique turnkey solution for the delivery of hospital care in the patient’s home.

TCP provides services 365 days a year and plays a pivotal role in local communities as they facilitate the transition of care from Hospitals to the local community and homes. Elaines dedication and commitment helped build and develop this highly successful team that collectively focus on delivering high quality care while always keeping patients at the centre of what they do.

Some of the unique and innovative services offered by TCP include: 1) Service for home distribution in Ireland of Clotting Factor Concentrates to haemophilia patients is still recognised as a global first 2) TCP Homecare provide serialised GS1 Bar Code labelling for real time Track ‘n Trace of individual products to enable (if needed) a rapid product recall 3) Electronic Patient Management System is a first of its kind; allowing real time patient evaluation reports to be sent to the referring team 4) TCP Homecare established the first out-of-hospital infusion centre in Ireland

Congratulations to the Dynamic 100.

67 Professor Ann Marie Healy, School of Pharmacy, Trinity College Dublin Professor Healy’s mentorship has resulted in the successful graduation of 23 PhD students and the guidance of 27 postdoctoral researchers to date.

She has over 25 years’ experience in pharmaceutics, pharmaceutical technology and drug delivery research. Her research is focused on obtaining an increased understanding of the physicochemical properties of active and excipient materials used in a variety of different dosage forms, and on harnessing that knowledge to improve product design in terms of in vitro and subsequently in vivo performance. This research objective is achieved through collaborative efforts and interdisciplinary research with both academic and industry partners.

Through the EPSRC-SFI Centre for Doctoral Training in Transformative Pharmaceutical Technologies, which is co-funded by the Engineering and Physical Science Research Council (EPSRC) of the UK and SFI, Professor Healy has worked with colleagues in Univeristy College Cork, University College Dublin, the University of Nottingham, and University College London to develop a unique, multidisciplinary training programme for PhD students.

The programme is designed to prepare strategic-thinking scientists for high achieving careers in the pharmaceutical and healthcare sectors and will train 75 PhD students between the UK and Ireland over an eight-year period (2019-2027). As Co-Director, Professor Healy has a pivotal role in ensuring the successful delivery of a comprehensive scientific and soft-skills training curriculum, that aligns with PhD students’ needs and interests.

Deirdre Kelly, Country Manager, Consilient Health – Ireland and Malta/Vice-Chair, Medicines for Ireland In 2024, Deirdre and the team at Medicines for Ireland published its new five-year vision Looking forward: Building the framework for a sustainable generic, biosimilar and value-added medicines industry in Ireland. The vision sets out MFI’s approach to address current and emerging market challenges, including demographic shifts, access to medicines, and inflationary pressures.

Established in 2016, MFI is the leading voice for the generic, biosimilar, and value-added medicines industry with its members supplying the majority of medicines to the HSE and patients directly.

Generic companies play an essential role in the supply of prescription medicines in Ireland, with eight of the top 10 companies in the total prescription market (based on volume of units) supplying generic medicines.

Deirdre joined Consilient Health in 2014 to set up the Irish business unit. Since then, Deirdre and the Irish team have successfully launched a range of medicines across CH’s key therapeutic areas in both the secondary and primary care settings with new launches in Malta from 2021.

Prior to joining Consilient Health, Deirdre spent 13 years at Eli Lilly, most recently as business unit manager responsible for the Osteoporosis, Cardiology, Oncology and Primary Care product portfolios. At Novo Nordisk, she was the lead marketer for growth hormone in the UK & Ireland territories. Deirdre started her career at Nutricia where she held a number of management positions.

Deirdre has a BSc (Hons) in Nutrition & Dietetics from Trinity College, Dublin with post graduate qualifications in marketing, health economics and a Diploma from the Institute Of Directors.

Deirdre is also a board member of Medicines For Ireland trade association, Irish Medicines Verification Organisation and is completing her term as President of the Irish Pharmaceutical Managers Institute (2022 / 2023).

Joanne Kissane, Registrar and Chief Officer, Pharmaceutical Society of Ireland As the regulatory authority for pharmacy in Ireland, the PSI plays a critical role in ensuring pharmacists expertise and contribution as part of the wider health service continues to develop in line with evolving patient care and innovations in the sector.

Joanne graduated from the School of Pharmacy, Trinity College, Dublin in 2000 and worked as a community pharmacist with LloydsPharmacy until 2011 when she became Superintendent Pharmacist for the group, a role she held for seven years. Subsequently, she became Head of Operational Excellence where she was responsible for leading the implementation and management of a highly efficient, customer-centric store operating model. Joanne is currently the Director and National Coordinator for APPEL (Affiliation for Pharmacy Practice Experiential Learning) which manages the experiential learning placements of the integrated pharmacy programmes of the three Schools of Pharmacy in Ireland. She completed a Masters in Quality and Safety in Healthcare Management with the Royal College of Surgeons in Ireland in 2017. Joanne is serving a second term on the Council. She is currently undertaking a Masters in Quality and Safety in Healthcare Management in the Royal College of Surgeons in Ireland.

Ireland’s leading healthcare provider.

United, we do better

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Dynamic 100: Women Trailblazers Sharon McCabe, CEO, McCabes and LloydsPharmacy Ireland Sharon McCabe was declared Business & Finance Business Person of the Month for September 2024, in association with KPMG Ireland.

In April 2024, PHX Ireland, via its subsidiary LloydsPharmacy, acquired McCabes Pharmacy, and over the past few months, have been bringing together the operations of two of the best known and most trusted retail pharmacy brands in the country, creating the largest retail pharmacy brand in Ireland under one trusted name: McCabes. This strategic move not only strengthens McCabes Pharmacy position as Ireland's largest and most patient centric pharmacy network but also expands the reach and commitment to exceptional healthcare services across the country. Led

by Sharon McCabe as CEO, McCabes Pharmacy will be more accessible to local communities across Ireland, while also serving as a professionally exciting place for healthcare colleagues and teams to work and build meaningful careers.

Since September and within a tight 14 week timeframe, the 80 Lloyds Pharmacies across Ireland have been rebranded with the final pharmacies expected to be completed in early December offering customers and local communities a more enhanced customer experience and refreshed in store layout. The extensive list of customer touchpoints including internal and external store signage, phone answer machines, dispensary bags, TIL receipts and colleague name badges, to name a few all required new design and artwork that needed to be created and produced under very tight timelines to align with the store rebrand roll out for a consistent and unified customer branding and experience.

Mairead McCaul, Managing Director, MSD Ireland Until April of 2024, Mairead McCaul was Managing Director of MSD Ireland (Human Health) before taking up her new position as Managing Director of MSD Animal Health Benelux. She is also Head of the MSD Ireland Country Leadership Team which includes representatives from MSD’s six sites in Ireland and key business areas.

However, the rebrand is not just about the physical rebranding of the stores but a wider project to offer an integrated multi-channel customer service and customer experience across the 110 pharmacies from delivering brand and customer experience training, aligning processes and systems, selecting product and category ranges, pricing and promotions, as well as moving towards a single platform website and app. It also includes aligning the internal and store operational processes and compliance for stores, HR policies and IT systems integration to name a few.

Mairéad previously served as a member of the IPHA strategy board and a Director on the board of Guaranteed Irish. Her leadership has been instrumental in fostering a culture of continuous improvement, inclusion, and empowerment. She is passionate about the One Health approach, which integrates human, animal, and environmental health, emphasising the interconnectedness of health issues and promoting comprehensive healthcare strategies. This focus has been central to her current work, reflecting the critical importance of collaborative leadership and the integration of diverse health sectors to improve overall health outcomes.

Prior to her appointment to her current role, Mairead was Business Unit Director, Oncology and Market Access, MSD Ireland (Human Health) and has a wealth of experience in senior roles across Sales Management, Marketing and Commercial Operations since joining MSD Ireland in 2007.

Earlier in 2024, Mairead was part of the Pharmaceutical Forum 2024 Panel at the Guaranteed Irish Pharmaceutical Forum. During this event, insights were shared around the theme of "Innovation in the Community – Positioning Ireland to Deliver Best Patient Care". The importance of data being at the centre for digital healthcare improvements was discussed.

Progress in digital data technology will allow more innovation and access for patients to make informed choices with healthcare professionals.

She is a passionate advocate of diversity and inclusion and has led many programmes of activities to support this area, previously coleading the MSD Women’s Network in Europe and most recently acting as an ambassador for MSD’s 2021 Neighbour of Choice partnership with Teen-Turn.

Prior to joining MSD, Mairead worked for eight years within the laboratory diagnostics sector. She qualified in nursing and midwifery and holds a BA (Hons) in Business Management from Dublin Business School. Mairead is an active member of a number of working groups within the Irish Pharmaceutical Healthcare Association and was recently appointed to the Board of Guaranteed Irish.

Congratulations to the Dynamic 100.

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Oonagh O’Hagan, Managing Director, Meaghers Pharmacy Group Oonagh is the current Compass WMB Female Entrepreneur Award recipient. Not only that, but earlier this year Meaghers Pharmacy Group were celebrating after being given Platinum Status at Ireland’s Best Managed Companies for the third year running. This is the 10th consecutive year that Meaghers have been awarded the title.

In May of 2024, Oonagh launched Pharmacy 360, a new innovation which will transform the way in which it interacts with patients. Pharmacy 360 is a new holistic health initiative created as a support to patients’ treatment plans to complement the medication they are being prescribed – taking the whole person into consideration.

Oonagh O’Hagan is a qualified pharmacist, the owner and CEO of the Meagher’s Pharmacy Group. Oonagh is a driven Entrepreneur and was named as Businesswoman of the year 2023 By Irish Tatler, Entrepreneur of the Year 2023 at the Women Mean Business awards and one of the 24 finalists in the Ernest and Young Entrepreneur of the Year program in 2021. Oonagh is keen to promote and champion other female business entrepreneurs and as such is a Lead Entrepreneur on the Going for Growth programme which supports Irish female entrepreneurs grow and scale their businesses.

Professor Judith Strawbridge, School of Pharmacy, RCSI Professor Judith Strawbridge, School of Pharmacy and Biomolecular Sciences at RCSI University of Medicine and Health Sciences, has been appointed to the Expert Taskforce to Support Expansion of the Role of Pharmacy.

Established by Minister for Health Stephen Donnelly, the taskforce will examine how pharmacists in Ireland can be enabled to operate at the top of their licence for the benefit of patients and the wider health service.

Professor Strawbridge was a founding lecturer on the pharmacy degree programme at RCSI and is currently Deputy Head (Education) of the School of Pharmacy and Biomolecular Sciences and Director of the Masters of Pharmacy (MPharm) Programme. She is widely recognised nationally for her scholarly expertise and passion for standards in pharmacy education and practice.

Judith Strawbridge was a founding Lecturer in the School of Pharmacy, and has over 20 years of experience in designing, delivering and evaluating teaching and learning across the healthcare professions. She has experience in clinical pharmacy and a PhD in Pharmacy Education.

Previous leadership positions include Programme Director of the BSc in Pharmacy 2011-2014, Associate Vice Dean for Student Affairs from 2008 - 2012, Year Lead for Year 3 of the integrated MPharm Programme 20172019. She was the inagural RCSI Lead for Patient and Public Engagement from 2018 - 2023. She is Programme Director of the MPharm Programme and Deputy Head (Education) of the School of Pharmacy and Biomolecular Sciences.

Ireland’s leading healthcare provider.

United, we do better

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Dynamic 100: People’s Choice

In association with Panadol, Irish Pharmacy News launched the search to find The People’s Pharmacist 2024 earlier this year; giving the Irish public the opportunity to nominate and vote for, their local pharmacist who has gone above and beyond.

The People’s Pharmacist Award seeks nominations from across the country, giving patients the opportunity to recognise and salute their local pharmacist.

Through this Award, we are enabling the public to have a voice in recognising the unwavering support and spirit that makes pharmacists the backbone of our health service in every community across Ireland.

From over 700 nominations we had eight extremely deserving finalists and after a nationwide voting campaign, Chanel Geoghegan was awarded this prestigious title.

Chanel Geoghegan Hickey’s Pharmacy Clones Chanel was the Winner of The People’s Pharmacist 2024. “Chanel is a true pillar of her community, consistently going above and beyond in her role as a pharmacist,” said one nominee.

“From personally delivering medications to patients’ homes to travelling to administer flu vaccines and checking in on elderly clients, Chanel’s dedication is unwavering. For families going through palliative care, she provides her personal mobile number, making herself available 24/7—even taking calls on her days off. Balancing her demanding role with raising three young boys, Chanel continues to put her patients first, never taking extended holidays and often putting others’ needs before her own.

“Her commitment to patient care is seen not only in her actions but also in her priorities. When medications are in short supply, Chanel often sources them from alternate wholesalers, absorbing any extra costs instead of passing them on to her customers. She is deeply committed to her patients' well-being, valuing their health over profit margins—a rare trait in any business owner.

“Chanel’s compassion, dedication, and integrity have made her a true standout in her profession—a unicorn in the world of pharmacy owners. Her community is not only grateful but also inspired by the exceptional care and kindness she brings to every aspect of her work.”

Keith Brennan, Haven Pharmacy, Ballyfermot Keith’s nominee explained, “Keith is committed to ensuring that every patient feels heard, valued, and cared for. No matter how busy his day may be, Keith makes a point of stopping whatever he’s doing to assist any customer who asks to speak with him, giving them his undivided attention and expertise.

“One of the most striking examples of his dedication came during a recent shortage of medications.

Despite the challenges, Keith went above and beyond to source a continuous supply of chemotherapy medication for my husband. He spent countless hours working with suppliers and searching for alternative options to make sure we had enough to get us through each week, providing us with peace of mind during an incredibly difficult time.”

Paul Burns, Dargle Valley Pharmacy, Bray Paul and his dedicated team have gone above and beyond to ensure exceptional support and care for their patients, offering invaluable assistance during some of life’s most challenging moments.

One nominee told us, “For me, Paul became a lifeline as I navigated treatment for bilateral breast cancer. With the complexity of my condition, I was prescribed numerous medications, including specialised high-tech treatments, all of which required meticulous management and timing. Paul and his staff were unwavering in their commitment to ensure that I always had the medication I needed, precisely when I needed it, making my treatment journey significantly less stressful. One of the most remarkable aspects of Paul’s service is his accessibility and dedication.”

Brian Fitzgerald, Mari Mina Pharmacy, Toomevara Brian’s nomination stems from his exceptional dedication as a community pharmacist, consistently going above and beyond to serve his village. One person nominating Brian described his commitment, saying, “Brian is always so kind and attentive whenever I visit his pharmacy. He truly goes above and beyond every single day. Nothing is ever too much trouble for him. Such a wonderful addition to the village."

Brian was also recognised for his charitable contributions. Earlier this year, during a charity mission to Africa, he generously sponsored the necessary medications for the entire team, even going as far as mailing supplies to those unable to visit his pharmacy. His actions, both at home and abroad, reflect his unwavering commitment to his community and his profession.

Working collaboratively with manufacturers, customers, patients and colleagues.

71 Martin Kelly, Kelly’s StayWell Pharmacy, Dundalk “As a dedicated community pharmacist, Martin consistently goes beyond his professional responsibilities to provide unparalleled care and support to every patient,” said one nominee.

“Martin is more than just a pharmacist; he is a cornerstone of our community. His dedication to patient well-being shines through in each interaction, whether he’s delivering expert advice, offering comfort and reassurance, or ensuring that patients fully understand their medications and treatment plans.

“Martin’s contributions are especially evident during challenging times. Throughout recent health crises, he has worked tirelessly to ensure that all patients had consistent access to necessary medications and accurate health information. Beyond his role in the pharmacy, Martin is actively involved in local health programs and support groups, continuously striving to uplift and improve the overall well-being of our community.”

Deirdre O’Rourke, Adrian Dunne Pharmacy, Kilbarrack At just 41, her nominee, a stroke survivor living with aphasia, reflects on the journey that began when she was 37, shortly after the birth of her son. Navigating life with aphasia brings unique challenges, but having the support of compassionate healthcare professionals has made an immense difference. Lisa shares that, throughout her experience, Deirdre and her team have been nothing short of exceptional: "Simple things like aphasia support were always there for me!"

Reflecting on the impact Deirdre has had, Lisa describes her as a pharmacist who goes above and beyond.

"I couldn’t put it into words about Deirdre," she says. "She is the kindest and most caring chemist I have ever met." For Lisa, Deirdre's genuine care and patient approach are invaluable, making a meaningful difference in her life. Deirdre ensures that every visit feels unhurried, offering detailed explanations for each medication and always willing to repeat information as often as needed.

Laura Reynolds, LloydsPharmacy, Rathmines Upon hearing of her nomination, Laura told us the surprise and excitement filled not just her store, but her home as well.

She said, “I am truly grateful for the support and recognition I've received, which reflects the wonderful community here in Rathmines. This nomination underscores the vital role community pharmacists play locally, and it’s humbling to be acknowledged in this way.

This year, for the first time, Laura provided vaccinations at her daughter’s school, covering 150 children.

One of her nominees said of Laura, “Laura is always greeting her customers with a smile, and is always happy to assist in any way. She ensures that we all leave the pharmacy feeling at ease and knowing that exceptional care has been and will follow throughout your/any heath journey. Her beautiful, enigmatic and professional nature epitomises the brilliance of what it is to be a pharmacist.”

Ultan McKeon, Quinn’s Pharmacy, Bray One nominee described Ulan as ‘an incredible support.’ “Ultan has been an incredible support to me and my family,” they said. “When my husband underwent a major operation two years ago, Ultan managed all of his new prescriptions and supplies, ensuring we had everything we needed.

“On Christmas Eve, he went above and beyond by sourcing essential supplies for us and even carried them to my car, as I had my baby with me at the time. He has also met us after hours when we've urgently needed prescriptions and is always available by text for any questions or concerns.

His dedication and kindness are truly remarkable!”

“Receiving this nomination means so much to not only me but our entire team. It shows us how much our contributions are valued by the community, and that our work truly makes a difference,” said Ultan.

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Dynamic 100

Emily Ashmore, Adrian Dunne Pharmacy, Ashbourne Emily Ashmore won the Alliance Community Pharmacy Technician of the Year Award 2024.

Emily is currently working as part of a busy and dynamic Dispensary team. She is a vital part of the pharmacy team and has recently taken up a more senior role.

She is eager to learn and is a keen student. Emily is at the end of her IPU Technician course and has excelled in every part of it. She is self-motivated and it is evident she enjoys learning aboutall aspects of a Pharmacy Technician’s role.

Her journey from a part-time employee to a lead technician underscores not just her commitment to her role but also her exceptional ability to grow, adapt, learn, and excel in the fast-paced environment of community pharmacy.

She is forward thinking, dynamic and innovative. Her exceptional IT skills have directly contributed to the innovation and improvements in efficiency within the pharmacy.

David Beggs, Founder, Pure Pharmacy David recently unveiled Genecheck - an innovate testing service which allows the pharmacy team at Pure Pharmacy to test a persons genetic response to prescribed medicines using pharmacogenomics.

It is the first of its kind to be offered in Ireland and more importantly in community pharmacy. It is the future of healthcare as it allows patient (and Doctor) to analyse a patient's response to commonly prescribed medications using their DNA allowing for personalised prescribing.

This service eliminates guess work during early stages of prescribing in the sense that if a patient does not suitably respond or metabolise a particular medication efficiently or successfully.

David was also EY Entrepreneur of the Year Finalist and a Finalist at the 2024 Irish Pharmacy Awards.

Dr Caitriona Bradley, Irish Institute of Pharmacy Dr Catriona Bradley started her career as a community pharmacist and currently leads the regulation of CPD for pharmacists, as Executive Director of the Irish Institute of Pharmacy (IIOP) on behalf of the pharmacy regulator The Pharmaceutical Society of Ireland (PSI).

The Irish Institute of Pharmacy is based in the Royal College of Surgeons, where Catriona collaborates with colleagues across Medicine, Nursing, Pharmacy, Physiotherapy, Psychology and Healthcare Leadership to support postgraduate learning for healthcare professionals. She is deeply committed to the delivery of person-centred care. Her qualifications in pharmacy, legal studies, quality improvement and coaching provide her with a breadth of skill and knowledge.

Caitriona’s career, which spans business, academia, professional regulation and leadership, enables her to draw on a wide range of experience and expertise. Her lived experience, as a parent, wife, daughter, friend, sibling, patient and carer, provide her with rich insights into the needs of people, families and communities.

She is committed to good governance and is a board member of her local primary school. She welcomes opportunities to contribute to society at both local and national levels and is committed to the success of the CORU Council and Executive.

Delivering over 18,000 totes per day to our valued customers

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Ann-Marie Broderick, Retail Operations Lead, McCabes Pharmacy Ann-Marie Broderick exemplifies the core principles of Safety Culture through her proactive leadership and unwavering commitment to continuous improvement. By introducing the SafetyCulture app, Ann-Marie revolutionized McCabes approach to quality management, creating a robust system that enhances safety, compliance, and operational efficiency across the business.

Ann-Marie’s strategic use of technology, coupled with her lean approach to operations, has helped eliminate inefficiencies, enhance data accuracy, and ensure consistent policy adherence across the organization. Her leadership in rolling out digital SOPs, near miss digitization, and temperature monitoring systems directly contributed to safer, more efficient pharmacies. Moreover, Ann-Marie’s commitment to collaboration, feedback, and continuous improvement has created a culture where safety and quality are prioritised, and where staff feel supported and empowered. Her contributions have not only transformed the way McCabes Pharmacy operates but have also set a standard for excellence in safety culture, inspiring others to strive for continuous improvement and operational excellence.

Caroline Burton, Head of Retail Marketing, Uniphar Caroline joined Uniphar as Head of Retail Marketing in 2022, bringing a wealth of experience and expertise to the role. She leads a dynamic marketing team, guiding the development and execution of strategic initiatives across advertising, sponsorship, PR, social media, and market research for Allcare, Hickey’s, McCauley, and Life Pharmacy.

With over 25 years marketing experience across Pharmacy, Retail, FMCG, and the Drinks industry, Caroline is focused on driving impactful marketing strategies that enhance customer engagement and brand loyalty. She holds an MBS in Marketing from UCD Smurfit Graduate Business School, a Bachelor of Commerce from University College Dublin, and a Professional Diploma in Digital Marketing from the Digital Marketing Institute of Ireland.

Shane Carney, Pharmacist, Fox’s Life Pharmacy, Birr During 2024, Shane reported saving up to 10 labour hours a week for him and his team since switching to automated price labels on their shelves. The e-paper shelf tags run on long-life batteries and are integrated with the store’s EPOS via a secure radio-frequency connection. The product information, prices, promotions and even label designs, can be updated individually, all-at-once, automatically or manually. Stores can update the labels from a handheld device, their back office or updates can be rolled out centrally from head office – a game-changer in terms of efficiency.

John Carroll, CEO, Navi Group John Carroll, a pharmacist by trade, is the owner, founder and CEO of Navi Group. From humble beginnings in 2009 with the creation of Axium Buying Group, John has led the Navi Group to consistently bringing new and innovative products, services, and IT solutions to the pharmacy market.

John has built a support team of over 70 people who are all focused on the same vision of making pharmacy life easier and more efficient for our continuously growing group of 585 business partners.

In the last year, John has spearheaded the development and rollout of Navi’s latest dynamic pharmacy EPOS solution, TillSense. TillSense is a national provider of a pharmaceutical front of shop retail solution, offering a unique, intuitive, cloud-based EPOS system with an exceptional level of functionality.

By choosing TillSense as their EPOS software provider, pharmacies are getting a more efficient EPOS solution, freeing up time for more customer interaction by creating a new and simplified workflow within the pharmacy.

TillSense is currently installed in 48 pharmacies nationwide, surpassing Navi’s target of 40 installs by year end.

Access wide range of products 24/7 on UDW.ie

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Dynamic 100 Colum Clarke, McCartan’s Pharmacy, Portmarnock Colum is described as someone who always goes above and beyond for both his staff and community. His care and diligence to people is next to none, the knowledge he has about all pharmacy products including beauty is un-rivalled. The team in Portmarnock is a small one and he helps all of his colleagues with all their individual jobs.

The following is just one of the many messages received from customers who wish to show their appreciation to Colum and all he has done from them over the years. “Colum is very much a treasured friend in our ‘family’ and there are four families and three generations who know him well. Nothing is ever a problem ‘cool under pressure’ is how I would describe him and such a kind hearted individual. We lost 2 parents last year, medication in blister packs constantly changing.

Colum would say ‘are you going into Dunnes? Give me 15 mins and I’ll have it sorted’. That level of care and service is a rarity in today’s world.”

Paul Coleman, Business Development Manager, Navi Group Paul is the newest member to Navi’s ever-expanding field team. Joining early in 2024 as Business Development Manager for the Munster region, Paul’s impact can already be felt across his Axium Buying Group customers.

Paul excels in helping his pharmacies to prosper through operational excellence. He prides himself on helping increase his pharmacies’ margins and efficiency through correct operational practices and his vast range of retail pharmacy knowledge, built up through years of experience with Scope, Life and Ocean Healthcare, giving him a well-rounded perspective on how to help his pharmacies.

This experience has helped Paul enhance Navi Group’s brand awareness of its platforms and services across the Munster region, with Paul helping to generate huge interest in Navi’s newest additions to the community pharmacy market: DispenSense and TillSense.

Anna Cotter, McCabes Pharmacy, Newcastle Anna has successfully implemented various strategies to make the pharmacy run more efficiently. She has successfully improved the dispensing process via applying Lean Manufacturing Tools. In order to be able to do this, she underwent Green Lean Six Sigma Belt course in January 2023 and received a certificate of completion in May 2023.

She has trained McCabes Newcastle Staff to help them advance according to their interests, and at the same time to improved productivity in the pharmacy. During that informal training in the workplace, she applied mentoring tools to ensure the learning is more effective and its’ effects last longer. Anna was able to do that thanks to completing the Professional Diploma in Coaching and Mentoring in Kingstown College (diploma received May 2023).

Ever since starting maternity leave in November 2023, she has made it a point to stay in tune with the Irish community pharmacy, engaging in various projects, including IIOP Mentoring Programme 2023/2024 as a mentor and Mentoring Ambassador.

Delivering to every corner of Ireland.

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James Coughlan, Supervising Pharmacist, Hickey’s Pharmacy, Johnstown James was a Finalist for the Reckitt Community Pharmacist of the Year Award at the 2024 Irish Pharmacy Awards. He exemplifies excellence in community healthcare, having made an extraordinary impact on public health over the past year. James transformed the store’s Winter Flu and COVID booster service, growing vaccinations from 230 in 2021/22 to an incredible 250% increase and the highest in Uniphar’s pharmacy network in 2023/24. This success was driven by James’s leadership, strategic planning, and proactive approach, including walk-in vaccinations, open online bookings, and innovative outreach initiatives such as school and residential care clinics.

James’s dedication extends beyond vaccinations. He championed in-store services like pneumococcal, shingles, and travel vaccinations, and introduced cholesterol and blood sugar testing, addressing community health needs comprehensively. By partnering with the “Healthy Meath” programme, James showcased his passion for promoting preventive healthcare, engaging local gyms and trainers to maximize reach.

Inside the pharmacy, James is a trusted healthcare advisor, sought after for his expertise on medication management and patient care. His efforts in training his team on new services have cultivated a culture of exellence, ensuring high-quality care for every customer.

Gobnait Cronin, Pharmacy Manager, Hickeys Pharmacy, Ballyphehane Gobnait is an exceptional store manager, leading a thriving pharmacy in Ballyphehane, Co. Cork. With expertise spanning both dispensary and retail operations, she ensures seamless integration of both elements to deliver outstanding results. Her ability to balance operational efficiency with exceptional customer care is at the heart of her success.

Gobnait leads her team with empathy, emotional intelligence, and clarity. She excels in building strong relationships with colleagues, fostering a culture of trust and mutual respect. Her open communication style and proactive approach empower her team to excel, ensuring they are engaged, well-trained, and aligned with store goals.

Under Gobnait’s leadership, the store consistently achieves key performance metrics such as prescription volume, pharmacy service provision, front-of-shop sales growth, and loyalty card uptake.

She encourages innovative strategies, such as link selling and loyalty promotions, which drive customer retention and differentiate the store from competitors.

Gobnait’s dedication to customer service is unmatched. She ensures every interaction is meaningful, from offering expert advice in the dispensary to anticipating retail customer needs. Her team follows her example, delivering a high standard of care that builds loyalty and enhances the store's reputation.

Professor Sally-Ann Cryan, Professor of Drug Delivery and Pharmacoengineering, School of Pharmacy and Biomolecular Sciences, RCSI Professor Cryan is part of a team of pharmacy researchers who this year have investigated the potential for a specific host-directed therapy to stimulate the immune system to eliminate tuberculosis (TB), while minimising harmful inflammation as one way to help bypass antibiotic resistance and complement existing treatments.

RCSI researchers used a technique called ‘microfluidics’ to manufacture inhalable biodegradable nanoparticles (NPs), containing the vitamin A derivative ATRA, that are small enough to be used in a nebuliser and reach the alveoli in the lung. The research shows that despite their susceptibility to TB infection, alveolar epithelial cell defences can be boosted by ATRA to efficiently eliminate the bacteria. The results are promising for future research into ATRA-loaded NP formulations as inhaled host-directed therapies for TB.

Karen Doherty, General Manager, McCabes Pharmacy Group Karen has been instrumental in the development and growth of the McCabes Pharmacy over the past decade overseeing the day to day operations of their pharmacy network and growth of their online offering. In the past year Karen has led the Business and kept the teams focused whilst the acquisition and merger with LloydsPharmacy under PHX Ireland was underway. Karen is highly experienced, passionate leader with many years in Pharmacy sector and has a positive action orientated can do attitude focused on delivering commercial growth and exceptional patient care.

She has played a pivotal role in the roll out of the McCabes Way Customer experience framework with McCabes colleagues and is and has been heavily involved with the integration of both McCabes and Lloyds teams.

Striving for the highest standards in operational excellence and quality.

United, we do better

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Dynamic 100 Enda Donnellan, Donnelly’s Pharmacy, Portmarnock

Enda took on the role , covering for Donnelly’s Pharmacist who has many years experience, seamlessly. He is always patient despite working in a high-volume dynamic environment. He takes the time to explain both HSE and Company directives to all the staff members.

Donnelly's has a significant proportion of elderly customers and Enda takes the time to explain any of their concerns regarding medications, and is very empathetic. He goes above and beyond the community pharmacist role. He has also promoted and arranged to hold open consultations with anyone from the local community about Dementia.

Orla Doyle, Area Manager, United Drug Wholesale Orla is an established Area Manager with United Drug for the past 5 years with a proven track record of enhancing customer satisfaction. Passionate about fostering strong relationships with customers. Orla believes in a customer – centric approach that prioritises understanding client needs and delivery tailored solutions. When pharmacy’s leverage all of Orla’s supports they can improve their margin and operations, ultimately driving business growth

Orlagh Dunne, Sales Manager, United Drug Wholesale Orlagh joined United Drug Wholesale in a newly formed role of Sales Manager in April this year. She leads a team of talented sales professionals, providing guidance, coaching, and mentorship to help them achieve their full potential. Known for her motivational leadership style and ability to inspire and empower her team, Orlagh encourages a culture of collaboration, accountability, and continuous improvement.

Orlagh worked on the launch of Profitlines Plus on the Pharmax website which provides customers with a quicker and easier front of shop ordering tool.

Adrian Dunne, Managing Director, Adrian Dunne Pharmacy Group Adrian Dunne Pharmacy Group had no less than seven pharmacies names as a Top 100 Finalist for the 2024 Retail Excellence Ireland National Retailer of the Year Award.

The Adrian Dunne Pharmacy team in Trim won the 2024 Uniphar Training & Development Award.

Managing Director Adrian Dunne acquired his first pharmacy in October 1999 having qualified as a Pharmacist several years prior. This marked the start of the Group’s journey. Fast forward 25 years, and Adrian and his team now serve 13 local communities, each one dedicated to providing exceptional care.

Backed by size and scale, part of PHOENIX group, we deliver health.

77 Ola El-Garawany, Supervising Pharmacist, Lillys Pharmacy, Ratoath Ola and her team were Finalists for the 2024 Online Pharmacy Retailer of the Year Award.

The pharmacy team at Lilly’s bring some very unique things to the table. Lillys is a health store and also uniquely, have a functional medicine practitioner in store in Ola the owner/pharmacist, and as a result they are able to offer some specialised supplements that are practitioner only brands, combined with the knowledge to recommend and sell these products.

The team have recently launched a Made in Ireland section which is comprised of over 20 Irish brands that they support. It is a passion to support local and as a small Irish business. From established skincare brands to start up supplement brands, Lillys pharmacy will always support. They also offer a huge range of specialist skincare and are also looking to get into aesthetic skincare.

Kevin Finnegan, Parmacist, Finnegan’s Pharmacy, Sallynoggin Kevin has been recognised for his outstanding service and dedication to the health and well-being of customers in Sallynoggin and the broader south Dublin community. Kevin exemplifies excellence in pharmacy practice, and his commitment to innovation and patient care is deserving of this esteemed recognition.

Kevin’s same-day, free prescription delivery service has transformed healthcare access for countless individuals across south Dublin. This offering is especially crucial for those with mobility issues, time constraints, or urgent medical needs, ensuring that everyone can receive essential medications promptly and without additional cost. His proactive approach in removing barriers to healthcare access demonstrates a deep commitment to his patients’ well-being.

In addition to his innovative delivery service, Kevin collaborates closely with the Irish Heart Foundation to organize free health screening events for Sallynoggin residents twice a year. These screenings provide invaluable opportunities for individuals to check their cardiovascular health, offering preventive care and early intervention that could be lifesaving.

Alan Franklin, ARC Claims Manager, United Drug Wholesale An established professional in the healthcare industry for the last 13yrs, positioned currently as the ARC Pharmacy Claims Business Support Manager with United Drug. Alan has a strong background in pharmacy operations and claims processing and brings a wealth of knowledge and experience to his role.

Alan is known for his strategic approach to problem-solving, exceptional leadership skills, and unwavering commitment to delivering high-quality service to customers. He is dedicated to staying abreast of industry compliance and best practices, continually seeking opportunities to enhance the performance and effectiveness of dispensaries.

Colin Galligan, CEO, Chemist Warehouse Ireland Colin graduated with a PhD in Pharmaceutics from The School of Pharmacy University of London.

Chemist Warehouse’s expansion in Ireland reflects the brands growing popularity and commitment to providing exceptional customer service and accessible healthcare and pharmaceutical products at competitive prices. To date the chain has 12 outlets in Blanchardstown, Henry St., Dun Laoghaire, Ashbourne, Navan, Ballincollig, Mallow, Carlow, Cork City, Artane, Drogheda and Talbot St., Dublin.

Colin leads with professionalism and a passion for retail pharmacy. Chemist Warehouse is indeed a progressive company with a dynamic leader at the forefront.

Dedicated, experienced customer care team.

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Dynamic 100 Laura Garrett, Operations Manager of the ILP Group Laura joined Uniphar in May 2016, where she was employed as Territory Manager for the Independent Life Pharmacy Group, covering the South and West regions. She had previously worked as an Area Manager for the Lloyds Pharmacy Group and was in that role for the previous 8 years in which she experienced the pharmacy business during times of upheaval and huge change. The main objective of the ILP Territory Manager role is to advise pharmacy owners on their businesses in terms of maximising sales, margin and efficiency, a role that Laura really enjoyed and remained in, for 5 years.

In Jan 2022, Laura was promoted to Operations Manager of the ILP Group where she has overall responsibility for the day to day running of the brand and acts as liaison between Uniphar and the Life owners to devise the strategic direction of the brand. Laura works collaboratively with the ILP Board of Directors to make sure that they are delivering the best in service to each member. Since 2022, the number of pharmacies within the brand has grown from 87 to 103. The Group was also voted #2 in the 2023 Customer Experience (CXi) Survey and was the #1 Retailer of the year Due to the growth in the number of pharmacies with the group, Laura now looks after a team of 4 Territory Managers and 2 Administrators.

David Gilsenan, Pharmacist, Hiltons Pharmacy, Cornelscourt David’s pharmacy team won the Viatris 2024 Community Pharmacy Team of the Year Award 2024. Hilton’s Pharmacy is a community pharmacy, which to them means that they strive to provide exceptional pharmaceutical care to their community, demonstrating a commitment to delivering a personalised service for their patients, accurate medication dispensing and compassionate patient counselling.

Their goal is to enhance the health and well-being of every patient they serve.

Through dedication, teamwork and a patient centred approach, they strive to be a trusted pillar in our local community supporting all of their patients on their healthcare journey. The team embrace every challenge with a smile and a laugh along with a dedication to deliver what is asked of them. It is this togetherness and enjoyment of each other’s company that has allowed the business to thrive.

Daniela Haruta, Allcare Pharmacy, Drogheda Daniella is a cornerstone of the Allcare Drogheda team, working seamlessly with two pharmacists to ensure their regular customers receive the highest level of care and support.

Her dedication to operational excellence and patient-centred service is evident in every aspect of her role.

Daniella’s expertise lies in managing essential operational tasks that keep the pharmacy running smoothly, including stock ordering, prescription preparation, and overseeing the claims process. Her meticulous attention to detail ensures accuracy and efficiency, allowing the pharmacists to focus on patient care and delivering critical services.

In addition to her operational contributions, Daniella plays an integral role in supporting the pharmacists as they provide a wide range of pharmacy services. Whether assisting with vaccination clinics or advising customers on their health needs, she brings a collaborative and proactive approach that enhances the overall patient experience.

Daniella’s ability to balance her behind-the-scenes responsibilities with direct customer support makes her an invaluable asset to the Allcare Drogheda team. Her commitment to maintaining high standards and her genuine care for both colleagues and customers ensure that everyone feels supported and valued.

Delivering best in-class products, service, and support for optimum patient care.

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Peter Hynes, Chief Procurement Officer, Navi Group Peter joined Navi in 2019 with responsibility for the ethical purchasing for the Axium Buying Group. During this time Peter has built a strong team, servicing members through improved terms and margins for pharmacy.

More recently, Peter has been promoted to Chief Procurement Officer, and in the last 12 months has taken on responsibility for all strategic sourcing activities on behalf of the Axium, aXel, CarePlus and StayWell partners.

Peter is now working with a new team to bring the benefits and logic that has been so successful in the ethical side of the business to the OTC / FOS side of the business to maximise members’ returns.

Reggie Ismailov, Solutions Manager, United Drug Wholesale As solutions manager for Pharmax, Reggie has been instrumental in troubleshooting and helping find resolutions within the Pharmax, compliance based buying group system.

He provides support to the hundreds of Pharmax members including calls and from customers. Reggie is prompt and efficient, always courteous, listening attentively to customers' concerns and feedback ensuring that their needs are understood and addressed appropriately. Reggie's thorough knowledge of products, services, and company policies allows him to provide accurate and helpful information.

Jill Jennings, Hickeys Pharmacy, Johnstown Jill has really embraced the expansion of the pharmacists’ role in the Johnstown community. She played a strong role in the delivery of both Covid and flu vaccinations in the store. In addition to her fantastic vaccine performance, she has carried out many health checks in conjunction with the ‘Healthy Meath’ initiative funded by Meath County Council and the Irish Pharmacy Union.

Jill has had a tremendous impact on not only the pharmacy’s business, but the Johnstown community. Her commitment to educating staff and patients on the importance of overall health, and in particular gut health, has seen the business’ performance thrive. Jill’s dedication to continuous learning and remaining up to date with the latest advancements in pharmacy is evident in her everyday pharmacy practice. She is willing to share her knowledge and expertise with the Johnstown team so that the team stay informed and provide evidence-based advice for patients.

Investing in latest innovation and processes for safe and timely delivery.

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Fathimah Kara, Pharmacist, Reidy’s Pharmacy, Rathcoole Fathimah once again over the past 12 months has shown unwavering commitment to the pharmacy profession and industry and all her patients. Her fundraising has continued to grow in strength, and she raised over ¤3,000 for various charities such as Pieta House by completing 5 and 10km runs and other fundraising events. Her service to the local community has grown aswell through sponsorship of local sports teams such as Rathcoole Football Club by sponsoring their events, donating prizes and sponsoring team jerseys and donating first aid kits free of charge.

The year has been hugely successful for Fathimah and her team where they were one of four pharmacies short-listed for ‘Pharmacy of the Year’ at this years Irish Healthcare Centre Awards and they are ending the year being finalists in the 2024 the Family Business Awards, Customer Experience Awards and Irish Pharmacy Excellence Awards in various categories.

Brian Kearney, Supervising Pharmacist, McCauley’s Pharmacy Tralee With over 15 years of dedicated service in store, Brian, Pharmacist at McCauleys Tralee, has become a cornerstone of his local healthcare community. His unwavering passion for patient-centered care has not only driven the growth of the pharmacy but has also cemented his reputation as a trusted and respected healthcare professional.

Brian’s commitment to his patients is second to none. Regardless of changes in the team around him, he has consistently delivered exceptional care, fostering loyalty among a growing number of patients who trust his expertise and compassion. His dedication extends far beyond the pharmacy counter—he often goes above and beyond, dedicating personal time to follow up on patient needs, liaising with doctors, and ensuring the best possible outcomes for those under his care.

Brian’s leadership has inspired everyone around him. His enthusiasm for pharmacy practice and his commitment to high standards have had a profound impact on his colleagues in both the dispensary and OTC. Through the training he provides and the example he sets, Brian has created a culture of excellence within the pharmacy team.

Professor Helena Kelly, Head of the School of Pharmacy, RCSI Professor Kelly was appointed earlier this year and succeeds Professor Tracy Robson, who was recently appointed Deputy Vice-Chancellor for Academic Affairs at the university. She will lead the School of Pharmacy and Biomolecular Sciences in its ambition to be recognised internationally as a leading centre for pharmacy education, research and innovation.

A registered pharmacist, Professor Kelly undertook her PhD in the area of stimuli-responsive hydrogels and sustained drug delivery. She spent eight years in the pharmaceutical and biopharmaceutical industry before returning to academia in 2008.

In March 2022 she was appointed as Deputy Head (Programmes Innovation) in the School of Pharmacy and Biomolecular Sciences with responsibility for the implementation of two new programmes, an MSc in Technologies and Analytics in Precision Medicine and a BSc in Advanced Therapeutic Technologies.

Professor Kelly’s research focuses on the use of delivery platforms in translational research applications.

Compliance based buying group

81 Emily Kelly, Superintendent Pharmacist, McCauley’s Pharmacy Emily Kelly is a pharmacist with board and senior management experience who is dedicated to making a meaningful impact in the pharmacy sector. Emily's career has taken her across Europe, with positions held in Italy, Germany, Belgium and Ireland. Emily is a mentor and peer support pharmacist with the IIOP and believes in lifelong learning. She currently works as a Superintendent and community pharmacist in Dublin. Emily is a pharmacist appointee to the PSI Council of Ireland and the Dublin representative on the IPU Employee Committee.

Gráinne Kelly, Pharmacist, Hickey’s Pharmacy, Northside Gráinne, the pharmacist in Hickey’s Northside, exemplifies exceptional patient-centered care, creating a trusted and welcoming environment for all. Over the years, her unwavering dedication has solidified relationships with patients who rely on her expertise for their healthcare needs. Gráinne provides a wide range of pharmacy services, including vaccinations for flu, COVID-19, shingles, and travel, ensuring her community has access to vital preventative care. She also leads initiatives such as blood pressure monitoring and compression stocking fittings, further enhancing patient health. Gráinne's collaboration with local GPs has been instrumental in supporting public health campaigns. She maintains open communication with healthcare professionals, providing a seamless link between patients and their wider care network. During vaccination drives, GPs often refer patients to Gráinne’s pharmacy, knowing they will receive the highest standard of care.

Her ability to handle challenges with professionalism is unparalleled. For example, she once managed a patient with high blood pressure who was too anxious to visit the hospital. Gráinne’s calm approach and direct communication with the patient’s GP ensured they received appropriate care promptly. In addition to her patient care expertise, Gráinne is a leader and mentor within her team, fostering a culture of learning and collaboration.

She supports the training of new staff, including interns and pharmacy technicians, creating an environment where everyone can thrive.

Sarah Kenny, Retail Operations Scheduling Manager, McCabes Pharmacy – formerly LloydsPharmacy In her first year in this newly created role, Sarah has demonstrated exceptional leadership, innovation, and analytical skill, delivering significant operational and financial improvements to the business. Her work has reshaped the centralised pharmacist rostering system, optimised staffing processes, and introduced strategic cost-saving measures, setting a new benchmark across the McCabes Pharmacy organisation.

One of Sarah’s primary achievements has been the establishment of a centralised pharmacist rostering system—a complex undertaking that required not only a shift in operational processes but also a cultural change among store teams, support office staff, and locum providers.

Sarah’s impact extends beyond operational efficiency; her initiatives have also delivered measurable financial benefits. Sarah Kenny’s remarkable analytical abilities, strategic thinking, and leadership in retail operations have produced outstanding commercial results in her short tenure.

Ciara Kirke, Clinical Lead, National Medication Safety Programme/Project Lead, iSIMPATHY, HSE Ciara is the Project Lead on the HSE iSIMPATHY project – A cross border initiative reviewing patients’ use of multiple medicines which has improved the safety of patients by reducing adverse drug reactions.

Launched in 2024, the evaluation report from the project showed 77% of interventions by HSE clinical pharmacists led to improved patient care; 4% of interventions prevented major organ failure or serious adverse reaction and saved over ¤1.2m due to fewer adverse drug reactions and admissions to hospital.

Patients reported significant improvements in their understanding of their medicines, increased ability to engage in daily activities and reduced side effects, following the reviews.

Full offering of ethical, OTC and front of shop products on one platform

United, we do better

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Dynamic 100 Adam Lambert, Head of Commercial – Front of Shop Retail, Uniphar Supply Chain & Retail Adam joined the Uniphar Supply Chain & Retail team in 2023 as part of the acquisition of the McCauley Health & Beauty Pharmacy Group in the role of Head of Commercial for Front of Shop Retail for the enlarged network.

After a career of over 20 years with McCauley Group during which he gained huge experience across Stores, Operations and Commercial management roles Adam is now responsible for the commercial strategies for Front of Shop retail for the Allcare, Life, Hickey’s and McCauley Groups.

During his time in McCauley, Adam was integral in helping evolve the group from four to thirty-seven stores and was involved in many key projects both commercially & operationally including re-branding, large – scale refits and acquisitions.

Adam brings a huge passion for the Retail Pharmacy sector with a focus on growth by fostering a positive work environment within the team coupled with the drive for continuous innovation in a competitive environment.

He is now focusing on growing the commercial front of shop business across all of the store groups under the Uniphar Supply Chain & Retail umbrella.

Maria Lettice, Technical Product Sales Specialist, Navi Group Maria has been a leading, dynamic figure in the major success of Navi Group’s innovative new systems being launched in community pharmacy, DispenSense and TillSense, over the last 12 months.

Maria has been instrumental in the onboarding and relationship management of Navi’s software customers, bringing copious amounts of technical and industry knowledge to her role, helping pharmacies to maximise their DispenSense and TillSense systems.

Maria has also leveraged her relationships and industry knowledge to further differentiate DispenSense and TillSense in the market, bringing further innovation to coincide with DispenSense’s already impressive array of new features in the market, such as Healthmail integration, Kanban workflow management and being first to market with the free contraceptive scheme and A4 receipt printing functions.

Agnese Liepina, Pharmacy Technician, Allcare Monasterevin Agnese embodies diligence, compassion, and unwavering support for both customers and colleagues. Known as the pharmacy's unsung hero, Agnese consistently goes above and beyond, making her an indispensable part of the team.

One extraordinary example of her dedication is when Agnese acted decisively during a medical emergency, saving the life of an elderly customer. Despite having no prior knowledge of the woman’s medical history, Agnese relied on her expert training in first aid and emergency medicine supply to ensure the patient’s full recovery. Throughout the ordeal, she maintained a calm and reassuring presence, creating a safe and comforting environment for all involved.

Agnese’s exceptional qualities extend far beyond emergencies. Her friendly demeanor and endless patience shine when training new team members, making them feel welcome and confident in their roles. A lifelong learner, she balances full-time work with her studies, excelling in her exams while continuously expanding her knowledge and skills as a technician.

Elaine Lillis, Superintendent Pharmacist, Meaghers Pharmacy Group Elaine Lillis MPSI is Superintendent pharmacist for the Meaghers Pharmacy Group. Having joined the Meaghers team 12 years ago as an intern pharmacist Elaine has grown with the company and in each role, she has held in that time contributed to its success. Leading a team of 20 pharmacists across nine stores she inspires confidence, respect, and the admiration of her colleagues. Dedicated to delivering excellence in patient care Elaine has introduced many new health services to the Meaghers group including an innovative partnership with Health Beacon to drive patient compliance for those using injectable medications. Her innovative approach earned Meaghers the title of Winner of innovation in services at IPN awards. As well as adding additional services to the Meaghers portfolio for the benefit of our local community Elaine has worked hard to engage with community groups to deliver education and her expertise to help their members and reinforce the special position of the pharmacist in the community.

Elaine is incredibly passionate about the future of Irish Pharmacy and works with TCD educating and developing future pharmacists.

Added Value services from buying groups to claims management tools.

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Sonya Lynch, Senior Key Account Manager, United Drug Wholesale Since joining United Drug Wholesale earlier this year Sonya has been responsible for overseeing a portfolio of accounts and ensuring their success and satisfaction. She has been adept at collaborating with cross functional teams to work on solutions to exceed customer expectations. Sonya has consistently identified opportunities to expand the scope of services to UDW customers.

Sarah Mackessy, Boots PharmacyWellpark, Galway Supervising Pharmacist, Sarah Mackessy is a deeply committed, professional and passionate community pharmacist in one of Boots newest stores. No matter what service or initiative the business launches, Sarah has proven that she is a true advocate for ensuring accessible healthcare for all in her community, and is a constant champion of her colleagues in her team.

Key to her success is the time and care she takes to talk to patients about services, the efficiency of her delivery of services and the accessibility she ensures with appointment availability spread throughout the day, before and after work and at lunchtimes.

She ensures the workload of the pharmacy is exceptionally well planned to support this.

Clodagh Maguire, Business Development Manager, Navi Group Clodagh joined Navi group in 2021, bringing vast experience from her time in Cahill May Robert’s and Uniphar. Since coming into her role as Business Development Manager, Clodagh has helped further cement Axium Buying Group as Ireland’s Number 1 community pharmacy procurement platform.

Clodagh has also positioned herself at the forefront of innovation in community pharmacy, helping to launch the newest dispensary and EPOS software solutions to the market. Furthermore, Clodagh has aided the advancement of Navi’s footprint through their array of additional services, such as symbol groups CarePlus and StayWell, as well as their highly regarded iGnite business intelligence system.

Clodagh prides herself on her relationship management, being a trusted adviser to her pharmacies and helping to add value through margin enhancing opportunities, operational efficiencies and her wealth of retail pharmacy experience.

Áine Martin, Head of Operation, McCabes Pharmacy – formerly LloydsPharmacy As a skilled pharmacist and inspiring leader, Áine has driven transformative initiatives across the organisation, with a steadfast focus on patient safety, regulatory compliance, and service quality.

Her leadership has been instrumental in building a robust structure of processes, illustrating that patient-centred care and operational excellence go hand in hand. Under Áine’s guidance, the Pharmacy Operations Team has set a new benchmark in Irish pharmacy, aligning with best practices and advancing innovation in safety and service delivery. Áine’s leadership in embedding a comprehensive, safety-focused platform has transformed operational practices and patient outcomes across McCabes locations. Recognising the need for an organization-wide safety approach, she championed a system redefining clinical governance, safety standards, and accountability. Áine's commitment has ensured that each pharmacy team has the tools and support necessary to maintain the highest care standards, resulting in improved consistency, reliability, and regulatory compliance.

Under Áine Martin’s leadership, the Pharmacy Operations Team has achieved significant improvements in patient care, operational efficiency, and compliance. Her strategic vision has transformed practices, establishing a culture of excellence that benefits patients, staff, and the broader community.

United, we do better

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Louis Martin, Retail Director, Uniphar Louise joined Uniphar 4 years ago as Consumer Business Unit Manager and doubled the company’s turnover and profit within 2 years. In 2022 she was appointed Retail Director, reflecting her ability to drive growth and manage large scale operations. In her role, Louise is responsible for the largest Irish owned community pharmacy network with over 270 pharmacies across Allcare, Hickey’s, McCauley and independent symbol partners Life Pharmacy.

Known for her energy, passion for pharmacy retail, and customer-centric approach, Louise is dedicated to delivering operational excellence and fosters a collaborative, commercially-driven team culture. Her focus on positive work environments and cross-functional teamwork underpins her leadership style, making her a key figure in shaping Uniphar’s retail success.

Caomibhe McAuley, Director of Pharmacy/Superintendent Pharmacist, Boots Ireland Caoimhe’s leadership has pioneered affordable pharmacy services to communities across the country and has overseen record numbers of patients accessing services and prescriptions at Boots. Under Caoimhe’s direction, more patients than ever before can now access vaccinations in their local Boots community pharmacy. She continues to lead innovation in community pharmacy, recently launching a national liver scanning service at Boots, connecting pharmacy to multidisciplinary healthcare colleagues to promote awareness of the importance of liver health.

A champion of women’s health issues, including menopause and fertility, Caoimhe has spearheaded the ‘Let's Make Menopause Visible’ campaign at Boots.

Passionate about community pharmacy, Caoimhe works to ensure it plays a key role in the ever-evolving healthcare landscape. She currently sits on the Executive Committee of the Irish Pharmacy Union and the HSE Community Pharmacy Planning Forum. Under Caoimhe’s stewardship, Boots Ireland has been named Ireland’s most reputable pharmacy in the Ireland RepTrak® 2023 annual study.

Niall McCabe, Head of Central Operations, Uniphar Niall Joined Uniphar in 2017, as Management Account within the Group finance function, and has since held various finance roles within Uniphar with a focus on warehouse operations, bringing structure and a new way of monitoring performance within the business.

In 2021 Niall moved into the Retail Division, as Senior Finance Business Partner. His main focus was driving margin optimization and cost control, where he introduced safeguards to ensure compliance across both, enhancing EBITDA growth across our owned network of pharmacies. Niall has been a key part in the integration of our pharmacy acquisitions, aligning process and reporting across brands to provide one central view of the business. Niall was promoted to Head of Central Operations in 2023 where he manages cost control, payroll and projects. He has put a lot of structure in these areas, during a difficult period in the market, and is making significant headway in all areas.

Ireland’s No.1 Provider of Ostomy Products & Services

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Finn McCann, Chief Technology Officer, Navi Group Finn McCann is the Chief Technology Officer at Navi Group. In 2021, Finn spearheaded the development of DispenSense, Ireland’s newest dispensary software system. DispenSense was created with one main goal: making pharmacy easier.

DispenSense is a cloud-based system making dispensing to patients, reliable safe and efficient. Some of the most recent dynamic features of the system developed in the last 12 months include: allowance for Healthmail integration, claiming of the free contraceptive scheme, a nursing home module and head office functionality, as well as the software being owing’s compliant for the PCRS. This dynamic innovation is a welcomed improvement allowing its users to direct their time to more patient-focused priorities. DispenSense has been successfully installed in 53 pharmacies so far, with a target of 55 installs by year end.

DispenSense is not just the dispensary system for today but the dispensary system for the future.

John McCourt, Millmount Pharmacy, Drogheda John’s professionalism and ongoing awareness of changes in pharmacy, including changing legislation, code of conduct, drug shortages, price changes and upcoming de-regulation of drugs is unparalleled. He leads by example by re-enforcing the professional culture the pharmacy team has developed in all 3 stores. His extremely approachable personality in many situations albeit sensitive or otherwise is a very special trait he possesses. John will always use negative experience as a learning tool and an opportunity to grow confidence and self-belief in his fellow colleagues, if any errors or near misses occur.

He is an integral part of the team and has been the driving force behind growing the dispensary business in Millmount Pharmacy.

John was a Finalist in the 2024 Perrigo Superintendent Pharmacist of the Year Award.

Paul McKay, Supervising Pharmacist, Hickey’s Pharmacy, Drogheda Paul delivers outstanding care and growing a thriving pharmacy business. In a high-street location where transient customers are common, Paul’s empathetic and solution-focused approach has earned him a loyal customer base who return each month, trusting his recommendations and comprehensive care.

Paul’s ability to balance the demands of a substantial OTC business while maintaining exceptional service for his regular customers is a testament to his dedication and skill. His focus on providing complete healthcare solutions ensures customers receive tailored advice and products that address their needs effectively.

A key driver of the store’s success is Paul’s commitment to expanding pharmacy services. From vaccinations to health screenings, Paul ensures his customers have access to essential healthcare benefits. His ability to seamlessly integrate these services into the business adds immense value for the local community, further cementing the pharmacy’s role as a trusted health destination.

Equally noteworthy is Paul’s dedication to colleague development. He takes pride in mentoring his team, supporting Pharmacy Technicians, Pharmacy Healthcare Advisors, and pharmacy interns to develop their skills and grow in confidence.

Complimentary cutting on average 10,000 ostomy bags a week

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Dynamic 100 Kevin McDonnell, Supervising Pharmacist, Allcare Pharmacy, Tonlegee Kevin has been the steady hand guiding his pharmacy through change and growth. When the pharmacy was acquired by Uniphar in 2023, Kevin’s exceptional leadership ensured a seamless transition for his patients, who continued to receive the same high standard of care they had come to expect. His ability to manage change effectively kept the pharmacy’s performance strong and consistent during this critical period.

Kevin is more than a pharmacist; he is a cornerstone of care in the local community. His genuine commitment to patient well-being is evident in his approach to fostering a welcoming environment built on empathy and trust. Greeted by name, Kevin’s customers know they are not just patients but valued members of the pharmacy’s extended family.

Under Kevin’s guidance, the pharmacy has continued to thrive, meeting the needs of a growing and diverse customer base. His leadership extends beyond the dispensary, creating a culture where his team feels supported and empowered to deliver exceptional service.

Kevin’s dedication to patient care and his ability to navigate the challenges of change have solidified his role as a trusted healthcare professional and community leader. His steadfast commitment ensures that Allcare Tonlegee remains a beacon of care and reliability in the local area.

Mark McPhillips, Mark’s Pharmacy, Ardee Mark was the winner of the 2024 Perrigo Superintendent Pharmacist of the Year Award.

Mark’s contributions to public health over the last year are extensive and multifaceted, highlighting his role as a community leader in healthcare. In summary, his role has been exemplary in promoting public health. His mentoring of pharmacists and interns, involvement in setting professional standards, introduction of specialised health services, commitment to community education, and pursuit of professional development, collectively underscore his profound impact on community health and the pharmacy profession.

Mark’s impact on Mark's Pharmacy and the Ardee community over the past year has been significant and multifaceted. His leadership and innovations have led to measurable improvements in both business performance and community health outcomes.

Philip Morrissey, National Sales Manager, Navi Group Philip joined the Navi team 4 years ago as a Business Development Manager. His success in supporting independent pharmacies was rewarded this year when Philip was promoted to National Sales Manager. In this role, Philip demonstrates outstanding leadership skills on a daily basis where he manages a team of five Navi Business Development Managers who are regionally based.

A key part of Philip’s role is understanding the busy nature of independent pharmacy and having a team of industry experts on hand to support our members. In doing so, Philip and his team work to deliver margin enhancing opportunities and operational efficiencies to Navi members nationwide.

Unrivalled support for customer care queries

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Tom Murray, Pharmacist, Murrays Pharmacy Ramelton Tom was appointed President of the Irish Pharmacy Union in early 2024. Mr Murray, a community pharmacist based in Donegal, will lead the IPU at a pivotal time for the profession, with major changes to the role of pharmacists expected in the coming years.

Within this role, he has led the profession on lobbying for Government recognition in areas such as pharmacy funding, the utilisation of pharmacy skills, streamlining of HSE reimbursement processes and a more proactive approach to medicine shortages. Tom has been a pharmacy owner, based in Donegal since 2001. He first qualified as a pharmacist, from Manchester University in 1995. He has previously served in a number of roles with the IPU including chair of its Finance Committee.

Frank Olden, Hickey’s Pharmacy, Cork Over the last 12 months, Frank Olden has made significant contributions to public health and pharmacy practice, demonstrating his commitment to advancing the profession and enhancing patient care.

Frank’s contributions over the past year encapsulate a blend of clinical excellence, educational mentorship, and proactive community engagement. His work in public health initiatives, educational roles, and clinical practice reflect his strong character, professional accomplishments, and deep understanding of the goals of pharmacy. He exemplifies the evolving role of the community pharmacist in healthcare.

Frank has had a profound impact on both Hickeys Pharmacy and the Cork community. His leadership has led to increased business efficiency and growth, while his community initiatives have significantly contributed to public health awareness and education. Frank’s influence extends beyond the walls of the pharmacy, cementing his role as a crucial healthcare provider in the community.

Paul Neill, Country Manager, Teva/Chairperson, Medicines for Ireland Medicines for Ireland is the leading representative body for the generic, biosimilar, and valueadded medicines industry. Paul and the team at MFI recently highlighted the urgent need for action to address the increasing medicine shortages affecting the Irish population. He has identified a multifaceted approach to address these shortages including implementing dynamic pricing policies that encourage competition and evolving the best-value biologics process.

Under Paul’s leadership, Medicines for Ireland co-hosted the European annual conference in Dublin this year, which marked saw the organisation marking 30 years of delivering more equitable access to off-patent medicines. Paul is the Country Manager for Teva Pharmaceuticals Ireland, the largest supplier of prescription medicines to the State. Paul brings with him a wealth of practical experience gained from almost twenty years in various commercial roles in the Pharmaceutical Market – ten of these in leadership roles in Teva.

Linda O’Brien, Retail Operations Director – Owned Stores, Uniphar Linda has built a distinguished career in retail pharmacy, leveraging over 20 years of experience to drive operational excellence and foster team development. Since joining Uniphar four years ago, she has made significant contributions, initially serving as Head of Sales and Operations Manager for Hickey’s Pharmacy before being promoted in 2023 to Operations Director – Owned Stores.

Linda’s pharmacy career started at Lloyds Pharmacy, where she progressed from sales assistant to roles such as store manager, dual site manager, best practice coach, and area manager. Her leadership skills were further honed as Head of Sales and Operations, where she successfully led teams through a change management project. Linda's knowledge and understanding of the retail pharmacy landscape enables her to navigate challenges while maintaining a steadfast commitment to delivering exceptional customer and patient care. She is passionate about fostering an inclusive, supportive workplace culture and is dedicated to driving continuous improvement to position Uniphar ahead of its competitors.

Dedicated Customer Care Team 01-463247 ostomy@united-drug.com

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Michaela O’Donovan, Supervising Pharmacist, McCauleys Pharmacy, Midleton Michaela is a shining light for the future of community pharmacy in Ireland. From completing her internship in McCauleys Fermoy to excelling as a relief and support pharmacist, Michaela has now embraced her first Supervising Pharmacist role with remarkable professionalism and energy.

Michaela embodies the evolving role of community pharmacy, seamlessly blending traditional dispensing and expert patient advice with the delivery of expanded pharmacy services. Her approach reflects the future of the sector, offering patients accessible, comprehensive healthcare within their local community.

Despite her relative inexperience, Michaela has already emerged as a role model for young pharmacists.

Her leadership has been pivotal in supporting fellow interns and early-career pharmacists, guiding them through the challenges of their roles while fostering confidence and competence. Her approachable and supportive demeanor has earned her respect among her peers and patients alike.

Michelle O’Hagan, Pharmacy Hub, Killinarden Michelle is an advocate for her patient’s health, and for the health of the local community.

She is heavily involved with South Dublin County Partnership and their HSE health promotion officers. She regularly has the smoking cessation officer in the pharmacy, carrying out clinics and providing information to the community on the free HSE We Can Quit Smoking Cessation programmes. She runs vaccination clinics, all year round for covid vaccines, and the seasonal flu vaccine.

She is also an advocate for mental health and wellbeing, getting personally involved in the ’Darkness into Light’ campaign (Pieta House) every year and the ‘Hello, How are you’ campaign (Mental Health Ireland) in 2023. She organised for the Marie Keating Mobile Unit to visit the pharmacy in October 2023 (for Tallaght Health Awareness Month) to encourage breast cancer health awareness. Michelle also enrolled the pharmacy in the IPU Safe Pharmacy initiative, and ensured all staff completed the training and that our pharmacy can be seen as a safe space for those who fall victim to domestic violence.

Michael O’Kane, Supervising Pharmacist, Hickey’s Pharmacy, Dundalk Michael is an outstanding pharmacist who has consistently gone above and beyond for patients, colleagues, and the wider community. His dedication to exceptional patient-focused care in our Dundalk store has made him a cornerstone of the pharmacy team. Michael takes the time to assist every patient, from guiding them through government healthcare schemes to providing clear, empathetic advice on how to take or use their medications effectively.

With a supportive and sympathetic approach, Michael ensures every patient feels heard and understood.

He offers private consultations when needed and actively promotes the New Medication Service, personally following up with patients to ensure they are comfortable with their treatment and to address any concerns. This service has been instrumental in improving medication compliance and building longterm customer loyalty.

In addition to his patient care, Michael plays a key role in staff development, encouraging in-store training and supporting dispensary colleagues pursuing technician qualifications. He has also been pivotal in assisting patients undergoing fertility treatments, providing expert guidance on medication procurement, administration, and emotional support during their journeys—a service highly valued by patients and clinics alike.

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Adrian O’Sullivan, Buying Groups Business Development Manager, United Drug As buying group business development manager with United Drug for over 5 years Adrian has worked tirelessly to educate members about new products, services and opportunities available through the buying group Pharmax. He has most recently worked on developing and implementing strategies to enhance the buying group’s value proposition to its members, taking the members feedback on board. He works collaboratively with other departments, such as marketing and operations, to align on these strategies and objectives to ensure Pharmax is the strongest offering in the market.

Kostas Papadimas, Donaghmede Pharmacy, Donaghmede Kostas is known for giving his patients that need counselling so much more of his time, ensuring that they are confident with a new medicine, or where a dose has changed. He has a calming voice which always reassures the patient where they may have a concern. Everyone who comes in contact with Kostas will have had their day brightened by the experience.

He has built a great relationship with the local doctor surgeries and indeed has vaccinated many of the local surgery staff. Donaghmede Pharmacy is one of the busiest pharmacies in North Dublin, dispensing being the number one priority and Kostas is great at working under the most intense pressure, while also finding time to vaccinate, take blood pressure readings, serve on the OTC counter and all the other jobs required.

Jenny Percival, Ryan’s Pharmacy, Derrinturn Jenny won the 2024 Athlone Pharmaceuticals Counter Assistant of the Year Award. She has had a huge impact on her pharmacy team and the community. It is very clear immediately that Jenny goes above and beyond time and time again. Nothing is too much of an ask or too far beyond Jenny’s reach. Her pharmacy in Derrinturn is treated with so much love and attention.

To many customers, Jenny is a counsellor, a friend to listen, a source of valuable healthcare information, a “free” courier service, an out of hours point of contact, always someone to have a joke and a laugh with to brighten your day, a personal shopper, a trusted salesperson, a forward planner/budgeter (ringing customers to tell them something they might like has come in, noticing them that a sale is about to happen), a first aider, the main point of contact even for their dispensary related queries, a mother figure.

Ruth Proctor, Commercial Director, RX & OTC, Uniphar Having joined the Uniphar Supply Chain & Retail team as a Retail Buyer in 2017, Ruth has continued to grow in tandem with the extensive growth that Uniphar has seen. Having focused on the Front of Shop aspect of the Retail business for the last 7 years, Ruth has now taken responsibility for the RX Buying department, alongside OTC for the Uniphar Retail Groups McCauley, Allcare, Life and Hickey’s Pharmacies. A graduate of DCU with a degree in Business through the Irish Language, Ruth has worked in buying roles in the Pharmacy industry for the last 14 years.

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Dynamic 100 Rajesh Purcell, Head of Operations, United Drug Wholesale Rajesh joined United Drug Wholesale as Head of Operations in 2023. She has brought a wealth of knowledge to the role and has made a significant impression on the business. Since joining she has focused on continuously improving productivity and the quality and service in wholesale operations to help get the right product to the right customer at the right time.

Simona Radovici, Supervising Pharmacist, Allcare Pharmacy, Clearwater At Allcare Clearwater, Simona exemplifies exceptional dedication, balancing outstanding patient care with the operational and strategic growth of the pharmacy. Her empathetic approach and commitment to delivering comprehensive healthcare solutions have earned her the trust and loyalty of both regular and transient customers.

Simona has embraced the full range of pharmacy services, from administering vaccinations and conducting health screenings to leading the Drugs Misuse Service. She addresses diverse healthcare needs with professionalism and sensitivity, consistently enhancing patient outcomes. In addition, Simona has played a key role in the development of a non-pharmacist store manager, fostering leadership and operational excellence within her team.

In 2024, she was instrumental in coordinating a mini-refit of her own store, ensuring minimal disruption to patient care while implementing improvements that have enhanced the pharmacy’s functionality and customer experience.

Simona’s focus on colleague development is also a cornerstone of her success. She actively mentors technicians, Pharmacy Healthcare Advisors, and interns, fostering a culture of collaboration and learning. Her leadership and proactive approach have positioned Allcare Clearwater as a trusted healthcare destination and a center of professional growth.

Mairead Reen, Pharmacist, Reen’s Life Pharmacy, Cork Reen’s Life Pharmacy on Main Street raised ¤3,754 for the Jack and Jill Foundation, which supports children with neurodevelopmental delay, as part of campaign that Life Pharmacy stores across Ireland participated in.

The Life100 campaign saw stores raise a total of ¤27,540 for the Jack and Jill Foundation by partaking in various fundraising activities in their local communities including sponsored walks, cycle-thons, cake sales and raffles encouraging customers and community members to donate along the way. Reen’s in Millstreet was named as the individual store which raised the highest amount over the course of the campaign.

Paul Reilly, CEO, United Drug As the Chief Executive Officer of PHX Ireland, Paul has overseen a number of notable event during 2023, including the acquisition of McKesson Ireland by Phoenix IRL and the new branding towards PHX Ireland.

Notably in 2023, PHX Ireland, via its subsidiary of LloydsPharmacy agreed to acquire McCabes Pharmacy, bringing together two of the best known retail pharmacy brands in Ireland. In May of this year, United Drug partnered with Locus Robotics to introduce ground-breaking warehouse automation. The deployment of 21 LocusBots at the Baldonnel Distribution Centre has enhanced productivity and accuracy while improving operational efficiency and scalability.

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91 Joan Reynolds, Senior Buyer, Uniphar Joan joined the Uniphar family in 2023 as a Senior Buyer, bringing with her a decade of experience from McCauley Group and a strong commercial background honed at Tesco Ireland. Since taking on this role, Joan has transformed the skincare and fragrance categories across Uniphar’s portfolio, which includes Hickey’s, Allcare Pharmacy, Life Pharmacy, and McCauley stores, as well as our franchise partners.

Joan’s approach combines a strategic focus on customer insights with a commitment to high-quality, on-trend offerings that enhance brand loyalty and drive sales. By introducing exclusive skincare and fragrance lines, she has elevated the customer experience while strengthening the company’s position in a competitive market.

Moreover, Joan has played a key role in aligning the buying strategies across Uniphar’s diverse retail brands, ensuring a cohesive and tailored product selection that meets the unique needs of each store’s customer base.

Aishlig Ryan, OTC Buyer, Uniphar Having joined Uniphar and the Pharmacy industry in 2022, Aisling has quickly established herself across various buying roles within Pharmacy, and is now leading the OTC buying across the Allcare, Life, Hickey’s and McCauley Pharmacy groups within Uniphar. As a graduate of UCC with a degree in Law and German, and with a professional background in Buying roles in eCommerce, Aisling has used this varied experience to bring a unique skillset to her role. This varied background, coupled with her ability to adapt quickly to change has allowed her to grow with an evolving Uniphar, with the recent acquisition of the McCauley Pharmacy group. Aisling has leveraged her background in Supplier Relations and Marketing in the successful launch of many new products and brands into the Irish Market, ensuring Uniphar are consistently leaders in innovation within the Irish Pharmacy market.

Dermot Ryan, Chief Operating Officer, Uniphar Dermot joined Uniphar 12 years ago as Financial Director of the Allcare Pharmacy business, taking over as Managing Director of the Retail Services business in 2017. Since, then, he has overseen the growth and expansion of the Uniphar Supply Chain & Retail business to become the market leader in wholesale to pharmacy in Ireland with a market share of c.54%, a 10-point jump in five years. He has built a network of 413 symbol and owned community pharmacies, from just 45 in 2017, creating the largest buying group in the country. In March 2022, Dermot was appointed Chief Operating Officer for Uniphar, overseeing Uniphar global operations. In his role, Dermot has responsibility for global supply chain networks, ensuring that Uniphar moves towards common technology platforms, building a globally connected distribution and warehousing network, and maximising our service offering to clients.

Shane Ryan, Ryan’s Pharmacy, Rathangan Shane has grown the Ryan’s Pharmacy business over the last 28 years. They are now five independent community pharmacies based in Rathangan, Edenderry, Rhode, Daingean and Derrintun.

Ryan’s Pharmacy is a vital part of the community and Shane believes passionately in developing strong relationships with customers while striving to provide a service that is not only excellent but reflects their high standards and delivers on their commitment. This is tangible from the top down, from Shane throughout the team of 70 staff across five locations. Shane is the driving force behind this and he has surrounded himself with likeminded people who believe in a strong sense of community. He is overseeing investment and growth in the Edenderry pharmacy store, doubling in size, furthered Cholesterol diabetes testing within the pharmacies and is actively collaborating with GP’s with increased communications on patient medications.

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Shane Ryan, General Manager, Takeda Ireland/President, IPHA With over 25 years in the pharmaceutical industry, Shane Ryan serves as General Manager of Takeda in Ireland. His commitment to excellence and ability to inspire his team have established Takeda Ireland as a leader in the pharmaceutical industry. Under his leadership, Takeda Ireland was recognized as Life Science Company of the Year in 2024.

Shane also plays a pivotal role in the life science industry. Newly appointed President of the Irish Pharmaceutical Healthcare Association (IPHA), Shane is motivated by IPHA’s mission to enhance health outcomes through innovative treatments and advancing the Ireland as a hub for life science innovation. A champion for diversity, Shane is committed to ensuring the sector represents individuals, carers and clinicians that it serves and volunteers his time to lead initiatives which drive this goal.

Paul John Charles Sambrooks, Mahers totalhealth Chemist, Drogheda Paul has worked tirelessly to deliver the best possible pharmacy service he can. He is dedicated to his patients and takes immense pride in his role and the work he does.

He has continually demonstrated dedication to his pharmacist role, coming in early to prepare the dispensary for the day ahead to make sure the day starts the best it can and will drop what he is doing to support his team members. In little over the year, Paul has introduced positive changed and built strong effective relationships with his patients, customers and members of the local community. He has also developed excellent professional relationships with members of the Healthcare Community within the area and has ambitions to develop the sector further on a local level.

Aisling Smith, Navi Group Aisling joined Navi Group in 2017 via the Navi Graduate Programme. After completing the graduate programme, she progressed to the position of OTC Buyer, then taking up the position of Retail Operations Manager shortly thereafter. In this position, Aisling managed a large group of our franchise members, on the road daily.

Aisling took up the senior role of Head of Business Relationship Management in 2023, managing all customer relationships across franchise, broker, IT and marketing in Navi Group, demonstrating her dynamism in this role by showing her outstanding ability to manage multiple teams across different areas of the business in a holistic manner, particularly over the last 12 months

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93 Nicole Smith, Pharmacy Technician, McCauleys Pharmacy, Navan SC Nicole exemplifies the perfect blend of operational excellence and heartfelt customer care. Renowned for her precision, Nicole ensures the dispensary operates seamlessly, handling everything from safe and efficient dispensing to maintaining a 100% claims record—a testament to her diligence and expertise.

What sets Nicole apart, however, is her exceptional empathy and connection with customers. She goes beyond her technical role, creating a warm, welcoming environment where patients feel genuinely cared for. Whether checking in on regulars, offering a listening ear, or brightening someone’s day with her humor, Nicole ensures that every interaction is meaningful. For many, she is more than a technician—she is a trusted confidante and a vital source of comfort.

Beyond her technical responsibilities, Nicole has been instrumental in training OTC staff and mentoring new technicians, providing consistency for both customers and colleagues during times of change. She played a pivotal role in delivering flu and COVID vaccination programs, managing calendars, paperwork, and patient flow with unwavering professionalism.

Tracey Stack, Pharmacy Technician, McCauleys Pharmacy, Tralee Tracey is the cornerstone of her team, ensuring the seamless operation of the pharmacy while providing exceptional care to customers. Often working behind the scenes, Tracey manages critical tasks such as stock control and monthly claims submissions with precision and diligence, ensuring the pharmacy runs efficiently and patients’ needs are met without delay.

Her attention to detail and commitment to excellence are the foundation of the dispensary’s operations.

Despite her workload, Tracey always prioritizes her customers, greeting each one with warmth and genuine care. Her personal approach ensures that patients feel supported and valued, often going the extra mile to assist those in need. For many, it’s her empathetic nature and consistent presence that keep them returning, as they trust her expertise and dedication.

Tracey’s role extends beyond technical responsibilities; she is a vital support to her pharmacists, enabling them to focus on delivering essential pharmacy services such as vaccinations. Her proactive and collaborative approach ensures these services are delivered smoothly and efficiently, enhancing patient satisfaction.

Michael Taylor, Head of Sales & Retail Solutions, United Drug Wholesale As Head of Sales and Retail Solutions for United Drug Wholesale for over 5 years, Michael ensures customers receive a level of service that exceeds expectations. He has developed the commercial team structure to continue delivery of outstanding support to customers and is constantly evaluating ways to improve the UDW customer offering. He and his team are passionate about building strong relationships with customers and helping them navigate their pharmacy challenges to achieve their goals.

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Marina Timotijevic, Marketing Manager, McCabes Pharmacy Group Marina Timotijevic has been involved with the marketing of McCabes Pharmacy over the past 8 years. Marina is the brand champion and has been heavily involved with overseeing and managing the brand guidelines as part of the Rebrand project from LloydsPharmacy to McCabes to ensure a consistent and aligned store and brand identity across the growing pharmacy network. Marina is exceptionally passionate and enthusiastic about Pharmacy and has played a key role in supporting the growth and development of the McCabes brand in the past.

Jean Tomkins, Business Development Manager, Navi Group Jean joined Navi Group as Business Development Manager for the greater Leinster region in February 2024, taking on a broad customer base of Axium Buying Group, iGnite and DispenSense customers, bringing a wealth of industry knowledge with her from her decades of experience in community pharmacy.

Jean has made a huge impact in her territory, managing a broad pipeline of new customers across all Navi Group services, helping Axium Buying Group further grow its position as Ireland’s most prominent buying platform, while also growing one of Navi’s most recent innovative additions to the community pharmacy market, DispenSense.

Ciara Toolen, Adrian Dunne Pharmacy Group Ciara's leadership continues to drive success in Adrian Dunne Pharmacy Group, fostering a culture of collaboration, support, and excellence. Ciara's dedication to staff development underscores the pharmacy commitment to providing compassionate and respectful care to their customers. Notably, she spearheaded the pharmacist-led training initiative, empowering pharmacists to share their expertise through cross-training sessions and collaborative learning opportunities, ultimately enhancing the pharmacists ability to serve their community with excellence.

Under Ciara's leadership, Adrian Dunne Pharmacy Group was honoured with the prestigious Best Workplace 2023 award by Great Place to Work. This recognition, with the Adrian Dunne Pharmacy Group ranking among the top 30 medium-sized companies, highlights their commitment to cultivating an exceptional workplace environment, a remarkable achievement within the pharmacy industry.

Ciara was a Finalist in the 2024 Perrigo Superintendent Pharmacist of the Year Award.

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95 Teo Vuckovic, CARA Allcare Pharmacy, Dun Laoghaire Teo is a dedicated and hardworking pharmacist, who has patient care and safety at the forefront of his mind with every task he performs. Teo works in a very challenging environment, where stressful situations, management challenges and timeframes are all impacting on his role on a daily basis. Regardless of the challenges put to Teo on a daily basis he will always get his job done and to a very high standard.

Teo has shown over his time working in this pharmacy that he is consistently trying to help others within his team in order to improve the pharmacy processes and procedures. He is approachable and flexible in his role and always willing to help out new pharmacists and technicians.

Sadhbh Whitty, McCauley Pharmacy Redmond Square Sadhbh is highly valued by her customers in Wexford Town, and that her commitment to providing excellent patient care extends beyond the walls of the pharmacy. Her willingness to go above and beyond in ensuring that her patients receive the care they need, even if it means making house calls, is a testament to her dedication to her profession and her customers. This level of personalized care is what sets great pharmacists apart and helps to build strong relationships between pharmacists and their patients.

Sadhbh has also engaged with other local healthcare professionals to understand the range of services available within her community.

Stephen Watkins, Managing Director, Boots Ireland With Stephen at the helm, Boots Ireland undertook a number of important initiatives during 2024. In November of this year, Boots unveiled their first flagship destination store in the heart of Cork City, a game-changer for the Irish beauty landscape. Earlier in the year, Stephen highlighted that Boots Ireland were recognised as one of the most reputable organisations in Ireland, securing third spot this year in the Ireland RepTrak® 2024 study.

Not only have they secured the third position overall, gaining five places on last year, but they are also thrilled to maintain their status as the most reputable pharmacy chain in Ireland for the 15th consecutive year.

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Clinical Profiles

NEW TREATMENT FOR PROSTATE CANCER PERFORMED FOR THE FIRST TIME IN IRELAND AT BEACON HOSPITAL A new and non-invasive treatment for prostate cancer has been successfully used in Ireland for the first time by Mr Mohammud Shakeel Inder in Beacon Hospital.

Focal Therapy (Sonablate HIFU System), involves the delivery of high intensity focused ultrasound energy (HIFU) to the affected area, which leads to a rapid rise in intracellular temperature, leading to instant cell death, while preserving surrounding tissue.

Unlike invasive surgery and radiotherapy, focal therapy does not impact on or damage surrounding cells, tissues or organs, significantly reducing the risks of erectile dysfunction, urinary incontinence and rectal toxicity. Compared to other treatments, focal therapy also provides patients with the highest chance to preserve ejaculation post-treatment.

The treatment is minimally invasive and performed under general anaesthesia. HIFU energy is delivered to an affected area of the prostate, externally via an ultrasound probe placed in the rectum. Treatment usually involves one session, which last an average of 1.5 - 2 hours. Most patients stay overnight in hospital and are discharged one day after surgery. Recovery is subjective but most patients are expected to be back to work within two weeks post treatment.

In studies on treatment outcomes for focal therapy for prostate cancer, survival rates are at 99 percent and treatment is best suited to those with localised prostate cancer that has not spread to other tissues or areas of the body.

Mr Mohammud Shakeel Inder, Consultant Urological Surgeon at Beacon Hospital said: “Prostate cancer is the most prevalent cancer in men in Ireland. One in seven men in Ireland will be diagnosed with the disease in their lifetime. With around 4,000 men affected yearly, it is important to adapt new technologies that provide better functional outcomes. By providing focal therapy in Ireland for the first time, patients suitable for the treatment can expect less downtime and a better quality of life without debilitating long-term side effects, often associated with prostate cancer treatment. Our first patient is on the road to recovery and a good prognosis is expected.”

Michael Cullen, CEO of Beacon Hospital said: “We are proud to announce yet another first-inIreland treatment being carried out here at Beacon Hospital. This innovative focal therapy is not only less invasive than traditional methods, but also significantly reduces common side effects and will have a dramatic impact on the lives of our patients. As one of the most technologically advanced private hospitals in Europe, we continue to invest heavily in the latest innovations to provide pioneering world-class medical and surgical care to our patients.”

DARZALEX® (DARATUMUMAB)SC BASED QUADRUPLET REGIMEN APPROVED BY THE EUROPEAN COMMISSION FOR PATIENTS WITH NEWLY DIAGNOSED MULTIPLE MYELOMA WHO ARE TRANSPLANT-ELIGIBLE Janssen-Cilag International NV, a Johnson & Johnson company, has announced that the European Commission (EC) approved the indication extension for DARZALEX® (daratumumab) subcutaneous (SC) formulation in combination with bortezomib, lenalidomide and dexamethasone (daratumumab-VRd) in patients with newly diagnosed multiple myeloma (NDMM) who are eligible for an autologous stem cell transplant (ASCT). Patients will have the opportunity to receive this daratumumab SCbased quadruplet therapy at initial diagnosis, providing them with a new treatment shown to significantly improve outcomes.

This approval is supported by data from the Phase 3 PERSEUS study, which evaluated daratumumab SC-based quadruplet regimen for induction and consolidation therapy, followed by daratumumab SC and lenalidomide (D-R) maintenance therapy, compared to bortezomib, lenalidomide and dexamethasone (VRd) during induction and consolidation, followed by lenalidomide (R) maintenance in 709 patients with NDMM eligible for ASCT. Michaela Hagenhofer, General Manager, Commercial Operations at Johnson & Johnson Innovative Medicine said: “Since daratumumab was first made available to Irish patients in 2018, it has become a foundational therapy for the treatment of multiple myeloma and has been used to treat more than 548,000 patients worldwide. At Johnson & Johnson, our ambition is to get in front of this incurable disease. The EC approval of this daratumumab SC based quadruplet regimen in frontline therapy marks a step towards a new standard of care.

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research and development in treating multiple myeloma, we are committed to continuing to deliver innovations to treat all patients across all stages of this disease.”

Multiple myeloma is the second most common blood cancer.6 Approximately 352 people are diagnosed with multiple myeloma each year in Ireland, with an estimated 2,200 people living with the condition. Data shows that the five-year net survival for someone diagnosed with MM in Ireland has increased by 37% from 27% to 64% in the period from 1994-2018.

However, global data shows that almost 29% of patients diagnosed with MM will die within the first year.

Findings from the PERSEUS study, after a median follow-up of 47.5 months, demonstrated a significant improvement in the primary endpoint of progressionfree survival (PFS), with the daratumumab-VRd regimen reducing the risk of disease progression or death by 58 percent compared to VRd (hazard ratio [HR], 0.42; 95 percent confidence interval [CI], 0.30-0.59; p<0.0001).1 Treatment with daratumumabVRd resulted in deeper responses compared to VRd with overall minimal residual disease (MRD)negativity rate assessed at 10-5 of 75.2 percent vs. 47.5 percent (p<0.001), complete response or better of 87.9 percent vs 70.1 percent (p<0.001) and importantly, sustained MRD negativity for ≥12 months of 64.8 percent vs 29.7 percent, respectively.

The overall safety profile of daratumumab-VRd was consistent with the known safety profiles for daratumumab SC and VRd. The most common haematologic adverse reactions (≥20 percent) in patients with multiple myeloma who received daratumumabVRd vs VRd were neutropenia (69.2 percent vs 58.8 percent), thrombocytopenia (48.4 percent vs 34.3 percent) and anaemia (22.2 percent vs 20.7 percent). The most common non-hematologic adverse reactions (≥20 percent) in patients with multiple myeloma who received daratumumabVRd vs VRd were peripheral neuropathy (53.6 percent vs 51.6 percent), fatigue (23.9 percent vs 26.5 percent), peripheral oedema (20.5 percent vs 21.3 percent), pyrexia (31.6 percent vs 31.4 percent), upper respiratory infection (31.6 percent vs 25.1 percent), COVID-19 (35 percent vs 23.9 percent), constipation (33.9 percent vs 34.0 percent), diarrhoea (61.0 percent vs 54.2 percent), back pain (22.8 percent vs 19.0 percent), insomnia (27.1 percent vs 17.6 percent), asthenia (26.8 percent vs 25.6 percent) and rash (23.4 percent vs 27.1 percent).

Daratumumab is currently approved in eight indications for multiple myeloma, four of which are in the frontline setting, including as part of treatment regimens for newly diagnosed patients who are transplant-eligible or ineligible for ASCT. Since 2015, DARZALEX® (daratumumab) has been manufactured at Johnson & Johnson’s biopharmaceutical manufacturing site in Ringaskiddy, Co Cork EARLY PHASE TRIAL A FIRST FOR CHILDREN IN IRELAND Children’s Health Ireland (CHI), in partnership with St. James’s Hospital have successfully opened Ireland’s first early phase clinical trial, enrolling eligible children with Duchenne muscular dystrophy (DMD). The global trial, called DELIVER, which started in August 2022 as the first-in-human (phase 1/2) trial of a therapeutic called DYNE-251 at sites around the world targets male children with a specific type of DMD (children amenable to exon 51 skipping).

The trial is being delivered by the HRB CHI Clinical Research Centre and the Wellcome HRB Clinical Research Facility at St James’s Hospital and involves delivery of a next generation molecular therapy developed by Dyne Therapeutics, a Massachusetts based biotechnology company, specialising in the development of therapies for rare muscle diseases. The study is progressing through at sites around the world but is the first time such an early phase trial has been conducted in children in Ireland.

Duchene muscular dystrophy (DMD) is a rare neuromuscular disease that results in progressive deterioration in muscle strength and premature death. Symptoms are often first detected as early as age two, but diagnosis often occurs between four and five years of age. The disease is almost exclusively seen in boys. It is caused by gene mutations that affect a protein called dystrophin, which plays a critical role in muscle cell structure and function. As they grow, children with DMD become gradually weaker, losing the ability to walk and ultimately being confined to a wheelchair.

Weakness of the muscles involved in swallowing, breathing and heart function are particularly serious and ultimately life threatening.

Currently, very few treatments are available for this devastating disease, and children and their families are anxiously awaiting treatments that can target the basic defect in DMD, aimed at slowing or stopping the inevitable decline in muscle function.

Clinical trials can be extremely complex to undertake and are

97 governed by very strict and detailed safety codes. They involve years of careful planning by a large team of experts within the hospitals, regulators and industry.

Global healthcare regulatory agencies comprehensively review data on investigational medicines before the clinical trial can start in humans.

Dr Declan O’Rourke, Consultant Paediatric Neurologist and principal investigator for the study at CHI, said, “This is a watershed moment for CHI. We have been working for many years to increase the number of trials we offer to our patients with progressive muscle diseases and have had some great successes already. DMD is a condition with very few treatment options currently, and with this trial, it is great to be at the very forefront of potentially bringing new, transformative therapies to children.”

The development of clinical trials in Neurology in CHI has been supported by a research grant from Children’s Health Foundation, CHI’s fundraising partner.

CHI’s Director of Research & Innovation, Paul McNally welcomed CHI’s participation in the ongoing study saying: “This is an exciting day for everyone involved in clinical trials in CHI. These early phase trials are an enormous undertaking but a vitally important thing for us to be able to do if we really want to become a leading children’s hospital and offer our patients the very latest in cutting edge treatments in the world. Our partnership with St James’s Hospital has been critical here and is an example of the type of benefits that we can expect when working together on the same campus when we move to the new children’s Hospital.”

offer a meaningful impact on this and other disease.”

DANDELION CLOCK SCULPTURES This month, Children’s Health Ireland (CHI) proudly completed the installation of two Dandelion Clock sculptures at the west entrance of the New Children’s Hospital. These striking sculptures, designed by renowned artist, Remco deFouw, and fabricated by Hickeys Engineering, mark the final piece in a series that now visually connects all Children's Health Ireland sites, including CHI at Connolly and CHI at Tallaght.

The Dandelion Clocks, first installed at CHI at Connolly and CHI at Tallaght in July, feature prisms that refract sunlight to project rainbows into the hospital buildings at certain times of the year. This unique design brings light and colour into the hospitals, creating a calming and uplifting atmosphere for children, young people, families and staff.

The sculptures are part of CHI’s Arts in Health Programme, which commissions original artworks from leading artists to ensure that the new hospital and its satellite centres offer an engaging, healing and creative environment for children and young people. The Dandelion Clocks directly respond to the hopes expressed by patients

Remco deFouw, Christian Brodie, Sinead White and CHI staff at the launch of the Dandelion Clock sculptures

and staff that art within the hospital would bring brightness and joy to these spaces.

“We are thrilled to see these beautiful sculptures now installed across all CHI sites,” said Mary Grehan, Arts in Health Curator.

“The Dandelion Clocks not only enhance the environment, but they also reflect our commitment to supporting the emotional and psychological well-being of the children and families we care for.”

The Dandelion Clock sculptures and the broader Arts in Health Programme are generously supported by the Children’s Health Foundation, whose ongoing contributions ensure the hospitals remain places of inspiration, creativity and healing.

GSK PRESENTS POSITIVE DATA FOR AREXVY, ITS RESPIRATORY SYNCYTIAL VIRUS (RSV) VACCINE, INDICATING PROTECTION OVER THREE RSV SEASONS GSK Ireland has announced new data from the AReSVi-006 (Adult Respiratory Syncytial Virus) phase III trial evaluating the efficacy of a single dose of Arexvy (respiratory syncytial virus vaccine, recombinant adjuvanted) against lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in adults aged 60 years and older, including those at increased risk over three RSV seasons (NCT04886596). [i] This data was presented at the CHEST 2024 Annual Meeting, organised by the American College of Chest Physicians.

Arexvy was the first RSV vaccine approved in the EU based on efficacy results for the prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in individuals 60 years of age and older and it is now also approved for use in individuals aged 50-59 who are at increased risk due to certain underlying medical conditions.

These results indicate that after a single dose of GSK’s RSV vaccine, cumulative efficacy over three RSV seasons was clinically meaningful at 62.9% against RSV-LRTD (97.5% CI, 46.7-74.8, 48 of 12,468 vs 215 of 12,498) and 67.4% against severe RSV-LRTD (95% CI, 42.4-82.7,15 of 12,468 vs 75 of 12,498) compared to placebo.

In the third season, the vaccine’s efficacy was 48.0% against RSVLRTD (95% CI, 8.7-72.0, 16 of 4,988 vs 61 of 10,031).

These results include efficacy against different RSV subtypes, in adults with advancing age (70-79 years of age), and those with certain underlying medical conditions. Since RSV can exacerbate medical conditions and potentially lead to hospitalisations, cumulative efficacy over three RSV seasons has the potential for significant health impact. It has the potential to offer health care professionals flexibility to administer the vaccine year-round. Over time, revaccination is expected to be required to maintain an optimal level of protection.

Eavan Daly, Director of Medical Affairs, GSK Ireland, said: “We are excited by this new data which

Having previously supported the CHI team to deliver gene therapy to many infants with a rare neurological disorder, the Wellcome HRB Clinical Research Facility at St James’s Hospital is no stranger to advanced paediatric trials. Director of the centre Prof.

Martina Hennessy said: “We are delighted to see this important ongoing trial finally becoming available in Ireland, resulting from the hard work and collaboration between the teams at CHI and St James’s. With the support of our funders and amazing colleagues, our centre has developed the facilities and expertise to be able to deliver the most advanced trials to both adults and children. This very productive partnership with CHI will allow us to explore new and potentially better types of medicines that may

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Clinical Profiles

shows that a single dose of Arexvy could protect older adults in Ireland at risk of RSV disease over three seasons to benefit public health. Arexvy has 94.6% efficacy in adults aged 60 years and older with at least one comorbidity of interest during the first season and is the only RSV vaccine with efficacy and safety data available through three seasons. We look forward to ongoing dialogue with the HSE and healthcare professionals to ensure equity of access to RSV vaccination, including those who are at high risk for severe outcomes and hospitalisation from RSV and account for the biggest burden on our healthcare system.”

RSV is a common contagious virus affecting the lungs and breathing passages and impacts an estimated 64 million people of all ages globally every year.[ii] Adults can be at increased risk for RSV disease due to comorbidities, immune compromised status, or advanced age. RSV can exacerbate multiple conditions, including COPD, asthma, and chronic heart failure, and can lead to severe outcomes, such as pneumonia, hospitalisation, and death.[iii] Each year RSV causes over 465,000 hospitalisations and 33,000 deaths in adults aged 60 and older in high-income countries.[iv] Professor Patrick Mitchell, Consultant Respiratory Physician at Trinity College Dublin and Tallaght University Hospital, said: “In Ireland I continue to see a significant increase in hospital admissions caused by RSV. Reducing the burden of this virus is a key priority for healthcare professionals as unfortunately some patients do end up being admitted to hospital and even the intensive care units as a result.

Ireland is among 16 countries globally that have national RSV vaccination recommendations for older adults and I hope we join other countries that already have national immunisation programmes in place.”

[iii] Centers for Disease Control and Prevention (CDC), RSV in Older Adults, 2024. Available at: https://www.cdc.gov/rsv/olderadults/index.html - Last accessed: September 2024 [iv] Savic M, et al., “Respiratory syncytial virus disease burden in adults aged 60 years and older in high-income countries: a systematic literature review and meta-analysis”, in Influenza Other Respir Viruses, 2023, 17(1):e13031, DOI: 10.1111/irv.13031 APPOINTMENT OF NEW CHAIRPERSON OF THE NATIONAL CANCER REGISTRY BOARD (NCRB) Following a States Board campaign, the Minister for Health Stephen Donnelly T.D. has appointed Dr Robert O'Connor as the new Chair of the National Cancer Registry. The appointment comes in the year the National Cancer Registry marks its 30th anniversary of collecting comprehensive cancer information for the population of the Republic of Ireland.

Robert O'Connor Ph.D. has been a member of the National Cancer Registry Board since 2019. Robert has served on multiple national charity, health and research boards and is Director of the HRB-funded National Clinical Trials Office.

With over 25 years of experience in clinical trials, oncology, and translational health research, he brings a fount of knowledge and a deep commitment to advancing cancer research and improving patient outcomes, making him an ideal fit for this critical role.

Robert’s Postdoctoral research transitioned laboratory findings into early-stage clinical trials for cancer. He served as Executive Chair at ICORG (now Cancer Trials Ireland), fostering connections between laboratory and clinical researchers. A former lecturer at Dublin City University, Robert later became Director of Research for the Irish Cancer Society, where he delivered the research strategy of the organisation, helped support the inclusion of research into national cancer treatment policy and developed patient partnership initiatives.

Welcoming the appointment of Dr Robert O’Connor, Prof. Deirdre Murray, Director of the NCRI, said: “Robert brings a wealth of experience to the National Cancer Registry with a strong research background and governance experience. I look forward to working with Robert and the other Board members in implementing our ambitious strategy.”

As Chair, Robert will lead the seven member NCRB, overseeing governance, strategic direction, and management of the Registry to ensure transparency, ethics, and effectiveness in serving the cancer community.

“I am immensely honoured to have been nominated as Chair of the Board of the National Cancer Registry,” said Robert following his appointment. “Our community faces a growing tide of cancer challenges and accurate, timely and trusted insight on cancer will be of ever-greater importance if we are to keep driving

improvements in outcome for people affected by cancer.

“I look forward to our ongoing strategy and governance work with my excellent fellow members of the Board, the world class team within our National Cancer Registry, our ever-supportive colleagues in the Cancer Policy Unit of the Department of Health and our many other stakeholders. Together, we will ensure the Registry remains a vital, trusted resource for those affected by cancer, policymakers, researchers, and the public.”

THE NMH FOUNDATION ANNOUNCES SPONSORSHIP WITH BEPANTHEN NAPPY CARE OINTMENT ON WORLD PREMATURITY DAY The National Maternity Hospital Foundation, in partnership with Bepanthen Nappy Care Ointment, marked World Prematurity Day with a special event welcoming families of children who were born prematurely at the hospital. Each year, over 4,500 babies are born prematurely in Ireland, with 1,202 babies born prematurely at the National Maternity Hospital last year.

As part of the sponsorship, Bepanthen will provide vital support to the NMH Foundation for the pioneering work taking place in The NMH’s Neonatal Intensive Care Unit (NICU), a world-class facility renowned for its dedication to saving and nurturing the lives of babies born too soon. The collaboration will focus on supporting cutting-edge research, fostering innovation, and developing new treatments and solutions to help premature infants to survive and thrive.

Bepanthen Nappy Care Ointment, which celebrates its 80th anniversary in 2024, is a breathable barrier cream designed to protect vulnerable skin from irritants and other causes of nappy rash.

[i] Clinicaltrials.gov, “Efficacy Study of GSK's Investigational Respiratory Syncytial Virus (RSV) Vaccine in Adults Aged 60 Years and Above”. Available at: https://clinicaltrials.gov/study/ NCT04886596 - last accessed: September 2024

Mary O’Donovan, Executive Director of The NMH Foundation, commented, “We are delighted to partner with Bepanthen in this meaningful initiative, particularly as we celebrate World Prematurity Day. The sponsorship funds will help us to accelerate vital research and innovation at The NMH, giving premature babies a better chance at survival and a healthier future.

Together, we are committed to advancing neonatal care and ensuring every baby born too soon gets the best possible care.”

[ii] National Institute of Allergy and Infectious Diseases, Respiratory Syncytial Virus (RSV). Available at: https://www.niaid.nih.gov/ diseases-conditions/respiratorysyncytial-virus-rsv – last accessed: September 2024

Lyndsey Ashe Byrne, Mother of Baby Stephen said, “If it wasn’t for the amazing staff at The National Maternity Hospital, we might not have our gorgeous baby Stephen with us this Christmas. Last year while I was pregnant with him,

References

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99 Against this backdrop, partnerships between indigenous firms and multinationals such as the Novartis and Deciphex collaboration, can deliver positive economic, clinical and societal outcomes in the coming years.

The roundtable also heard that with AI set to transform sectors such as healthcare over the coming years, the public and patients are being engaged to ascertain the degree in which safeguards and regulation can provide comfort that with AI advances, a human will still be in the loop. The Irish public are being invited to share their insights for policymakers through important initiatives such as the IPPOSI ‘Citizens’ Jury on AI in Healthcare’.

Baby Stephen pictured here with Mum Lyndsey, Dad Stephen and Sister Layla

he stopped moving at around 30 weeks. When he was born, he was so tiny, just 2lbs. The NMH NICU team saved him. They knew what to do, they gave him a fighting chance, and he is thriving now. We are so grateful”.

Holly Elliott-Gurr, Brand Manager, Bepanthen said, “We are honoured to partner with the NMH Foundation and contribute to their mission of funding lifechanging research happening at The National Maternity Hospital.

Our commitment to baby health and wellbeing aligns perfectly with the Foundation's mission, and we are excited to see the impact this collaboration will have on premature infants and their families. That is why we will be donating to the NMH Foundation for every Bepanthen Nappy Care Ointment sold.”

accelerate the painstaking work of drug discovery and development.

Ultimately, this collaboration has the potential to positively impact patient pathways.

In Ireland, Novartis and Deciphex marked the agreement at a panel discussion titled ‘How Ireland can be the Centre of Artificial Intelligence (AI) for Europe’. Taking place at Novartis Ireland and officiated by Minister of State for Digital Dara Calleary TD, the event featured contributions from Novartis and Deciphex leadership and representatives from IDA Ireland and patient-led platform, IPPOSI. The event heard from panelists that government policies and State support, ongoing investment and a strong pipeline of tech talent from universities are key factors in creating a fertile ecosystem where the AI sector in Ireland is flourishing.

Minister of State for Digital Dara Calleary TD said: “I am delighted to officiate at today’s panel discussion. Ireland’s AI sector is flourishing, with a partnership approach between State bodies, enterprise and the public key to delivering transformative societal benefits in the coming years. The Novartis-Deciphex collaboration is a great example of how this approach works in practice, with an indigenous medtech collaborating with a global leader in pharma to harness cutting-edge technology and deliver better outcomes for patients.”

Michael Lohan, CEO, IDA Ireland said, “Artificial Intelligence is a cornerstone of Ireland’s strategy to drive innovation and fuel economic growth. By fostering a robust AI ecosystem, we are not only attracting leading global tech companies but also empowering local enterprises to compete on the world stage. The integration of AI across various sectors is pivotal in enhancing productivity, creating high-value jobs, and ensuring Ireland remains at the forefront of technological advancements”

Dr. Donal O’Shea, CEO of Deciphex said: “We are thrilled to collaborate with Novartis in leveraging AI technology to drive innovation in preclinical research. This partnership underscores our commitment to advancing healthcare through the development of cutting-edge solutions that address critical challenges in drug development lifecycles. Novartis is committed to innovating AI-based approaches with potential to accelerate drug discovery and development and bring life-changing medicines to patients faster.” Statement approved by stakeholder Caitriona Walsh, Country President, Novartis Ireland said: “I’m excited that Novartis has entered into a collaboration agreement with Deciphex to develop Artificial Intelligencebased approaches aimed at improving the efficiency and accuracy of preclinical studies.

We believe AI has transformative potential to accelerate the painstaking work of drug discovery and development. I look forward to seeing how our collaborative efforts can help us improve and streamline existing processes to deliver impactful medicines to patients more quickly.”

Pictured at the Novartis and Deciphex AI event are (from left): Caitriona Walsh, Country President, Novartis Ireland, Dr. Donal O’Shea, CEO of Deciphex and Laura Kavanagh, Research & Advocacy Manager, the Irish Platform for Patients’ Organisations (IPPOSI).

Pictured taking part in the panel discussion are (from left); Moderator Elaine Burke; Minister of State for Digital Dara Calleary TD; Laura Kavanagh and Neasa McNabola, Senior Scientific Adviser, IDA BioPharma Team

NOVARTIS AND DECIPHEX HOST ROUNDTABLE ABOUT IRELAND’S AI SECTOR TO MARK COLLABORATION Novartis Ireland has marked its Collaboration Agreement with Deciphex, a Dublin-based digital pathology company, at a specially convened roundtable on Artificial Intelligence (AI).

The collaboration is a global agreement between Novartis and Deciphex. Harnessing cuttingedge technology, it seeks to develop a suite of AI tools that will improve the efficiency and accuracy of preclinical studies and

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