March 2020 Volume 12 Issue 3 PHARMACYNEWSIRELAND.COM
THE INDEPENDENT VOICE OF PHARMACY
In this issue:
Help your customers break the habit this Lent
NEWS: Recycling Pilot launched in Pharmacy Page 4
PROFILE: McAuleys Pharmacy opens in Ardfinnan Page 11
REPORT: Medication adherence in pharmacy Page 16
FEATURE: Leg & Foot Care Page 28
Acts fast and lasts for hours* *based on 25% reduction in cravings at nearly 3 hours Nicorette Icy white 4mg Medicated Chewing Gum. For the treatment of tobacco dependence by relieving nicotine craving and withdrawal symptoms, thereby facilitating smoking cessation in smokers motivated to quit. Helping smokers temporarily abstain from smoking . In smokers currently unable or not ready to stop smoking abruptly. Gum may also be used as part of a programme to reduce smoking prior to stopping completely.. Dosage: Smoking cessation: The gum should be used whenever there is an urge to smoke. Not more than 15 pieces of the chewing gum may be used each day. If not successful after 12 weeks the patient should be encouraged to make a fresh attempt to stop smoking. Temporary Abstinence: See full prescribing information. Gradual cessation: See full prescribing information. Contraindications: Use in non-smokers, Use in persons hypersensitive to nicotine or any ingredient in the formulation. Special Warnings and Precautions: The benefits of quitting smoking outweigh any risks associated with correctly administered 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, Nicorette Gum may be considered but as data on safety in this patient group are limited, initiation should only be under close medical supervision. 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. 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. Phaeochromocytoma and uncontrolled hyperthyroidism: Nicotine, both from NRT and smoking, causes the release of catecholamines from the adrenal medulla. Therefore, Nicorette should be used with caution in patients with uncontrolled hyperthyroidism or pheochromocytoma. - 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 reductions in nicotine-induced catecholamine release can affect carbohydrate metabolism. Patients with diabetes mellitus may require lower doses of insulin as a result of smoking cessation. - Smokers who wear dentures may experience difficulties in chewing Nicorette Gum. The chewing gum may stick to and may in rare cases damage dentures. Transferred dependence: Nicotine in any dose form is capable of inducing a dependence syndrome after chronic use and is highly toxic after acute use. However, dependence with Nicorette Gum is a rare side-effect and is both less harmful and easier to break than smoking dependence. 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.. Undesirable Effects: See full prescribing information for full list of undesirable effects. Immune System Disorders: Hypersensitivity - Common Anaphylactic reaction - Not known. Psychiatric Disorders – Abnormal Dreams – Uncommon. Nervous System Disorders: Headache - Very Common, Burning sensation, Dysgeusia, Paraesthesia – Common. Eye Disorders: Blurred Vision, Lacrimation increased – Common. Cardiac Disorders: Palpitations, Tachycardia - Not known. Vascular Disorders: Flushing, Hypertension – Uncommon. Respiratory, Thoracic and Mediastinal Disorders: Cough, Throat irritation - Very common. Bronchospasm, Dysphonia, Dyspnoea, Nasal Congestion, Sneezing, Throat tightness – Uncommon. Gastrointestinal Disorders: Hiccups, Nausea - Very common. Abdominal pain: Diarrhoea, Dry mouth, Dyspepsia, Flatulence, Salivary hypersecretion, Stomatitis, Vomiting – Common. Eructation Glossitis, Oral mucosal blistering and exfoliation, Paraesthesia oral – Uncommon. Dysphagia, Hypoaesthesia oral, Retching – Rare. Dry throat, Gastrointestinal discomfort Lip pain - Not known. Skin and Subcutaneous Tissue: Hyperhidrosis, Pruritus, Rash, Urticaria Disorders – Uncommon. Erythema - Not known. Musculoskeletal and Connective Tissue Disorders: Pain in jaw – Uncommon. Muscle tightness - Not known. General Disorders and Administration Site Conditions: Fatigue – Common. Asthenia, Chest discomfort and pain, Malaise – Uncommon. Allergic reactions including angioedema - Rare. MA Holder: Johnson & Johnson (Ireland) Limited, Airton Road, Tallaght, Dublin 24, Ireland. MA Number: PA 330/37/9 Date of Revision of the Text: June 2018. Legal Category: Products not subject to medical prescription. Further information available upon request from Johnson & Johnson (Ireland) Ltd. IRE/NI/20-4096
AWARDS: Launch of the 2020 Irish Pharmacy Awards Page 41
TEAM TRAINING: Allergies & Hayfever Page 66
Gets to Work Instantly GetstotoWork Work Instantly Gets Gets to WorkInstantly Instantly
Gaviscon Extra chewable tablets. Gaviscon Extra oral suspension. For the relief of Heartburn & Indigestion. For Gaviscon Extra chewable tablets. Gaviscon ExtraALWAYS oral suspension. the relief & Indigestion. For the use in adults and children 12 years and over. READ THEFor LABEL. Dateof ofHeartburn Preparation: November 2018, Gaviscon chewable tablets. oral suspension. ForFor thethe relief of of Heartburn & Indigestion. Gaviscon Extra chewable tablets. Gaviscon Extra oral suspension. relief & Indigestion. For the use inExtra adults and children 12Gaviscon years andExtra over. ALWAYS READ THE LABEL. Date ofHeartburn Preparation: NovemberFor 2018, IRL/G-OTC/1118/0033 thethe useuse in in adults and children 1212 years and over. ALWAYS READ THE LABEL. Date of of Preparation: November 2018, adults and children years and over. ALWAYS READ THE LABEL. Date Preparation: November 2018, IRL/G-OTC/1118/0033 IRL/G-OTC/1118/0033 IRL/G-OTC/1118/0033
Page 5: Meaghers a Great Place to Work
As we progress through the year with pace, there is much to look forward to, and celebrate within community pharmacy in Ireland at present. Elections are now over, meaning the political parties can put their focus on bringing their manifesto’s to fruition, and make good on the promises made for health and pharmacy in particular.
Page 6: Philanthropy Award for Ade Page 9: Pharmacists call for greater access to NRT Page 10: Black’s Allcare Pharmacy raises ¤1,350
Page 14: Medication adherence and the role of the pharmacist
PUBLISHER: IPN Communications Ireland Ltd. Clifton House, Fitzwilliam Street Lower, Dublin 2 - 00353 (01) 6690562
ADVERTISING DIRECTOR Debbie Graham: 00353 (87) 288 2371 email@example.com ADVERTISING EXECUTIVE Amy Evans: firstname.lastname@example.org CONTRIBUTORS Breda Heneghan DESIGN DIRECTOR Ian Stoddart Design
“The rate of smoking in Ireland has fallen steadily over the last five years,” he says, citing the Healthy Ireland 2019 Survey. “This is a huge achievement and all those responsible should be commended, most notably the quitters themselves. However, 17% of people over the age of 15 still smoke every single day and that is far too many. “The welcome reduction over the last five years will not be sustained into the future unless access to support is improved. In particular, we need to offer greater support to medical card patients as the research shows smoking in deprived areas is far higher than the national average (24%) and higher still for those unemployed (40%).”
MANAGING DIRECTOR Natalie Maginnis email@example.com EDITOR Kelly Jo Eastwood: 00353 (87)737 6308 firstname.lastname@example.org
Ireland continues to lag behind the rest of Europe when it comes to medicines availability, and therefore it must be at the forefront of all political leaders minds, and that of the Health Minister, to ensure Ireland’s public enjoy the same freedom of access as their counterparts. In other news, February 26th marked No Smoking Day in Ireland, which brought about calls for the health system here to do more in helping smokers kick the habit. A lack of innovation and a lack of action in how smoking cessation supports are offered has been highlighted by local pharmacist Tomas Conefrey on behalf of the Irish Pharmacy Union.
Page 34: Marking World Obesity Day in community pharmacy Page 41: Launch of the 2020 Irish Pharmacy Awards
Community Pharmacy continues to be a dynamic and progressive sector; on page 5 we detail how Meaghers Pharmacy Group are celebrating their win of a ‘Great Place to Work’ accolade, whilst on page 6 you can read about Ade Stacks, Stacks Pharmacy Group MD taking home a Philanthropy Award for her excellence and vital charity work.
20 Irish Pharmacy IRISH News is PHARMACY circulated to all NEWS independent, multiple Pharmacists and academics in Ireland. All rights reserved by Irish Pharmacy News. All material published in Irish Pharmacy News is copyright and no part of this magazine may be reproduced, stored in a retrieval system or transmitted in any form without written permission. IPN Communications Ltd. has taken every care in compiling the magazine to ensure that it is correct at the time of going to press, however the publishers assume no responsibility for any effects from omissions or errors.
Turn to page 9 for the full story. This issue also sees the launch of the 2020 Irish Pharmacy Awards. Taking place on Saturday 23rd May in the Clayton Hotel, Burlington Road, demand for entries is anticipated to be at an all time high. Turn to page 41 for details on all the categories and entry criteria and request your application form by contacting myself or Aoife Jackson at Aoife@ipn.ie
Regulars FEATURE: BABY AND CHILDREN HEALTH FEATURE: OBESITY EDUCATIONAL: ASTHMA TEAM TRAINING: ALLERGIES & HAYFEVER PRODUCT PROFILES:
P22 P34 P36 P66 P70
Looking professional needn’t come at the price of style with Buttercups’ pharmacy uniforms, a beautifully curated collection of elegant tunics, tailored dresses and practical trousers. Choose from a wide range of colours and styles, which are all designed to flatter while giving your staff a professional edge. All our uniforms are made from premium, durable material that is designed to be comfortable and easy to maintain.
Buttercups Uniforms, 401 Kefron House, Deansgrange Business Park, Deansgrange, County Dublin Contact us: +353 1 219 0215 Email: email@example.com
Online health for Chronic Diseases A new, online health service, currently available only in Cork, is expected to roll out further afield. Laura Dowling, LloydsPharmacy Pharmacist to develop lifelong habits that will benefit their health — the service includes unlimited, one-to-one health consultations, recipe range, dietary advice, shopping lists, and an online support forum.
The digital therapeutic service RediCare helps prevent, manage, and treat chronic health conditions, such as obesity, high blood pressure, high cholesterol, and pre- and Type 2 diabetes. Digital therapeutics involves software being applied to medicine to deliver a treatment, with a clinically proven result. 60% of people in Ireland have at least one chronic health condition, so LloydsPharmacy has teamed up
with RediCare ControlDTx to give their customers access to the new online service. “The public has an insatiable appetite for health information, but they want it correct,” says Laura Dowling, aka social media’s ‘Fabulous Pharmacist’ and supervising pharmacy manager at LloydsPharmacy, Stillorgan, Co Dublin. The RediCare programme gives participants the tools and support
With an emphasis on wraparound support from health coaches and pharmacist, Ms Dowling explains, “Someone can come into the pharmacy and we’ll help them sign up online if they’re older and not that techie. It takes a couple of minutes and they’re good to go,” she says. The pharmacist will be on hand if the participant needs more support to get confident with the programme, if they have a question, or simply want to voice any concerns about their condition. Once signed up, the patient inputs their details — e.g. their medical diagnosis, whether they have multiple chronic conditions — and the programme is tailored to their circumstances and profile.
Inhaler recycling pilot launched in Pharmacy There are currently no inhaler recycling facilities for people living with respiratory-related illnesses in Ireland and no free inhaler disposal facilities available for pharmacists. Now, Dr Cara Augustenborg, Environmental Scientist and broadcaster has launched an inhaler recycling pilot scheme, to be rolled out in over 100 pharmacies across Ireland. This is the first national respiratory inhaler recycling initiative on behalf of Teva Pharmaceuticals Ireland (Teva). The launch took place at O'Connor's Pharmacy, Dublin 4 and is part of a nationwide pilot scheme which aims to encourage people living with respiratoryrelated illnesses to recycle their used or out of date inhalers. Currently, in Ireland, people living with respiratory-related illnesses are encouraged to return their used inhalers to their local pharmacy, where they are then disposed of with other medical waste through incineration.
Dr Cara Augustenborg
However, it’s unclear how many Irish consumers dispose of their inhalers correctly. When inhalers aren’t disposed of correctly, they are sent to landfill which is harmful
to the environment both in plastic material waste and in greenhouse gas emissions as the residual gas from canisters may be released to the atmosphere. Teva has partnered with global recycling group TerraCycle to bring its Zero Waste Box scheme to 100 Irish pharmacies across Ireland in a 12-month recycling pilot scheme. TerraCycle’s Zero Waste Box is a cardboard box that collects, and stores used inhalers until they are collected by TerraCycle and then recycled to help make new products including playground materials and garden equipment. In the same way as recycle ‘green’ bins are used in households every day, Teva’s new recycling initiative provides a convenient way for people living with respiratoryrelated illnesses to recycle their used or out-of-date inhalers. The Zero Waste Box can be used by pharmacy goers when they are collecting prescriptions or a new inhaler, making it convenient for their lifestyle.
Pharmacists to Strike Community pharmacists in Northern Ireland last night voted overwhelmingly to take industrial action, saying funding issues have reached “end game” and could affect patient safety. At a closed meeting organised by Community Pharmacy Northern Ireland in Belfast on Monday February 24, 98% of contractors voted to take action, with the precise nature to be “formalised” in the coming weeks. The meeting was attended by 95 contractors representing 418 of Northern Ireland’s 530 pharmacies. Contractors warned of “serious underfunding” – CPNI believes the sector is underfunded by £20m each year - and a shortage of pharmacists and locums as many switch to working in general practice. The strike vote came shortly after months-long industrial action by three healthcare unions in Northern Ireland was called off following a deal being struck with recently appointed health minister Robin Swann. The deal is concerned with safe staffing levels and pay parity with health workers in England and Wales. CPNI Chief Executive Gerard Greene said, “We have been warning the Department for years of this growing crisis. A litany of unresolved issues stemming from sustained underfunding now means that community pharmacists have reached breaking point. “The decision to take action is not one reached lightly and we regret that the refusal of the Department to address this crisis has brought us to this, but our network is at the point where the safe delivery of crucial frontline services for patients could be compromised.” Mr Greene called on the Department to engage in “meaningful talks to stabilise community pharmacy funding and address the current issues.” Fermanagh contractor Loretto McManus said that with morale at “an all-time low” the result of the ballot was “no surprise”. Ms McManus said “excessive hours” and “unrelenting pressures” were jeopardising pharmacists’ ability to safely carry out their role.
News Antimicrobial Stewardship in Pharmacy
Pharmacy a Great Place to Work!
Pharmacists are in a unique position to be able to educate patients and support prescribers in ensuring that antibiotics are prescribed effectively and only when really needed.
Managing Director Oonagh O’Hagan said, “I could burst with pride. We have collected a few awards over the years but this one is really special as it’s all about our people.
The HSE’s website on antibiotic prescribing is a useful resource for guidance on safe prescribing of antibiotics. It also provides guidance on pediatric prescribing, prescribing in pregnancy and important drug interactions, as well as a list of the preferred antibiotics for common community infections.
“Great Place to Work® Ireland tell us that the definition of a “Great Place to Work” is ‘A place where our people trust the people they work with, take great pride in what they do and enjoy the people that they work with’ and so this award really is a recognition of our culture and how we interact and behave with each other.
This preferred list, referred to as the ‘green/red’ antibiotic list was developed to assist in prescribing more narrowspectrum antibiotics. This can be printed out and kept in the pharmacy for reference.
“It’s less about what we do and more about how we do it. What a talented, passionate, caring and kind team we have and I couldn’t be more proud of them all and what we have built together.
Pharmacists should work in partnership with prescribers to ensure that this guidance is followed, and remember, in many cases in primary care the preferred antibiotic is no antibiotic. Antibiotic resistance has become a global crisis in recent years as a result of overuse and misuse of the drugs, threatening the world’s ability to treat common infectious diseases. Most recently, the World Health Organisation (WHO) released data confirming that antibiotic resistance is making gonorrhoea “much harder” and “sometimes impossible” to treat. To tackle the global crisis, the Irish government announced the country’s first National Action Plan on Antimicrobial Resistance 2017-2020. Medical professionals have warned that epidemics of conditions such as tuberculosis (TB) and pneumonia could strike Ireland and become untreatable as antibiotic resistance continues to increase. A study commissioned by the UK government found that more than 700,000 people globally die every year as a result of antibiotic resistance. By 2050, this figure could reach over 10 million — more than the current number of annual cancer deaths. Similarly, the Irish Pharmacy Union have warned that antibiotics should be used “sparingly and appropriately and only when absolutely necessary.”
Meaghers Pharmacy were celebrating recently having been named as one of Ireland’s Best Places to Work at the Great Place to Work Ireland Awards.
Thank you to each and every member of our team. Together we are so much greater than the sum of all our parts.”
Oonagh O’Hagan, Managing Director, with the pharmacy team from Meaghers Pharmacy – a Great Place to Work
Calls for new Medicines Policy Ireland remains among the slowest in Western Europe to provide new medicines to patients. In the last Dáil, there were patients groups regularly having to protest for access to new medicines. Ministers ended up making political decisions on medicines. At the same time, very large savings, price cuts and cash rebates are still being provided by pharmaceutical companies to the HSE. Oliver O’Connor, the Chief Executive of IPHA, said the industry is clear that there is a better way possible. “First, political parties should pledge to improve patients’ access to new medicines and assure them that protesting for medicines will be a thing of the past. “Second, the next Government should adopt an explicit policy on how to allocate funding to new medicines, relying on both the State and industry contributions. “As the political parties finalise their policy proposals ahead of the February 8th poll, we would urge them to place improving patients’ access to new medicines at the core of their plans for health,” said Mr O’Connor. Irish patients are waiting up to three times longer for the same medicines patients in other European countries can get. “That means doctors have fewer options for treatments than in
other countries. That must affect standards of care in Ireland. It means the latest treatments are often beyond the reach of patients and their doctors. We are convinced this can be fixed. It needs political will to work out a better way with the industry for reimbursing new medicines. “Budget 2020 allocated no new funding for new medicines. This will not be sustainable. It will not deliver new medicines on time for patients. The reliance on industry and HSE internal savings alone to fund new medicines will run out of road. The HSE has to take care of a growing and ageing population, absorbing a substantial part of its additional funds. “The way forward is political backing by parties and the next Government for serious discussion on funding new medicines between central Government, the HSE and the industry,” said Mr O’Connor. “This can be achieved in time for Budget 2021.”
Some of the new medicines waiting to be adopted by the health services are for cancer. According to the National Cancer Registry of Ireland, every three minutes someone gets a cancer diagnosis. Every hour someone dies from the disease. Cancer has overtaken heart disease as the most common cause of death in Ireland. Since 2007, life expectancy in Ireland has risen by 2.5 years, according to the Government. This is, in part, down to better treatments for cancer and heart disease. These gains in life expectancy will slip back if we do not tackle the access to new medicines problem. “Without funding, new medicines, some of them already deemed cost-effective through pharmacoeconomic assessments, will remain stuck in the system. There, they will not reach patients and, consequently, medical needs will go unmet. Now is the time to fix this,” said Mr O’Connor.
Philanthropist Award for Ade Stacks Pharmacy Group Managing Director, Adrienne Stack has just been announced as Local Philanthropist of the Year. Adrienne was Informed by her own family’s experience, Adrienne set up Hugh’s House in memory of her son Hugh and in support of other families with very sick children; providing a ‘home from home’ for them in the city centre while their children are in hospital. She has given significant personal and financial resources to the project. Pictured is Vodafone’s Liam O’Brien, Stephen Vernon, National Philanthropist of the Year and Adrienne Stack, Local Philanthropist of the Year (Pic Jason Clarke) Ireland, said society should not underestimate the positive role philanthropists play in raising awareness of the value and impact of strategic giving.
The 2020 Philanthropist of the Year Awards are hosted by The Community Foundation for Ireland, one of Ireland’s largest philanthropic organisations as a way to recognise and celebrate
extraordinary leadership and generosity in the area of philanthropy. Speaking about the 2020 awards, Tina Roche, Chief Executive, The Community Foundation for
“Now in its 12th year, The Community Foundation for Ireland’s Philanthropist of the Year Awards recognises extraordinary leadership in philanthropy. Whilst acknowledging that many people who give back prefer to do so in a low profile and anonymous way, we see the need for positive role models to create a ripple effect of generosity throughout Ireland. Previous Philanthropist of the Year Winners have achieved significant feats through their philanthropy and we hope this award continues to showcase that great work and demonstrate the potential that philanthropy holds.”
Prioritise ‘evidence-based medicine’ for Sláintecare The new government of Ireland must prioritise ‘evidence-based medicine’ in its rollout of Sláintecare, according to RCSI President Mr Kenneth Mealy. Mr Mealy's comments came ahead of RCSI's Charter Day Meetings, its annual surgical conference that explores medical innovations and healthcare challenges. Healthcare spending in the West is rising to unsustainable levels as populations grow, age, and succumb to chronic illnesses that require expensive long-term treatment. Wasteful practices and inefficiencies, such as unnecessary procedures or the use of more expensive medicines despite the availability of cheaper and equally effective alternatives, drive up costs. An OECD report estimates that as much as 20% of all American and 33% of all Australian healthcare spending costs are "wasteful". Ireland's health service regularly exceeds its budget.
“Without a serious look at how and why our health service spends the money it does," said Mr Mealy. "We run the risk of building something that is, in the long term, unaffordable, and unsustainable.
practitioners leads to the squandering of limited resources that could be better spent or utilised elsewhere.
“We need to review the full care journey we provide for patients so that we're not spending or allocating resources in an inefficient and ineffective manner.
“Antibiotics, too, are frequently over-prescribed, often because patients simply 'expect' to be given a treatment following a GP visit, even though their complaint may be relatively mild. This depletes stocks of valuable medicine and ultimately leads to antibiotic resistance, which in turn leads to greater long-term healthcare expenditure as patients spend more time in hospital with severe infections.
“For example, individual doctors and surgeons often use drugs, treatments, and implants that are three or four times more expensive than the available alternatives. In these cases, the familiarity and personal preference of healthcare
“Whatever form the next Irish government takes, it's crucial that its Sláintecare implementation programme is guided by rules governing best practice and driven by a judicious, evidence-based approach to patient treatment.”
“While an appropriate budget is crucial to service provision, we must ensure that we are not throwing money at a broken system underpinned by broken practices,” he said.
Update on Anti-Epileptic Medicines The HPRA has included pregabalin and gabapentincontaining medicinal products on the List of Interchangeable Medicines. As pharmacists will be aware, these medicinal products are indicated for the treatment of epilepsy. Pharmacists have a particularly important role in providing information and education to patients on medicines. When a medicine is substituted, pharmacists must take time to ensure that patients receive appropriate counselling to ensure that patients understand the correct use of their medicines and are not confused by changing packaging, colour or shape of the tablets/capsules.
Safe Supply of Methotrexate The European Medicines Agency (EMA) has recommended new measures to prevent serious and potentially fatal errors with the dosing of methotrexate for treating inflammatory diseases such as rheumatoid arthritis, psoriasis and Crohn’s disease. The recommendations result from a review of reports that patients are using Methotrexate incorrectly despite previous measures to prevent errors. Pharmacists are reminded that methotrexate for inflammatory conditions is intended for use just once a week. Serious side effects including fatalities have occurred when methotrexate is taken more often.
Unauthorised Medicines The HPRA is advising the public that U-Dream Full Night and U-Dream Lite, marketed as herbal sleep aid products, have been found to contain an undeclared substance that is similar to zopiclone, a prescription only medicine. It is known that zopiclone can cause drowsiness, dizziness and abnormal sleep behaviours. Although these products are not authorised for sale in Ireland, the HPRA has become aware that packs of U-Dream Full Night and U-Dream Lite have been sold to consumers in Ireland from retail outlets, including health stores. It is also possible that some consumers may have purchased either of these products online.
LOOKING FOR A BETTER NIGHT’S SLEEP?
DISCOVER NYTOL’S FIRST * CLINICALLY PROVEN SLEEP AID *New to Nytol range in Ireland. Nytol One-A-Night 50 mg Tablets contains diphenhydramine hydrochloride. A symptomatic aid to the relief of temporary sleep disturbance in adults. Adults: One tablet to be taken 20 minutes before going to bed, or as directed by a physician. Do not exceed the maximum dose of one tablet in 24 hours. Elderly patients or patients with liver or kidney problems should consult their doctor before taking this medicine. Children under 18 years: Not recommended. The product should not be taken for more than 7 days without consulting a doctor. Contraindications: hypersensitivity to the active substance or to any of the excipients, stenosing peptic ulcer, pyloroduodenal obstruction, phaeochromocytoma, known acquired or congenital QT interval prolongation, known risk factors for QT interval prolongation. Special warnings and precautions: pregnancy/lactation, renal and hepatic impairment, myasthenia gravis, epilepsy or seizure disorders, narrow-angle glaucoma, prostatic hypertrophy, urinary retention, asthma, bronchitis, COPD. Patients should be advised to promptly report any cardiac symptoms. Do not take for more than 7 consecutive nights without consulting a doctor. Use in the elderly should be avoided. Avoid concomitant use of alcohol or other antihistamine-containing preparations. Do not drive or operate machines. Interactions: CNS depressants, MAO inhibitors, anticholinergic drugs (e.g. atropine, tricyclic antidepressants), metoprolol and venlafaxine, CYP2D6 inhibitors, Class Ia and Class III anti-arrhythmics. Side effects: thrombocytopenia, hypersensitivity reactions, confusion, paradoxical excitation, sedation, drowsiness, disturbance in attention, unsteadiness, dizziness, convulsions, headache, paraesthesia, dyskinesias, blurred vision, tachycardia, palpitations, thickening of bronchial secretions, dry mouth, gastrointestinal disturbance, muscle twitching, urinary difficulty, urinary retention, fatigue. Legal classification: P: PA1186/016/001. MAH: Chefaro Ireland DAC. The Sharp Building. Hogan Place. Dublin 2. Ireland. RRP (ex. VAT): 20s €7.99. SPC: https://www.medicines.ie/medicines/nytol-one-a-night-50-mg-tablets-34889/smpc IRE-NYT-2019-013
Food supplements do not replace a varied diet and healthy lifestyle. Vitamin B1 helps support normal heart function. Vitamin D helps maintain normal bones. Vitamin B6 helps support normal energy release. Vitamin D contributes to normal muscle function. Vitamin A helps support normal vision.
Urgent need for improved NRT – say Pharmacists The health system needs to do more to help smokers quit, otherwise smoking rates will not fall fast enough. This warning was issued by the Irish Pharmacy Union (IPU) on National No Smoking Day as they criticised the lack of action and innovation in how smoking cessation supports are offered. “The rate of smoking in Ireland has fallen steadily over the last five years,” stated Tomás Conefrey, a community pharmacist and member of the IPU, citing the Healthy Ireland 2019 Survey. “This is a huge achievement and all those responsible should be commended, most notably the quitters themselves. However, 17% of people over the age of 15 still smoke every single day and that is far too many.
“The welcome reduction over the last five years will not be sustained into the future unless access to support is improved. In particular, we need to offer greater support to medical card patients as the research shows smoking in deprived areas is far higher than the national average (24%) and higher still for those unemployed (40%). “Nicotine replacement therapy is proven to work and can
significantly improve the chances that an attempt to quit will be successful. NRT has been successfully available in pharmacies for many years but unfortunately medical card patients still must go through their GP. This reduces the convenience and creates an unnecessary barrier for would-be quitters. There is no reason why this artificial barrier should remain in place and it will limit Ireland’s ability to lower smoking rates.”
The HSE, meanwhile, called on people who smoke to take on the 28-day #TheLastStop no smoking challenge in March. Research shows that those who can quit smoking for 28 days, are five times more likely to quit for good. Starting from the 2nd of March people who smoke across the country took part in the 28-day challenge.
7th FIP Congress The International Pharmaceutical Federation (FIP) has united with the Canadian Society for Pharmaceutical Sciences (CSPS) and the University of Montreal to invite community pharmacists to the 7th FIP Pharmaceutical Sciences World Congress (PSWC2020), taking place from 22 until 27 May 2020 in beautiful Montreal, Canada. We live in exciting times. More than ever, innovation is emerging at the interface of disciplines, holding the promise of smart therapeutics, medicines that are sophisticated in their design and optimised to meet the needs of individuals and communities in a complex world. PSWC is your chance to network with leading experts from across the world, compare best practices and learn about the latest trends in pharmaceutical sciences, including the potential of information-based technologies, challenges and opportunities in global health and new collaborative models for stimulating innovation. Get the latest information at: https://pswc2020.fip.org/
Pharmacists reiterate calls to ‘play it safe’ Valentine’s Day may have been and passed, but shocking figures have emerged which shows Ireland’s incidence of sexually transmitted infections (STIs) continued to rise in 2019. Provisional figures from the HSE indicated a 16% increase in diagnoses of chlamydia, with approximately half of reported cases occurring in young people of 15-24 years. The Health Protection Surveillance Centre has also released provisional figures showing that in the week to Wednesday, February 12th alone, Ireland recorded 241 cases of chlamydia and 93 cases of gonorrhoea. CarePlus Pharmacy used Valentine’s Day to remind young people all over the country to take care of their sexual health. CarePlus Pharmacy believes sexual health is a vital part of a person’s well-being at any time of the year. As part of this campaign, CarePlus Pharmacy dropped into the Students’ Union at University College Cork to help distribute over 5,000 free condoms, to remind young people from across Ireland of the importance of ‘playing safe’. Pharmacist Nigel Moloney from Carrigaline CarePlus Pharmacy in Cork says “Sexual health awareness has come a long way in Ireland, but we believe the
President of UCC Students’ Union, Ben Dunlea with Students, Sarah O'Connor and Brian O'Mahony as CarePlus Pharmacy advises young people around the country to ‘Play Safe’ this Valentine’s. Picture: Michael O'Sullivan /OSM PHOTO
message can’t be repeated often enough: ‘be prepared’. There are simple steps to keep in mind in order to avoid facing unplanned pregnancy or sexually transmitted infection. If you have any questions or concerns, feel free to come and talk to your CarePlus Pharmacist about the various options available.” CarePlus Pharmacists and their teams value their role at the heart of their communities at more than 60 outlets around Ireland. Sexual health is one of the areas where they’re trained to give advice, in confidence.
New research conducted by LetsGetChecked for Sexual Health Awareness and Guidance (SHAG) week showed that only nine percent of 25 to 34 year olds had an intention to get screened this year. Similarly, only 14% of the younger
age bracket stated that they had gotten an STI check in 2019. Provisional figures from the HSE have indicated a 16 percent increase in cases of chlamydia since last year, with about half of reported cases occurring in young people between 15 to 24 years.
CBD in Pharmacy notice of recalls Following a national survey of CBD oil food products, the Food Safety Authority of Ireland (FSAI) has issued a recall notice for a number of CBD products. The FSAI has prepared the following FAQs on CBD and Hemp oils in Ireland. A national survey of CBD products by the Food Safety Authority of Ireland (FSAI) has found that the majority of products analysed were in breach of various articles of food law and some posed potential safety risks for consumers. The survey, published today, reveals that 37% of the products tested had a THC* content that could result in safety limits set by the European Food Safety Authority (EFSA) being significantly exceeded and the implicated batches of these products are currently being recalled. In addition, it was found that the analytically determined CBD content in over 40% of samples varied significantly (>50%) from the declared CBD content. The implications of these results for consumers range from consumers being grossly misled to being put at risk by the ingestion of relatively high levels of THC. The majority of the 38 products tested from the Irish market were
manufactured outside of the country. The FSAI is working with the Environmental Health Service of the HSE and the relevant food businesses in relation to the matter. The survey found that 37% of the products tested contained levels of THC that significantly exceed the EFSA safety limit. This indicates a more widespread problem with THC content in these products that merits further investigation. While consumer safety is the priority, the undeclared presence of THC in these products can also pose a risk for drivers, as well as athletes who may be buying and consuming these products without knowing they contain a psychotropic substance. Pharmacists Notice All food supplements should be notified to the FSAI when placed on the market and when a label changes. This can be checked by contacting FSAI. If you have
a questions or concerns about a food supplement on the market please contact the FSAI. Pharmacies must ensure they know the regulatory status of any product being supplied and the legislative requirements that governs such products. Medicinal claims cannot be made for products that are not authorised as medicines. Under the Code of Conduct for pharmacists it is expected that all pharmacists must give honest, relevant and accurate information regarding the costs, benefits and risks of medicinal products, non-medicinal products and services provided by them. For information on cannabis for medical use, the Department of Health has published an online repository of information on medical cannabis. It provides information on the existing Ministerial medical cannabis licence scheme and the medical cannabis access programme currently under development.
Black’s Allcare Pharmacy raises ¤1,350 Black’s Allcare Pharmacy in Monaghan has raised €1,350 for Elaine Tate, a native of nearby village Rockcorry who was diagnosed with kidney cancer in 2014. Blacks Allcare Pharmacy staff with Operation Transformation leader Lorraine ONeill Monaghan GAA footballer Darren Hughes and Michelle Moffett from Croc Elaine is a primary school teacher, wife and mother of three. In 2019, she suffered a rare reaction to chemotherapy medication which resulted in her becoming paralysed from the waist down. The condition is irreversible and, as a result, she continues to be confined to a wheelchair. Black’s Allcare Pharmacy held an in-store Spinathon to raise funds for Elaine, with proceeds going towards supporting Elaine and her independence. The event was supported by Operation Transformation leader Lorraine O’Neill, local GAA footballers, politicians, Gardaí and many local residents. A GoFundMe page has also been set up for members of the public to support Elaine. You can find the page at www.gofundme.com/f/ challenge-for-elaine-tate.
Medicine Shortages The Health Products Regulatory Authority has been notified of a shortage of the following products: • Benetor 10mg Tablet – PA1595/001/001 • Celecoxib 100mg Capsule – PA2315/228/001 • Celecoxib 200mg Capsule – PA2315/228/002 • Creon 25000 Gastro-resistant Capsules – PA2010/008/002 • Epanutin 50mg Capsule – PA0822/011/002 • Frumil Low Strength 20mg/2.5mg Tablet – PA0540/101/001 • Indivina 1mg/2.5mg Tablet – PA1327/005/001 • Indivina 2mg/5mg Tablet – PA1327/005/003 • Noxafil 300mg/ml Concentrate for Solution for Infusion – EU/1/05/320/004 • Pepcid AC 10mg Tablet – PA0330/053/001 • Stilnoct 10mg Film Coated Tablet – PA0540/160/002 The following shortage has been resolved and supply has resumed to the Irish market: • Divigel 0.1% w/w Gel – PA1327/002/001 • Gerax 0.5mg Tablet – PA0577/010/002 • Gerax 1mg Tablet – PA0577/010/003 • Innohep 16,000IU in 0.8ml Solution for Injection in Prefilled Syringe – PA0046/060/014 • Keflex 250mg Capsule – PA1226/002/001 • Minulet 75mcg/30mcg Coated Tablet – PA0822/093/001 • Mysoline 250mg Tablet – PA1777/001/001 • Ovranette 30mcg/150mcg Film Coated Tablet – PA0822/094/001 • Suprefact 1mg/ml Solution for Injection – PA0540/074/001
McCauley’s Opens in Ardfinnan
On January 21st 2020, Gerry McCauley and his wife, Rosemarie, opened the only Pharmacy in the small town of Ardfinnan, County Tipperary.
hey’re both qualified Pharmacists and Gerry has the industry in his blood, as his dad was the founder of the well-known Sam McCauley brand. After several years working in various parts of the Pharmacy sector including locum, supervising Pharmacist, research and more, Gerry spotted an opportunity for a new store in Ardfinnan, close to his home in Clonmel where he and Rosemarie live with their five young children. It seemed like the perfect fit, but Gerry says it took time to get everything right: “Between acquiring the site, going through the planning permission process and keeping my other business interests on track, it was a year-long journey but we’re delighted to have everything up and running now”. Gerry and his CarePlus team are enjoying a warm welcome from the local community. Gerry says there’s a strong demand for the health services they provide: “There’s a GP practice open three days a week here so we’re well placed to meet the needs of their patients, and we also service the neighbouring village of Newcastle and a sizeable catchment area.”
Gerry is full of praise for the offering from CarePlus Pharmacy Group: “Obviously when we were considering opening the shop we had to look at all the possible brand options, but CarePlus Pharmacy was the clear winner. With their commercial connections it was clear that their buying power is fantastic. The excellent IT and Technology systems, category managment, Head Office support, top class business development team and other elements like the attractive branding, and features like new product launches and promotions all convinced us CarePlus was the way to go”. “For a shop that’s just starting out, the complete package offering that CarePlus Pharmacy has is simply a no-brainer. Could you do it yourself? Yes, but in my opinion, as someone who’s seen most parts of the industry at this stage, it would be a fool’s errand. This industry brings with it incredible downward pressure on pricing and profit erosion, so to have the support of CarePlus buying power, and of their team who have been so helpful to us, took an awful lot of the stress out of our start-up process”.
PHARMACYNEWSIRELAND.COM | 11
Pharmacy show Love for Heart Health Keanes CarePlus Pharmacies recently showed their support for the Irish Heart Foundation’s Go Red for Women Campaign. Go Red for Women is the Irish Heart Foundation’s national fundraising campaign, in support of women across Ireland – one quarter of whom will die from cardiovascular disease. Cardiovascular disease is one of the leading causes of death in Ireland, taking the lives of more than 4,000 women in Ireland last year. Women are almost six times more likely to die from cardiovascular disease than breast cancer. However, the good news is that 80 per cent of premature death from cardiovascular disease is preventable. All the donations from Go Red for Women will help raise awareness of women’s heart health and support the Irish Heart Foundation’s life-saving programmes that keep women’s hearts beating all over Ireland. These include, CPR training, heart health checks, patient support groups and information events.
CPD Practice Review April 2020 The next Practice Review will take place in April 2020 and the Irish Institute of Pharmacy has scheduled a number of support events in the coming months. In addition to invite only webinars specifically for pharmacists selected for Practice Review in April they will also hold Practice Review Roadshows, which are available to all pharmacists to attend. The Practice Review Roadshow events will provide an overview of Practice Review and will be of interest to all pharmacists eligible for selection for Practice Review (i.e. pharmacists practicing in patient-facing roles), who want to learn more about the process. Each Roadshow will include: • A presentation which gives an overview of each component of the Practice Review, i.e. the Standardised Pharmacy Interactions (SPIs) and the Clinical Knowledge Review (CKR) • Insights from a pharmacist who participated in Practice Review October 2019 • A Question and Answer session You can register for a Practice Review Roadshow in the Practice Review section of the IIOP website at www.iiop.ie
Managing Quality in Pharmacy Practice The Irish Institute of Pharmacy has recently established a new programme for community pharmacists, along with Pharmapod. This new programme ‘Managing Quality in Pharmacy Practice’ was developed for the Irish Institute of Pharmacy (IIOP) by Pharmapod. This is a self-directed online training programme which will take approximately 4-6 hours to complete. The aim of the programme is to introduce pharmacists to recognised principles of quality management and help them to implement these principles in their own practice. The programme content covers aspects of quality management relevant to pharmacy practice,
including the principles of quality management, how to develop a quality management system, principles of risk management, quality improvement, and how to develop a process to review quality related adverse events such as medication errors. It also covers national and international policies, strategies and best practices.
• Describe Quality Improvement and Quality Assurance Models and how to apply these models to your practice • Develop, implement and review a Quality Management System relevant to your pharmacy practice
At the end of this programme you will be able to:
• Apply the principles of risk management to identify deficits and risks in the quality of pharmacy services you offer
• Describe the principles of quality management, including recognised quality management theories and frameworks
• Develop a process to review quality-related adverse events such as medication errors and customer complaints
Guidelines for Pharmacy The roles that pharmacists in community, hospital and clinical biology can play in preventing the spread of the new coronavirus 2019-nCoV and supporting the efficient management of infection by healthcare systems have been outlined in a new document published by the International Pharmaceutical Federation (FIP). “Since pharmacies are often the first point of contact with the health system and given that cases have already been seen in a number of countries, it is important that the whole pharmacy workforce is well informed and prepared,” said taskforce chair Mrs Jane Dawson, who is also secretary of FIP’s Military and Emergency Pharmacy Section and director of health policy for the New Zealand Defence Force. The document gives reliable information on 2019-nCoV and covers preventive measures (from how to wear a mask to effective disinfection), what equipment to stock, advice that pharmacists can give, and laboratory testing. FIP’s document, “Coronavirus 2019-nCoV outbreak: Information and interim guidelines for pharmacists and the pharmacy workforce”, will be downloadable in the six official United Nations languages along with other resources on the FIP website. “Although the CPA guidance is aligned with characteristics particular to the system of pharmacy in China, it contains valuable expertise that can be used by pharmacists around the world, and it complements FIP’s guidance for an international audience. The CPA has kindly agreed to share this document in English and Chinese through the FIP website,” Mrs Dawson said. “As demonstrated by previous SARS-CoV and MERS-CoV outbreaks, coronavirus infections can be contained through the active engagement of decisionmakers, healthcare professionals and the community. This guidance is a valuable resource to ensure preparedness of our workforce in combating this new coronavirus and perhaps future ones. It also highlights the huge benefit of international collaboration via FIP,” she added.
Hay Fever - Key Market Trends Key market trends in the Child and Babycare Category identified and discussed by Anne-Sophie Martin, Brand manager for GP number 1 recommended, 100% natural sea water nasal spray brand STÉRIMARTM. symptoms quickly and effectively. It also presents an opportunity to not only drive sales on treatments but also support this as upsell of products with preventative properties, or natural products that can complement their existing treatment choice for more efficient management of symptoms.
According to Mintel reports, not only do a quarter of parents in the UK who have children between the ages of 0 to 2 like to use natural alternatives to personal care products on their children, but one fifth are worried their children are sensitive or allergic to certain ingredients in personal care products. This means that many parents now not only want to know that products are effective, and ‘more natural’ but also they are becoming much more aware of what the different ingredients are in the products they are using, investigating that their full ingredient list is completely safe before believing brand and packaging claims. This is a trend that is predicted to grow throughout the healthcare market in general, as shoppers become more conscious about what they are putting in their own and especially their children’s bodies, opting for products that they perceive to be the ‘healthier alternative’ with minimal or no risk of potential side effects. It is not enough for brands to just state their natural qualities anymore, they need to be able to prove it with ‘nothing to hide’ ingredients and straightforward claims clearly stated on pack. But while they are becoming more savvy, research conducted on behalf of STÉRIMARTM towards the end of 2016 showed that while parents are open to trying new products if they think they will work and are recommended by peers, they are still looking to GP’s
as a first port of call for advice on treatment. This is mainly due to the fact that they think the childcare category can be confusing and hard to navigate themselves, with many products lacking clear benefits and reasons to believe.
price rising by £0.25. New launches and higher price points play a key role in contributing to the growth in this area, mainly driven by decongestants, although hay fever is also a strong subcategory.
This is a great opportunity for Pharmacies to bridge the gap between GP advice and peer recommendation, helping parents to navigate through the array of products available. By ensuring that staff are knowledgeable* about which products are not only effective, but also the ones that are most often recommended by GPs and which are completely natural, will help position them as a trusted and convenient destination for parents to get advice and treatment recommendation for their children. This can be coupled with ensuring that the childcare products are well categorized at shelf to make it easy for parents to navigate at point of sale. If possible, products could be grouped by ailment and put in age suitable order.
STÉRIMAR™ range of natural sea water based nasal sprays is one of the brands that has helped drive the growth of the Nasal Spray category. Last year, Stérimar grew by 18.3% and attracted an impressive 77k more shoppers. Stérimar is now standing as the 7th largest brand in the whole nasal treatment market with the second largest percentage value growth. The brand is also thriving across the sub-categories becoming the 6th biggest brand in the decongestant sector, the 4th biggest brand in the children’s sector and the 3rd biggest brand in the overall hayfever sector.
Opportunities for pharmacy businesses with the Stérimar™ children’s range According to Kantar Worldpanel and Nielsen Scantratck data 28.01.2017, the Nasal Spray category is a growing area within healthcare. In 2016 the Nasal Spray market grew by 10.3%, attracting 91k more shoppers than the previous year, with the average
This is supported by the fact that it is the UK’s GP number 1 recommended brand as well as the fact that the products in the children’s range contain only natural sea water and purified water with some additional copper salts for Stérimar Kids. These gentle yet effective products tick several of the key boxes for parents who are seeking healthier alternatives.
Stérimar hay fever products have a base of 100% natural purified sea water and can be used alongside a nasal congestion medication and antihistamines based on medical advice. This means that pharmacists are able to up sell and widely recommend Stérimar in the knowledge that it is safe to use and will not cause any rebound congestion. Customers should also be educated on the relevance of preventative solutions when tackling hay fever symptoms. As the first line of defence against pollen, it is essential to keep your nose as healthy as possible to help protect from the symptoms of hay fever. Washing your nose daily with an isotonic solution will simply wash away contaminants and debris trapped in the nose while helping prevent the onset of allergic reactions and ensuring the nasal lining is kept moistened.
How to Make the Most of the Hay fever Sub-category?
Advise your customers to start using Stérimar nasal sprays well in advance and a couple of weeks before they usually start experiencing symptoms and to keep using it regularly throughout the season to keep symptoms at bay.
Anne-Sophie Martin says, “Pharmacies should present themselves as the convenient destination for informative advice and products that will address
*You can now avail of in store training with our Product Trainer Annette O’Sullivan – simply enquire through your Intrapharma Rep to arrange this.
For more information, samples and pricing please contact your Intrapharma Representative on 01463 2300
Listen out for the Pollen Count brought to you by Sterimar April to July
How to maximise the benefits of medicines Medication Adherence in Pharmacy Non-compliance with prescribed regimens can cause grave health consequences. Worldwide, non-adherence is a major hurdle in providing effective healthcare, achieving disease control and preventing adverse events.
The World Health Organisation defines medication adherence as “the degree to which a person’s behavior corresponds to the agreed recommendations from a healthcare provider.” Though medication adherence commonly refers to drug compliance, in a broader sense this includes all treatment instructions such as self-care, medical device use, exercises, and therapy sessions.
Though a single intervention or intervener cannot adequately address a problem as complicated as patient medication non-adherence, pharmacists can make a significant impact in many ways. Here, Community Pharmacist Breda Heneghan, MPSI, looks at how pharnacists can maximise the benefits of medicines.
Today in Ireland we have an elderly population (65+yrs) of 637,567 which equates to 13.4% of the population. Some 65% of this population suffer from two or more chronic disease (e.g. Diabetes and Hypertension) and they are required to take multiple medicationsto help control these problems. As the complexity of health problems increase, this puts an
"Drugs don't work in patients who don't take them" C. Everett Koop, M.D.
ENJOY ENJOY THE THE SUMMER SUMMER WITH WITH
HAYFEVER HAYFEVER & ALLERGY RELIEF
& ALLERGY RELIEF FROM
For further information, please contact our Telesales Team - Eugene, Jeanne Marie or Rita on
1800 304 400
For further information, please contact our Telesales Team - Eugene, Jeanne Marie or Rita on 1
1800 304 400
e in ยนCetrine Allergy7 1mg/ml Oral Solution, and available in 200ml bottle and launched 28 in November 2019. Cetrine Allergy 10mg FCT available in 7 and 30 packs, Lorat 10mg Tablets available in 7 and 28 C packs, or Rhinex Relief 50 micrograms/actuation to Nasal report spray, suspension, available as 1 x 60 doses. Medicinal products not subject to medical prescription. For further information, SPC or to report CF adverse drug reactions, No: contact the Marketing Authorisation 22863 Holder: Rowex Ltd., Bantry, Co. Cork. Ireland. Freephone: 1800 304 400. Fax: 027-50417. Date of preparation: (01-20) CCF No: 22863
increasing burden of managing treatment on the patient and their families. Evidence shows that the more complex a treatment regimen becomes, the higher the risk that the patient is not following or adhering to the treatment guidelines. This means that many patients living with multiple conditions do not get to reap the benefit of their prescribed medicines which we know will work if taken correctly. It can also lead to unnecessary suffering and wasted resources; however, patients are often reluctant to tell their doctor or pharmacist that they do not take their medicines or that they struggle to take their medicines correctly. Pharmacists are in a perfect position to identify and help patients with medication adherence issues as they often engage with the patient more frequently than other health professionals (eg) monthly for example when the patient is picking up their prescription. Pharmacists are medicines experts and can provide a medicines review and possible introduction of a Monitored Dosage System if deemed necessary in the form of weekly/ monthly blister packs. Financial and health costs of not taking medicines properly Non-adherence to prescribed medication is costing EU governments approximately ¤125 billion annually andcontributes to the premature deaths of 200,000 Europeans per year. In the Irish population, more than ¤319 million is spent each year on medicines for the one in five of the population aged over 50 with polypharmacy (use of many medicines at one time).
– it is that simple! But adherence is not simple. The reasons behind medication adherence are complex, and can sometimes go beyond a lack of information, forgetfulness, or even access to medication itself. Understanding the complexity of non-adherence factors is key to addressing the issue. Non-adherence categorised as two types: intentional and unintentional Unintentional non-adherence relates to barriers beyond a person’s control which prevent them from following a prescribed treatment. These include obstacles such as financial barriers, lack of information or understanding about their condition or prescribed treatment, forgetfulness, and ability. Intentionally not taking medicines Intentional non-adherence relates to the persons beliefs, perceptions and motivations, where a person is reluctant to adhere due to attitudes, concerns, opinions or fears. One useful way to establish what might be driving non-adherence is known as the ‘Perceptions and Practicalities approach’. Perceptions refers to how people’s beliefs about medicines might explain their medication taking behaviour. For example, patients may have concerns about potential harmful side-effects or believe that prolonged use of medicines might be toxic. Some patients may not see medicines as being necessary.
When long-term medication is prescribed for patients with chronic diseases, it is estimated that approximately 50% of individuals fail to adhere to the prescribed regimen. If you do not take your medication, it is not going to work
This is particularly the case in conditions that are asymptomatic such as hypertension or hyperlipidaemia. The medications used to treat these conditions are also typically experienced as neutral which might initially seem positive. However, when patients feel no different whether they take or fail to take their medications this can pose a problem for long-term adherence. Un-intentionally not taking medicines Practicalities refer to all those factors that are not about the patients’ motivation to take their medication. This can include memory problems, costs, access to medications and lack of skill in taking medication appropriately. Pharmacists can help encourage questions from the patient Here are some key questions that the pharmacist can discuss with the patient to help initiate, frame and guide a conversation about their medicine taking: 1. Opener: E.g “You have a lot of medications to manage”, E.g. “Are you taking your medications by doing the following ...?” 2. Encourage the patient to elicit more information/guidance from you, the pharmacist: E.g. Are there any medications that you,the patient would be less likely to take? Why is that? Are you worried? Do you think they are doing you any good?
3. See if your questions can encourage the patient to offer more insight? E.g. “Is there anything that you could do differently that you think would help with taking the medications?” Help to ensure medication is taken as prescribed Here are some general strategies that might be helpful: 1. Some patients can get their medications provided in reminder packaging by the pharmacist. The pharmacistcan deem if this is necessary on a case by case basis – Monitored Dosage Systems (MDS) or ‘Blister Packs’ 2. Some patients find it helpful to link taking their medication to a routine they do every day. For example, brushing their teeth or having a cup of tea in the morning or evening after they have eaten. 3. Is there anyone at home that can give the patient a reminder to take their medications or make sure that they have them available? E.g.Putting a reminder into their phone or get someone to do so for them. 4. Remind the patient to see what happens to their blood pressure/cholesterol/other relevant sign or symptom over the next few weeks if they can take all doses of their medication as and when prescribed. Medication Adherence Capability, Opportunity and Motivation all influence how patients take their prescribed medication. Capability -Doesthe patient have the physical and psychological capacity to take the medication as prescribed? E.g. – Does the patient have arthritis which
DONâ€™T LET PAIN HOLD YOU BACK
ESSENTIAL INFORMATION Solpa-Extra 500mg/65mg Soluble Tablets contain paracetamol and caffeine. For the treatment of mild to moderate pain. Adults and children over 16 years: 1-2 tablets dissolved in water every 4-6 hours. Max 8 tablets a day. Children 12-15 years: 1 tablet disolved in water every 4-6 hours. Max 4 tablets a day. Not suitable for children under 12 years. Contraindications: Hypersensitivity to the ingredients. Precautions: Particular caution needed under certain circumstances, such as renal or hepatic impairment, chronic alcoholism and malnutrition or dehydration. Precautions needed in asthmatic patients sensitive to acetylsalicylic acid, patients on a controlled sodium diet and with rare hereditary problems of fructose intolerance. Patients should be advised not to take other paracetamol containing products concurrently. Pregnancy and lactation: Not recommended during pregnancy and breastfeeding. Side effects: Rare: allergies. Very rare: thrombocytopenia, anaphylaxis, bronchospasm, hepatic dysfunction, cutaneous hypersentitivity reactions. Unknown: nervousness, dizziness. Further information is available in the SmPC. PA 1186/017/001. P. MAH: Chefaro Ireland DAC, Treasury Building, Lower Grand Canal Street, Dublin 2, Ireland. Date of preparation: April 2017. IRE/NHPT/SOL1/2019-003.
make opening tablet containers difficult?(Pharmacist can offer the patient tablet vials without the child resistant closures to improve ease of opening?);Does the patient have any memory difficulties? (Perhaps the patient could benefit in getting their medication in a weekly or monthly blister pack) – Opportunity -Does the patient have physical opportunity to take the medication as prescribed? Is it easy to source, collect and pay for the medication?(E.g.Many pharmacies provide a prescription home delivery service to patients) Motivation-Does the patient want to (i.e., have the motivation) take the medication as prescribed? Have they noticed any side effects? Unintentional reasons may be due to forgetfulness, confusion or a lack of integrating medicationtaking into daily routine. If this is the case, then the patient might benefit from an organizational based approach to improving adherence like blister packs form their local pharmacy. Monitored dosage systems (MDS) There are multiple types and different options for patients, depending on individual concerns. An MDS is any medication storage and organisational device designed to simplify patients’ medication usage and commonly
comes in the form of a box or blister pack divided into the days of the week and times of day. Tray-style blister packs are suitable for home use. There are other pouch/bubbletype systems available which are for people with more active lifestyles, as individual timeslots containing medications can be taken out of the tray. Determining if a patientmay benefit from medicines in a ‘blister pack’ Some of the criteria can be used by a pharmacist to determine if the patient would benefit from a blister pack: • Is the patient on a complex medication system? • Is the patient confused about medication instructions? • Does the patient regularly forget to take their mediation? • Is there evidence of medication wastage/medication returns to the pharmacy? • Does the patient visit the pharmacy irregularly to collect their medication? • Has the patients’ carer/nurse/ doctor requested assistance or raised medicine adherence concerns? • Does the patient have learning difficulties, eyesight problems or dementia?
Not all medicines can be included into the ‘blister packs’ perhaps due to their prescribing directions (i.e. take only when needed), their stability or storage requirements. The blister packs require advance planning, so encourage patients to notify the pharmacy at least 48 hours in advance of when the next pack is due. Pharmacist can help simplify complex medication regimes for patients ‘Blister packs’ provide patients and their families support in managing their healthcare requirements especially as they age, and their needs become more complex. Elderly patients living alone can retain independent living with supervision as required, confident that their medication needs are been looked after correctly.
twice daily tablet, in terms of adherence. Pharmacists are in a great position for medication review due to monthly interactions with the patient/carer or families and clear insight into what medications are actually collected on a regular basis (versus what is prescribed). These consultations are also an opportunity for patient education and feedback on effectiveness and side effects of therapy and may require feedback to and communication with doctors (to optimise medicine regime); however clear consent will be obtained by the pharmacist to avoid breakdown of patient trust.
Another option is to reduce the number of tablets to be taken by patients with multimorbidity, a move toward combination products available can be utilised (e.g. 3 active ingredients in one tablet). However, the increased cost of these formulations must be kept in mind.This can be discussed in further detail with the prescriber and pharmacist. Additionally, the use of prolonged release formulations (where clinically suitable) would further reduce the frequency of taking a tablet. So, a once daily prolonged release tablet is better than a
Written by Breda Heneghan MPSI, Pharmacist at Whelehans Pharmacy, 38 Pearse St, Mullingar
News Trust is key in Pharmacy purchases When it comes to personal health and wellbeing, and that of families, consumers look to the experts for guidance. New research, commissioned by Kantar on behalf of Boots Ireland, reveals that trust, expert advice and convenience are important to people in Ireland, with 70% of those surveyed saying it is important that they trust their pharmacist when buying healthcare products. Of those surveyed, 57% stated they really value advice and help from staff when buying a new medicine, while 68% want to pick up their prescriptions as quickly as possible and avoid long queues. The research also reveals that Ireland is a nation of carers, with 35% of people taking full
responsibility for the health of their entire family. The new prescription ordering service allows Boots customers to manage one-off and repeat prescriptions for themselves, their family members and those they care for. They can also shop for a wide range of healthcare and wellness products when visiting the pharmacy to pick up their prescription, which was found to be important to 42% of people surveyed. The Boots prescription ordering service helps reduce the wait time by allowing customers to preorder their prescriptions through the Boots app before going in
to their chosen Boots to collect their medication. This makes it easier for customers to collect prescriptions when time is limited, like during lunch breaks or before or after work As a result, the service allows for a more personal interaction between the customer and their pharmacist in-store, as the prescription is already dispensed before the customer visits the pharmacy. Time can instead be spent getting advice about the medicine or treatment, allowing customers to ask any pressing questions they may have and build up a relationship with the friendly,
well-trained and knowledgeable pharmacy team. Caoimhe McAuley, Director of Pharmacy at Boots Ireland said, “We are constantly striving to offer our customers the best quality service. Giving our customers the ability to pre-order their prescriptions will save them valuable time and ultimately, allow our pharmacists more time to interact with customers and give them advice, while discussing their medication or treatment with them. This service represents another step in our vision to have an even greater impact on peoples’ health in Ireland.”
HEADACHE PANADOL EXTRA SOLUBLE RELIEVES 5 TYPES OF TOUGH PAIN
Headaches Period pain Joint pain
Back pain Dental pain
Panadol Extra Soluble has a dual active formula which provides up to 30% more powerful pain relief than standard paracetamol.1
RECOMMEND PANADOL EXTRA SOLUBLE for fast pain relief
Reference. 1. Laska EM et al. JAMA. 1984; 251(13):1711-1718.
Panadol Extra 500mg/65mg Soluble Effervescent Tablets. Contain paracetamol. Always read the label/leaflet. Product Information: Please consult the summary of product characteristics for full product information. Panadol Extra 500mg/65mg Soluble Effervescent Tablets, paracetamol 500mg, caffeine 65mg. Indications: Relief of mild to moderate pain including rheumatism, neuralgia, musculoskeletal disorders, headache, symptoms of colds and flu, fever, toothache and menstrual pain. Dosage: Adults and children 16 years and over: 2 tablets up to 4 times a day. Do not exceed 8 tablets in 24 hours. Children aged 12-15 years: 1 tablet up to 4 times a day. Do not exceed 4Â tablets in 24 hours. Do not give to children under 12 years. Minimum dosing interval: 4 hours. Contraindications: Hypersensitivity to paracetamol, caffeine or any ingredients. Precautions: Avoid concurrent use with other paracetamol-containing products. Diagnosed liver of kidney impairment. Patients with depleted glutathione levels or chronic alcoholism or sepsis. Avoid excessive caffeine intake. Caution in those with hereditary sugar intolerance or on a low sodium diet. Should not be used in pregnancy or lactation without medical advice. Do not exceed the stated dose. Prolonged use except under medical supervision may be harmful. Side effects: See SPC for full details. All very rare: Thrombocytopenia, hypersensitivity reactions including anaphylaxis and skin rash, angioedema, Stevens-Johnson syndrome, bronchospasm, hepatic dysfunction. Frequency unknown: Nervousness, dizziness. When combined with dietary caffeine intake, higher doses of caffeine may increase potential for caffeine related adverse events such as insomnia, restlessness, anxiety, irritability, headaches, GI disturbances and palpitations. Overdose: Immediate medical advice should be sought in the event of an overdose, even if symptoms of overdose are not present. Legal Category: Supply through pharmacy only. MA Number: PAÂ 678/39/10. MA Holder: GlaxoSmithKline Consumer Healthcare (Ireland) Limited, 12 Riverwalk, Citywest Business Campus, Dublin 24. Additional information is available upon request. Text prepared: November 2019. CHGBI/CHPAN/0107/19
Chronic Medication Service for Pharmacy A collaborative approach to chronic disease management could save lives in Ireland, it has been stated. Community pharmacist and IPU Executive Committee member Caitriona O’Riordan said that the “evidence of the benefits of the community pharmacy sector is clear, but the ambitions of Government is sadly not.” Explaining the proposal for a chronic disease management services Ms O’Riordan said “Many people in Ireland live with the reality of chronic illnesses. The effective management of these can have profound impact on people’s health. Doing so in an efficient and convenient manner can also significantly improve quality of life and reduce the stress of such conditions. The clinical benefits of pharmacy involvement in chronic disease management are compelling and we have long advocated for a collaborative approach between community pharmacists, GPs and practice nurses.”
Citing the example of hypertension Caitriona O’Riordan said: “Over ¤1.36 billion euro could be saved by the state over thirty years if a pharmacy-based blood pressure management service was rolled out. More importantly this would avoid over 70,000 cardiovascular events.” “Earlier this month a study by Imperial College London published in the Lancet highlighted that Ireland has among the highest levels of high blood pressure in the developed world, but very worryingly we also have among the lowest diagnosis rates. These are warning signs we cannot afford to ignore any more.”
Providing an example of where the expansion of pharmacy services has been successfully delivered in Ireland O’Riordan said: “Since Irish pharmacists first started vaccinating in 2011, flu vaccine deliveries have increased overall by 48%. Pharmacists now represent 15% of all flu vaccinations, with a 99% public satisfaction rate. We now want to deliver similar result in other areas of patient care.” “Sláintecare Report recommends the use of all available mechanisms and processes to ensure healthcare is delivered at the lowest level of complexity and is safe, efficient and good for patients. It further recommends
that priority is given to health promotion and preventative care, and that there is a strong focus on medicines management.” “There are currently over 1,900 community pharmacies nationwide ready to play their part in making Sláintecare a success. However, in spite of many promises there is little evidence the Government is taking the simple steps necessary to empower pharmacists to do more and help save patients’ lives. This needs to change,” concluded Caitriona O’Riordan, Executive Committee member of the Irish Pharmacy Union.
Life Long Learning in Pharmacy 2020 The 13th International Life Long Learning in Pharmacy Conference is coming to Dublin, Ireland, from 3 to 6 of July 2020. The Royal College of Surgeons in Ireland (RCSI) is hosting this pharmacy education event at its historic St Stephens Green campus. Develop your knowledge and skills in the field of pharmacy education through a variety of educational programs, hear from world renowned leaders presenting internationally significant research and development, and network with colleagues from around the globe. With a remarkable list of keynote speakers including Zubin Austin (Canada), Mary E Collins (Ireland) and Rose Marie Parr (Scotland), this is a mustattend pharmacy event. To register to attend the conference visit https://lllpharm2020.com/registration/
Limerick Pharmacists take on the Arctic Limerick Pharmacy ladies Kelly Tonge and Emma Dunne will both be taking on the 2020 Arctic Challenge to raise vital funds for Debra Ireland. Debra Ireland is the national charity established in 1988 to provide patient support services and to drive research into treatments and cures for those living with the genetic skin condition, epidermolysis bullosa (EB). Those who have EB, have skin that is as delicate and fragile as the wings of a butterfly, and just as easily damaged. EB has been described by a Consultant Dermatologist in Our Lady’s Children’s Hospital as “easily the most debilitating and devastating disease I have ever seen.” The condition is extremely painful and leads to disability and deformity.
Many patients who survive childhood face the frightening reality that they could develop a very aggressive form of skin cancer, due to the constant breakdown of their skin. Both Kelly and Emma work out of McCabes Pharmacy in Limerick and have an 11k fundraising target to reach. You can make a donation in any McCabes Pharmacy store or visit their everyday hero fundraising page at the link below to make a donation. https://give.everydayhero.com/ie/ kelly-s-artic-challenge?fbclid=IwA R0RZ8IPYfYtog5QpDHHZJW71X xH4nYoWS6uPU7qOgH4WvhSXN RgfmmIooo
McCabes Pharmacy Limerick staff members Emma Dunne and Kelly Tonge
For babies, infants For babies, For babies, infants infants and children and and children children from 0+ months from 0+ from 0+ months months
100% natural 100% natural 100% natural 5 drops a day 5 drops a day 5 drops a day Easy to use Easy to use Easy to use Allergen free Allergen free Allergen free
A L LY P R ICA L LY P R ICA L LY P R IC
NNN V EV EV E O O O
• • • • • • • • • • • •
C LCI LCI L I N N N
MyPro Kolicare is a clinically MyPro Kolicare is a clinically MyPro a clinically provenKolicare probioticisformula that proven probiotic formula that proven probiotic formula that effectively prevents and treats effectively prevents and treats effectively prevents indications and treats of the early childhood the early childhood indications of the early childhood indications of Colic, whilst promoting a healthy Colic, whilst promoting a healthy Colic, whilst promoting a healthy digestive system for baby. digestive system for baby. digestive system for baby.
For more information please contact: For more information please contact: t: 4602 e: firstname.lastname@example.org For(044) more933 information please contact: t: (044) 933 4602 e: email@example.com t: (044) 933 4602 e: firstname.lastname@example.org
Find us online: Find us online: @MyProFamily Find us online: @MyProFamily @MyProFamily
Pharmacy Support to Parents ccording to Euromonitor, Irish parents are increasingly investing in their childrenâ€™s health, particularly using preventative measures to help build up and support their immune systems through the use of paediatric vitamins and dietary supplements, supporting the latterâ€™s strong position within overall paediatric consumer health. With Irish parents now working longer hours, with in many cases both parents employed, an increasing number of young children are being placed in child care facilities, which increases their risk of being exposed to a higher number of illnesses. Supporting parents of young babies and children can be the beginning of an enduring relationship between pharmacy and customer.
Pain and Fever in Children Pain is defined as a highly unpleasant physical sensation caused by illness or injury. Acute pain is one of the most common adverse stimuli experienced by children, occurring as a result of injury, illness and medical procedures. If a child's pain is not treated quickly and effectively, it can have long-term consequences, which may include anticipatory anxiety during future procedures, a lowering of the pain threshold
22 | PHARMACYNEWSIRELAND.COM
and sensitisation to future pain, reduced effectiveness of analgesics and increased analgesic requirements subsequently. If pain is not treated quickly and effectively in children, it can have long-term physical and psychological implications. Therefore, it is important for pharmacists to understand the importance of effective pain control in children. Pain assessment is challenging in
paediatrics, as infants and young children are not able to adequately verbalise pain. As a result, children have been under-treated for pain compared to adults. Recent advances in the research of pain in children have made significant contribution to the understanding of pain perception in children. We now know that the anatomical, physiological and biochemical mechanics needed for pain perception are present early in intrauterine life. In fact, preterm
Pain Relief for the Family* Feeling better already
Easofen for Children Strawberry 100 mg/5 ml Oral Suspension and Easofen for Children Six Plus Strawberry 200 mg/5 ml Oral Suspension. Contains maltitol liquid & sodium. Sugar free and colour free. *Easofen for Children Strawberry is for infants from 3+ months and should only be given to infants aged 3-6 months who weigh more than 5 kg. Easofen 200 mg Film-coated Tablets and Easofen Max Strength 400 mg Film-coated Tablets are for adults and adolescents (over the age of 12 years). Contains ibuprofen. Retail sale through pharmacies only. A copy of the summary of product characteristics is available upon request. PA 126/60/1-4 PA Holder: Clonmel Healthcare Ltd., Clonmel, Co. Tipperary. Date prepared: December 2019. 2019/ADV/EAS/140H
infants can perceive pain in a way comparable to older children. Fever Fever is a normal physiological response to illness that facilitates and accelerates recovery. Although it is often associated with a self-limiting viral infection in children, it may also be a presenting symptom of more serious conditions requiring urgent medical care. Therefore, it is essential to distinguish between a child with fever who is at high risk of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who can be managed conservatively at home. It is vital that pharmacists, when assessing children who present with fever, can make appropriate decisions on when to refer, the appropriate use of medication and how to advise parents and caregivers. Fever in children is one of the most common reasons for parents or caregivers to seek medical attention for their child. It is frequently a cause for concern among parents and healthcare providers who fear that it may be associated with increased morbidity, such as seizures, brain damage or death. Furthermore, there is confusion about how and whether to manage fever. Although fevers are often a presenting symptom of a selflimiting viral infection, they are also associated with serious bacterial infections, such as meningitis and pneumonia, and other noninfective illnesses. Therefore, the underlying illness causing the fever needs to be determined and it is essential to be able to distinguish between a child with fever who is at high risk of serious illness and a child who requires specific treatment, hospitalisation or specialist care, and those at low risk who can be managed conservatively at home. This is not only true for clinicians, but also for pharmacists and pharmacy workers, who may be the first to see the ill child or caregiver. • Fever is defined as a body temperature ≥38oC. • Fever in itself is not detrimental, but rather a normal physiological response to infection or illness. In the absence of a diagnosis, treatment with the sole aim of reducing temperature is inappropriate and some febrile children will recover more quickly if the fever is not treated. • Most fevers are due to a selflimiting viral infection, but bacterial infections and other causes must be excluded. • Serious bacterial infection is more common in young children. • Any fever in a child aged <3 months is significant and should be thoroughly
investigated and referred to specialist care if the source of the fever cannot be found. Measurement of body temperature Body temperature should be measured in the ear using an infrared tympanic thermometer, or in the axilla. When taking an Axillary measurement, do not measure temperature directly after bathing. Ensure that the child’s axilla is dry. If using a glass thermometer, before placing it in the axilla, shake the thermometer until the liquid is below the 36oC line. Place the tip of the thermometer in the armpit and lightly press the child’s elbow against the chest to close the tip of the thermometer in the armpit. Managing pain in children Discomfort during a febrile illness is often due to associated pain; e.g. myalgia, sore throat, headache. Ibuprofen and paracetamol may be considered to improve comfort (with accompanying improvements in feeding activity and irritability), because they may also provide relief from pain and may reduce the risk of dehydration. They should be used to make the child more comfortable and not used routinely with the sole aim of reducing the temperature. The use of antipyretic medication and attention to the fever must not detract from monitoring the child’s activity and level of consciousness (as an indicator of worsening illness) and paying attention to adequate hydration. Both paracetamol and ibuprofen are safe and effective for shortterm use in children. The practices of combining or alternating paracetamol and ibuprofen
have limited value and are not recommended. Dose of antipyretic medication in children should be accurately based on body weight and should not merely be estimated. For accurate dosing, liquid medicines should be administered with a syringe. The use of NSAIDs has been associated with an elevated risk of severe skin and soft-tissue infections in patients with varicella zoster virus infection. Therefore, paracetamol is recommended as the antipyretic of choice in children with chicken pox. Medicines containing combinations of NSAID(s), paracetamol, codeine and/or antihistamines should not be used in children. Nonpharmacological measures can be used as an adjunct therapy in the management of pain in both adults and children. Nonpharmacological strategies such as physical and psychological comfort measures are useful in conjunction with pharmacological options to help lower levels of anxiety, distress and pain. Some physical comfort measures include the use of massage or heat and/or cold compresses, applying pressure or vibration and repositioning. Psychological comfort measures include use of imagery, distraction and relaxation techniques. Congestion Clearing congestion in a small child can be a challenge. For starters, it’s not always obvious what’s causing a stuffy nose. Infants and toddlers often catch colds because they are just starting to build up their immunity to common viruses. But there are many other potential causes of congestion. If a child has a stuffy nose, breathing in steam with added
essential oils, such as eucalyptus or rosemary, may help to relieve it.For babies, placing a few drops of saline (salt water) just inside their nose, before they feed, will help to relieve a blocked nose. Saline drops are available. Cold medicines for relief of older children and adults are not recommended for infants and toddlers. Fortunately, there are plenty of safe and effective treatments. Symptoms Nasal congestion happens when blood vessels and tissue in the nasal cavity fill up with too much fluid. It can make it hard to sleep and lead to problems like a sinus infection (sinusitis). A baby may also have trouble feeding if he or she is congested. There are some tell-tale signs that can help you tell the difference between viral and bacterial infections. For example, if a child has a runny nose, the colour of the discharge is an important clue. Clear and watery discharge at first usually come from a virus, though the mucus may turn white, green, or yellow for a few days before it turns clear again. Blocked noses can be caused by a mild infection, like the cold or flu, but it’s worth checking if a child has accidentally blocked a nostril themselves. A gentle option is to wash away the mucus that’s causing the blockage, so the child can breathe more easily. A natural treatment like a nasal spray of saline drops can help to do this. Safe Treatments One of the safest and most effective ways to help clear a
PHARMACYNEWSIRELAND.COM | 25
“There are many different types of illnesses parents can seek help with from a pharmacist including colic, teething, constipation, temperatures, flu-like symptoms, and more minor afflictions including cradle cap and nappy rash” baby’s congestion is with a saline (salt water) spray or natural nose drops. These products are available without a prescription and are preservative free. The drops or spray work to maintain daily nasal hygiene by gently cleansing “nasally” nostrils and preserving the natural balance of the nasal mucosa of the infant/child. They can improve the evacuation of mucus, which ultimately prevents colds and limits the occurrence of allergic symptoms like hay fever. By clearing the child’s nose and allowing them to breathe more freely, this also results in improved sleeping and feeding. If advising the use of drops, tell the parent to place two drops in each nostril to loosen the mucus inside. A suction bulb can be used to withdraw the saline and mucus. Tips for using a nasal spray • Get the timing right. It’s hard to use a nasal spray when a baby’s feeling wriggly, so try dosing them when they are nice and relaxed, like after a bath or a feed. • If a child’s under 2: 1. Lay the child down and turn their head to one side. 2. It’s sometimes helpful to lay them on a pillow, so you can tilt their head back slightly. 3. Put the nozzle into a nostril and press the spray head once.
4. Then repeat in the other nostril. • If they’re over 2: 1. Put the nozzle into one nostril, holding the bottle vertically. 2. Press the other nostril closed. 3. Press the spray head once and spray deeply, asking your child to breathe in at the same time. 4. Then repeat in the other nostril. • Don’t worry about misfires If a little spray gets in their eye, don’t panic. It may surprise them a little but saline solution is very gentle and shouldn’t cause any harm. • If it is tricky to use a nasal spray with a young baby, try using nasal drops instead, as some people find these easier. Other tips Moisture and warmth can help too. Try advising a parent to take the child into the bathroom while they run a steamy shower or bath. Advise the parent to make sure their little one gets plenty of restful sleep – this will really help give them the strength they need to recover. If the child is older than one, advise the parent to prop up the child’s pillow. It can help the child breathe more easily while they sleep. A range of plug-in products which release vaporised oils into the child’s room or vapour rubs are also available for young children. Health in Pregnancy Pregnancy can be a time of great excitement, but it can also come with great worry. Conflicting advice on how they should manage their own health and that of their unborn baby can leave many expectant mothers confused or even fearful about the months ahead. According to recent guidelines, community pharmacists and allied healthcare professionals should focus on the following during any first contact with a woman in the early stages of pregnancy: • Folic acid supplementation • Food hygiene, including how to reduce the risk of food-acquired infection • Lifestyle advice, including smoking cessation, and the implications of recreational drug use and alcohol consumption in pregnancy. Expectant mothers should be reassured that it is not necessary to invest in expensive multivitamin supplements, and that eating a good balanced diet during pregnancy, along with folic acid and vitamin D supplements, should be all that is required to ensure the best possible health
26 | PHARMACYNEWSIRELAND.COM
outcomes for both themselves and their unborn child. Many pregnant women will suffer from heartburn. To treat heartburn, a common painful pregnancy ailment, both antacids and alginates are considered safe to use during pregnancy provided the recommended doses are adhered to. Pregnant women on iron supplements should be cautioned that antacids could prevent proper iron absorption, so should be taken at least two hours before or after the iron supplement. Newborn Conditions Newborn babies are very susceptible to bacterial infections with recent studies suggesting that that the body engineers this vulnerability deliberately, allowing beneficial microbes to colonize the baby’s gut, skin, mouth and lungs. Learning to manipulate this system could lead to treatments for infections in newborns, and perhaps even improve the way babies are vaccinated. During the last three month of pregnancy, antibodies from the mother are passed to the unborn baby through the placenta. This type of immunity is called passive immunity because the baby has been given antibodies rather than making them itself. Immunity in newborn babies is only temporary and starts to decrease after the first few weeks or months. There are many different types of illnesses parents can seek help with from a pharmacist including colic, teething, constipation, temperatures, flu-like symptoms, and more minor afflictions including cradle cap and nappy rash. Coughs and colds There are many different types of coughs and colds and bronchiolitis is one of the more common illnesses that parents will come up against with their babies. It is an illness of the respiratory tract and it is caused by an infection that affects the tiny airways that lead to the lungs called the bronchioles. As these airways become inflamed, they swell and fill with mucus, which can make breathing difficult. Bronchiolitis most often affects infants and young children because their noses and small airways can become blocked more easily than those of older children or adults. It typically happens during the first two years of life and most commonly at about three to six months of age. It is more common in males, premature babies, children
who have not been breastfed, and those who live in crowded conditions but it can happen to any baby. Bronchiolitis is usually caused by a viral infection, most commonly respiratory syncytial virus (RSV). RSV infections are responsible for more than half of all cases of bronchiolitis. Other viruses associated with bronchiolitis include rhinovirus (the common cold virus), influenza (flu), human metapneumovirus, adenovirus, coronavirus, and parainfluenza.
Dealing with Colic Pharmacists play a unique role in the assistance of families coping with colic. They are easily accessible to parents and may often be the first healthcare professional to turn to for advice on an inconsolable infant. Colic is probably one of the most feared 5-letter words known to new parents. It can best be defined by inconsolable crying episodes in a healthy and well-fed infant, using the "rule of 3"—crying for more than 3 hours a day, for more than 3 days a week, and for longer than 3 weeks. Typical symptoms include high-pitched screams, furrowed brow, flushed face, and clenched fists. Symptoms tend to be worse in the late afternoon and evening hours. Fortunately, colic is a selflimiting abdominal condition which usually begins at 2 weeks of age and is often gone by the time the infant is 3 months old. The cause is still unknown. There are several points of advice, including:
Advise parents that colic is not curable, but inform them of some popular soothing techniques that may help
Make them aware of the fact that colic occurs in both breast-fed and formulafed babies, and the cause is unknown
Reassure them that colic is temporary and is usually gone by the time the infant is 3 months old
Ask open-ended questions related to how the parents are coping Changes as simple as choosing the right baby bottle can help avoid the swallowing of air and thereby, put a stop to wind related colic in babies.
Calpol® Infant & Calpol® Six Plus
Ireland’s No.1 pain & fever reliever*
From fever to blocked noses, Calpol® has got you covered
Lets Kids be Kids MAH: Johnson & Johnson (Ireland) ltd. Airton Road, Tallaght, Dublin 24. Products not subject to medical prescription. Full prescribing information available upon request. Calpol® Vapour Plug & Nightlight is an electrical device and non-medicine. CALPOL® Saline Nasal Spray, CALPOL® Saline Nasal Drops and CALPOL® Blocked Nose Spray are medical devices for congestion relief. *IMS December MAT Units 2019 ( For Calpol® Infant and Calpol® Six Plus medicinal products)
OTC Management of Foot & Leg Conditions C
ommon problems that patients will present with in pharmacy include cracked heels, dry skin and fungal growth with these issues becoming more prevalent as people start to let more air at their feet in the warmer months.
Feet are often the most neglected part of our bodies with research showing that people are more likely to have their car serviced than have their feet checked by a Podiatrist. This is contrary to the fact that our feet are our main mode of transport and deserve equal amounts of care and attention. According to the HSE, during a lifetime, feet may walk the equivalent of four times around the world so it is essential that they are taken care of at all times. According to Podiatry Ireland, our feet are complex. They house a quarter of the bones in the body, as well as a network of muscles, ligaments and joints. They are also vulnerable to injury and disease with over 300 identified foot ailments. While our feet suffer wear by the age of fifty, they have also lost up to half of the shock-absorbing capability of the natural foot pad which cannot be replaced like a pair of shoes.
Some feet have special needs - children's feet, sporting feet, working feet, mature feet and feet affected by disease. There are many different types of foot ailments that Podiatrists treat including athlete’s foot, bunions, arthritis, and Achilles tendonitis. Many of these complaints may present at Pharmacy first and Podiatry Ireland has the following advice for pharmacists when advising their patients on foot care: 1. Advise patients to alternate shoes - they should not wear the same pair of shoes everyday 2. Barefoot cautions - patients should avoid walking barefoot as their feet will be more prone to injury and infection. At the beach or when wearing sandals, patients should always use sunblock on their feet as well as the rest of their body 3. Feet washing - patients should wash feet regularly, especially between the toes and they should always ensure to dry them completely
28 | PHARMACYNEWSIRELAND.COM
4. Feet Inspection - patients should always inspect feet regularly. They should pay attention to changes in colour and temperature of the feet, look for thick or discoloured nails (a sign of developing fungus), and check for cracks or cuts in the skin. If there is peeling or scaling on the soles of feet it could indicate athlete's foot. Any growth on the foot is not considered normal.
some extent that’s true, there are still warning signs that good pharmacists should take note of and refer on to a GP or podiatrist, along with effective support and treatment for feet and leg conditions.
5. Shoe fit - patients should make sure that shoes fit properly. It is important to purchase new shoes later in the day when feet tend to be at their largest and they should replace worn out shoes as soon as possible.
• Age: Feet flatten and widen with age, the fat padding the sole of the foot wears down and skin becomes drier. Foot pain in older people may be an early sign of age-related illnesses such as diabetes, arthritis and circulation issues. Foot problems may also impair balance.
Pharmacies should ensure that they signpost the footcare section clearly within store and stock a comprehensive range of wellknown products for customers to choose from. With an ageing population, suffering from foot, knee and joint problems is seen as just part of getting older, but although to
Those at Risk Some people are more likely to experience pain in their feet and lower leg than others. Risk factors include:
• Gender: Women are more likely than men to suffer severe foot pain and this may be due to the type of shoes they wear. • Occupation: Foot problems, including arthritis in the foot and ankle, toe deformities, pinched nerves between the toes,
Athletes Foot - Athlete’s foot is contagious via skin to skin contact and indirectly if one uses the same towel as a person with the condition. Athlete’s foot, a common fungal infection that usually develops between the toes, most commonly affects teenagers and young adults. The infection usually clears up within days or weeks with antifungal treatment. Customers can choose between fungicidal products that kill the fungus and fungistatic products, which slow down its growth until it stops. A low-potency steroid cream may be recommended if the skin is very sore.
plantar fasciitis, adult-acquired flat foot and tarsal tunnel syndrome, have been attributed to repetitive use at work – for example, in people whose job means they have to walk long distances or stand for many hours at a time. • Activity: Sports players and people who take part in vigorous exercise. Women are at higher risk of stress fractures than men. Common Foot Conditions Corns and Callouses - Corns (which usually appear on the tops or sides of toes) and calluses (found on the soles of feet) are areas of hard, thickened skin that develop when the skin is exposed to excessive pressure or friction. Problems can be prevented by wearing well-fitting shoes and using protective gel pads or strips to reduce pressure. Hardened skin can be gently removed with a pumice stone or foot file. OTC products containing salicylic acid are available to treat established corns or calluses, but severe cases or people with diabetes or circulation problems should be referred to a podiatrist. Cracked Heels - Cracked heels are often caused by open-backed shoes such as sandals or flip-flops striking the heel. Older people are most at risk of cracked heels, as well as those who stand for prolonged periods. Limiting unsupportive footwear can help to prevent the problem arising, while regularly applying a moisturising foot cream can help keep feet smooth and soft. A pumice stone or foot file can be used to remove hard skin; these are particularly effective when used after a bath or shower.
Athlete’s foot is highly infectious, as the fungi multiply quickly in warm and humid environments, such as swimming pools, showers and changing rooms. Good foot hygiene can help to reduce the spread of an infection and involves drying the feet thoroughly, particularly between the toes, wearing clean cotton socks, rotating footwear and avoiding walking barefoot in changing rooms. Symptoms of Athlete’s foot include: • An itchy, red rash, which often starts in between the 4th and 5th toes, before spreading to the other toes. • Scaling or cracking of the skin may occur. • Blisters can occur. If these burst, they can cause pain & swelling. Verrucas - A verruca is a wart on the sole of the foot caused by infection with the human papilloma virus (HPV), which is picked up from contaminated floors in changing rooms or around swimming pools. The affected skin is usually white and may have a black spot in the centre. Verrucas may clear up naturally, but treatment is advisable to prevent the infection spreading. Several treatment options are available OTC, including salicylic acid gels, creams, plasters and paints, cryotherapy sprays containing dimethyl ether propane and silver nitrate. To make verrucas more susceptible to treatment, the affected area should be soaked in warm water for a few minutes and gently filed with a pumice stone or emery board. Waterproof plasters are available to protect the verruca and prevent the infection from spreading. Diabetic Foot Care Diabetes can cause nerve damage and blood vessel disease in the feet. This may cause skin and tissue breakdown, which can develop into non-healing wounds (ulcers), which are
30 | PHARMACYNEWSIRELAND.COM
at risk of infection. This may even result in limb amputation. Structural deformity leaves bony prominences exposed to increased external pressure on the skin, leaving it at risk of being damaged. Identification of patients at risk of diabetic foot disease allows early intervention of preventative measures to be taken, and thus reduces the risk of further complications. As the number of type 2 diabetes (T2D) cases continues to escalate each year, pharmacists are likely to encounter patients inquiring about proper diabetic foot care. Foot problems are very common in patients with T2D, accounting for a significant portion of diabetesrelated complications and health care costs. Pharmacists are in a pivotal position to educate patients with a new diagnosis of diabetes about their care. Pharmacists should remind patients about the importance of routine diabetic foot care to prevent or delay complications, such as diabetic foot ulcers and amputations. Patients with diabetes, especially those with poorly controlled disease, are more susceptible to skin-related complications; therefore, patients should be reminded that many dermatologic conditions can be either prevented or effectively treated if identified early. Conducting a daily skin inspection and adhering to daily skin care, especially foot care, is imperative for all patients with diabetes. Pharmacists should seize every opportunity to stress the importance of maintaining tight glycaemic control and remind patients how proper and routine foot care is critical to decreasing the incidence of foot ulcers and amputations. It is estimated that nearly 85% of amputations are preventable with education and early intervention. The primary goal of diabetic foot care is prevention of diabetesrelated complications, such as changes in the skin (dryness and itching) and foot ulcers, which are often attributed to vascular disease, neuropathy, and relative immunosuppression. Prevention is Key Strategies for preventing foot problems include patient education, patient involvement and adherence, maintenance of tight glycaemic control, and daily care and inspections of the skin, feet, and nails. Several OTC dermatologic products are marketed specifically for foot care in patients with diabetes. Prior to recommending any of these products, pharmacists should encourage patients with certain signs or symptoms to seek immediate medical care to avoid
further complications. Examples of diabetic foot care products include antimicrobial lotions, skin moisturisers, and antifungal and callus treatments. Varicose veins occur when valves in the leg veins stop working properly, resulting in blood flowing down the veins the wrong way. According to research, varicose veins affect around 30% of adults. There is a stereotype that it is only the old and the overweight that will suffer from them but the condition is hereditary and can strike at any time of life – although it does become commoner with passing years. Although varicose veins are thought to be bulging veins that protrude from the legs, in up to half of all cases the problematic veins remain hidden under the skin. Many people will often seek simple removal of these thread or spider veins. However, if the underlying hidden varicose veins have not been found and treated first, then thread or spider vein treatments are much less likely to work. Why are my legs aching? Tired, aching legs are a common problem, especially in people who sit or stand for long periods. It could be a sign that leg veins are allowing blood to flow backwards and pool, rather than travel up towards the heart. Insole arch supports may provide extra support for the ankles, which can limit any swelling, while compression hosiery can improve the flow of blood, relieving the tiredness and aching sensation. Deep vein thrombosis (DVT) causes pain and swelling in the leg as a result of blood clotting while it is still inside the blood vessel. It usually affects one leg only. If DVT symptoms occur, they may include tenderness in one leg (usually the calf), a heavy ache in the affected area, warm skin in the area of the clot, and also red skin, particularly at the back of the leg below the knee. If customers are concerned about DVT, they should see their GP. Category Management Pharmacists should think beyond foot and leg care when it comes to making a sale. If someone picks up corn plasters, combination treatments may be required, and there is an opportunity for a link purchase such as insole supports to take the pressure off the area. Also, what about pain relief? This is precisely where community pharmacy can add value over and above its competitors – it’s an opportunity not to be missed. This category should be displayed next to or near the first aid category. This is where you will find antiseptic creams and plasters, so the link to the category is appropriate.
Fed up of unsightly
FUNGAL NAIL INFECTION? Not everyone is the same. Thatâ€™s why our clinically tested solution is now available in 3 application formats: Pen, Spray and Brush. All 3 give fast, visible results and require no filing. Alongside the new look packaging, Nailner Pen and Nailner Spray now offer even more applications than before. Choose your Nailner.
Available To Order From Brandshapers - Customer Service 053 9179007
Pharmacy Students Prize Giving The School of Pharmacy and Pharmaceutical Sciences hosted its annual prize giving ceremony recently. Professor John Gilmer, Head of School, welcomed academics, sponsors, students, family and friends to the ceremony. The Prize Giving Ceremony is a celebration of the outstanding performance of the TCD Pharmacy students in their academic achievements in the B.Sc. (Pharm.) and M.Pharm Degree course. Prizes are awarded for excellent academic performance in particular areas of Pharmacy study. All prizes are valued by the School as a statement of support for our students and by the recipient for the recognition it offers for their achievement. Professor John Gilmer, Aoife Maher and Mr Brian Collins, Uniphar
Paul Higgins Memorial Medal/UNIPHAR Prize in Pharmaceutical Chemistry Winner: Aoife Maher This prize is awarded to the student who attains the highest overall combined mark in modules PHU44102. Presented by: Mr. Brian Collins, Uniphar Director of Innovation and Strategy Meagher's Senior Fresh Pharmacy Prize
Ms. Elaine Lillis, Cathal Hannafin and Assoc. Professor John Walsh
Winners: Cathal Hannafin This prize is awarded to the student with the highest combined overall mark in the Senior Fresh year. Presented by: Ms. Elaine Lillis, Superintendent Pharmacist, Meagher's Pharmacy Group. Solvotrin Therapeutics Junior Fresh Pharmacy Prize Winner: Talitha Pattison
Professor John Gilmer, Talitha Pattison and Mr Ronan McClafferty
This prize is awarded to the student with the highest combined overall mark in the Junior Fresh year. Presented by: Mr. Ronan McClafferty, Global Commercial Director, Solvotrin Therapeutics. Sanofi Prize in Pharmacognosy Winner: Aoife Maher Awarded to the student who attains the highest overall combined mark in module PHU33102.
Ingrid Walsh, Aoife Maher and Assoc. Professor Helen Sheridan
Presented by: Ms. Ingrid Walsh, Head of Primary Care, Sanofi Ireland.
Asthma breakthrough Researchers from Trinity have made a breakthrough that may eventually lead to improved therapeutic options for people living with asthma. The researchers have uncovered a critical role for a protein (Caspase-11), which had previously never been implicated in the disease. Lead author Zbigniew Zaslona, working with a team led by Luke O’Neill, Professor of Biochemistry in the School of Biochemistry and Immunology in the Trinity Biomedical Sciences Institute, has been exploring the role that inflammation plays in asthma – a very common and often serious disease of childhood. Ireland has one of the highest incidences of asthma in Europe, which in its most severe form remains difficult to treat and can be fatal. Caspase-11 is a protein with an important role in defending against bacteria, but the team in Trinity has found that when it is over-active it can provoke a damaging inflammatory reaction. When this happens, it is likely to be a key driver of allergic inflammation in the lungs of asthmatics. Dr Zaslona said, “Caspase-11 can cause cells to die, which is a very inflammatory event as the cells then release their contents, which can irritate tissues in our body. We have found that Caspase-11 is a key driver of inflammation in the airways in asthma. This causes the signs and symptoms of asthma which most notably involves difficulty breathing.” Although symptoms of mild asthma can be managed with current therapies, severe asthma remains very difficult to treat and asthma rates are constantly on the rise. Dr Zaslona added, “A variety of irritants such as airborne pollutants, certain types of pollen and house dust mites can induce cell death in the lungs. Our work suggests that Caspase-11 is sensing these noxious things and causing disease.” The work was funded by the the Wellcome Trust and European Research Council.
Cosmetic & Gift Trade Fair
2020 The Main Hall, RDS, Ballsbridge, Dublin Sunday 17 th May
10am - 6pm
Monday 18 th May
9am - 8pm
Tuesday 19 th May 9am - 6pm
% of those wh sleep ove as ‘good
2015 2016 2017 around 2018Obesity 2019 Pharmacy Engagement
Seebeing pageheld 3 for further With World Obesity Day this month,information now is an ideal time for community pharmacists and their teams to be thinking about the opportunities around assisting those consumers with their weight management and engaging with them on the health risks of excess body fat. Dr Cliodhna Foley Nolan, Medical Director of Safefood
Excess body weight is the most significant nutritional issue of our times. Almost 1 in 4 children on the island of Ireland are currently carrying excess weight.
Obesity is estimated to cost the island of Ireland around ¤1.64 billion euros (¤1.13 billion Republic of Ireland; ¤510 million Northern Ireland) every year.
provide unpaid care to of those aged between a friend or family member 45 and 54ofprovide Causes Obesity with a longterm illness, regular care Theunpaid basic cause of overweight or obesity is an excess of calories amount of weight loss, Pharmacists can be an essential ormoderate health problem disability from food compared to energy can be beneficial.
The new World Obesity Day is a global campaign engaging regional and national campaigns, and local activities and events. Organisations around the world will acknowledge and celebrate unified efforts on 4th March 2020.
used by the body over time i.e. energy imbalance. The factors that affect energy balance are complex and include behaviour (e.g. breakfast consumption), environment (e.g increased availability of high fat foods) and genetic factors
See page 18 for further information
Pharmacists can also encourage patients to utilise long-term weight-management goals rather than just some of the quick-fix OTC products. Pharmacists should stress to their patients that even a
• Type 2 diabetes
Being obese increases the risk of developing a number of serious and potentially life-threatening diseases including:
Obesity has been defined by the World Health Organisation as abnormal or excessive fat accumulation that presents a risk to health.
See page 11 for further information
• Certain cancers such as breast and colon cancer
See page 19 f
9% resource for obese patients attempting to manage their weight. They can monitor patient medication profiles to detect those prescribed agents that may have the potential for weight gain, and they can provide information about proper weight-loss programmes.
• Cardiovascular disease
27% 1% * = less than 1%
Excess weight is also linked to sleep apnoea, infertility, stress, depression, gallstones, complicated pregnancy and arthritis.
Childhood obesity is associated with a higher risk of obesity, premature death and disability in adulthood. However, an obese child is not only at increased risk of chronic disease later in life but also at risk in the short term health problems. Obese children are also more likely to suffer various orthopaedic and neurological conditions, breathing disorders, early markers of cardiovascular disease including high blood pressure, insulin resistance and psycho-social problems.
% of th National Physic
Healthy Ireland Ireland has one of the highest rates of obesity in Europe, with one in four adults now classed as obese and one in four children already overweight, according to the most recent Healthy Ireland survey.
And it seems that men are more likely to have weight problems than women, with 70% of Irish males tipping the scales at an unhealthy weight, compared to 52% of females.
Dr Cliodhna Foley Nolan, Medical Director of Safefood, says the speed with which obesity is rising amongst men is most alarming. “The rate of increase has trebled within the past 15 years and this is very worrying,” she says. “Women are not doing great either, as it has doubled for them, but the reason obesity amongst men seems to be on the rise is because they tend not to go on diets or be as aware of their size as women are. Whether that is to do with the type of clothing they wear or the fact that being overweight is more acceptable amongst men is not clear.
See page 7 fo
“But central obesity [excessive weight around the abdomen] is very common in men and it is extremely damaging to their health. And many do nothing about it until they suddenly find out that they have an illness – so they need to start taking steps to change this, fast.”
USE A FOR IN THE SUN
See page 17 f
Asthma Medication Trends in Pharmacy Research carried out across community pharmacies in Ireland last year, has looked at asthma medication usage trends, using anonymised patient transactional dispensing data. The evidence found, shows that three in ten use more than 12 reliever inhalers a year, putting them at risk of an asthma-related death, while seven in ten are using more than three reliever inhalers a year, putting them at risk of an asthma attack (or some form of asthma exacerbation). The Asthma Society of Ireland launched the research findings, carried out by hmR Ireland, last month (February), which looks at the over-reliance on reliever inhaler medication by people with asthma in Ireland. Reliever inhalers, which most people will recognise as the blue inhalers, if over-used, are strongly linked with severe asthma exacerbations and asthma related deaths. An asthma exacerbation is an episode of progressive worsening of symptoms of asthma, including shortness of breath, wheezing, cough, and chest tightness and it can progress to a severe asthma attack. Developing Risk Using three or more reliever inhalers a year indicates a person is at risk of an severe asthma exacerbation while the use of twelve or more a year is an indication someone is at risk of an asthma-related death, according to the Global Initiative for Asthma (GINA), a body tasked with evidence-based strategy for asthma management working to improve the lives of people with asthma in every corner of the globe. hmR Ireland worked with 70% of Irish pharmacies in 2019. The Health Market Research results also found that within five years of diagnosis, half the asthma population are over-reliant on their reliever inhaler. In the year after diagnosis, 30% children aged 0-17 are overusing their reliever inhaler. Furthermore, in the year after diagnosis, 60% people aged 50 or over are overusing their reliever inhaler.
Sarah O’Connor, CEO of the Asthma Society of Ireland, says, “International research shows that reliever inhaler overuse can be a major factor in asthma exacerbations and asthma related deaths, as in the UK’s National Review of Asthma Deaths report and GINA’s Global Strategy for Asthma Management and Prevention. This makes the findings of this hmR Ireland research about Irish patients relying on their reliever inhaler stark and very worrying to us. One person dies every six days from asthma in Ireland. “Alarmingly, within five years of diagnosis, half of people become over-reliant on it. As people with asthma get older, their rate of over-reliance increases, resulting in increased levels of uncontrolled asthma. A key point at which people become over-reliant on their reliever inhaler is between year one (year of diagnosis) and year two. This “year two” of asthma is when the largest increase in inhaler over-reliance occurs and we need healthcare professionals to know this so that they can intervene to help and support their patients to have the best possible asthma management.”
symptoms. It prevents symptoms from arising several weeks and months down the road, as long as it is habitually taken. The UK’s National Review of Asthma Deaths report (2014) showed that there was evidence of excessive prescribing of reliever medication: 39% of those who died had been prescribed more than 12 short-acting reliever inhalers in the year before they died, and 4% had been prescribed more than 50 reliever inhalers. Those prescribed more than 12 reliever inhalers were likely to have had poorly controlled asthma.” To reduce asthma-related deaths and exacerbations, the Asthma Society of has launched its over-arching Asthma SafetyCare campaign, an initiative aiming to end asthma deaths in Ireland by making patients and public aware of asthma management issues. The Asthma Society hopes the Asthma SafetyCare campaign will make a tangible difference to asthma deaths by combatting problematic aspects of asthma management, with this first project looking at SABA over-reliance. This SafetyCare specific project is a healthcare professional and patient education campaign, featuring
The Asthma Society is calling on all people who are over-reliant on their reliever inhaler to act now to get their asthma in control.
Asthma Overuse by County:
The Medical Director of the Asthma Society of Ireland, Marcus Butler, adds, “A reliever inhaler works within minutes to relieve asthma symptoms when they happen - it gives a short-lived improvement in symptoms, effectively just buying time, but can eventually fail to keep a patient safe from asthma if more appropriate and effective controller inhalers are not used on a daily basis. A controller inhaler works over a much longer duration than reliever inhalers to eventually ease the underlying airway inflammation which ultimately causes asthma
County Rate of overuse (after 5 years)
case study videos, a healthcare professional webinar, research, infographics, outreach and media engagement, aiming to educate people with asthma and their healthcare professionals of the dangers of being over-reliant on their reliever medication. The Research also revealed: • In the initial year of diagnosis, one in five people overuse their reliever inhaler. • In the first year after diagnosis, there is: a 6% increase in the number of people using 12 or more reliever inhaler a year (2% to 8%) and a 17% increase in the number of people using three or more reliever inhalers per year (16% to 33%). There is a corresponding drop of 23% of people using two or less (considered the appropriate amount) reliever inhalers per year (82% to 59%). • In the year after diagnosis the following numbers of people over-use their reliever inhaler: three out of 10 people aged 0-7, three out of ten people aged 7-17, two out of five people aged 18-32, half the people aged 31-50, and three out of five people aged over 50. Westmeath Kerry Roscommon Cork Cavan Wexford Galway Sligo Wicklow Mayo Kildare Laois Kilkenny Meath Donegal
50% 49% 49% 48% 48% 47% 47% 47% 46% 45% 45% 44% 44% 43% 43%
• *This graph shows the rate of overuse of reliever medication per county after five years of being prescribed an inhaler.
SHAPING FUTURE HEALTHCARE TOGETHER JOIN IRELANDâ€™S LARGEST PHARMACY SHOW AND MEET OUR PHARMACY EXPERTS, KEY OPINION LEADERS AND GLOBAL LEADING BRANDS.
CITYWEST CONVENTION CENTRE, DUBLIN 24
19-20 APRIL 2020 Register at pharmacyshow.ie // 14 YEARS OF SUCCESS AND GROWING // GUEST SPEAKERS // EXPERT LED WORKSHOPS // EXCLUSIVE NETWORKING OPPORTUNITY FOR CUSTOMERS & SUPPLIERS @united-drug pharmacyshow.ie
Pharmacy to Get Moving on Heart Health Community pharmacy teams play a pivotal role as a community and health asset in communities. High quality public health and clinical interventions drive delivery that is focused on prevention, health improvement and protection of local communities. prevalence of sedentary lifestyle in most European populations.” “Walking should be the primary mode of preventive and healthenhancing physical activity to be increased. Walking has been referred to as the ‘best buy in public health’. This is followed by cycling as, like walking, it can be integrated into daily lifestyles,” the report added. In relation to people living with cardiovascular conditions such as heart disease and stroke, the EHN report underlined the importance of physical activity for secondary prevention (reduce the impact or severity of a disease once it is already diagnosed) of cardiovascular disease. The report showed the effectiveness of physical activity in patients, highlighting the need for flexible, individualised and ‘menubased’ programmes, tailored to the circumstances and needs of individual patients as part of cardiovascular rehabilitation.
Making healthy choices such as stopping smoking, improving diet and nutrition, increasing physical activity, losing weight and reducing alcohol consumption through pharmacy teams could make a significant contribution to reducing the risk of disease, improving health outcomes for those with long term conditions, reducing premature death and improving mental wellbeing.
is better than none – though more is better.”
Physical activity can be the difference between people recovering from cardiovascular disease and returning to normal active life or continuing a life as a patient,” according to a new report on physical activity and heart health.
Benefits of Activity
The report on physical activity policies for cardiovascular health, was launched by the European Heart Network (EHN) ; a European alliance of organisations dedicated to fighting heart disease and stroke and supporting patients, of which the Irish Heart Foundation is a member. According to the report, “it is never too late to start with physical activity, and any exercise
The report stated that physical inactivity was responsible for approximately 330,000 cardiovascular deaths in Europe and increased the risk of cardiovascular disease (CVD) by more than 20 per cent. However, in Europe, it is estimated that 25% of women and 22% of men are physically inactive.
The EHN report found that being active was beneficial for both healthy people and those living with cardiovascular disease and highlighted the under-use of policy measures to promote physical activity at a population-level to prevent cardiovascular disease. Addressing policy leaders, the report recommended, “physical activity – and especially systematic exercise training – are effective means of CVD prevention, and critical components of promotion of good health more generally. However, the potential public health impact of physical activity is not maximised due to the high
It added that exercise based cardiac rehabilitation “appeared to be under-utilised, with insufficient policy actions being taken to integrate physical activity into normal care.” “It does not have to be complex or over-demanding: even low levels of physical activity have health benefits and rehabilitation programmes can be undertaken at home,” the EHN stated.
Critical Roles The EHN report focuses on heart disease and stroke, but physical inactivity is also strongly associated with obesity, diabetes, poor mental health and some cancers. The report concluded that regular physical activity plays a “critical role” in both preventing and treating cardiovascular disease and that “policy-makers should focus on ensuring physical activity is central to the prevention and treatment of cardiovascular disease.” Commenting Janis Morrissey Head of Health Promotion, Information and Training at the Irish Heart Foundation said that to a large extent, physical activity has been designed out of our lives and the world we live in actually encourages us to be inactive. “It is not enough to tell people to be more active. We need policies to create an environment where being active is easy, for example segregated cycle ways. Not only does being active benefit the individual, there are also benefits to the population in terms of cleaner air, reduced use of fossil fuels, lower carbon footprints and greater social inclusion. As the National Physical Activity Plan for Ireland comes up for review, it is timely that this report has been published.”
Enhanced vent system
Celebrating a Decade of Success With a reputation across Ireland in the provision of locum and permanent recruitment services, PharmaConex are this month marking a milestone in the company’s history. Celebrating a hugely successful 10 years in business, the company is reflecting on success.
“Durability, Reliability and Trust still remain as the core values that go towards making any Company successful.” The same can be said of PharmaConex who have firmly established themselves, not only as a company but as a team who deliver on service, value and excellence in provision. The beginning came about in 2007, when locally well known registered pharmacist, Paolo Iacovelli invested three years developing a tailored Pharmacist Locum concept before officially launching PharmaConex in 2010. What began as a locum agency to fill an industry gap, quickly grew to offer a more holistic recruitment service. Today, combined with sister company PharmFinders, PharmaConex delivers a Locum and Permanent Recruitment Service across Ireland and the UK. Evolving and Investing Nicola Ryan, Operations Director and Ashling Quinlan, Clients Services Director look back over the past 10 years and give us an insight into what the next decade has in store for this Irish brand. The team behind the brand pride themselves on being what they refer to as a ‘people’s agency’ – remaining solely focused on the community pharmacy industry. NRF certified and described as ‘approachable, responsive and dedicated’, the team provide a fully personalised service. “We are proud of the strong relationships we have built within the sector and believe these relationships are founded on the basis of a consistent and reliable service,” Nicola says. “We stand by our quality promise and continuously review, analyse and implement developments to improve our services.” As the community pharmacy industry continues to evolve, PharmaConex intends on following suit with investments in training, software and company development. However, as Nicola
emphasises, PharmaConex’s personal approach is here to stay. “There is a number of positive changes in the pipeline,” she told Irish Pharmacy News. “However, our account managers remain as committed as always to delivering a personalised service to each of their clients.” With a wealth of recruitment knowledge throughout the UK and Ireland, Ashling addresses one of the key underlying issues faced by community pharmacy; that of pharmacy recruitment and retention. In May of last year, the Irish Pharmacy Union highlighted this very issue at their annual conference in Galway saying that a shortage of community pharmacists could become a ‘critical’ problem. Recruitment and Retention “There is no denying it, Ireland is experiencing a nationwide shortage of Pharmacists,” says Ashling. “Addressing this is not an easy task. Throughout 2020 we intend on opening the Irish market to UK candidates through our UK based sister company, PharmFinders.” Over the last ten years, training and development continues to be at the forefront for the company. “We delivered our first career development day in November of last year,” adds Ashling. “This was our largest event held to date and consisted of workshops, seminars and an industry leader exhibition.”
professional knowledge allows us to show appreciation to Locums as well as ensure we are delivering a high standard of pharmacists to our clients.” Nicola hints that IT and software upgrades are also on the cards, thus in turn, improving website functionality for all users. Thank you from the Team With a nod to those who have
helped PhamaConex become what it is today, both Nicola and Aisling said, “Thank you to everyone who has supported PharmaConex over the past 10 years. We are all looking forward to working with you in the future.” Get in contact with the PharmaConex team today on 061 530 202 for your Locum or Recruitment needs.
Furthermore the introduction of webinars has been a huge success, allowing pharmacists to develop their professional knowledge without leaving home. Investments in training and development workshops, seminars and webinars are set to continue. Looking at the benefits this brings to both Locums and clients, Nicola adds, “Assisting with CPD preparations as well as broadening
Get in contact with the PharmaConex team today on 061 530 202 for your Locum or Recruitment needs.
2020 Award Categories: KBC Business Banking Community Pharmacist of the Year Award Superintendent Pharmacist of the Year Award JPA Brenson Lawlor Young Community Pharmacist of the Year Award Clonmel Business Development (Chain) Award Innovation & Service Development (Chain) Award McLernon Computers eHealth & Innovation Award RB Nurofen Rapid Relief OTC Retailer of the Year GSK Self Care Award Pharmacy Student of the Year Award United Drug Business Development (Independent) Award Baby Health Pharmacy of the Year Award Avène Counter Assistant of the Year Award Community Pharmacy Team of the Year Award PharmaSource Community Pharmacy Technician of the Year Award AYA Category Development Award
Joining Standards of Excellence & Innovation The Irish Pharmacy Awards 2020 “There are no secrets to success. It is the result of preparation, hard work and learning from failure” In launching the ninth annual Irish Pharmacy Awards, we are seeking to uncover those individuals and teams putting in the groundwork quoted above to the enhancement of community pharmacy throughout Ireland. The Irish Pharmacy Awards represent a unique and high-profile opportunity to celebrate the excellence and amazing achievements of Ireland’s pharmacy
professionals, and reaffirm Irish Pharmacy News’s commitment to the core pursuits of pharmacy: excellence in health and innovation. The Awards recognise outstanding examples of high standards, best practice, innovation and excellence. It has been, and continues to be, the goal of Irish Pharmacy News to recognise the exact added value of the contribution made by community pharmacists and their teams. Through the submissions to these Awards and the examples of innovation that they demonstrate,
also create a platform which fosters shared learning and education.
IPN want to inspire you to think about your role, that of your team and of the community pharmacy profession in which you operate, as a whole.
The closing date for all entries is March 31st. After this, our prestigious judging panel, comprised of pharmacy, industry and business leading professionals, will face the difficult task of shortlisting and selecting the overall winners.
The 15 Award Categories are inviting entries across a broad spectrum of fields; from innovation and business development, to the rising stars of the profession and the teams and individuals making a difference. The aim of the Irish Pharmacy Awards is to celebrate, recognise and reward those displaying dedication and commitment. They
Clonmel Corporate Ad 210x297mm_(new version).pdf
The winners will be announced at a gala dinner in the Clayton Hotel, Burlington Road, Dublin on Saturday, May 23rd, 2020. 1
PHARMACYNEWSIRELAND.COM | 41
The Irish Pharmacy
Clonmel Business Development (Chain) Award 2020 * Open to all pharmacies with more than 3 stores
The Clonmel Business Development (Chain) Award serves to recognise those who have displayed success in terms of sales, training, recruitment, customer service, product development or other areas of business development. Entries should demonstrate an innovative approach to creating new business, and outline the timescales, objectives and results of the initiative. Judges will look for a business initiative that stands out in terms of its scale, scope or approach. This award will credit the company that has demonstrated excellent levels of customer service backed by clear standards and adequate monitoring performance. Account will be taken of: Clear demonstration of an identified need and personal rationale along with details of the process of implementation from concept to design, planning and results Evidence will be displayed for plans for further research and development Evidence of a sound business plan, sales and marketing strategies Strong leadership skills with the ability to drive the business forward Innovation and ambition
42 | PHARMACYNEWSIRELAND.COM
Awards The Irish Pharmacy
RB Nurofen Rapid Relief OTC Retailer of the Year Award 2020 * This Award is open to those pharmacy businesses with more than 3 stores throughout Ireland
Customer purchases of OTC products have consistently risen, for many reasons. The convenience of treating a condition with an OTC product is appealing to the typically busy person, who seeks to avoid a lengthy and expensive GP visit in favour of meeting the demands of home and work. In addition, patients in the information age have an increased level of awareness about health. The over-the-counter market continues to thrive as manufacturers continue to think of new promotional and packaging ideas and as the general public take a greater interest in their own health and wellbeing. Pharmacies are increasingly witnessing heightened footfall as GP visits decrease. Pharmacy staff are the focal point for helping customers select appropriate OTC medicines, suggest diagnostic testing and accessory products and must be aware of when to refer individuals to the pharmacist. Knowledge of the market is essential; seasonal products and accessories; the use of displays and front of shop expertise and judges will want evidence of excellent merchandising strategies. Account will be taken of: Demonstration of identifying key promotional opportunities to add value for the customer such as health promotion events and displays
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Winners Irish Pharmacy Awards 2012 SPONSORED
Irish Pharmacy Awards 2013 Winners
OTC Retailer of the Year Award (Chain)
(EPN) pharmac in Blackrock in has had a hug community sin Goretti Brady, of DocMorris & said; “It was ve see our flagsh doors for the f all so proud to and launched model, with He for the Custom
Sponsored by Reckitt Benckiser
A showing of continuous working with manufacturers and suppliers to plan yearly promotional calendars to meet pharmacy profit goals Implementation of innovative strategies to competitive pricing Examples of education for staff on new products and convenyance to customers as to efficacy and usage
Edel Niland, Krista Sherlock, Tony Hynds, Managing Director, Actavis Ireland, and Diane Patterson with the Business Development of the Year (Independent) Award
Business Development of the Year Award Winner 2012
From the pharmacy to the home Homepharmacy! The problem of compliance is an increasing one and one which is encountered by most pharmacists at some point within the dispensary. For Galway pharmacist Frank
Pictured left to right are Smantha Ryan Doyle, Stacey Sheridan, Cormac Tobin, Karoline Kelly, Reckitt Benckiser, Marie McCarthy, Colin Chapman, Reckitt Benckiser, Nicola Kenny, Martina Doyle and Goretti Brady
44 | PHARMACYNEWSIRELAND.COM
The pharmacy landscape has changed significantly in recent years. The over the counter (OTC) market continues to prosper. Treating a condition with an OTC product is on the increase due to the cost of visiting a GP. Many pharmacies have started to heavily invest in their front of shop with colleague training and inventive category management principles. The OTC Retailer of the Year award recognises and rewards
Lloydspharmacy Blackrock was chosen to lead a European wide scheme to help the local community to understand and manage their healthcare needs. It is the first of its kind to open in Ireland and is based on best
technology wit scanners whic team to recom treatment spec to the custome also stocks ma and new Skinc
AVAILABLE NOW NOW AVAILABLE
Â Â Â? Â? Â? Â?Â? Â? Â Â? Â? Â? Â? Â? Â? Â? Â? Â Â? Â? Â? Â? ÂÂ€ Â‚Âƒ Â„Â„Â… Â? Â† Â‡ ÂÂ€ Â„Â„ Â€ Âƒ Â? Â? Â? Â Â ÂÂ€ Â‚Âƒ Â„Â„Â… Â? Â† Â‡ ÂÂ€ Â„Â„ Â€ Âƒ Â? Â
ÂÂ€ Â? Â? Â? Â Âˆ Âˆ
ÂÂ€ Â‰Â‚Âˆ Â Â‰Â‚Âˆ Â Â? Â? Â? Â‹ ÂŒÂˆ Â ÂŽ Âˆ Â Â Â?ÂŠ Â Â?ÂŠ Â‹ ÂŒÂˆ Â ÂŽ Âˆ Â Â‘ Â‹ ÂŒ Â‹ ÂŒ Â‘ Â‹ ÂŒ Â‹ ÂŒ McAnena it is an potentially dangerous been spent on trying to find a solution and College of Pharmacy has authorised an Msc issue which required urgent action within his the different approaches used, they found based on the work ÂÂ€ we are doing which is Â‹ ÂŒ Â‹Âˆ Â ÂŒ Â? Â‹ÂˆÂ’ÂŽ Â“ÂŒ Â Â?Â?Â? Â? Â‹ ÂŒ Â‹Âˆ Â ÂŒ Â?
ÂÂ€ Â‹ÂˆÂ’ÂŽ Â“ÂŒ Â Â?Â?Â? Â? catchment area. that community pharmacy had not been hoped to be complete by October with the explored as a resource. offer of a potential Phd. thereafter. When setting about establishing his new Âˆ Â Âˆ Â Â” Â? Â? Âˆ Â Â‡ Â€ Â” Â? Â? Âˆ Â Â‡ Â€ initiative Frank's priority was to make sure The service is offered in conjunction with The patients Frank and his team dealÂˆ Â with patients were not putting their own health the Public Health Nursing Service, GPs and are all referred from professionals within at risk but not taking health care workers. the Primary Care model. These patients, Â? Â?
ÂŽ Â• Â• Â? Â?
ÂŽ their medication. usually, cannot make their way to the shiny Frank came upon the idea for the initiative of Frank, who owns Eyre new Primary Care edifice for a multiplicity cy opened its doors the knowledge and expertise to Homepharmacy after a family member was Âˆ Â Â‹ Â‡ Â— Âˆ Â Square Pharmacy of reasons. They may be too sick, too old, Â– Âˆ Â Â‹ Â–Â ÂŒ Â ÂŒ Â‡ Â— Âˆ Â n April 2013 and diagnosed with early Alzheimerâ€™s and the recommend a product in Galway, tells IPN, to their too infirm, too disturbed, too confused, too medical management problems it presented. ge impact on the patients that can, are for example, "50% of patients contrary, too reclusive or too disinterested. Â— Â” Â— Âˆ Â˜ Â˜ Â™Â‡ Â† Â? Â? Â…Â— Âˆ Â A chance with a public health nurse Colin Â— Â” Â— Âˆ Â˜ Â˜ Â™Â‡ Â† Â? Â? Â…Â— Âˆ Â nce its opening. statistically known to complement their prescription (in meeting At Homepharmacy theirBenckiser medication is Marie Chapman, Reckitt and led to the referral of a number of patients be non compliant â€“ pharmacist) managed, and an attempt is madeBlackrock to try Managing Director McCarthy, LloydsPharmacy, consultation with the with a variety of problems. The first was this a problem which to educate and give advice, liaise with Â? Â‹ ÂŒ Â? & Lloydspharmacy and soisenhance their treatment on thirty different meds, 72 years old and Â? Â‹ ÂŒ Â? does not seem to be fellow professionals and make ourselves ery exciting to outcome. is what solubleâ€“ That â€œCheck your setsbipolar along with a multiplicity of other an integral part of the Primary care team. ailments. hip store open its Â… Â… Â— Â‡
Â‹ Â— ÂŒ usown apart. We arecabinet bringing the medicine first realised his team had made a Â… Â…Frank Â— Â‡ Â‹ Â— ÂŒ first time. We are dispensary forward into theFrank fronttells us, " I went to his home and and you will find some major breakthrough when a doctor rang unused medicineâ€?. o have developed and asked him to perform a certain role â€˜as of shop.â€? found him in a very agitated state. We sat Â… Â? Â‘ However, within that a part of her teamâ€™. These turned out to be Â… Â… Â… Â? Â‘ such an innovative and went through his meds explaining 50% is a further 10%, not an idle comment but the beginning of a what each was for and how they were to ealth and Wellness The frontnon of shop is designed whose compliance relationship that has been duplicated with Âˆ Â Â‹Â€ ÂƒÂ„Â„Â‘ ÂŒ Â… Â‹Â‡ Â…ÂŒ Âš be taken. We then blisterpacked his meds mer at its coreâ€? Âˆ Â Â‹Â€ ÂƒÂ„Â„Â‘ ÂŒ Â… Â‹Â‡ Â…ÂŒ Âš to gives create a positive rise to seriousexperience other medics since. American studies have and started a weekly delivery to him. This problems, The health shown that 1 in 4 nursing home patients are forhealth the customer. resulted in a marked decrease in G.P. Visits Â‹ Â›ÂÂ€ Â„Â„Â‘ ÂŒ Â…
ÂŒ Â‘ hospital admissions, there because of medicine mismanagement. The team and P.H.N. interventions, plus we succeeded Â… bar orientation encourages one Â‹ Â›ÂÂ€ Â„Â„Â‘ ÂŒ Â‹ÂˆÂ’ÂŽ
ÂŒ Â‘ meds, Without overstating the role of his team in removing a huge quantity of unused in Lloydsonaccumulated one discussion betweeninthe over dosage and trying to remedy this problem he Â‡ is adamant meds. He actually brought in two Â‹Â€ Â„Â„Â‘ ÂŒ Â… Â‹ Â… ÂŒ Â‹Â€ ÂƒÂ„Â„Â‘ ÂŒ pharmacy Lloydspharmacy experts Âƒ and side effects which they have a major part to play in keeping Â‹Â€ Âƒhoarded Â„Â„Â‘ ÂŒ Â‡ Â… Â‹ Â… ÂŒ Â‹Â€ ÂƒÂ„Â„Â‘ ÂŒ Dunne's store bags with the comment, "I Blackrock is customers in atocomfortablewont need these anymore." in turn leads patients out of nursing homes and hospitals. specifically massive losses environment. Thetohealth bar is Â? Âˆ Â
Â‹ Â?ÂŒ Â… Â‡ Âœ Â‡ Frank believes that Community Pharmacy "He is still a patient four years later and had Â?
Â‹ Â?ÂŒ Â… Â‡ Âœ Â‡ trained in Âˆ Â in setthe offexchequer by touch screen tablet is a work in progress that has received little three years without a hospital admission, the form oftounused, areas of computers allow customers help from the powers that be, however, by
Âˆ Â Â… Âž Âˆ Â˜ Â˜ Â™Â‡ Â† Â? previously his admission rate was 2 to 3 over prescribed and chronic and to hoarded explore medicines. products and relevant
Âˆ Â Â… Âž Âˆ Â˜ Â˜ Â™Â‡ Â† Â? sheer perseverance and making themselves times a year." acute Pain completely disposed to their patients conditions. The customer can test The next patient Frank encountered was Â… Â‰Â‡ Â? Âˆ Â
Â? "Doctorsand diagnose Frank feels that they are close to a major Management products take away samples Â… Â‰Â‡ Â? Âˆ Â
Â? illiterate with a benzodiazepine abuse and prescribe; patients breakthrough in the way the pharmacy and Skincare. from the health bar. problem. "We went through the same go home and take is practised and perceived within the Before the Âˆ Â˜ Â˜ Â™Â‡ Âƒ Â„Â„Â† Â?
Â… Â… Â… introductory process, removed meds and the Â˜ Â˜ Â™Â‡ medicines A, B community and within the Primary Âˆ Âƒ Â„Â„Â† Â? Care
Â… Â… Â… pharmacy equals However model. â€œWe offerC.our customers a started weekly visits. An interesting side opened its issue was that I discovered her family was if C, compliance or
Â‡ Â? Â&#x; Âš ÂŽ Â–Â– Â? Â‹ ÂŒ Â? fantastic healthcare service. We "Domicillary pharmacy has been piloted in stealing her valium, leading to increased doors for concordance is not
Â‡ Â? Â&#x;Â™ Â™ Âš ÂŽ Â? Â‹ ÂŒ Â? have cutting-edge technology Canada and in Devon [Sara Dilks] in England anxiety and further requests for scripts. The followed, the whole trade, the , both financed and led Âƒ by the NHS and the at expensive our disposal and our undesirables in her family did Âˆ not bother Â˜ Â˜ Â™Â‡ Â„Â„Â† Â? ÂĄÂ˘ Â€ Â… Â? Â… Â? exercise of training team had ÂƒÂ˜ government to varying degrees of success.Â„Â„Â† Â? with the blister packsand she is now Â˜ Â˜ Â™Â‡ taking ÂƒÂ˜ Âˆ Âƒ ÂĄÂ˘ Â€ Â… Â? Â… Â? plans robustand and intensive. time,are expertise 22 days of We are the first to initiate a Home Pharmacy the dose she was on when she started. Weappropriate enjoy andmedicine encourage ahalf holistic Â? Âˆ Â Â‡ Â€ Â‚ Â‹Â‰
ÂŒ Â… Â‹Â˜ ÂŒ which brings Pharmacy to the patient not extensive dispensing is a waste approach in patient care. We "We have over aÂˆ Â hundred patients availing of Â? Âš Âš Â‚ Â‹Â‰
ÂŒ Â… Â‹Â˜ ÂŒ theÂ‡ Â€ patient to the pharmacy all based on training to at least and potentially conducted extensive research into and each one has an individual this service a modification of a standard Community dangerous." Â† expand their Â™Â‡ Â™ Â? Âš ÂŁ Â? Â ÂÂ€Â‚Â Â?Â
to tell." Robert Gordon university our customersâ€™ needs and story along Pharmac," he says. strengths and Â† Â™Â‡ Â™ Â? Âš ÂŁ Â? Â ÂÂ€Â‚Â Â?Â
Thus theCondition idea of with Skin Treatment, knowledge,
Â… ourHomepharmacy research alsowas revealed including borne. Homepharmacy
Chronic Pain Support was vital.â€? involves Frank and Skincare Goretti Brady said. Â‹Â„Â„with Â„Â„Â¤ ÂĽ ÂŒ Â…
Â…Â? ÂˆÂ? Â… Â? his team delivery training medicines to aÂĽ ÂŒ Â… patients home weekly using Â‹Â„ Â„ Â„Â„Â¤
Â…Â? Âˆ Â? Â… Â? a Dermata monitored dosage to the Assystem such,tailored the Lloydspharmacy Â‡ Â‘ Â? Â? Â Â?Âƒ Â Â?Âˆ Â‡ Â„Â…Â?Â‹ ÂŒ ologist, individual needs of each patient. The service team has been trained in Pain Â‡ Â‘ Â? Â? Â Â?Âƒ Â Â?Âˆ Â‡ Â„Â…Â?Â‹ ÂŒ tohas ensure been in operation for the last two years management, both acute and colleagues and has proven to be of huge value. Â‹Â€ÂƒÂ„Â„Â‘ÂŒ Â… Â‹Â‡ Â…ÂŽ Â‹ ÂŒ chronic. Pain Assessment Tests understood Â‹Â€ÂƒÂ„Â„Â‘ÂŒ Â… Â‹Â‡ Â…ÂŽ Â‹ ÂŒ The initiative also gained him the prestigious were devised to gauge the skin conditions Business Development of the Year and Â…Â‡ Â‡ ÂŽ Â‹ ÂŒ Â‹ Â‡ teamâ€™s knowledge before such as (Independent) Award, sponsored by at the Â…Â‡ Â‡ ÂŽ Â‹ ÂŒ Â‹ Â‡ after the training to ensure inagural Irish Pharmacy Awards 2012. days eczema, Â˜ Â“ Â… Â‡ Â‹ Â‡ efficiency. The frontÂ…ÂŒ of shop has psoriasis make it a priority to have an is delighted and the award has The teamand at Homepharmacy decided to a PainofManagement zone and Â˜ Â“ Â… Â‡ Â‹ Â‡ acne. try to tackle the problem compliance. Â…ÂŒ more customers excellent relationship with their features a complete of Homepharmacy In spite of the millions that had already range of Frank McAnena
Âœ ÂŽencouraged Â‹ ÂŒ Â‹ ÂŒÂ Â‹ÂŒ into the pharmacy. To receive Â‹ÂŒ Â‹ÂŒ customers and the ÂŒ community. Pain medicines, medical devices
Âœ ÂŒ ÂŽ Â‹
ÂŒ Â‹ ÂŒÂ Â‹ÂŒ Lloydsrecognition for the hard work all Â‹ÂŒ Â‹ÂŒ On the official opening of to supplement Pain Relief, pharmacy our colleagues have put in over Â™ Â‹ÂŒ Â‰Â‡ Â– Â‹ÂˆÂŠ ÂŒÂ† Â‹ÂŒÂ… Â‹ ÂŒÂ… Âœ the flagship store customers compliance tools and information Blackrock the past few months, is fantastic. benefited from many initiatives Â™ Â‹ÂŒ Â‰Â‡ Â– Â‹ÂˆÂŠ ÂŒ Â† Â‹ÂŒ Â… Â‹ ÂŒÂ… Âœ and literature to understand Pain. has taken a ItÂ‰Â‡ will encourage us to go onwards e.g. complimentary skin analysis, Â‡ Â‹ÂŒ Â‹ ÂŒ Â‡ Â… Â‹ÂŒ Lloydspharmacy Blackrockâ€™s pioneering and upwards in serving our 1 to 1 expert advice and personal Â‡ brand Â‹ÂŒ Â‰Â‡ Â‹ ÂŒ Â‡ Â… Â‹ÂŒ focus on Pain is also supported step towards customers.â€? recommendations from Â‹ÂŒ by information points and Â‹ÂŒ
Â†Â‡Â?Â˜ Â… Â• Â… Â†ÂŚÂ˜ Â… Â• Â Â€Âƒ ÂˆÂ‰Â?ÂŠÂ‹ÂŠÂŒÂŽÂ‘ÂŒÂ’ÂŽ its Skincare representatives. There are interactive displays. â€œThe team Â‹ÂŒ Â‹ÂŒ
Â†Â‡Â?Â˜ Â… Â• Â… Â†ÂŚÂ˜ Â… Â• Â Â€Âƒ ÂˆÂ‰Â?ÂŠÂ‹ÂŠÂŒÂŽÂ‘ÂŒÂ’ÂŽ OTC. The The future for Lloydspharmacy ongoing health promotions in had specialised training and has They Â? Â‹Â„ÂÂŒÂĄÂ Â„Â§ÂƒÂ€Â˘ Â™ÂŽ Â Â Â?Â˜ Â? Â“Â?Â Â€Â„ÂÂ¤ pharmacy looks very optimistic. have store for the community on we can offer customers advice features already proven to be a success Â? Â‹Â„ÂÂŒÂĄÂ Â„Â§ÂƒÂ€Â˘ Â™ÂŽ Â Â Â?Â˜ Â? Â“Â?Â Â€Â„ÂÂ¤ that is informed. We can positively a monthly basis, each with a skin analysis THE INDEPENDENT VOICE OF PHARMACY
th digital skin ch enables the mmend the best cifically tailored er. The pharmacy any innovative care products
help our customers with their
technology to compliment that.â€? Store manager McCarthy mentioned.
opening. The storeâ€™s atmosphere and community involvement is a credit to the colleagues. On
Pain and skin care needs. All of Â? Â? Â€ Â„ÂÂ˘beyond Â˜Â†Â‘ÂˆÂ‘Â„Â€ÂÂ˘This Â‘Â„Â„ÂÂƒ is a special award for our team go over and Lloydspharmacy so soon after for our customers and haveÂˆÂ‘Â„Â€ÂÂ˘ Â? Â? Â€ Â„ÂÂ˘we Â˜Â†Â‘ Â‘Â„Â„ÂÂƒ
in their key areas of Skin and Pain already showing substantial growth compared to the same period last year.
Awards The Irish Pharmacy
Avène Counter Assistant of the Year Award 2020
Pharmacists may grab many of the headlines, but alongside each is the remainder of the pharmacy team, all of whom play a critical role in the success of the pharmacy and the services it provides. Perhaps you are a counter assistant, or know of a counter assistant who has helped recruit patients to the pharmacy’s services, delivered health promotion activities, or forged links with the local community. Or you/they might have improved safety or efficiency in the dispensing process, taken on delivery of clinical services or management responsibilities, or mentored colleagues. The Avène Counter Assistant of the Year Award recognises excellence in knowledge and service to retail customers. Nominations for the category can be made through self-nomination, by colleagues or by pharmacy business owners.
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Winners Irish Pharmacy Awar SPONS
Irish Pharmacy Awards Winners
Judges will be looking to reward those who bring something extra to the consumers experience of the pharmacy setting within a community.
Counter Assistant of the Year Award
Account will be taken of:
Sponsored by Sanofi
Clear demonstration of how the nominee/counter assistant has successfully placed customer care at the forefront of their pharmacy The details and rationale for any specific initiatives developed by the nominee for customer care Levels of excellence displayed above and beyond that expected from a counter assistant role Clear evidence of team working and excellent communication between the individual, their peers/colleagues and their patients and local community
46 | PHARMACYNEWSIRELAND.COM
Edel Niland, Krista Sherlock, Tony Hynds, Managing Director, Actavis Irela Business Development of the Year (Independent) Award
Business Developm of the Year Award Winner 2012
Awards The Irish Pharmacy
Baby & Child Health Pharmacy of the Year Award 2020
This Award celebrates the application of innovation and dedication within the children/baby market in pharmacy. It will recognise an outstanding pharmacy store, project or initiative where creative thinking, sound research and team working have combined to achieve real service development in this specific area. Judges will be looking for the store, or team that have pioneered an initiative providing an excellent, compassionate standard of service within the children/ baby market to this patient group. It might be a model that ensures a high level of continuity of care in this area, or a unique way of working or providing care to this population. Account will be taken of: Clear demonstration of an identified need and personal rationale along with details of the process of implementation from concept to design, planning and results
Evidence will be displayed for plans for further research and development
Evidence of the process by which the project was developed and implemented Evidence of impact on women and families within the local community
PHARMACYNEWSIRELAND.COM | 47
ycamrahP evitatneserpeR raeY eht fo
The Irish Pharmacy
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Winners Irish Pharmacy Awards 2012 SPONSORED
Irish Pharmacy Awards 2013 Winners
Innovation and Service Development Award (Chain) Innovation and Service Development (Chain) Award 2020 Sponsored by Clonmel Healthcare * Open to all pharmacies with more than 3 stores
The Innovation & Service Development Award’s principal aim is to reward innovation within the community pharmacy sector. The judging panel will be looking for ways in which a project is both innovative and successful. This Award identifies individuals and teams working within multiple community pharmacies in Ireland whose ideas or inventions have, or could lead to, improvement in the patient experience in all areas of care throughout their community. Applications are sought from those demonstrating clear enthusiasm and commitment to the enhancement of community pharmacy in Ireland, exceptional quality above and beyond what is expected and an ability to overcome challenges in pursuit of goals.
Business Development of the Year Award Winner 2012
Activities that may involve pioneering new models or systems that improve pharmacists ’ impact as members of the healthcare team ; patient safety and Martin Gallagher, Clonmel Healthcare (Sponsor), Brian Pagni, outcomes; patient care in general and otherBradley's Pharmacy and Kevin McCabe. professional development
Measurable benefits of your initiative. Please use financial data wherever possible (percentages, rations, graphic images etc.), as well as other statistics to show how your project has bought added value, profits, customer satisfaction improvements, productivity increases or any other benefit relevant to this award category
48 | PHARMACYNEWSIRELAND.COM
a c o a w P o t a p c a t t t t a o
The level of competition and s a new imaginative projects F in this year’s category of s Innovation and Service p p Development Award (Chain) f sponsored by Clonmel P Healthcare, demonstrates the lengths the pharmacy B in industry is willing to go b to, to improve the service t they provide to their w m customers in a tough time a for the sector. Technology g is at the forefront of this t change and the Bradley’s B Pharmacy App, which A was awarded the winning e trophy, shows that a Edel Niland, Krista Sherlock, Tony Hynds, Managing Director, Actavis Ireland, and Diane Patterson with the n innovation can enhance Business Development of the Year (Independent) Award the patient’s pharmacy P experience by From making life the pharmacy a more convenient while also o to the home c improving the relationship w Homepharmacy! between the pharmacist p and patient. The problem of compliance is an increo
Account will be taken of:
Development of a system or tool for pharmacy that will directly or immediately impact IPN August 2013.indd 16-17 patient care or the profession and/or serve as an example or template for other pharmacy professionals to follow
one and one which is encountered by
most pharmacists at some point withip Brian Pagni, Managing Director dispensary. For Galway pharmacist Fr o of Bradley’s Pharmacy said, “To p win the Innovation and Service p Development Award (Chain) is s important but what makes us t at Bradley’s feel privileged to o win is the fact that the award is d judged by our peers. The judging r panel is made up of successful business people and people I who know the sector. They P know what innovation should s be introduced to the sector. T This endorsement, mixed with P the high level of competition at f the awards, makes winning the t award extra special.” t t The Bradley’s Pharmacy App is a completely branded with their a own name, logo & information. t This new and free pharmacy f
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Awards The Irish Pharmacy
Winners Irish Pharmacy Awards 2012 SPONSORED
Irish Pharmacy Awards 2013 Winners
McAnena it is an potentially dangerous issue which required urgent action within his catchment area.
been spent on trying to find a solution and the different approaches used, they found that community pharmacy had not been explored as a resource. When setting about establishing his new initiative Frank's priority was to make sure The service is offered in conjunction with patients were not putting their own health the Public Health Nursing Service, GPs and at risk but not taking health care workers. their medication. Frank came upon the idea for the initiative of Frank, who owns 28 day supply, the patient will scheduled texts goEyre out at 2pm and Homepharmacy after a family member was Square Pharmacy receive a text two days before their prescriptions are collected from diagnosed with early Alzheimer’s and the in Galway, tells IPN, medical management problems it presented. next repeat prescription is due, the"50% GP by 3.30pm. of patients are A chance meeting with a public health nurse informing them that, if they wish, statistically known to led The was developed to to the referral of a number of patients their prescription will be made beservice non compliant – with ainvariety of problems. The first was enhance patient experience ready for collection. this is athe problem which on thirty different meds, 72 years old and Brennan’s. does not seem to be bipolar along with a multiplicity of other If Brennan’s are not currently soluble– “Check your Fergus Brennan,cabinet Managing ailments. own medicine holding a valid prescription for a
McLernon Computers Innovation and Service & Innovation Development eHealth Award (Independent)
(Independent) Award 2020
Sponsored by McLernon Computers
patient, they can text a reminder to order a new prescription and, in this way they always have a prescription to hand before the patient’s medication is dispensed.
and you find some Director ofwill Brennan’s Pharmacy Frank tells us, " I went to his home and unused medicine”. group said; “The Text Collect found him in a very agitated state. We sat However, that and went through his meds explaining service has within always been customer 50% is aservice further 10%, what each was for and how they were to led. If the didn’t genuinely whose non compliance be taken. We then blisterpacked his meds solve a problem for our customers, gives rise to serious and started a weekly delivery to him. This then it would not have been health problems, resulted in a marked decrease in G.P. Visits implemented. Our patients voted hospital admissions, and P.H.N. interventions, plus we succeeded with the success of the initiative.” accumulated meds, in removing a huge quantity of unused
THE INDEPENDENT VOICE OF PHARMACY
College of Pharmacy has authorised an based on the work we are doing which hoped to be complete by October with offer of a potential Phd. thereafter.
The patients Frank and his team deal w are all referred from professionals within the Primary Care model. These patients usually, cannot make their way to the sh new Primary Care edifice for a multiplici of reasons. They may be too sick, too o too infirm, too disturbed, too confused, contrary, too reclusive or too disinterest At Homepharmacy their medication is managed, and an attempt is made to try to educate and give advice, liaise with fellow professionals and make ourselve an integral part of the Primary care team Frank first realised his team had made a major breakthrough when a doctor rang and asked him to perform a certain role a part of her team’. These turned out to not an idle comment but the beginning relationship that has been duplicated w other medics since. American studies h shown that 1 in 4 nursing home patients there because of medicine mismanagem Without overstating the role of his team trying to remedy this problem he is adam they have a major part to play in keepin patients out of nursing homes and hosp
Feilim Henry, Supervising Pharmacist for over dosage and hoarded meds. He actually brought in two Prescriptions can be prepared in store bags with the comment, "I the Brennan’s side effects which Dunne's advance for patients so thatwont the need these anymore." Pharmacy in turn leads to massive losses to to spend more Group, is Pharmacist is able Frank believes that Community Pharma "He still a patient four years later and had the exchequer in project time with the patient. However, is the is a work in progress that has received l three years without a hospital admission, the form unused, manager for benefits of of ‘Text Collect’ do not help from the powers that be, however, previously his admission rate was 2 to 3 over this innovative stop atprescribed customer and relationships. sheer perseverance and making themse times a year." hoarded medicines. service. Henry completely disposed to their patients The next patient Frank encountered was There is also a benefit for stock "Doctors diagnose said; “Patients Frank feels that they are close to a majo illiterate with a benzodiazepine abuse control. For some special or the and prescribe; patients breakthrough in the way the pharmacy expect more problem. "We went through the same go home and take is practised and perceived within the more perishable items, such as than just introductory process, removed meds and FergusCare Bre the medicines A, B community and within the Primary ostomy products or nutritional healthcare started weekly visits. An interesting side equals C. However model. feeds, Brennan’s don’t need from their issue was that I discovered her family was if C, compliance or to have them on shelf until the Pharmacist, "Domicillary pharmacy has been piloted stealing her valium, leading to increased concordance is not prescription is being dispensed, they want to Canada and in Devon [Sara Dilks] in Eng anxiety and further requests for scripts. The followed, the whole , both financed and led by the NHS and which meansexercise there isofless wastage. see innovation undesirables in her family did not bother expensive government varying degrees of succe Brennan’s offers however, Point, to and allows their patients and the with the blister packs and she is now taking time, expertise and We arefind theout firstinformation to initiate a Home Pharm Since implementing Text Collect, gone on a variet half the doseBrennan’s she was onhas when shethrough started. a pharmacy appropriate medicine brings Pharmacy patient no Brennan’s has an increase subjects, suchtoasthe weight number of changes in order to whichof dispensing is seen a waste adapting "We have over a hundred patients availing of the patient to the pharmacy all based on in the popularity of the service management or cancer, at their at least and potentially keep up one withhas their to change. this service and each anInishowen individual a modification of a standard Community dangerous." across their three pharmacies own convenience. ‘Text Collect’ story to tell."customers. Robert Gordon university Pharmac," he says. in Innishowen, especially within is simple, Thus the idea of “It’s an established, concise The Buncrana pharmacy moved certain patient groups secure and Homepharmacy was such as medical data base that is easy location twice as the town women the combined oral anonymous borne.taking Homepharmacy understand and allows a patien expanded for the convenience of contraceptive, involves Frankwho and get a reminder and it allows to consult a pharmacist if it is Edel Niland, Krista Sherlock, Tony Hynds, Managing Director, Actavis Ireland, and Diane Patterson with the their customers. to his come back in for their next team delivery us to build Business Development of the Year (Independent) Award needed, as opposed to using to a patients using pack,home thusweekly reducing the risk of amedicines better “We moved the Buncranca shop a monitored dosage system tailored Google at home,” said Brennan increasing the 7 to pillthe free days and relationship individual each patient. The service because the town was moving contraceptive cover. with our needs of losing has been in operation for the last two years The data base has been used b away from what used to be the patients.” and has proven to be hugeGP value. Brennan’s for ten years, but it h retail centre to another area. Theoflocal surgery also trusts been updated to a tablet from a The GP surgery and a number and supports the new service. The The‘Text initiative also gained him the prestigious kiosk for convenience. It is also of multinational supermarkets Some Business Development of of thetheir Yearstaff are currently Collect’ used as a training tool for CPD (Independent) sponsored at the along with a one way system taking part in by 'Text & Collect.' service allows Award, the staff of Brennan’s. inagural Irish Pharmacy Awards 2012. were driving our customers away Where the local GP wishes to the pharmacy The problem of compliance is an increasing from the old pharmacy location. contact a patient, they are able to to work more one and one which is encountered by The team at Homepharmacy decided to Brennan added; “This resource We realised that our patients and attach a note to the prescription, efficiently as most pharmacists at some point within the try to tackle the problem of compliance. well placed, as a pharmacy is o customers were having to go out safethat in the that even Frank McAnena they have of Homepharmacy dispensary. For Galway pharmacist Frank In spite ofathe millions had knowledge already seen as an information source of their way to get to the pharmacy without seeing the patient, prescription and adapted quickly by moving the patients. Part of our role is ofte Brennan’s will pass on the ready for the guide patients to the best form pharmacy to the new, thriving part patient in message. This has also helped treatment-that’s what this reso of Buncrana.” advance and their workload and in so doing Robin Hanna McLernon Computers, Fergus Brennan, Feilim Henry-Brennan’s Pharmacy does.” patients don’t enhances the relationship between With the move, the pharmacy saw have to wait the pharmacy and the surgery. Henry explained what it means an increase in their customer base. for it to be to win the Innovation and Servi Brennan’s has a history of dispensed. Award; “Winning the award has Fergus said; “I have always been innovation and pride themselves encouraged us to now live up t interested in technology and Henry said; on adapting to change ahead of the award and it has encourage new ideas for improvement. We “One of the curve. us to do more for the future. would have been one of the first the biggest Pharmacy is perfectly placed Brennan’s Pharmacy Group saw an opportunity to make The pharmacy group had already Buncrana and Carndonagh. pharmacies to invest in an EPOS “Innovation doesn’t have to be just benefits of the service is time to add enormous value to the introduced a prescription collection system in 1997 and then the about digital and technological saving. Most of the service is run their prescription service more efficient and to offer their health service but we have to u When a patient comes on board service in 2012 and felt the ‘Text prescription collection service was advancements that are out of this by one of pharmacy assistants, technology to its full potential patients more consultation time with the Pharmacist with Collect’ was a natural progression. with the 'Text & Collect' service, introduced two years ago. We are world. Pharmacy is changing all Bredgeen. The time saved gives us to provide the best possible they receive a short text outlining always thriving to improve our the time and pharmacies have more opportunities to speak with their ‘Text Collect’ service. Their successful implantation service. We always want to tha The pharmacy group tested the service and confirm consent, service through new IT solutions.” patients when they are in-store and to adapt to keep up and survive. of this new service led them to walking away with the Rebecca Clarke of Pharma We the new ‘Text Collect’ service while allowing them to opt out of For us at Brennan’s, that is what will allow us to offer more services for developing the Text Collect on a small pilot group initially Brennan’s also have a bespoke the service at any time by texting Innovation in Service Development Award (Independent) innovation is about, adapting to in the pharmacy in the future.” solution and working with us to in Clonmany, Inishowen, Co. Health information service back, ‘OPT OUT’. change to improve the service of sponsored by McLernon Computers at the Irish successfully implement it for ou Donegal and after its success This service has resulted in available on mobile iPad and our customers,” said Brennan. patients’. Brennan’s keep the patients Pharmacy Awards 2013. they expanded the service to all Brennan’s having a structured touchscreen PC in store for plan to their daily routine. All of the Text & Collect is a new service three pharmacies in Clonmany, prescription and, based on a their patients. This called Health
An adapted category for long standing sponsor, McLernon Computers, the eHealth & Innovation Award seeks to recognise and reward those that are showcasing digital health innovations, solutions and applications within their pharmacy business.
Business Development of the Year Award Winner 2012
IPN July 2013.indd 24-25
From the pharmacy to the home Homepharmacy!
eHealth - when applied effectively - delivers more personalised 'citizen-centric’ healthcare, which is more targeted, effective and efficient.
This award category is aimed at those embracing the integration of Information and Communication Technologies in the world of healthcare, encouraging forward and leading edge thinking in the growing sector of eHealth.
The judging panel will be looking for ways in which a project is both innovative and successful, identifying pharmacy individuals and teams working within the independent pharmacy sector in Ireland whose applications have, or could lead to, improvement in the patient experience in all areas of care throughout their community through the use of eHealth. Account will be taken of: Focus on resources and organisational focus on eHealth as well as initiatives implemented
Activities which may involve introducing new models or systems that improve pharmacists’ integration as members of the healthcare team Examples of impact and benefit for the end-user/patient care Demonstration of measurable benefits of the initiative (Please use supplementary data wherever possible, as well as other statistics to show how your project has bought added value, profits, customer satisfaction improvements, productivity increases or any other benefit relevant to this award category)
PHARMACYNEWSIRELAND.COM | 49
Awards The Irish Pharmacy
Pharmacy Student of the Year Award 2020
This Award serves to recognise the next generation within community pharmacy in Ireland. The Pharmacy Student of the Year Award recognises and celebrates outstanding pharmacy students by showcasing their skills to the pharmacy profession. Judges will be looking for a pharmacy student who has made consistent, sustained and outstanding contributions toward pharmacy student participation on both a local and national level. Those who are able to demonstrate leadership abilities, advocacy for health system pharmacy, and a devotion toward community pharmacy are invited to apply. This category showcases the skills and abilities of some of Ireland’s outstanding pharmacy students to the pharmacy profession while also giving students a chance to apply their skills and be judged on them. Account will be taken of: Demonstration of performance through the academic year Engagement in extracurricular activities, such as participation in committees, or having launched an initiative to the benefit of fellow students Evidence of activities to promote the advancement of the profession of pharmacy Outstanding academic excellence / achievement together with outstanding achievement / contribution as an individual to student life
50 | PHARMACYNEWSIRELAND.COM
Awards The Irish Pharmacy
PharmaSource Community Pharmacy Technician of the Year 2020 It is evident that pharmacy technicians are playing an increasingly important supporting role as pharmacists are increasingly spending more time with patient consultations and engaging local stakeholders. The shift in emphasis from dispensing to healthcare provision has meant that the wider pharmacy team has to pull together – pharmacy technicians capture the essence of this in everything that they do. The PharmaSource Community Pharmacy Technician of the Year Award will recognise the winner’s important contribution to the community pharmacy technician profession. Applications are invited from both the independent and chain sectors. The judges will be looking for those who can demonstrate promotion of the role of the Pharmacy Technician and those who continue to champion excellence through forward thinking and innovation. The winners’ achievements will be an inspiration to those pursuing innovative practice; to those striving to raise standards; and to pharmacists who, through their professionalism, provide models for others within pharmacy. Account will be taken of: Evidence of long-term, consistent dedication and outstanding achievements that have led to the advancement of the profession of pharmacy and public health Evidence of a large variety of skills, attributes and accomplishments Evidence of an individual strong in character, cumulative professional accomplishments and the ability to properly represent and model what pharmacy technicians as a profession encompasses Evidence of an understanding the goals of pharmacy, and significantly contributing to how these goals may be achieved
PHARMACYNEWSIRELAND.COM | 51
Awards The Irish Pharmacy
GSK Self-Care Award 2020
The GSK Self-Care Award recognises community pharmacy’s commitment to tackling health inequalities and serves to reward achievement in the development and implementation of health promotion, self-care and community wellbeing strategies/initiatives. It is designed to encourage excellence in the production and dissemination of accessible, well-designed and clinically balanced patient support. The Award will be presented to the team or individual who can demonstrate a significant positive impact on the experience of those who use Pharmacy services. This may be through campaigns, promotions or initiatives which have identified a need within the community to address certain health issues. Account will be taken of: Evidence of long-term, consistent dedication and outstanding achievements that have led to the advancement of the profession of pharmacy and self-care Evidence of an individual strong in character, cumulative professional accomplishments and the ability to properly represent and model what pharmacy as a profession encompasses Evidence of an understanding the goals of pharmacy, and significantly contributing to how these goals may be achieved
52 | PHARMACYNEWSIRELAND.COM
MORE EFFECTIVE RELIEF FROM
Voltarol Emulgel P 1% w/w Gel *than non-medicated gel Voltarol Emulgel P 1% w/w Gel, contains diclofenac diethylammonium. Always read the label/ leaﬂet
Voltarol Emulgel Extra Strength 2% w/w Gel, contains diclofenac diethylammonium. Always read the label/ leaﬂet
Product Information: Please consult the Summary of Product Characteristics for full product information. Voltarol Emulgel P 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 P 1% w/w Gel: 2g to 4g of gel, applied topically 2 times daily – morning and evening. Voltarol Emulgel Extra Strength 2% w/w Gel: 2g to 4g of gel, applied topically 3-4 times daily. It is recommended that treatment to be limited to 7 days. Patients should consult their doctor if the condition does not improve. Contraindications: Patients with or without chronic asthma in whom attacks of asthma, urticaria or acute rhinitis are precipitated by aspirin or other non-steroidal anti-inflammatory agents. Hypersensitivity to diclofenac, acetylsalicylic acid or other non-steroidal anti-inflammatory drugs. Hypersensitivity to any other ingredient of the gel. Use in third trimester of pregnancy, in children and adolescents aged less than 14 years is contraindicated. Warnings and Precautions: Caution with oral NSAIDs as may result in unwanted side effects. Avoid use with other products containing diclofenac. Apply only to intact, non-diseased skin and not to skin wounds or open injuries. It should not be used with occlusion. It should not be allowed to come into contact with the eyes or mucous membranes, and should never be taken by mouth. 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. Pregnancy and Lactation: The systemic concentration of diclofenac is lower after topical administration, compared to oral formulations. During the first and second trimester of pregnancy, diclofenac should not be given unless clearly necessary. Only use during lactation on the advice of a health professional. Diclofenac is contraindicated during the third trimester of pregnancy. Should not be applied on the breasts of nursing mothers, nor elsewhere on large areas of skin or for a prolonged period of time. 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. Overdose: The low systemic absorption of topical diclofenac renders overdosage extremely unlikely. MA Holder: GlaxoSmithKline Consumer Healthcare (Ireland) Limited, 12 Riverwalk, CityWest Business Campus, Dublin 24, Ireland. MA Number: Voltarol Emulgel P 1% w/w Gel (diclofenac): PA 678/140/002. Voltarol Emulgel Extra Strength 2% w/w Gel: PA 678/140/003. Legal Category: Pharmacy only. Text revised: April 2018. Further information available on request. CHGBI/CHVOLT/0130/18
Awards The Irish Pharmacy
AYA Vitamins Category Development Award 2020
The AYA Vitamins Category Development Award aims to recognise the specialist knowledge and expertise of pharmacies in areas such as first aid, derma skincare or vitamins, minerals and supplements. Running a successful pharmacy means much more than knowledge of top-selling products. The ability to optimise retail performance through a specific group of products managed as a distinct business unit shows an understanding and appreciation of the market and the ability to excel in these competitive times. Judges of this category will be looking for an identified need within the pharmacy, followed by details of the project implementation process from conception to resolution. The Award is seeking entries from those who can demonstrate the measurable benefits from a specific project or initiative and have added value, profits, increased productivity and customer satisfaction. Account will be taken of: Evidence of training, education and/or support initiatives undertaken by the pharmacist/pharmacy team Demonstration of benefits from a specific project Examples of fresh thinking within category development for the enhancement of this sector within community pharmacy Ambition in improving performance, furthering knowledge and understanding of the market
54 | PHARMACYNEWSIRELAND.COM
Awards The Irish Pharmacy
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Winners Irish Pharmacy Awards 2012 SPONSORED
Irish Pharmacy Awards 2013 Winners
Pharmacy Team of the Year Award Sponsored by McNeil Healthcare
THE INDEPENDENT VOICE OF PHARMACY
McAnena it is an potentially dangerous
stores located in Clonmany, issue which required urgent action within his Carndonagh and Buncrana. Forarea. catchment Fergus the journey was a long one as he set out on aWhen roadsetting with about establishing his new initiative Frank's priority was to make sure one destination; to find individuals patients were not putting their own health matching the Brennans desire of at risk but not taking providing excellence in customer their medication. service every day. Frank, who owns Eyre “Our patients and our customers are the reason we open our doors every day,” he says. We have three simple routines that ensure we keep moving forward: Appreciate each others skills; Have trust and honesty Celebrate our successes
Edel Niland, Krista Sherlock, Tony Hynds, Managing Director, Actavis Ireland, and Diane Patterson with the Business Development of the Year (Independent) Award
From the pharmacy to the home Homepharmacy!
The service is offered in conjunction with the Public Health Nursing Service, GPs and health care workers.
Frank came upon the idea for the initiative of Homepharmacy after a family member was diagnosed with early Alzheimer’s and the medical management problems it presented. A chance meeting with a public health nurse led to the referral of a number of patients with a variety of problems. The first was on thirty different meds, 72 years old and bipolar along with a multiplicity of other ailments. Frank tells us, " I went to his home and found him in a very agitated state. We sat and went through his meds explaining what each was for and how they were to be taken. We then blisterpacked his meds and started a weekly delivery to him. This resulted in a marked decrease in G.P. Visits and P.H.N. interventions, plus we succeeded in removing a huge quantity of unused hoarded meds. He actually brought in two Dunne's store bags with the comment, "I wont need these anymore."
“Our team foundation beliefs lie in sourcing staff whom will fit into our mission and ethos,” explains Fergus. “We have strong core values that translate to endeavouring to serve our community and customers in a caring and supportive manner and it is this that drives us to work together as efficiently as possible.” Brennans pharmacy have three
College of Pharmacy has authorised an Msc based on the work we are doing which is
hoped to be complete by October withBlack, the Feilim Henry, Sarah McCarron, Michael offerBrennan, of a potential Phd. thereafter. Fergus Bridgeen McConologue
The patients Frank and his team deal with are all referred from professionals within the Primary Care model. These patients, usually, cannot make their way to the shiny new Primary Care edifice for a multiplicity of reasons. They may be too sick, too old, too infirm, too disturbed, too confused, too contrary, too reclusive or too disinterested. At Homepharmacy their medication is managed, and an attempt is made to try to educate and give advice, liaise with fellow professionals and make ourselves an integral part of the Primary care team. Frank first realised his team had made a major breakthrough when a doctor rang and asked him to perform a certain role ‘as a part of her team’. These turned out to be not an idle comment but the beginning of a relationship that has been duplicated with other medics since. American studies have shown that 1 in 4 nursing home patients are there because of medicine mismanagement. Without overstating the role of his team in trying to remedy this problem he is adamant they have a major part to play in keeping patients out of nursing homes and hospitals.
Frank believes that Community Pharmacy is a work in progress that has received little help from the powers that be, however, by sheer perseverance and making themselves disposed to prestigious their patients a daily basis, improving patient completely For winning the improved the teams product The next patient Frank encountered was "Doctors diagnose Frank ‘Community feels that theyPharmacy are close toTeam a major of knowledge. so asabuse the patient illiterate withcompliance a benzodiazepine and prescribe; patients breakthrough in the way the pharmacy the Year Award’ Fergus comments, doesn’t run ourthe ofsame their medicinesis practised problem. "We went through go home and take and perceived within the Using these stratgeies has meant “It is important to acknowledge also removed frees us meds up to and spend more introductory and process, the medicines A, B community and within the Primary Care theequals team C. can offer patients the other nominees within our started weekly visits. An interesting side time to consult with our patients. model. However issue was that I discovered her family was theif best advice and catgeory. Stacks pharmacy, C, compliance or respond "Domicillary pharmacy has been piloted in leading increased effectively to enquiries make her valium, McCabes pharmacy, Boots concordance is not theystealing “As a team wetoworked together on Canada and in Devon [Sara Dilks] in England anxiety and further requests for scripts. The followed, the whole pharmacy, DocMorris pharmacy, about products and services this project to fully identify the best , both financed and led by the NHS and the “We have undesirables in her family did not bother expensive exercise of Marketpoint pharmacy, Murrays advertised. way of utilising our skills so as to government to varying degrees of success. with the blister packs and she is now taking clear goals, time, expertise and the as started. efficiently asWe arepharmacy the first to initiate a Home Pharmacy half the dosedeliver she was onservice when she roles and appropriate medicine The team also support many local possible.” which brings Pharmacy to the patient not dispensing is a waste responsibilities "We have over a hundred patients availing of “The to standard of service being causes and charities, emphasising the patient the pharmacy all based on at least and potentially and I feel this service and each has an individual providedofthroughout pharmacy their desire to lend a hand to their a modification a standard Community Using theone brennanspharmacy. dangerous." investing story to tell." Robert Gordon university in Ireland across the board is he says. local community. com email system, staff can be Pharmac," in these Thus the idea of exceptional and it has been kept informed refularly of onging relationships Homepharmacy was inspirational to have been “We strive to make links with our developments and this is used as a borne. Homepharmacy with each shortlisted amongst the calibre of local community. Our contribution unique communication tool within involves Frank and other has the those names above; and a true is very important to us and we the branches. his team delivery knock-on honour to have been selected havehome sponsored medicines to a patients weeklymany using community effect. We all as the winner. This has given us events competitions including “A huge achievement for us as a a monitored dosage systemand tailored to the need to focus a further drive to keep moving local primary schools, the individual needs of the each patient. The service team was to reach the Top 100 on providing forward with our goals and vision, Carndonagh Community Hospital, has been in operation for the last two years Stores in the Retail Excellence an uplifiting there is a bright future on the and has proven to be huge value. theofFunny Feet Fund and the Croc Ireland Awards last year. The "He is still a patient four years later and had three years without a hospital admission, previously his admission rate was 2 to 3 times a year."
customer Crusade. We have held our own awards programme involves the The initiative also gained him the prestigious service in-store events, Business Development of the Year including those to rigorous assessment of retail experience support hospice (Independent) Award, sponsored by atcare the and Daoffodi practice and the selection of best and therefore Day for the Irish inagural Irish Pharmacy Awards 2012.Cancer Society. in class retail operators. Working if we are All of our team members received in an independent pharmacy The team at Homepharmacy decided to happy working training on various cancer issues makes it difficult to benchmark try to tackle of compliance. together as the problem from ourhad relief pharmacist. Frank McAnena ofagainst Homepharmacy spite our of the millions that already ourselves the rest of the aInteam, pharmacy industry. Achieving our customers Fergus continues: “Toegther we place in the Top 100 stores with will feel that always have an eye on what we tough multinational competition energy in a can improve within the pharmacy and wining such high recognition positive way and the team to improve our indicates we are delivering also.” service. We have recently received excellent customer service through the boost of additional manpower a driven, dedicated and patient Evidence of which has allowed us to move focused team. Our team was their innovation forward with our health promotion commended for being attentive, is apparent activity. We are never standing friendly and knowledgeable throughout. still.” with a vast product range and a Team leader fantastic store. We strive to create within the In late 2012 Brennans began Brennans Clonmany branch, a comfortable, friendly and warm offering a new mobile messaging Feilim Henry constistently uses atmosphere, which was evident service for patients called ‘Text & every opportunity to train staff in the report. We support and Collect’. All team members have colleagues and pass on new encourage each other to maintain promoted this service and they ideas about giving the patients our high standards of customer are now providing it to over 150 exceptional pharmacy service. service. We are all extremely patients. Feargal, group support pharmacist passionate about our customers is the training co-ordinator for OTC and our team. We are very proud “We had a series of meetings medicines and minor ailments. of our success and recognition as to find the best way to deliver He gives focused and structured one of the Top 100 retail stores in this service and it has helped OTC training, which has greatly us to organise our workload on Ireland.”
The problem of compliance is an increasing one and one which is encountered by most pharmacists at some point within the dispensary. For Galway pharmacist Frank
Michael Black, Feilim Henry, Fergal McDermot, Orla O’Donnell, Geraldine Freeman, McNeil Healthcare (Sponsor), Fergus Brennan, Danielle McNenamin, Elizabeth Doran, Michael Mullen, Aaron Carlyle, Brennans Pharmacy Donegal
As Henry Ford once said, “Coming together is a beginning. Keeping together is progress. Working together is success.” This is certainly a true adage for their team working together within Brennans Pharmacy Group, who scooped the prestigious Community Pharmacy Team of the Year Award. For Managing Director Fergus Brennan, their excellent collaboration has produced results exceeding their individual capabilities; allowing patients and customers to engage with confidence and thus generating a synergy that has enabled the team and business to grow immensely.
Square Pharmacy in Galway, tells IPN, "50% of patients are statistically known to be non compliant – this is a problem which does not seem to be soluble– “Check your own medicine cabinet and you will find some unused medicine”. However, within that 50% is a further 10%, whose non compliance gives rise to serious health problems, hospital admissions, accumulated meds, over dosage and side effects which in turn leads to massive losses to the exchequer in the form of unused, over prescribed and hoarded medicines.
been spent on trying to find a solution and the different approaches used, they found that community pharmacy had not been explored as a resource.
Community Pharmacy Team of the Year Award 2020
“Each member of the team is a ‘champion’ of their own skillset. We work in an intense environment and I feel it’s important that each member of staff is aware of what they bring to the table to assist with the effective working of their colleagues.
Business Development of the Year Award Winner 2012
This Award will be given to the community pharmacy team that demonstrates the best combination of team spirit and enhancement of patient care at all levels.
horizon for Brennans with many challenges. But challenges bring opportunity.
“Pharmacy is undergoing critical change at the moment, but we firmly believe that if we adapt to this change as quickly and efficiently as possible, the future is not only bright, it’s inspiring.”
The judges will be looking for those who encourage and support each other and those who have collectively demonstrated innovation and forward thinking.
“Under the caring and inspirational leadership oF Feilim Henry, we genuinely work as one happy Family in our team at Brennans Clonmany . We enjoy each others company and have built real trust, co-operation and Friendship in our group. We Feel privileged to serve our local community every day. We look Forward to Further growth and exciting changes in the years ahead so that we can continue to deliver an outstanding community pharmacy service to our patients,” adds Fergus.
The key to any successful pharmacy is Teamwork and this award recognises the power and potential of a focused and unified approach to healthcare initiatives. Teams can be based within one organisation or spread over multiple organisations; but they must comprise individuals working towards the same objective or goal.
IPN August 2013.indd 26-27
Account will be taken of: How the team has demonstrated their ability to deliver clear benefits to patients; and/or staff members through working together efficiently and effectively How the team has worked together to achieve its objectives over the past twelve months Projects that the team has successfully managed which demonstrate excellence in quality, innovation, productivity and prevention A clear display of the principles underpinning their success as a team
PHARMACYNEWSIRELAND.COM | 55
Awards The Irish Pharmacy
KBC Business Banking Community Pharmacist of the Year Award 2020
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
The KBC Business Banking Community Pharmacist of the Year Award seeks to recognise a community pharmacist who is defining the future standard of pharmacy practice by his or her professional practice and/or by advocacy in the pharmacy industry.
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
atrnaehsP erphesRirI yecvaitm ht fo 31r0ae2tYsislaed niFrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Winners Irish Ph
Nexazole: for the treatment of erosive ref
Prescribing Information for Nexazole 20 mg & 40 mg gastro – resistant capsules, Composition: Each capsule contains 20 mg or 40 mg of esomeprazole (as eso Pharmaceutical Form: Hard, gastro-resistant capsule: Slightly pink body and cap, cont Therapeutic Indications: Treatment of erosive reflux oesophagitis. Prevention of rela term management of patients. Symptomatic treatment of gastroesophageal reflux dise concurrently given with appropriate antibiotic therapy for treatment of H.pylori-asso associated gastric and duodenal ulcers in patients requiring continued NSAID-treatme gastric ulcers and duodenal ulcers in patients at risk requiring continued therapy. Pro prevention of rebleeding of peptic ulcers. Treatment of Zollinger Ellison Syndrome. Dosa Capsules should be swallowed whole with liquid. The capsules can be opened and the carbonated water or if desired this solution administered through a gastric – tube in p Prescribing for Nexazole 40 mgorgastro – resistant capsules, The capsulesInformation and / or contents should 20 notmg be &chewed crushed. Treatment of erosi Composition: EachLong-term capsule contains 20 mg or 40 mg esomeprazole (as to eso daily for 4 weeks. management of patients withofhealed oesophagitis Pharmaceutical Form: Hard, gastro-resistant capsule: Slightly20 pink cap,Eradi cont Symptomatic treatment of gastroesophageal reflux disease: mgbody onceanddaily. Therapeutic Indications: reflux+oesophagitis. Prevention all of twic rela H.pylori-associated ulcers: Treatment 20 mg withof1 erosive g amoxicillin 500 mg clarithromycin, term management of patients. Symptomatic treatment of gastroesophageal reflux dise gastric & duodenal ulcers: 20 mg once daily for 4 – 8 weeks. Prophylaxis treatment: 20 concurrently given with appropriate antibiotic therapy for40treatment H.pylori-asso after i.v induced prevention of rebleeding of peptic ulcers: mg once of daily for 4 week associated gastric duodenal requiring continued NSAID-treatme dose is 40 mg onceand daily. Dosageulcers shouldinbepatients individually adjusted. Daily doses up to 160 gastricdose ulcers and duodenal requiring continued therapy. Pro daily exceeds 80 mg, it ulcers shouldinbepatients divided at andrisk given twice daily. Severe liver imp rebleeding peptic ulcers. Treatment of ZollingertoEllison Syndrome.orDosa aprevention max. doseof of 20 mg. ofContraindications: Hypersensitivity esomeprazole to a Capsules be swallowed with liquid. The capsules can be opened andinsuffi the should notshould be administered withwhole atazanavir. Pregnancy and breast-feeding due to carbonated water orand if desired this solution through a gastric gastric – tube tum in p Special warnings precautions for use:administered The possibility of a malignant The capsules and / or contents should not be Regularly chewed ormonitor crushed. Treatment of erosi may alleviate symptoms and delay diagnosis. patients on long-term daily for 4should weeks.contact Long-term of patientschange with healed oesophagitis to treatment their management physician if symptoms in character. If esomep Symptomaticthen treatment of gastroesophageal reflux disease: 20 mg oncealso daily. antibiotics, the instructions for the use of these antibiotics should be Eradi follo H.pylori-associated 20 mg 1 g amoxicillin + 500 mg such clarithromycin, all twic may lead to slightlyulcers: increased riskwith of gastrointestinal infections as Salmonella an & duodenal 20 mg once daily for 4 – 8intolerance, weeks. Prophylaxis –gastric Patients with rareulcers: hereditary problems of fructose glucose treatment: – galactose20m after i.v induced prevention rebleeding peptic ulcers: 40 mg once daily for week insufficiency should not takeofthis medicine.ofDrug Interactions: Esomeprazole can4 affec dose is 40 mgDose oncereduction daily. Dosage be individually adjusted. Daily to 160 itracanazole. may should be required when administered withdoses drugsupmetabo daily increase dose exceeds 80 mg, itconcentration. should be divided and patients given twice daily. Severe liver imp may their plasma Monitor when given in combinatio a max. doseUndesirable of 20 mg. effects: Contraindications: Hypersensitivity to esomeprazole or todiaa derivatives. Common: Headache, abdominal pain, constipation, shouldLife: not be administered with Authorisation atazanavir. Pregnancy breast-feeding due toLtd., insuffi Shelf 2 years. Marketing Holder:and Pinewood Laboratories Ba Special warnings and precautions for use: ThePApossibility of a malignant gastric istuma Marketing Authorisation Holder Number(s): 281/146/1-2. This medicine may alleviate symptomsisand delay on diagnosis. monitor ofpatients on 2010. long-term prescribing information available request.Regularly Date of revision text: July treatment should contact their physician if symptoms change in character. If esomep antibiotics, then the instructions for the use of these antibiotics should also be follo may lead to slightly increased risk of gastrointestinal infections such as Salmonella an – Patients with rare hereditary problems of fructose intolerance, glucose – galactose m insufficiency should not take this medicine. Drug Interactions: Esomeprazole can affec itracanazole. Dose reduction may be required when administered with drugs metabo may increase their plasma concentration. Monitor patients when given in combinatio derivatives. Undesirable effects: Common: Headache, abdominal pain, constipation, dia Shelf Life: 2 years. Marketing Authorisation Holder: Pinewood Laboratories Ltd., Ba Marketing Authorisation Holder Number(s): PA 281/146/1-2. This medicine is a prescribing information is available on request. Date of revision of text: July 2010.
Nexazole: for the treatment of erosive ref
Judges will be looking for those who demonstrate leadership and exemplifies the evolution of the pharmacy profession toward an expanded role in health care. The winner will be able to show significant contributions to the pharmacy industry overall resulting in meaningful improvements in the quality of patient care and improved delivery models and pharmacy’s role on the health care team. Applications are invited from both the independent and chain sectors. To be eligible, a nominee must have been practicing for at most 5 years. (Those working under the age of 30 should apply for the Young Community Pharmacist of the Year category. Student pharmacists should be nominated for the Life Pharmacy Student of the Year category.) Account will be taken of: Evidence of long-term, consistent dedication and outstanding achievements that have led to the advancement of the profession of pharmacy and public health
Community Pha the Year Award Community Pha the Year Award Sponsored by Pinewood Healt
Sponsored by Pinewood Healt
Going the e Meaghers MD Oo Going the e Nexazole_IPN_A4.indd 1
Meaghers MD Oo
The Community Pharmacist of the Year is presented at the Irish Pharmacy Awards. T qualities, gone over and beyond theYear call of The Community Pharmacist of the is d pharmacy sector. presented at the Irish Pharmacy Awards. T
qualities, gone over and beyond the call of d pharmacy sector.
Edel Niland, Krista Sherloc Business Development of t
Busines of the Y Winner
Evidence of a large variety of skills, attributes and accomplishments Evidence of an individual strong in character, cumulative professional accomplishments and the ability to properly represent and model what pharmacy as a profession encompasses Evidence of an understanding the goals of pharmacy, and significantly contributing to how these goals may be achieved
Oonagh O'Hagan with Danny Lynskey, Sales Representative, Pinewood Healthcare
Oonagh O'Hagan with Danny Lynskey, Sales Representative, Pinewood Healthcare
56 | PHARMACYNEWSIRELAND.COM
IPN July 2013.indd 8-9
Opening doors for business
20 mg & 40 mg gastro-resistant capsules, hard
KBC Business Banking for Professionals.
20 mg & 40 mg gastro-resistant capsules, hard
sharmacy Awards 2012 SPONSORED
macy Awards 2013
, hard. Qualitative and Quantitative omeprazole magnesium dihydrate). taining white to almost white pellets. apse of healed oesophagitis in longease (GERD). Eradication of H. pylori ociated ulcers. Treatment of NSAIDent. Prophylaxis of NSAID-associated olonged treatment after i.v. induced age and Method of Administration: pellets mixed in half a glass of nonpatients with swallowing difficulties. ,ive hard. Qualitative and Quantitative reflux oesophagitis: 40 mg once omeprazole magnesium dihydrate). prevent relapse: 20 mg once daily. taining almost pellets. ication white of H. to pylori for white treatment of apse of healed oesophagitis in longce daily for 7 days. NSAID associated (GERD). Eradication H. pylori 0ease mg once daily. Prolongedoftreatment ociated ulcers. Treatment of NSAIDks. Zollinger Ellison Syndrome: Initial ent. NSAID-associated 0 mgProphylaxis have been ofused. If the required olonged treatment after i.v. pairment: Patients should notinduced exceed age of Administration: any and of theMethod excipients. Esomeprazole pelletsdata. mixed in half under a glass12ofyears. nonficient Children patients withbeswallowing mour should excluded asdifficulties. Nexazole reflux oesophagitis: mg once mivetreatment. Patients on40 on-demand prevent isrelapse: mg once daily. prazole used in20combination with icationTreatment of H. pylori foresomeprazole treatment of owed. with ce for 7 days. NSAID associated nd daily Campylobacter. Contains sucrose 0malabsorption mg once daily.orProlonged treatment sucrase-isomaltase ks. Zollinger Ellison Syndrome: Initial ct the absorption of ketoconazole and 0 mg have been used. the required olised by CYP2C19 as Ifesomeprazole pairment: Patientsorshould exceed on with warfarin other not coumarine any of the excipients. Esomeprazole arrhoea, flatulence, nausea/vomiting. ficient data. Children 12 years. allymacarbry, Clonmel,under Co. Tipperary. mour should be only excluded as Nexazole a prescription product. Further m treatment. Patients on on-demand prazole is used in combination with owed. Treatment with esomeprazole nd Campylobacter. Contains sucrose malabsorption or sucrase-isomaltase ct the absorption of ketoconazole and olised by CYP2C19 as esomeprazole on with warfarin or other coumarine arrhoea, flatulence, nausea/vomiting. allymacarbry, Clonmel, Co. Tipperary. a prescription only product. Further
armacist of armacist of Ireland’s No. 1 Generic Healthcare Specialists
Ireland’s No. 1 Generic Healthcare Specialists
extra mile onagh O'Hagan extra mile 27/07/2010 11:40:05
one of the most prestigious awards to be The winner will have demonstrated true leadership duty and made personal imprint ontothe one of the mosta prestigious awards be
The winner will have demonstrated true leadership duty and made a winner personal imprint ‘pre-reg’on yearthe and there are now This year’s worthy is
THE INDEPENDENT VOICE OF PHARMACY
McAnena it is an potentially dangerous issue which required urgent action within his catchment area. When setting about establishing his new initiative Frank's priority was to make sure patients were not putting their own health at risk but not taking their medication. Frank, who owns Eyre Square Pharmacy in Galway, tells IPN, "50% of patients are statistically known to be non compliant – this is a problem which does not seem to be soluble– “Check your own medicine cabinet and you will find some unused medicine”. However, within that 50% is a further 10%, whose non compliance gives rise to serious health problems, hospital admissions, accumulated meds, over dosage and side effects which in turn leads to massive losses to the exchequer in the form of unused, over prescribed and hoarded medicines. "Doctors diagnose and prescribe; patients go home and take the medicines A, B equals C. However if C, compliance or concordance is not followed, the whole expensive exercise of time, expertise and appropriate medicine dispensing is a waste at least and potentially dangerous."
When you choose KBC you are assigned a dedicated Business Partner. A specialist who understands the Pharmacy Sector, available online and in person, so you can spend your time where it matters most.
been spent on trying to find a solution and College of Pharmacy has authorised an Msc the different up approaches used, they found on the work we are doing is my concerns to which my fellow to date and has introduced a basedbrought that community pharmacy had been to be complete October with thein membersbyand the Women pharmacy APP fornot the pharmacy hopedboard explored as atogether resource. offer of a potential Phd. thereafter. Retail Committee were formed.” with a range of other
innovative The service is offered in products. conjunctionShe withhas alsoThe patients Frank and his team deal with O’Hagan conducted a further the Public Health Nursing Service, GPs and a are allbrought referred from professionals within put the team forward for several my Women concerns to my fellow up to date and has introduced surveyCare into working in health care workers. model.and These pilot studies. board and members thepatients, Women pharmacy APP for the pharmacy the Primary Retail discovered theshinyin usually, cannot make their waythat to the Retail Committee were formed.” with a range of other Frank came together upon the idea for the initiative of dominant Ireland is Her advice to her staff is that new Primary Careconsumer edifice for in a multiplicity Homepharmacy after a family member innovative products. Shewas has aalsoof reasons. Theyconducted may be too asick, tooand old, predominantly female (70%) "it is notAlzheimer’s enough to and dispense O’Hagan further diagnosed with early the put the team forward for too infirm, disturbed, too confused, too that too 78% ofWomen all employees prescription; we must go several the extra survey into workingininretail medical management problems it presented. pilot with studies. contrary, reclusive or too disinterested. aretoo female. However less than mile patient Retail and discovered that the A chance meeting withevery a public health(because) nurse At Homepharmacy their medication isit to 11% of these women make that is what will compel them to led to the referral of a number patients dominant Ireland Her advice to herofstaff is that managed, and anconsumer attempt is in made to tryis higher management positions with a varietyreturn Theare first to enough us. We allwas blessed predominantly female (70%) "itofisproblems. not to dispense a to educate and give advice, liaise withand on thirty different meds, 72 years old and the of companies work in. with the opportunity improve that 78% all employees in retail fellow within professionals and makethey ourselves prescription; we musttogo the extra bipolar alongpeople’s with a multiplicity of other “I firmly believe that by addressing well-being on aan integral part of the Primary less care than team. are female. However mile with lives everyand patient (because) ailments. within first disparity realised his team companies had made a daily do them our very 11% of these women make it to that isbasis; what we willmust compel to Frank this breakthrough whendiversity a doctor rang ismanagement a greater of Frank tells us, " I went to his home and best for patient every time".major there higher positions return toevery us. We are all blessed and asked him around perform a certain role ‘as thought board roomwork tables found him inwith a very agitated state. We sat within thetocompanies they in. the opportunity to improve of Ireland her team’. These turned out tomake be O’Hagan is also passionate abouta part in and went through his meds explaining and this is can only “I firmly believe that by addressing people’s lives and well-being on anot an idle comment but the beginning of a the community. She decided to what each was for and how they were to good commercial sense to any this disparity companies daily we must our very relationship that has within been duplicated with be taken. Weretain thenbasis; blisterpacked hisdo meds the name of Meagher for the business.” there is a greater diversity of for delivery every patient every time". and started abest weekly to him. Thissuch pharmacy because it was a other medics since. American studies have thought around shown“One that 1ofinthe 4 nursing homeroom patients are resulted in a key marked in G.P.community Visits key board objectives oftables partdecrease of Dublin O’Hagan is the also passionate aboutthere because ofand medicine in Ireland ismismanagement. can only make and P.H.N. interventions, plus we succeeded the Women in this Retail group is to andcommunity. she thought it apt to continue decided to Without overstating the role of histoteam in removing athe huge quantity ofShe unused good sense anyisin atcommercial thethis reasons why there trading under theoffamily name trying look to remedy problem he is adamant retain name Meagher forofthe hoarded meds. He the actually brought in two business.” a disparity in female participation Meagher. Dunne's store bags withbecause the comment, pharmacy it was"I such a they have a major part to play in keeping at higher level and out of the nursing homes and hospitals. “One of keypositions objectives ofto wont need these anymore." key part of the Dublin communitypatients
You focus on your business. We’ll focus on you.
Of her involvement in the Baggot
1800 804 414 kbc.ie/business
six Meaghers' Pharmacies in the Oonagh O’ Hagan, Managing community and has been Thus the idea of group. Director of Meagher’s Pharmacy people. welcomed with open arms,” said Homepharmacy was Group, who has done just that. “I spent my pre-reg year in a member of her team. “In all, she borne. Homepharmacy “She wanted to give something In her nomination, her team ‘pre-reg’ year there are now This year’s dedication worthy winner is Meagher’s on and Baggot Street, O’Hagan’s to the involves Frank and has ¤40,000 for St backraised to theover Baggot Street said; “Oonagh believes that six Meaghers' Pharmacies in the Oonagh O’ Hagan, Managing ck, Tony Hynds, Managing Director, Actavis Ireland, and Diane Patterson with the his team delivery Dublin under the tutorship of profession of pharmacy and Mary’s and the local community.” community and has been empowerment of employees is group. Meagher. It was a family Director of Meagher’s Pharmacy the Year (Independent) Award medicines to a patients home weekly using Pierce entrepreneurial skills made her welcomed with open arms,” said a system must; she believes Group, who hasothers done in just that. Although the Meagher's Pharmacy a monitored dosage tailored to thethat within business, having been established stand out from her “I spent my pre-reg year in a member her team. “In all, she team we allThe have ourteam individual individual needs of a each service Group is a of credit to O’Hagan’s In herpatient. nomination, her in the 1920s his mother. When category. wasto nominated Meagher’s onby Baggot Street, O’Hagan’sOonagh dedication the has raised over ¤40,000 for St has been in operation for the last two years strengths whichbelieves we can that bring to dedication to pharmacy and said; “Oonagh IDublin first started there,ofI saw by her ownof team at Meagher's under working the tutorship profession pharmacy and Mary’s andskills, the local community.” and has proven to be ofteam hugeand value. the we capitalize leadership what sets empowerment of must employees is the pharmacy's and I Pharmacy Group, which shows Pierce Meagher.potential It was a family entrepreneurial skills made her the on these strengths.” Oonagh O’Hagan is her advocacy for The initiative also gained him thebelieves prestigious a must; she that within Although apart the Meagher's Pharmacy used to joke that been if he ever wanted admiration and others support business, having established stand out from in that her they “She had the unique ability of Development has been known to our point out Business of the Year women. She established the Retail a team we all have individual Group is a credit to O’Hagan’s to sell to let me know, but I never have for their MD. in the 1920s by his mother. When category. Oonagh was nominated being able to see the (Independent) potential in Award, sponsored by aat the something that staff member Excellence Ireland (REI), and Women in strengths which we can bring tois dedication to pharmacy thought it would happen.” I first started working there, I saw by her own team at Meagher's inagural Irish Pharmacy Awards 2012. her employees and of encouraging good at before they realize they “Oonagh is an inspiration for Retail Group, the what first group the team and we must capitalize The problem leadership skills, sets of its the potential and Iof compliance is an increasing Pharmacy Group, which shows liketeam to think are good strengths.” at it themselves. It is with But,pharmacy's it did happen; about not only every pharmacist but the type in Ireland. one and eight one which is encountered bythem to develop it. I’dThe on these at Homepharmacy decided to Oonagh O’Hagan apart is her advocacy for used to joke that if hequalified ever wanted admirationwho andmeets support that they I have inherited that trait. this belief intoher team’s years after O’Hagan from at some point within “She the unique ability ofhave most pharmacists thehad everyone her,” said try toWe tackle the problem of compliance. has great been known point out ability women. She established the Retail to sell to let me know, but I never “The pharmacy group within REI have for their MD. team in the Meagher’s, of Homepharmacy thatthat shehad continues to build an isFrank McAnena dispensary. For college and had been working inGalway pharmacist Frank In spite ofwho the already being members able to see potential in millions Joanne O'Hagan, Marketing something that a staff member Excellence Ireland (REI), Women in thought it would happen.” is very strong. Being a Managing joined us when and theyofwere 18 and excellent team of people, other pharmacies. her employees encouraging Manager Meagher's Pharmacy. good at before they realizewho theyare “Oonagh of is an inspiration for Retail Group, the first group of its Director can sometimes be a we have seen them flourish and the best in the field.” them to develop it. I’d like to think “She is the Superintendent are good at it themselves. It is with But, it did about not only every pharmacist but type in Ireland. “I was toldhappen; I had one weekeight to raise very lonely place but, when you develop their careers throughout I have inherited that trait. We have Pharmacist andmeets always keeps this great credits belief inher herstaff, team’s years after O’Hagan from everyone who her,” said O’Hagan justability as the finance to match qualified an offer that are member ofgroup REI you have the years. I would have to saywho that “Thea pharmacy within REI abreast of the everMarketing changing team members in Meagher’s, that she continues to build won an the college and had been working Joanne O'Hagan, much as herself for having was already on the table,” she in likeminded people in asimilar this is what I find to be the18 most is very strong. Being Managing pharmacyofmarket and interfaces joined us when they were and excellent team of people, who are other pharmacies. Manager Meagher's Pharmacy. award. said. “I was 28 and had no backing positions whosometimes you can call on,” Director can be a rewarding part of my jobwatching well with our patients. She is we have seen them flourish and the best in the field.” “She is the Superintendent but I managed put week a business said This is when beneficial “I was told I hadtoone to raise very O’Hagan. lonely place but, you people their potential and always interested in receiving developrealize their careers throughout “I can’t let this opportunity pass Pharmacist and always keeps their plan together present thisthat and a great support to have.” O’Hagansaying credits herwinning staff, just as the finance to and match an offer are aismember of REI you have playing a part in that.” feedback updated services without that the years. I would have to say that abreast ofon thethe ever changing to myalready bank and I lefttable,” that 7am It became apparent over the much as herself for having won the was on the she likeminded people in similar and products, which the group Community Pharmacist of the this is what I find to be the most pharmacy market and interfaces meeting with28 the necessary finance O’Hagan is passionate about years though award. said. “I was and had no backing positions whothat youthe canlevel call of on,” delivers them. She leads Year would not have happened rewarding part her of my jobwell withtoour patients. She isby and theto Baggot Street the group and staff butwatching does female participation senior but Ibought managed put a business said O’Hagan. This isatbeneficial example and labours on, instilling if wasn’t for the hard workpass and people potential and always interested in receiving their “I itcan’t let this opportunity Pharmacy.” not like realize to thinktheir of her pharmacy management and board level plan together and present this and is a great support to have.” the same dedication to theservices staff dedication of the Meagher team. playingas a part in that.” feedback on the updated without saying that winning stores 'a chain'. Instead, she positions amongst REI members to my bank and I left that 7am It became apparent over the and products, encourages themthe to group go O’Hagan said that she used the It is the Meagher's teamof who and which Community Pharmacist the would prefer that each pharmacy was whenthat compared meeting with necessary finance O’Hagan is passionate about yearslow though the leveltoofthe beyond patients expect business skillsthe which she had encourages andhave inspire me every delivers what to them. She leads byfrom Year would not happened in group was upon as number of females working in and bought theher Baggot Street thethe group and herlooked staff but does female participation at senior their pharmacists in each of the inherited from mother and day to be the best that work I can and example and labours on, instilling if it wasn’t for the hard a community-based lower level positions in retail. Pharmacy.” not like to think of herpharmacy, pharmacy management and board level Meaghers' Pharmacies.” never looked back. possibly be.” the same dedication to the staff dedication of the Meagher team. which a personal service “Following a surveyREI carried out stores offers as 'a chain'. Instead, she positions amongst members and encourages to the go O’Hagan she good used the It is the Meagher's team at thelow REIwhen annual retreat into2012 and connects witheach the patients and O’Hagan “My Mumsaid wasthat a really In 2001, Oonagh them bought understands thewho would prefer that pharmacy was compared the beyond what patients expect business which had encourages and inspireMeaghers me every which highlighted disparity business skills woman,” sheshe continued. Pharmacy where she did her from importance of keeping customers. in the group was looked upon as number of femalesthis working in I their pharmacists in each of the inherited from her mother and day to be the best that I can a community-based pharmacy, lower level positions in retail. Meaghers' Pharmacies.” never looked back. possibly be.” which offers a personal service “Following a survey carried out at the REI annual retreat in 2012 and connects with the patients and O’Hagan understands the “My Mum was a really good In 2001, Oonagh bought the which highlighted this disparity I business woman,” she continued. Pharmacy where she did her importance of keeping Meaghers customers.
ss Development Year Award r 2012
From the pharmacy to the home Homepharmacy!
support women to overcome these the Women in Retail group is to
and she thought it apt to had continue believes that Community Pharmacy "He is still a Street patient four years later community, herand team told Frank challenges whateverwhy theythere mayisbe. lookinat the reasons progress that has received little trading family name three years without aunder hospital admission, IPN that she isthe responsible for of is a work We intend to like-minded a disparity in bring female participation the powers that be, however, by Meagher. previously his admission rate was 2drives to 3 for thehelp from massive fundraising women together so we can hear sheer perseverance and making themselves at higher level positions and to times a year." local church, St Mary’s. In 2010 how some of the most inspirational Of her involvement in the Baggot completely disposed to to their patients these support women overcome The next patient Frank encountered was and 2012, Oonagh her organized a Frank women success in their feels thatachieved they are close to amay major Street community, team told challenges whatever they be. illiterate withparish a benzodiazepine abuse BBQ, was a hugely inThe the the pharmacy careers. WIR group will also IPN that she which is responsible for breakthrough We intend to way bring like-minded problem. "We went through the same is practised and perceived within thewho successful event that brought offer a forum where women fundraising drives women together soPrimary we canCare hear introductory massive process, removed meds and for thecommunity and within the together businesses andInresidents. worksome in theof retail can meet local church, St Mary’s. the sector most inspirational started weekly visits. An interesting side 2010 model.how The money raised not only to network, support and encourage and 2012, Oonagh organized a to issue was that I discovered her family waswent women achieved success in their the church but alsoaused to "Domicillary pharmacy has been piloted each other realize theirwill fullalsoin stealing her valium, leading towas increased parish BBQ, which was hugely careers. ThetoWIR group Canada andainforum Devonwhere [Sara women Dilks] in England establish links in community potential.” anxiety and further requests forthe scripts. The successful event that brought offer who , both financed and led by the NHS and the undesirablesand in her family did not bother this has made a considerable together businesses and residents. work in the retail sector can meet “Most women have the of mindset government to varying degrees success. with the blister and she nowof taking difference toraised the is lives many Thepacks money not only went to to network, support and encourage We arethat the they first to initiate a Home between Pharmacy have to choose half the dosepeople. she was on when she started. the church but was also used to whichfamily each to realize their full bringsother Pharmacy to the patient not life and their career at some "We have over a hundred patients of establish links theavailing community potential.” the patient to pharmacy all based on “She wanted toingive something point inthe their lives. I have gone this service and one has an a individual of a standard Community andeach this has made considerablea modification to Gordon the Baggot Street through this experience and I want “Most women have the mindset story to tell."back Robert university Pharmac," he says. difference to the lives of many to share have learned. It that theywhat haveIto choose between is possible to have all - there family life and their itcareer at some doesn’t have lives. to be Iahave choice. It’s point in their gone about having the right support through this experience and I want mechanisms at learned. work andIt at to share whatboth I have home to allow you to fulfill both is possible to have it all - there roles. My Mum had it all; healthy doesn’t have to be a choice. It’s career and a great family life and about having the right support she inspired me toat believe that at I mechanisms both work and can have both you too. to I want help home to allow fulfillto both others to achieve success and to roles. My Mum had it all; healthy give something back to the career and a great family lifewomen and who are passionate about working she inspired me to believe that I in the retail sector.” can have both too. I want to help others to has achieve success and to O’Hagan made an imprint give something back to the women for women in both pharmacy who retail. are passionate about working and REI also announced in theO’Hagan retail sector.” that will be taking on
THE BANK OF YOU + YOUR BUSINESS the role ofhas Chairperson of REI in O’Hagan made an imprint 2014/2015. for women in both pharmacy and retail. REIon also announced Commenting winning that O’Hagan will be taking on Community Pharmacist of the the role of Chairperson of REI in Year award, O’Hagan said, “I’m 2014/2015. delighted to be awarded this
prestigious title. took me by Commenting on Itwinning complete surprise when of mythe Community Pharmacist name was called out and Year award, O’Hagan said,even “I’m to be nominated was a huge delighted to be awarded this achievement in itself. The prestigious title. It took mereaction by to date has been absolutely complete surprise when my fantastic I look to what name wasand called outforward and even lies ahead of me was as Community to be nominated a huge Pharmacist YearThe for reaction 2013.” achievementofinthe itself. to date has been absolutely fantastic and I look forward to what lies ahead of me as Community Pharmacist of the Year for 2013.”
KBC Bank Ireland plc is regulated by the Central Bank of Ireland. 01/08/2013 09:54:55
Awards The Irish Pharmacy
raeY eht fo tsilaniF
ycamrahP hsirI 3102 sdrawA YCAMRAHP NI ECNELLECXE
ycamrahP evitatneserpeR raeY eht fo tsilaniF
Young A IrishYear Pharmacy Aw Winners Winners Irish Pharmacy
Actavis Business Deve of the Year Award (Ind Sponsored by Actavis
United Drug Business Development (Independent) Award 2020 * Open to all pharmacies with less than 3 stores
Edel Niland, Krista Sherlock, Tony Hynds, Managing Dir Business Development of the Year (Independent) Award
The United Drug Business Development (Independent) Award serves to recognise those who have displayed success in terms of sales, training, recruitment, customer service, product development or other areas of business development. Entries should demonstrate an innovative approach to creating new business, and outline the timescales, objectives and results of the initiative.
Business Deve of the Year Awa Winner 2012
Michelle Quinn, Burren Pharmacy with Award sponsor Barry Doyle of Actavis
IPN August 2013.indd 18-19
Judges will look for a business initiative that stands out in terms of its scale, scope or approach. This award will credit the company that has demonstrated excellent levels of customer service backed by clear standards and adequate monitoring performance. Account will be taken of: Clear demonstration of an identified need and personal rationale along with details of the process of implementation from concept to design, planning and results
Young Pharmacist of the Yea Aaron Carlyle of Brennans P
Evidence will be displayed for plans for further research and development Evidence of a sound business plan, sales and marketing strategies Strong leadership skills with the ability to drive the business forward Innovation and ambition
A McKesson Company
58 | PHARMACYNEWSIRELAND.COM
IPN July 2013.indd 20-21
gAwards Pharmacist of the 2012 Award wards 2013
McAnena it is an potentially dangerous
THE INDEPENDENT VOICE OF PHARMACY
been spent on trying to find a solution and
The Irish Pharmacy
College of Pharmacy has authorised an Msc
premises, which Quinn came upaction with within his issue which required urgent the different approaches used, they found based on the work we are doing which is purchased in 2007, relocation catchment area. the branding that community pharmacy had not been hoped to be complete by October with the explored as a resource. offer of a potential Phd. thereafter. was a priority. A redevelopment ourselves. It When setting about establishing his new project was undertaken to took a lot of initiative Frank's priority was to make sure The service is offered in conjunction with The patients Frank and his team deal with transform a 19th century derelict work but am health patients were not putting theirI own the Public Health Nursing Service, GPs and are all referred from professionals within building on the town square, the soatpleased andtaking risk but not health care workers. the Primary Care model. These patients, their of medication. usually, cannot make their way to the shiny original town pharmacy, into a proud the Frank came upon the idea for the initiative of Frank, who owns Eyre new Primary Care edifice for a multiplicity state-of-the-art retail pharmacy result.” Homepharmacy after a family member was Square Pharmacy of reasons. They may be too sick, too old, premises, the new home of diagnosed with early Alzheimer’s and the in Galway, tells IPN, too infirm, too disturbed, too confused, too medical management problems it presented. the new Burren Pharmacy and In "50% retail,ofit's patients are contrary, too reclusive or too disinterested. A chance meeting with a public health nurse completing the main market statistically At Homepharmacy their medication is important to known be to led to the referral of a number of patients square in Lisdoonvarna. non compliant – managed, and an attempt is made to try thebeexpert on with a variety of problems. The first was is a problem which to educate and give advice, liaise with thethis products on thirty different meds, 72 years old and does not seem to be fellow professionals and make ourselves The transformation of Burren you sell and bipolar along with a multiplicity of other soluble– “Check your an integral part of the Primary care team. ailments. Pharmacy concentrated on offer quality. own medicine cabinet Frank first realised his team had made a bringing the pharmacist from One innovative and you will find some major breakthrough when a doctor rang Frank tells us, " I went to his home and unused medicine”. behind the dispensary to the and asked him to perform a certain role ‘as step which has found him in a very agitated state. We sat However, within that a part of her team’. These turned out to be front of shop where they can and went through his meds explaining been taken 50% is a further 10%, not an idle comment but the beginning of a what each was for and how they were to interact with the patients. within the whose non compliance relationship that has been duplicated with be taken. We then blisterpacked his meds pharmacy gives rise is to serious other medics since. American studies have and started a weekly delivery to him. This to health introduce A key aspect of the new problems, shown that 1 in 4 nursing home patients are resulted in a marked decrease in G.P. Visits hospital admissions, there because of medicine mismanagement. pharmacy layout was to promote Burren and P.H.N. interventions, plus we succeeded The overhaul of a business accumulated meds, Without overstating the role of his team in Pharmacy in removing a huge quantity of unused interaction between patient and over dosage and trying to remedy this problem he is adamant hoarded meds. He actually brought in two recommended pharmacist, removing barriers can be a daunting task, side effects which they have a major part to play in keeping Dunne's store bags with the comment, "I products, and taking the pharmacist in turn leads to patients out of nursing homes and hospitals. there is always a risk wont need these anymore." explaining what to outside the dispensary. Burren massive losses Frank believes that Community Pharmacy of the project not going they for andin "He is still a patient four years later and had Pharmacy make a point of theare exchequer is a work in progress that has received little three years without a hospital admission, why thethey form are of unused, listening and responding to according to plan. Burren help from the powers that be, however, by previously his admission rate was 2 to 3 over prescribed and worth buying. specific patient concerns, sheer perseverance and making themselves times a year." Pharmacy in Lissdoonvarna hoarded medicines. This has been Quinn herself has experienced completely disposed to their patients The next patient Frank encountered was particularly decided to make the jump illness in her family and through "Doctors diagnose Frank feels that they are close to a major illiterate with a benzodiazepine abuse and prescribe; successful in patients breakthrough in the way the pharmacy this experience, understands to rebrand their pharmacy problem. "We went through the same go home and take is practised and perceived within the encouraging firsthand the importance of a introductory process, removed meds and the medicines A, B community and within the Primary Care in 2012 and have reaped patients to pharmacist understanding the started weekly visits. An interesting side equals C. However model. ask about, small issues as well as the big the rewards ever since. issue was that I discovered her family was if C, compliance or "Domicillary pharmacy has been piloted in and switch is not issues of an illness. stealing her valium, leading to increased concordance In spite of the incessant Canada and in Devon [Sara Dilks] in England anxiety and further requests for scripts. The to followed, pharmacy the whole , both financed and led by the NHS and the undesirables in her family did not bother tales of economic gloom in expensive exercise of only products. “I like to take the time to listen government to varying degrees of success. with the blister packs and she is now taking time,Quinn’s expertise and From recent times, the pharmacy and address all the concerns of We are the first to initiate a Home Pharmacy half the dose she was on when she started. appropriate medicine experience which brings Pharmacy to the patient not my patients. My brother suffered dispensing is a waste has consistently expanded "We have over a hundred patients availing of in at working in potentially the patient to the pharmacy all based on from an illness and I saw how least and this service and each one has an individual a modification of a standard Community and grown over the last Pharmacy in dangerous." it can feel like a barrier if a story to tell." Robert Gordon university Pharmac," he says. Lisdoonvarna pharmacy doesn’t understand Michelle Quinn, Burren Pharmacy year under the direction of Thus the idea of for several the small issues in an illness, Homepharmacy was Michelle Quinn, Pharmacy years, she was such as carrying certain borne. Homepharmacy able to identify Manager and owner of involves Frank and products like certain dressings rector, Actavis Ireland, and Diane Patterson with the what products his team delivery etc. Little touches like these can Burren Pharmacy, and this d medicines home weekly using her customers improve a patient’s quality of to lifea patients a monitored dosage system tailored to the year’s winners of Actavis would require and I try to do this with Burren individual needs of each patient. The service and what stock would be Business Development Pharmacy,” Quinn said. has been in operation for the last two years documentation was developed engaged with the old and requested. She ensures that and has proven to be of huge value. of the Year Award young, for instance delivering and circulated to all local hotels the pharmacy carries products Quinn wanted to make congratulations and welcome TheBurren initiative also gained himexclusive the prestigious and guesthouses, outlining the that are to Burren (Independent). Pharmacy unique and to stand Business Development of the Year packs to parents of newborn services and choice available Pharmacy and they (Independent) Award, sponsored by at the now carry out from any other pharmacy. babies free of charge.” from the Pharmacy. In addition, a vastly improved Having correctly anticipating inagural Irish Awards 2012. range of Critical to any retail business is Pharmacy The problem of compliance is an increasing as part of the development work, products. more governmentone cuts it was andand one which is encountered bybranding. Previously,The teamfelt at Homepharmacy decided to a substantial gift centre was Quinn concluded, “It’s a tough strains on dispensing margins, at some point within bythe Quinn that the unique namethe problem of compliance. most pharmacists try to tackle incorporated in the shop with time for Pharmacy at the Burren Pharmacydispensary. decided to “I have been here a long time Frank McAnena of Homepharmacy For Galway pharmacist Frank In spite of the millions that had already of the pharmacy, trying in with moment and sometimes we premium gifts such as quality change their business model and I know what my customers the locality, was not sufficiently have to change in order to be Irish Jewellery available to from a model heavily based on want, I try to make sure we capitalised upon. As part of the successful. I think the pharmacy purchase. dispensing fee incomes, a model carry products that are a little new shop design, efforts were model and the business model that is adopted by many small bit different that sets us (Burren made to incorporate limestone can complement each other as Burren Pharmacy understands to medium sized independent Pharmacy) apart,” Quinn said. features in keeping with the long as it is done well and if it is, that independent pharmacists pharmacies throughout Ireland, Burren, while maintaining a it can be very effective.” are a key part of their to focus more on the front All staff received training in professional and modern look. community. of shop sales and patientareas such as skincare and New carrier bags, consistent She added, “We have had pharmacist interactions. merchandising. Each team signage and staff uniforms were an incredible year, we have Quinn said, “2012 was a year member was encouraged put in place, to differentiate the watched the business grow of outreach and engagement Quinn said, “We made the major to identify and take specific pharmacy and its offering from and then winning the Business strategic decision to concentrate with our local community. I competitors. The customer responsibility for at least Development of the Year Award on the front of shop after a lot shopping experience has been one aspect of the business have visited several schools was an added bonus. It’s such of research and the inevitable transformed, with a bright, development, leading to a performing science experiments, a confidence boost to have changes in Irish Pharmacy. It modern store that is exclusive to sense of ownership and pride in we have run art competitions all our hard work recognised. has turned out to be the right Burren Pharmacy. achievements and therefore a and sponsored the local GAA Coming home as winners to decision and what could have team that works well together. team, amongst many other Lisdoonvarna has given the been a very tough year has activities. Our innovative digital Quinn said, “What sets our community a sense of pride and turned into a very positive year community display is updated branding apart from other Lisdoonvarna is a small town made everything worthwhile.” for us.” regularly and is a focal point pharmacies is that nothing is that relies heavily on tourism generic. Burren Pharmacy team for community news, attracting and Burren Pharmacy saw this Having outgrown their former researched everything and attention to the shop. We have as an opportunity. Multilingual
ar winner, Pharmacy
Young community pharmacists have the potential to make a difference in the future of the pharmacy profession, the teams they work within and the communities they serve. The ‘Young Pharmacist of the Year’ award recognises this potential and rewards the drive and ambition that young Irish pharmacists are frequently demonstrating.
patients were not putting their own health at risk but not taking their medication. Frank, who owns partakes in. He hasEyre After completing his qualification, Square Pharmacy number Carlyle returned home to Derry and completed in Galway,atells IPN, worked in several pharmacies in of "50% development of patients are Northern Ireland before he started courses suchknown as statistically to be non compliant at the Brennan’s Pharmacy Group ‘Practical Retail – this is a problem which as a locum in 2010. Within six Management does not seem to be months, Carlyle was managing Skills’ by Retail soluble– “Check your the busiest store of the three Excellence Ireland, own medicine cabinet Brennan’s Pharmacies in Buncrana Fluand Vaccination you will find some and had progressed to becoming Training unusedand medicine”. within that Supervising Pharmacist and Store heHowever, is currently 50% is a further 10%, Manager. undertaking whose non compliance an advanced gives rise to serious In his nomination, Fergus Brennan, course healthinproblems, Managing Director of the Brennan’s ‘Internal hospital admissions, Group said; “From his very first accumulated meds, Verification day as a locum, Aaron Carlyle over dosage and and Quality stood out as an exceptionally side effects which Assurance’. talented young pharmacist, with in turn leads to massive real passion for professional and Carlyle haslosses to thecreated exchequer in business excellence. He is a also the form of unused, natural leader. I am grateful and a consultancy over prescribed and proud that he has chosen to invest role outside of hoarded medicines.
JPA Brenson Lawlor Young Community Pharmacist of the Year Award 2020
these crucial early years of his career with us in Brennan’s. He is a tremendous asset to our team and a passionate believer in our core values and mission.”
the Pu health
Frank c Homep diagno medica A chan led to t with a on thirt bipolar ailmen
Frank t found h and we what e be take and sta resulte and P.H in remo hoarde Dunne wont n
"He is three y previou times a
the Brennan’s The ne "Doctors diagnose Pharmacy, illiterat and prescribe; patients where he and take problem go home introdu creates the medicines A, B started equals C. However bespoke and issue w if C, compliance or accredited Carlyle said; “My relationship with stealin concordance is not training anxiety Fergus and Michael (a partner in followed, the whole packages toexercise of undesi the Brennan’s Group) developed expensive a variety of with th time, expertise and quite quickly. It was really obvious half the areas such as appropriate medicine From the pharmacy the Brennan Group had something dispensing is a waste community to the home "We ha special and I felt I could add to at least and potentially pharmacies, Homepharmacy! this se it, more importantly I knew it was dangerous." story to colleges, something I wanted to be part of.” Thus thethe idea of including Homepharmacy was Carlyle has an apparent passion The JPA Brenson Lawlor UniversityYoung of Bristol, and a numbe Homepharmacy for health care that is obvious from of borne. pharmacies in Northern Ireland Community Pharmacist of the involves Frank and his dedication. Within months of such as ‘Lloyds Pharmacy’ and Edel Niland, Krista Sherlock, Tony Hynds, Managing Director, Actavis Ireland, and Diane Patterson with the his team delivery Year Award recognises rising talent The 2013 Young Pharmacist of the starting in the Buncrana branch ‘Bradley’s Pharmacy’. Business Development of the Year (Independent) Award medicines to a patients home weekly using Year, Aaron Carlyle, demonstrates of Brennan’s, developed a who a monitored dosagedespite system tailored to the – thoseheindividuals being “When I came out of college new structure across individual the three needs of each these qualities and more. In his patient. The service in the early stages of their pharmacy there was a training organisation has been pharmacies. He redrafted job in operation for the last two years short career to date, Carlyle in Derry that offered pharmacy and has demonstrating proven to be of huge value. descriptions and each team has shown his passion for the careers are already qualifications from pharmacy member was set a specific pharmacy profession by combining The initiative also gained himto thethe prestigious that they can make a difference support staff responsibility, depending on Development Business of the Yearup to Pharmacy clinical and health care skills with Technicians. Iby was approached to pharmacy profession the companies (Independent) Award, sponsored at the their skill set. This new structureand pioneering entrepreneurial skills. Pharmacy Awards 2012. get involved and had to develop resulted in increased staff The problem of compliance is an increasing for whom theyinagural workIrish and the communities After finishing his A-levels in Derry, the materials for the service one and one which is encountered bysatisfaction and improved The team at Homepharmacy decided to courses and they Carlyle had a keenmost interest in approach a number of pharmacie pharmacists at some point within thetheserve. to tackle of compliance. from teams acrosstrythe boardthe of problem Science and studied Pharmacy F to get involved. It was a challenge dispensary. Forin Galway pharmacist Frank In spite of the millions that had already the Brennan’s Pharmacy Group. 01/08/2013 10:46:00 The University of Manchester. that I was willing to take on This award is open to pharmacists aged Brennan said; “Aaron has made and I have had success with it. “I was attracted to a career in aup significant to the of entry The training courses are about to 30contribution - at the date submission Pharmacy because I wanted Brennan’s Pharmacy Group developing people and that’s to help people, but I was also -and the profession as a whole. something that I am passionate interested in business. One of the Evidence of these significant who are working within any pharmacy, multiple about.or The opportunity to make a things I love about Pharmacy is contributions is demonstrated coursegreater personal and local based where their involvement has been the amalgamation of the twoindependent, in the through the fantastic team he has was something I wanted to do.” sector.” than six months.helped to build and nurture in his Carlyle has the qualifications of Buncrana branch. He focuses on Carlyle added, “Pharmacy has a a Pharmacy Assessor and has effective team engagement to get great relationship with a broader It is the individual qualities that will be evaluated, rather brought the training programme the most out of those he works range of patients. We are in an with, to the worked proven than those of any ofsubscribing the projects on.to Brennan’s and created influential position to help patients the ‘Brennan’s Training and theory that engaged staff go above with self care. The health care Development Programme.’ and beyond the requirements of sector is changing because of role.” of: Account will betheir taken Brennan said of the programmes several reasons, including financial advantages to the pharmacy constraints. We can now, more Carlyle understands the group; “This is a huge bonus for than ever, help patients to have importance of business Judges will want to see effective communication skills a company of our size, allowing more interaction with their own management and his interest in with both staff and customers us to invest and focus on quality care pathways, which can help the topic has been evident from and accredited training, helping them to not only recover but also the training and constant updating to develop our people at a time of his skills that he regularly to stay healthy.”
Business Development of the Year Award Winner 2012
From the pharmacy to the home Homepharmacy!
Demonstration of a commitment to mentoring or other leadership activities Operation within their own pharmacy liaising with key staff members and management and developing key communication skills A dedication and commitment to furthering the profession into the future
PHARMACYNEWSIRELAND.COM | 59
Awards The Irish Pharmacy
Superintendent Pharmacist of the Year 2020
Superintendent pharmacists have overall responsibility for setting out the standards and policies for the provision of pharmacy services by their organisations. The role of Superintendent Pharmacist is a key position carrying full time responsibility and accountability. This Award will be looking to recognise those individuals who are serving as key drivers for the implementation of enhanced and excellent pharmacy care within the community they serve. Judges will be looking for applications from those that are focused on establishing a framework for achievement of a high quality, safe and consistent service for the benefits of the patient, as well as facilitating the development of the professional role of the pharmacist. Account will be taken of: Applications are invited from independent and multiple Superintendent Pharmacists who can demonstrate one or more of the following: Understanding patient needs when delivering healthcare in the community Examples of great patient experience and care, innovation and ambition Best practice in delivering professional services and patient reviews Encouragement of staff education in patient health and wellbeing advice Strong leadership skills with the ability to drive the business forward
60 | PHARMACYNEWSIRELAND.COM
Create a better home environment with our new Medicare Cirrus and Nimbus Humidifiers. They help to purify the air by reducing dust, bacteria, odours and toxins.
Humidifiers are ideal for infants and those who suffer with... Allergens & Sinuses
PERFECT FOR ALL SEASONS
Key Benefits O Improves quality of sleep by reducing snoring O Lowers the risk of catching colds and flus O Reduces the occurrence of dry skin
Eczema & Dry Skin
O Relieves allergy flare ups and hay fever symptoms O Reduces asthma triggers O Helps prevent headaches and sinus congestion
Asthma & Respiratory Problems
Turn a Humidifier on in your store. Your staff and customers will love it!
1800 307 777 â€˘ Freefax
1800 313 395
Diagnosing appropriate use – Diabetes Diagnostics in Pharmacy
ommunity pharmacies don’t need to ask whether there’s a market for diabetes products and services. The market is there. There are approximately 20,000 adults living with Type 1 diabetes in the Republic of Ireland. Long-term good health depends, perhaps more than with any other long-term condition, on full engagement of the person with Type 1 diabetes in life-long day-to-day self-management.
The question pharmacists should be asking themselves is how they can best serve the market and the patients who suffer from diabetes, a prevalent chronic medical illness that can lead to heart disease, stroke, kidney disease, circulatory problems, blindness and more. The diabetes products that pharmacies should offer fall into three categories: • Medication - both injectible and oral - as well as the products to deliver injectible medications such as pen needles and insulin syringes • Self-monitoring blood glucose supplies so patients and care givers can test and monitor blood glucose levels. Those items include devices like blood glucose meters, test strips lancets and lancing devices. • Other over-the-counter, nonprescription items related to lifestyle. These may include fast acting glucose, skin and foot care products, woundcare products, sugar-free OTC medications like cough and cold remedies, nutritional products, and related durable medical equipment.
Used properly, diagnostic products allow for earlier detection of health problems and closer monitoring of existing conditions while also encouraging increased patient involvement in their personal health. Used improperly, diagnostic products are of limited value and may even be detrimental to the patient's health. Therefore, the role of the pharmacist in distributing diagnostic products and assisting the patient to understand the proper use of such products is critical. A number of factors such as increasing prevalence of infectious diseases, rising incidences of lifestyle diseases such as cardiac diseases and diabetes, rising usage of home-based point-ofcare (POC) testing devices, and technological advancements with regard to development of advanced, faster, and easy-touse devices are stimulating the demand for diagnostic testing. Over the last two decades it has been firmly established that tight glycaemic control is associated with a significant reduction in serious long term diabetes related complications. Self-monitoring
62 | PHARMACYNEWSIRELAND.COM
of blood glucose is an effective tool in the self-management of glucose levels in people with Type 1 diabetes and people with Type 2 diabetes using insulin therapy. It helps people with diabetes using insulin achieve tight glycaemic control and to identify low blood glucose levels before the development of severe hypoglycaemia. Pharmacists are the first point to likely come into contact with those with undiagnosed diabetes who rarely access their GP. Some may present symptoms of diabetes, but many will be asymptomatic. They also see people who may be at risk of developing the disease. When people with diabetes monitor their blood glucose regularly, they are taking responsibility and playing an active role in their own health and well-being. Self-monitoring of blood glucose allows patients to identify episodes of hypo- and hyper-glycaemia as well as their daily responses to food and medications. With guidance from pharmacists, patients can use this information to adjust their diet, exercise, or medication regimen in order to
minimise adverse diabetes-related outcomes and complications. It also is important for each diabetes patient to have a meter they are able to use properly. Pharmacists can work to expand their pharmaceutical care services by helping people with diabetes pick the right blood glucose meter and understand the importance of self-monitoring of blood glucose for all people with diabetes. There are a number of key factors pharmacists should consider when offering self-monitoring of blood glucose services: Work in a supportive care planning partnership together with the person with diabetes, to assess whether selfmonitoring of blood glucose levels is appropriate. This involves carrying out an individual assessment, discussing options and making an agreed/joint decision based on individual needs and circumstances to ensure resources are adequately used. Encourage those who treat their diabetes with insulin or medication that can cause hypoglycaemia to continue to monitor for safety reasons.
The consultation should address use and frequency of testing, and target blood glucose level and be agreed between the person with Type 2 diabetes and their health care professional team. SMBG should be integrated within a care package, accompanied by education which includes self-monitoring of blood glucose levels that enables the individual to interpret results and use the data to reinforce lifestyle change, adjust treatment and activities or inform their healthcare professional. The person’s treatment regimen, lifestyle and individual needs should be taken into account to determine, if blood glucose testing is appropriate, and how frequently the person with diabetes needs to test. Education should not only cover how to adjust treatment, but also ‘motivational knowledge’ that shows why good control is so important. The increasing popularity of home screening kits in recent years has created a whole new area of pharmacy services, bringing preventative healthcare into people’s homes, and increasing awareness of certain conditions. These test kits are not designed to replace medical advice: they are for use at the beginning of the care pathway as a convenient and confidential way to be tested quickly for a suspected condition.
Pharmacists play a vital role in ensuring that these screening kits are used correctly to provide the most reliable results possible. The range of self-testing products available is increasing every year: Now alongside the well-known pregnancy tests on pharmacy shelves there are tests covering every aspect of health: from coeliac disease to meningitis, bowel cancer to menopause, there are even DNA paternity tests available to purchase over the counter. For those willing to pay for the convenience, they can provide peace of mind and allow regular monitoring of health, without the need for unnecessary GP visits. Sexual health tests are no exception to this, providing an alternative to traditional clinicbased testing services. There are many companies who have identified the need for simple and accurate home testing kits which allow people to test themselves for STIs in private, without attending a GUM clinic. Needle Administration Proper injection technique is important to ensure that insulin is delivered as it is intended to be delivered. With correct injection technique it can decrease the risk of hypoglycaemia, improve glycaemic control (e.g. HbA1c and glycaemic variation) and help to reduce instances of lipohypertrophy.1 Pen needles are available in
4mm, 5mm, 6mm, 8mm and 12.7mm lengths. The Mayo Clinic Guidelines recommend only using a needle of 4-5mm. Ensuring a shorter insulin pen needle such as 4-5mm is used, this helps to reduce the risk of an intra-muscular injection. Which can be painful for a patient and also means a higher risk of a hypoglycaemic event. Skin thickness is on average 2mm-2.5mm in most adults.2 Average skin thickness of 2mm is consistent across all injection sites regardless of a patient’s Age, Gender, Body Mass Index or Ethnicity.2 Needle technology is continuously improving thechoice of pen needles that are available to patients.High flow rate needle (extra thin wall) needleshave been shown to be appropriate for all injectingpatients. Their obstruction, bending and breakagerates are the same as for conventional qualityneedles (extremely low), and they offer distinct flowadvantages. Technologies which affords less painful morecomfortable injections may help patients concord withcorrect rotation as they move away from potentiallypainless injections into Lipohypertrophy tissue and use normalor healthy injection sites which may be much moresensitive. Using 5 bevel tip geometry needles has also shown to have 23% less penetration force compared to 3 bevel needles and
therefore easier to penetrate the skin. Currently in Ireland, only BD Micro-Fine™ has this technology. In a study carried out by BD 63.1% found the 5 bevel needle easier to insert. 60.7% of patients preferred it and 61.9% found it more comfortable.3 There are 3 risk factors for Lipohypertrophy:1,5,6 • Duration of insulin use • Poor injection site rotation • Needle reuse 98% of patients with lipohypertrophy do not rotate correctly.170% of those patients who reuse their needles have lipohypertrophy.1 1.Blanco M, Hernández MT, Strauss KW, Amaya M. Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab. 2013Oct;39(5):44553. doi: 10.1016/j.diabet.2013.05.006. Epub 2013 Jul 22. 2,Gibney MA, Arce CH, Byron KJ et al. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: implications for needle length recommendations. Curr Med Res Opin. 2010;26(6):1519-1530 3. Hirsch LJ, et al. Impact of a Modified Needle Tip Geometry on Penetration Force as well as Acceptability, Preference, and Perceived Pain in Subjects with Diabetes.J Diabetes Sci Technol 2012;6(2):328-335. 4, Grassi G, et al., Optimizing insulin injection technique and its effect on blood glucose control. Journal of Clinical & Translational Endocrinology. 2014. 1: p145-150 5. Misnikova I.V. et al. The risks of repeated use of insulin pen needles in patients with diabetes mellitus. Journal of Diabetology 2011 ; 1:1-5 6. Vardar B, Kizilci S. Incidence of lipohypertrophy in diabetic patients and a study of influencing factors. Diabetes Res Clin Pract 2007;77:231-6.
Research and Pharmacy Reach The current cost of managing diabetes in Ireland is estimated to be approximately €2 billion (12-14%) of the annual health budget with very little of this spent on the prevention or effective self-management of diabetes. As a result many people with diabetes develop complications earlier and present to the health service with a range of complications varying from cardiovascular, stroke, renal, eye and foot complications. It is estimated that 65% of the annual diabetes health spend is on dealing with these complications with the remaining spend covering manpower, medication, blood glucose monitoring and ambulatory costs. These were the startling statistics presenting by Diabetes Ireland to TDs and Senators on World Diabetes Day last year (November 14th). Marking World Diabetes Day pharmacists in Ireland issued advice to people living with diabetes and those concerned about the risk of developing Type 2 diabetes. The Irish Pharmacy Union (IPU) has said that pharmacies can help by providing
advice on managing the condition or helping to reduce the risks of developing Type 2 diabetes, which is on the rise in Ireland.
as well as supporting you by providing health promotion and advice on lifestyle modifications.”
IPU Executive Committee member Ann-Marie Horan said, “Diabetes mellitus is a chronic condition that is caused by a lack of insulin, insufficient levels of insulin or a resistance to insulin produced. Insulin is a hormone which is required to convert sugar in the body into energy. In Ireland, over 250,000 people live with diabetes. This is a lifelong condition which can be managed well by following a healthy lifestyle, taking medication as well as having the correct support and education in place.”
Scientists from institutions across Europe have identified a new molecule that could be used as a biological ‘marker’ in the early diagnosis of type 1 diabetes and signify whether a treatment is working or not.
According to Ms Horan, “Pharmacists can play an important role in managing the condition. This can include advice on how to monitor your glucose levels, advice on treatment options available and their side effects,
64 | PHARMACYNEWSIRELAND.COM
Currently, screening for and diagnosing Type 1 diabetes is done by measuring blood glucose levels and detecting autoantibodies (proteins that allow the immune system to attack and destroy beta cells). However, these ‘markers’ are often only detected when a person has already lost most of their insulin-producing beta cells. The research, published in the journal Diabetologia, shows that the molecule miR-409-3p was reduced both in mice with a Type 1-like condition and in people recently diagnosed with Type
1 compared to their unaffected counterparts. Found to be involved in regulation of the immune response, levels of the molecule rose when mice with a Type 1-like condition were treated with an immunotherapy. In this research project, partfunded by JDRF, a team of scientists wanted to find a new marker for Type 1 diabetes that was present in the very early stages of the condition. This way, a person could be diagnosed and treated much sooner, reducing their risk of complications associated with high blood glucose. It could also help scientists in developing treatments that protect beta cells from the immune system’s attack, by allowing them to intervene sooner to save more beta cells and improve glucose management. Additionally, a new marker could allow researchers to monitor how well future treatments such as immunotherapy are working in people with Type 1 diabetes.
News High Uptake of Vaccines The HSE has issued a reminder that HSE school vaccination teams are now returning to secondary schools to offer the 2nd dose of HPV vaccine and a dose of MenACWY vaccine to first year students. Each year in Ireland about 400 people will be diagnosed with a cancer caused by the HPV virus. Dr Lucy Jessop, Director of the HSE National Immunisation Office said, “We are very encouraged by the uptake for the 1st dose of HPV vaccine for first year students since September 2019. This is the first year boys have also been offered the HPV vaccine and school teams are reporting very busy clinics across the country. “Based on activity at our school clinics, our immunisation teams are confident that this year we’ll regain the WHO target of 80% uptake for the HPV vaccine nationally.” The HPV vaccine is endorsed by the Irish College of General Practitioners (ICGP), the Irish Pharmacy Union and the Irish Cancer Society’s HPV Alliance and by major medical and scientific bodies worldwide including the World Health Organization, the Centres for Disease Control in the USA, the EU funded European Centre for Disease Control and Prevention and the International Federation of Obstetricians and Gynaecologists.
MenACWY The MenACWY vaccine is also being introduced for all students in first year of secondary school. It replaces the MenC booster that has normally been given to students at this time. MenACWY covers more meningococcal strains than previously (A, C, W and Y) which can cause meningitis and septicaemia. “Over the last couple of years there has been in increase in meningococcal disease in this age group. We are delighted to now be offering the MenACWY vaccine to all first year students in secondary school through the HSE school vaccination programme,” said, Dr Jessop.
Pharmacy OTC online training course Life Pharmacy has reached a key training milestone withits first 20 pharmacy staff completing a 14-module OTC training course through an innovative eLearning platform. The platform was introduced by the group last year to bolster the level of training available to its employees. Catherine McCormack from Collerans Life Pharmacy in Mayo receives her certificate of completion from pharmacist Niamh Colleran
The OTC course is focused on common conditions encountered in community pharmacies and the associated treatment options that are available to treat and alleviate them. Staff can take modules at a time that suits them, allowing them to tailor their learning according to their schedule. Topics covered include aches and pains, winter health, eye and ear, baby and child care and oral health, among others. Following each module, learners are asked fifteen multiple choice questions to assess their understanding of the area concerned. In addition, patient scenario-based assessments are contained at both the half-way point and end of the programme. The assessments support previous module learnings and reflectrealworld interactions with patients and customersthat pharmacy staff manage on a daily basis. Activities are placed throughout the programme which direct the learner to carry out tasks or supplementary reading to support their learning.
A certificate of completion is available after successfully passing individual modules.Alapel badge is also provided to employees who complete the course to indicate to customers their status as a Life Healthcare Expert. Sarah Thomas Jichi from Britton's Life Pharmacy receives her certificate of completion from pharmacist Danielle McLaughlin
A First for Sleep Aid in Ireland Perrigo has launched Nytol’s first* clinically proven sleep aid onto the Irish market. Nytol One-A-Night is now available over the counter in pharmacy to help customers suffering from temporary sleep disturbance1. An online survey conducted in 2019 shows that over 6 in 10 adults in Ireland have difficulties getting to sleep, or staying asleep at night, with women more likely to suffer than men and stress being the main cause for sleep problems. “That’s a significant cohort of people who would benefit from pharmacy support,” says Catherine O’Connor, Brand Manager, Perrigo. “The research also showed that Irish people consider getting enough sleep the no.1 priority in maintaining good health and wellness, yet the majority claim to be getting less hours sleep than what they perceive to be ‘healthy’.”2
Sleep problems usually get better by changing your sleeping habits3, but when everyday coping mechanisms and nonpharmacological strategies have not worked, Nytol One-A- Night can be taken for up to 7 nights to help get the sleep pattern back on track. Each tablet contains 50mg Diphenhydramine Hydrochloride, which can help those suffering from temporary sleep disturbance.1 If the problem persists, please refer your customer to their GP. For more information about Nytol and useful tools to assist in the conversation with your customers in pharmacy, talk to your Perrigo business representative.
*new to Nytol 1 https://www.medicines.ie/ medicines/nytol-one-a-night-50-mgtablets-34889/smpc 2 Research was conducted between 15th – 22nd February 2019 via an online survey of 1000 nationally represented Irish adults aged 18+ by CORE Research on behalf of Perrigo. 3 https://www2.hse.ie/conditions/ mental-health/insomnia.html
Topic Team Training – Hayfever & Allergies A community pharmacy environment that fosters teamwork ensured high levels of consumer satisfaction. This series of articles is designed for you to use as guide to assist your team in focusing on meeting ongoing CPD targets and to identify any training needs in order to keep the knowledge and skills of you and your team up to date. The below information, considerations and checklist provides support to enable you to run a team training session and identify opportunities for learning within the topic of Hay fever and Allergies. Allergic disease within Ireland is increasing. Community pharmacists have an important role to play in the advice and information they can provide. For many patients, the pharmacy may be the first point of contact for several reasons, including the convenience of expert knowledge without the need to make an appointment or take time off work or school. Patients are looking for advice and the appropriate treatments that are flexible and fit in with their busy lifestyles. Allergy is an umbrella term for a group of allergic conditions, including: • Asthma • Eczema (atopic dermatitis) • Hay fever (allergic rhinitis) • Food allergy • Drug allergy • Venom allergy It is common for allergic conditions to co-exist and research has shown that there are close links between food allergies, asthma, hay fever and eczema. A genetic tendency to develop allergies is termed ‘atopy’. Children with an immediate family history of allergies are at an increased likelihood of developing one, but not necessarily the same type as their family member. The progression of allergic disease from birth to late childhood has been historically described as the ‘allergic march’, meaning the natural order by which allergic disease develops over time. The first signs of an allergic disease seen in infants are usually a food
allergy and eczema, with asthma and hay fever having a later onset. Where a food allergy and asthma co-exist, there is an increased risk of a severe allergic reaction – especially when the food allergy is caused by peanuts. Dispensing asthma and allergy medications provides a chance to review medication compliance and ensure patients know how to use their devices, such as inhalers and adrenaline autoinjectors. Community pharmacists are well placed with their product and knowledge to recommend specific treatments for hay fever. Antihistamines are commonly used to treat mild symptoms, such as runny or congested nose, sneezing, and itching or watery eyes. These should always be nonsedating so they do not impact on an individual’s ability to carry out their day-to-day activities. Patient education should always be provided for correct use of nasal sprays and eye drops. Some simple advice on pollen avoidance: • Wear wraparound sunglasses and a wide-brimmed hat (reduces pollen exposure to the face and eyes). • Monitor the pollen count and plan the day to avoid being outdoors at peak pollen times. • Keep windows and doors closed at home, in the office or car, to stop pollen coming inside. • Avoid drying washing outside as pollen can brought inside on garments, bed linen, sheets. • Advise on washing or showering to those who have been outside to remove pollen from the skin and hair. People’s experience of hayfever symptoms can vary from year to
year, which can make it difficult for customers to know which products to use, even those who have experienced symptoms before. So in order to ensure pharmacists are tailoring the treatment to their customers’ needs, they and their teams should offer a wide and varied range of remedies in multiple formats.
Key Points: Check your pharmacy team are aware and understand the following key points: Hay fever affects at least one in five people The wide range of hay fever symptoms The impact of hay fever on work, school and leisure
How to avoid/minimise hay fever triggers
Am I, my team, aware of guidance on the use of corticosteroids use in hayfever treatment?
The danger of anaphylactic shock
Are the team trained in all OTC treatments available in the suitability to each patient group?
Types of pollen and when they can cause symptoms during the year
Does my team know what different sources of pollen are most likely to cause symptoms, and which symptoms they will cause? Am I and my team educated on advice to offer in avoiding pollen?
66 | PHARMACYNEWSIRELAND.COM
How the pollen count varies with time of day and weather
Learning www.asthma.ie/hayfever - Further details on hay fever in Ireland and association with asthma.
Actions: Include POS with associated condition treatments such as asthma and other allergies Ensure efficient sign posting to further help and advice or reputable sources for allergy testing Keep products merchandised together, along with related products such as inhaler guides, to help build sales Ensure that this important category is fully stocked at all times and merchandising plans are amended based on seasonal time of year Ensure that I know the recommendations for each OTC treatment depending on the allergy Train the team to meet all the above considerations
asal prevent seasonal ENT infections (co nasal sitis, allergic rhinitis …) eeor irritated nose related to external 2
nasal hygiene ons, pollution,Daily long term drug intake, rocess… month +0 +0month CLEANS, MOISTENS AND PROTECTS THE NOSE
Adult/ /Child Child Adult
14 Moneen Business Park, Castlebar, Co. Mayo. | 094 902 4000 | email@example.com
prevent seasonal ENT infections (co revent seasonal ENT infections (c sitis, allergic rhinitis …)
tis, allergic rhinitis …) 2
or irritated nose related to external r irritated nose related to externa Daily nasal hygiene ons, pollution, long term drug intake, Daily nasal hygiene s, pollution, long term drug intak PROTECTS THE NASAL MUCOS rocess… CLEANS, MOISTENS AND PROTECTS THE NOSE
CLEANS, MOISTENS AND PROTECTS THE NOSE
cess… sal cavities: facilitates the secretions, bacteria, viruses, 14 Moneen Business Park, Castlebar, Co. Mayo. | 094 902 4000 | firstname.lastname@example.org
Update on Use and Learn in Ireland Following on from previous communications about plans to end the use and learn period on a phased basis, the Safety Features Oversight Group has now agreed that this will be done in the following phases starting from 2 March 2020: Phase
What This Means
Confirmed date –
Products that are parallel imported and parallel distributed:
Use & learn ends for products that are parallel imported and parallel distributed and products handled by primary wholesalers2 (certain activities only)
Monday 2nd March 2020
A manufacturer who carries out repackaging operations on products intended for the Irish market must ensure that alerts generated when they verify and/ or decommission the originator packs are resolved. The cause of any alerts received during the upload of data for the new barcodes must be investigated and resolved before the packs can be supplied. The HPRA is writing to all parallel importers and parallel distributors, who are active in Ireland, with detailed guidance. Primary wholesalers: Primary wholesalers are requested to scan one pack per pallet of incoming goods and, if any alerts are generated, quarantine the incoming packs from that pallet and request that the marketing authorisation holder (MAH) investigate and correct any data errors. The HPRA is writing to the relevant wholesalers with detailed guidance.
Phase 2: Use & learn ends for all wholesalers3
Planned for May 2020 exact date to be notified in due course
Use and learn will end for all wholesalers. All alerts generated as a result of their scanning activity must be investigated and resolved before the packs can be supplied onwards. The HPRA and IMVO will carry out targeted consultation with the relevant parties.
Phase 3: Use & learn ends for pharmacies, hospitals and all others who supply medicines to the public
Planned for September 2020 - exact date to be notified in due course
Use and learn will end for all entities who supply medicines to the public including pharmacies and hospitals. All alerts generated as a result of their scanning activity must be investigated and resolved before the packs can be supplied. The HPRA, PSI and IMVO will carry out targeted consultation with relevant parties.
1. The Safety Features Oversight Group comprises the Irish Medicines Verification Organisation (IMVO), Department of Health, Health Products Regulatory Authority (HPRA), Pharmaceutical Society of Ireland (PSI), Health Service Executive (HSE) and Private Hospitals Association (PHA). 2. For the purposes of this communication, a ‘primary wholesaler’ is considered to be the wholesaler that first receives stock into Ireland from a wholesaler or manufacturer in another EU member state and supplies it to the Irish market, or the wholesaler that receives stock directly from an Irish manufacturer and supplies it to the Irish market. 3. Relates to all wholesale distribution authorisation (WDA) holders, including pharmacies that carry out wholesaling activities.
Methadone overdose Risk Patients receiving methadone treatment are most at risk of overdosing in the month following the end of methadone treatment and during the first four weeks of treatment, according to a new study. Led by RCSI researchers, the study however, did not observe transfers between services as high risk periods, with no deaths occurring following a transfer. This suggests that the current structures in Ireland promote a smooth transition of patients between services. The study was funded by the Health Research Board and was a collaboration between the School of Pharmacy and Biomolecular Sciences in RCSI, HRB Centre for Primary Care Research in RCSI, the HSE Addiction Services, Trinity College Dublin and the HSE National Social Inclusion Office. People with opioid dependence have more than 10 times the risk of premature death than the general population. The most effective treatment is the prescription of legal, substitution drugs, most commonly methadone. The researchers analysed data from 2,899 people who were prescribed and dispensed methadone in addiction services between January 2010 and December 2015. They observed 154 deaths, and 55 (35.7%) of those were identified as drugrelated poisonings. The rate of drug-related poisoning deaths was more than four times higher in the month following the end of treatment and over three times higher in the first four weeks of treatment when compared to the remaining time in treatment. These findings are consistent with growing evidence from other international studies. No deaths were observed in the first month following transfer between treatment providers. Transfers between addiction services and primary care are facilitated by GP Coordinators employed by the addiction services. The GP Coordinator provides all relevant clinical details on the patient being transferred to the new treatment provider.
Sustainable fish oil brand Aqua Biome launches two innovative omega 3 supplements
The dreaded morningafter the night before…
Aqua Biome, a new sustainable and innovate fish oil supplement brand, has launched two products to the market which are available from leading pharmacies nationwide.
PAYOT Hangover Morning Mask – RRP ¤6.95 Sometimes we need a helping hand in ridding our skin of impurities and returning its glow and shine; enter PAYOT Hangover Morning Mask! This detox mask with Goji berry extract is super rich in Vitamin C, providing your skin with the shot of energy it needs to revive. With delicious fresh and fruity notes of peach, white musk and melon, this fabric mask is sure to provide your skin with a helpful boost of energy and leave you looking healthy and ready for the day ahead!
Aqua Biome Fish Oil is available in Classic Strength and Maximum Strength bringing all the best benefits of fish oil with none of the usual contaminants. A fish oil like no other, Aqua Biome is the world’s first fish oil with DPA, known as the “missing omega”. The unique Aqua Biome formulas are based on cutting edge science to ensure optimal benefits for the body, providing the perfect blend of the three omegas DPA, EPA and DHA. DPA is the missing omega 3 that most other fish oils don’t know about. The unique Aqua Biome blend of DPA, EPA & DHA helps create and support a healthy microbiome, which has an array of positive impacts on the entire body. The crucial omega Salatac GelbePress Release DPA can converted to either EPA or DHA by the body as its required. This is the ultimate natural ratio of omega’s, and is now understood to be more beneficial for human health than EPA and DHA alone.
This 100% natural fabric mask take just 15 minutes to delivery all the benefits of the products active ingredients and leave skin comfortable, beautiful and fresh. Enriched with 19ml of product, the tightly woven fabric envelops the face and Adding Aqua Biome to your daily routine can help create a stops the product from evaporating. With plant and tangy fruit healthy microbiome, which can help promote: extracts, PAYOT Morning Masks are the quick, useful and Convenient & painless answer to warts and verrucas affordable solution to problematic morning skin. Proper digestion Healthy energy levels Healthy skin Balanced mood Immune system support PAYOT Hangover Morning Mask – RRP ¤6.95 – supportBrain and joint health As we nationwide head into summer, will be launchingCardiovascular a new campaign to advertise Salatac Gel to the Available in pharmacies and onlineDermal at Website: https://www.aqua-biome.co.uk/ Gel Press Release general public in national newspapers and magazines. AsSalatac warts and verrucas are highly contagious and https://cosmeticsonline.ie/
easily transmitted in pools and changing rooms, the new campaign, running in April- May, will focus on children at a swimming pool. Clonmel Healthcare Roll Out Consumercentric Rebrand with ¤325,000 investment Convenient & painless answer to warts and verrucas
Caldesene Medicated Powder has been the gold standard for Convenient & painless answer to warts and verrucas As we head into summer, Dermal the treatment and prevention of nappy rash for over 45 years. Gel kit Each convenient, complete Salatac contains: will be launching a new Clonmel Healthcare is pleased to unveil its new, brighter gelwe containing salicylic acid, withwill specially As head summer,campaign Dermal be launching a new campaign to advertise Salatac toaadvertise branding and packaging•thatTreatment will make Caldesene, the into leading Salatac Gel to nappy rash product, look even more impactful on the shelves general national application newspapers the and magazines. As warts and verrucas are highly c designed nozzle forpublic easy,intargeted in Irish pharmacies. general public in national easily transmitted in pools and changing rooms, the new campaign, running in April- May • An emery board totheremove hardened skin and newspapers A bolder design has been created, while ensuring children at a swimming pool. magazines. As warts recognisable Caldesene•lookPatient is retained. The front of leaflet with usage information instructions and verrucas are highly the packaging has been decluttered, so consumers can contagious and easily understand the core message – Caldesene medicated powder transmitted in pools and changing rooms, the new prevents and treats nappy rash - quickly and easily. convenient, Salatac Gelbeen kit contains: campaign, in AprilMay, to willbe focus on childrenas at cryotherapy a Topical salicylic acidEach treatments such complete as Salatac Gel running have shown as effective Marketing Director, Martin swimming pool. • “We Treatment gel containing salicylic acid, with a specially Gallagher said have
Salatac Gel forms a waterproof barrier over the lesion, meaning no plasters are required, and created designed nozzleEach easy, targeted application convenient, complete Salatac Gel kit contains: transmitting the wart or verruca to others isforless likely. a new image to highlight
• prevents An emery board to remove hardened skin that Caldesene • Treatment gel containing salicylic acid, with a specially and treats nappy rash, Remember Salatac Gel is a proven, convenient and painless treatment for patients with warts • be Patient leaflet with usage instructions designed nozzle forfirst-line easy, targeted application and it should used at information
and verrucas this everysummer. change. It was so
• An emery board to remove hardened skin important to us that we maintained the brand Topical salicylic acid treatments as Salatac Gel have been shown to be as effective a • Patientsuch information leaflet with usage instructions heritage, whilst conveying Salatac Gel forms a waterproof barrier over the lesion, meaning no plasters are required to the consumers that Topical salicylic acid treatments such as Salatac Gel have this is still the same great transmitting the wart or been verruca to others less likely. shown to be asiseffective as cryotherapy. Salatac Gel product that they have forms a waterproof barrier over the lesion, meaning no grown up with. The product are required, andand transmitting wart or treatment verruca to for patie Salatac Gel isplasters a proven, convenient painlessthe first-line has notRemember changed in any others is less likely. way. This new modern, and verrucas this summer. attractive packaging is Remember Salatac Gel is a proven, convenient and attention-grabbing and painless first-line treatment for patients with warts and clearly communicates the product on-shelf.” verrucas this summer.
70 | PHARMACYNEWSIRELAND.COM
If you would like to order samples, please use: Web: www.fresubinsamples.ie Email: email@example.com Phone: +353 (0)1 841 3030
Date of preparation: October 2019 Job code: EN/3.2kcal.005.19
Give them a second chance with the CONTOUR®NEXT ONE and CONTOUR®XT blood glucose meters For many reasons, we don’t always get it right first time. When testing their blood glucose, it can mean wasting a test strip and having to re-prick. Its frustrating for them. With Second-Chance® sampling, they have another opportunity to get an accurate result by applying more blood to the same strip* with no need to re-prick their finger. Talk to your patients about the CONTOUR®NEXT ONE and CONTOUR® XT meters, that both use the CONTOUR® NEXT test strips with Second-Chance® sampling. www.diabetes.ascensia.ie
* Wu H-P et al. Performance of a New Algorithm for Sample Re-application During Blood Glucose Test Strip Underfill Conditions. Poster presented at the 15th Annual Canadian Diabetes Association, October 10–13, 2012, Vancouver, British Columbia, Canada. Ascensia, the Ascensia Diabetes Care logo, Contour and Second-Chance are trademarks of Ascensia Diabetes Care Holdings AG. All other trademarks are the property of their respective owners. © 2020 Ascensia Diabetes Care Holdings AG. All rights reserved. Date of preparation: March 2020. Code: HCPCNOXT032020v1