IPN February 2025

February 2025 Volume 17  Issue 2 PHARMACYNEWSIRELAND.COM

THE INDEPENDENT VOICE OF PHARMACY

In this issue: NEWS: High Levels of Trust in Pharmacy Page 7

MEDICINES: Latest Shortages Survey Page 14

FEATURE: Marking International Epilepsy Page 24

RESEARCH: Advancing Cervical Cancer Programme Page 38

CPD: Urinary Incontinence Page 41

AWARDS: OTC & Retail Pharmacy Product Awards Page 47

TEAM TRAINING: Omega 3 Page 82

CLINICAL: Juvenile Idiopathic Arthritis Page 92 This Publication is for Healthcare Professionals Only

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Generic Product Launch

Varenicline Teva Film-coated Tablets varenicline

Smoking Cessation Medicine Available on private prescription only.

Indications Varenicline Teva 0.5 mg and Varenicline Teva 1 mg Film-coated Tablets (initiation pack) and Varenicline Teva 1 mg Film-coated Tablets Varenicline Teva is indicated for smoking cessation in adults.

Varenilcine 0.5mg and 1mg Film-Coated Tablets Abbreviated Prescribing Information Presentation: Each film-coated tablet contains varenicline citrate equivalent to 0.5mg and 1mg varenicline. Indications: Varenicline is indicated for smoking cessation in adults. Dosage and administration: Oral use. Adults: The recommended dose is 1mg Varenicline twice daily following a 1-week titration (see SmPC for details). Children: Not recommended for use. Elderly: No dosage adjustment is necessary. Elderly patients are more likely to have decreased renal function, prescribers should consider the renal status of an elderly patient. Renal impairment: No dosage adjustment is necessary for patients with mild (estimated creatinine clearance >50ml/min and ≤80ml/min) to moderate (estimated creatinine clearance ≥30ml/min and ≤50ml/min) renal impairment. For patients with severe renal impairment (estimated creatinine clearance <30ml/min), the recommended dose of Varenicline is 1mg once daily. Hepatic impairment: No dosage adjustment is necessary. Contraindications: Hypersensitivity to the active substance or to any of the excipients. Precautions and warnings: Physiological changes resulting from smoking cessation, with or without treatment with Varenicline, may alter the pharmacokinetics or pharmacodynamics of some medicinal products, for which dosage adjustment may be necessary (examples include theophylline, warfarin and insulin). As smoking induces CYP1A2, smoking cessation may result in an increase of plasma levels of CYP1A2 substrates.

Changes in behaviour or thinking, anxiety, psychosis, mood swings, aggressive behaviour, depression, suicidal ideation and behaviour and suicide attempts have been reported in patients attempting to quit smoking with Varenicline.

Depressed mood, rarely including suicidal ideation and suicide attempt, may be a symptom of nicotine withdrawal.

Clinicians should be aware of the possible emergence of serious neuropsychiatric symptoms in patients attempting to quit smoking with or without treatment. If serious

Teva Pharmaceuticals Ireland, Digital Office Centre Swords, Suite 101 - 103, Balheary Demesne, Balheary Road, Swords, Co Dublin, K67E5AO, Ireland.

neuropsychiatric symptoms occur whilst on Varenicline treatment, patients should discontinue Varenicline immediately and contact a healthcare professional for reevaluation of treatment. Smoking cessation, with or without pharmacotherapy, has been associated with exacerbation of underlying psychiatric illness (e.g. depression). In clinical trials and post-marketing experience there have been reports of seizures in patients with or without a history of seizures, treated with Varenicline. Varenicline should be used cautiously in patients with a history of seizures or other conditions that potentially lower the seizure threshold. At the end of treatment, discontinuation of Varenicline was associated with an increase in irritability, urge to smoke, depression, and/or insomnia in up to 3% of patients. In such instances, tapering should be considered. Patients taking Varenicline should seek immediate medical attention if they experience signs and symptoms of myocardial infarction or stroke. Interactions: Varenicline has no clinically meaningful drug interactions (see SmPC for further details). No dosage adjustment of Varenicline or co-administered medicinal products listed below is recommended. In vitro studies indicate that Varenicline is unlikely to alter the pharmacokinetics of compounds that are primarily metabolised by cytochrome P450 enzymes. Furthermore, since metabolism of Varenicline represents less than 10% of its clearance, active substances known to affect the cytochrome P450 system are unlikely to alter the pharmacokinetics of Varenicline, therefore a dose adjustment of Varenicline would not be required. Varenilcine is not known to affect the pharmacokinetics of metformin, digoxin, bupropion and warfarin. Co-administration of cimetidine, with Varenicline increased the systemic exposure of varenicline by due to a reduction in varenicline renal clearance. In patients with severe renal impairment, the concomitant use of cimetidine and Varenicline should be avoided. Pregnancy and lactation: As a precautionary

measure, it is preferable to avoid the use of varenicline during pregnancy. A decision on whether to continue/ discontinue breast-feeding or to continue/discontinue therapy with varenicline should be made taking into account the benefit of breast-feeding to the child and the benefit of varenicline therapy to the woman. Effects on ability to drive and use machines: Varenicline may have minor or moderate influence on the ability to drive and use machines. Varenicline may cause dizziness, somnolence and transient loss of consciousness, and therefore may influence the ability to drive and use machines. Adverse reactions: Diabetes mellitus, suicidal ideation, depression, hallucinations, psychosis, seizure, cerebrovascular accident, transient loss of consciousness, myocardial infarction, angina pectoris, tachycardia, atrial fibrillation, electrocardiogram ST segment depression, gastritis, haematemesis, severe cutaneous reactions including Stevens Johnson Syndrome and Erythema Multiforme, angioedema. Very Common: Nasopharyngitis, abnormal dreams, insomnia, headache, nausea. Common: Bronchitis, sinusitis, weight increased, decreased appetite, increased appetite, somnolence, dizziness, dysgeusia, dyspnoea, cough, gastrooesophageal reflux disease, vomiting, constipation, diarrhoea, abdominal distension, abdominal pain, toothache, dyspepsia, flatulence, dry mouth, rash, pruritus, arthralgia, myalgia, back pain, chest pain, fatigue, liver function test abnormal.

Consult the Summary of Product Characteristics in relation to other side effects. Overdose: In case of overdose, standard supportive measures should be instituted as required. Legal category: POM. Marketing Authorisation Number: 0.5mg PA1986/129/001, 1mg PA1986/129/002.

Marketing Authorisation Holder: Teva B.V., Swensweg 5, 2031GA Haarlem, Netherlands. Job Code: MED-IE-00084. Date of Preparation: July 2024.

Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie.

Adverse events should also be reported to Teva UK Limited on +44 (0) 207 540 7117 or medinfo@tevauk.com

Freephone: 1800 - 201 700 | Email: info@teva.ie

Prescription Only Medicine.

Date of Preparation: October 2024 | Job Code: Vcli-IE-00010 Further information is available on request or in the SmPC. Product Information also available on the HPRA website.

5

Contents

Foreword

Page 6: Pharmacy and Department of Health conflict over HRT scheme

We start this issue with some positive news, with feedback from the most recent Ipsos Veracity Index, the longest-running poll on trust in professions in Ireland which shows public levels of trust in the pharmacy profession remains high.

Page 8: McCabes Pharmacy completes rebranding

Healthcare professionals are again the three most trusted professions, with Nurses (97%), Local Pharmacists (96%) and Doctors (94%) leading the way. You can read more about this on page 7.

Page 12: The benefits of becoming an Axium member

6

Page 14: Mitigating medicine shortages Page 30: OTC Management of Podiatry in Pharmacy

In other news, the Irish Pharmacy Union (IPU) has welcomed the commitments outlined in the newly announced draft Programme for Government, which address key priorities for community pharmacies.

Page 34: Researchers discover link in reducing risk of chronic diseases

8

Page 47: OTC & Retail Pharmacy Product Awards 2025 – The Finalists Page 84: Unlocking Success at the Irish Pharmacy Awards – Tips & Advice

34

MANAGING DIRECTOR Natalie Maginnis n-maginnis@btconnect.com

SALES MANAGER Amy Evans | amy@ipn.ie 0872799317

47

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

DESIGN DIRECTOR Ian Stoddart Design PHARMACYNEWSIRELAND.COM @Irish_PharmNews IrishPharmacyNews

The February issue wouldn’t be complete without our annual showcase of the Finalists for the 2025 OTC & Retail Pharmacy Product Awards. A highly anticipated event in the Irish retail calendar, the Irish Pharmacy News OTC and Retail Pharmacy Product Awards are the only industry accolades dedicated to recognising and rewarding companies and their products within the OTC market.

These Awards serve as a platform to celebrate and showcase excellence in product innovation, marketing, and customer value. Since their launch in 2008, they have been committed to highlighting advancements and innovation within the pharmacy sector.

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

Barbara Paldus | Dr Kathy Gately Kari Bø | Neil Fleming Cinny Cusack | Déirdre Daly Cara M Martin | John J O’Leary Sharon O’Toole Elizabeth Culleton-Quinn Paddy McGeoghegan Dr Orla Killeen Dr Diarmuid McLaughlin

While these commitments represent progress, urgent action is essential to turn them into meaningful improvements for pharmacists and patients. Commenting on the Programme, IPU President Tom Murray said, “Community pharmacies are the cornerstone of Ireland’s healthcare system, providing trusted, accessible care to millions annually. However, financial instability, excessive administrative burdens, and the lack of increased services threaten their sustainability.”

Turn to page 10 to read the full story.

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

CONTRIBUTORS

Meanwhile, on page 8, we reveal that the start of 2025 has marked a significant milestone for McCabes Pharmacy as it completes the rebranding of multiple stores across Ireland, transitioning from LloydsPharmacy to McCabes Pharmacy. This move cements the position of McCabes Pharmacy as Ireland’s largest and most patient-centric pharmacy brand, with 110 locations nationwide.

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

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

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

IRISH PHARMACY NEWS

Starting on page 47, we showcase those products which have been shortlisted as finalists across categories, including Best Beauty Product, Best Marketing / Launch Product, Best Menopause Product, Best Sleep/ Stress Product, Best Children and Baby Product, and much more.

I hope you enjoy the issue.

Regulars CPD: URINARY INCONTINENCE

P41

FEATURE: EPILEPSY

P46

TEAM TRAINING: OMEGA 3

P82

FEATURE: HPV PREVENTION

P88

FEATURE: JUVENILE IDIOPATHIC ARTHRITIS

P92

CLINICAL PR:

P96

PHARMACYNEWSIRELAND.COM

6

News

HRT Scheme Faces More Delays The free HRT scheme was scheduled to commence in January 2025. However, as of mid-January, the rollout has encountered significant delays. The Department of Health has retracted its initial commitment to launch the scheme this month, leading to criticism from various stakeholders. The Irish Pharmacy Union and the Irish Medical Organisation have highlighted significant issues with the proposed implementation, expressing concerns over the lack of clarity and preparedness.

Minister for Health, Jennifer Carroll MacNeill "A lack of guidance and a refusal by the Department of Health and the HSE to engage with the IPU on members' concerns is the reason for the failure to introduce this scheme to date," it said in a statement.

It added that it has not been given a list of medication that will be covered, that there has been no guidance issued by the Department, and a tested IT system is not in place.

According to documents seen

by RTE’s Prime Time, the Irish Pharmacy Union have said significant implementation gaps remain, making it currently impossible for pharmacies to begin providing the HRT scheme.

The Department of Health has said it is engaging with the pharmacy union, including meeting twice before Christmas.

The goal is to introduce the free scheme "as soon as possible" it said in a statement.

Meanwhile, earlier this month (February), Deputy James O’Connor asked the Minister for Health Jennifer Carroll MacNeill for an update on the situation.

“This measure will cover any HRT medications and products which are currently reimbursable by the HSE, which have been prescribed for the purposes of alleviating the symptoms of menopause. The cost of GP consultation fees and pharmacy dispensing fees are not included in the measure.

“The Department of Health engaged with both the Health Service Executive (HSE) and the Irish Pharmacy Union in relation to the practical rollout of this measure.

“The Department of Health is working to introduce this measure as soon as possible,” she said.

PMI Annual Summit 2025 The Pharmaceutical Manager’s Institute (PMI) Annual Summit takes place on April 3rd, 2025 at Croke Park. This must-attend event will showcase a diverse range of industry and subject experts under the general theme of “evolving through change”. This is the flagship event in the PMI’s calendar with over 300 attendees from across the industry along with a host of exhibitors. It provides an excellent platform to learn, connect and grow! Visit www.thepmi.com for full details.

Detecting SF Medicines Pharmacists in both community and hospital settings are wellpositioned to swiftly detect substandard and falsified (SF) medical products in supply chains, report them to the authorities, and educate and advise affected patients, the International Pharmaceutical Federation (FIP) told the World Health Organisation (WHO) Executive Board in Geneva, Switzerland, recently.

Speaking on behalf of FIP during the agenda item on SF, Tjaša Škerl Rifelj, from the International Pharmaceutical Students' Federation, welcomed the WHO Member State mechanism’s efforts to address SF medical products and facilitate collaboration among stakeholders. In the statement, FIP highlighted its collaboration with WHO as proof of the critical role pharmacists play in detecting and reporting SF products, underscoring the importance of their involvement in tackling this issue, as well as the positive outcomes resulting from this partnership.

During the Executive Board meeting this week, FIP is also taking part in joint statements on the health and care workforce, climate change, and health emergencies with the World Health Professions Alliance (WHPA) and members of the Health Stakeholder Network (HSN).

Substandard and falsified (SF) medical products as defined by the World Health Organisation, are major threats to public health. Through increasing globalisation, the problem has expanded in both developed and developing countries.

Pharmacists are key to combatting SF medical products because they are healthcare professionals with direct access to patients. Pharmacists are the gatekeeper for appropriate medication management.

Pharmacists are not only necessary to ensure supply of medicines in a proper and just manner, but they also check for unauthorised sales of medicines or medical products that are not of certified quality. As the final member of the pharmaceutical distribution chain as well as often being supply chain managers, pharmacists are crucial in preventing introduction of SF medical products into the supply chain and in promoting adherence.

PHARMACYNEWSIRELAND.COM

News Action on Shortages The latest PGEU Medicines Shortage Survey underscores the persistent and significant impact of medicines shortages across Europe. Over the past twelve months, pharmacies have consistently faced high levels of shortages, with 61% of countries reporting that the situation has not improved compared to the previous year’s survey, which was an exceptionally high benchmark for shortages.

This year’s survey highlights a concerning trend: the time pharmacists dedicate to managing medicines shortages continues to rise, with European community pharmacists now spending around 11 hours per week addressing this issue.

This substantial demand on their time diverts resources from other critical healthcare services but remains essential to ensure patients receive the care they need.

Clare Fitzell, PGEU President, announces, “We reached a steady state that is unacceptable for patients, pharmacists and prescribers – shortages are not getting worse, but also are not resolving.

Behind every medicine shortage is an anxious patient and their diligent pharmacist trying to seek alternatives and solutions.

Some countries have facilitated pharmacists through their legal framework to find a greater range of solutions for patients, such as generic substitution and therapeutic substitution, which provides for a timelier solution for patients and harnesses the expertise of pharmacist.

This is one of the important measures we have put forward for consideration in our latest position on proactive measures to address medicine shortages.”

Clare highlighted the importance of ongoing policy initiatives and urged countries to expedite their implementation, “Pharmacists can do so much more if they are provided with the necessary tools, opportunities, and resources. This requires greater transparency and information sharing across the supply chain; robust reporting mechanisms; enhanced professional competencies; and financial measures to offset the economic impact on pharmacies.”

7

Trust in Pharmacy remains High Public trust in their community pharmacists continues to rate highest, with trust levels declining for many others.

Trust continues to be critically important in Ireland.

But who do the Irish public trust to tell the truth?

The Ipsos Veracity Index is the longest-running poll on trust in professions in Ireland, first measured in 2005. The 2024 edition, conducted via nationally representative telephone survey, tracked the latest movements in public trust in key professionals.

Key Highlights show:

Veracity Index 2024 Who Do We Trust The Most?

Q. Now I will read you a list of different types of people. For each would you tell me if you generally trust them to tell the truth, or not?

• Healthcare professionals are again the three most trusted professions, with Nurses (97%), Local Pharmacists (96%) and Doctors (94%) leading the way.

Nurses

97%

Local Pharmacists

96%

=

Doctors

94%

+1

• Trust in Teachers (91%, +3 points) and Gardai (82%, +5 points) has increased since last year.

• Public trust in Bankers (45%, +4 points) continues to recover, up 18 points over a five-year period.

• Our trust in Clergy/Priests is at 57%, down 4 points.

• Trust scores for EU Leaders (41%, -10 points) and Landlords (32%, -7%) show significant falls since 2023.

Tarik Laher, Director at Ipsos B&A said, “The Irish public continues to trust our nurses, pharmacists and doctors the most when it comes to telling us the truth, as healthcare professionals continue to top the Ipsos B&A Veracity Index.

+2

Teachers

91%

+3

Engineers

90%

+2

Gardaí Judges

82% 82%

+1

Scientists

81%

-3

+5

Civil Servants

74%

-2

Weather Forecasters

72%

-9

Ordinary Person in the Street

58%

-9

Economists

58%

-2

57%

-4

• 58% of us trust our fellow citizen; however, this is down 9 points, perhaps a broader reflection of recent societal unrest on key issues.

• Declines are seen in the trust levels for Scientists (81%, -3 points), Weather Forecasters (72%, -9 points) and Pollsters (51%, -6 points).

Change Since 2023

Level of Trust

Profession

Clergy/Priests Pollsters Local Councillors

51%

-6

51%

+3

Charity Chief Executives

48%

Bankers

45%

+4

Business Leaders

44%

-3

Journalists

44%

EU Leaders

41%

Government Ministers Estate Agents Landlords of Private Property

35%

-1 +1

32%

-7

27%

Artificial Intelligence (AI)

24% 23%

Advertising Executives

= -10

34%

Politicians Generally

Social Media Influencers

-3

6%

= NEW

-1 -5

For this survey Ipsos B&A conducted 710 telephone interviews with individuals in Ireland aged 16+ between 6th - 21st June 2024.

For further information on Veracity Index please contact: Tarik Laher tarik.laher@ipsos.com Phone +353 (0)1 4389000

“Overall, we retain our faith in many professions, with teachers and the Gardai showing high levels of trust and positive increases this year.”

Pharmacists Welcome new Minister for Health The Irish Pharmacy Union (IPU) congratulates Jennifer Carroll MacNeill on her appointment as Minister for Health. The IPU is looking forward to early engagement with the Minister to prioritise the commitments outlined in the programme for government. In particular, we urge immediate action to support community pharmacists and enhance accessible healthcare delivery for the benefit of patients throughout the country.

Tom Murray, President of the IPU, said, “On behalf of community pharmacists across Ireland, I congratulate Minister Carroll MacNeill on her appointment.

We welcome the opportunity to collaborate with the new Minister to address the challenges currently faced by pharmacists, resolving these issues are critical to ensuring

a robust, effective and accessible healthcare system.”

Mr Murray added, “Community Pharmacists play a vital role in the healthcare system, yet the sustainability of community pharmacies is a risk due to outdated policies and lack of resources. Implementing the commitments in the programme

for government without delay is essential to empower pharmacists and improve patient care nationwide.”

The IPU looks forward to constructive engagement with Minister Carroll MacNeill and her team, aiming to deliver tangible benefits for pharmacists, patients, and the wider healthcare sector.

PHARMACYNEWSIRELAND.COM

8

News

McCabes Pharmacy: A New Chapter in Irish Community Healthcare The start of 2025 has marked a significant milestone for McCabes Pharmacy as it completes the rebranding of multiple stores across Ireland, transitioning from LloydsPharmacy to McCabes Pharmacy. This move cements the position of McCabes Pharmacy as Ireland’s largest and most patient-centric pharmacy brand, with 110 locations nationwide.

Denis O’Driscoll, Superintendent Pharmacist at McCabes Pharmacy and Yen Ying Lee, Supervising Pharmacist pictured at McCabes Pharmacy in Castleknock

on their dedication to essential services such as flu vaccinations, blood pressure monitoring, and health screenings, which continue to bridge the gap between patients and primary care providers.

Throughout January, McCabes Pharmacy hosted a series of celebrations across the country to mark the transition. Stores in Castleknock, Letterkenny, Adamstown, Kenmare, and Wicklow have unveiled their new McCabes Pharmacy identity, each event reinforcing their mission of providing accessible, expert-led pharmacy care.

These events brought together pharmacy teams, customers, and key figures in healthcare and government, emphasising their role in supporting patient health at a community level.

The Baltinglass rebranded store in Co. Wicklow was another key moment with McCabes Pharmacy CEO Sharon McCabe and Ireland South MEP Cynthia Ní Mhurchú, cutting the ribbon in celebration of the milestone.

Letterkenny in Co. Donegal and Kenmare in Co. Kerry marked their transition with exclusive in-store events and promotions for their local communities. In addition to official rebrandings - a brand new McCabes Pharmacy store was unveiled at The Crossings in Adamstown, West Dublin, delivering personalised care and trustworthy advice to the Adamstown community.

Continuity in Patient Care and Innovation For healthcare professionals, the transition from LloydsPharmacy to McCabes Pharmacy represents more than just a rebrand - it reflects a renewed investment in patient care, professional

At the Castleknock Pharmacy opening, Minister for Public Expenditure, Infrastructure, Public Service Reform and Digitalisation, Jack Chambers TD, a qualified medical doctor, highlighted the importance of pharmacies in modern healthcare. He commended McCabes Pharmacy

Sharyn Browne, Manager and Anita Mulready, OTC Assistant pictured at McCabes Pharmacy in Castleknock

PHARMACYNEWSIRELAND.COM

development, and pharmacyled healthcare solutions. The established pharmacy teams remain at the heart of each store, ensuring that customers experience the same high standard of care from trusted pharmacists, technicians, and support staff.

McCabes Pharmacy’s commitment to healthcare innovation continues with enhanced digital services, medication management support, and a focus on preventative healthcare initiatives. The rebrand allows McCabes Pharmacy to further integrate these services across its expanding network, positioning itself as a leader in modern pharmacy care.

Looking Ahead With 110 stores nationwide, McCabes Pharmacy is setting the standard for patient-centric healthcare in Ireland, with recent rebrands marking a new era of community-driven, expert-led pharmacy care while ensuring customers continue to benefit from trusted services under the McCabes banner. For pharmacists and healthcare professionals, this expansion and investment in clinical services create new opportunities for collaboration, patient education, and accessible healthcare solutions. As the healthcare landscape evolves, McCabes Pharmacy remains committed to keeping patients at the heart of everything they do.

Addressing HIV Stigma In a recent survey 7 in 10 people did not know that when a person living with HIV is on effective treatment, they cannot pass it on to sexual partners.

The HSE in partnership with people living with HIV, recently launched ‘You, Me and HIV,’ a new nationwide campaign to address misconceptions around HIV and help reduce the stigma experienced by people living with HIV in Ireland.

Research has found that late diagnosis is often related to fear of diagnosis and stigma, highlighting the need to reduce stigma around HIV and testing.

The latest figures from the Health Protection Surveillance Centre (HPSC) show a decrease in the rate of first-time HIV diagnoses in Ireland in 2023. However, nearly two in five people (39%) were diagnosed late.

Advancements in treatment for HIV, mean that people on effective treatment cannot pass HIV to sexual partners.

HIV activists, and ‘Poz Vibes’ podcast creators Enda McGrattan, also known as drag star Veda Lady, and Robbie Lawlor, are among the people involved in the campaign.

HIV Fact Check: • HIV, regardless of whether or not a person is on treatment, is not passed on from kissing, or from using the same cups, plates, forks or toilet seats.

You can’t get HIV from shaking someone’s hand or giving them a hug.

• People on effective treatment cannot pass HIV to sexual partners. When a person living with HIV is on effective treatment, the viral load is so low that it is not detected in their blood. This is often referred to as 'undetectable' equals 'untransmittable' (U=U).

• People living with HIV on effective treatment can have healthy pregnancies and go on to deliver healthy babies without passing on the virus. Effective treatment in pregnancy prevents infection in babies. HIV is not a reason to avoid pregnancy.

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10

News

Pharmacists welcome Programme for Government

CervicalCheck Initiatives

The Irish Pharmacy Union (IPU) has welcomed the commitments outlined in the newly announced draft Programme for Government, which address key priorities for community pharmacies. While these commitments represent progress, urgent action is essential to turn them into meaningful improvements for pharmacists and patients.

Marking Cervical Cancer Prevention Week (20 January – 26 January), the HSE’s CervicalCheck programme highlighted how screening is now even more accessible to all eligible women.

Commenting on the Programme, IPU President Tom Murray said, “Community pharmacies are the cornerstone of Ireland’s healthcare system, providing trusted, accessible care to millions annually. However, financial instability, excessive administrative burdens, and the lack of increased services threaten their sustainability.

The Programme for Government acknowledges these issues, but we urge immediate action to

secure the future of pharmacies and improve patient care.”

within 2025 to provide clarity and stability.”

“Pharmacists have endured nearly two decades of declining professional dispensing fees, placing unsustainable pressure on pharmacy businesses as their running costs continue to rise.

The Programme’s commitment to reviewing the fee structure and streamlining reimbursement processes is a step in the right direction. However, these discussions must conclude

“Investing in community pharmacies delivers proven benefits. It improves patient outcomes, ensures value for money, and enhances primary care accessibility. The IPU is eager to collaborate with the incoming Minister for Health and will be seeking an early meeting to develop and implement these measures. Pharmacists are ready and willing to do more for their patients, provided we receive the necessary resources.”

Impact of Poor Sleep Researchers at Maynooth University’s Kathleen Lonsdale Institute for Human Health Research and Department of Psychology have recently published a study showing that sleep problems are very common in people with Parkinson’s disease, and such sleep problems are associated with poorer quality of life in patients. Parkinson’s disease is the second most common neurodegenerative brain disease after Alzheimer’s, and is estimated to affect 18,000 people in Ireland, and over six million people worldwide.

Andrew Coogan, Maynooth University

The study highlights the direct consequences of these sleep problems: they were found to be strongly linked to increased symptoms of depression, greater difficulty with independent living, and an overall decline in quality of life. Furthermore, sleep disturbances were found to worsen the severity of “OFF periods,” the times when the effects of Parkinson’s medication diminish, leaving patients vulnerable to a return of debilitating symptoms.

The MU study, led by PhD candidate Ziba Asadpoordezaki, Research Fellow Dr Beverley Henley, and Professor Andrew Coogan, was published in the Journal of Sleep Research. The research team analysed data from over 38,000 Parkinson’s patients, gathered by the Michael J. Fox Foundation.

This comprehensive database

includes valuable insights into the patients’ experiences with Parkinson’s, as well as details on their mental health, cognition, and sleep patterns. The findings revealed that an overwhelming 84% of patients with Parkinson’s disease report struggling with sleep issues—significantly higher than the general population of the same age group.

PHARMACYNEWSIRELAND.COM

Professor Coogan said: “Sleep problems are a significant burden to quality of life in a number of chronic health conditions. Our study shows how important sleep is to address in Parkinson’s disease, one of the most common and debilitating brain diseases.”

The full study can be found here: https://onlinelibrary.wiley.com/ doi/10.1111/jsr.14453

The most effective action women aged 25 to 65 can take to prevent cervical cancer is to #ChooseScreening and come for follow-up appointments if advised. Women can go to any GP practice or clinic registered with CervicalCheck for their free screening test. Women do not need to be registered with a GP practice to request a screening test from them.

More than 4,000 healthcare professionals across the country provide CervicalCheck screening across a range of community and healthcare settings, including some of Ireland’s Sexual Assault Treatment Units (SATUs) and Limerick Female Prison. Connie McGilloway is an Advanced Nurse Practitioner and Forensic Clinical Examiner at the Donegal Sexual Assault Treatment Unit (SATU) in Letterkenny.

Connie said, “The need for the service is reflected in the fact that we have a higher-thanaverage number of women who have a subsequent referral for follow up in colposcopy. The reason for that could be lack of early detection, the fact they haven’t had a test before.

Women tell us afterwards if they knew they would be looked after that way during the test they would’ve had one earlier.”

CervicalCheck offers HPV cervical screening every three years to women and people with a cervix aged 25 to 29; and every five years to those aged 30 to 65 years. Cervical screening is for women who do not have any symptoms of cervical cancer. Never ignore symptoms of cervical cancer, speak to your GP, even if you have had a recent normal screening result.

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12

News

Axium Buying Group: 5 benefits of becoming a member Axium has grown to become Ireland’s largest independent community pharmacy buying group.

Serving over 590 independent pharmacies nationwide with ~30% market share, Axium is built on the support of a best-in-class team, all focused on the same vision of making pharmacy life easier for their pharmacy business partners.

Aisling Smith Head of Business Relationship Management 087 393 7073

Donegal

Philip Morrissey National Sales Manager 087 441 6072

Monaghan

Sligo Leitrim

In the increasingly complex world of community pharmacy, making business as efficient and cost-effective as possible is crucial. It was on this basis that pharmacist, John Carroll, founded Axium Buying Group in 2009, aiming to empower independent Irish pharmacies to thrive amidst challenges in the market.

Cavan

Mayo

Louth

Roscommon Longford

Meath

Westmeath

Galway

Dublin Offaly

What is Axium?

Axium is an established order management solution that provides speed and convenience to pharmacies when ordering dispensary medicines and consumables across a number of suppliers in the market, with the confidence that the products they are ordering are in stock and at the best possible price.

Kildare Wicklow

Laois

Clare Carlow

Tipperary Kilkenny

Limerick

Wexford

5 benefits of being an Axium member Joining Axium Buying Group offers numerous benefits for independent pharmacies, each designed to help make their business more efficient, protect margins, save time, and ensure competitive advantage.

Waterford

Kerry Cork

1. Buying power With the collective strength of over 590 retail pharmacists, Axium negotiates preferential pricing and discounts on ethical lines, generic lines and PIs. To streamline and maximise front of shop buying, Axium has a complimentary, electronic, front of shop ordering system – Axel where orders can be placed with multiple direct suppliers.

2. Improving efficiency Along with buying power and line level transparency on all purchases, one of Axium’s most attractive benefits is the improvement in operational efficiency it offers pharmacies.

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Maria Lettice Technical Product Sales Specialist Nationwide, 087 238 8873

Sarah Leadbetter Business Development Manager North Leinster Region, 087 393 7073

Jean Tomkins Business Development Manager Leinster Region, 087 183 7293

Clodagh Maguire Business Development Manager Connacht and Ulster Region, 087 091 2165

Paul Coleman Business Development Manager Munster Region, 087 687 8018

Axium leverages advanced IT systems to streamline ordering processes, making it easier and more efficient for pharmacies to manage inventory, saving valuable staff time in the process.

Axium supports customers with information in relation to upcoming manufacturer shortages and recommended alternatives and have recently developed an electronic back-order feature to assist pharmacy teams in sourcing stock as soon as it becomes available after a shortage.

Pack replacement ordering eliminates bulk buying, and all discounted and non-contract lines are set up on one platform, to provide a one-stop ordering system. A customer testimonial touches on this; “I particularly love the back-order facility, due to rising out of stock medication. The alerts option for back in stock products is a win/ win for the business - excess stock isn’t ordered and staff time is minimised constantly searching for out of stock medicine. This way, our customers are not without their medicine and the business is not dispensing at a loss by supplying ULM. I call it the “one stop shop”, as all can be purchased under the one frame ULM, Contract Lines, Ostomy and discounts applied.”

- Eleanor Hennelly McHale, MPSI. Staunton’s Pharmacy Castlebar.

3. Business Intelligence reporting Axium have significantly invested in iGnite, their Business Intelligence reporting solution. iGnite provides a pharmacy with significant savings by helping them analyse their lost opportunities for order savings, margin maximisation in dispensing behaviours and how to reduce claims errors.

Other benefits of iGnite BI reporting include: Margin maximisation - Monitoring ordering patterns - Identifying lost margin - Reviewing better margin options based on current dispensing Pre-claims analysis - Up-to-date potential claims losses - Opportunity to fix issues before they’re submitted at month end - Up-to-date with current PCRS guidelines for claiming Post-claims analysis - Identify partial payments from PCRS - Identify losses due to claiming errors 4. Transparency Net prices are displayed on invoice with full line level transparency on all purchases. Another customer testimonial attests to this: “The most important thing to me is Axium’s transparency on pricing – I get full line level transparency on all purchases I make, which gives peace of mind and saves time reviewing invoicing. Their product range on ethical lines, generics and parallel imports is next to none. I would highly recommend becoming an Axium member.”

David O’Connell – O’Connell’s Pharmacy, Borrisoleigh Axium innovate by fostering a collaborative approach with their members. They are always open to taking feedback on board, understanding challenges their members may be faced with and putting solutions in place to make

ordering easier, including in the case of stock outages, where a feature was developed based on feedback from pharmacies, so alternative lines are suggested.

Saving this time for the team means more time put back into delivering high quality patient care.

5. Relationship management support & customer service Axium prides itself on its high level of customer service, with a team of dedicated pharmacy technicians available to answer all your queries by phone from the Support Office, or online via an interactive chat function.

Axium understands the needs of busy pharmacies to receive the highest level of customer support, and have expanded their team on the road, all of whom have many years of expertise and are well known in the world of community pharmacy.

The team, pictured here on the Axium map of Ireland, regularly make face-to-face visits to Axium pharmacies and are dedicated to helping them achieve the highest procurement margins and operational efficiencies in store, while offering best-in industry levels of customer service.

Axium are holding a full day Claims training event in Dublin this month, in order to give back to the pharmacy community. This event has had huge interest so is fully booked for the February date, but keep an eye out on the Navi Group LinkedIn account for further Claims training events and locations.

Interested in joining Axium? email: customerservice@axium.ie or get in touch with one of our BDMs using their contact details in this piece.

MSc Pharmaceutical Technology & Quality Systems Applications are open for the Sept 2025 intake of the MSc in Pharmaceutical Technology and Quality Systems (QP Masters) programme at UCC. This part-time 2-year blended programme fulfils the educational requirements for QP status and is aimed at graduates who are planning a career as a Qualified person or in Quality Management.

Applications are open until all places are filled. Early application is advised as places are limited.

Further information and links to the application portal can be found on the programme webpage at www.ucc.ie For more details, contact Linda McGuire at l.mcguire@ucc.ie

Obesity Model of Care Dr Grace O’Malley from RCSI’s Obesity Research and Care Group has spearheaded RCSI’s participation in a World Health Organisation (WHO) visit to Ireland which examines the implementation of Ireland’s Obesity Model of Care and builds on the WHO framework for improving obesity care.

Dr O’Malley, who is a Senior Lecturer in RCSI’s School of Physiotherapy and Clinical Lead in the Healthy Living Service at Children’s Health Ireland (CHI), welcomed the WHO delegation to CHI’s service for complex obesity in children and young people.

Obesity is a critical global health challenge with severe implications for individuals and health systems. From 1990 to 2022, obesity rates among children and adolescents aged 5-19 years quadrupled from 2% to 8%, while adult obesity more than doubled from 7% to 16%.

The WHO visit to CHI highlighted the crucial role of multidisciplinary teams in delivering evidence-based paediatric obesity treatment, showcasing the CHI service’s key contribution to clinical care for vulnerable children and adolescents and describing the RCSI-led research aimed at understanding how to develop effective obesity care services for children and young people.

RCSI is the first university in Ireland to introduce mandatory obesity training for undergraduate medicine and physiotherapy students.

Since 2022, RCSI has delivered paediatric obesity training to more than 3,000 current and future healthcare professionals with over 8,000 hours of training completed to date. The training programme was developed initially as a Slaintecare initiative and receives funding annually from the Department of Health and the Health Service Executive.

This training aligns with the university's commitment to interprofessional education which helps prepare our students to deliver excellence in patient care in a multi-disciplinary environment, and with its dedication to UN Sustainable Development Goal 3 – good health and well-being.

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News

Mitigating Pharmacy Medicine Shortages The latest PGEU Medicines Shortage Survey underscores the persistent and significant impact of medicines shortages across Europe. Over the past twelve months, pharmacies have consistently faced high levels of shortages, with 61% of countries reporting that the situation has not improved compared to the previous year’s survey, which was an exceptionally high benchmark for shortages.

Clare Fitzell, PGEU President

This year’s survey highlights a concerning trend: the time pharmacists dedicate to managing medicines shortages continues to rise, with European community pharmacists now spending around 11 hours per week addressing this issue. This substantial demand on their time diverts resources from other critical healthcare services but remains essential to ensure patients receive the care they need.

Pharmacists’ efforts to mitigate the impact of shortages include

counselling patients on available alternatives, sourcing and procuring alternative medicines, collaborating with prescribers to identify suitable options and negotiating reimbursement with payment agencies for alternative treatments.

Leveraging Pharmacists’ Expertise Clare Fitzell, PGEU President, announced, “We reached a steady state that is unacceptable for patients, pharmacists and

prescribers – shortages are not getting worse, but also are not resolving. Behind every medicine shortage is an anxious patient and their diligent pharmacist trying to seek alternatives and solutions.

Some countries have facilitated pharmacists through their legal framework to find a greater range of solutions for patients, such as generic substitution and therapeutic substitution, which provides for a timelier solution for patients and harnesses the expertise of pharmacist. This is one of the important measures we have put forward for consideration in our latest position on proactive measures to address medicine shortages.”

Policy Progression to Expand Roles for Pharmacists In 2024, one-third of European countries enacted legislation granting pharmacists greater flexibility to combat medicines shortages. These new powers include adjusting dosages and formulations, compounding medicines, and performing therapeutic substitutions.

Additionally, 20% of countries are actively developing legislative initiatives to further extend pharmacists’ responsibilities, enabling them to manage shortages more effectively and expand their scope of practice.

Clare highlighted the importance of ongoing policy initiatives and urged countries to expedite their implementation. She said, “Pharmacists can do so much more if they are provided with the necessary tools, opportunities, and resources. This requires greater transparency and information sharing across the supply chain; robust reporting mechanisms; enhanced professional competencies; and financial measures to offset the economic impact on pharmacies.

The ongoing EU-level initiatives present a pivotal opportunity to strengthen the resilience of the medicines supply chain.

“We urge the European Institutions and Agencies to swiftly advance policies that ensure the safe and reliable supply of medicines for all European citizens. We look forward to progress on the Reform of the EU General Pharmaceutical Legislation, the work of the European Medicines Agency, and the adoption of the Critical Medicines Act.”

Genome for Ireland Project The Minister for Health, Jennifer Carroll MacNeill, has announced the establishment of a Genome of Ireland research project and Ireland’s participation in the Genome of Europe to advance disease prediction and prevention. The Genome of Ireland will establish a genomic dataset of at least 1,200 individuals living in Ireland.

Ireland’s participation in the Genome of Europe is an important collaboration towards creating a bigger European genome repository for population genomic studies towards advancing medical research and improving public health. A genome is the complete set of genetic information in an organism, providing all of the information the organism requires to function. In living organisms, the genome is stored in long molecules of DNA called chromosomes.

The Genome of Europe project will enable groundbreaking medical research that improves diagnosis

and treatment, and advances personalised medicine, disease prediction, and prevention. It will also support public health policy measures, for example, for rare diseases and cancer. The project encompasses 49 partner institutions across 27 European countries and has a total budget of almost ¤45 million, out of which ¤20 million is funded under the Digital Europe Programme.

Minister for Health, Jennifer Carroll MacNeill, said, “This will help bring in a new era of smarter, more targeted treatments that make full use of advances

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in genomics, leveraging the innovations that are arising from the biotechnology revolution.”

Ireland’s genomic data will be aggregated with that of other countries at European level, making it one of the world’s most comprehensive genomic endeavours to-date. The wider European project will offer a unique data resource that will redress the fragmentation in genetic information across Member States, including Ireland.

The Department of Health is fully committed to supporting this Europe-wide initiative and is

providing funding via the Health Research Board (HRB) who are supporting the RCSI University of Medicine and Health Sciences for delivery of the Genome of Ireland project.

CEO of the HRB, Mairead O’Driscoll, added, “This is one of the world’s most comprehensive projects of its kind. The mapping of 100,000 genomes will help diagnostic technologies to stratify patients, creating targeted therapies and individualised medicines to act on specific biological features of disease in each individual patient.”

Advertorial content - Latest clinical trial data for Adex Gel

Adex Gel has been shown to improve atopic eczema from moderate to mild in 2 weeks without corticosteroids1 Summary of trial results In a recent trial of children with moderate atopic eczema, conducted in NHS GP practices (to reflect real-life settings), the mean disease severity score (SCORAD) improved significantly: • from 37.14 (moderate atopic eczema) at baseline • to 22.56 (mild atopic eczema) after 2 weeks • and to 18.48 (mild atopic eczema) after 4 weeks, per protocol analysis of 41 children.

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Adex Gel is an emollient with an ancillary anti-inflammatory, nicotinamide 4%, to help reduce inflammation.

Adex Gel can be used continuously, for as long as necessary, all over the body including on the face, hands and flexures. Available on NHS prescription and suitable for patients aged 1 year+.

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SCORAD SCORE

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Mean SCORAD – Per Protocol Analysis 45

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Adex Gel

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0

Baseline

Week 2

Week 4

Baseline (N=41) Week 2 (N=40) Week 4 (N=41) Mean

In addition, the mean children’s dermatology life quality index score (CDLQI) improved significantly from 9.3 (moderate effect on child) at baseline, to 3.7 (small effect on child) after 4 weeks.

Application of Adex Gel in the trial Three times daily, for 4 weeks, instead of usual emollient or as the first-line treatment for moderate atopic eczema, in both scenarios, without supplementary use of any oral or topical steroids or immunomodulators.

Adex Gel has been shown to be an effective treatment for moderate atopic eczema in children in a real-world setting.

SCORAD is a tool used in clinical trials to assess atopic dermatitis severity based on disease area, intensity and subjective symptoms (itch and sleeplessness). The CDLQI is designed to measure the impact of any skin disease on the lives of children.

SCORAD Score

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Product name: Adex™ Gel. Key ingredients: Isopropyl myristate 15%, liquid paraffin 15%, nicotinamide 4%. Uses: Highly moisturising and protective emollient with an ancillary anti-inflammatory medicinal substance for the treatment and routine management of dry and inflamed skin conditions such as mild to moderate atopic dermatitis, various forms of eczema, contact dermatitis and psoriasis. Package sizes: 100g tube and 500g pump pack. Further information is available from: Dermal Laboratories Ltd, Tatmore Place, Gosmore, Hitchin, Herts, SG4 7QR, UK. ‘Adex’ is a trademark.

SCORAD, SCORing Atopic Dermatitis.

Scan for Adex Gel essential information and adverse event/incident reporting.

CDLQI, Children’s Dermatology Life Quality Index.

Reference: 1. Gallagher J. et al. Evaluation of a nicotinamidecontaining emollient for moderate atopic eczema in paediatric patients: A prospective, multi-centre GP study reflecting real-life settings.

Data presented at the Annual Meeting of the Austrian Society of Dermatology and Venereology (ÖGDV), November 2024, Graz, Austria.

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Adverse Events/Incidents should be reported. Reporting forms and information for the UK can be found at yellowcard.mhra.gov.uk, and for the Republic of Ireland at www.hpra.ie. Adverse Events/Incidents should also be reported to Dermal.

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AMD

Awareness Month: Age-Related Macular Degeneration Pharmacists cannot stop the progressive loss in central vision that comes with age-related macular degeneration, but they can help patients understand the treatment options. degenerative condition characterised by abnormal blood vessels that grow underneath the retina. The condition gets worse as these faulty blood vessels leak fluid in the back of the eye. This may lead to swelling and damage of the macula, the part of the retina that lets you see colour and maintain sharp vision.

A healthy retina is a dry retina. If this fluid isn’t controlled, central vision will gradually get worse, leading to difficulty doing everyday activities such as reading, recognising faces and driving.

The leaky blood vessels are caused by an excess of a tiny protein called vascular endothelial growth factor (VEGF). Most eye doctors agree that the best way to control these tiny proteins is with an anti-VEGF treatment.

Treatments that help control fluid and stop blood vessels from leaking may slow the progression of wet macular degeneration.

What are the symptoms?

• Gaps or dark spots (like a smudge on glasses) may appear in their vision, especially first thing in the morning. Objects in front of them might change shape, size or colour or seem to move or disappear.

• Colours can fade.

Age-related macular degeneration (AMD) is a chronic disease leading to progressive central vision loss.

The symptom of central vision loss is due to the fact that the damaged macula is in the centre of the retina. Patients with AMD may be unable to recognise faces, read, or drive a vehicle.

AMD is the most common cause of sight loss in people over the age of 50 in Ireland and it's estimated that 7% of Irish people over 50 years of age are living with AMD. On account of our ageing population, the number of people in Ireland affected by this condition is expected to increase.

Symptoms of AMD include decreased central vision, central scotoma, and metamorphopsia.

Scotoma is an area of partially diminished vision surrounded by a field of normal or well-preserved vision. Metamorphopsia is a visual defect that causes people to see objects in a distorted manner; straight objects appear wavy or curvy. Patients will complain of distorted vision, lack of bright colours, or blurred vision.

There are 2 types of macular degeneration: dry and wet. All AMD begins as “dry.” In some cases, it progresses to “wet,” which is a more severe form characterised by abnormal blood vessel growth that produces fluid in the retina. Wet age-related macular degeneration (wet AMD) is the leading cause of severe vision loss and legal blindness in people over the age

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of 65 in North America, Europe, Australia and Asia.

Dry macular degeneration, also known as the nonexudative form, is more common and found in approximately 90% of AMD patients. The onset of dry AMD is subacute. Management of dry AMD includes attempts to prevent progression to and frequent monitoring for the development of wet macular degeneration Wet (also known as exudative or neovascular) macular degeneration occurs in about 10% of AMD patients. It is the more acute form and more likely to cause vision loss.

Wet AMD (age-related macular degeneration) is a chronic,

• Sufferers may find bright light glaring and uncomfortable or find it difficult to adapt when moving from dark to light environments.

• Words might disappear when they are reading.

• Straight lines such as door frames and lampposts may appear distorted or bent.

In Dry AMD symptoms are often mild, such as needing stronger glasses or better lighting for reading. When progression to Wet AMD occurs, the patient may notice the onset of blurring of reading vision with distortion (due to fluid or blood under the macula). Sometimes patients are unaware until they take a moment to cover or close one eye at a time. At this stage, the progression can be rapid and patients should seek help promptly from their eye doctor.

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AMD

Amsler Grid

or distorted, e.g. a doorframe.

If you see a smudge, gaps or dark spots appearing in your field of vision, or have difficulties in reading small print, even with glasses, or difficulty in recognising faces, it is recommended to make an appointment with an eye doctor, optometrist or GP as soon as possible.

An Amsler Grid is a simple test designed to pick up symptoms of Wet AMD. However, it is not a substitute for an eye examination.

The patient checks each eye separately with reading glasses on. If they notice new blurring or distortion of the lines on the grid this could indicate the presence of Wet AMD and they should be examined promptly by their eye doctor.

2. Risk groups: People over 50 should have a regular eye exam (every 2 years or as directed by the doctor). If you have fair skin, light eyes, high blood pressure, or have been exposed to prolonged periods of sunlight, then you should also have regular check-ups.

Causes The exact cause of AMD is unknown. However, extensive research efforts over the last decade are playing an important role in uncovering some of the clues as to what may be causing the disease.

Researchers know that certain genes can cause AMD, but they don’t know what triggers the gene. While AMD can be inherited, many lifestyle choices can make progression of the disease worse.

Some risk factors that are believed to increase the chances of developing AMD include being over the age of 50 and having a family history of AMD. Having high blood pressure, a poor diet or being overweight are also thought to be risk factors for this condition.

immediately. A healthy lifestyle may help prevent AMD. This includes not smoking, eating a healthy diet, and being physically active.

Following the recommended guidelines and the use of appropriate pharmacologic agents may help patients with AMD slow

Because the exact causes of AMD are not yet known, some people may develop AMD even in the absence of these risk factors.

Age-Related Studies (AREDS1 and AREDS2) have shown that a combination of vitamins and antioxidants may help reduce the risk of progression of Early AMD to late-stage AMD. The recommendations include supplements containing vitamins C and E, zinc, copper, lutein and zeaxanthin.

Treatment for Wet AMD is most often through a series of injections into the eye using a drug called anti-VEGF (anti-vascular endothelial growth factor). This treatment works by reducing the growth of new blood vessels.

Response to this treatment is usually better in the early stages of Wet AMD, although even later stages can be stabilised. In some cases, individuals may notice improvements in their vision.

It is important to remind patients at risk for AMD to have regular eye exams, even when they are symptom-free. Patients complaining of a recent or chronic loss or change of vision should be urged to see an ophthalmologist

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vision loss progression, increase visual acuity, and experience a greater quality of life.

Knowing the symptoms and signs to be aware of: 1. Symptoms: look out for straight lines appearing wavy

3. Healthy diet: eat a diet low in saturated fats and rich in omega 3 fatty acids (oily fish and walnuts). Green, leafy vegetables (spinach and kale) contain antioxidants, eggs and yellow/orange-based fruit contain nutrients such as lutein, zeaxanthin and beta-carotene – all work to protect the macula.

4. Vitamin supplements: certain nutritional supplements containing vitamins C and E, zinc, copper, lutein and zeaxanthin can slow down

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the progression of AMD in people already showing signs of the condition.

5. Get moving and stop smoking: every week we should engage in 150 minutes of medium-level activity such as brisk walking, swimming and light jogging.

Smoking poses a significant risk for AMD especially in women.

Latest Research An innovative new EU research project called I-SCREEN will help with early detection of age-related macular degeneration (AMD), the most common cause of severe vision loss in individuals aged 55.

The I-SCREEN project will pioneer an AI-based programme to identify and monitor age-related macular degeneration (AMD) at its earliest stages.

Further information resources:

Utilising the precision of AI, the project aims to revolutionise AMD care by introducing a unique AI-powered platform compatible with optical coherence tomography (OCT) scanners found in highstreet optometry practices. This approach will empower Primary Care Optometrists to diagnosis AMD earlier and facilitate more timely treatment by efficient referral to secondary care.

• The Irish College of Ophthalmologists www.eyedoctors.ie

Bringing together twelve partnering institutions from across Europe, including Queen’s University Belfast, I-SCREEN will receive more than EUR 4.7 million from the European Innovation Council’s (EIC) Pathfinder programme over the next four years.

• The Macular Society www.macularsociety.org

Leading the project in Belfast is Dr Ruth Hogg from the Centre for Public Health at Queen’s University Belfast. Dr Hogg, along with researchers from Northern Ireland Clinical Research facility, will recruit a cohort of patients with intermediate AMD to follow for two years to identify the earliest stage of transition to late AMD which will help refine the AI models that could be used in the community.

• Retina International also has an international AMD toolkit on their website

Commenting on the importance of this research project, Dr Ruth Hogg said: “AMD poses a significant healthcare challenge, often slipping under the radar until severe vision loss occurs. The I-SCREEN project is dedicated to addressing this silent threat, leveraging AI and cloud technology together with imaging devices and expertise within Optometry to make early AMD detection and treatment accessible to citizens from their local high street.”

I-SCREEN Coordinator Professor Ursula Schmidt-Erfurth from Medizinische Universität Wien highlighted the key objective of the project: "In AMD, as a population-wide burden, early detection resulting in timely treatment and a wide access to care is paramount. It is our responsibility in healthcare to combine forces in respect to human expertise and technology to provide life-long vision for the entire society."

The I-SCREEN project is made possible through the collaboration of a multidisciplinary consortium.

This consortium brings together a network of clinical retina experts, computer scientists working at the cutting edge of AI development, an infrastructure of community-based opticians/optometrists, and business specialists experienced in clinical decision support systems for ophthalmology.

News Six-Year Plan for National Suicide Research Foundation Expanding real-time suicide surveillance nationally and globally, implementing the ongoing delivery of high-quality impactful research and ensuring that the research undertaken by the National Suicide Research Foundation (NSRF) continues to inform policy and practice are amongst the strategic aims and ambitions of the new NSRF Strategic Plan (2025-2030): Leading Research, Shaping Change, launched today in University College Cork (UCC).

The NSRF is a centre for excellence nationally and internationally in the field of suicide and self-harm prevention. The development of this strategic plan sets out key priority areas and research topics to guide the NSRF over the coming six years.

The strategy outlines the NSRF’s revised vision, mission and values, building on the consistent and high-impact work by the NSRF since its establishment in 1994, which is to support the reduction of suicide and self-harm in Ireland and globally, through impactful research. The strategy has been coproduced in consultation with key stakeholders and research partners, including those working in policy and those with lived experience of suicide and self-harm.

The strategic plan outlines five key priority areas to guide the research activities of the NSRF over the

coming year. These are: • Research Excellence - Build, strengthen and lead excellent research with integrity, involving innovative, impactful, open and engaged research.

• Surveillance - Further develop data systems and champion the role of monitoring of self-harm and suicide.

• Impact - Inform policy, practice and perspectives on suicide prevention by strengthening and expanding the impact of our work.

• Communication - Increase the impact of NSRF’s research through dissemination and communication.

• Organisational Strength - Ensure that the NSRF is well-resourced. Flexible and strategically positioned.

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The strategy will support the ongoing activities of the NSRF in leading out on key research across a number of areas, including upstream approaches to suicide prevention, life course epidemiology, workplace mental health, social determinants of suicide and self-harm, postvention and suicide bereavement, education and training, service improvement and evaluation, and surveillance and real-time data.

In 2023, the NSRF and UCC entered into a formal Memorandum of Collaboration. This Memorandum of Collaboration supports a vision of enhancing and sustaining capacity, knowledge and quality in research and policy development into suicide, selfharm and related mental health and social factors. It will improve cohesion and integration between the different research and work streams in both organisations,

reducing fragmentation and improving the potential for greater research innovation and joint positions. The goal is to develop a leadership role in interdisciplinary collaboration in mental health and suicide prevention research at national and international level.

Dr Eve Griffin, Chief Executive Officer, National Suicide Research Foundation, Adjunct Professor, School of Public Health, University College Cork, said: "This strategic plan, leading research, shaping change, provides a roadmap for the NSRF and our collaborators, to continue to deliver research which is impactful and transformative for the prevention of suicide in Ireland and globally. The strategy is underpinned by collaboration, and we are committed to generating evidence which is co-produced by a range of partners and collaborators and with people with lived experience."

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Health Reform needed to integrate Pharmacy Health system reforms to further integrate the community pharmacy sector are required to strengthen Ireland’s pandemic preparedness, according to new research conducted by health policy analysts from Trinity College Dublin.

Aaron Koay, PhD Scholar in Population Health & Human Factors, Trinity College Dublin

Legislative changes to expand pharmacists’ roles, particularly during public health emergencies, are among the recommendations outlined in the new research published in the journal Qualitative Health Research.

The researchers also called for improved IT integration between pharmacies and the health system to facilitate the sharing of patient records.

The retrospective analysis of Ireland’s National COVID-19 Vaccination Programme involved stakeholder engagement, the review of 246 documents as well as interviews with eleven senior policy makers in the government and various parts of the health system.

Lead author Aaron Koay, who conducted the research while undertaking an MSc in Comparative Social Change in the School of Social Sciences and Philosophy in Trinity, explained:

“During the height of the COVID-19 pandemic, community pharmacies became the epicentre of primary care in Ireland when most health services, including GPs, switched to remote care.

“However, unlike some other high-income countries, community pharmacies in Ireland were involved relatively late in the COVID-19 vaccination programme – four months after GPs were engaged. This delay was even more puzzling since community pharmacies in Ireland had been providing various vaccination services for almost a decade, including the annual flu vaccine.

“Our research identified differing views on the reasons why there was such a delay in community pharmacists providing COVID-19 vaccination. Some attributed it to regulatory and logistical challenges, while others cited perceived doubts about the capability of community pharmacies to effectively and safely vaccinate the public.

“The study also highlights the lack of strategic direction within the pharmacist profession and lack of influence on national health policy — for example the Chief Pharmacy Officer post in the Department of Health has been vacant since 2013 and no pharmacy representative was present on the High-level Task Force on COVID-19 Vaccination.”

The research publication comes at a time when there is an important window for policy changes, according to the authors, with the formation last year of a review panel to evaluate the Government’s COVID-19 response.

The missed opportunity to engage community pharmacies earlier in providing COVID-19 vaccination to save lives should be part of the evaluation, advise the authors.

While the Irish Government has recently committed to expanding the role of pharmacists in Ireland, the authors also cautioned against complacency because, as this research reveals, policy implementation can be obstructed or delayed.

Pharmax: Transforming Pharmacy Operations with Unmatched Benefits Simplified and Quicker Ordering with Pharmax Pharmax.ie has enhanced its platform, streamlining how front of shop products are ordered, making the process quicker and easier for independent pharmacies. Designed by United Drug, Ireland’s leading pharmaceutical wholesaler, Pharmax is a compliance-based, best-in-class buying group focused on empowering pharmacies with the tools they need to thrive.

Why Choose Pharmax?

Pharmax offers retail pharmacies competitive pricing, enhanced purchasing power, and access to an extensive range of products and promotions. By leveraging the local expertise of United Drug and the global scale of the PHOENIX group, Pharmax ensures members benefit from best-in-class pricing and improved margins across high-volume medications and retail products.

• Next-day delivery and pack replacement ordering.

• Access to an extensive portfolio of over 3,000 products.

• Improved margins through competitive pricing and promotional offers.

Addition of Profitlines Plus

Pharmax delivers a range of exclusive benefits to its members, including:

Pharmax members can now take advantage of Profitlines Plus, a new solution that streamlines the buying process. This integrated system brings together over 3,000 Consumer and Wholesale products, offering:

• Best-in-class pricing across a wide range of products.

• A comprehensive range of category-leading promotions.

Exclusive Member Benefits

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• Simplified front-of-shop ordering.

• Additional discounts through rebates applied on statements.

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24

News

Nominations open for Registered Pharmacist Appointments to PSI Council Registrar Joanne Kissane encourages registered pharmacists to consider nomination; Five positions for pharmacists will be available Registrar and Chief Officer of the PSI, Joanne Kissane

Council is made up of people from a variety of backgrounds who come to serve on the Council via a variety of routes. The process of selecting pharmacist members, who make up 10 of the 21 members, is prescribed in legislation.

There will be five pharmacists completing their current terms as Council members with the PSI in June this year. The nomination process to appoint new pharmacist members is now open.

Registrar and Chief Officer of the PSI, Joanne Kissane, herself a pharmacist and former Council member, encourages PSI registered pharmacists interested in making a public service contribution to consider

the information available about the role. The nomination period is open until midday on Wednesday, 19 March.

The PSI Council is the governing body of the regulator. The 21 members, all appointed by the Minister for Health in the public interest, are collectively responsible for the delivery and implementation of the regulator’s strategy and for ensuring that the PSI fulfils its statutory remit. The

The PSI is keen to see that the Council is representative of society, which in turn is reflected in the diversity of the Pharmacist Register, which currently stands at over 7,700 pharmacists.

The Council has recently approved its strategy for 2025-2028. The Council will oversee the delivery of this strategy and the work of the PSI during what will be a period of significant change for pharmacy and the healthcare landscape.

Amongst other things, expanded scope of practice as well as digital health changes are on the agenda.

It is imperative that the Council has the expertise, experience and objective scrutiny available

to support decision-making that places patient and public safety at its centre, while stewarding the ongoing evolution of the ways that PSI meets its regulatory functions.

The vacancies occurring for pharmacist members are those currently held by Mr. John Given, Ms. Katherine Morrow, Mr. Rory O’Donnell, Ms. Marie Louisa Power and Mr. Sean Reilly, whose terms of office end on 20 June 2025.

Interested pharmacists will find information about the role of a Council member, criteria for appointment and the nomination form on the PSI website, www.psi. ie. Nominees and their proposers must be on the PSI Register of Pharmacists.

An election will be held on 16 April if the nominations exceed the five vacancies available. All registered pharmacists are eligible to vote in the election and will be issued a ballot paper by post in early April.

Pharmacists are encouraged to check that their postal address is up-to-date on the PSI Registration Portal (https://registrations. thepsi.ie/) in order to receive their election post. https://www.psi.ie/news/callnominations-appoint-pharmacistmembers-council-psi-0

Health in Ireland Key Trends 2024 Minister for Health Jennifer Carroll MacNeill TD has published Health in Ireland Key Trends 2024.

The annual publication illustrates the significant improvements in health outcomes in the past decade and highlights some of the challenges in the access of timely and efficient healthcare.

Minister Carroll MacNeill said, “Our population is growing, and we are living longer healthier lives.

With our average life expectancy now at 82.6 years, the fifth highest in the EU, we need to continue to focus on the future demands for health care.

“The Key Trends report shows our health service is one that continues to deliver better results for the people of Ireland, in some cases among the best in Europe.

“We are in the midst of the greatest expansion in the Irish health service in the history of the State. Spending on health has almost doubled between 2014 and 2023, and this is reflected in the enhanced availability of services all over the country, and in improved outcomes for many health conditions.

“The information contained in Key Trends is very useful in helping us to monitor the impact of our policies which protect and promote the health of the nation, as well as to keep focused on making improvements as we plan for the future.”

PHARMACYNEWSIRELAND.COM

Highlights from the publication, which covers demographics, population health, hospital and primary care, health sector employment and expenditure, include: • The number of people in Ireland who reported their health as being good or very good (79.5%) in 2023 was the highest in the EU, well above the EU average of 67.7%. Ireland also had the highest rate of self-perceived good health in 2022 • Life expectancy in Ireland is fifth highest in the EU, at 82.6 years • The population has grown by 14.8% since 2015, with the over

65s group increasing by 36.5% between 2015 and 2024 • Between 2014 and 2023, the mortality rate from cancer fell by 14.7%, the mortality rate from circulatory system diseases fell by 19.5%, the mortality rate for ischaemic heart disease fell by 27.7% and the mortality rate from respiratory system diseases fell by 15.4% • The proportion of total health expenditure paid for either out-of-pocket or through private health insurance has been reducing in recent years; the government funded 77.4% of total health expenditure in Ireland in 2023

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26

Eczema

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

Written by Barbara Paldus, CEO, Codex Labs Corp

was included to meet USA FDA OTC Monograph M016.

The plant-biotech stem cells selected to repair and fortify the skin barrier include: • Calendula officinalis: antioxidant, anti-inflammatory and wound healing benefits2 • Symphytum officinale: allantoin promotes desquamation; rosmarinic acid increases ceramide formation3 and inhibits itch-causing S. aureus The researchers explore Conventional AD treatments include topical corticosteroids alongside skincare routines with emollients/moisturizers and gentle cleansers. Integrative dermatology considers the role of the skin-gut axis in AD: in addition to topicals, it also addresses gut dysbiosis and systemic inflammation.

Eczema Skin-Gut Axis Increased intestinal permeability (IP) is also known as leaky gut.

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

Studies have found that children with AD have increased IP, and one study reported a correlation between a marker of increased IP and the Scoring Atopic Dermatitis (SCORAD) index.1 Novel Biotech topical treatment for AD The topical regimen discussed here consists of Bia™ unscented soap and Bia eczema relief lotion, made with the patented biotech BiaComplex 2.0.

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

BiaComplex 2.0 is comprised of plant stem cell extracts as well as hyaluronic acid and NP ceramides. 1% colloidal oatmeal

• Haberlea rhodopensis: myconoside stimulates extracellular matrix synthesis4 • Padina pavonica thallus: laminarins and alginic acids moisturize and support wound healing.5 The use of sunflower oil as a carrier enables the bioactive compounds to penetrate skin without synthetic penetration enhancers. Its high concentration of linoleic acid (>60%) helps maintain skin barrier integrity, serves as an emollient, and reduces TEWL. It is safe for those with tree nut allergies, which are common in AD. Treatment of Pruritus Inflammatory skin disorders such as AD are also characterised by intense pruritus, leading to significant discomfort and distress. Particularly in children, interleukin-13 (IL-13), a cytokine that regulates immune responses and inflammation, can promote intense itch. Research has shown that elevated levels of IL-13 are present in the skin of individuals with AD.6 Gene expression studies of the BiaComplex 2.0 applied to epidermal tissues demonstrated downregulation of IL-4 cytokine genes that can activate IL-13, thereby reducing itching.7 Novel Anti-Inflammatory Oral Treatment for AD L-histidine, an amino acid, supports skin barrier integrity through filaggrin formation and has

PHARMACYNEWSIRELAND.COM

been found to significantly reduce AD severity and flare-ups: children taking 0.8 grams of L-histidine daily for 12 weeks experienced 49% reduced AD severity;8 adults taking 4 grams of L-histidine daily for 8 weeks experienced 34% reduced AD severity.9 The Antü Skin Barrier Support supplement combines 4 g of L-histidine and three antioxidant, gut barrier supporting plants (M3Complex): • Matico (Buddleja globosa): stigmasterol helps protect gut mucosa and reduces gut inflammation10 • Maqui (Aristotelia chilensis): anthocyanins and flavonoids help neutralize free radicals • Murta (Ugni molinae): gallic acid, quercetin, and kaempferol enable strong antioxidant activity against lipid peroxidation.

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

M3Complex is an effective option for reducing gut and systemic inflammation in AD. Clinical Test Results Two clinical trials were performed at Eurofins in Poland. The results are comparable to corticosteroids (e.g. triamcinolone

or betamethasone) and have been submitted for publication.

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

By day 56, in 100% of subjects, SCORAD decreased by 99% (p < 0.0001) and pruritus decreased by 93% (p < 0.0001) compared to day 0 baseline. All skin parameters improved by day 56: 78% hydration increase, 40% TEWL decrease, and 65% desquamation index decrease.

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

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

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

References available on request

28

News

New Brand Ambassador for AYA AYA, the leading Irish vitamin and supplement brand for all the family, is delighted to unveil Anna Geary as its new Brand Ambassador for 2025.

Anna Geary, AYA Brand Ambassador for 2025

Day, this is a potent powerhouse multivitamin bursting with 40 vital vitamins and minerals to meet the complex demands of modern life.

Containing all your vitamin Bs for energy, Vitamin C for immunity and Vitamin D, which is essential for anyone who lives in Ireland as we don’t get much sunshine during the winter months’’.

As an experienced broadcaster, wellness and fitness expert and mum of one, Anna enjoys a busy lifestyle and relies on her AYA vitamins and supplements to help her to stay well, support her immunity, and give her the energy she needs to live life to the full. And she ensures her family take AYA supplements regularly too, meeting their nutritional requirements every day.

Anna’s Brand Ambassador work with AYA will see her supporting some exciting new product launches, creating social media content to promote the brand, and attending events throughout the year.

Anna Geary, comments on AYA Brand Partnership, “I’m excited to be partnering up with the Irish brand, AYA. When it comes to developing health & wellbeing habits that last, I believe it’s far easier to ‘add things in’ rather than to ‘cut things out’. Adding in AYA supplements is an effective way to help meet my nutritional needs, with minimum fuss. They offer a wide range of vitamins for all my family needs. I have been taking AYA supplements for years because they are a trusted brand that work, and their supplements help to boost my immune system, energy levels and overall health. My go to AYA product is the Ultimate One a

AYA is committed to delivering only the highest quality food supplements and vitamins to support health and well-being for all the family. The range of 50 products caters for all your family’s needs. Exclusive to Irish pharmacy AYA is widely available across the country including Allcare Pharmacy, Life Pharmacy, Hickeys Pharmacy, McCauley Pharmacy, and other leading Groups and Independent Pharmacies, where staff are trained to give advice and guidance on appropriate products.

AYA’s research-backed products are formulated by scientists to deliver noticeable health benefits to customers and are gluten-free and vegan-friendly or vegetarian.

The distinctive blue bottles of AYA’s adult range reflect the iconic apothecary of the old world, with contents that have been formulated based on the latest cutting-edge research.

Promoting Research in Pharmacy The FIP Academic Institutional Membership (AIM) has published a new report titled “Promoting research and postgraduate education in pharmacy and pharmaceutical sciences” to mark the International Day of Education.

Gathering insights from 24 experts, the report highlights 50 evidence-based initiatives that have successfully improved postgraduate enrolment, research quality and career pathways.

The report offers actionable strategies and resources for academic institutions. It emphasises partnerships with stakeholders, the importance of a research-driven culture, and the need to adapt to evolving global pharmaceutical trends.

“This report supports the FIP Education vision of equitable access to transformational change in pharmaceutical education and training that advances pharmaceutical practice and sciences to improve global health. It is a vital contribution to enhancing the scale and scope of pharmaceutical research for the decade ahead,” said John Pieper, FIP Education Chair.

PHARMACYNEWSIRELAND.COM

WHO Platform on Obesity The Minister for Health, Jennifer Carroll MacNeill, has reaffirmed Ireland’s commitment to reducing the prevalence of overweight and obesity in Ireland, which will lead to improved health outcomes for many people.

She was speaking as she welcomed the World Health Organisation team for Special Initiative for Non-Communicable Diseases and Innovation, and international delegates from Portugal, Slovenia and Spain to Dublin for a unique Demonstration Platform for the prevention and treatment of obesity.

The three-day event is being co-hosted by the Department of Health, the Health Service Executive and the WHO Regional Office for Europe. It is designed to support countries to work together to strengthen the management of obesity in the WHO European Region, in line with the UN Sustainable Development Goals.

Research shows that globally obesity is the fourth highest risk factor for diseases such as cardiovascular disease, diabetes and many forms of cancer.

The Demonstration Platform will examine Ireland’s policies to address obesity, and will focus in particular on the HSE Model of Care which was developed under the current Obesity Policy and Action Plan 2016-2025 (OPAP) and is currently being implemented. Ireland’s model was chosen as a study for optimum health care delivery as it describes practical, scalable solutions for organising care, enhancing staffing resources, and optimising treatment for patients.

Minister Jennifer Carroll MacNeill said, "It is a great honour that Ireland has been chosen to host this important Demonstration Platform, providing an opportunity to highlight the extensive programme of work underway to address obesity.

We know that adverse health outcomes from obesity have a huge impact not only on the lives of people living with obesity, but also on our health services and the wider economy.

Our government is committed to addressing this in order to protect and improve long-term population health.”

30

Podiatry

OTC Management of Foot & Leg Conditions Irish Pharmacy News recently spoke with Joe Egan from , to learn more about the common foot and leg conditions patients may present to their local pharmacy with.

Joe Egan, Lead Podiatrist, Priory Foot Clinic

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

Joe is the Lead Podiatrist with the Podiatry Clinic and a Finalist at the 2024 Hospital Professional Honours for the MedFind Sourcing Solutions Innovation and Service Development category.

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. Podiatrists are health care professionals who are Coru Registered.

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.

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 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.

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.

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 some extent that’s true, there are still warning signs that good pharmacists should

There are many different types of foot ailments that Podiatrists treat including athlete’s foot, bunions, arthritis, and Achilles tendonitis.

PHARMACYNEWSIRELAND.COM

take note of and refer on to a GP or podiatrist, along with effective support and treatment for feet and leg conditions. A list of all Coru Registered Podiatrist can be found at www.PodiatryIreland.ie Those at Risk Some people are more likely to experience pain in their feet and lower leg than others. Risk factors include: • 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.

• 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, 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

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32

Podiatry

or friction. Problems can be prevented by wearing well-fitting shoes and using protective gel pads or strips to reduce pressure.

Joe Egan Podiatrist at Myfeet. ie says that many of these issues are very treatable and that, your podiatry team is very important to look at you holistically and treat accordingly for your foot and leg problems.

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.

Customers can choose between fungicidal products that kill the fungus and fungistatic products, which slow down its growth until it stops. Lamisil Cream offers effective relief from Athlete’s foot.

• Use an antifungal product.

After washing and drying the feet, apply an antifungal product.

The antifungal terbinafine such as Lamisil which has been shown to be very effective.

Lamisil offers two treatment options – Lamisil AT, a 7-day treatment, and Lamisil Once, a single-application solution for convenience. Both contain terbinafine, which is up to four times faster in treating athlete’s foot compared to azole-containing products. By effectively targeting the fungus, Lamisil helps relieve symptoms and prevent recurrence, making it a trusted choice for fast and effective treatment.

• Change socks regularly.

Change socks at least once a day — more often if feet get really sweaty.

Trusted by those seeking relief from fungal skin infections, Lamisil Cream provides convenient and targeted treatment for affected areas. With its easy-to-use cream formulation, it ensures thorough coverage and absorption, promoting healing and restoring skin health.

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. CCS Cracked Heel Repair is an effective option.

Formulated with 25% moisturebinding urea and lactic acid (AHA) for gentle exfoliation, it works to restore smooth, healthy skin. It is often recommended by Podiatrists.

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 Athlete’s foot is contagious via skinto-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.

A low-potency steroid cream may be recommended if the skin is very sore.

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.

These tips can help ease the symptoms of Athlete's foot or avoid a recurrence: • Keep feet clean and dry. Wash feet twice a day and gently towel-dry between the toes.

PHARMACYNEWSIRELAND.COM

• Wear light, well-ventilated footwear. Avoid shoes made of synthetic material, such as vinyl or rubber. Wear sandals when possible to let feet air out.

• Alternate pairs of shoes. Use different shoes from day to day.

This gives shoes time to dry after each use.

• Protect feet in public places.

Wear waterproof sandals or shoes around public pools, showers and lockers rooms.

• Try not to scratch the rash.

Sufferers can try soothing itchy feet by soaking them in cool water.

• Don't share shoes. Sharing risks spreading a fungal infection.

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.

Treatents include: Wartie Freeze: Wartie is a medical device used for the removal of warts and verrucae through cryotherapy at home, which involves freezing the wart or verruca to destroy the tissue. It only freezes the Wart and not the surrounding skin its unique metal tip allows higher precision than other products.

Wartie Plasters: These contain salicylic acid, a keratolytic agent.

Salicylic acid helps break down the thickened skin of the wart, gradually softening and removing the layers of wart tissue. The plasters protect the verruca and prevent the infection from spreading. 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.

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 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

33 early. A podiatrist will advise you on a regular treatment plan that suits you best.

salicylic acid, it is suitable for individuals with sensitive skin, including diabetics.

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.

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.

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.

CCS have an extensive range of products to provide the feet with the moisture and care. CCS Foot Care Cream, the UK’s leading footcare cream, is clinically tested, paraben-free, and specially formulated to deliver intense moisture. As it does not contain

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.

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

Why are my legs aching?

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?

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

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.

News

¤63.84m Accelerating Research RCSI University of Medicine and Health Sciences is set to play a key role in the newly announced €63.84 million ‘Accelerating Research to Commercialisation’ (ARC) Hub investment programme. Launched by Minister for Further and Higher Education, Research, Innovation and Science, James Lawless TD, the ARC Hubs aim to fast-track the commercial potential of scientific research across Ireland.

The ARC Hub programme, co-funded by the Government of Ireland and the European Union through the European Regional Development Fund (ERDF), establishes two new research hubs: the ARC Hub for Therapeutics and the ARC Hub for ICT. These hubs will provide integrated support to researchers, bridging the gap between scientific discovery and commercialisation.

Speaking at the announcement, Minister Lawless said: “The Research Ireland ARC Hubs for Therapeutics and ICT represent a new model for regional innovation and entrepreneurial training that will catalyse a step-change in the translation of cutting-edge, publicly-funded research towards

impact at a regional level. The ARC Hubs will enhance and accelerate the commercialisation of research to create new products, processes and services.”

The ARC Hub for Therapeutics, led by Professor Vincent Kelly in Trinity College Dublin (TCD) in collaboration with Professor Leonie Young at RCSI and Professor Liam Gallagher at University College Dublin (UCD), will accelerate translational research in small molecule and biologic therapeutics, biomaterials, biomarkers with therapeutic potential and advanced therapy medicinal products.

Welcoming RCSI’s involvement, Professor Fergal O’Brien, Deputy

Vice Chancellor for Research and Innovation at RCSI, said: "Supported by the Innovation Team in the Office of Research and Innovation, RCSI is proud to play a key role in this initiative, contributing its clinical and scientific expertise in therapeutics research and development.

“With a strong track record in drug discovery and translational medicine, RCSI is committed to bridging the gap between academic research and clinical application. Our expertise in understanding disease mechanisms, developing advanced therapeutics, combined with close ties to clinical practice, will ensure that the ARC Hub drives pioneering advancements

in therapeutics. Through this partnership with TCD and UCD, we will support Irish researchers in bringing academic innovations to the clinic and the global biopharma market, ultimately delivering real benefits for patients.”

Six translational research projects at RCSI have been awarded funded for phase 1 of the ARC Hub covering areas including blood clotting therapeutics for patients with bleeding disorders, a novel treatment for Parkinson’s disease, addressing hypoxia in solid tumours, gene therapy-based biomaterials for cartilage repair, gene therapies for epilepsy, von Willebrand disease and inhaled delivery of antifungal therapeutics for lung infections.

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34

Oncology/Research

TransAtlantic Cancer Alliance for Liquid Biopsy Research and Training The TransAtlantic Cancer Alliance for Liquid Biopsy Research and Training project was recently funded by the HRB All-Ireland NCI Cancer Consortium (AICC) grant. This project, led by Dr Kathy Gately, a senior clinical lecturer at the Trinity St. James Cancer Institute (TSJCI) and colleagues, focuses on developing a network of liquid biopsy experts and data scientists across the island of Ireland in collaboration with National Cancer Institute (NCI) experts at Johns Hopkins University (JHU), Baltimore, US. Written by Dr Kathy Gately

The project was co-created in consultation with clinician scientists (Prof Patrick Forde (TSJCI/JHU) and Prof Valsamo Anagnostou (JHU)) and an AllIreland team of thoracic surgeons

(Mr Gerard Fitzmaurice and Mr Rory Beattie), pathologists (Prof Stephen Finn & Prof John O’Leary), clinicians (Prof Jarushka Naidoo & Dr Aidan O’Brien), translational research scientists (Prof Paul

Figure 1.0 The TransAtlantic Cancer Alliance

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Mullan, Prof Lorraine O’Driscoll, Dr Ezgi Oner & Dr Sharon O’Toole), research nurse (Ms Sinead Hurley), patient advocate Mr Seamus Cotter, bioinformatician (Dr Pilib O’Broin) and the Northern Ireland Biobank. Each providing firsthand knowledge of the needs of the Irish health research and

services system North and South.

The project will hire a research assistant and post-doctoral fellow who will initially focus on advancing liquid biopsy research for patients with lung cancer with the goal of expanding to other cancer types.

The liquid biopsy (LB) has emerged as an important minimally invasive tool to detect micrometastatic disease and assess changes longitudinally at more frequent intervals. The LB tumor circulome comprises circulating tumor cells, tumor DNA (mutated/methylated), RNA, proteins and extracellular vesicles (EVs) that are shed from the tumor and are implicated in various cancer processes.

Cell-free DNA (cfDNA) released into the blood due to apoptosis, necrosis and phagocytosis is known as circulating tumor DNA (ctDNA) when it originates from tumor cells. ctDNA is the most extensively studied component of the LB and is used to identify patients harboring minimal residual disease (MRD) following

Figure 1.0 The TransAtlantic Cancer Alliance

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36

Oncology/Research

curative treatment and guide the administration of adjuvant therapy. Our goal is to co-analyse the multiple LB components in longitudinal patient samples.

The TransAtlantic Cancer Alliance will expand and add value to the HEA funded, All-Ireland Liquid Biopsies Consortium (CLuB) (Figure 1). Together, novel circulating tumor biomarkers and predictive signatures identified will be developed as diagnostic assays to support personalised medicine approaches for patient care. The Alliance will also establish an interorganisational scientific exchange programme for innovative training and education opportunities, for the next generation of LB leaders.

The post-doctoral fellow working on this project and two additional researchers, will have the opportunity to undertake LB research and training, in Prof Anagnostou’s molecular

oncology laboratory, at the Sidney Kimmel Cancer Center at JHU. The postdoc will train for 2 years and the two researchers for 2 months at JHU and will facilitate knowledge transfer upon their return to Ireland. Anagnostou leads a dynamic and diverse group focusing on studying tumor evolution under selective pressure of cancer therapies, especially immunotherapy. She has discovered novel genomic mechanisms of response and resistance to cancer immunotherapy and tied those to evolutionary trajectories of ctDNA in blood.

Her team are particularly interested in translating scientific discoveries in clinical cancer care, with clinical trials underway that capitalize on their liquid biopsy discoveries.

Ongoing studies include genomic mechanisms of response and resistance to immunotherapy,

cancer cell and tumor microenvironment evolution, development of minimally invasive methodologies to capture MRD and identification of tissue and blood-derived genomic biomarkers of response to therapies.

Anagnostou has a keen focus on mentorship and career development of lab members and employs a personalised mentorship approach. The postdoc will have the opportunity to participate in the International Society for Liquid Biopsy (ISLB) annual meetings, present their work, and engage with world renown experts as well as participate in the ISLB Young Committee, which offers additional mentorship, networking and professional development opportunities, aimed at empowering the post-doctoral fellows to become future leaders in the field. Secondments to JHU

will be an integral part of the TransAtlantic Cancer Alliance’s education and training programme and will provide a unique opportunity for significant career development for researchers.

This specialised training, generously supported by Prof Anagnostou and JHU, will establish an impactful mechanism for inter-organisational, knowledge exchange between research leaders at the Sidney Kimmel Cancer Center and All-Ireland Cancer Centres and academic partners.

This unique collaboration brings together leading experts with a wealth of diverse knowledge and experience to further strengthen and sustain the development of a transatlantic, cross-border, network for clinical cancer research and innovation to advance the LB in the clinic for personalised patient care.

News Reducing Risk of Chronic Diseases Researchers have found that a newly developed diet inspired by the eating habits of non-industrialised societies can significantly reduce the risk of a number of chronic diseases – and are to share recipes with the public.

Jens Walter, a University College Cork Professor and a PI at APC Microbiome Ireland, a Research Ireland centre, with co-author Joao Filipe Mota

• Reduced blood sugar by 6%

Industrialised diets—high in processed foods and low in fiber— have contributed to a substantial rise in chronic diseases like obesity, diabetes, and heart disease, in affluent countries such as Ireland.

A paper published in the prestigious scientific journal Cell shows that a newly developed diet that mimics eating habits in non-industrialised communities led to significant metabolic and immunological improvements in a human intervention study. In just three weeks the diet: • Promoted weight loss • Decreased bad cholesterol by 17%

• Reduced C-reactive Protein (a marker of inflammation and heart disease) by 14% These improvements were linked to beneficial changes in the participants’ gut microbiome, the home to trillions of bacteria that play a vital role in our health, influencing digestion, immunity, and metabolism. The research was conducted by an international teams of scientists led by Professor Jens Walter, a leading scientist at University College Cork where he holds a Research Ireland Professorship.. The human trial was performed at the University of Alberta in Canada, Prof. Walter’s previous institution.

“Industrialisation has drastically impacted our gut microbiome, likely increasing the risk of chronic

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diseases.” explained Prof.

Walter, who is also a Principal Investigator at APC Microbiome Ireland, a world-renowned Research Ireland centre.

Although participants did not consume fewer calories on the NiMe diet, they lost weight, and the diet alone led to considerable cardiometabolic benefits.

“To counter this, we developed a diet that mimics traditional, non-industrialised dietary habits and is compatible with our understanding on diet-microbiome interactions. In a strictly controlled human trial, participants followed this diet and consumed L. reuteri, a beneficial bacterium prevalent in the gut of Papua New Guineans but rarely found in the industrialised microbiomes.”

Commenting on this study, Professor Paul Ross, Director of APC Microbiome Ireland, said, “This study shows that we can target the gut microbiome through specific diets to improve health and reduce disease risk. These findings could shape future dietary guidelines and inspire the development of new food products and ingredients, as well as therapeutics, which target the microbiome.”

The study demonstrated that the new diet entitled NiMeTM (Non-industrialised Microbiome Restore) diet enhanced short-term persistence of L. reuteri in the gut.

“The recipes from the NiMe Diet will be posted to our Instagram (@nimediet) and Facebook pages, and they will also be included in an online cookbook soon. It is important to us to make these recipes freely available so that everyone can enjoy them and improve their health by feeding their gut microbiome,” said Dr. Anissa Armet from the University of Alberta, a registered dietitian that designed the NiMe diet and one of the lead authors of the publication.

However, it also improved microbiome features damaged by industrialisation, such as reducing pro-inflammatory bacteria and bacterial genes that degrade the mucus layer in the gut.

These changes were linked to improvements in cardiometabolic markers of chronic disease risk.

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Recommend Capasal Therapeutic Shampoo Prescribing information

Salicylic acid 0.5% w/w, coconut oil 1.0% w/w, distilled coal tar 1.0% w/w.

Uses: As a shampoo in the treatment of dry, scaly scalp conditions such as seborrhoeic eczema, seborrhoeic dermatitis, pityriasis capitis, psoriasis and cradle cap in children.

It may also be used to remove previous scalp applications.

Directions: Adults, children and the elderly: Use as a shampoo, once or twice weekly until the condition improves. Thereafter, occasional use may be necessary. Wet the hair thoroughly. Massage a small amount of the shampoo into the scalp, leaving on for a few minutes. Remove as much lather as possible with the hands, before rinsing out thoroughly under running water. Repeat if necessary.

Contra-indications, warnings, side effects etc: Please refer to SPC for full details before prescribing. Do not use if sensitive to any of the ingredients. In case of irritation or if there is no improvement after 4 weeks, or the condition is aggravated, discontinue treatment. Keep away from the eyes. Keep out of the reach of children.

Use in pregnancy: avoid use during first trimester.

Package quantities, trade prices and MA number: 100ml bottle €3.78, 250ml bottle €7.30, PA23128/008/001.

Legal category: Supply through pharmacy only.

Further information is available from: Dermal Laboratories (Ireland) Ltd, Head Office Tatmore Place, Gosmore, Hitchin, Herts, SG4 7QR, UK. Date of preparation: June 2024. ‘Capasal’ is a trademark.

Adverse events should be reported.

Reporting forms and information can be found at www.hpra.ie. Adverse events should also be reported to Dermal.

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38

Oncology/CLuB Research

All-Ireland Cancer Liquid Biopsies Consortium (CLuB) advancing Ovarian Cancer Research The All-Ireland Liquid Biopsy Consortium (CLuB; www.clubcancer.ie) is a collaborative program focused on advancing liquid biopsy technologies for cancer diagnosis and treatment. It unites researchers, clinicians, patients and institutions across both Northern Ireland and the Republic of Ireland.

Written by Sharon O’Toole, Senior Research Fellow, Departments of Obstetrics and Gynaecology/ Histopathology, Trinity Centre, St. James's Hospital

the direction of Dr Pilib Ó Broin to develop better algorithms for diagnosis and treatment.

The consortium aims to develop minimally invasive, cost-effective, and reliable liquid biopsy methods that could complement or, in some cases, replace traditional tissue biopsies. These blood tests seek to enable earlier and more precise diagnoses, support personalised treatment strategies, and enhance patient outcomes. By combining expertise across the island, the consortium accelerates innovation in the field of liquid biopsy.

CLuB is led by Prof Lorraine O’Driscoll in Trinity College Dublin and the Northern Ireland lead is Prof Paul Mullan in Queens University Belfast (QUB). It is funded by the Higher Education Authority under the North South Research Programme, emerging hub of excellence. The premise of CLuB was to amalgamate the fragmented research that was happening across the country so that the information is maximised for liquid biopsies from patients.

This information would then be processed by data scientists in the University of Galway under

CLuB focuses on a number of components of the liquid biopsy, namely; • Circulating tumours cells (CTCs) – cancer cells that have detached from a primary tumor and are circulating in the blood. (Dr Sharon O’Toole, Prof John O’Leary and Dr James Beirne lead the ovarian strand and Dr Kathy Gately leads the lung strand) • Circulating tumour DNA (ctDNA) – fragments of DNA shed from tumors into the bloodstream.

(Prof Paul Mullan) • Extracellular vesicles – small vesicles released from cells, including tumour cells, that carry various molecular signals. (Prof Lorraine O’Driscoll) • Other biomarkers – such as proteins that may indicate the presence of cancer or provide an insight into the tumour behaviour.

In addition to blood samples, CLuB under the direction of Dr Niamh Buckley in QUB, also works with excised tumor

tissue/organoids as "avatars" to better understand the origin of components present in liquid biopsies and test the effectiveness of potential treatments.

• Bloating that is persistent and doesn’t come and go

Ovarian cancer is one of a number of cancers being investigated within the CLuB consortium which also includes lung, breast, pancreatic and gastric and has the ambition to expand to other cancer types in the interest of all patients with cancer.

• Abdominal and pelvic pain you feel most days

Ovarian cancer is one of five gynaecological cancers (vulva, vaginal, cervix, uterine and ovarian) but it has the highest mortality of the gynaecological cancers due to late presentation of disease and the development of chemoresistance.

Annually, approximately 400 women are diagnosed with ovarian cancer, and almost 300 women die from this disease in the Republic of Ireland (National Cancer Registry Ireland). In Northern Ireland, almost 300 are diagnosed and 128 women die (Northern Ireland Cancer Registry). Ovarian cancer is the fourth leading cause of cancer death in women in Ireland, after lung, breast, and colorectal cancer. Currently there is no screening for ovarian cancer and current diagnostics lack sensitivity and specificity. Symptoms of ovarian cancer can be vague and CLuB realises the importance of awareness initiatives and supports the work of the Irish Network for Gynaecological Oncology (https://isgo.ie/irish-network-forgynaecological-oncology/) in their award winning BEAT awareness campaign.

• Eating less and feeling full more quickly

• Toilet changes in urination or bowel habits CLuB researchers Dr Brian Henderson and Ms Faye Lewis working alongside Dr Mark Ward are focused on novel diagnostics for ovarian cancer but also looking at the role of the liquid biopsy for helping guide the treatment for ovarian cancer patients to enable a more precision medicine-based approach. CLuB is following patients longitudinally throughout their treatment, with the help of our research nurse Sinead Hurley and researcher Marika Kanjuga, to determine the role of the biomarkers in predicting response to treatment.

Embedded in CLuB is the patient voice and CLuB are fortunate to have the input of a passionate and dynamic patient advocacy panel who are excited at the prospect of developing novel liquid biopsy tests to improve patient outcomes (Jacqueline Daly, Krista Costello, Roberta Horgan and Gemma Ward, coordinated by CLuB project manager Dominique Plant).

CLuB is grateful to our funders (Higher Education Authority North South Research Programme), the clinicians who consent and to all the patients who donate their samples for research.

CLuB Investigators L-R: Ms Etain O'Rourke, Dr Sharon O'Toole, Professor John O'Leary, Mr Ryan Barr, Dr. Seyed Aghil Hooshmand, Dr Pilib Ó Broin, Dr Niamh Buckley, Mr Michéal Ryan, Ms Dominique Plant, Professor Paul Mullan, Dr Kathy Gately, Professor Lorraine O'Driscoll, Ms Marika Kanjuga, Ms Volga M. Saini, Dr Brian Henderson, Dr Syed Umbreen, Dr Mark Ward, Dr Ezgi Oner, Ms Faye Lewis and Mrs Gemma Ward.

PHARMACYNEWSIRELAND.COM

Generic Product Launch

Fingolimod Teva 0.5 mg hard capsules fingolimod

High Tech Prescription Medicine

Indications Fingolimod Teva 0.5 mg hard capsules Fingolimod Teva is indicated as single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following groups of adult patients and paediatric patients aged 10 years and older: Patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy (for exceptions and information about washout periods see the SmPC) or Patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by 2 or more disabling relapses in one year, and with 1 or more Gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI. Fingolimod Teva Hard Capsules Abbreviated Prescribing Information Presentation: Each hard capsule contains 0.5mg fingolimod as hydrochloride.

Indications: Fingolimod Teva is indicated as single disease modifying therapy in highly active relapsing remitting multiple sclerosis (MS) for adult patients and paediatric patients (10 years and older) with: Highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy; Or with rapidly evolving severe relapsing remitting MS defined by 2 or more disabling relapses in one year, and with 1 or more Gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI. Dosage and administration: For oral administration. Treatment should be initiated and supervised by a physician experienced in MS. Adults: The recommended dose is one 0.5mg capsule taken orally once daily.

Children (10 years of age and above): The recommended dose is dependent on body weight. Paediatric patients with body weight ≤40kg: one 0.25mg capsule taken orally once daily. Paediatric patients with body weight >40kg: one 0.5mg capsule taken orally once daily. Paediatric patients who start on 0.25mg capsules and subsequently reach a stable body weight above 40kg should be switched to 0.5mg capsules. The safety and efficacy of fingolimod in children aged below 10 years has not been established. Elderly: Fingolimod Teva should be used with caution in patients aged 65 years and over due to insufficient data on safety and efficacy. Renal impairment: No dose adjustments are needed in patients with mild to severe renal impairment. Hepatic impairment: No dose adjustment needed in patients with mild or moderate hepatic impairment, but caution should be exercised when initiating treatment in these patients. Fingolimod Teva must not be used in patients with severe hepatic impairment (Child-Pugh class C).

Contraindications: Immunodeficiency syndrome. Patients with increased risk for opportunistic infections, including immunocompromised patients (including those currently receiving immunosuppressive therapies or those immunocompromised by prior therapies). Severe active infections and active chronic infections (hepatitis, tuberculosis). Active malignancies. Severe liver impairment (Child-Pugh class C). Patients who in the previous 6 months had myocardial infarction (MI), unstable angina pectoris, stroke/transient ischaemic attack (TIA), decompensated heart failure (requiring inpatient treatment), or New York Heart Association (NYHA) class III/IV heart failure. Patients with severe cardiac arrhythmias requiring anti-arrhythmic treatment with class Ia or class III anti-arrhythmic medicinal products. Patients with second-degree Mobitz type II atrioventricular (AV) block or third-degree AV block, or sick-sinus syndrome, if they do not wear a pacemaker. Patients with a baseline QTc interval ≥ 500 msec. During pregnancy and in women of childbearing potential not using effective contraception.

Hypersensitivity to the active substance or to any of the excipients. Precautions and warnings: Initiation of treatment results in a transient decrease in heart rate (HR) and may also be associated with AV conduction delays, including the occurrence of isolated reports of transient, spontaneously resolving complete AV block. All patients should have an electrocardiogram (ECG) and blood pressure measurement performed prior to and 6 hours after the first dose of Fingolimod Teva. All patients should be monitored for a period of 6 hours for signs and symptoms of bradycardia with hourly HR and blood pressure measurement. Continuous ECG monitoring during this 6 hour period is recommended. The same precautions as for the first dose are recommended when patients are switched from the 0.25mg to the 0.5mg daily dose. In the event of post-dose bradyarrhythmia-related symptoms, initiate clinical management and monitor the patient until the symptoms have resolved. Very rare cases of T-wave inversion have been reported in adult patients treated with fingolimod. In case of T-wave inversion, the prescriber should ensure that there are no associated myocardial ischaemia signs or symptoms. If myocardial ischaemia is suspected, seek advice from a cardiologist.

Fingolimod Teva should not be used in patients with sino-atrial heart block, a history of symptomatic bradycardia, recurrent syncope or cardiac arrest, or in patients with significant QT prolongation, uncontrolled hypertension or severe sleep apnoea.

Fingolimod has an immunosuppressive effect that predisposes patients to an infection risk, including opportunistic infections that can be fatal, and increases the risk of developing lymphomas and other malignancies, particularly those of the skin. Before initiating treatment with Fingolimod Teva, a recent complete blood count (CBC) (i.e.

Teva Pharmaceuticals Ireland, Digital Office Centre Swords, Suite 101 - 103, Balheary Demesne, Balheary Road, Swords, Co Dublin, K67E5AO, Ireland.

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Prescription Only Medicine.

within 6 months or after discontinuation of prior therapy) should be available.

Assessments of CBC are also recommended periodically during treatment, at month 3 and at least yearly thereafter, and in case of signs of infection. Absolute lymphocyte count <0.2x109/l, if confirmed, should lead to treatment interruption until recovery.

Initiation of treatment with Fingolimod Teva should be delayed in patients with severe active infection until resolution. Suspension of Fingolimod Teva should be considered if a patient develops a serious infection and consideration of benefit-risk should be undertaken prior to re-initiation of therapy. Patients should report symptoms of infection up to 2 months after discontinuation of fingolimod. Serious, life-threatening, and sometimes fatal cases of encephalitis, meningitis or meningoencephalitis caused by herpes simplex and varicella zoster viruses have occurred with Fingolimod Teva.

Treatment should be stopped if these develop, and appropriate treatment initiated.

Patients need to be assessed for their immunity to varicella (chickenpox) prior to treatment. A full course of vaccination for antibody-negative patients with varicella vaccine is recommended prior to commencing treatment. Cases of cryptococcal meningitis, sometimes fatal, have been reported after approximately 2-3 years of treatment. If cryptococcal meningitis is diagnosed, fingolimod should be suspended and appropriate treatment should be initiated. Progressive multifocal leukoencephalopathy (PML) has been reported under fingolimod treatment. Before initiating treatment with fingolimod, a baseline MRI should be available (usually within 3 months) as a reference.

MRI findings may be apparent before clinical signs or symptoms. If PML is suspected, MRI should be performed immediately for diagnostic purposes and treatment with fingolimod should be suspended until PML has been excluded. Due to the immunosuppressive properties of fingolimod, vaccination against Human papilloma virus (HPV) should be considered prior to treatment initiation. Macular oedema has been reported in patients treated with fingolimod 0.5mg. Perform an ophthalmological evaluation 3–4 months after fingolimod initiation. Evaluate the fundus, including the macula, in patients reporting visual disturbances. Fingolimod Teva should be discontinued if a patient develops macular oedema. Increased hepatic enzymes have been reported in MS patients treated with fingolimod. Signs of liver injury, including markedly elevated serum hepatic enzymes and elevated total bilirubin, have occurred as early as ten days after the first dose and have also been reported after prolonged use. Do not use fingolimod in patients with severe pre-existing hepatic injury (Child-Pugh class C). Due to the immunosuppressive properties of fingolimod, initiation of treatment should be delayed in patients with active viral hepatitis until resolution. Recent (i.e. within last 6 months) transaminase and bilirubin levels should be available before initiation of treatment. If liver transaminases are at least 5 times the upper limit of normal (ULN) or at least 3 times the ULN associated with any increase in serum bilirubin, Fingolimod Teva should be discontinued. Blood pressure should be regularly monitored during treatment as Fingolimod Teva can cause hypertension. Fingolimod Teva should be used with caution in patients with severe respiratory disease, pulmonary fibrosis and chronic obstructive pulmonary disease. Rare cases of posterior reversible encephalopathy syndrome (PRES) have been reported during treatment. If PRES is suspected, Fingolimod Teva should be discontinued. When switching patients from another disease modifying therapy to Fingolimod Teva, a CBC is recommended prior to initiating treatment to ensure that immune effects of the previous therapy have resolved. Vigilance for skin lesions is warranted and a medical evaluation of the skin is recommended at initiation, and then every 6 to 12 months taking into consideration clinical judgement. Patients should be referred to a dermatologist in case suspicious lesions are detected. Patients treated with fingolimod should be cautioned against exposure to sunlight without protection. If lymphoma is suspected during treatment, Fingolimod Teva should be discontinued. Rare cases of tumefactive lesions associated with MS relapse have been reported. Severe exacerbation of disease has been observed rarely in some patients stopping fingolimod. Caution is therefore indicated when stopping fingolimod therapy.

If a decision is made to stop treatment with fingolimod a 6-week interval without therapy is needed, based on half-life, to clear fingolimod from the circulation. Caution is indicated with the use of immunosuppressants soon after the discontinuation due to possible additive immune system effects. The safety profile in paediatric patients is

similar to that in adults. Cases of seizures, anxiety, depressed mood and depression have been reported with a higher incidence in paediatric patients treated with fingolimod compared to patients treated with interferon beta-1a. It is recommended that paediatric patients complete all immunisations in accordance with current immunisation guidelines before starting Fingolimod Teva. Interactions: Anti-neoplastic, immunomodulatory or immunosuppressive therapies should not be co-administered due to the risk of additive immune system effects. During and for up to two months after treatment vaccination may be less effective. The use of live attenuated vaccines may carry a risk of infections and should be avoided. Treatment with Fingolimod Teva should not be initiated in patients receiving beta-blockers, or other substances which may decrease HR, such as class Ia and III antiarrhythmics, calcium channel blockers (such as verapamil or diltiazem), ivabradine, digoxin, anticholinesteratic agents or pilocarpine. Co-administration of fingolimod with ketoconazole resulted in a 1.7-fold increase in fingolimod and fingolimod phosphate exposure (AUC) by inhibition of CYP4F2. Caution should be exercised with substances that may inhibit CYP3A4 (protease inhibitors, azole antifungals and some macrolides such as clarithromycin or telithromycin). Co-administration of strong CYP3A4 inducers (rifampicin, phenobarbital, phenytoin, efavirenz) should be used with caution as they may reduce the AUC or fingolimod and its metabolite. Concomitant administration with St. John’s Wort is not recommended. Co-administration of fingolimod with oral contraceptives (ethinylestradiol and levonorgestrel) did not elicit any change in oral contraceptive exposure. Pregnancy and lactation: Fingolimod is contraindicated in women of childbearing potential not using effective contraception. Post-marketing data suggest that use of fingolimod is associated with a 2-fold increased risk of major congenital malformations when administered during pregnancy compared with the rate observed in the general population. Women of childbearing potential should provide a negative pregnancy test result before treatment initiation and must receive counselling regarding the serious risk to the foetus. Effective contraception must be used during treatment and for 2 months after discontinuation of Fingolimod Teva. Fingolimod should be stopped 2 months before planning a pregnancy. If a woman becomes pregnant during treatment, fingolimod must be discontinued. When stopping fingolimod therapy for planning a pregnancy the possible return of disease activity should be considered.

Women receiving Fingolimod Teva should not breastfeed. Effects on ability to drive and use machines: Has no or negligible influence on the ability to drive and use machines, however, dizziness or drowsiness may occasionally occur when initiating treatment.

Adverse reactions: Pneumonia, progressive multifocal leukoencephalopathy (PML), cryptococcal infections, basal cell carcinoma, malignant melanoma, lymphoma, squamous cell carcinoma, Kaposi’s sarcoma, leucopenia, thrombocytopenia, autoimmune haemolytic anaemia, hypersensitivity reactions, seizure, posterior reversible encephalopathy syndrome (PRES), macular oedema, bradycardia, ECG T-wave inversion and acute hepatic failure. Very Common: Influenza, sinusitis, headache, cough, diarrhoea, back pain and increased hepatic enzyme levels. Common: Herpes viral infections, bronchitis, tinea versicolor, lymphopenia, depression, dizziness, migraine, blurred vision, AV block, hypertension, dyspnoea, eczema, alopecia, pruritus, myalgia, arthralgia, asthenia, decreased weight and increased blood triglyceride levels. Consult the Summary of Product Characteristics in relation to other side effects. Overdose: If an overdose constitutes first exposure to fingolimod, it is important to monitor patients with a continuous (real time) ECG and hourly measurement of HR and blood pressure, at least during the first 6 hours. If after 6 hours the HR is <45bpm in adults, <55bpm in paediatric patients aged 12 years and above, or <60bpm in paediatric patients aged 10 years to below 12 years, or if the ECG at 6 hours after the first dose shows second degree or higher AV block, or if it shows a QTc interval ≥500msec, monitoring should be extended at least for overnight and until the findings have resolved. The occurrence at any time of third degree AV block should also lead to extended monitoring including overnight monitoring. Neither dialysis nor plasma exchange results in removal of fingolimod from the body. Legal category: POM Marketing Authorisation Number: PA0436/047/001.

Marketing Authorisation Holder: Norton Waterford, T/A IVAX Pharmaceuticals Ireland, Unit 301, IDA Industrial Park, Cork Road, Waterford, Ireland Job Code: MED-IE-00050.

Date of Preparation: February 2022.

Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie.

Adverse events should also be reported to Teva UK Limited on +44 (0) 207 540 7117 or medinfo@tevauk.com

Date of Preparation: September 2024 | Job Code: FIN-IE-00002 Further information is available on request or in the SmPC. Product Information also available on the HPRA website.

The end of erectile problems?

Touch wood.

Available over the counter. No prescription required.

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

ABBREVIATED PRESCRIBING INFORMATION Product Name: Sidena 50 mg Tablets.

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

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

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

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

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

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

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

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

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

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

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

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

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

Supply status: Supply through pharmacies only.

CPD: Urinary Incontinence Continuing Professional Development

CPD

41

AUTHOR: Written by Elizabeth Culleton-Quinn1,2, Kari Bø3, Neil Fleming1, Cinny Cusack4 & Déirdre Daly5 School of Medicine, Trinity College, Dublin, Ireland Discipline of Physiotherapy, Trinity Centre for Health Sciences, St James Hospital, James’s Street, Dublin 1 2

Department of Obstetrics and Gynecology, Norwegian School of Sports Sciences Oslo, Norway and Akershus University Hospital 3

Physiotherapy Department, Rotunda Hospital, Dublin

4

Elizabeth Culleton-Quinn

School of Nursing and Midwifery, Trinity College, Dublin

5

60 Second Summary Pelvic floor dysfunction (PFD) is a collection of conditions, signs, and symptoms that can affect the pelvic floor with urinary incontinence (UI), which is defined as a “complaint of involuntary loss of urine,” the most commonly experienced PFD. UI has been found to be more prevalent among athletes than among their non-athletic counterparts.

To our knowledge, there has been no research to date investigating the prevalence and experience of UI among elite female Gaelic sports athletes.

The study presented here is the quantitative component of a mixed-methods study investigating the prevalence and experiences of pelvic floor muscle dysfunction in elite female athletes/sportswomen that was aimed at investigating the prevalence and experience of UI and associated risk factors.

This was a cross-sectional study involving elite female Gaelic sports athletes (county Camogie players and county Ladies Gaelic Football players) in Ireland. An online self-completed anonymous questionnaire was developed and administered using Qualtrics©.

A total of 185 players (Camogie players n = 102, Ladies Gaelic Football players n = 83) submitted responses deemed sufficiently complete for analysis. Mean age (SD) of players was 25 (5) years [range 18 to 37 years].

Significantly more of the parous players (100%, 8 out of 8) reported experiencing UI compared with the nulliparous players (60.3%, 85 out of 141; Fisher’s exact test p = 0.025).

There was no significant difference in the prevalence of UI between those reporting medical risk factors (62.8%, 81 out of 129) compared with those with no medical risk factors (54.6%, 12 out of 22; Chisquared = 0.540, df = 1, p = 0.462).

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

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

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

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

3. PLAN - If I have identified a

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

4 previous steps, log and record your findings.

Published by IPN. Copies can be downloaded from www.irishpharmacytraining.ie Disclaimer: All material published is copyright, no part of this can be used in any other publication without permission of the publishers and author. P&G has no editorial oversight of the CPD programmes included in these modules.

Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes Introduction Pelvic floor dysfunction (PFD) is a collection of conditions, signs, and symptoms that can affect the pelvic floor with urinary incontinence (UI), which is defined as a “complaint of involuntary loss of urine,” the most commonly experienced PFD.1 UI has been found to be more prevalent among athletes than among their nonathletic counterparts.2, 3 Although the effect of physical activity and sport on the pelvic floor is not yet fully understood4 research indicates that there are certain risk factors that may influence the prevalence of UI. Risk factors for UI include female sex, high-impact sport, long hours of training, and elite status as an athlete.5,6,7,8 Stress urinary incontinence (SUI), which has been defined as “complaint of involuntary loss of urine on effort or physical exertion (e.g., sporting activities), or on sneezing or coughing”1, appears to be the most commonly reported form of UI among female athletes.3, 6 Research has indicated that athletes experience triggers for their UI, such as jumping activities, and adopt strategies, including prevoiding, wearing pads, and fluid restriction, to try to manage and

mitigate the symptoms of their UI in sport.6, 7, 9, 10 A recent systematic review identified the need for sports-specific mixed methods or qualitative research to further examine the experience of PFD among elite sportswomen.9 Gaelic team sports are the national and most commonly played sports in Ireland and include Camogie and Ladies Gaelic Football, where two 15-member teams (1 goalkeeper, 6 backs, 2 midfielders, and 6 forwards), playing on a large grass pitch (145 m by 90 m) aim to score points (over the bar) and goals (equal to three points, under the bar) on H-shaped posts during a 60-min game. These sports are also played in Australia, Britain, Europe, North America, the Asia/Gulf region, and Africa. Camogie is played with a hurley (stick) and a sliotar (small, hard, leather-covered ball) and players may strike the sliotar with the hurley, solo (move with the sliotar balanced or bouncing on the hurley), hand pass, or kick the sliotar.11 The Camogie Association has a membership of over 600 Camogie clubs and over 100,000 players worldwide.12 Ladies Gaelic Football is played with a round, Gaelic football (400 g) and players can kick, catch, solo (players drop the ball onto the foot and kick it

Continuing Professional Development supported by

back into their hands), bounce, or hand pass the ball.13 The Ladies Gaelic Football Association has over 1,000 clubs with over 150,00 players worldwide.14 Camogie and Ladies Gaelic Football players on county teams who compete in the respective National League and AllIreland Championships represent the elite players in these sports.

To our knowledge, there has been no research to date investigating the prevalence and experience of UI among elite female Gaelic sports athletes. The study presented here is the quantitative component of a mixed-methods study investigating the prevalence and experiences of pelvic floor muscle dysfunction in elite female athletes/sportswomen that was aimed at investigating the prevalence and experience of UI and associated risk factors.

A secondary objective was to investigate players’ knowledge of the pelvic floor muscles (PFMs) and pelvic floor muscle training (PFMT).

Materials and Methods Study Population This was a cross-sectional study involving elite female Gaelic sports athletes (county Camogie players and county Ladies Gaelic Football players) in Ireland. All players who

42

CPD: Urinary Incontinence

Background characteristicsa, b (n =)c

All players

Camogie players

Ladies Gaelic football players

p value*‡

BMI, mean (SD) (n = 178)

22.9 (2.6)

23.4 (2.6) (n = 96)

22.4 (2.6) (n = 82)

p = 0.004*

Has a history of medical risk factor (n = 173)

83% (144/173)

80% (80/100)

87.7% (64/73)

p = 0.182**

Daily fluidsd (ml), mean (SD), (n = 185)

2,820.4 (901.1)

2,779 (996.3) (n = 102)

2,870.8 (771.1) (n = 83)

p = 0.311*

Daily bladder irritante fluids (ml), mean (SD), (n = 185)

807.8 (523.2)

727.8 (513.9) (n = 102)

906.0 (520.8) (n = 83)

p = 0.015*

Percentage of daily fluid intake as bladder irritantse, f, mean (SD), (n = 185)

29.5 (19.1)

26.3 (16.4) (n = 102)

33.4 (21.4) (n = 83)

p = 0.047*

Drinks alcohol (n = 184)

89.1% (164/184)

94.1% (95/101)

69/83 (83.13%)

p = 0.018**

Units alcohol/week, mean (SD), (n = 161)

5.2 (4.9)

4.4 (4.5) (n = 94)

6.3 (5.2) (n = 67)

p = 0.015*

Weekly time spent in sporting activity (min), mean (SD), (n = 126)

472.0 (175.8)

441.5 (156.2) (n = 70)

510.1 (192.3) (n = 56)

p = 0.040*

BMI Body Mass Index To determine differences between sports, data were analyzed using *Mann–Whitney U test or **Chi-squared test a Quantitative variables were expressed as means ± SD b Categorical variables were expressed as numbers and percentage values c Number of players who answered the question d Non-alcoholic fluids e Bladder-irritant fluids include caffeinated or carbonated drinks f (ml of bladder-irritant fluids/ml of total fluids) × 100) Table 1 Background characteristics of the players From: Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes

fulfilled the inclusion/exclusion criteria, aged 18 years and over, and able to understand written English, were invited to participate in the study.

Exclusion criteria were players who were aged 17 years and younger, pregnant or had given birth within the previous year or who had had previous pelvic surgery or pelvic disease.

Survey Instrument Development and Evaluation An online self-completed anonymous questionnaire was developed and administered using Qualtrics©. Background demographics and potential risk factors based on former studies in the area of UI generally and UI and sport were collected and included age, BMI, presence of medical risk factors for UI (including gynecological or bladder and bowel conditions, diabetes, asthma, lumbar spine, or pelvic girdle musculoskeletal symptoms), parity, types and amount of fluid intake (total fluids; total amount of bladder-irritant fluids: caffeinated, or carbonated drinks; proportion of bladder-irritant fluids/total fluids and alcohol consumption), and time spent in sporting activities per week.5, 7, 15,16,17,18,19,20,21 The prevalence, nature, and severity of UI was assessed by the International Consultation on Incontinence QuestionnaireUrinary Incontinence Short Form (ICIQ-UI-SF) questionnaire, which has been shown to have reliability, validity, and sensitivity.22 Players were classified as being continent if they answered “never” to the question “How often do you leak urine?” UI was further classified

as stress urinary incontinence (SUI), urge urinary incontinence (UUI), mixed urinary incontinence (MUI) from answers to the options in the question “When does urine leak?” An Everyday Life (EDL) score (1–10) was obtained from a question “Overall how much does your leaking urine interfere with your daily life?”

Finally, the ICIQ-UI-SF sum score indicating the severity of UI was calculated from the sum of the frequency, amount, and effect on daily life. Severity scores were categorized as slight (1–5), moderate (6–12), severe (13–18), and very severe (19–21).

The questionnaire also included questions about the players’ knowledge regarding the location of the PFMs and the practice of PFMT, their experience of UI (including triggers for UI and strategies employed to manage their UI) and whether players with UI had discussed or sought treatment for UI. Validity and reliability were evaluated in October and November 2020 respectively, prior to commencing the study. Content validity was evaluated by 16 physiotherapists (14 women’s health physiotherapists, 1 in education and women’s health research, and 1 physiotherapist involved in the treatment of sports injuries in female Gaelic sports athletes) using a relevance rating scale.23 The scale level content validity index average (S-CVI/average) was 0.997 and all 16 experts agreed on 96% of the items (46 out of 48). Reliability was tested using a convenience sample of club-level

Camogie players, with 12 players completing the questionnaire on two occasions 1–2 weeks apart. Cohen’s Kappa, used to establish test–retest reliability, was Kappa range = 0.625 to 1.000, indicating good reliability.

A link to the questionnaire was emailed to the county players by the Gaelic Players Association (GPA), the player representative body for intercounty players in Ireland (~1,350 female players with ~1,280 aged 18 years or older)24, which acted as gatekeeper for the study. The link was made available to the county Camogie players on two separate occasions: late November to mid-December 2020, for the end of the 2020 intercounty season, which had been delayed owing to the COVID-19 pandemic, and May to September 2021 to both county Camogie and Ladies Gaelic Football players for the 2021 intercounty season.

Results Background Characteristics of the Players A total of 185 players (Camogie players n = 102, Ladies Gaelic Football players n = 83) submitted responses deemed sufficiently complete for analysis. Mean age (SD) of players was 25 (5) years [range 18 to 37 years]. Almost all players had never smoked or vaped (97.8%, 181 out of 185). Only 8 players were parous, with the majority being nulliparous (95.3%, 161 out of 169). Table 1 outlines the background characteristics of the players.

Prevalence of Urinary Incontinence A total of 159 players answered the ICIQUI-SF section of the questionnaire (Camogie players n = 79, Ladies Gaelic Football players n = 80). Ninety-eight players reported UI, giving an overall prevalence of 61.6%. The overall

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43 Descriptive All players with UI (n=98)

Camogie players with UI (n=47)

Ladies Gaelic football players with UI (n=51)

p value*‡

Prevalence of SUI only, % (n) Prevalence of UUI only, % (n) Prevalence of MUI, % (n) Leaks for no obvious reason, % (n) EDL score, mean ± SD ICIQ-UI-SF sum score (mean ± SD)

55.3 % (26) 10.6 % (5) 29.8 % (14) 4.2 % (2) 2.2 ± 2.2q 6.2 ± 3.7

49.0 % (25) 3.9 % (2) 33.3 % (17) 13.7 % (7) 2.3 ± 2.4 6.0 ± 3.1

p = 0.533** p = 0.255*** p = 0.657** p = 0.163*** p = 0.862* p = 0.732*

52% (51) 7.1 % (7) 31.6 % (31) 9.2 % (9) 2.3 ± 2.3 6.1 ± 3.4

ICIQ-UI-SF, sum score indicated the severity of UI To determine differences between sports, data were analyzed by *Mann–Whitney U test, **Chi-squared tests, or ***Fisher’s exact test EDL Everyday Life Score, SUI stress urinary incontinence, UUI urge urinary incontinence, MUI mixed urinary incontinence Table 2 Urinary incontinence findings from the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI-SF) questionnaire From: Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes

prevalence was slightly higher among the Ladies Gaelic Football players with 63.8% (51 out of 80) reporting UI and 59.5% (47 out of 79) of Camogie players reporting UI. However, there was no significant difference in the overall prevalence of UI between sports (Chisquared = 0.305, df = 1, p = 0.581). Table 2 reports findings of the ICIQ-UI-SF, giving the prevalence of SUI, UUI, and MUI along with the EDL and ICIQ-UI-SF scores of the players reporting UI. There was no significance difference in prevalence of SUI, UUI, MUI, or the EDL or ICIQUI-SF scores between the two sports.

UI Prevalence and Risk Factors Significantly more of the parous players (100%, 8 out of 8) reported experiencing UI compared with the nulliparous players (60.3%, 85 out of 141; Fisher’s exact

Figure 1

test p = 0.025). There was no significant difference in the prevalence of UI between those reporting medical risk factors (62.8%, 81 out of 129) compared with those with no medical risk factors (54.6%, 12 out of 22; Chi-squared = 0.540, df = 1, p = 0.462).

Shapiro–Wilks and Kolmogorov–Smirnov tests on the continuous variables of age, BMI, fluid intake, alcohol consumption, and time spent in sporting activity per week indicated non-normal distributions.

Layers who experienced UI were found to drink greater daily amounts of bladder irritants or drank a higher percentage of daily fluids as bladder-irritant fluids ((ml of bladder-irritant fluids/ml of total fluids) × 100). Similarly, those players experiencing UI reported longer average weekly minutes of sporting activity than players who reported that they were continent. Although

weekly units of alcohol did not appear to be higher in those players reporting UI, this finding approached significance and was therefore included in the logistic regression model along with the above findings.

Results from logistic regression analysis indicated that players with a greater number of weekly minutes of sporting activity were more likely to experience UI (OR 1.05, 95% CI 1.002–1.008).

Players’ Experience of Urinary Incontinence (Triggers for UI, Strategies to Manage UI) Of the 98 players reporting UI, 78 answered the question as to whether they noticed leakage at particular times during their sporting activity. Of these, 65% (51 out of 78) reported triggers for their UI (Fig. 1).

Eighty players answered questions regarding the use of strategies to manage or mitigate their UI, with 86% (69 out of 80) reporting that they used strategies to manage their UI during their sporting activity (Fig. 2).

Seventy-eight players answered the questions asking if they had talked to anyone about their UI, with 24% (19 out of 78) of reporting that they had talked to another person about their UI. Most commonly, players spoke to family (68%, 13 out of 19) or friends (58%, 11 out of 19); 2 players (11%, 2 out of 19) had spoken to a physiotherapist, and 2 players (11%, 2 out of 19) had spoken to a GP about their UI. Eighty of the 98 players with UI answered the questions regarding receiving treatment of their UI, with only 13% (10 out of 80) reporting that they had received treatment. All of the Ladies Gaelic Football players with UI answered this question, with only 8% (4 out of 51) receiving treatment. Twenty-nine Camogie players answered this question, with 21% (6 out of 29) reporting that they had received treatment. All 8 parous players answered this question, with half of these players reporting that they had received treatment for their UI. Eight of the ten players received treatment for their UI from a physiotherapist, 6 from a gynecologist, 3 from a GP, and 1 from a nephrologist. Mostly commonly, the players reported PFMT as the recommended treatment, with 8 prescribed PFM strengthening exercises and 6 prescribed pelvic floor relaxation exercises or stretches. Two players

Continuing Professional Development supported by

44

CPD: Urinary Incontinence Figure 2

and over half (30 out of 51) reported sprinting activities to be triggers. This is consistent with the findings of previous research reporting that SUI is the most common form of UI among high-impact athletes and is considered to be a consequence of the increased abdominal pressure experienced and the impact of ground reaction forces on the pelvic floor during high-impact sport.6, 8, 25 In addition, around two-fifths of the players reporting triggers said that UI occurred toward the end of matches or training, potentially suggesting pelvic floor fatigue.21

were prescribed bladder training and 2 were prescribed medication to treat their UI. Knowledge and Practice of Pelvic Floor Muscles and Pelvic Floor Muscle Training All players (N = 185) answered the questions concerning the pelvic floor muscles (PFMs) and pelvic floor muscle training (PFMT). Fifty-five percent (101 out of 185) said that they knew where the PFMs are, 41% (75 out of 185) said that they had learned about PFMT, 26% (48 out of 185) said that they were confident in performing PFMT, and only 13% (24 out of 185) reported that they had done PFMT in the last 4 weeks.

The overall prevalence of UI among these elite players was high (61.6%). This may not be surprising owing to the high velocity, high impact, and physical nature of the two sports, which include kicking a large ball (Ladies Gaelic Football) or striking a sliotar (Camogie), as well as running, sprinting, jumping, catching, and passing over a large 145 m × 90 m pitch.

Research has indicated that high-impact sports, elite status, and long hours of training are risk factors for UI3, 6, 7, 25, which is supported by the findings of the current study, with logistic regression indicating that players who had longer weekly sporting activity time were significantly more likely to experience UI.

Prevalence of UI

Rugby is a high-impact team sport played on a large grass pitch and a study by Sandwith and Robert involving Canadian Intervarsity female rugby players found that over half (54%) reported UI.20 A recent study by McCarthyRyan et al. investigating the prevalence of UI among female rugby players in the UK and Ireland, who were playing rugby at any level, reported a rugby-related prevalence of SUI of 43%.26 Pires et al., in a review evaluating the prevalence of UI and the influence of sport modality, reported that the prevalence of UI in high-impact sports (involving running and jumping) ranged from 14.3% to 75.6%. Of the team sports, volleyball (75.6%) was found to have the highest prevalence, followed by indoor football (50.0%).8 Gaelic sports involve less jumping than volleyball, but more jumping than rugby and indoor football, and this could potentially explain the relative prevalence of UI reported here.

Although the prevalence of UI was slightly higher among the Ladies Gaelic Football players than among the Camogie players, there was no significant difference between sports in the prevalence of UI, the prevalence of SUI, UUI, MUI, or the EDL or ICIQ-UI-SF scores.

Stress urinary incontinence (52.0%) was the most common form of UI reported in this study, and almost one-third reported MUI, with few (7.1%) reporting UUI only. Of those players who reported triggers for their UI, over fourfifths (42 out of 51) reported jumping activities

Discussion This quantitative study is to our knowledge the first to investigate the prevalence and experience of UI among elite female Gaelic sports athletes (Camogie and Ladies Gaelic Football players) in Ireland. The differences between the Camogie and Ladies Gaelic Football players regarding age, BMI, parity, presence of medical risk factors, and total fluid intake were relatively small and considered to be of no clinical significance. Camogie players were found to have a higher consumption of weekly units of alcohol and the Ladies Gaelic Football players were found to have a higher consumption of bladder-irritant fluids and interestingly, the Ladies Gaelic Football players reported significantly longer weekly sporting activity time (p = 0.04), which was identified as a significant risk factor for UI in this current study.

Although not found to be statistically significant in the regression analysis model, the results suggested that players who included more bladder irritants in their fluid intake were more likely to experience UI, which corresponds with findings from previous research literature.16, 17 This suggests a need for education regarding bladder health and type of fluids among the players.

Parity appeared to influence the prevalence of UI, with all eight parous players experiencing UI. Four parous players sought treatment, although it is unknown if these players sought treatment before or after returning to their sport. Groom et al. recently published a return to running after pregnancy protocol that highlighted the fact that postpartum women benefit from individualized pelvic floor assessment and rehabilitation for the prevention and management of PFD on their return.27 A recent qualitative study by Davenport et al. suggested that there appears to be limited support for elite female athletes in their return to sport postpartum and that there is a need for evidence-based return-to-sport protocols.28 Interestingly, half of the parous players did not receive treatment for their UI. Future research should include surveying or interviewing past county players to explore if PFD and UI post-childbirth was a factor in leaving elite-level play and if they were aware of the treatment options available. Consideration should be given to the development of a protocol for a return to Gaelic sport postpartum following further mixed-methods research conducted with these elite players.

Conclusions Urinary incontinence is prevalent among this cohort of elite female Gaelic sports athletes.

Risk factors for UI among the players include parity and greater weekly time spent in sporting activity. Players utilized strategies to manage the symptoms of UI rather than seek help for what is a treatable condition. This study suggests a need for increased awareness and education regarding pelvic floor health and the treatment of UI among these players.

References available on request

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46

Epilepsy

Time, Safe, Stay! Be clear on how to respond to a seizure this International Epilepsy Day! For this edition of Irish Pharmacy News, Epilepsy Ireland Advocacy & Communications Manager, Paddy McGeoghegan updates us on the organisation’s plans for their biggest awareness-raising day of the year….

Written by Paddy McGeoghegan, Epilepsy Ireland

know about TIME, SAFE, STAY! But what exactly do we mean about by these three key words?

TIME - the first thing you should do is TIME the seizure. This is because if a seizure goes over 5 minutes, an ambulance should be called.

I am delighted to once again be writing in this edition of Hospital Professional News to update readers on Epilepsy Ireland’s plans for International Epilepsy Day – thank you to the editorial team for the invite to contribute.

SAFE - keep the person SAFE during the seizure. If a person is having a convulsive seizure, cushion their head with something soft, if possible and remove any harmful objects, e.g. furniture from their vicinity. NEVER put anything in a person's mouth or restrain them during a seizure. Be aware that there are also types of seizures where the person does not experience convulsions.

Instead, they may “zone out” or stare blankly, become confused or agitated, display behaviours like chewing, smacking their lips, fiddling with their clothes, or wandering aimlessly. In this type of seizure, the person’s awareness of their surroundings is affected, and it is important to gently guide

As I write this, we are just weeks away from International Epilepsy Day on February 10th. This is our most important day of the year where we seek to increase public understanding and awareness of a condition that affects over 45,000 people in Ireland today.

This year, like previous years and as guided by the people we represent, we are building a new campaign to highlight the importance of knowing how to correctly respond to a seizure and those three important words of TIME, SAFE, STAY. The new campaign will be featured on traditional media, TV, digital billboards, radio and of course, social media. The campaign will be fronted by our two incredible volunteers, Emma and Gareth, whose images will be used to show that epilepsy and seizure first aid becomes much clearer when you

PHARMACYNEWSIRELAND.COM

the person away from any danger.

As with convulsive seizures, never restrict the person’s movements.

STAY - during the seizure and after it passes, STAY with the person.

Often after a seizure, a person with epilepsy will be confused and, in many cases, exhausted.

Make sure to stay with them until recovery is complete, explain what has happened and gently reassure them. The person may have experienced an injury if they have fallen, and if this is the case, ensure normal first aid steps are taken.

This marks the fifth year that we have promoted the key words of TIME, SAFE, STAY when it comes to seizure response, following its inception in 2021. Why do we keep returning to the promotion of these key words? In short, it is working!

For the past 10 years, we have been regularly commissioning and tracking ‘market research’ data on public awareness of and attitudes to epilepsy. It is very interesting and encouraging to look at some of the changes that have taken place in that time: • A person should be restrained during a seizure - 18% agreed with this statement in 2013 compared to just 5% in 2024.

• Almost all seizures involve falling to the ground followed by stiffening and jerking movements - 43% agreed this

statement was true in 2013. This had fallen to 19% in 2024.

• Put an object in a person’s mouth during a seizure - 51% agreed with this statement was true in 2013 vs 21% in 2024.

• Timing the seizure is a key seizure response - 1% said this was correct in 2013 but thanks to TIME-SAFE-STAY, this jumped to 45% by 2024.

Public attitudes do not change overnight and there is still work to do but is clear that we are moving in the right direction – particularly since the introduction of Time, Safe, Stay in 2021.

We hope we will continue to see increased understanding of epilepsy and seizure first aid following February 10th through our new campaign and would appeal to readers of Hospital Professional News to please share TIME, SAFE, STAY with their colleagues, patients, family and friends. We also have detailed posters which can be downloaded, printed and shared from our website.

As always, should Epilepsy Ireland be of assistance to you either in a personal or professional capacity, please do not hesitate to get in touch with us by calling 01 455 7500, emailing info@epilepsy.ie or by visiting www.epilepsy.ie.

OTC & Retail Pharmacy Product Awards 2025 A highly anticipated event in the Irish retail calendar, the Irish Pharmacy News OTC Retail and Pharmacy Product Awards are the only industry accolades dedicated to recognising and rewarding companies and their products within the OTC market.

These Awards serve as a platform to celebrate and showcase excellence in product innovation, marketing, and customer value. Since their launch in 2008, they have been committed to highlighting advancements and innovation within the pharmacy sector.

Pharmacies are the most important distribution channel for consumer health, offering a trusted, accessible, and professional environment for healthcare products and advice. Unlike other retail outlets, pharmacies provide expert guidance from trained pharmacists, ensuring that consumers make informed decisions about over-the-counter (OTC) medications, vitamins, and wellness products.

They serve as a critical touchpoint for public health, offering personalised recommendations, preventative care, and early intervention for minor ailments.

Additionally, pharmacies maintain strict quality control and regulatory compliance, ensuring the safety and efficacy of the products they distribute. Their accessibility, expertise, and commitment to patient care make them an essential link between healthcare manufacturers and consumers.

value sales growth for 2023 was expected to be 6%.

The five major OTC categories (including Pain Relief, Cough, Cold and Respiratory products (CCR), Vitamins and Minerals, Digestive Health, and Habit Treatment) account for ¤450 million of the total value. Unlike other markets, Cough, Cold and Respiratory Products (CCR) is the second largest category in the Irish OTC market.

According to General Manager with IQVIA, Gwynne Morley, “The Global OTC market is expected to grow at +6.8% CAGR during the next five years. It is also forecasted that Europe’s OTC market will grow at 6.1% in 2024. Growth within Ireland’s OTC market is not as optimistic based on the performance of the first half of the year – sales value growth is flat, with 0.4% PPG for the 6-month period ending April 2024.”

Value of OTC Medicines Over the following pages, we showcase those products which have been shortlisted as finalists across categories, including Best Beauty Product, Best Marketing/ Training Campaign, Best Baby Skincare Product, Best Sleep/ Stress Product, Best Children and Baby Product, and much more.

As hospitals and doctors in Ireland face increasing pressure, the role of the pharmacist as the first point of contact in the healthcare system has never been more vital.

Pharmacy services, diagnostic testing, and over-the-counter (OTC) medicines now play a greater role than ever in supporting public health. The pharmacy retail market continues to thrive, despite growing competition from large supermarkets and budget retail chains. To stay ahead, retail pharmacists must develop strong strategies around product knowledge, education, and marketing.

customers toward informed and responsible healthcare choices.

With a greater emphasis on self-care and self-medication, consumers must be confident in selecting safe and effective products. All OTC Award entries will be evaluated by an expert panel of judges from both independent and multiple pharmacies across Ireland. Be sure to check out the April issue of Irish Pharmacy News for the full list of winners.

The OTC Awards highlight excellence in product innovation and marketing—key factors that help pharmacists enhance customer value. As external retailers and powerful buying groups expand their influence, continuous innovation in the OTC market is essential. With consumers increasingly turning to the internet for health information and online shopping, many are managing ailments without consulting a doctor or pharmacist. However, pharmacists still play a crucial role in guiding

OTC Market According to IQVIA, a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries, the total value of the OTC market in Ireland based on IQVIA’s data for 12 months, from May 2023 to April 2024, was ¤571 million. This market grew by 2.1% (value) and decreased by 3.1% (volume) when comparing year-on-year growth.

This was significantly lower than the forecasted growth as Ireland’s

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Zest Active Zest Active contains a combination of 25 active ingredients, including vitamins, minerals, amino acids, beta glucans and choline all delivered in one daily powdered sachet. It offers multiple benefits, including support for the immune system, energy, brain and muscle function.

Best VMS Product More people than ever are taking charge of their health, fueling a nationwide wellness movement.

Staying ahead of consumer needs—or at least keeping pace—is crucial in today’s rapidly evolving market. This is especially true in the dynamic and ever-changing vitamins, minerals, and supplements (VMS) category, where shoppers expect cutting-edge solutions at their local pharmacy.

Specifically formulated for individuals aged 18-30, Zest Active is designed for those seeking an all-in-one solution to support overall wellbeing.

It is the ideal companion for students, fitness enthusiasts, people with busy and active lifestyles, and those looking to support their overall health.

Zest Active is available in two flavour options, Orange and Berry Burst, and is suitable for vegans and vegetarians. It is also gluten-free and halal certified.

Recent market research indicates that vitamin sales will continue to rise as consumers prioritise prevention over treatment. With advancements in at-home and clinical blood testing, more individuals are actively monitoring their health, leading to increased awareness of vitamin deficiencies and the growing demand for targeted supplementation.

The Finalists in this Category are:

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Cleanmarine Bone Factors Cleanmarine® Bone Factors is a gold standard blend of the finest quality and scientifically researched vitamins, minerals and nutrients that play a vital role in supporting female bone health before, during and after menopause.

This supports normal bone maintenance and has 10 bone specific nutrients including Calcium, Magnesium, Vitamin C, Zinc, Vitamin D & K2.

Eskimo Brain 369 Whether you're preparing for exams or looking to maintain normal brain function, Eskimo Brain 369 is a premium dietary supplement designed to support your overall well-being. This expertly formulated blend combines omega-3, omega-6, GLA (gamma-linolenic acid), omega-9, vitamin D3, vitamin E, and coenzyme Q10 to help maintain key body functions. DHA (Docosahexaenoic Acid) contributes to the maintenance of normal brain function, with a daily intake of 250mg. Just as calcium is important for bones, DHA plays a vital role in brain health. Omega-3 fatty acids, including EPA (Eicosapentaenoic Acid) and DHA, also contribute to normal heart function.Taking a daily fish oil supplement, naturally rich in omega-3, is an easy way to support your heart and brain health.

Vitamin D contributes to the maintenance of normal bones and muscle function, while vitamin E helps protect cells from oxidative stress.

Seven Seas Pregnancy Vitamins with Omega-3

AYA Ultimate One a Day AYA Ultimate One a Day is a potent multi-vitamin to support everyday wellbeing with 40 nutrients and only RRP ¤15.95

Seven Seas Pregnancy is a PREGNANCY VITAMIN SUPPLEMENT FOR HEALTHY BABY DEVELOPMENT: Omega-3 DHA supports the healthy development of baby's brain and vision2, Folic Acid supports the healthy development of baby1. WITH AN ADVANCED* FORM OF FOLIC ACID: Provides 400 μg folate provided by Folic Acid and L-Methylfolate - a form that is directly available to the body. Also supports with Zinc, Iron, Vitamin D, Magnesium, Vitamins B2, B6, B12.1, 3-7

Key features: High Potency comprehensive formula.

Contains nutrients that contribute to the reduction of tiredness and fatigue.

Patented timed-release tablet releases nutrients over 6 hours.

*Compared to Folic Acid, L-methylfolate is a form of folate which is ready to be used directly by the body.

References available on request.

Contains amino acid chelated minerals to maximise absorption.

Provides a gentle form of iron less likely to cause constipation or digestive discomfort.

At Eskimo-3, we are committed to providing safe, sustainably sourced, and high-quality omega-3 supplements.

Eskimo Brain 369 is available in liquid and capsule form at health food stores, pharmacies, and online at eskimo3.ie.

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Best Skincare Product Irish consumers remain highly invested in their skincare routines, with a strong focus on achieving healthy, radiant skin and preventing signs of aging.

Clinisoothe+ Skin Purifier

Elave Intensive Ointment 250g

Clinisoothe+ Skin Purifier is a groundbreaking solution developed by leading scientists to protect, soothe, and heal the skin. Its advanced hypochlorous technology purifies and balances, while providing antimicrobial protection.

Clinisoothe+ is suitable for all skin types, even the most sensitive, with a skin-neutral pH and free from toxins, alcohol, and artificial fragrance.

Elave Sensitive Care Intensive Ointment is a treatment ointment formulated to protect the skin's natural barrier and reduce flare-ups of eczema, dermatitis, psoriasis and other dry itchy skin conditions.

Ideal for both face and body, this vegan, cruelty-free product is scientifically designed to reduce irritation, redness, and breakouts, promoting faster recovery and healthier skin. Clinisoothe+ represents innovation, purity, and effectiveness, offering seven skin benefits in one revolutionary formula.

Replaces skin's oils and forms a waterproof barrier to prevent water loss.

In recent years, skincare innovation has surged, particularly in the areas of anti-aging and multifunctional products that cater to busy lifestyles. Pharmacists can recommend targeted treatments, from hydrating creams to barrierrepair solutions, ensuring safe and effective use. As trusted healthcare providers, they also educate customers on ingredient benefits, skincare routines, and solutions for conditions like eczema and contact dermatitis.

The Finalists in this Category are:

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Regular use reduces flare-ups of eczema, dermatitis, psoriasis and other dry, itchy sensitive skin conditions and can extend breaks between corticosteroid treatments.

Clinically proven to be kind and mild to dry sensitive skin.

No Sulfates: No Parabens: Vegan.

Suitable for the treatment of dry skin that may result from other medical conditions or their treatment.

Suitable for use during pregnancy.

Made In Ireland.

fabÜ SKIN-HAIRNAILS GLOW

Cetaphil’s Gentle Skin Cleanser

fabÜ SKIN-HAIR-NAILS GLOW is a premium skincare supplement designed to support healthy skin, hair, and nails.

Developed by pharmacist Laura Dowling, this advanced formula combines Reishi mushroom, amino acids, and essential vitamins to contribute to normal collagen formation, cell protection, and skin hydration.

Cetaphil’s iconic Gentle Skin Cleanser designed for face & body to hydrate as it cleanses. The Gentle Skin Cleanser is clinically proven to remove dirt, makeup, and impurities gently while preserving the skins natural moisture barrier. The versatility of the Gentle Skin Cleanser means it can be used with and without water. Key ingredients include Niacinamide to restore, Glycerin to hydrate and Panthenol to soothe sensitive skin.

Key ingredients include Vitamin C, A, D, E, and Niacinamide, which contribute to skin renewal, as well as Zinc, which contributes to the maintenance of normal hair and nails.

Users have reported improvements in the appearance of their nails, skin, and hair with continued use. This product is also suitable for those experiencing hair thinning associated with post-partum and menopausal changes.

Priced at less than ¤1 a day, fabÜ SKIN-HAIR-NAILS GLOW is an affordable solution for consumers, something that is hugely important to our founder Laura Dowling, who strives to offer accessible wellness and beauty solutions for everyone.

The Gentle Skin Cleanse is clinically proven to:  Provide 48 hours hydration (When wiped off)  Protect against dryness  Improve the resilience of sensitive skin Cetaphil is the #1 dermatologist recommended cleansing brand and specifically formulated to be gentle on sensitive skin, with over 75 years of experience. The Gentle Skin Cleanser is the hero of the Cetaphil marketing campaign across social media, influencers, youtube, amazon prime and digital display in 2025 with the campaign ‘For Everyone’s Sensitive Skin’.

Olay Super Serum Level up your skincare with Olay Super Serum, a powerful face serum containing 5 serum benefits in one, for your best skin in every drop.

1. Better Skin Texture 2. More Even-Looking Skin Tone 3. Firmer Feeling Skin 4. Smoother Visible Lines 5. Long Lasting Hydration.

The concentrated formula is supercharged with 5 potent ingredients: Niacinamide, Vitamin C, Collagen Peptide, Vitamin E, and Alpha Hydroxy Acid (AHA). It penetrates deep into your skin's surface and absorbs quickly without leaving a sticky or tacky feeling. Clinically tested across diverse skin tones and types.

Suitable for Skin Type: Normal, Oily, Dry. Skin Concerns: Visible Pores, Dryness, Fine Lines & Wrinkles, Uneven Texture, Dullness.

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CALPOL® Vapour Plug Bronchostop Junior Bronchostop Junior is a medical device & Nightlight according to Directive 93/42/EEC, used The CALPOL® Vapour Plug can help soothe and comfort your child at night and ease breathing.

Best Children and Baby Product Baby care products play a key role in pharmacies, especially in Ireland, where birth rates remain higher than the EU average. Currently, Ireland has 14.4 births per 1,000 residents, compared to the EU average of 10.1.

CALPOL® Vapour Plug & Nightlight releases soothing lavender and camomile vapours that comfort your child through the night and help with clear & easy breathing.

Its soft nightlight provides a gently reassuring glow, as well as guiding you in the room so you can avoid disturbing your child while they rest.

CALPOL® Vapour Plug & Nightlight is an electrical device and non-medicine.

ALWAYS READ THE LABEL. IE-CAL-2025-106910

Pharmacy teams are uniquely positioned to support parents from birth onwards, offering expert advice on managing common childhood ailments.

From colic to colds and flu, pharmacies provide trusted guidance and essential products to help families navigate the early years with confidence.

The Finalists in this Category are:

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to relieve any cough (dry & chesty) associated with a cold for children from 1 year. Children under 3 years of age should consult with a doctor to exclude more serious diseases being present.

Use in children under 1 year of age is not recommended.

Children aged 1 year and above: 5ml up to 3 times daily. Children 2 to 3 years: 5ml up to 4 times daily. Children 4 to 5 years: 7.5ml up to 4 times daily. Children 6 to 11 years: 15 ml up to 4 times daily.

Always read the instructions for use.

Elave Sensitive Care Baby Bath (Ecocert Organic) Elave Sensitive Baby Bath [Ecocert Organic] is a clinically tested extremely gentle cleanser enriched with Organic Camomile and Organic Aloe Vera to protect and hydrate baby’s delicate skin.

Natural and Organic certified by ECOCERT - 99% of the total ingredients are from natural origin and 20% of the total ingredients are from Organic farming.

NO SULFATES, SLS, SOAP, PERFUME, MI, ALCOHOL, COLOURS & MORE.

Nelsons Teetha Granules

Optibac Babies & Children

Nelsons Teetha® Teething Granules is a homeopathic medicinal product used within the homeopathic tradition for the symptomatic relief of teething pain and the symptoms associated with teething which are sore and tender gums, flushed cheeks and dribbling.

Optibac Babies & Children is a premium probiotic for digestive health and wellbeing, from the brand of friendly bacteria supplements most trusted by parents†. Expertly formulated for babies, toddlers and children aged 0-12, this supplement contains 3 strains of friendly bacteria including the world’s most scientifically studied strain, L. rhamnosus GG. It also contains added Vitamin D3 and prebiotic FOS fibres.

Backed by extensive research, it targets various aspects of children's health including immunity, digestion and skin health, with strains proven to reduce infections, colic, digestive issues, asthma symptoms, and eczema. Each daily sachet is flavourless and easy-to-take.

Parents can be confident with this more natural option, free from added sugar, artificial flavours and colours. It’s also suitable for most diets as it’s free from dairy, gluten and soy. †Optibac is the brand of friendly bacteria supplements most trusted by parents. in Ireland. See website T&Cs for survey details, 500 people, November 2024.

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

Optibac For Women

Wellwomen Max

Optibac For Women is a specialist supplement for those seeking high quality friendly bacteria for women’s intimate flora, from Ireland's most trusted & recommended brand of friendly bacteria supplements†. Contains the world-renowned probiotic combination of Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14®, clinically trialled in over 25 studies across 30 years, and proven to support vaginal health, particularly for those with concerns like thrush, cystitis, or bacterial vaginosis.

This supplement works by supporting natural pH levels, inhibiting pathogens, and enhancing the action of standard treatments such as antibiotics and antifungals. Unlike creams or pessaries, these easy-to-take capsules are suitable for ongoing use and convenient for women of all ages, including during pregnancy, breastfeeding, perimenopause, and menopause. Vegan, gluten-free, and packaged in recyclable glass jars, Optibac For Women is an ecoconscious choice. Plus, for every pack sold, Optibac donates to Womankind Worldwide, supporting women's rights globally, with ¤925,000 raised to date.

Vitabiotics Wellwoman Max Capsules & Tablets is the ultimate daily supplement designed specifically for women.

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

The Finalists in this Category are:

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This comprehensive 3-in-1 multivitamin triple pack provides all-round support for key areas of health, including energy, immune system, hormone levels, bone health and brain function.

Women’s Flora Vitabiotics Wellwoman Max Capsules & Tablets is the ultimate daily supplement designed specifically for women. This comprehensive 3-in-1 multivitamin triple pack provides all-round support for key areas of health, including energy, immune system, hormone levels, bone health and brain function.

It supports key areas such as:  Energy - with vitamins B6 and B12 which contribute to normal energy release  Immune system - with vitamins C and D which contribute to normal immune system function  Regulation of Hormonal activity provides vitamin B6 which contributes to the regulation of hormonal activity  Bone Health - contains calcium and vitamin D which contribute to the maintenance of normal bones.

Always Infinity FlexProtect Sanitary Towels Size 4 Night Extra Wings

Relactagel

Always Infinity FlexProtect Night Extra Absorbency pads are made differenlty and work differently. Infinity FlexProtect sanitary towels are designed for up to Zero Feel and up to Zero Leaks. They offer you flexible protection.

BV is the most common cause of abnormal vaginal discharge in women of childbearing age. It is a bacterial infection that develops where there is less of the normal bacteria (lactobacilli) and an overgrowth of other types of bacteria at higher pH.

They feature our softest top layer and absorbs 20% more vs our Always Ultra Secure Night Pads. Additionally, Always Infinity FlexProtect Night Extra Absorbency pads offer 50% more coverage vs. Always Infinity FlexProtect Size 1. With Always Infinity FlexProtect pads your period is the last thing on your mind.

Relactagel is a lactic acid gel that is clinically proven to treat and prevent Bacterial Vaginosis (BV). Giving relief from often embarrassing abnormal vaginal odour and discharge associated with BV.

There are several things that may upset the natural acidity of the vagina causing BV: including fluctuating hormone levels during your period, pregnancy or menopause, Sexual intercourse, antibiotics as well as stress.

Relactagel is a lactate gel that restores the natural pH of the vagina by promoting the growth of naturally occurring flora or lactobacilli.

Relactagel is an over-the-counter BV treatment. Each box contains 7 hygienic prefilled single- use applicators for a 7-day treatment course.

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Alflorex® Alflorex® is the leading probiotic for IBS, a condition that affects up to 1 in 7 people in Ireland every day. This probiotic is taken daily to manage and prevent recurrence of IBS symptoms. It costs approx. ¤1/day and reduces ALL of the symptoms of IBS including: • abdominal pain

Best Digestive Product

• bloating & gas • unpredictable bowel movements like alternating diarrhoea and constipation The unique 35624® culture in Alflorex is a naturally occurring bacterial strain found in the human gut. This Bifidobacterium longum culture is part of the family of bacteria given by mother to baby at birth.

Pharmacies play a vital role in providing OTC digestive remedies, offering expert advice and accessible solutions for common issues like indigestion, heartburn, bloating, and constipation.

Pharmacists help customers choose the right treatments, from antacids and probiotics to laxatives and enzyme supplements, ensuring safe and effective use.

They can also provide guidance on lifestyle and dietary changes to support long-term digestive health. As trusted healthcare professionals, pharmacy teams are well-equipped to identify when symptoms may require medical attention, ensuring customers receive appropriate care. Their expertise makes pharmacies a go-to resource for managing everyday digestive concerns with confidence.

The Finalists in this Category are:

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Optibac Gut Health Gummies Optibac Gut Health Gummies have been formulated especially to support digestive and immune health from the Ireland’s most trusted and recommended brand of friendly bacteria supplements†. This easy all-in-one supplement contains friendly bacteria, plus your daily intake of Vitamin D3 & Zinc to maintain immunity, Calcium to support digestion and FOS fibres which increase natural gut bacteria. Contains the highly researched probiotic strain, Bacillus coagulans Unique IS-2, scientifically studied in hundreds of people in goldstandard trials and shown to reach the gut alive where it complements the natural gut bacteria. Gut Health Gummies are made with real fruit purees with no added sugar, artificial sweeteners, preservatives or colourings for a naturally delicious flavour.

It is also vegan and allergen-free, with no gluten or dairy. With a home-compostable inner pouch made from plant fibres and recyclable carton, Gut Health Gummies is free from plastic. Good for you, and good for the planet.

Triple Action Biotic

Alflorex® Dual Action

DiaCare

Triple Action Biotic is a powerful formulation to support your gut health and overall wellbeing.

Alflorex® Dual Action is a unique combination of two PrecisionBiotic® cultures (35624® and 1714 - Serenitas®.

A clinical study confirmed the combination of the 35624® and 1714 Serenitas® strains were synergistic.

DiaCare is an advanced oral electrolyte solution designed to support electrolyte balance, aid normal digestion, and promote hydration. Formulated for children aged 3+ and adults, DiaCare is ideal for managing fluid loss caused by diarrhoea, fever, or other conditions.

DiaCare’s scientifically balanced blend of glucose electrolytes, minerals, and Lactobacillus Rhamnosus GG probiotic fibers work to restore hydration, aid digestion and support gut health.

Your digestive system is complex, and the intestine is one of the longest organs in your body. So perhaps it’s not surprising that different parts of your digestive system have different needs, which is where Triple Action Biotic can help.

Triple Action Biotic contains three key elements; PRE, PRO, and POST, that work synergistically together in your gut for a holistic approach to digestive health.

This product was developed in line with Rome IV criteria, which now defines Irritable Bowel Syndrome (IBS) as a ‘disorder of gut-brain interactions’. Two individual strains, two different modes of action both targeting key mechanisms in IBS together, this specific combination of strains targets the gut-brain axis and helps manage both the gut and psychological symptoms associated with Irritable Bowel Syndrome (IBS).

With a pleasant orange flavor, DiaCare is vegan-friendly, gluten-free, and gentle on the stomach. It is the perfect choice for restoring balance to the gut, rehydrating effectively, and supporting digestive health when it's needed most.

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Vivio Junior Multivitamin Tonic

Best Baby and Children’s Supplement Vitamins, minerals and supplements (VMS) have always been an important category in the pharmacy.

Vivio™ Junior is a delicious-tasting multivitamin tonic suitable from 1year+ and specifically formulated by the latest research and nutrient guidelines for children. It is packed with 14 nutrients: 12 vitamins, including Vitamin D, C, and B12 and 2 minerals zinc and added iodine to support growth in children, their immune system and cognitive function.

Vivio Junior is here for parents of children under 12 who want to bridge nutritional gaps caused by fussy eating, busy schedules, or the challenges of providing fully balanced meals. It's designed to support your child’s immune system during school or winter, help them bounce back after illness, and give you an extra tool in your parenting arsenal to make life a little easier.

Growing children, especially those who don’t eat a varied diet, sometimes don’t get enough vitamins A and C. It can also be difficult to get enough vitamin D through food alone for them.

Children’s vitamins, alongside a healthy balanced diet, can help to make sure babies and children are getting everything they need to prevent vitamin deficiencies and stay healthy.

The Finalists in this Category are:

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Junior Revive Junior Revive is a super supplement with 22 Active ingredients including 12 vitamins, 6 minerals, 4 fruit & vegetable powders, Beta Glucans, Fibre, Live Friendly Bacteria and Choline to support a child’s immunity, energy and mental performance all in one daily sachet.

Junior Revive is unflavoured, making it great for fussy eaters. It can be added to yoghurt, juice, healthy cereal, or a smoothie for convenient ways to take.

What sets Junior Revive apart is its scientifically formulated blend, free from fillers, binders, artificial colours, flavours, and contains no added sugar. It’s suitable for Diabetics, Vegans & Vegetarians, it’s Gluten Free and Halal Certified.

Junior Revive has received many positive reviews from parents, praising its ability to support their children's wellbeing and seamlessly integrate into their morning routine.

This reflects a strong commitment to addressing the modern nutritional gaps faced by busy families, encouraging healthy habits from an early age.

BioGaia Protectis Baby Probiotic Drops

Tonstix Throat Pops

BioGaia ProTectis Baby Drops with L. reuteri, the world’s most clinically researched probiotic strain for infant colic, offer an unparalleled solution for colicky infants. Proven to reduce excessive crying by over 76%, providing significant relief for both babies and parents.

Tonstix Honey Jelly Pops are a breakthrough solution for children’s sore throats and coughs, combining efficacy with child-friendly appeal. Made from natural ingredients, Tonstix delivers soothing relief while its fun, safe stick design makes this an easy, mess-free option that children love! Recent studies by the Center of Applied Bioscience Research revealed Tonstix honey-based formulation exhibits wound-healing and anti-inflammatory properties, underscoring its dual benefits. Ideal for pharmacy professionals seeking an innovative, safe, and effective product to recommend to parents, Tonstix transforms a common ailment into a stress-free experience. Suitable for children aged 2 years +

With a well-documented anti-inflammatory, anti-viral, and anti-fungal mode of action, BioGaia ProTectis supports a healthy gut microbiome, addressing colic at its root cause. Clinically backed and trusted by healthcare professionals worldwide, it enhances digestive comfort and immune resilience.

The drops’ user-friendly and easy to administer, making them an essential addition to any pharmacy’s infant care offering. Choose BioGaia ProTectis Baby Drops award winning drops are the gold standard in probiotic innovation, delivering evidence-based relief and peace of mind for families everywhere.

Alflorex® Children Alflorex® Children brings the benefits of our scientifically studied Bifidobacterium longum 35624™ culture in a convenient and reliable dissolvable powder form that has a hint of vanilla Each sachet of Alflorex® Children is packed with 1 x 108 bacteria proven to reach the gut in peak condition. The naturally occurring bacteria is part of the family of bacteria given by mother to baby at birth.

The powder is easily dissolved in milk, yoghurt or a smoothie and is an ideal solution for your children’s daily routine.

The unique 35624® culture in Alflorex® Children is a naturally occurring bacterial strain found in the human gut. This Bifidobacterium longum culture is part of the family of bacteria given by mother to baby at birth.

Tonstix are Nut, Dairy and Gluten Free.

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The Sport Starter Kit The Ultimate Aerosol-Free Hair Solution for Athletes

Best Beauty Product The OTC beauty market is experiencing significant growth, driven by consumer demand for high-quality, accessible skincare, haircare, and cosmetics. Advances in dermatological research, clean beauty trends, and a focus on self-care have fueled interest in effective, science-backed products.

Pharmacies are playing a key role in this expansion, offering trusted brands alongside expert guidance.

Stay focused on your sport without worrying about pesky flyaways. The Sport Starter Kit – Gift Box is designed for active women who need strong, sweat-proof hold without the hassle of hairspray. Featuring the Sleek N Easy Wax Stick and Sleek N Easy Sport Stick, this kit is your on-the-go solution for sleek, controlled hair—before, during, and after your workout.

The Sleek N Easy Wax Stick instantly tames baby hairs and frizz with a lightweight, non-greasy hold, perfect for achieving a polished look in seconds.

The Sleek N Easy Sport Stick goes even further—engineered for high-intensity activities, it keeps hair locked in place while hydrating and strengthening strands with castor oil, Vitamin B5, and glycerin.

Aerosol-Free Alternative – No mess, no crunch, just effortless control. Perfect for gym bags, changing rooms, and post-game touch-ups. Stay sleek, stay confident—wherever you play!

Multifunctional skincare, anti-aging solutions, and dermatologically tested products are particularly popular. Additionally, social media influence and a shift toward preventative skincare continue to shape purchasing habits. As consumers seek convenience and expertise, pharmacies remain essential destinations for OTC beauty products that combine efficacy with affordability.

The Finalists in this Category are:

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fabÜ SKIN-HAIRNAILS GLOW fabÜ SKIN-HAIR-NAILS GLOW is a premium beauty supplement designed to support healthy skin, hair, and nails.

Developed by pharmacist Laura Dowling, this advanced formula combines Reishi mushroom, amino acids, and essential vitamins to contribute to normal collagen formation, cell protection, and skin hydration.

Key ingredients include Vitamin C, A, D, E, and Niacinamide, which contribute to skin renewal, as well as Zinc, which contributes to the maintenance of normal hair and nails.

This supplement supports the body’s natural collagen production, helping to maintain skin elasticity and resilience.

Priced at less than ¤1 a day, fabÜ SKINHAIR-NAILS GLOW is an affordable solution for consumers, something that is hugely important to our founder Laura Dowling, who strives to offer accessible wellness and beauty solutions.

OPTASE® LIFE Sensitive Eye Makeup Remover OPTASE LIFE Sensitive Eye Makeup Remover is an advanced cleansing solution specially formulated for people with sensitive eyes. It offers an effective and gentle way to remove makeup while leaving the skin around the eyes feeling nourished and refreshed. ®

This unique product contains innovative and patented Ionised Water Technology, which acts like a magnet to attract and lift away makeup and impurities effortlessly.

It is also enriched with nourishing ingredients like Hyaluronic Acid, Pro-vitamin B5, and Manuka honey, leaving the eyelids feeling soothed, nourished and refreshed.

Shaant Probiotic Supplement A probiotic supplement designed to support both a healthy gut and skin microbiome, as well as help manage acne by lowering skin sebum production with guggulsterones that help manage blood lipids and green tea antioxidants.

Clinically demonstrated to reduce both inflammatory lesions and comedones by 60% in 8 weeks.

Dr. Hauschka Translucent Bronzing Tint Dr. Hauschka Translucent Bronzing Tint RRP ¤24.95 Create a natural, sunkissed and fresh complexion with Dr. Hauschka Translucent Bronzing Tint. Multi-tasking hero product - can be used as a bronzer, a base by itself, mixed with moisturizer or mixed with your base to deepen it.

Dr Hauschka's Translucent Bronzing Tint is a multi-tasking handbag hero that can be used alone or mixed with your favourite moisturiser.

Infused with tinted mineral pigments and medicinal plant extracts, it expertly blends with your individual skin tone, blends and softens the appearance of blemishes and imperfections. to create a natural, sunkissed and fresh complexion.

Skin looks healthy, fresh, even-toned and radiant.

Formulation: Witch hazel, olive oil, beeswax and mineral pigments protect and nurture while evening out skin tone.

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Acnecide 5% Face Gel Acnecide 5% Face Gel targets the 3 main causes of acne: bacteria, clogged pores, and excess oil. Containing 5% Benzoyl Peroxide, Acnecide helps control breakouts, unblock pores and reduce blackheads and whiteheads, killing up to 95% of spot-causing bacteria in one week.

Best Best Marketing/ Launch product When launching a new product there are several steps to success that are crucial for any business, taking time and careful planning. These include understanding your target audience and how to reach them effectively, looking at what makes your product innovative or different and unifying the product team across all channels, whether it’s marketing, social media or sales.

The finalists in this category have demonstrated that consistency is key when launching a new product within the OTC market.

The Finalists in this Category are:

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Acnecide 5% w/w Gel contains Benzoyl peroxide. Indications: Gel: For the topical treatment of acne vulgaris. Wash: For the cutaneous treatment of acne vulgaris of the face, chest and back, where comedones and papules predominate.

Legal category: P. Information about this product, including adverse reactions, precautions, contraindications and method of use can be found at: Gel: Acnecide 5% w/w Gel (hpra.ie). Wash: Acnecide Wash 5% w/w Gel (hpra. ie). Marketing authorisation number: Gel: PA 22743/001/001; Wash: PA 22743/001/002. Further information is available from Licence Holder: Galderma (UK) Limited, Evergreen House North, Euston, London, NW1 2DX. GBACC-2400075 October 2024

Bladder Support with Go-Less® A natural solution to bladder health for less frequent visits and fewer night-time disturbances.

As we age, both men and women can encounter bladder issues. This can lead to increased urgency, frequency and occasional leakage, making life very uncomfortable, especially when travelling or going somewhere without immediate access to a toilet. It can even affect your sleep when you have to get up to go to the loo during the night (a condition known as 'nocturia').

You can take back control with Bladder Support with Go-Less®. This advanced formulation, containing a combination of botanical extracts and micronutrients, is specially designed to maintain good bladder function and support normal urinary flow.1 Each capsule contains 300 mg GoLess®, a powerful and effective ingredient containing natural extracts of pumpkin seed and soy germ. We’ve also added vitamins B6, D3 and zinc, to help support muscle health and hormonal balance.2 References available on request

AYA Electrolyte Plus

Sleek Styler Brush

AYA Electrolytes Plus is an affordable great tasting Electrolyte combined with Vitamins and Minerals. Robbie Henshaw is our Brand Ambassador and this is his favourite essential AYA product.

Introducing the Sleek Styler Brush – the ultimate tool for effortlessly smooth, shiny, and frizz-free hair. Crafted with premium boar bristles, this brush gently distributes natural oils from root to tip, keeping your hair nourished and healthy without the need for additional products.

- Affordable RRP ¤8.95 - Great taste of lemon/lime or blackcurrant.

- Provides hydration as well as supporting energy and immunity.

- Taste, packaging and marketing innovative.

The brand was created in 2019 and has went from strength to strength in particular since 2023 when we signed Robbie Henshaw and Amber Barrett and gave the brand a refresh and a stronger identity.

Designed for effortless styling, the lightweight, ergonomic handle ensures a comfortable grip, while the carefully placed bristles work to reduce breakage, tame flyaways, and enhance natural volume for a salon-quality finish at home. Whether detangling, styling, or simply refreshing your look, the Sleek Styler Brush glides effortlessly through all hair types, leaving your strands soft, manageable, and full of shine.

Perfect for daily use, this brush is durable, versatile, and a must-have for anyone looking to elevate their haircare routine.

Smoother, healthier hair starts here – experience the Sleek Styler difference today!

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Pharma Plus Menoplus

Best Menopause Product The over-the-counter market for menopausal women is expanding rapidly as more women seek accessible solutions for managing symptoms like hot flashes, mood changes, sleep disturbances, and joint pain. Increased awareness and open conversations around menopause have driven demand for hormone-free alternatives, including herbal supplements, and vitamins like magnesium and vitamin D.

Pharma Plus Menoplus is an Irish menopause support supplement, developed by Irish pharmacists using evidence-based nutrition backed by science. Launched in 2022, the Pharma Plus brand reflects our commitment to providing high-quality, effective solutions for women’s health.

Menoplus is designed to support women through all stages of menopause with its carefully crafted formula. Packaged in a 60-tablet pack (a two-month supply) and competitively priced at ¤28.99, it represents great value. The product is also safe to use alongside Hormone Replacement Therapy (HRT), though we always recommend consulting a GP if unsure.

As a proudly Irish product registered with Guaranteed Irish, Menoplus embodies our dedication to supporting local businesses, sustaining employment, and contributing to Irish communities.

Pharmacies play a key role by offering expert advice and trusted products, from vaginal moisturizers to bone health supplements. As holistic wellness gains traction, demand for adaptogens and plantbased remedies continues to rise.

The growing focus on women’s health ensures continued innovation in this space.

The Finalists in this Category are:

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Menopace Max Menopace Max provides 26 nutrients including vitamin and mineral tablets with Calcium, which contributes to the maintenance of normal bones. It also includes Red Clover extracts to support your diet and Green Tea capsules.

Menopace Max provides essential nutrients and extra Soya Isoflavones to be taken before (perimenopause), during and after the menopause and includes: - The highest level of nutritional support in the Menopace range.

- Includes calcium which is needed for the maintenance of normal bones.

- Includes Red Clover extracts with four highly-researched Isoflavones.

- Does not contain any drugs or hormones.

Meno Active Meno Active is a menopause super supplement that is formulated to support women through all stages of the Menopause. It takes a 360 approach to this time in a woman’s life and supports multiple systems in their body that is impacted by menopause.

This formulation contains 31 active ingredients including 10 vitamins, 7 minerals, 4 digestive enzymes and 3 strains of live friendly bacteria all in one sachet. Plus a botanical capsule with ashwagandha, sage and soya isoflavone (Genistein) and an Omega-3 capsule with 378mg of EPA and 252mg of DHA. The tropical flavoured sachet, botanical capsule and Omega-3 capsule can all be taken together each day to support hormonal activity, brain function, bone health and intimate support as well as the heart, energy, skin, hair and teeth.

fabÜ SHROOMS MENO & PERI

A.Vogel Menoforce A.Vogel Menoforce is a licensed herbal medicine for the relief of menopausal hot flushes and excessive perspiration exclusively based on long-standing use.

fabÜ SHROOMS MENO & PERI is an award-winning supplement designed to support women’s well-being during midlife. Formulated by pharmacist Laura Dowling, it blends Lion’s Mane mushroom with essential vitamins and minerals to contribute to hormonal activity, psychological function, metabolism, and bone and muscle function.

It is the first supplement on the Irish market to focus on this stage of life.

The feedback since launch has been incredible. Women simply love it! Word of mouth and organic user experience content have helped make this one of the top-selling products for women’s wellness in Ireland.

This scientifically formulated blend includes Magnesium, which contributes to normal muscle function; Vitamin B6, which contributes to the regulation of hormonal activity; Vitamin B12, which supports normal psychological function; and Vitamins D & K, which contribute to bone health. Chromium contributes to normal macronutrient metabolism and blood glucose levels.

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Active Iron Pregnancy Active Iron is an Irish iron supplement which is clinically proven to increase iron and energy levels, helping to fight tiredness & fatigue*. Active Iron is specially formulated to avoid constipation, making it kind on the stomach while being strong enough to increase iron levels.

Best Pregnancy/ Fertility Product Community pharmacy is often the starting point for many when it comes to fertility and pregnancy. Infertility is a public health concern and as such, utilisation of pregnancy and fertility services is prevalent, and the role of the pharmacist and the wider pharmacy team.

Pharmacists can assist customers by providing education on infertility causes, referrals, nonpharmacologic and pharmacologic management options, and the OTC options. For those trying for a baby, there are some essentials that can really help to support them.

The Finalists in this Category are:

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Active Iron Pregnancy is a combination product containing non-constipating Active Iron plus a complete time-release multivitamin, providing all the essential nutrients mum and baby need throughout each trimester.

It contains 20 active ingredients in 2 specialised components: - Active Iron 25mg Capsule.

- Triple layer multivitamin tablet, formulated to work in sync with Active Iron and maximise bioavailability and absorption of active ingredients by controlling when each layer is released. * Ledwidge et al. PRECISION Study. Int J Clin Pharm (2023).

Pregnacare Max When you want the most comprehensive support from the Pregnacare range for you and your baby, Pregnacare Max is a trusted source of essential nutrients with Calcium and Omega-3 Capsules providing Omega-3 fatty acids - 300mg DHA and 60mg EPA Pregnacare Max is the ultimate pregnancy support in the Pregnacare range with a specially formulated by experts to be our most optimal and comprehensive pregnancy supplement. It is ideal for mums-to-be who want the maximum nutritional support during pregnancy.

It includes carefully balanced nutrients including L-Methylfolate, an advanced form of Folic Acid and 500mg calcium which contributes to the maintenance of bones and teeth to provide extra support.

With an Innovative formula including 21 vitamins and minerals, including iodine which contributes to normal production of thyroid hormones and function and 10μg vitamin D.

Bio‑Oil® Natural Skincare Oil

Proceive® Women As the most advanced fertility supplement on the Irish market, Proceive® Women is scientifically formulated to support the nutritional needs of women trying to conceive. Developed using extensive clinical research, it delivers 1,038mg of 28 carefully selected nutrients - over three times the level of nutrition found in other brands. This includes 400µg of folic acid in the superior L-Methylfolate form, ensuring optimal absorption.

Bio‑Oil® Skincare Oil (Natural) is an all-natural product clinically proven to help improve the appearance of scars and stretchmarks. Its unique formulation is also highly effective for uneven skin tone, ageing and dehydrated skin. The formulation is 100% natural containing 14 extraordinary oils for the daily skincare routine.

The unique formulation easily absorbs into the skin and has clinically proven results.

After 8 weeks 97% of subjects showed a noticeable improvement in stretch marks.

Bio-Oil® Skincare Oil (Natural) absorbs easily and helps boost skin’s elasticity by keeping it supple and hydrated, it promotes skin regeneration by supporting and restoring damaged skin.

Bio-Oil® Skincare Oil (Natural) is not fragranced, making it suitable for sensitive skin. It does not contain any animal-derived ingredients.

Before Proceive®, there was no fertility supplement category in Ireland - we pioneered the space and set the standard that others now follow. As a homegrown Irish brand with Guaranteed Irish status, innovation is at our core. Now on our fifth formulation update, we continuously refine our products in line with the latest scientific research. Our latest advancements have further enhanced nutrient bioavailability, and we are proud that the Proceive® range is now fully certified vegan.

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ImmunoVit Zinc Defence Lozenges Prone to colds in the winter months?

Scientific studies*, show that zinc acetate lozenges can significantly reduce the duration and severity of cold symptoms, particularly when taken within 24 hours of onset. Clinical evidence supports a daily intake of up to 90 mg (for no more than 10 days) helping the body recover from colds faster and boost immune response.

Best Immunity Product A healthy immune system is the first step of attack against outside invaders such as bacteria or viruses. When an immune system is strong, consumers are more likely to be able to ward off sickness.

Each lozenge contains 34 mg of zinc acetate, which provides 10 mg of active ionic zinc - the most effective form of zinc for immune health. *Scientific studies supporting zinc acetate supplementation: https://pmc.ncbi.nlm. nih.gov/articles/PMC5418896/ https://pmc.ncbi.nlm.nih.gov/articles/ PMC4359576/

There are lifestyle factors that can aid a healthy immune system such as getting enough sleep and exercise, but OTC supplements are also available to help strengthen the body’s immune response either by taking them regularly or at the onset of certain symptoms.

The Finalists in this Category are:

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Immunace Original A normal immune system is a key part of your overall health. But Immunace Original isn’t just vitamin D, zinc and selenium. It’s an advanced multivitamin that also includes Bioflavonoids, Amino Acids, plus vitamins E and C which contribute to the protection of cells from oxidative stress caused by free radicals, and more.

Designed to deliver comprehensive support, Immunace Original gives you advanced nutrition all year round including benefits below: - Supports your immune system with targeted nutrients.

- With vitamin C, zinc and selenium which contribute to the normal function of the immune system.

- A comprehensive multivitamin, developed with international nutritional experts.

Pharma Plus Active Immune Peach & Mango Pharma Plus Active Immune Peach & Mango is an award-winning supplement.

It is a pharmacist-developed supplement formulated using evidence-based nutrition to support immune health and energy levels.

This product simplifies supplementation while prioritising safety and effectiveness keeping in mind the likelihood of interactions. It contains a selection of minerals, vitamins and Wellmune® which is a leading beta yeast glucan clinically shown to strengthen the immune system.

Wellmune® allow you to be well and stay well. Ingredients which are not recommended for the general population, which are likely to interact with medication (such as iron, caffeine, vitamin k, calcium and potassium) have been purposely omitted from the preparation to aid with ease of recommendation by pharmacy teams. It can be taken any time of day with or without food, its free from caffeine, gluten free and vegan friendly.

Revive Active Revive Active contains a combination of 26 active ingredients including vitamins, minerals and amino acids all delivered in one daily powdered sachet offering multiple benefits, including immune support, energy and heart health. The perfect way to supplement your body’s natural resources.

Revive Active as a brand has never compromised on the quality and quantity of the ingredients it uses and that is why each sachet contains 8 active ingredients that support the immune system. These are vitamins C, D, B12 and B6 as well as Folate, Copper, Zinc and Selenium.

Each daily sachet provides a multifaceted approach to supporting the immune system. It is a premium Irish brand that puts the consumer first to ensure that they feel the benefits from taking the product every day.

It is suitable for adults from 30 years of age, has two flavour options Orange & Mango and Tropical and is suitable for Vegans and Vegetarians, is gluten free and halal certified.

RRP: ¤59.95 for a 30 day supply

AYA Ultimate One a Day AYA Ultimate one a day supports immunity through a variety of immunity boosting nutrients. It is also time released formula helping body absorb the formula.

Great quality potent formula at starting at ¤15.95 Contains Vitamin D, C, A, copper & Zinc Key features: High Potency comprehensive formula.

Contains nutrients that contribute to the reduction of tiredness and fatigue.

Patented timed-release tablet releases nutrients over 6 hours.

Contains amino acid chelated minerals to maximise absorption.

Provides a gentle form of iron less likely to cause constipation or digestive discomfort.

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O.R.S Sport Electrolyte Tablets

Best Sports Product The OTC sports medicine category is a vital part of the health and wellness market, catering to athletes, fitness enthusiasts, and active individuals seeking quick and effective relief for injuries and muscle recovery.

Demand for products like pain relief gels, muscle balms, and joint support supplements continues to grow as more people embrace active lifestyles.

O.R.S Sport Hydration Tablets are expertly developed by Pharmacists to meet the hydration needs of athletes and fitness enthusiasts, following the World Health Organisation’s oral rehydration solution guidelines. Approved and recommended by InformedSport.com, they are approved for professional use, ensuring safety and quality for competitive athletes.

These low-calorie tablets (8.5 kcal) combine electrolytes, magnesium, additional sodium, and vitamin D to deliver rapid and effective hydration that lasts longer than water alone. Perfect for restoring fluids lost during exercise, O.R.S Sport Hydration Tablets support optimal performance and recovery. Trusted by professionals and amateurs alike, they are the ultimate companion for sport and fitness hydration.

Pharmacies play a crucial role in this category, offering expert advice on injury prevention, recovery, and rehabilitation.

Consumers are also increasingly seeking natural and sciencebacked solutions, making sports medicine an evolving and dynamic OTC segment.

The Finalists in this Category are:

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ULTRAPURE Laboratories Wintergreen Heat Rub Cream Guaranteed Irish and loved by athletes such as David Gillick, ULTRAPURE Laboratories® Wintergreen Heat Rub Muscle Cream is a must for tired and aching muscles.

Produced in County Mayo, this soothing muscle rub is infused with natural extracts, rich oils, calming Wintergreen Oil and Rosemary Camphor Oil, Juniper Berry Oil and antioxidant-rich Caffeine Powder. Use before exercise to help warm up muscles and after exercise as part of your everyday muscle recovery routine. Apply to the legs, arms, shoulders and back.

Physiologix Ultimate Wrist Support The Physiologix Ultimate Wrist Support relieves pain and inflammation whilst giving freedom of movement for the thumb and fingers. The Physiologix Ultimate range uses innovative AIRFLEX Technology for compression and heat retention, to improve blood circulation and reduce pain.

The Physiologix Ultimate Wrist Support offers firm compression and superior support for sprained, stiff or weak wrists.

The wrap-around adjustable strap helps provide extra support, while allowing a custom fit and blood flow safety. The therapeutic AIRFLEX material helps to warm muscles and joints to assist the natural healing process.

Nuasan Active CBD Gel

AYA Electrolytes Plus

Nuasan Active CBD Gel is a powerful, fast-absorbing formula designed to provide targeted relief for sore muscles and aching joints. Whether you're an athlete recovering from intense training, dealing with everyday muscle tension, or managing ongoing pain symptoms, this gel is the perfect addition to your recovery routine.

AYA Electrolytes Plus is an affordable great tasting Electrolyte combined with Vitamins and Minerals.

Formulated with High-Strength CBD (500mg) and chili extracts for an instant warming sensation, the gel supports muscle and joint recovery while helping to reduce inflammation and discomfort.

No sticky residue, just quick relief exactly where you need it.

- Great taste of lemon/lime or blackcurrant.

Robbie Henshaw is our Brand Ambassador and this is his favourite essential AYA product.

- Affordable RRP ¤8.95

- Provides hydration as well as supporting energy and immunity.

- Taste, packaging and marketing innovative.

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BioGaia Prodentis

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

Driven by consumer interest in all things natural, the market for natural products available over-the-counter has increased over the last number of years.

Consumers are purchasing these for both prevention and immune boosting properties as well as to help aid healing when they are sick.

Prodentis stands at the forefront of oral health innovation by offering a scientifically validated, non-invasive, and natural solution to some of the most common oral health challenges in the form of an easy to take minty lozenge. This advanced oral probiotic containing 2 Lactobacillus reuteri strains which are the most clinically researched probiotic strains for oral health in the world. Lactobacillus reuteri DSM 17938 and Lactobacillus reuteri ATCC PTA 5289 promote oral health in a way that traditional dental products cannot.

Its dual action mechanism works by inhibiting harmful bacteria while promoting beneficial ones, supporting gum health, reducing plaque build up and combating bad breath naturally. Clinical studies have shown its efficacy in reducing gingivitis, periodontitis, and halitosis, making it a ground breaking approach in preventive dental care. Safe to take during pregnancy for bleeding gums. BioGaia Prodentis is not just a supplement; it is a gamechanger in preventative and therapeutic oral care.

The Finalists in this Category are:

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Cys-Control FORT Plus with microbiotics Cys-Control Fort Plus is a 100% plant-based food supplement designed to support the natural balance of the urinary system and microbiota.

Combining three plant-derived active ingredients—D-Mannose, Heather extract, and Cranberry extract—with two microbiotic strains, it offers a unique and natural approach to maintaining overall urinary system well-being.

The product is delivered in a dual-sachet system that separates plant extracts from microbiotic strains, preserving the efficacy and shelf-life of the probiotics. Suitable for adults, including during pregnancy and breastfeeding, Cys-Control Fort Plus is a safe and effective product for those seeking a natural option to support their urinary system and microbiota balance.

Zerochol Cardio Plus Zerochol Cardio Plus is a natural food supplement with plant sterols, red yeast rice, CoQ10 and vitamin B1, clinically proven to lower LDL cholesterol and maintain healthy heart function.

- Clinically Proven: The ingredients in Zerochol Cardio Plus have been scientifically studied and clinically proven

by EFSA to effectively lower cholesterol levels and support heart function.

- Comprehensive Support: By combining plant sterols, red yeast rice, coenzyme Q10, and vitamin B1, Zerochol Cardio Plus offers a well-rounded approach to cholesterol management and heart health and may decrease the risk of developing heart disease.

- Vegan and Vegetarian-friendly formula.

- Natural Solution: Zerochol Cardio Plus provides a natural and holistic approach to managing cholesterol levels and maintaining cardiovascular health, making it a suitable option for those seeking natural alternatives to traditional medication.

- Convenient Once a Day Formula for ease of use and compliance.

fabÜ SHROOMS MENO & PERI

Dr Hauschka Rose Day Cream

fabÜ SHROOMS MENO & PERI is an award-winning supplement designed to support women’s well-being during midlife. Formulated by pharmacist Laura Dowling, it blends Lion’s Mane mushroom with essential vitamins and minerals to contribute to hormonal activity, psychological function, metabolism, and bone and muscle function.

Dr. Hauschka Rose Day Cream is a true classic in the Dr. Hauschka range, Rose Day Cream captures the diverse powers of the rose to nurture and protect dry, mature and sensitive skin, while soothing skin with a tendency toward redness and enlarged capillaries (couperose).

Formulation: Precious extracts of rose petals, wild rose hips, marsh mallow and St. John’s wort balance and tone the skin.

Shea butter, rose petal wax and avocado oil protect skin from drying. Rose Day Cream works to maintain the skin’s oil and moisture balance.

It is the first supplement on the Irish market to focus on this stage of life.

The feedback since launch has been incredible. Women simply love it! Word of mouth and organic user experience content have helped make this one of the top-selling products for women’s wellness in Ireland.

This scientifically formulated blend includes Magnesium, which contributes to normal muscle function; Vitamin B6, which contributes to the regulation of hormonal activity; Vitamin B12, which supports normal psychological function; and Vitamins D & K, which contribute to bone health. Chromium contributes to normal macronutrient metabolism and blood glucose levels.

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Nytol Nytol One-A-Night 50 mg Tablets contains diphenhydramine hydrochloride. A symptomatic aid to the relief of temporary sleep disturbance in adults. Product not subject to medical prescription.

PA1186/016/001. MAH: Chefaro Ireland DAC. The Sharp Building, Hogan Place, Dublin 2, Ireland. Always read the leaflet.

Best Sleep/ Stress Product The sleep and stress market is a valuable category for pharmacies, addressing the growing demand for solutions to manage insomnia, anxiety, and daily stress. With modern lifestyles becoming more fast-paced, consumers are seeking effective, non-prescription remedies such as melatonin, magnesium, herbal supplements, and adaptogens like ashwagandha.

Pharmacies play a key role in guiding customers toward safe and effective options while educating them on sleep hygiene and stress management techniques. The rising interest in holistic wellness has also driven demand for natural and drug-free alternatives, making this category an essential and growing segment within the pharmacy space.

The Finalists in this Category are:

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PrizMAG Pure Magnesium Bisglycinate PrizMAG Pure Magnesium Bisglycinate is an advanced magnesium supplement formulated to help alleviate stress, improve sleep quality, and address magnesium deficiency. Made with pure magnesium bisglycinate, it ensures superior bioavailability for effective absorption without digestive upset. Free of magnesium oxide, fillers, and allergens, PrizMAG is the purest choice for relaxation and nervous system support.

Rescue Kids Night Dropper Rescue Kids Night Dropper provides soothing support for your child's nightly routine, encouraging a calming ritual to prepare them for a restful sleep.

Containing the 5 original Dr. Bach flower essences, as well as White Chestnut, this product is suitable for children aged 3+.

fabÜ R&R RELAX

Zenflore® Calm

fabÜ R&R RELAX is a pharmacistformulated supplement designed to support relaxation and well-being.

Created by pharmacist Laura Dowling, this science-backed formula blends functional mushrooms, adaptogens, vitamins, and minerals to contribute to mental well-being.

Zenflore® Calm harnesses the unique 1714-Serenitas® bacterial culture.

Combining the unique 1714-Serenitas® culture with specially selected b vitamins, and also enriched by a new exciting formula containing saffron extract Zenflore® Calm providing support for mind and body through life’s daily challenges.

With key ingredients like Maitake mushroom and Ashwagandha, along with Vitamin B12, which contributes to normal psychological function, and Magnesium, which contributes to the reduction of tiredness and fatigue, fabÜ R&R RELAX is designed to support relaxation.

 Aids Mental Performance

This unique formulation is developed to help individuals unwind in the evening while maintaining clarity and focus during the day. Consumers appreciate its role in supporting their overall well-being.

 Reduces Fatigue.  Improves Coping The special 1714-Serenitas® culture in Zenflore Calm has been clinically studied in partnership with scientists and clinicians from one of the world’s leading centres of research on the human microbiome.

Priced at less than ¤1 a day, fabÜ R&R RELAX offers an accessible wellness solution, a key priority for founder Laura Dowling.

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Best Eye Care Product

HYLO-FORTE

MACU-SAVE GOLD+

HYLO-FORTE® is an eye drop that provides intense lubrication and longlasting relief from symptoms of dry eye disease. HYLO-FORTE® contains 0.2% Hyaluronic Acid and provides patients with a preservative free & phosphate free formulation that is gentle on sensitive eyes. It is contact lens compatible making it convenient for patients and remains sterile for up to 6 months once opened.

It is suitable for adults and children of all ages and can be used during pregnancy and breastfeeding.

MACU-SAVE is an advanced eye health supplement designed to slow macular degeneration and maintain vision to keep from sever loss of vision. It contains clinically proven ingredients, including the three macular carotenoids—Lutein, Zeaxanthin, and Meso-Zeaxanthin— harvested from the highest-quality marigold plants (Tagetes Erecta), to enhance the quality of vision and visual performance.

MACU-SAVE also features FloraGlo Lutein and OPTISHARP Natural Zeaxanthin for optimal visual performance. Enriched with Vitamin B2, which contributes to the maintenance of normal vision, and Vitamin E, which protects cells from oxidative stress, MACU-SAVE is a trusted, science-backed choice for maintaining eye health and supporting visual quality in the long term. Recommended by Ophthalmologists nationwide.

The eye care market in Ireland has seen steady growth, driven by increasing consumer awareness and demand for advanced, specialised solutions. More people are prioritising eye health, seeking products that address specific needs such as digital eye strain, dry eye, and age-related vision changes.

Technological advancements and a growing aging population have further fuelled this trend, with consumers looking for innovative treatments, from hydrating eye drops to blue-light-blocking solutions. Pharmacies are playing a key role in meeting this demand, offering expert guidance and a wide range of over-the-counter products to support eye health and overall vision care.

The Finalists in this Category are:

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One Nutrition Macu Complete

MacuShield Original+ Omega 3

HYLO DUAL INTENSE®

One Nutrition Macu Complete is one-aday multi nutrient formula designed to support normal vision and healthy eyes*.

MacuShield Original+ Omega 3 is a food supplement for eye health* that has been developed in collaboration with leading eye experts. Our product combines all three macular carotenoids: Lutein, mesozeaxanthin and zeaxanthin in a 10/10/2 ratio. These nutrients are found at the back of the eye, at the macula, where they form the macular pigment. The macular carotenoids in MacuShield are obtained from marigolds (Tagetes Erecta), with the petals specifically used for this purpose.

HYLO DUAL INTENSE® is the next generation drop in therapeutic relief for dry eye disease. HYLO DUAL INTENSE® is a long lasting, preservative free, combination eye drop containing 0.2% High Molecular Weight Hyaluronic Acid and 2% Ectoin® that provides patients with instant, long-lasting relief from intense dry eye symptoms.

Macu Complete contains 12 nutrients including 4 macular carotenoids combined with Omega 3 from Algae Oil, Vitamin C, Zinc, Copper, B vitamins and Grape seed extract in an optimum formulation.

The 4 macular carotenoids are zeaxanthin, meso-zeaxanthin, lutein and EVTene™, which contains the most natural form of carotenes, in a ratio that is similar to the carotenoids content found in carrots.

UVA/UVB, LED lighting and digital screens radiate blue light which can damage eye cells (oxidation). Macu Complete supports eye health by providing eye nourishing antioxidants which research indicates are supportive to the human eye.2,3,4 *Omega 3 DHA contributes to the maintenance of normal vision. The beneficial effect is obtained with a daily intake of 250 mg of DHA. Vitamin B2 (Riboflavin) contributes to the maintenance of normal vision. Zinc contributes to the maintenance of normal vision.

Our formula also contains vitamin B2 and 250mg of DHA, an omega fatty acid, which are each scientifically proven to help maintain normal vision. DHA also contributes to the maintenance of normal brain function ,the beneficial effect is obtained with a daily intake of 250mg DHA. Our Omega 3 is sourced from algal oil, which is a sustainable plantbased alternative to fish oil and therefore leaves no fishy taste. MacuShield, part of Irelands No.1 Eye Supplements brand.*

These dual acting ingredients work together to break the viscous cycle of dry eye offering patients superior hydration while also stabilising the patient’s tear film and reducing inflammatory symptoms.

HYLO DUAL INTENSE® is conveniently presented in the patented COMOD bottle which offers patients precise dosing with a guaranteed 300 drops and 6 months sterility from first opening.

*MacuShield Original + Omega contains Vitamin B2 and 250mg DHA, which each help to maintain normal vision.

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Best Irish Pharmacy Brand Product

Active Iron

Nutri Nua

Active Iron is an Irish iron supplement which is clinically proven to increase iron and energy levels*, helping to fight tiredness & fatigue. Active Iron is specially formulated to avoid constipation, making it kind on the stomach while being strong enough to increase iron levels.

Made in Ireland, Nutri Nua is a range of high quality nutritional supplements, containing plant-based ingredients and suitable for vegans. The range contains the most bioavailable forms of nutrients, containing no artificial additives or fillers.

Nutri Nua was developed by Wholefoods to specifically meet the needs of the Irish pharmacy consumer. We felt there was a gap in the market within pharmacy for a range of supplements that were free from artificial additives and available at an affordable price. All our products are made from fully recyclable packaging here in Ireland. This is what makes the brand truly innovative and unique.

Active Iron’s groundbreaking whey protein formula targets the body’s natural site of absorption, the DMT-1. This helps reduce oxidation and protects the gut from inflammation. As a result, Active Iron delivers better absorption of iron sulfate. * Ledwidge, M. et al. PRECISION Study.

Int J Clin Pharm (2023)

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

With OTC Products available from global companies also, Irish brands must work hard to establish themselves in order to get ahead of the competition.

The Finalists in this Category are:

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We continue to support pharmacies through the provision of quality training materials, including a database of product training videos available on the Wholefoods website. We also have a specific training manual for stores to order from Wholefoods. Innovation will continue for Nutri Nua through new product launches, and in 2024, two new products were added to the range - a No Flush Niacin supplement and a Hair, Skin & Nails supplement.

Pharma Plus Brand

Revive Active

fabÜ

Pharma Plus is a premium range of supplements developed by Irish pharmacists using evidence-based nutrition and backed by scientific research. Designed with healthcare professionals in mind, Pharma Plus aims to simplify the recommendation process for OTC staff while supporting customers' health and well-being.

This Irish super supplement, formulated and manufactured in Ireland, is delivered in a powdered format and contains a comprehensive combination of vitamins, minerals and amino acids in one convenient daily powdered sachet.

The daily sachet can be added to water, juice or a smoothie and due to the form of ingredients used they have higher bioavailability as vitamins and minerals dissolved in liquid form are absorbed in the body more easily than in tablet form.

fabÜ is an innovative Irish pharmacy brand that blends science with the power of nature to create targeted nutritional supplements. Founded by award-winning pharmacist Laura Dowling, fabÜ harnesses the principles of pharmacognosy—the study of medicinal plants, herbs, and mushrooms—to formulate high-quality, effective natural health solutions. Laura used her 21 years of experience in community pharmacy to listen to people and learn about their concerns. She developed this Irish brand for Irish people, addressing their specific needs.

The range currently includes: Active Immune Peach & Mango 30pk – for energy and immune support; Active Immune Berry 30pk - for energy and immune support; Active Immune Teen 28pk - for energy and immune support in teens; Meno Plus 60pk – a perimenopause and menopause supplement; Omega 3 1000mg 60pk – to support brain function, heart health and vison; Pharma Glow 28pk – Marine collagen to reduce fine lines and wrinkles.

While improving skin elastically.

And something exciting is coming soon— stay tuned!

Revive Active was the original daily powdered supplement and what still makes this product stand out from the crowd is the fact that each sachet contains 150mg of CoQ10, 3,000mg L-Arginine and 1,000mg Taurine as well as 23 other quality ingredients. Customers really feel the difference when they take Revive Active and that is why it’s still Ireland’s Number 1 Vitamin and Dietary Supplement *.

This super supplement is suitable for adults from 30 years of age.

References available on request

Launched in 2022, fabÜ has quickly gained recognition and trust, and is now available in over 1,200 Irish pharmacies and health food stores. Each product is carefully designed to support specific general health needs, including wellbeing, relaxation, psychological function, immune support, and digestive health.

The range includes seven expertly formulated supplements, incorporating functional mushrooms, essential vitamins, and minerals to deliver science-backed results based on authorized claims. fabÜ’s commitment to consumer education and retail support sets it apart.

Your only supplement solution.

Created by pharmacists with you in mind.

Your only supplement solution.

Created by pharmacists with you in mind.

PHARMACYNEWSIRELAND.COM | 79

A.Vogel Echinaforce Throat Spray

Vivio Junior Cough Syrup

Echinaforce® Sore Throat spray is a traditional herbal medicinal product used to relieve sore throats associated with coughs, colds and flu, exclusively based upon long-standing use as a traditional remedy.

VIVIO® Junior Cough Syrup is a 100% natural and preservative-free cough syrup, specifically formulated for Children 1 year+ for both dry, chesty and congested cough.

Best Cough, Cold and Flu Product The cough, cold, and flu market is a crucial category for pharmacies, especially during peak seasons.

Consumers rely on pharmacies for fast, effective relief from symptoms like congestion, sore throat, and fever, driving strong demand for decongestants, cough syrups, lozenges, and immunesupport supplements.

Pharmacists play a key role in advising customers on the best treatments while ensuring safe use, particularly for vulnerable groups.

As more people seek preventative solutions, including vitamins and natural remedies, this category remains essential for pharmacy growth and customer care.

The Finalists in this Category are:

80 | PHARMACYNEWSIRELAND.COM

The exclusive formula has a soothing and delicious taste thanks to the natural honey and strawberry. The added marshmallow extract reinforces the soothing and calming properties of the syrup due to its natural mucilage properties. Dry cough: VIVIO® Junior Cough Syrup forms a protective film on the throat, thanks to the xanthan gum and arabic gum action, which protect the throat from the contact of irritant or infectious agents, relieving its irritation and keeping it hydrated and lubricated. Chesty and Congested cough: VIVIO® Junior Cough Syrup also hydrates and reduces the thickness of the mucus thanks to the cane sugar, which stimulates saliva and increases the water content in the mucus to make it more fluid and easier to clear. Free from artificial colours, flavours or sweeteners. Gluten and lactose free. Suitable for vegetarians.

Does not need to be refrigerated.

Solpa Cold and Flu

Vicks VapoRub 50g

For the relief of symptoms of colds and flu and the pain and congestion of sinusitis, including aches and pains, headache, blocked nose, sore throat, chills, lowering of temperature, and to loosen stubborn mucus and provide relief from chesty coughs. Product not subject to medical prescription. PA1186/021/002. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland.

Vicks VapoRub is an ointment which is used to relieve nasal catarrh (inflammation of mucous membranes in the nose and throat), congestion (a blocked nose), sore throat and coughs due to colds. Vicks VapoRub contains four active ingredients: Camphor, Turpentine oil, Levomenthol and Eucalyptus oil.

Solpa Cold & Flu Multi Relief Max Powder for Oral Solution, Paracetamol 1000 mg, Guaifenesin 200 mg, Phenylephrine Hydrochloride 12.2 mg. For the relief of symptoms of colds and flu and the pain and congestion of sinusitis, including aches and pains, headache, blocked nose and sore throat, chills, lowering of temperature, and to loosen stubborn mucus and provide relief from chesty coughs. Product not subject to medical prescription. PA1186/021/003. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland.

• Levomenthol and camphor calm a cough • Eucalyptus oil and Levomenthol relieve nasal congestion (blocked nose) • Eucalyptus oil relieves catarrh

Benylin® Day & Night Tablets BENYLIN® DAY & NIGHT tablets are the only cold/flu remedy to offer 24 hour relief with tablets specifically designed for Day and Night.

Each white tablet contains 500mg Paracetamol and 60mg Pseudoephedrine hydrochloride. Each blue tablet contains 500mg Paracetamol and 25mg Diphenhydramine hydrochloride. During the day the white tablet relieves fever and decongests the nose. During the night the blue tablet helps relieve cold symptoms to aid a better sleep.

Each pack contains 12 ‘’day’’ tablets and 4 ‘’night’’ tablets. Today’s hectic lifestyle means cold suffers often don’t have the opportunity to take time out from their busy lives. BENYLIN® DAY & NIGHT tablets unique offering helps consumers to keep going throughout the Day by relieving their symptoms, while the Night Tablet relieves cold symptoms and so aids a better night’s sleep.

The product is the only day & night tablets for 24 hour cold and flu relief, and the consumer-friendly packaging clearly demonstrates which tablets are for each occasion, day and night.

PHARMACYNEWSIRELAND.COM | 81

Topic Team Training – Omega 3 A community pharmacy environment that fosters teamwork ensures high levels of consumer satisfaction.

This series of articles is designed for you to use as a 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. essential for healthy circulation.

ALA can contribute to the production of EPA and DHA in the body but not in amounts enough to be of benefit.

The below information, considerations and checklist provide support to enable you to run a team training session and identify opportunities for learning within the topic of Omega 3.

Omega-3 is one of the most widely studied areas of nutrition, with claims of benefits to multiple aspects of health, from AMD to CVD. Fish oil’s popularity has soared in recent years, propelled by research that suggests consuming omega-3 fatty acids can ward off heart disease. Community pharmacists play an important role in helping patients make informed decisions about fish oil and omega-3 supplementation.

But with hundreds of OTC options available (and labels claiming that the supplements treat everything from bipolar disorder to menstrual cramps) how can pharmacists distinguish between them to help patients make the best choice?

Fish oils are a type of polyunsaturated fatty acids (PUFAs). They are the omega-3 and omega-6 fatty acids.

Regarding heart health, the active ingredients in fish oils are DHA and EPA. The hypothesis is that omega-3s offer protection

from cardiovascular disease by reducing the heart’s susceptibility to arrhythmias, decreasing platelet aggregation and lowering blood pressure and triglyceride levels.

Sold by pharmacists since the early years of the 20th century, cod liver oil is one of the oldest and most well-known food supplements. The oil first gained its reputation as an effective preventative against rickets because of its high vitamin D content and it was taken by generations of children, decreasing in popularity only when, in the 1960s, the British government decided to phase it out as a welfare food.

Fish oils are most commonly used in supplements for conditions related to the heart and blood system. They may also be used for many kidney-related problems.

There is little doubt that n-3 fatty acids have an important role in nutrition. They are significant structural components of the phospholipid membranes of tissues throughout the body, particularly in the brain and retina. Because of their role in cell membranes, n-3 fatty acids are essential for the formation of new tissue and are therefore important for development and growth (eg, during foetal and infant development).

For optimal foetal health, women can be advised to take a DHA dominant Omega-3 oil from the start of their pregnancy.

Long chain n-3 fatty acids (and other fatty acids) are present in breast milk and European Union regulations now allow their addition to infant formulas.

Pharmacy team should be aware of, and understand, the following key points: • Those who could benefit from an increased intake of n-3 fatty acids. The typical Irish diet contains relatively low amounts of these.

• Fish oil appears to reduce the risk of CHD. It may help to

There are eleven types of Omega-3 but the three most referred to are: • ALA (alpha linolenic acid) which contributes to overall health but is deemed to be of lower importance that other types.

• EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are both deemed to be of most importance to over health,

Key Points:  The causes of acute pain, including the various types of injury  What types of pain can be considered for management in the pharmacy

Consider:

 Which customers should be referred to the pharmacist

 Is the pharmacy team fully trained on the indications and benefits of all products for the treatment of acute pain?

 The use of the PRICE method

 How are pain relief products (oral and topical) displayed in the pharmacy?

 The importance of not taking certain oral analgesics for longer than three days without referral

 Do we make the most of the potential for linked sales (e.g. oral and topical analgesics, food supplements, complementary therapies, support bandages)  Am I up to date with the latest guidance?  Am I aware which preparations are recommended first-line?

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reduce the risk of thrombosis (by increasing bleeding tendency), reduce blood levels of triacylglycerols, prevent atherosclerosis and arrhythmias and reduce blood pressure • Fish oil may have a role in various mental disorders, such as depression, schizophrenia and Alzheimer’s disease, but research in this area is in its infancy How much Omega-3 is required?

The ideal intake of Omega-3 likely varies by age, gender and overall health. International guidelines vary and take the form of portion recommendations rather than actual amounts of Omega-3. The Irish Heart Foundation advises eating fish twice a week for a healthy heart. One adult portion of salmon contains approximately 1.24 grams of DHA and 0.59 grams of EPA. Generally, daily intake of Omega-3 should not exceed 3 grams. The Association of UK Dieticians gives the following weekly oily fish portion recommendations for overall health: • 18 months to 3 years – 1-3 tablespoons • 4 to 4 years – 2-4 tablespoons • 7-11 years – 4-6 tablespoons • 12 years to adult – 140g.

Actions: Ensure support staff understand the following key points:  The common types of acute pain  The characteristics of a good analgesic for OTC use in the treatment of acute pain  The benefits and limitations of OTC medicines  The importance of what outcome a patient presenting with pain wants  Lifestyle issues that may impact on pain recovery, and tips on improving lifestyle

 Questions to ask the customer

 What approaches are recommended by the World Health Organisation (WHO) analgesic ladder

 The role of dietary supplements

 When to refer customers to the pharmacist.

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Vitamin D Manganese Vitsupports amin C JointCare your active lifestyle1

Vitamin D contributes to the maintenance of normal bones and normal muscle function. Manganese contributes to the normal formation of connective tissue. Vitamin C contributes to normal collagen formation for the normal function of bones and cartilage. *Source ©2024 NIQ data,Bones Value and Units, Vitamin & MinMuscles erals (Client defined), 52 w/e 28.Cartilage 09.24, Total UK. Verify at htConnective tps://seven-seas. co.uk/ Tissue Food supplements are not intended as a substitute for a varied and balanced diet and a healthy lifestyle.

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

84

Awards

Unlocking Success: Expert Tips for Entering the 2025 Irish Pharmacy Awards Entering awards for your pharmacy business is an excellent opportunity to gain recognition, establish credibility, and celebrate your achievements.

Winning an Award can boost your business’s visibility, attract new customers, and set your pharmacy apart from competitors. However, entering any Awards can be a competitive process that requires careful planning, attention to detail, and a strong strategy.

strengths align with the category you choose. For example, if your pharmacy has a successful medication management programme, entering a category that recognises innovation in healthcare services might be the best fit.

In this article, we will provide tips and advice on how to successfully enter the 2025 Irish Pharmacy Awards, focusing on the essential elements of the process, crafting your application, and standing out from the competition.

• Eligibility Requirements: Some awards have specific eligibility criteria. Ensure your pharmacy meets these before proceeding.

If there are prerequisites, like a minimum number of years in operation or specific types of services provided, make sure to confirm that your business qualifies.

1. Understand the Awards You Are Entering Before you start the application process, it’s crucial to thoroughly research the awards you’re interested in. Different awards have various categories, eligibility criteria, and judging processes.

Understanding these aspects is the first step to ensuring that you apply for awards that align with your pharmacy's strengths and objectives.

• Research the Award’s History and Reputation: Look into the prestige of the Award and how long it has been running. An award with a solid reputation in the industry can offer more value than one that is relatively new or lacks credibility.

• Understand the Categories: Many awards have different categories, such as Customer Service Award, Innovation and Service Development, Pharmacist of the Year and SelfCare. Ensure your pharmacy’s

2. Identify Your Unique Selling Points (USPs) One of the key steps in the award application process is identifying the unique qualities of your pharmacy business that make it stand out. Think about what makes your pharmacy different from others in your area and how this can be a point of distinction in your application.

• Innovative Services: If you’ve introduced unique services that benefit your customers, such as specialised health consultations or a personalised medication management system, highlight these. Any innovation that improves customer care or pharmacy operations can be a great selling point.

• Customer Service Excellence: The level of service you provide to your customers can be a deciding factor in awards. For

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10/08/2022

instance, if your pharmacy staff go the extra mile by offering consultations, reminder services for prescriptions, or creating a welcoming and professional environment, these details should be emphasised.

• Community Involvement: Pharmacies often play a key role in their local communities.

If your pharmacy is involved in charity work, health education campaigns, or community outreach programs, be sure to showcase these initiatives.

• Quality of Products and Services: Emphasise the quality and range of products you offer, including any specialised or hard-to-find items. If you have exceptional quality control, customer satisfaction rates, or other metrics that showcase your commitment to excellence, include these in your submission.

3. Plan and Organise Your Application Entering an award requires a well-organised and thoughtfully crafted application. Judges are typically looking for clear, concise, and compelling information that highlights your achievements.

Here are some strategies to help you plan and structure your application effectively: • Follow the Guidelines: Each award application will come with a set of instructions.

Carefully read these and ensure that you follow the guidelines regarding word counts,

14:58

Introducing...

A DIVISION OF

Haleon, formerly part of GSK

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document formatting, and any additional materials you need to submit, such as photos, videos, or testimonials.

• Use Clear and Engaging Language: Be sure to communicate your points clearly. Avoid jargon or overly complex language. Instead, focus on how your pharmacy meets or exceeds the award criteria. Engage the reader by using examples, statistics, and evidence wherever possible.

• Tell a Story: While it’s important to be factual, storytelling can make your application more compelling. Consider describing how your pharmacy has evolved, challenges you’ve overcome, and how you’ve grown or improved over time.

This narrative can help the judges relate to your journey.

• Provide Evidence: Your application should include measurable evidence to support your claims. This might include customer satisfaction surveys, success rates for your services, testimonials, or case studies.

Numbers are particularly persuasive; for example, “Our customer satisfaction score has increased by 25% over the past year” or “We’ve helped over 500 patients manage chronic conditions through our personalised care programme.”

• Highlight Achievements and Impact: Focus on both the tangible and intangible results of your work. For example,

YOUR KEY TO LOWER CHOLESTEROL LIFE IS TOO SHORT TO WORRY ABOUT CHOLESTEROL Contains Plant Sterols, proven to lower cholesterol levels.

Zerochol Cardio + contains plant sterols, red yeast rice, CoQ10 and vitamin B1 to support Heart Health.

Zerochol is a dairy free, sugar free and low calorie alternative to yoghurts, drinks and spreads.

Choose Zerochol Cardio+ to support Heart Health and Lower Cholesterol, if you are NOT taking statin medication and are aged betweem 18 and 70 years.

Choose Zerochol Max Strength as a First step in Lowering Cholesterol, Suitable for all adults 18+ years and if you are taking medications inc. statins.

Zerochol® Max Strength and Zerochol® Cardio + are not intended for those who do not need to control their cholesterol. Please consult your doctor if you are taking medication.

This is not intended to diagnose high cholesterol and is only to provide a guide to choosing the most appropriate Zerochol product.

Zerochol Cardio + Product Code: 19972. Zerochol Max Strength Product Code: 19940

zerochol.ie

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Awards

don’t just list the services you offer, but also explain how they positively impact the lives of your customers or the wider community.

4. Focus on Customer Experience Many awards, especially those in the healthcare or service industries, will place a strong emphasis on customer experience.

This is one area where your pharmacy can truly shine, as personalised care and excellent service are often what sets a pharmacy apart.

• Testimonials and Feedback: Collect testimonials from customers who have had positive experiences with your pharmacy. This can be in the form of letters, online reviews, or short quotes that can be integrated into your application.

Positive feedback from your patients can add authenticity and weight to your application.

• Highlight Customer-Centric Policies: If you have customerfriendly policies, such as flexible hours, home delivery services, or patient counselling, make sure to describe these in your application. Explain how these services enhance the overall customer experience and make life easier for your patients.

• Measure Customer Satisfaction: If possible, collect and present data about your customers’ satisfaction levels. This can be done through surveys, reviews, or customer retention rates. Showing that your customers consistently rate your services highly can be a strong endorsement of your pharmacy’s commitment to quality care.

5. Leverage Your Team Your team is the backbone of your pharmacy business, and their hard work and dedication should be recognised. Highlighting your team’s contributions to the success of your pharmacy can strengthen your application.

• Celebrate Employee Contributions: Showcase your employees’ dedication and how they contribute to the pharmacy’s success. This could be through their expertise, teamwork, or exceptional customer service.

• Training and Development: If your pharmacy invests in employee training and development, mention this in your application. Continuous learning and improving skills not only benefit your staff but also

your customers, and it can make your pharmacy stand out.

• Leadership and Management: If you or your management team have been instrumental in driving the success of the pharmacy, describe your leadership style and any strategies you have employed to improve business performance. Good leadership can be a significant factor in award applications.

6. Be Thorough with the Submission Once you have compiled your application, take the time to double-check everything before submission. Small errors can detract from the overall professionalism of your entry.

• Proofread: Ensure there are no spelling or grammatical mistakes in your application. A wellwritten and polished submission will leave a positive impression on the judges.

• Review Your Evidence: Make sure that all evidence you’ve submitted is clear, relevant, and supports your claims. Include any documents or links as required, and ensure that they are properly formatted.

• Meet the Deadline: Make sure that you submit your application before the deadline. Late entries may be disqualified, so it’s important to leave ample time for last-minute edits and submissions.

7. Engage in the Award Ceremony If your pharmacy is nominated or wins an award, be sure to fully engage in the ceremony. This is a significant milestone, and it’s important to take full advantage of the exposure and networking opportunities.

• Celebrate Your Success: Whether you win or are nominated, it’s important to celebrate the achievement.

Share the news with your customers through social media, press releases, and in-store displays. This recognition can build trust with your customers and elevate your brand.

• Network with Other Professionals: Award ceremonies offer a chance to network with other pharmacy owners, industry professionals, and potential partners. Take the opportunity to learn from others, share ideas, and discuss industry trends.

• Leverage Your Award: If you win an award, use it as a marketing

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tool. Display the award prominently in your pharmacy, mention it in advertising materials, and incorporate it into your brand messaging.

Awards offer social proof of your pharmacy’s excellence, and it can help boost credibility and attract new customers.

8. Keep Improving Even if you don’t win, the process of entering awards can be a valuable learning experience.

Use the feedback from judges to identify areas for improvement in your pharmacy business. Awards are not only about recognition— they can also be an opportunity for growth.

• Identify Strengths and Weaknesses: Reflect on the feedback you received and use it as a guide to continue refining your services and operations. Identifying areas for improvement can help you become more competitive in future award cycles.

• Set New Goals: Based on your experience, set new goals for your pharmacy business.

Whether it’s expanding your services, improving customer satisfaction, or investing in new technology, aim to build on y our strengths.

Conclusion Entering the Irish Pharmacy Awards for your pharmacy business, staff and teams, can be an exciting and rewarding process.

By carefully selecting the right Award categories, highlighting your pharmacy’s strengths, and crafting a compelling application, you can enhance your chances of success.

Remember that the application process is not only about winning but also about showcasing your pharmacy’s achievements, gaining recognition, and setting the stage for future growth. Use the tips and advice outlined above to guide your efforts and ensure that your pharmacy stands out in the competitive landscape of the Irish Pharmacy Awards.

Generic Product Launch

Fluticasone Furoate Teva 27.5 micrograms/spray Nasal Spray, Suspension fluticasone furoate

Indications Fluticasone Furoate Teva 27.5 micrograms/spray, Nasal Spray, Suspension Fluticasone Furoate Teva is indicated in adults, adolescents and children (6 years and over).

Fluticasone Furoate Teva is indicated for the treatment of the symptoms of allergic rhinitis.

Fluticasone Furoate Teva Nasal Spray Abbreviated Prescribing Information.

Presentation: Each spray actuation delivers 27.5mcg of fluticasone furoate. One actuation delivers 8.25mcg of benzalkonium chloride. Indications: Indicated in adults, adolescents and children (6 years and older) for the treatment of the symptoms of allergic rhinitis. Dosage and administration: Intranasal route only. Adults, Adolescents (12 years and over): The recommended starting dose is two spray actuations (27.5mcg of fluticasone furoate per spray actuation) in each nostril once daily (total daily dose, 110mcg). Children (6 to 11 years): The recommended starting dose is one spray actuation (27.5mcg of fluticasone furoate per spray actuation) in each nostril once daily (total daily dose, 55mcg). Children (under 6 years of age): Not recommended for use. Elderly: No dose adjustment required. Renal and Hepatic Impairment: No dose adjustment required. Contraindications: Hypersensitivity to the active substance or to any of the excipients. Precautions and warnings: Systemic effects of nasal corticosteroid may occur, particularly at high doses prescribed for prolonged periods. These effects are much less likely to occur than with oral corticosteroids and may vary in individual patients and between different corticosteroid preparations. Potential systemic effects may include Cushing’s syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, cataract, glaucoma and more rarely, a range of psychological or behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression (particularly in children). Treatment with higher than recommended doses of nasal corticosteroids may result in clinically significant adrenal suppression. If there is evidence for higher than recommended doses being used, then additional systemic corticosteroid cover should be considered during periods of stress or elective surgery. As with all intranasal corticosteroids, the total systemic burden of corticosteroids should be considered whenever other forms of corticosteroid treatment are prescribed concurrently. If there is any reason to believe that adrenal function is impaired, care must be taken when transferring patients from systemic steroid treatment to fluticasone furoate. Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include

Teva Pharmaceuticals Ireland, Digital Office Centre Swords, Suite 101 - 103, Balheary Demesne, Balheary Road, Swords, Co Dublin, K67E5AO, Ireland.

Freephone: 1800 - 201 700 | Email: info@teva.ie

Prescription Only Medicine.

cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids. Growth retardation has been reported in children receiving nasal corticosteroids at licensed doses. A reduction in growth velocity has been observed in children treated with fluticasone furoate 110mcg/day for one year. Therefore, children should be maintained on the lowest possible efficacious dose which delivers adequate symptom control. It is recommended that the growth of children receiving prolonged treatment with nasal corticosteroids is regularly monitored. Concomitant administration with ritonavir is not recommended because of the risk of increased systemic exposure of fluticasone furoate.

Interactions: Fluticasone furoate is rapidly cleared by extensive first pass metabolism mediated by the cytochrome P450 3A4. Based on data with another glucocorticoid (fluticasone propionate), that is metabolised by CYP3A4, co-administration with ritonavir is not recommended because of the risk of increased systemic exposure of fluticasone furoate. Caution is recommended when co-administering fluticasone furoate with potent CYP3A inhibitors including cobicistat-containing products as an increase in the risk of systemic side effects is expected. Co-administration should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side effects, in which case patients should be monitored for systemic corticosteroid side effects. Pregnancy and lactation: Fluticasone furoate should be used in pregnancy only if the benefits to the mother outweigh the potential risks to the foetus or child.

Administration of fluticasone furoate to patients who are breast-feeding should only be considered if the expected benefit to the patient is greater than any possible risk to the child. Effects on ability to drive and use machines: no or negligible influence on the ability to drive and use machines. Adverse reactions: Hypersensitivity reactions including anaphylaxis, angioedema. Very Common: Epistaxis. Common: Headache, nasal ulceration, dyspnoea. Consult the Summary of Product Characteristics in relation to other side effects. Overdose: In a bioavailability study, intranasal doses of up to 2640mcg/day were administered over three days with no adverse systemic reactions observed. Acute overdose is unlikely to require any therapy other than observation.

Legal category: POM. Marketing Authorisation Number: PA1986/126/001. Marketing Authorisation Holder: Teva B.V., Swensweg 5, 2031GA Haarlem, Netherlands. Job Code: MED-IE-00087. Date of Preparation: October 2024.

Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie.

Adverse events should also be reported to Teva UK Limited on +44 (0) 207 540 7117 or medinfo@tevauk.com

Date of Preparation: January 2025 | Job Code: GEN-IE-00109 Further information is available on request or in the SmPC. Product Information also available on the HPRA website.

88

Cervical Cancer

Bridging the Gaps in HPV Cancer Prevention Authors Cara M Martin and John J O’Leary on behalf of the CERVIVA consortium Cara Martin BSc (Hons), MSc, PhD, FRCPath, Associate Professor in Molecular Pathology, Tumour Biology and Cancer Screening, Cancer Prevention Research Theme Co-Lead, Trinity St. James's Cancer Institute, Co-Lead of CERVIVA Research Consortium, School of Medicine, Trinity College Dublin.

John O’Leary MD, DSc, PhD (Oxon), MSc, MA (j.o.), MA (Oxon), FRCPath, FFPathRCPI, FRCPI, FTCD. Chair of Pathology, Trinity College Dublin - Co-Lead of CERVIVA Research Consortium, Discipline of Histopathology and Morbid Anatomy, The School of Medicine, Trinity College Dublin. vaccination reduces the risk of these cancers too, and we must do more to increase uptake of the HPV vaccine among girls and boys, by increasing awareness of the role of HPV in these other cancer types and the benefits of HPV vaccination for the prevention of these cancers in both men and women.

Cara M Martin

John J O’Leary

Cervical cancer is a largely preventable disease but worldwide it remains one of the most common cancers and causes of cancer-related death in women. In 2020, the World Health Organization launched the global strategy to accelerate the elimination of cervical cancer as a public health problem.1 Elimination of cervical cancer as a public health problem will be reached by achieving fewer than four new cases per 100,000 women in every country. To achieve this goal, three targets have been clearly identified to accelerate elimination and achieve this goal.

annually. Ireland is in an excellent position to move rapidly towards cervical cancer elimination, having access to excellent populationbased cervical screening and HPV vaccination programmes.

Indeed, the HSE have recently published a roadmap and action plan to align with the WHO targets setting 2040 as a target date for Ireland to achieve cervical cancer elimination.2 Since the introduction of CervicalCheck The National Cervical Screening Programme in 2008,3 Ireland has seen a year on year 2.8% decline in the incidence of cervical cancer. Furthermore, following the introduction of HPV vaccination in 2010, some early data is emerging on the positive impact of HPV vaccination in reducing the number of women presenting with abnormal cervical screening tests.4

• 90% of girls to be fully vaccinated with the Human Papilloma Virus (HPV) vaccine by age 15, • 70% of women to be screened by age 35 and again by age 45 using a high-performance test (equivalent to or better than an HPV test), • 90% of women identified with cervical disease (precancerous lesions or invasive cancer) to receive treatment.

In Ireland, the current cervical cancer rate is estimated at 10.1 per 100,000 women,2 with almost 290 new cases being diagnosed

Virtually, all cases of cervical cancer are caused by HPV, however, HPV infection also increases the risk of other cancers such as vulval, vaginal, penile, anal and head and neck cancer.

Ongoing research in Ireland suggests there remains a lack of awareness of the role HPV plays in these other cancers. Moreover, the incidence of most of these other HPV associated cancers is increasing in Ireland.5 HPV

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Our research group CERVIVA is a multi-investigator consortium led

by Professor John O’Leary and Professor Cara Martin of Trinity College Dublin, encompassing researchers at several national and international academic institutions, and health agencies (www.cerviva.ie). The consortium was established in 2005, with the purpose to advance high quality peer-reviewed research programmes in HPV associated diseases and it continues to conduct transformative research in this area.

Our research programme is focussed developing new improved cervical screening approaches, for both vaccinated and unvaccinated populations, understanding barriers to screening and vaccinations among certain groups and developing new screening approaches and biomarkers for early detection of other HPV associated cancers including vulva, vagina cancers, anal cancer, and oral cancers.

Some of our flagship research programmes that support the HSE’s plan for cervical cancer elimination include the following: CERVIVA HPV Primary Screening Study Molecular triage strategies for HPV positive women, funded by the Health Research Board. This is an observational cohort study which has recruited over 13,000 women (aged 25-60years) who attended primary care for their routine cervical smear. The study

led by TCD was established in partnership with CervicalCheck the National Cervical Screening Programme in Ireland, to evaluate a range of different HPV and novel biomarker tests and technologies for use in cervical screening, specifically in the context of HPVbased primary screening. Our study assesses a range of different biomarker and triage options for use with HPV based screening to help stratify those women at risk of developing cervical cancer and show the potential benefits of including additional biomarkers such as for example partial HPV genotyping, methylation biomarkers and p16ink4a/ki67 biomarkers into the screening algorithm.6, 7 The study is the first of its kind internationally that is looking at this range of molecular triage tests and their performance longitudinally. The study is ongoing and will continue to collect data for 10 years following participants initial enrolment in the study.

CERVIVA-Vax: Monitoring the impact of HPV vaccination in Ireland, funded by the Health Research Board The introduction of HPV vaccination and changes to cervical screening protocols with introduction of HPV testing, raise important clinical challenges for cervical screening programmes, most notably regarding the impact of HPV vaccination on screening as it is currently organised and how this will affect the disease landscape and sub-type of human papilloma virus (HPV), present in the Irish population. Monitoring the impact of vaccination on screening is hugely important.

CERVIVA-Vax will generate Irish data relating to the early impact of HPV vaccination on cervical screening. By investigating the early impact of HPV vaccination on screening in Ireland, CERVIVAVax will be able to inform policy

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90

Cervical Cancer

and practice in relation to the best cervical screening approaches for vaccinated and unvaccinated women. Indeed, together with the National Screening Service, some early evidence is available on the impact of HPV vaccination at reducing the number of women presenting with abnormal cervical screening tests.4 What influences cervical screening uptake in older women and how can screening programmes translate this knowledge into behaviour changing strategies? A CERVIVA-Cervical Check coproduction project Well-organised cervical screening is effective in reducing cervical cancer incidence and mortality.

To achieve these benefits, high coverage is essential. In Ireland, the coverage target is 80%.2 While overall coverage has risen from 74.7% in the first 5 years to 78.3% in the 5 years to 2020, it has consistently been lower in older (50-60years) than younger (25-49years) women.8 This distinctive pattern is not seen in other countries with organised programmes and the reasons for it are unknown. This CERVIVA CervicalCheck co-production

project is generating evidence on the influences on cervical screening participation among older women in Ireland, to inform development and implementation of evidence-based strategies to increase screening coverage in this group. We are learning more about the barrier’s women in this group face with respect to participation in screening, ranging from previous experiences to ease of arranging appointments for example.

On this Cervical Cancer Prevention Week, we continue to work towards the vision of an Ireland where cervical cancer and indeed all HPV associated cancers are rare in every community. Our research programme supports the National Action Plan for Cervical Cancer Elimination. We encourage all eligible woman to avail of cervical screening and encourage all parents to vaccinate their children are to ensure they are protected against HPV. References: 1. https://www.who.int/initiatives/ cervical-cancer-eliminationinitiative 2. Ireland’s Cervical Cancer Elimination Action Plan

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2025-2030. Strategic Vision 2025-2040 https://assets.hse. ie/media/documents/Irelands_ Cervical_Cancer_Elimination_ Action_Plan_2025-2030.pdf 3. National Cancer Registry Ireland.

Cancer Trends No. 38. Breast, cervical and colorectal cancer 1994-2019: National trends for cancers with populationbased screening programmes in Ireland. NCRI; 2022.

Available from. https://www. ncri.ie/sites/ncri/files/pubs/ Trendsreport_breast_cervical_ colorectal_22092022.pdf 4. Rourke, M., Fitzpatrick, P., Popoola, O., Boms, R., Mooney, T., Heavey, L., Mason Mohan, C., Martin, C.M., Jessop, L, Russell, N.E. The effect of HPV vaccination on the rate of high-grade cytology in 25-year-old women attending cervical screening in Ireland. Ir J Med Sci 193, 665–668 (2024). https://doi.org/10.1007/s11845023-03551-y 5. National Cancer Registry Ireland. Cancer Trends No 40.

HPV-associated cancers 2024.

Available from https://www.ncri. ie/sites/ncri/files/pubs/NCRI_ HPVRelatedCancers_2024_0.pdf

6. White, C, Reynolds, S, Murphy, K, Keegan, H, Naik, P, O'Brien, R, Pilkington, L, Sharkey Ochoa, I Gleeson, G, Russell, N, Nuttall, D, Tewari, P, Wright, F O'Toole, S, Sharp, L, Flannelly, G, O'Leary, JJ, Martin, CM. Performance of the HPV E6/E7 mRNA Aptima HPV assay combined with partial genotyping compared with the HPV DNA Cobas 4800 HPV test for use in primary screening: Results from the CERVIVA HPV Primary Screening Study in Ireland. Int J Cancer. 2023 Aug 26. doi: 10.1002/ijc.34685.

Online ahead of print. PMID: 37632406 7. O'Leary JJ, White C, Spillane C, Naik, P, O'Brien, R, Reynolds, S, Pham, T, Pilkington, L, Sharkey Ochoa, I, Bolger, N, Barry O'Crowley, J, Tewari, P, O'Toole, S, Sweeney, M, Keegan, H, Normand, C, Sharp, L, Flannelly, G, Martin, CM. Cervical screening: A new way forward (tests of risk and tests of disease). HRB Open Res 2018, 1:3 (doi: 10.12688/ hrbopenres.12794.1) 8. CervicalCheck Programme Report September 2017-March 2020

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92

JIA

An Update on Juvenile Idiopathic Arthritis Written by Dr Orla Killeen, Consultant Rheumatologist and Dr Diarmuid McLaughlin, Clinical Fellow, Children’s Health Ireland for up to 60% of all cases with the knee being the most commonly affected joint.

The heterogeneous nature of JIA adds to the complexity of fully understanding the underlying pathophysiology. It is likely a number of different risk factors, including genetic (HLA associated) and environmental (infectious triggers), are involved resulting in an auto-immune driven disease process with the production of proinflammatory cytokines causing synovial inflammation.

Dr Orla Killeen

Dr Diarmuid McLaughlin

Juvenile Idiopathic Arthritis (JIA) refers to a group of inflammatory arthritides of unknown cause that begin before 16 years of age and persists for at least 6 weeks. It is the most common chronic paediatric rheumatological condition affecting approximately 1 in 1000 children and young people less than 16 years of age with an overall female predominance.

on the subtype of JIA. It can be asymptomatic and potentially lead to irreversible sight loss including blindness. All children with a diagnosis of JIA should be referred to ophthalmology for uveitis screening (within 6 weeks of referral) with subsequent regular uveitis monitoring by slit lamp examination. Duration of uveitis monitoring will depend on the age of the child at diagnosis and subtype of JIA, however is typically up until the age of 11-12 years (RCO/BSPAR Guidelines).

It is important that other causes of arthritis, including infection and malignancy, are excluded before the diagnosis is made. The key features of JIA include joint pain, stiffness, swelling and loss of movement or reduced function.

Chronic anterior uveitis is strongly associated with JIA and can occur in up to 30% depending

The International League Against Rheumatism (ILAR) classification criteria characterise JIA into 7 different subtypes as shown in Table 1. Oligoarticular JIA is the commonest subtype accounting

Right sided knee effusion in a child with oligoarticular JIA

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Clinical Assessment, Investigations & Diagnosis Whilst investigations can be helpful to exclude other pathologies, JIA remains a clinical diagnosis without a single diagnostic investigation.

If there is clinical concern of JIA then a paediatric rheumatology referral should not be delayed even if investigations are normal.

Careful clinical assessment therefore remains essential with a detailed history and a basic musculoskeletal assessment, as a minimum, such as the paediatric Gait, Arms, Legs, Spine (pGALS).

Particular focus to changes of the child’s activities, new limitations, developmental regression in addition to exploration of key features including joint pain, stiffness and swelling are important. If an abnormality is detected on pGALS assessment,

then a more detailed joint assessment should be performed such as the paediatric Regional Examination of the Musculoskeletal System (pREMS). Further information on clinical assessment and these examination methods can be found in the recommended further reading.

Elevated inflammatory markers including erythrocyte sedimentation rate, C-reactive protein and ferritin are likely to be elevated in Systemic JIA, however can be entirely normal in the other JIA subtypes. Autoantibodies can aid with prognosis and subtyping of JIA but are not diagnostic. Positive antinuclear antibodies (ANAs) in the presence of JIA can be associated with an increased risk of chronic anterior uveitis, however also occurs in other paediatric rheumatological diseases (e.g. childhood Systemic Lupus Erythematosus), nonrheumatological paediatric disorders (e.g. auto-immune hepatitis) and in healthy children.

Rheumatoid factor is rarely positive, less than 5% of all JIA patients, and more likely to be present in adolescent females with polyarticular disease predicting a more aggressive disease course and similar disease pattern to adult onset rheumatoid arthritis.

Therefore, JIA should still be considered in a child presenting with joint symptoms with a Dactylitis of the 1st, 2nd and 4th toes in a child with psoriatic JIA

93 negative rheumatoid factor. HLA B27 positivity is associated with enthesitis related JIA, however is found in approximately 20% of healthy children and can also be found in other paediatric inflammatory diseases including chronic recurrent multifocal osteomyelitis (CRMO) and inflammatory bowel disease. It is important to note that up to approximately 30% of those with enthesitis related JIA can be HLA B27 negative.

Untreated JIA associated chronic anterior uveitis with band keratopathy, posterior synechiae and cataract formation

(e.g. synovial fluid aspiration in presence of single hot swollen joint in febrile child to exclude septic arthritis) and malignancy (e.g. bone marrow aspirate in a child with joint pain and/or swelling, malaise, fever and pancytopenia).

Imaging can be helpful as part of the diagnostic work-up and later during the disease course for monitoring of disease activity and potential complications.

Further investigations are considered case by case and in particular to exclude alternative diagnoses such as infection Table 1: JIA Subtypes based on the ILAR Classification Criteria

Subtype Oligoarticular JIA

Definition Arthritis affecting 1 to 4 joints during the 1st 6 months of disease; 2 subcategories recognised: 1. Persistent Oligoarticular JIA: No more than 4 joints affected throughout disease course 2. Extended Oligoarticular JIA: More than 4 joints affected after the 1st 6 months of disease

Polyarticular JIA: Rheumatoid Factor Positive Polyarticular JIA: Rheumatoid Factor Negative Psoriatic JIA

Affecting 5 or more joints during the 1st 6 months. Rheumatoid factor positive on at least 2 occasions measured 3 months apart during the 1st 6 months Affecting 5 or more joints during the 1st 6 months. Rheumatoid factor negative

Enthesitis Related JIA

Arthritis and enthesitis or arthritis or enthesitis and at least 2 of: • HLA B27 positivity • Sacroiliac joint tenderness and/or inflammatory lumbosacral back pain • Onset in male over 6 years of age • Acute symptomatic anterior uveitis • Family history of HLA B27 associated disease

Systemic JIA

Arthritis in 1 or more joints with or preceded by fever of at least 2-week duration, documented daily for at least 3 days, accompanied by 1 or more of: • Evanescent erythematous rash • Generalised lymphadenopathy • Hepatomegaly and/or splenomegaly • Serositis

Arthritis and Psoriasis or arthritis and at least 2 of: • Dactylitis • Nail pitting or onycholysis • Psoriasis in 1st degree relative

Undifferentiated JIA Arthritis that fulfils none or in 2 of the above categories Table 1: JIA Subtypes based on the ILAR Classification Criteria Clinical Assessment, Investigations & Diagnosis

X-Rays are likely to be normal initially, however can be helpful in detecting bony erosions and considering alternative causes for a child’s pain (e.g. presence of osteochondral defect).

Ultrasonography (US) can detect early or longstanding inflammatory changes within the joint and is useful in monitoring of disease activity. MSK US in paediatric rheumatology is continuing to be established, well tolerated by children and can be performed rapidly at the bedside. Magnetic Resonance Imaging (MRI) ideally performed with gadolinium contrast is helpful for those where diagnostic uncertainty exists, in the presence of a normal ultrasound or monitoring for further complications. Availability can however be limited with delays in younger children requiring general anaesthetic.

Management Principles of management include early referral to the paediatric rheumatology specialist multidisciplinary team (MDT), initiation of early treatment and monitoring for complications.

Complications (such as joint damage, sight impairment, growth disturbance) are fortunately less frequently seen due to earlier diagnosis and mostly due to recent advancements in the development of biological agents to treat JIA and chronic anterior uveitis.

The MDT including physiotherapy, occupational therapy, clinical nurse specialists and psychology are all essential in the optimal management of a child with JIA. Preparing the young person with JIA for transition to adolescent services is particularly important to ensure timely transition at an appropriate timepoint for the

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JIA

With 94 the continued use of biological agents, the need for autologous haemopoietic stem cell transplant has reduced and is reserved for severe, refractory cases of JIA. Generic Name Etanercept Adalimumab Infliximab

Class TNF-α blocker TNF-α blocker TNF-α blocker

Golimumab Tocilizumab

TNF-α blocker IL-6 blocker

Anakinra Abatacept

IL-1 blocker T-cell blocker

Route and Frequency Subcutaneous injection once or twice weekly Subcutaneous injection fortnightly Intravenous infusion – initially 2 weekly and then 4-8 weekly. Also available as subcutaneous injection Subcutaneous injection monthly Intravenous infusion – fortnightly or monthly.

Also available as subcutaneous injection Subcutaneous injection daily Intravenous infusion - initially 2 weekly and then monthly. Also available as subcutaneous injection Orally twice daily

Table 2: Biological agents currently used in the treatment of JIA

Ruxolitinib, JAK inhibitor Tofacitinib Table 2: Biological agents currently used in the treatment of JIA

A separate focusing on Systemic Macrophage Syndrome will be young personarticle with regards to their is likely toJIA be and needed in order to Activation or where there is intolerance disease control and education. to standard DMARD therapy. establish rapid disease control discussed in May’s edition The diagnosis of JIA does not Screening for infection (namely followed by a weaning course of change and therefore should tuberculosis) before commencing oral prednisolone. not be relabelled as rheumatoid and blood monitoring before and Methotrexate is the most arthritis as the patient moves to during biologic therapy is important frequently used Disease Modifying in addition to contraception adultJIA: services.

Key Points Anti-Rheumatic Drug (DMARD) counselling and awareness Non-Steroidal either in weekly subcutaneous condition. or • JIA isAnti-Inflammatory the commonest paediatric rheumatological Key features of infection risk (including the Drugs (NSAIDs) are 1st line oral form. It is used in cases avoidance of live vaccinations include joint swelling, pain, stiffness and restricted movement treatments for JIA. NSAIDs such as extended oligoarticular and recommendation of annual in isolation are unlikely to beassessment JIA, is polyarticular or psoriatic • Careful clinical necessaryJIAwith consideration of alternative inactivated influenza vaccination). sufficient to control the arthritis.

JIA where isolated IACIs are diagnoses such as infection and malignancy Intra-articular corticosteroid Table 2 summarises the main unlikely to provide sufficient injections (IACIs) are used for the cancontrol agents used in the • Initial investigations oftenofbedisease. normal and should notbiological delay referral treatment of Oligoarticular JIA and treatment of JIA. Anti-TNF • with Chronic anterior candevelopment be asymptomatic and screening is isnecessary foras a of biological in those polyarticular jointuveitis The therapy typically used agents to selectively inhibit the involvement for further 1st line biological agent, except allwaiting children with JIA effects of pro-inflammatory systemic treatment to take full in systemic JIA where an anti MDT involvement to the management JIAreceptor antagonist cytokines have transformed of a child effect.• This lessens the potentialis central IL-1with or IL-6 the management of JIA where use of•high dose systemic steroids is used.

T cell blockage Intra-articular corticosteroid injections, DMARD and biologic therapy form and additional immunosuppression, and their multiple side effects and Janus Kinase (JAK) inhibitors are mainstay treatments for JIA to DMARD therapy, is required. toxicity in the a growing child. of In cases reserved typically for cases that Biological agents are also of severe JIA, such as systemic not responded • A diagnosis of JIA does not change or become relabelledhave as the patient to anti-TNF becoming increasingly used as 1st JIA or aggressive polyarticular JIA therapy. Anti CD-20 therapy, such moves joints to adolescent services.

Timely transition is key is less frequently lineadult treatments in some subtypes involving multiple – pulsed and as rituximab, intravenous methylprednisolone of JIA (e.g. enthesitis related JIA) used but can be considered in cases of refractory rheumatoid factor positive polyarticular JIA. Advancements in research and ongoing clinical trials are JIA: Key Points promising with the development of additional biological agents. With • JIA is the commonest paediatric rheumatological condition. the continued use of biological Key features include joint swelling, pain, stiffness and agents, the need for autologous restricted movement. haemopoietic stem cell transplant • Careful clinical assessment is necessary with consideration of has reduced and is reserved for alternative diagnoses such as infection and malignancy. severe, refractory cases of JIA. • Initial investigations can often be normal and should not A separate article focusing on delay referral.

Systemic JIA and Macrophage • Chronic anterior uveitis can be asymptomatic and screening is Activation Syndrome will be necessary for all children with JIA. discussed in May’s edition • MDT involvement is central to the management of a child with JIA.

Further reading

• Intra-articular corticosteroid injections, DMARD and biologic therapy form the mainstay of treatments for JIA.

Clinical examination including pGALS and pREMS assessment methods – Paediatric Musculoskeletal Matters (PMM) learning portfolio www.pmmonline.org

• A diagnosis of JIA does not change or become relabelled as the patient moves to adolescent and adult services. Timely transition is key.

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Musculoskeletal clinical assessment guide in children and young people - https:// versusarthritis.org/media/ n2wd1am4/va_paediatrichandbook-2024_digital-finalversion.pdf References available on request Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, MaldonadoCocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P; International League of Associations for Rheumatology.

International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol.

2004 Feb;31(2):390-2. PMID: 14760812. https://www.rcophth.ac.uk/wpcontent/uploads/2022/02/2006_ PROF_046_JuvenileArthritisupdated-crest-2.pdf - Accessed 20th January 2025 Zaripova, L.N., Midgley, A., Christmas, S.E. et al. Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches. Pediatr Rheumatol 19, 135 (2021). https://doi. org/10.1186/s12969-021-00629-8 McLaughlin D, Keir M, Foster H, Jandial S. Chronic arthritis in children and young people. Online Journal of Medicine. Elsevier.

January 2022.

McKenna D, McLaughlin D, Campbell C, Mulholland M, Thompson A, Loughran C, Jackson P, Rooney M. Fifteen-minute guide to managing oligoarticular juvenile idiopathic arthritis. Arch Dis Child Ed. 2022; 107:175-181.

Osteoporosis

95

Osteoporosis: Shattering the Silence Although osteoporosis is often described as the ‘silent epidemic’, the alarm bells for a crisis in the management of osteoporotic fractures continue to sound very loudly.

There is currently a high prevalence of osteoporosis and low bone mass in the Irish population, a feature that is set to grow in accordance with our aging population. The consequences of an osteoporotic fracture, particularly a hip fracture, can be bleak, often leading to longer term disability and increased mortality.

The challenge of course, is to identify the people at risk, before a fracture occurs, and to implement an appropriate treatment strategy to reduce fracture risk. Given that successful treatment strategies are available, the solution may seem straight-forward. However, current research shows that there is a large treatment gap, with many people at risk not receiving the treatment they need. While there are various factors that contribute to this treatment gap, lack of timely diagnosis is known to play a role.

In the identification of fracture risk, DXA (Dual X-Ray Absorptiometry) is the gold standard for the measurement of bone mass density (BMD) and the diagnosis of osteoporosis. Indeed, BMD, as determined by DXA, is the single best predictor of fracture.

However, with limited DXA services, and an aging population, how can we ensure that the ‘correct’ people are referred for DXA, so as to optimise efficiency of resources, while providing care and prevention for the people most at risk? Research shows that DXA is most beneficial when used to target people with known risk factors, such as advancing age, low body weight and use of glucocorticoid medications.

Indeed, the International Society for Clinical Densitometry (ISCD) provide very clear guidelines on who should be referred for DXA https://iscd.org/officialpositions-2023/. Their position is that all women aged 65 or older, and men aged 70 or older, are appropriate candidates for DXA, as well as certain other cohorts of the population with clinical rationale.

However, despite this awareness, a mismatch persists within the system, with many people, sadly, missing the opportunity for appropriate preventative care.

Although a national screening programme would provide appropriate and equal access for all, this has not yet materialised for Ireland, despite long-standing calls from academics and clinicians.

While Fracture Liaison Services

have made immense progress in improving the identification of people at risk of secondary fractures, the ultimate goal is to identify risk earlier and avoid fracture in the first instance.

In the midst of this quandary, research forges ahead to develop useable and innovative approaches for the improved identification of people at risk of osteoporotic fracture. Some of these approaches use predictive algorithms based on known risk factors. The FRAX® fracture risk assessment tool https://frax. shef.ac.uk/FRAX/index.aspx, first launched at the University of Sheffield in 2008, is the best known of these, with its use in Ireland known to have increased between 2011 and 2019. As well as age, sex and weight, it currently includes 8 other risk factors, with the additional option to include BMD, if available, for more accurate predictions. With the more recent launch of FRAXplus®, development is ongoing to refine calculations and to keep apace of emerging research. As many different risk factors for osteoporosis have been identified, accurate prediction of fracture risk is potentially a complex task.

However, even simple calculations, such as the Osteoporosis Self Assessment Tool (OST), which considers only age and body weight, have been shown to have high predictive value for use in point-of-care settings. Tools such as these have utility, not only in the clinical decision-making process of referral for DXA, but in and of themselves, for the identification of men and women at various stages of life, who may benefit from evidence-based lifestyle, behavioural, and possibly even appropriate pharmaceutical strategies, to maintain bone mass as they age. Another avenue of research is the potential use of bioimpedance analysis for the estimation of bone mass.

Bioimpedance analysis is a safe, relatively low cost and convenient technology. It is non-invasive, and takes less than a minute to provide a body composition assessment with calculated estimates of fat, muscle and even bone mass. While it is well-established to provide reliable and valid calculations of fat and muscle mass, its validity for the estimation of bone mass is less certain. While further research is needed in this area, the concept of being able to quickly provide a full

Written by Dr Louise Horrigan, Lecturer, University of Galway

In the midst of this quandary, research forges ahead to develop useable and innovative approaches for the improved identification of people at risk of osteoporotic fracture. assessment to include an estimate of bone mass, at the same time as the indicators of other conditions associated with body composition, such as obesity, is very appealing. Other point-of-care assessments that can indicate a risk of fracture include functional tests such as handgrip strength, the timed up-and-go test and the one-leg standing test. These functional tests, while often used to assess muscle strength, can also be indicative of bone mass and bone strength, partly due to the close physiological relationship between muscle and bone, but also because they assess aspects of balance and strength, which are critical for the prevention of falls. Indeed, the risk of falling is an aspect of fracture risk that, while influenced by age, bodyweight and other factors, is probably more difficult to quantify than any single physiological or clinical risk factor. Therefore, notwithstanding the importance of good access to DXA, point-of-care assessments such as these have an important complementary role to play in the overall clinical assessment of fracture risk.

So while we await a national screening programme for osteoporosis, researchers and

clinicians will continue to strive in various ways, to innovate, to collaborate, and to develop, in order to shatter the silence on this debilitating and life-limiting epidemic. Part of this work is to increase the utility of point-of-care assessments, in order to improve the identification of people at risk of fracture, and ultimately to reduce the risk and improve the quality of life for our aging population and their families.

References: E E, Wang T, Yang L, Dempsey M, Brennan A, Yu M, et al. Utility of Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Irish Men and Women: Results of the DXAHIP Project. J Clin Densitom.

2021;24(4):516-26.

Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, et al. SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos.

2021;16(1):82.

Horrigan LA, Cooke M, Diskin J, Brennan A, Carey JJ. Could pointof-care bioimpedance analysis be another tool in the prevention of osteoporotic fractures? J Orthop.

2025;64:29-33.

O’Sulivan, D; Carey JJ https:// hospitalprofessionalnews. ie/2022/05/09/why-ireland-wouldbenefit-from-a-national-screeningfor-osteoporosis/ Hospital Professional News Ireland. 2022 May 9: 46 – 48.

Gregori G, Johansson L, Axelsson KF, Jaiswal R, Litsne H, Larsson BAM, et al. The role of different physical function tests for the prediction of fracture risk in older women. J Cachexia Sarcopenia Muscle. 2024;15(4):1511-9.

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Clinical Profiles

ALISON BOYLE APPOINTED AS DIRECTOR OF IRELAND’S FIRST PUBLIC HEALTH GALLERY AT RCSI RCSI University of Medicine and Health Sciences has announced the appointment of Alison Boyle as Director of the university’s new public health gallery, the first of its kind in Ireland.

In her role as Gallery Director, she will be responsible for driving the vision and potential for RCSI’s pioneering public engagement initiative, through curated programme development.

Alison brings with her more than two decades of international experience in science communication and large-scale public engagement. She previously worked with the Science Museum in the UK, most recently as Keeper of Science Collections where she led a team of curators responsible for a collection that attracted millions of visitors each year through physical exhibitions and online content. She joins RCSI from Research Ireland where she was Programme Manager for Education and Public Engagement, overseeing a range of nationwide initiatives including Science Week.

RCSI’s innovative public health gallery will be a cornerstone of the university’s ¤95 million campus transformation project, located at 118 St Stephen’s Green, which will provide essential infrastructure for cutting-edge health sciences research, innovation, and community engagement.

Accepting her role as Gallery Director, Alison Boyle said: “In a world of misinformation, there has never been a more pivotal time to empower the public with accurate health information. The public health gallery at RCSI is a oncein-a-lifetime opportunity to engage people in conversations about health research through creative, innovative, and artistic ways. In partnership with our stakeholders, I am looking forward to welcoming

visitors to a dynamic and inviting space, reflecting RCSI’s strategic goal of innovating for a healthier future, along with our commitment to the UN Sustainable Development Goals.”

Alison Boyle holds a PhD in Science and Technology Studies from UCL and an MSc in Science Communication from Imperial College London. She previously studied at the University of Galway.

LAUNCH OF NATIONAL PAEDIATRIC MORTALITY REGISTER ANNUAL REPORT The National Office of Clinical Audit (NOCA) has today published the National Paediatric Mortality Register (NPMR) Annual Report 2025, presented by Professor Michael Barrett, Chair of the NPMR Governance Committee and Consultant in Paediatric Emergency Medicine at the NOCA Annual Conference 2025.

This report provides a detailed analysis of data on mortality in children and young people in Ireland from 2019 to 2023, with a focus on 2022 and 2023 data. It highlights the need for timely and reliable data that will inform policy aimed at addressing the number of deaths, a large proportion of which are preventable.

Between 2022 and 2023, there were a total of 612 deaths, 363 among infants under 1 year, 145 in children aged 1–14 years and 104 in young people aged 15–18 years registered in Ireland.

The report reveals that while mortality in children continues to decline globally, in Ireland, there has been no significant decline in the mortality rate of older children (10–14 years and 15–18 years) since 2013. The infant mortality rate has also plateaued and is higher than that of some other European countries. The absence of a centralised, universal system for the timely reporting and analysis of child deaths continues to hinder progress in addressing the root causes of these fatalities.

Key Findings 2022 and 2023: Trauma • Twenty percent of deaths in children aged 1–14 years and 51% of deaths in young people aged 15–18 years were due to trauma.

• Over one quarter (27%) of all trauma deaths in children aged 1-14 years and 14% of trauma deaths in older children 15-18 years were due to road traffic collisions (RTCs).

Alison Boyle RCSI

• Among 15–18-year-olds, suspected self-harm*† was responsible for 54% of all injuryrelated deaths and 19% in children aged 1–14 years.

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*Note: relates to a subset of trauma deaths that in the absence of better data are most likely selfharm and are an estimate of the true number of self-harm deaths.

This figure may vary from Central Statistics Office (CSO) published data on suicide deaths.

Cancer • Cancer accounted for 25% of deaths in children aged 1–14 years and is the second leading cause of death among 15–18-year-olds accounting for 16% of deaths in this age group during the period 2019-2023.

Infant Mortality • 75% of infant deaths occurred during the neonatal period (aged less than 28 days), primarily due to conditions arising during pregnancy and the first week of life (56%) and genetic disorders (38%).

• The provisional infant mortality rate for 2022–2023 was 3.2 per 1,000 live births, higher than the previous rate of 3.1 per 1,000 and no longer below the EU average rate.

Sudden Infant Death Syndrome • Provisional data for 2022 and 2023 shows that the number of deaths attributed to sudden infant death syndrome (SIDS) increased, with rates rising from 0.24 per 1,000 live births in 2019–2021 to 0.35 per 1,000 live births in 2022–2023.

Professor Barrett commented “Each young life holds immense potential—not just for their own futures but for the contributions they could bring to society. This report reminds us of the urgent work needed to protect this potential. Between 2022 and 2023, there were 612 child and youth deaths registered. Among older children, trauma, including road traffic collisions and suspected self-harm, remains a leading cause of death, alongside slight increases in SIDS and infant mortality rates.

These figures represent children whose futures were cut short and families forever changed by loss. This report is a call to action for policymakers, healthcare providers, and communities to invest in systems that save lives.

While the NPMR provides vital data, it is our shared responsibility to turn knowledge into meaningful change, ensuring every child in Ireland has the chance to thrive.”

Recommendations from the Report • Implementing a centralised electronic data collection system for timely and accurate reporting of child mortality nationally.

• Enhancing suicide prevention efforts through collaboration with the HSE National Office of Suicide Prevention.

• Supporting the investigation and review of data on SIDS cases to identify high-risk groups and implement targeted prevention strategies.

• Conducting detailed reviews of data on infection-related deaths to identify opportunities for intervention.

The report also includes Matilda’s story, shared by her mother Rebecca Maher, which serves as a poignant reminder that every statistic represents a child, a family, and a loss that could inspire meaningful change.

Kate Burke, Patient and Public Interest Representative on the NPMR Governance Committee, shared her personal perspective: “Reading this report as a bereaved parent is deeply challenging. While it needs to be clinical and statisticsbased, it is vital that readers recognise that each number represents a child, like Matilda, or my son Kieran. The journey of a bereaved parent does not end with registering a death—it is lifelong and impacts every aspect of life.

My hope is that this report serves as more than an academic exercise but becomes a true tool for change, improving children’s health and reducing deaths.”

Copies of the report will be available to download from www.noca.ie.

1 IN 3 MEN UNAWARE OF OESOPHAGEAL CANCER A recent survey, commissioned by the Oesophageal Cancer Fund (OCF), has revealed that nearly 1 in 3 (30%) men in Ireland are unaware of Oesophageal Cancer. It also shows a significant misunderstanding of Oesophageal Cancer symptoms with 64% of males surveyed unaware that prolonged, chronic heartburn or acid reflux can increase the risk of Oesophageal Cancer. The survey of 1,000 adults was conducted nationwide by Amárach Research in January 2025.

The charity, OCF, says it is determined to address this low level of awareness through its annual Lollipop Day campaign which was launched over the weekend and is taking place on 28th February and 1st March, at over 80 locations nationwide.

While women surveyed displayed a greater awareness of this cancer, 10% still reported being unfamiliar with the disease. Overall, 20% of respondents across all demographics were unaware of Oesophageal Cancer. This type

97 The Oesophageal Cancer Fund is asking that the public buy a lollipop (¤3) from volunteers nationwide on the 28th February and 1st March 2025 to show support and help fund research into Oesophageal Cancer. The charity is also urging more local businesses, schools and clubs to get involved by organising their own Lollipop Day to help fill the gap in awareness identified.

TECVAYLI® (TECLISTAMAB) BISPECIFIC ANTIBODY APPROVED FOR REIMBURSEMENT IN IRELAND FOR THE TREATMENT OF PATIENTS WITH MULTIPLE MYELOMA OCF’s patron and pro-golfer, Padraig Harrington of cancer affects more men than women in Ireland, by a ratio of eight to one and it has a 5-year survival rate of 25%. Worldwide, Oesophageal Cancer is the sixth leading cause of cancer mortality.

Throughout February, which is Oesophageal Cancer Awareness month, OCF is reminding the public of the importance of recognising the early symptoms of this cancer. These symptoms include difficulty swallowing food, ongoing heartburn or acid reflux, a persistent cough or unexplained weight loss.

Over 500 people are diagnosed with Oesophageal Cancer each year in Ireland, and it estimated that 2,000 people are currently living with and beyond Oesophageal Cancer here.

Unfortunately, approximately 70% of patients experience possible symptoms of Oesophageal Cancer for 3 months before contacting their doctor.

OCF’s patron and pro-golfer Padraig Harrington is helping the charity to drive the early detection message, lending his voice to this awareness campaign, through video messages and radio ads. His father Paddy died of Oesophageal Cancer in July 2005, nearly 20 years ago. Padraig Harrington says: “Oesophageal cancer is something I know too well, as my father, Paddy, passed away from it. And I want people to know the symptoms. So, if you’re struggling to swallow food, have persistent heartburn, acid reflux or a persistent cough, unexplained weight loss, or pain, don’t ignore it. Talk to your GP. Catching this cancer early can make all the difference. And I am encouraging more people to get involved with OCF’s Lollipop Day to raise vital awareness and funds for oesophageal cancer. Early detection saves lives.”

Johnson & Johnson Innovative Medicine have announced that TECVAYLI® (teclistamab) as monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma (RRMM) has been approved for reimbursement in Ireland.

Patients must have received at least three prior therapies, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody and have demonstrated disease progression on the last therapy. The announcement follows conditional marketing authorisation (CMA) from the European Commission (EC) granted in 2022 for teclistamab, a bispecific antibody that redirects CD3-positive T-cells to B-cell maturation antigen (BCMA)expressing myeloma cells to induce the killing of tumour cells.

Multiple myeloma remains an incurable blood cancer, with nearly all patients relapsing and requiring subsequent therapy. As the disease progresses, relapses for patients become more aggressive with each new line of therapy, and remissions become progressively shorter.[4] Approximately, 380 people are diagnosed with multiple myeloma each year in Ireland.

Prof Siobhan Glavey, Consultant Haematologist said: "Multiple myeloma is a complex disease, and despite important scientific progress, patients who develop relapsed and refractory disease after having been exposed to three major drug classes have limited therapeutic options and generally face poor outcomes.

This new treatment option has the potential to provide substantial clinical benefit and new hope to patients, with high rates of deep and durable responses as well as the added convenience of being off-the-shelf. The reimbursement of teclistamab in Ireland marks a major step towards ensuring Irish patients have access to the most innovative treatments available.”

Michaela Hagenhofer, General Manager Commercial Operations, Johnson & Johnson Innovative Medicine Ireland said: "Our ambition to eliminate multiple myeloma is stronger today than ever before. We aim to reach this goal by investing in cutting-edge innovations that address individual patient needs and offer healthcare professionals options they have not had before. We are proud to have provided early access of teclistamab to Irish patients which not only provided valuable extra time but also allowed clinicians to gain real-world experience with a bispecific. The reimbursement of teclistamab in Ireland marks exciting progress on this journey and we are proud to bring this innovation to Irish myeloma patients.”

CMA is the approval of a medicine that addresses unmet medical needs of patients based on less comprehensive data than normally required, where the benefit of immediate availability of the medicine outweighs the risk, and the applicant is able to provide comprehensive clinical data in the future.

The approval was supported by positive results from the multicohort, open-label Phase 1/2 MajesTEC-1 study (NCT03145181 and NCT04557098), evaluating the safety and efficacy of teclistamab in adults with RRMM (n =165). Patients received a weekly subcutaneous injection of teclistamab at a dose of 1.5 mg/ kg, after receiving step-up doses of 0.06 mg/kg and 0.3 mg/kg. In the study, 104 out of 165 patients achieved an overall response rate (ORR) of 63 percent (95 percent Confidence Interval [CI]; range, 55.2–70.4) after a median of five prior lines of therapy.

Notably, 58.8 percent of patients receiving teclistamab achieved a very good partial response (VGPR) or better and 39.4 percent achieved a complete response (CR) or better. The median time to the first confirmed response was 1.2 months (range, 0.2–5.5 months) and the median duration of response was 18.4 months (95 percent CI; range, 14.9–not estimable).

Results from the MajesTEC-1 study were also published in The New England Journal of Medicine and showed that treatment with teclistamab resulted in deep and durable responses.[9] The median duration of progression-free survival was 11.3 months (95 percent CI; range, 8.8–17.1) and the median duration of overall survival was 18.3 months (95 percent CI; range, 15.1– not estimable).

Adverse events (AEs) were consistent with this patient population. The most common AEs were cytokine release syndrome (72 percent; 0.6 percent Grade 3, no Grade 4), neutropenia (71 percent; 64 percent Grade 3 or 4) and anaemia (55 percent; 37 percent Grade 3 or 4).

Infections were frequent with the most common being upper respiratory tract infections (37 percent; 2.4 percent Grade 3 or 4) and pneumonia (28 percent; 19 percent Grade 3 or 4).

Hypogammaglobinaemia occurred in 123 patients (75 percent) and 39 percent of patients received intravenous or subcutaneous immunoglobulin therapy.

Neurotoxic events were low grade (15 percent; 14 percent Grade 1 or 2) and five patients (three percent) had immune effector cellassociated neurotoxicity syndrome.

TEVA LAUNCHES FINGOLIMOD TEVA Teva Pharmaceuticals is pleased to announce the launch of Fingolimod Teva, a generic high tech prescription medication indicated for multiple sclerosis.

Fingolimod Teva is available in 0.5 mg hard capsules (28 capsules).

For any queries or further information, please contact your local Teva representative. Further product information is available upon request or from the SmPC available at HPRA.ie. Adverse events should be reported.

Reporting forms and information can be found at www.hpra.ie.

Adverse events should also be reported to Teva UK Limited on +44 (0) 207 540 7117 or medinfo@tevauk.com. Date of preparation: January 2025 Job code: GEN-IE-NP-00126

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Clinical Profiles

TEVA LAUNCHES FLUTICASONE FUROATE TEVA Teva Pharmaceuticals is pleased to announce the launch of Fluticasone Furoate Teva 27.5 micrograms/spray, nasal spray, suspension. This product is indicated in adults, adolescents and children (6 years and over) for the treatment of the symptoms of allergic rhinitis.

For any queries or further information, please contact your local Teva representative.

Further product information is available upon request or from the SmPC available at HPRA.ie.

Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie. Adverse events should also be reported to Teva UK Limited on +44 (0) 207 540 7117 or medinfo@tevauk.com.

Date of preparation: January 2025 Job code: GEN-IE-NP-00129

by targeting nicotine receptors in the brain, reducing cravings and withdrawal symptoms associated with quitting smoking. For any queries or further information, please contact your local Teva representative. Product information is available upon request or from the SmPC available at HPRA. ie. Adverse events should be reported. Reporting forms and information can be found at www. hpra.ie. Adverse events should also be reported to Teva UK Limited on +44 (0) 207 540 7117 or medinfo@tevauk.com. Date of preparation: December 2024 Job code: Vcli-IE-00013 DAIICHI SANKYO ANNOUNCES REIMBURSEMENT OF VANFLYTA®(QUIZARTINIB) FOR PATIENTS WITH NEWLY DIAGNOSED FLT3-ITD POSITIVE AML Daiichi Sankyo’s (TSE: 4568) VANFLYTA® (quizartinib) has been reimbursed by the HSE in combination with standard cytarabine and anthracycline induction and standard cytarabine consolidation chemotherapy, followed by quizartinib single-agent maintenance therapy for adult patients with newly diagnosed AML that is FLT3-ITD positive.

Quizartinib is the first selective FLT3 inhibitor licensed in Ireland specifically for the treatment of newly diagnosed adult patients with FLT3-ITD positive AML, which globally represents about 25 to 30% of all new AML cases.[1],[2] “We are pleased to have worked with the HSE to secure reimbursement for quizartinib.

Irish adult patients with newly diagnosed FLT3-ITD positive AML can now receive a selective targeted therapy for their disease for the first time,” said Eiji Nanasawa, Country Manager, Daiichi Sankyo Ireland. “This development for Irish patients further solidifies Daiichi Sankyo’s position as a fast growing, leading player in the oncology space.”

TEVA LAUNCHES VARENICLINE TEVA FOR SMOKING CESSATION Teva Pharmaceuticals is pleased to announce the launch of Varenicline Teva, a generic prescription medication indicated for smoking cessation. Varenicline Teva works

“The approval of quizartinib by the HSE represents an important advance in the treatment of acute myeloid leukaemia. Quizartinib specifically targets leukaemia cells harbouring a frequently occurring mutation and in a large randomised trial, QuANTUM-First, has been shown to result in important improvements in patient median overall survival.” said Dr Vitaliy Mykytiv, Consultant Haematologist, Cork University Hospital.

 This medicinal product is

subject to additional monitoring.

This will allow quick identification of new safety information.

Reporting suspected adverse reactions after authorization of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the HPRA Pharmacovigilance Website: www.hpra.ie. Adverse events or a product complaint about a Daiichi Sankyo medicine can also be directly reported to Daiichi Sankyo Ireland Ltd. D09 YF97 by telephone: +353 (1) 4893000 PROJECT FROM GALWAY UNIVERSITY HOSPITAL ANNOUNCED AS NOCA QUALITY IMPROVEMENT CHAMPION 2025 The National Office of Clinical Audit (NOCA) is pleased to announce that a project from Galway University Hospital has been awarded the prestigious NOCA Quality Improvement Champion Award 2025. The winning project, titled ‘Improving Prescribing Accuracy of PRN Medications for Haematology/Oncology Patients to Improve Safety and Efficacy’, was announced at the NOCA Annual Conference 2025 earlier this week, an RCSI Charter Week 2025 event.

The event brought together 500 healthcare professionals from across Ireland and further afield to showcase clinical audit and quality improvement initiatives focused on enhancing patient safety and care, with the audience voting for the winning project.

Dr Nessa Keane, Registrar in Palliative Medicine, presented the project, which was led by a multidisciplinary team at Galway University Hospital. The project focused on reducing prescribing errors related to “as needed” (PRN) medications for haematology and oncology patients, achieving a 73% reduction in errors through tailored education, revised guidelines, and increased awareness.

Dr Keane said "I am delighted to accept the NOCA Quality Improvement Champion Award

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on behalf of the Department of Palliative Medicine at Galway University Hospital. Together, we have made significant progress toward reducing errors in the prescription of medications used on a pro re nata (as needed) basis so as to avoid adverse side effects while maximising efficacy. Our team will now focus on maintaining and building on this progress."

Collette Tully, Executive Director of NOCA, highlighted the significance of the award and the importance of recognising quality improvement efforts - "Quality improvement initiatives like this are key to driving better outcomes for patients.

The NOCA Quality Improvement Champion Award recognises and promotes the incredible work happening in healthcare settings nationwide and highlights how innovation and collaboration can enhance patient safety."

The NOCA Annual Conference 2025 featured four shortlisted projects for the Quality Improvement Champion Award and over 40 poster presentations showcasing the breadth of clinical audit and quality improvement work across the country.

The winning poster, titled ‘Paediatric Medication Plans for Life-Limiting Conditions’, was from Portiuncula University Hospital and presented by Aoife McInerney, Senior Pharmacist. The project involved the development and implementation of individualised, comprehensive medication plans that have significantly improved patient care, particularly for those with life-limiting conditions.

Ann Cosgrove, Integrated Healthcare Area Manager for Galway and Roscommon explained “The National Office of Clinical Audit has been a major force behind reform in our healthcare system and is essential to improving the quality and transformation of clinical services. These awards honour quality improvement projects that aim to improve patient safety and care, and I want to congratulate our awardees on their accomplishments.”

SARCLISA - FIRST ANTI-CD38 TREATMENT APPROVED IN CHINA FOR PATIENTS WITH NEWLY DIAGNOSED MULTIPLE MYELOMA INELIGIBLE FOR TRANSPLANT The National Medical Products Administration (NMPA) in China has approved Sarclisa, in combination with a standardof-care regimen, bortezomib, lenalidomide, and dexamethasone (VRd), for the treatment of adult patients with newly diagnosed

99 multiple myeloma (NDMM) ineligible for autologous stem cell transplant (ASCT) based on data from the IMROZ phase 3 study.

Olivier Nataf, Global Head, Oncology said, “When Sanofi entered China more than four decades ago, we did so with the intention of bringing potentially transformative therapies to Chinese patients. This approval, occurring just weeks after Sarclisa’s first in the country, represents tremendous progress towards advancing this mission.

Now, patients with multiple myeloma and their providers have access to two new Sarclisa-based regimens that have the potential to improve outcomes across lines of therapy.”

This approval closely follows the decision from the NMPA earlier in January 2025, approving Sarclisa in combination with pomalidomide and dexamethasone (Pd) for the treatment of adult patients with relapsed or refractory MM (R/R MM) who have received at least one prior line of therapy, including lenalidomide and a proteasome inhibitor. Beyond China, in the Asia-Pacific region, a regulatory submission for Sarclisa in NDMM patients not eligible for hematopoietic stem cell transplantation (HSCT) is currently under review in Japan.

Sarclisa (isatuximab) is a CD38 monoclonal antibody that binds to a specific epitope on the CD38 receptor on MM cells, inducing distinct antitumor activity. It is designed to work through multiple mechanisms of action including programmed tumor cell death (apoptosis) and immunomodulatory activity. CD38 is highly and uniformly expressed on the surface of MM cells, making it a target for antibody-based therapeutics such as Sarclisa. In the US, the non-proprietary name for Sarclisa is isatuximab-irfc, with irfc as the suffix designated in accordance with nonproprietary naming of biological products guidance for industry issued by the US Food and Drug Administration.

Currently, Sarclisa is approved in more than 50 countries, including in the US, EU, Japan, and China, across multiple indications. Based on the ICARIA-MM phase 3 study, Sarclisa is approved in the US, EU and Japan in combination with Pd for the treatment of patients with R/R MM who have received ≥two prior therapies, including lenalidomide and a proteasome inhibitor; this combination is also approved in China for patients who have received at least one prior line of therapy, including lenalidomide and a proteasome inhibitor.

Based on the IKEMA phase 3 study, Sarclisa is also approved

in more than 50 countries in combination with carfilzomib and dexamethasone, including in the US for the treatment of patients with R/R MM who have received one to three prior lines of therapy and in the EU for patients with MM who have received at least one prior therapy. In the US, EU, and China, Sarclisa is approved in combination with VRd as a frontline treatment option in transplantineligible NDMM patients, based on the IMROZ phase 3 study.

For more information on Sarclisa clinical studies, please visit www.clinicaltrials.gov.

CALL FOR PEOPLE WITH CYSTIC FIBROSIS WHO HAVE RARE GENES TO ACCESS TRIALS OF LIFE-SAVING THERAPY A concerned group of parents are calling for individual trials of the modulator therapies for their children with Cystic Fibrosis who still do not have access to these highly effective medications.

In 2020, the European Medicines Agency (EMA) approved the roll-out of the modulator therapy Kaftrio in Ireland by Vertex pharmaceuticals.

This authorisation covered over 900 gene variants and since then has extended to benefit more people with CF including 35 children with CF who were denied access in 2022. However, there remains a group of people whose CF is caused by a rare gene variant, who do not have access to these therapies.

Currently, marketing authorisation for medications like Kaftrio is granted using genetic variant based evidence. This relies on sufficient data being gathered through clinical trials. However, for people with rare genes that cause their CF, this data does not exist as their genes are too rare.It is impossible to conduct the necessary clinical trials, fulfilling all research requirements for this group.

only gene variants proven to be responsive to the drug in clinical trials in patients rather than lab based testing are eligible for Kaftrio. Aaron’s gene has not been included in a clinical trial to date as it is so rare, so he can’t access it” explains Louise.

In the past two years, Aaron has taken part in the HIT CF research study in Utrecht which aims to provide better treatment and better lives for people with CF and rare mutations.

“Taking part in HIT-CF study has shown that Aaron would benefit from Kaftrio, once administered in conjunction with other medication.

Crucially this is only in lab trials not in real world studies and so the Irish system doesn’t recognise it. Even Vertex, have now recognised the potential benefits and have listed his gene type for the next generation of modulator therapy. But as long as the Irish system remains as it is, he will not get access to this treatment which could change his life,” Louise explains.

Abilash Kumar’s daughter is 8 years old and lives with CF. She has a rare gene variant and has regular admissions to hospital which is 255km from their home. These can last for up to 14 days at a time.

“We don't think of anything other than my daughter's treatment and routine. Trying to manage work, family, education and my daughter's medication and physio is overwhelming. And every day without treatment, CF is damaging her lungs – damage which cannot be undone,” Abilash explains.

A third parent* from the group explains what daily life is like for their child and why they are calling for the EMA to make this change.

“There is urgent need for broader access to Kaftrio. My child constantly feels unwell. Their daily routine is dominated by two hours of physiotherapy, nebulizers, antibiotics and treatments, leaving little room for the carefree activities someone this age should enjoy.

The illness also severely limits their social life - no overnight stays with friends or spontaneously going out for the day due to the extensive medical equipment and treatments that must be managed.

“Then there is the impact on education. My child is a very good student and becomes upset and embarrassed that they miss around two months of school every year due to hospital admissions. It is heart breaking to watch their condition progress while knowing that there is a treatment available that could make a transformative difference.”

According to the group, the EMA have the power to grant their children and others in their situation a chance at improving their health, stop the irreversible damage caused by CF and offer a different future. They are calling for the children’s clinical teams to be allowed to undertake an assessment of the treatment’s efficacy for each child, and for the children to have access to these drugs if they are found to work.

Louise Patterson from Wicklow with son Aaron

Louise Patterson from Wicklow and Abilash Kumar from Donegal are two parents of the group whose children with CF have rare genes. The group, supported by Cystic Fibrosis Ireland, believe the only solution for people with CF like their children is for the EMA to reconsider their policies and allow individual trials of the therapies, led by their clinical teams.

According to published research, real world studies in France, the United States, and Israel have shown that Kaftrio may benefit up to 50% of pwCF who have a rare gene variant.

“Aaron has a rare gene which means he is excluded from this therapy. Currently in Ireland,

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