IPN December 2023

December 2023 Volume 15  Issue 12 PHARMACYNEWSIRELAND.COM

Dynamic 100 Issue THE INDEPENDENT VOICE OF PHARMACY

In this issue: NEWS: Pharmacy ‘Most Trusted’ of the Professions Page 4

ROADSHOW: Pharmacy Regulator engages with Registrants Page 7

INTRODUCING THE 28s TABLET PACK

AWARDS: Niamh is The People’s Pharmacist Page 12

VALUE FOR RECURRENT SUFFERERS

END OF YEAR REVIEW: Medicines for Ireland reflect on 2023 Page 18

FIND OUT HOW TO SUPPORT YOUR PATIENTS

CPD:

Esomeprazole Product Information: Please consult the Summary of Product Characteristics for full product information. Nexium Control 20 mg gastro-resistant tablets and hard capsules (esomeprazole). Indications: The short term treatment of reflux symptoms (e.g. heartburn and acid regurgitation) in adults. Dosage: The recommended dose is 20 mg esomeprazole (one tablet or capsule) per day. Tablets or capsules may need to be taken for 2-3 consecutive days to achieve symptom improvement. Maximum treatment duration: up to 2 weeks. Contraindications: Hypersensitivity to the active substance, substituted benzimidazoles or to any of the excipients. Esomeprazole must not be used concomitantly with nelfinavir. Precautions: Refer to doctor if patient has: Jaundice or severe liver disease, unintentional weight loss, recurrent vomiting, dysphagia, haematemesis or melaena and when gastric ulcer is suspected or present, malignancy should be excluded as treatment with esomeprazole may alleviate symptoms and delay diagnosis, gastric ulcer or gastrointestinal surgery, continuous treatment of indigestion or heartburn for 4 or more weeks, or is over 55 years old with new or recently changed symptoms. Not suitable for long term use. Treatment with proton pump inhibitors (PPIs) may lead to a slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter and in hospitalised patients, also possibly Clostridium difficile. Consult doctor prior to have an endoscopy or urea breath test. Co administration with atazanavir is not recommended.

Interactions with medicinal products metabolised through CYP2C19 should be considered. The use of esomeprazole with clopidogrel should be discouraged.

Patients should not take another PPI or H2 antagonist concomitantly. PPI are associated with very infrequent cases of SCLE. If lesions occur, especially in sunexposed areas of the skin, and if accompanied by arthralgia, the patient should seek medical help promptly. Side effects: Common: headache, abdominal pain, constipation, diarrhoea, flatulence, nausea/ vomiting, fundic gland polyps (benign). Uncommon: peripheral oedema, insomnia, dizziness, paraesthesia, somnolence, vertigo, dry mouth, increased liver enzymes, dermatitis, pruritus, rash urticaria. For rare, very rare and other side effects please refer to the SPC for full information. Legal category: Supply through pharmacy only. Product licence number: EU/1/13/860/001; EU/1/13/860/002; EU/1/13/860/003; EU/1/13/860/004 and EU/1/13/860/005. MAH: GlaxoSmithKline Dungarvan Limited, Knockbrack, Dungarvan, County Waterford, Ireland. Additional information is available upon request. Text prepared: June 2022.

Contains esomeprazole. Always read the label/leaflet.

Trade marks are owned by or licensed to the Haleon group of companies. PM-IE-NEX-23-00004.

SM4271 2023_Nexium_Irish_Pharmacist_FPA 4 PRESS_READY.indd 1

This Publication is for Healthcare Professionals Only

22/03/2023 15:52

Coughs and Colds Page 43

FEATURE: Overactive Bladder Page 46

DYNAMIC: Pharmacy’s Dynamic 100 Page 64

2024 & Retail Pharmacy Product Awards

Would you like to enter the OTC & Retail Pharmacy Product Awards?

The OTC & Retail Pharmacy Product Awards showcase the best and latest Pharmacy Retail Products across the Irish landscape Deadline for entries: January 5th, 2024 If you would like to enter please contact Robyn Maginnis for further information on: robynmaginnis@ipn.ie

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Contents

Foreword

Page 5: Menopause Award for Keane’s HealthPoint Pharmacy

The Irish Pharmacy Union (IPU) and the Pharmaceutical Society for Ireland (PSI) have welcomed the initial recommendation of the Expert Taskforce set up by Minister for Health Stephen Donnelly allowing pharmacists to extend the validity of prescriptions beyond six months. This recommendation, which will take effect from 1 March 2024, will allow pharmacists to extend prescriptions up to a maximum of 12 months if they consider it safe and appropriate to do so.

Page 6: McCabes Pharmacy Group and PHX Ireland join forces Page 12: Niamh Colleran crowned The People’s Pharmacist 2023

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Turn to page 5 for the full details.

Page 14: The Future of PharmacIE event Page 18: Medicines for Ireland reflect on 2023 Page 38: Accreditation for Brennans Pharmacy Page 40: Pfizer publish most recent Health Index

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Page 64: Annual Dynamic 100 of Pharmacy PUBLISHER: IPN Communications Ireland Ltd. Clifton House, Fitzwilliam Street Lower, Dublin 2 00353 (01) 6690562

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MANAGING DIRECTOR Natalie Maginnis n-maginnis@btconnect.com EDITOR Kelly Jo Eastwood: 00353 (87)737 6308 kelly-jo@ipn.ie

dynamic

ADVERTISING EXECUTIVE Esther Elliott-Coulter: 00353 (87) 062 2025 Esther@ipn.ie EDITORIAL/ EVENTS & MARKETING EXECUTIVE Aoife Hunter: aoife@ipn.ie CONTRIBUTORS Dermot Twomey | Paul Neill Eimear O’Leary | Joanne Kissane Kieran More | Aoife McDonald Dr Sally Griffiths | Dr David Breen Pádraig Burke | Chris Macey Jane Fleming | Aoife McNamara Dr Lorraine Nolan | Dr Mary Flynn Theresa Lowry-Lehnan

DESIGN DIRECTOR Ian Stoddart Design PHARMACYNEWSIRELAND.COM @Irish_PharmNews IrishPharmacyNews

“We welcome the announcement by Minister Donnelly and the commitment to progress the first recommendation from the Expert Taskforce,” said Joanne Kissane, Registrar and Chief Officer, Pharmaceutical Society of Ireland.

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

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

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

In other news, it was announced that PHX Ireland, via its subsidiary LloydsPharmacy, has agreed to acquire McCabes Pharmacy, bringing together two of the best known and most trusted retail pharmacy brands in the country. The proposed deal will see the combined retail pharmacy outlets merge their operations, trade under the McCabes brand and be led by Sharon McCabe. The transaction is conditional upon approval by the Competition and Consumer Protection Commission (CCPC).

We will have more on this emerging story in the January issue of Irish Pharmacy News.

The December issue contains a series of End-of-Year Reviews from the profession and industry leading bodies and associations.

Looking at the medicines agenda, Paul Neill, Chairperson of Medicines for Ireland notes the volume of generic medicines used in Ireland has increased by 70% since 2012, accounting for 57% of all prescribed medicines compared with just 33% ten years ago.

The increased use of generic medicines has yielded hundreds of millions in savings for the state; however, Ireland remains far short of the European average for generic usage, which is at 70%. You can read his in-depth article on page 18.

On page 26, President of the IPU Dermot Twomey reflects on what has been a pivotal year for pharmacy whilst on page 27, Registrar and Chief Officer of the PSI Joanne Kissane details their key areas of focus.

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

Finally, may I take this opportunity on behalf of the entire IPN team to wish all our readers and supporters a very Merry Christmas, and a prosperous New Year. See you in 2024!

Regulars FEATURE: SEASONAL AILMENTS

P28

FEATURE: LUNG CANCER

P41

CPD: COUGHS AND COLDS

P43

FINANCE: PENSION LEGISLATION

P50

FEATURE: SMOKING CESSATION

P60

PHARMACYNEWSIRELAND.COM

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News

Pharmacy Most Trusted Source for Self-Care

PharmaceutiHOWasWILLING ARElikely THEtoPUBLIC MINOR CO Community pharmacies have emerged the source most be used TO SELF-TREAT cal Workforce by the public for help regarding minor healthpublic conditions.

This ison according Transformation General survey public perceptions and experience o to a recent survey conducted by Ipsos on behalf of the Irish Pharmaceutical On the fifth anniversary of the

Healthcare Association (IPHA),• the organisation*Self-Care that represents Self-Care defined as treating yourself or a family member for minor health conditions, without seeing Astana Declaration on primary health care, the International companies and pharmaceutical %innovators in Ireland.

Who Are Comfortable Self-Treating These Minor Conditions themselves, it is important that we do continue to seek professional advice from healthcare professionals, such as pharmacists Fairly/Very Comfortable and GPs, when necessary.

Adam Lee, Chairperson, IPHA Self-Care Division

Only a quarter of people would be likely to turn to a general internet search for help regarding minor health conditions, such as coughs, colds, flus and headaches, while only 8% would consider using social media sources for this information.

In the midst of ever-increasing pressures on our health system, and GP care becoming more and more difficult to access, the benefits of Self-Care are clear to see with 82% believing that treating minor health conditions at home would put less pressure on the health system. 77% also believe that it is cheaper to self-treat rather than see a GP.

Minor cuts and burns minor health conditions, which is (including sunburn) vital for maintaining a functioning and migraines health system byHeadaches keeping people colds andand flu (including fever andIt out of Coughs, GP clinics hospitals. sore throats) is encouraging to know that, as Digestive system issues such as indigestion, diarrhoea, vomiting a society, we are connected with Skin conditions and allergies suchin as Ireland rashes, Self-Care.

Health literacy hay fever has increased and weeczema, know where Sprainsreliable or muscle complaints such back pain to find sources ofashealth information.

Irishsuch people Eye and While ear complaints as earache, conjuctivitis are comfortable in treating

82%

“Self-care empowers people to 77% manage important elements of their own77% and their loved ones’ lives. This research indicates that 57% is the first step and first Self-Care choice for most Irish people who 56% are taking an increasingly active 52% role in their healthcare”, said Adam Lee, Chairperson of the 32% IPHA Self-Care Division.

Trust In Information Sources For Self-Care Likely to consider these sources for advice on minor health conditions

83%

79%

Local Pharmacy

68%

GP

Practice Nurse or Public Health Nurse

64% National Health Websites i.e HSE or NHS

44%

33%

25%

8%

Family Member or Friend

Health Insurance Company

General Internet Search

Social Media

When looking online for information on minor health conditions, I know the websites I can trust

Attitudes Towards Sel Pharmaceutical Federation (FIP) has issued a document calling on its 156 national member organisations, individual 84% 82% members and global pharmacy agencies to take action to feel they are capable of treating are happy to treat minor accelerate pharmaceutical minor health conditions health conditions themselves workforce transformation. themselves rather than visit a GP

The “FIP Brisbane Calls to Action” document describes 10 actions, which include 88% advocating enhanced training pathways for professional keep some basic medicines recognition to better address at home to manage minor healthcare challenges, and health conditions Agree/Strongly Agree themselves developing adaptable systems, tools and mechanisms (including competency development Motivations And Barriers T frameworks), that will support the development of a range of progressive roles forMotivations to Self-C pharmacists, including in preventive health care and prescribing. These actions were 77% 82 developed with the consensus of over 120 delegates from more than 40 countries attending It is cheaper to treat minor a workforce symposium health conditions themselves rather than visiting a GP “Accelerating towards 2030: Workforce transformation for better health”, hosted byBarriers the to Self-Car FIP Global Pharmaceutical Observatory (GPO) and the FIP 40% 40% Hub46% in Brisbane, Australia, in September.

A lack of convenient access to the necessary treatments or medications

A worry that I

A lack of information

might make the how to treat “This symposium representedabout health condition minor health worse conditions a mid-term point between “Irish people clearly have faith FIP’s Global Conference on in their own ability to self-treat Pharmacy and Pharmaceutical Sciences Education in 2016 — ataged which global visionbetween for the1st – 14th June Survey conducted by Ipsos via syndicated telephone Omnipoll, 997 interviews with adults 18+awere conducted pharmaceutical workforce was created — and the World Health From 6 to 12 November, the HPRA took part in the global #MedSafetyWeek Organization Global Strategy on campaign, a collaboration involving more than 80 medicines regulatory Human Resources for Health 2030 ambitions. This has marked agencies and several non-governmental organisations, to raise awareness a significant opportunity to about the importance of reporting side effects of medicines. With the review our pharmacy workforce transformation objectives, and theme ‘Who can report?’, this year’s campaign will focus on the key role of our Brisbane Calls to Action every patient, pharmacist, doctor and nurse who reports a side effect and were developed, driven by expert insights and current evidence contributes to using medicines safely. from FIP GPO and Hub,” said The HPRA wishes to highlight says, “Every report is important “If you, or a patient in your care, FIP CEO Dr Catherine Duggan. experience a side effect with a the importance of reporting side in building knowledge and The symposium delegates also medicine, we encourage you to effects through their national understanding of the benefits and expressed enthusiasm for a make a report to us.” reporting system. All reports risks of medicines in clinical use revised mission plan for the made to them will be thoroughly and allows action to be taken to Reports about side effects can be global pharmacy workforce. assessed and examined to minimise risks and to optimise use submitted easily through a number “As we move forward, FIP is determine the right steps to be for patients. of ways: working on a range of followtaken to maximise patient safety. up resources, including a • Completing the HPRA’s online In the last five years, the HPRA “Reporting suspected side comprehensive strategy and reporting forms. See hpra.ie/ has received and processed over effects helps to make medicines roadmap and accompanying report 24,000 reports of suspected side safer for patients all around the guides and tools to further effects directly from patients, • Emailing a completed form world. In some cases, it can empower our efforts to transform carers, and health professionals.

• Printing and posting a result in better prescribing and the pharmacy workforce and completed form dispensing advice to help support advance global health,” Dr Sinead Curran, Director of Human Duggan said.

Products Monitoring at the HPRA, better patient outcomes.

• Phoning on (01) 676 4971

Agree

42%

V.

38%

Disagree

Neither agree nor disagree/Don't know = 20%

Pharmacy urged – ‘Play your Part’

PHARMACYNEWSIRELAND.COM

News Cardiac Rehabilitation Model of Care Heart & Stroke Voice Ireland (HSVI), Ireland’s alliance of heart and stroke patients and carers, has welcomed the HSE’s new Model of Care for Integrated Cardiac Rehabilitation.

The initiative presents Ireland’s first standardised model of care for cardiac rehabilitation services across the country.

Equality of access, greater flexibility of choice, and community integrated rehabilitation services are all key priorities of this new model, which in line with the best international evidence and practice, proposes a new patient-centred model of care.

David Kelly, Chair of HSVI, said, “Heart & Stroke Voice Ireland welcomes the HSE’s newly published Model of Care for Integrated Cardiac Rehabilitation.

HSVI was established to give a unified voice to heart patients, stroke survivors and their carers, and to advocate for a patientcentred model of care, and more equitable access to rehabilitation services, both of which are core elements of this new strategy.

“As patients and carers, HSVI recognises the importance of being able to access high quality cardiac rehabilitation services – when successfully implemented, they are proven to increase longevity, reduce anxiety and depression post event, and overall enhance one’s recovery after a cardiac event or diagnosis of heart disease.”

“Previously, many patients might have struggled to complete their full rehab programme, as a result of geographic barriers, time constraints, or a sense that the programme did not fully recognise their needs. This new HSE model will introduce a standardised model of care that ensures all cardiovascular patients across the country are afforded equal access to the highest international standards of cardiac rehabilitation, in a way that best suits their needs”, David Kelly added.

In line with Sláintecare, the model recommends the integration of cardiac rehabilitation services across hospital and community settings to provide person-centred care by a multidisciplinary team.

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Top Workplace for Menopause Support Award for Keane’s Keane’s HealthPoint Pharmacy has been named ‘Ireland’s Best Workplace for Menopause.’ The award was given to the pharmacy team at a special event at the Stella Cinema in Rathmines.

Winning this Award has meant a great deal, as Managing Director John Keane says, “This award helps us understand what our team members and customers are going through. It’s about being there for them in more ways than one.”

Furthermore, John added that for the pharmacy to be recognised amongst larger companies adds further value to the accolade.

“It’s a big deal for us to be named alongside well-known companies like Bank of Ireland and LIDL,” COO Gillian Ryan. “This award shows that even a smaller business can make a meaningful difference in people’s lives.”

Receiving this award is a great starting point, but it’s not the end.

“We see this as the beginning of a longer journey. We have more plans to improve and grow, and we are excited to take those steps,” says John.

Keane’s have recently rebranded, but their commitment to caring remains the same. They have a

Cathal Divily, Great Place to Work; Loretto Dignam, the Menopause Hub; Gillian Ryan and John Keane, Keane’s HealthPoint Pharmacy, and Nora Casey, broadcaster and entrepreneur strong team of 80 people working across seven different sites, all dedicated to serving their communities.

Duration of Prescription Extension The Irish Pharmacy Union (IPU) and the Pharmaceutical Society for Ireland (PSI) have welcomed the initial recommendation of the Expert Taskforce set up by Minister for Health Stephen Donnelly allowing pharmacists to extend the validity of prescriptions beyond six months. This recommendation, which will take effect from 1 March 2024, will allow pharmacists to extend prescriptions up to a maximum of 12 months if they consider it safe and appropriate to do so.

For several years the IPU has tirelessly advocated for better recognition of the unique skillset of pharmacists and for the endorsement of an expansion of their scope of practice to support patient care. This recommendation by the taskforce acknowledges the IPU position and supports an enhanced role for pharmacists, a move that will improve the care provided to patients in their communities.

Commenting on the taskforce recommendation Derek Reilly, interim Secretary General of the IPU said, “This announcement not only acknowledges the pivotal role of pharmacists as medicines experts but also represents

a significant step towards broadening the professional scope of pharmacists. We look forward to seeing additional detail on the implementation of this recommendation and we hope that it is the first of a number of recommendations that will support an enhanced role for pharmacists.”

However, Mr Reilly emphasised the urgent need to address substantial underfunding of the pharmacy sector. He pointed out that the pharmacy profession has endured significant fee reductions over the last 15 years and remains the only healthcare sector without restored fees. Significant resources will be required to support any enhanced role for pharmacists,

and we look forward to continuing discussions with the Department on a restoration of funding to an appropriate level.”

“We welcome the announcement

by Minister Donnelly and the commitment to progress the first recommendation from the Expert Taskforce,” said Joanne Kissane, Registrar and Chief Officer, PSI. “The first recommendation will play a significant role in alleviating pressure in the health system, improving patient access, healthcare delivery and leading to better patient outcomes. Further to this, it will also facilitate healthcare delivery, at the lowest point of complexity and in line with the vision of Sláintecare.

PHARMACYNEWSIRELAND.COM

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News

McCabes Pharmacy and LloydsPharmacy Unite PHX Ireland, via its subsidiary LloydsPharmacy, has agreed to acquire McCabes Pharmacy, bringing together two of the best known and most trusted retail pharmacy brands in the country. The proposed deal will see the combined retail pharmacy outlets merge their operations, trade under the McCabes brand and be led by Sharon McCabe.

Sharon McCabe

LloydsPharmacy operates 82 stores across the Republic of Ireland, while McCabes Pharmacy has 32 stores across the greater Dublin Area. The transaction is conditional upon approval by the Competition and Consumer Protection Commission (CCPC).

The combined retail entity will form part of the family-owned PHOENIX group, who are the leading integrated healthcare provider in Europe providing pharmaceutical wholesale, pharmacy retail, and services for the pharmaceutical industry. PHOENIX group recently established a strong Irish presence

Paul Reilly

following the completion of the McKesson Europe acquisition which includes United Drug, Ireland’s leading pharmaceutical wholesaler and distributor, and TCP Homecare, innovators in clinical home nursing services and direct to patient delivery solutions.

Terms of the transaction have not been disclosed.

Paul Reilly, Chief Executive Officer of PHX Ireland, said, “We are delighted to welcome the McCabes Pharmacy group into the PHOENIX family. We have worked with McCabes for many years via our United

Drug business and have always admired the innovation of services and distinctive customer service levels that Sharon and her team have brought to the Irish market.

Sharon will lead the combined 110+ community pharmacies with a patient and colleague-centric approach, while continuing to provide the high standard of services both groups have been providing for many years.”

Sharon McCabe, Chief Executive Officer of McCabes Pharmacy, said, “Both McCabes and LloydsPharmacy are businesses rooted in the communities they

serve. We have shared ambition, values, and a vision for primary care in Ireland which centres on providing patients and their families with the very best advice, support and access to medicines. We are both focused on enhancing the role of the pharmacist for the benefit of Irish patients and on creating a compelling and engaging place to work for pharmacists, technicians and all our retail colleagues.

McCabes Pharmacy has excelled in delivering exceptional person to person care and with leading digital solutions. We are excited to work with The Lloyds teams to rebrand as McCabes Pharmacy. McCabes Pharmacy, like PHOENIX group, is a family-owned business, and we look forward to working with LloydsPharmacy and PHOENIX group to help our patients and customers across Ireland”.

Steve Anderson, Member of the Executive Board Operations & Logistics at PHOENIX group, said: “This is great day for our Irish colleagues and the wider PHOENIX group. This acquisition further highlights PHOENIX group’s commitment to growing and investing in new markets.

After concluding the acquisition of McKesson Ireland in November 2022, we continue to see huge potential in the Irish market and are committed to supporting the ambition of our local leaders on the ground.”

Boots doubles Footprint in Limerick Boots is proud to celebrate twenty years in the Crescent Shopping Centre in Limerick and what better way to mark the milestone, than by opening a brand new store in the centre.

The pharmacy team of the new Boots pharmacy store in The Crescent Shopping Centre, Limerick

Pictured at the opening of Boots new store in The Crescent Shopping Centre, Limerick were Pat Laffey, Boots, Head of Property and Operations, Joe Scallan, Boots, Director of Stores, Melanie O’Donohoe, Boots store manager and Jeff Durcan, Boots, Area Manager West

PHARMACYNEWSIRELAND.COM

The new location doubles the Boots footprint at the venue, retains their brilliant existing employees and creates ten additional roles.

Commenting on the opening of the new store, Stephen Watkins, Managing Director of Boots Ireland said: “Boots Ireland is celebrating 20 years in the Crescent Shopping Centre, what better way to celebrate the milestone than investing in a new store in the centre! Our new location doubles our footprint and is the ultimate destination in the region for our customer’s beauty needs in a stunning new beauty hall. We’re delighted to bring the biggest global and Irish beauty brands to Limerick and I can’t wait for customers to experience our new location. I wish Melanie and all the team there lots of success.”

News

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Pharmacy Roadshow across Ireland The pharmacy regulator reflects on a series of successful regional roadshows held in October The PSI recently concluded its series of regional roadshows for 2023, marking another significant milestone in its ongoing commitment to engaging with registrants. The roadshows were the first in-person events held by the PSI following the pandemic and were an opportunity to discuss several important topics, including pharmacy governance roles, pharmacist workforce planning and fitness to practise.

The events took place in Sligo, Limerick, Cork and Dublin.

Attendees from across the country commended the events for providing useful insights into the ongoing work of the PSI and affording the opportunity for pharmacists from all sectors to raise any queries they had with PSI staff.

As an important element of the PSI’s engagement with those it regulates, the regional roadshows aimed to connect with registrants and to listen to insights and reflections from those in attendance. The roadshows allowed the PSI to inform registrants of the latest sectoral developments, as well as capturing feedback and insights on various PSI projects and initiatives.

The input received through the roadshows will help to shape the PSI’s future corporate strategy, policies and actions.

Responsibilities of those in governance roles One of the key areas of focus of the roadshows was to provide information to registrants on the responsibilities of those occupying governance roles within pharmacies. The aim was to provide clarity to enable those currently in these roles to allow them fully to discharge their statutory responsibilities, as well as to support pharmacists who may be considering a governance role as the next step in their career.

The PSI recognises the importance of effective and transparent governance within pharmacies and provided an overview of the statutory responsibilities of each governance role as set out in the Pharmacy Act 2007 and relevant Regulations. As provided for in the Pharmacy Act, governance roles refer to pharmacy owners, superintendent pharmacists and supervising pharmacists. While these roles are common to all pharmacies, the PSI highlighted that the way in which these roles are implemented in practice can vary, as each pharmacy and how it delivers the services it offers will be different. The PSI also acknowledges that although regulations made under the Pharmacy Act attempt to define the overall responsibilities of each governance role, there are times when these responsibilities overlap.

The PSI also highlighted its plans to publish guidance on governance roles by the end of 2023 to further support and assist pharmacists and pharmacy owners. The PSI reiterated its intention to work with registrants to ensure that all those in governance roles, along with other pharmacists and pharmacy support staff, can work together to ensure safe, high-quality services are delivered to patients and the public.

Workforce planning for pharmacy The regional events also served as a vehicle for the PSI to present the latest developments and future plans around the recently launched Workforce Intelligence Report.

This report is the first of its kind for pharmacy in Ireland. It comes in response to reports of increasing risks to the availability and future sustainability of pharmacists within patient-facing roles and in the absence of previous national strategic workforce planning initiatives for pharmacy.

It examines the issues relating to the recruitment and retention of pharmacists in both community and hospital settings and is a significant milestone, providing a baseline view of pharmacy workforce data and views from pharmacists on the profession.

Attendees were given an overview on the background of the report, its findings and recommendations.

The roadshows provided an opportunity for the PSI to share outputs from the report and also to receive additional insights from pharmacists and pharmacy owners on challenges and opportunities relating to pharmacist workforce planning.

In response to the report, the PSI confirmed its commitment to the ongoing collection of robust data and insights to support strategic workforce planning for pharmacy and will issue an adapted Workforce Survey to all pharmacists later this year to build on the data already gathered. The next steps concerning strategic workforce planning were also outlined. The PSI along with the Department of Health have committed to forming a multiagency group to specifically look at workforce planning for pharmacy, with an initial focus on progressing recommendations and

actions in the report. Furthermore, pharmacy workforce planning is being considered as part of a Department of Health project and this will be delivered with support from the EU Commission and the economic consultants Indecon.

The inclusion of pharmacy in this project is an important recognition of the role that pharmacists play now and into the future as part of the multi-disciplinary team within our health system. Concluding on the Workforce Intelligence Report, PSI Registrar and Chief Officer Joanne Kissane noted that an ongoing commitment is needed from all stakeholders and the profession to ensure the future sustainability of the workforce.

The third topic explored during the roadshows related to Fitness to Practise and Complaints. The roadshows facilitated open and constructive conversation, with the aim of enhancing understanding of these statutory processes among registrants. An overview of the processes and data on volumes and types of complaints were provided, along with practical advice for registrants who find themselves involved in a Fitness to Practise process.

Registrants were encouraged to read the PSI’s complaints guidelines, respond to queries promptly, exercise care when providing observations during the Preliminary Proceedings Committee (PPC) stage and respect the independence of witnesses and staff. Additionally, the importance of attending inquiries when invited to do so was highlighted.

Keynote speakers pictured at a recent PSI Roadshow

The PSI outlined that the purpose of fitness to practise in professional regulation is to promote and uphold professional standards and to promote confidence and trust in the regulatory processes for both the public and the profession. The process serves as a deterrent for conduct not to be repeated, but it is not intended to be punitive.

A key benefit of the in-person roadshows was the constructive conversations that took place between registrants and the PSI on the topics being presented, along with other matters of importance to those in attendance. The PSI regards the regional roadshows as a valuable opportunity for connection and engagement, facilitating important conversations and knowledge-sharing and extends its appreciation to all registrants who attended and participated in these informative and collaborative events. The organisation remains committed to maintaining open channels of communication and engagement with its registrants and wider stakeholder network to ensure that the highest standards of pharmacy practice are maintained in Ireland.

For those who were unable to attend the roadshow events, recordings of the presentations are available on the PSI website.

To access these, or for more information about the PSI and its work, please visit www.psi.ie

PHARMACYNEWSIRELAND.COM

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News

Building a culture of Mentoring in Pharmacy Launch of 4th IIOP (Irish Institute of Pharmacy) Mentoring Programme for pharmacists, by pharmacists The 4th formal Irish Institute of Pharmacy (IIOP) Mentoring Programme was launched in October 2023.

Mentoring is a key component of professional development and personal growth. It is a supportive, nurturing relationship; a sounding board that enables someone through a transition in learning. The relationship may cover a variety of contexts and when successful, it benefits all.

The IIOP’s Mentoring programme is evidence based, formal yet flexible for pharmacists by pharmacists. Designed to suit the life of a busy pharmacist, a structure is provided which is flexible and personalised to the mentoring pair. It is bespoke to pharmacists working in all practice areas and is the first of its kind offered to pharmacists in Ireland.

Together, we are working to create a culture of mentorship within the Irish pharmacy profession. As we work through times of change and innovation, we can support each other in a way that is difficult to achieve through other means.

The current Mentoring Programme kicked off with mentor and mentee onboard training and the

introduction of Mentoring pairs in early December. A total of 30 pairs were matched through the programme and over 150 pharmacists have now completed the mentoring skills training and are eligible to be mentors.

Pharmacists from all sectors and all career stages applied. Matching of the mentors and mentees was completed by the programme team based on mentee preferences, mentor experience, personality descriptors and diversity. The mentoring pairs reflected the breadth of the profession with both inter and intra practice area matching.

week. Other outcomes were:

To give you an idea of how it works on average, mentoring pairs meet for 60 minutes every 3-4 weeks, outside of work, with time spent on preparation and reflection in addition to this. Our programme is flexible by nature with orientation training and ongoing support provided by the programme team.

Pharmacists involved previously fed back that mentoring gave them energy and that they looked forward to the sessions in their

Want to get Involved?

• 100% of pharmacists involved said the programme met their expectations and that they would want to be involved in continued mentoring initiatives.

• Improvements were seen in confidence and competence with reflective practice for the mentees.

• Improvements were seen for the mentors in their mentoring skills such as setting clear goals, acknowledging strengths, setting expectations, and asking powerful questions.

Check out our mentoring portal on the website where you can find more information about mentoring, how you can get involved, and links to additional resources. Keep an eye on our social media for updates and ways to get involved.

As always, we would love to hear from you. You can get in touch at our dedicated email address mentoring@iiop.ie.

Best Use of Cobotics Award United Drug, Ireland’s largest pharmaceutical distribution company and - Locus Robotics, the market leader in autonomous mobile robots (AMRs) for Fulfilment warehouses, and have been named winners of the “Best Use of Cobotics” award at the prestigious Robotics & Automation Awards in London.

Twenty one Locusbots have been deployed at United Drug’s Distribution Centre in Baldonnel for workers. The LocusBots’ seamless integration with the warehouse team has enabled United Drug to efficiently meet growing e-commerce demand and double productivity.

The award recognises the innovation and significant added value of the Locus AMR solution to improving efficiency and productivity at United Drug Baldonnel distribution centre, while also improving the overall workplace ergonomics

Paul Malone, Head Of Operations for UDD & UDC at United Drug Ireland, said, “Locus has been an invaluable partner in scaling our operations to help meet our customers’ growing demands.

The LocusBots truly partner with our warehouse team to drive optimal efficiency and create better jobs and allow our employees to thrive in an optimised and safe environment. We’re thrilled to see this work recognised.”

“Locus is honoured to receive this prestigious industry recognition

PHARMACYNEWSIRELAND.COM

alongside our customer, United Drug. Our commitment to innovation, proven usability and fast time to value has helped them to optimise their Fulfilment productivity and efficiency to meet ever-increasing order volumes,” said Rick Faulk, CEO of Locus Robotics. “This award further validates our mission to provide cost-effective and highly productive robotics automation solutions for the e-commerce and Fulfilment industry around the world.”

The Robotics & Automation Awards highlight innovation demonstrated by both British and international organisations in the application of robotic or automated systems throughout the supply chain, across logistics, manufacturing, retail, food and beverage, aerospace, cleaning and sanitation, construction, agriculture industries.

Understanding Cystic Fibrosis A major new study led by RCSI University of Medicine and Health Sciences and Children’s Health Ireland (CHI) has been awarded funding of ¤5.6M to work with babies and children in Ireland and the UK over the next five years to build a better understanding of cystic fibrosis.

Children born in the 2020s with cystic fibrosis often have more treatment options and potentially better outcomes than those born with the disease in previous decades. But there is still much we need to understand about cystic fibrosis in babies and children in this new era of care.

Cystic fibrosis (CF) is an inherited disease that mainly affects the lungs and digestive system. Ireland has the highest incidence of the condition in the world: approximately 1,400 children and adults in Ireland live with the condition and typically more than 30 new cases of CF are diagnosed here each year.

The ENHANCE study – Establishing Natural History in an Advanced New CF Care Era – will be led by the CF research team at Children’s Health Ireland and will be carried out at 13 paediatric (children’s) CF clinic sites in Ireland and the UK. “The ways that we can help children with CF have evolved considerably over the last 15 years, notably with new medicines becoming available, and many children will start these treatments from very early in life,” says Paul McNally, Associate Professor of Paediatrics at RCSI and Consultant in Respiratory Medicine at CHI. “This means the outlook for children with CF is considerably better than it was 15 years ago, but there is much about this that we don’t yet understand.”

The ENHANCE study will monitor how CF complications develop in small children, and how different groups of children with CF develop features of the disease.

EW N

COLD & FLU SYMPTOMS

ONLY TRIPLE ACTIVE FORMULATION Solpa Cold & Flu Multi Relief Max Powder for Oral Solution, Paracetamol 1000 mg, Guaifenesin 200 mg, Phenylephrine Hydrochloride 12.2 mg. For the relief of symptoms of colds and flu and the pain and congestion of sinusitis, including aches and pains, headache, blocked nose and sore throat, chills, lowering of temperature, and to loosen stubborn mucus and provide relief from chesty coughs. Adults, the elderly and adolescents aged 16 years and over: One sachet every 4-6 hours as required to a maximum of 4 sachets (4 doses) in a 24-hour period. Do not give to children and adolescents under 16 years. Not to be continued for over 3 days without consulting a doctor. Contraindications: Hypersensitivity to any of the ingredients, severe hepatic impairment, hyperthyroidism, hypertension, diabetes, cardiovascular disease, those taking tricyclic anti-depressants or beta-blockers or other antihypertensive agents, patients who are taking or have taken monoamine oxidase inhibitors within the last two weeks or those currently receiving other sympathomimetics, phaeochromocytoma, closed angle glaucoma, and porphyria. Precautions: circulatory disorders, chronic alcoholism, urinary retention or prostatic hypertrophy, gilbert’s syndrome, concomitant treatment with flucloxacillin and medicinal products affecting hepatic function, glucose-6-phosphate dehydrogenase deficiency, haemolytic anaemia, glutathione deficiency, dehydration, chronic malnutrition, elderly, adults and adolescents weighing less than 50kg, may act as a cerebral stimulant. Use with paracetamol-containing products. Do not take with alcohol. Pregnancy and lactation: Not to be taken during pregnancy or whilst breast feeding without medical advice. Side effects: Thrombocytopenia, agranulocytosis, anaphylaxis, severe cutaneous hypersensitivity, bronchospasm, hepatic dysfunction, acute pancreatitis, angioedema, angle glaucoma. See SmPC for full list of side effects and further information. Product not subject to medical prescription. PA1186/021/003. MAH: Chefaro Ireland DAC, The Sharp Building, Hogan Place, Dublin 2, Ireland. Date of preparation: Feb 2023.

SPC: https://www.medicines.ie/medicines/solpa-cold-flu-multi-relief-max-powder-for-oral-solution-35312/spc#tabs IRE SCF 2023 09

Uniphar Celebrates with 3 brands in Top 10 CXi Ireland Customer Experience Report 2023 Uniphar proudly celebrates its performance in the 2023 CXi Ireland Customer Experience Report, with three of its brands securing coveted positions within the Top 10. This noteworthy recognition underscores Uniphar’s unwavering commitment to delivering outstanding customer experience.

Ireland CXi Report 2023 Ireland’s Top 10

Allcare Pharmacy No. 1 Retail brand Allcare Pharmacy, the largest Irish-owned pharmacy group, operating over 100 pharmacies nationwide, has ranked second overall in this year’s CXi Ireland Customer Experience Report, up an impressive 15 places on 2022. Celebrating ten years in operation this year, Allcare is the No. 1 Retail brand in Ireland for customer service and was lauded in the Report as “new sector champions”.

This prestigious recognition is especially attributed to the passion and dedication of our dedicated and trusted healthcare and retail professionals. Emerging from the Covid-19 pandemic, we recognised the need to invest in a tailored customer service training programme for all of our healthcare teams, which was developed by a dedicated in-house training team. The results of that work are borne out with our ranking first in the Pharmacy Sector for impact of staff and achieving a score above 8.00, which is a measure of CX Excellence.

Customer loyalty and trust are highly correlated to the impact that employees have on customer experience and we are delighted to have

ranked first in the Pharmacy Sector and second in the overall survey for recognising customer loyalty.

We continue to offer great value to our customers who gave us a +13% score, the highest in the Pharmacy Sector.

We always strive to find ways to make it easier for our customers to do business with us and continue to invest heavily in technology solutions with innovations such as our patient app and SMS messaging helping improve communications particularly with vulnerable patients.

Allcare has also recruited 22 new members into its franchise network over the last 3 years and has ambitious plans to grow the network with an additional 10 new members in 2024.

Congratulations to all of our highly dedicated pharmacy teams and our independently owned symbol partners in Allcare Franchise in making Allcare Pharmacy the No.1 Retail Brand for customer service.

What our customers said about us Very attentive and informed staff. Always ready to help

They offer more products at very good prices

Life Pharmacy ranks No. 6

This is the second year for Life Pharmacy to feature in the CXi Ireland Customer Experience Report with the brand moving up three places from last year to Number 6. At Life Pharmacy, we are committed to dealing with customers and patients in a human way. Our ability to connect with them has always been a differentiator for our business.

Our commitment to our customers and patients is recognised in our impact of staff score improving +5.7% this year and taking our score above 8.00, which is a measure of CX Excellence and placing us second in the Pharmacy sector.

Life pharmacy is the Number 1. ranking in the Pharmacy Sector for customer experience got better, up 4% on last year and is third overall in the survey.

Customer loyalty and trust are highly correlated to the impact that employees have on customer experience and we are delighted to have ranked second in the Pharmacy Sector and sixth in the overall survey for recognising customer loyalty.

A key element of CX success is being able to make continual improvements to customers’ experiences. Life pharmacy saw our score for making improvements increase +7.8% in 2023, ranking us second in the Pharmacy Sector and third in the overall survey.

Congratulations to all of our highly dedicated Pharmacy teams and our independently owned symbol partners and the Life Board Members for making Life Pharmacy the 6th best brand in Ireland for customer experience.

What our customers said about us They are a lovely lovely bunch so helpful, take the time to listen and know what they are talking about

I have started picking up meds more recently and the staff are very accommodating and helpful

Hickey’s Pharmacy ranks No. 8 Our mantra to deliver exceptional CX for our patients, customers and communities continues with Hickey’s Pharmacy securing eight place in this year’s CXi Ireland Customer Experience report.

Our team is made up of leading healthcare professionals with a deep knowledge of all thing’s prescription. We go the extra mile to make it easy for patients and customers to do business with us. Our success is down to doing many of the small tasks brilliantly particularly in the digital health space with our patient app and SMS messaging for patients. Our score for the impact of staff increased +6.8% in 2023, which is the biggest increase in the Pharmacy Sector.

Hickey’s

Pharmacy ranks third in the Pharmacy Sector and nineth overall in the survey for impact of staff.

Our commitment to product and CX training has enabled us to deliver remarkable standards of care through a dedicated in-house training team. We have become the first point of call for our communities on many health issues.

Staff always so helpful and offer to lend a hand

Affordability is strongly linked to all of the Emotional Drivers, particularly You Make It Easy and You Deliver On Your Promise so simplifying interactions, reducing customer effort and managing expectations is important to us. Our dedication and hard work has resulted in Hickey’s

Pharmacy affordability score improving +8.6% this year, the second highest increase in the Pharmacy Sector.

Congratulations to all of our highly dedicated pharmacy teams in making Hickey’s Pharmacy the No.8 brand for customer service.

Hickey’s Pharmacy ranks highest for the emotional drivers, You Get Me at third and I Trust You at eighth in the overall survey. These scores demonstrate strong capabilities by our healthcare teams, showing empathy for customers’ circumstances and building trust in every interaction with them.

What our customers said about us Staff bring a positive atmosphere

Lovely helpful staff, nothing a problem. Will go out of way to assist

Extremely helpful with all medical needs and offers. Commonly go out of their way to oblige costumers

To network of of pharmacies pharmacies contact contact Alan Alan Carroll: Carroll: acarroll@uniphar.ie acarroll@uniphar.ie To join join our our growing growing network

r e n n i W The People’s Pharmacist 2023 in association with Panadol: Niamh Colleran Niamh Colleran has been awarded the title of The People’s Pharmacist for 2023 following a nationwide voting campaign that saw over 12,000 votes and a reach of over 150,000 In association with Panadol, Irish Pharmacy News launched the search to find The People’s Pharmacist 2023 earlier this year; giving the Irish public the opportunity to nominate and vote for, their local pharmacist who has gone above and beyond.

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

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

From over 450 nominations we had eight extremely deserving finalists and after a nationwide voting campaign, Niamh Colleran of Colleran’s Life Pharmacy, was awarded this prestigious title.

Niamh was presented with her award by Dave Barrett,

County Manager with Haleon, Cathaoirleach Gerry Murray and Managing Director of IPN Communications, Natalie Maginnis.

Now more than ever before, it has become clear to everyone that pharmacists are one of the most critical members of Ireland’s health service family, embedded in the heart of every community.

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

Colleran’s Life Pharmacy is based in Charlestown, Co Mayo with pharmacist Niamh at the helm.

The pharmacy serves a wide catchment area of customers and patients but the enhanced services they provide, and care in always wanting to provide the highest standards of service, have really touched the life of one customer as they have engaged in their own health battle.

This nominee told Irish Pharmacy News, “We have been served by this wonderful pharmacy since moving to the area. They have always gone above and beyond their duties but in the last few months while I’ve been receiving chemotherapy they have been remarkable.

“I can’t say enough about how supportive, friendly and professional they are. Niamh and her pharmacy team have really helped to make an unpleasant and difficult situation so much easier to get through.

“Our daughter fought cancer for 5 years sadly passing after Christmas. She and my son had the same care and support.

They will drop prescriptions to the house when needed, offer advice, call the hospital pharmacy regarding prescriptions on my behalf and so much more; Nothing is too much trouble.

“This extends right down to the entire team, the experts at makeup advice who have spent considerable time with me testing pencils, powders and so on to replace the now, non-existent eyebrows, thanks to my complete hair loss from chemotherapy.

Niamh truly deserves this honour.”

Pharmacy Background Colleran’s Pharmacy was established by Niamh’s grandfather, Luke Colleran in 1931, with his son – Niamh’s father joining him in 1974. Having grown up with such an extensive background in the pharmacy world, Niamh went on to study the profession at the School of Pharmacy in London, graduating in 1997.

She tells us, “Having worked for a short time in Chelmsford Hospital, I returned to Ireland in 1999 to work in Beaumont Hospital. While

Natalie Maginnis, Managing Director, IPN Communications, Cathaoirleach Gerry Murray, Niamh Colleran and Dave Barrett, Country Manager, Haleon

12 | PHARMACYNEWSIRELAND.COM

there I completed a Masters in Hospital Pharmacy at Trinity College and having worked for a short time in Bourke’s Pharmacy, Rathmines, I returned to Hospital Pharmacy as Chief Pharmacist in the National Rehabilitation Centre in Dun Laoghaire.

“It was in 2010 that I moved west to work with my father Paddy.

“Having been established for a very long time, Colleran’s Pharmacy has created a great loyalty from generations of families in a very wide hinterland.”

On hearing of her nomination, Niamh added, “I was extremely honoured to have been nominated for this award and consider it a privilege to be able to continue to serve the people of Charlestown and surrounding districts.

“We always try to give 100% to our customers and I hope they feel they are always our priority.

“We are very lucky to have a loyal, dedicated staff, some of whom have been with us for over 30 years, and I am very proud of them. I know this achievement

Niamh Colleran with her pharmacy team of Paddy Colleran, Suzanne Horkan, Adele Kirrane, Catherine Duffy, Catherine McCormack and Sharon O’Donnell

of winning Pharmacist of the Year is also a recognition of the hard work of the entire team at Colleran’s Life Pharmacy.”

Pharmacy teams play a pivotal role as a community and health asset across Ireland. High quality public health and clinical interventions drive delivery that is focused on prevention, health improvement and protection of local communities.

There have been many challenges for the profession over the last number of years, but Niamh reflects that with challenge comes opportunity.

Dave Barrett, Paddy Colleran and Niamh Colleran

“Pharmacists across the country are under extreme pressure and are incredibly busy.

Knowing we are making a difference to customers’ lives does make it very worthwhile.

Community pharmacists are facing some serious challenges today in Ireland with medication shortages being a huge problem at present.

“The network of primary care pharmacies in Ireland is ideally placed to support patient selfcare and prevention through early

intervention. Pharmacists and their teams are an easy access and great first port of call for all ailments.

In the future I would like to see paperwork reduced and patient contact increased with funding allocated to allow pharmacists to play this important role.

“Finally I want to say a very sincere thank you to all our customers for their support for me at this time and for their loyalty over the years.”

The 2023 People’s Pharmacist Finalists:  Mark McPhillips, Marks Staywell Pharmacy, Ardee, Co. Louth  Tony Fitzsimmons, Collon Pharmacy, Collon, Co. Louth  Stephen Bradley, Meagher’s Pharmacy Baggot Street, Co. Dublin  Jessica Millar, Grant’s Pharmacy, Arklow, Co. Wicklow  Garret Harrington, Harrington’s Pharmacy, Ballincollig, Co. Cork  Brian O’Sullivan, Gannon’s Pharmacy, Coolscart, Co. Limerick

Cathaoirleach Gerry Murray, Niamh Colleran, Paddy Colleran and Haleon Country Manager Dave Barrett

 Ray Walsh, Ray Walsh Totalhealth Pharmacy, Co. Tipperary

PHARMACYNEWSIRELAND.COM | 13

14

News

The future of pharmacy is looking bright with APPEL! APPEL (Affiliation for Pharmacy Practice Experiential Learning) held their unique careers event, Future of pharmacIE, on the 20th of October. This annual event was launched in 2021 but ran virtually for the first two years due to the COVID-19 pandemic. This year, students and pharmacy professionals alike embraced the opportunity to meet each other in-person in RCSI Dublin.

Representatives from a number of leading pharmacy organisations were at the event, answering students’ questions on what experiential learning placements and future careers were like in their practice setting.

With over 300 attendees, exhibitors were kept busy with visitors to their stands throughout the afternoon.

MPharm programme shared their experiences since graduation and gave advice on gaining professional experience in different practice settings. Later in the afternoon, another panel discussion featured leading pharmacists speaking about their career paths in pharmacy.

upcoming placements and future careers.

Additionally, pharmacy professionals and organisations relished the opportunity to meet the next generation of pharmacists in Ireland and catch up with old friends!

There were also panel discussions to inspire students for their future pharmacy careers.

In the first panel, recent graduates of the

The exciting afternoon wrapped up at 4pm as connections were still being made for the future.

Students were delighted to have the opportunity to learn more about different organisations and practice settings in preparation for their

APPEL would like to thank everyone who attended Future of pharmacIE and all those who helped in planning the event. If you would like to learn more about APPEL placements, visit www.appel.ie.

Recent MPharm Graduate Panel Discussion: (l-r) Ruth McCarthy (APPEL Practice Educator for UCC), Jack Murray (PhD candidate in UCC), Caren Lee (Pharmacist with Boots Ireland), Caoimhe Bolger (Pharmacist with St. Vincent’s University Hospital), Dylan Dooley (Pharmaceutical Assessor with the HPRA)

Career Paths in Pharmacy Panel Discussion: (l-r) Ruth McCarthy (APPEL Practice Educator for UCC), Joanne Kissane (Registrar and Chief Officer of the PSI), Denis O’Driscoll (Superintendent Pharmacist of Lloyds Ireland), Muriel Pate (Chief II Pharmacist with the HSE Acute Hospital Division)

The APPEL team: (l-r) James Horan, Eimear Ní Sheachnasaigh, Anne Teresa Morgan, Rachel Hamilton, Katherine Morrow, Ruth McCarthy, Balazs Balogh

Pharmacy students at the panel discussions

The Lloyds Pharmacy team: (l-r) Susan O’Meara, Gabrielle O’Shaughnessy, Emma Rogers, Thomas Nascimento

Novartis Ireland: Claudia Guenoden and Brona Staunton

Irish Institute of Pharmacy: Audrey Cunningham (Operations Coordinator) and Ashley Ajie who is completing her 4th-year experiential learning placement with the IIOP

St James’ Hospital pharmacy department; (l-r) Miriam Coghlan, Melwin Solis, Roisin Friars, Robert Staunton. Miriam is the Preceptor to Melwin, Roisin, and Robert who are completing their 4th-year experiential learning placements in St. James’

(l-r) Eimear Ní Sheachnasaigh, APPEL Practice Educator for Trinity College Dublin, Eoghan Stynes, 4th-Year Trinity Student, Rachel Hamilton, APPEL Operations Manager, David O’Grady, Sanofi Ireland. Eoghan is completing his 4th-year experiential learning placement in Sanofi Waterford and David is his Preceptor

PHARMACYNEWSIRELAND.COM

v

RECOMMEND FOR FAST RELIEF OF TOUGH PAIN

paracetamol/caffeine DUAL ACTIVE FORMULA PROVIDES 30% MORE POWERFUL PAIN RELIEF THAN STANDARD PARACETAMOL1

GENTLE ON THE STOMACH AND NON-DROWSY**

SOLUBLE RELIEF FOR TOUGH PAIN, INCLUDING HEADACHES, PERIOD PAIN AND DENTAL PAIN

FIND OUT MORE AT HALEONHEALTHPARTNER.COM *compared to standard paracetamol. **when used as directed/always read the label before use.

Reference: 1. Laska EM et al. JAMA 1984; 251(13): 1711-1718.

Product Information: Please consult the summary of product characteristics for full product information. Panadol Extra 500mg/65mg Soluble Effervescent Tablets, paracetamol 500mg, caffeine 65mg. Indications: Relief of mild to moderate pain including rheumatism, neuralgia, musculoskeletal disorders, headache, symptoms of colds and flu, fever, toothache and menstrual pain. Dosage: Adults and children 16 years and over: 2 tablets up to 4 times a day. Do not exceed 8 tablets in 24 hours. You may need a lower dose if you are underweight (<50kg), malnourished, dehydrated or if you have alcohol problems. Children aged 12-15 years: 1 tablet up to 4 times a day. Do not exceed 4 tablets in 24 hours. Do not give to children under 12 years.

Minimum dosing interval: 4 hours. Contraindications: Hypersensitivity to paracetamol, caffeine or any ingredients. Precautions: Avoid concurrent use with other paracetamol-containing products. Diagnosed liver of kidney impairment. Patients on concomitant treatment with drugs that induce hepatic enzymes. Patients with depleted glutathione levels or chronic alcoholism or sepsis. Avoid excessive caffeine intake. Caution in those with hereditary sugar intolerance or on a low sodium diet. Should not be used in pregnancy or lactation without medical advice. Caution, due to paracetamol, if administered with flucloxacillin due to increased risk of high anion gap metabolic acidosis. Do not exceed the stated dose. Prolonged use except under medical supervision may be harmful. If high fever, or signs of secondary infection occur or if symptoms persist for longer than 3 days, consult your doctor. Side effects: See SPC for full details. All very rare: Thrombocytopenia, hypersensitivity reactions including anaphylaxis and skin rash, angioedema, Stevens-Johnson syndrome, Toxic Epidermal Necrolysis, bronchospasm, hepatic dysfunction. Frequency unknown: Nervousness, dizziness.

When combined with dietary caffeine intake, higher doses of caffeine may increase potential for caffeine related adverse events such as insomnia, restlessness, anxiety, irritability, headaches, GI disturbances and palpitations. Overdose: Immediate medical advice should be sought in the event of an overdose, even if symptoms of overdose are not present. Legal Category: Supply through pharmacy only. MA Number: PA 678/39/10. MA Holder: GlaxoSmithKline Consumer Healthcare (Ireland) Limited, 12 Riverwalk, Citywest Business Campus, Dublin 24. Additional information is available upon request. Text prepared: September 2022. Contains paracetamol. Always read the label/leaflet.

Trade marks are owned by or licensed to the Haleon group of companies. PM-IE-PAN-21-00017.

HPRA End of Year Review 2023’s achievements and challenges for the HPRA and a nod to the developments and opportunities ahead for the organisation in 2024 This year was another busy period for the HPRA as it focused on delivering its planned programme of work across each of the health product areas it regulates. As with most years, the HPRA was also faced with managing a wide variety of emerging issues spanning the full spectrum of its regulatory remit.

Written by Dr Lorraine Nolan, Chief Executive, Health Products Regulatory Authority

Some of these were familiar developments in the regulatory world, such as adaptations to the way we work due to changes in legislation. Others arose in response to continued advancements and innovation across the sectors we regulate.

The year started with a global surge in demand for antibiotics, which brought new challenges in the area of medicines shortages, not only in terms of their numbers, but also the impact on our health system.

Medicines shortages and availability Over the course of 2023, medicines regulatory authorities across the globe reported higher instances of medicines shortages than had been experienced in previous years. This is believed to be the result of a complex combination of multiple contributory factors, including the impact of the COVID-19 pandemic on medicines supply chain resilience, geopolitical events, rising costs, and increasing frequency of major weather events.

The HPRA continued to focus its efforts on initiatives to respond to and mitigate shortages as and when they arise. Additionally, a great deal of work was undertaken to build greater resilience in the medicines supply chain with a view to identifying and

preventing potential shortages before they occur. At a national level, this included the work of the national Medicines Shortages Framework, through which the HPRA coordinates and oversees a multistakeholder response to medicines shortages. At the EU level, the HPRA participates in two groups coordinated by the European Medicines Agency (EMA), both of which have important roles in the monitoring and management of medicines shortages across Europe. As part of this work, the European medicines regulatory network has carried out supply and demand modelling for key antibiotics used to treat respiratory infections in advance of the 2023/2024 winter season. This led to the publication of recommendations for actions to avoid shortages of these antibiotics to ensure sufficient supply to meet the needs of EU patients. Additionally, the network is compiling an EU list of critical medicines, the purpose of which will be to ensure that medicines most critical to EU health systems are available at all times.

Perhaps the greatest strategic opportunity in relation to medicines availability lies in having the capacity to take pre-emptive actions to prevent the occurrence of shortages. With this in mind, the HPRA met with the Minister for Health and his Department and agreed a number of strategic focus areas to build greater resilience in the national supply chain.

The HPRA, across many areas of its work, values its interaction and collaboration with pharmacists and other healthcare professionals.

Throughout 2023, medicines availability has been a key focus area for that interaction. We look forward to working with the Department of Health and all health stakeholders that have a role in this area, in building greater resilience in medicines’ availability.

16 | PHARMACYNEWSIRELAND.COM

Legislative changes to health product regulation Over the course of 2023, we continued to embed new processes arising from changes to legislation introduced in the preceding years. The end of January 2023 saw a significant milestone in the implementation of the Clinical Trials Regulation, as it marked the point at which use of the new Clinical Trials Information System (CTIS) became mandatory. Efforts to strengthen the system brought improvements that supported its users and will help us to realise the aims of the Regulation, including centralisation of key regulatory activities and increased transparency. Further information, including for trial sponsors, is available on the CTIS website: euclinicaltrials.eu In relation to medical devices, it is no secret that implementation of the Medical Devices Regulation and In Vitro Diagnostics Regulation has presented significant challenges. However, a lot has been achieved, and throughout the past year the HPRA continued to work with other EU regulators, industry, healthcare professionals, and patients to explore what is possible within the existing framework and implementing legislation. It is only through unified and collaborative action that we can achieve the aims of the legislation, which is to create a robust, transparent, and sustainable regulatory framework that improves clinical safety and enables availability of state-of-theart treatments for EU citizens.

In April of this year, the European Commission published its proposal to review the EU’s pharmaceutical legislation. The revision, which will be the most extensive update to EU medicines legislation in over 20 years, includes proposals for a new Directive and a new Regulation, which revise and replace the existing pharmaceutical legislation.

Some of the key focus areas of the legislation will be improving access to and availability of medicines, supporting innovation, and tackling antimicrobial resistance. Work is already underway to review the proposal, both nationally and

across the European medicines regulatory network. This is with the goal of ensuring the final legislative package helps foster a modern, patient-focused pharmaceutical sector, while also supporting innovation.

Communication and engagement Under the HPRA’s current strategic plan, key areas of focus for the organisation include communication and engagement, as well as health system partnerships. The HPRA is undertaking numerous initiatives to develop its information resources and communication platforms to strengthen its partnership with, and contribution to, the health system.

One such initiative that illustrates these efforts is the ongoing project to redevelop the HPRA’s website.

As part of this project, the layout of the website will be modernised, with accompanying improvements in readability and accessibility of the site’s content. In tandem, the manner in which the website interacts with the HPRA’s other digital systems will be modified to optimise how information is presented to website users. This is one of the largest projects undertaken by the HPRA in 2023, requiring significant input and collaboration from across the organisation. The outcome will be an improved website that better serves the needs of the HPRA’s diverse range of stakeholders, including professionals working across our pharmacies nationally.

Looking ahead to 2024 While we can be certain that many of the developments that emerged in 2023 will continue into the new year and beyond, I look forward to seeing how the HPRA will continue to rise to these challenges and meet them head on. The issues facing regulators are increasingly experienced on a global scale, and it is evident that the strongest approach to shared challenges is a unified approach. The HPRA remains committed to working in partnership with colleagues across the national health system, as well as the international regulatory network, to deliver for the benefit of public and animal health.

28PACK PACKNOW NOWAVAILABLE AVAILABLE. 28

CCF: 24971 Date of preparation: (09-22) ABBREVIATED PRESCRIBING INFORMATION Product Name: Emazole Control 20 mg Gastro-Resistant Tablets Composition: Each tablet contains 20 mg esomeprazole (as magnesium dihydrate).

Description: Light pink oval film coated tablet.

Indication(s): Proton Pump Inhibitor (PPI): Short-term treatment of reflux symptoms (e.g. heartburn and acid regurgitation) in adults. Dosage: Swallow tablets whole with liquid, do not chew or crush. Disperse in half a glass of non-carbonated water if difficulty in swallowing. Stir until tablets disintegrate, drink liquid with pellets immediately or within 15 min, or administer through a gastric tube. Do not chew or crush pellets. Adults: The recommended dose is 20 mg esomeprazole (one tablet) per day. It might be necessary to take the tablets for 2-3 consecutive days to achieve improvement of symptoms. Duration of treatment is up to 2 weeks. Once complete relief of symptoms has occurred, treatment should be discontinued. If no symptom relief is obtained within 2 weeks of continuous treatment, the patient should be instructed to consult a doctor. Elderly (≥ 65 years old): As per adults. Paediatric population (< 18 years): Not recommended. No relevant use in this group in the indication: “short-term treatment of reflux symptoms (e.g., heartburn and acid regurgitation)”. Severe impaired renal function: Caution.

Severe liver impairment: 20 mg max daily dose.

Contraindications: Hypersensitivity to esomeprazole, substituted benzimidazoles or any of the excipients. Not with nelfinavir. Warnings and Precautions for Use: On demand treatment: Contact a physician if symptoms change in character. In the presence of any alarm symptom (e.g. significant unintentional weight loss, recurrent vomiting, dysphagia, haematemesis or melaena) and when gastric ulcer is suspected or present, malignancy should be excluded, as treatment with esomeprazole may alleviate symptoms and delay diagnosis. Treatment with proton pump inhibitors (PPIs) may lead to a slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter and in hospitalised patients, also possibly Clostridium difficile. Patients should consult their doctor before taking this medicinal product if they are due to have an endoscopy or urea breath test. Absorption of vitamin B12 may be reduced due to hypo- or achlorhydria. Not recommended for long-term use as the following may also occur: Hypomagnesaemia; Risk of fracture. Consider stopping Emazole Control in cases of Subacute cutaneous lupus erythematosus (SCLE) accompanied by arthralgia. Interference with laboratory tests: Increased Chromogranin A (CgA) level may interfere with investigations for neuroendocrine tumours. To avoid this interference, Emazole Control treatment should be stopped for at least 5 days before CgA measurements. If CgA and gastrin levels have not returned to reference range after initial measurement, measurements should be repeated 14 days after cessation of PPI treatment. Contains glucose and sucrose.

Interactions: Effect of esomeprazole on other drugs: Co-administration with atazanavir is not recommended. If the combination of atazanavir with a PPI is judged unavoidable, close clinical monitoring is recommended in combination with an increase in the dose of atazanavir to 400 mg with 100 mg of ritonavir; esomeprazole 20 mg should not be exceeded. Esomeprazole is a CYP2C19 inhibitor. When starting or ending treatment with esomeprazole, the potential for interactions with drugs metabolised through CYP2C19 should be considered. Serum levels of cilostazol, cisapride, tacrolimus, methotrexate may be increased. An interaction is observed between clopidogrel and esomeprazole, but the clinical relevance is uncertain. As a precaution, concomitant use of esomeprazole and clopidogrel should be discouraged. Gastric acid suppression by PPIs increase or decrease absorption of drugs with pH dependent absorption (decreased absorption of ketoconazole, itraconazole); esomeprazole inhibits CYP2C19 metabolising enzyme and could increase plasma concentrations of diazepam, citalopram, imipramine, clomipramine, phenytoin (monitor plasma levels of phenytoin), etc. resulting in need of a dose reduction; monitor INR when given with warfarin or similar. Caution as absorption of digoxin can increase. Effect of other drugs on esomeprazole: CYP2C19 and CYP3A4 inhibitors (clarithromycin, voriconazole) may increase the esomeprazole exposure. Dose adjustment not regularly required, except in severe hepatic impairment and long-term use. CYP2C19 and/or CYP3A4 inducers (rifampicin and St. John’s wort) may lead to decreased esomeprazole serum levels by increasing the esomeprazole metabolism.

Pregnancy and Lactation: Caution in pregnancy due to lack of clinical data. No studies in lactating women, therefore, not recommended during breast-feeding. Ability to Drive and Use Machinery: Minor influence on the ability to drive or use machines. Adverse reactions such as dizziness (uncommon) and blurred vision (rare) have been reported. If affected, patients should not drive or use machines. Undesirable Effects: Common: Headache, abdominal pain, constipation, diarrhoea, flatulence, nausea/vomiting, fundic gland polyps (benign). Uncommon: Peripheral oedema, insomnia, dizziness, paraesthesia, somnolence, vertigo, dry mouth, increased liver enzymes, dermatitis, pruritis, rash, urticaria, fracture of the hip, wrist or spine. For other side effects refer to the SPC. Marketing Authorisation Holder: IQ Pharmatek Ltd., Gurtnafleur, Old Waterford Road, Clonmel, Co. Tipperary. Marketing Authorisation Number: PA 22777/001/001. 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 Legal Category: Not subject to medical prescription.

Date of Preparation: September 2019 Adverse events should be reported. Reporting forms and information can be found on the HPRA website (www.hpra.ie) or by emailing medsafety@hpra.ie or by emailing Rowex pv@rowa-pharma.ie

Supply Through Pharmacy Only

Medicines for Ireland End of Year Review Ambition for the Generic and Biosimilar Ecosystem Since its foundation in 2016, Medicines for Ireland has been promoting the benefits of the increased use of generic and biosimilar medicines in Ireland. As a progressive organisation, our core objective is to improve how Ireland procures and supplies medicines to expand patient access to affordable, lifesaving and lifeenhancing treatment, all while generating significant cost savings for the State.

Written by Paul Neill, Chairperson of Medicines for Ireland

As I take over as Chairperson of Medicines for Ireland, I am hopeful that the vital role played by the generic and biosimilar industry in providing affordable and accessible healthcare solutions to patients and the state will continue to scale in terms of delivery and recognition.

As the supplier of the majority of medicines in Ireland to both the HSE and to patients directly, Medicines for Ireland members are critical and central stakeholders in the Irish health service. Our association and members have embraced the opportunity to bring about significant positive change in the accessibility and affordability of healthcare. We are vocal advocates for progressive policies and are a reliable source of information for policymakers, state bodies and the public.

Knowledge is the catalyst for progressive change, and we are committed to providing the resources and expertise required to make informed decisions.

As the Irish healthcare budget remains under significant pressure, generic medicines can offer substantial cost savings for both healthcare systems and patients. The volume of generic medicines used in Ireland has increased by 70% since 2012, accounting for 57% of all prescribed medicines compared with just 33% ten years ago.

The increased use of generic medicines has yielded hundreds

“It is clear to us that the current medicines reimbursement structure is not fit for purpose, and the wider ecosystem in which we operate can be enhanced. We are facing a situation of shortages, a weak supply chain and an inability to meet patient demand”

of millions in savings for the state; however, Ireland remains far short of the European average for generic usage, which is at 70%.

Our members remain dedicated to providing safe, effective, and affordable medicines to the state and patients in Ireland.

However, it is clear to us that the current medicines reimbursement structure is not fit for purpose, and the wider ecosystem in which we operate can be enhanced. We are facing a situation of shortages, a weak supply chain and an inability to meet patient demand.

To realise the great possibilities our forward-thinking industry can provide, we must continue to foster strong and progressive relationships with the state, including politicians, state bodies, and European partners. These relationships are vital in shaping policies that support a better and more cohesive climate that benefits patients, healthcare systems and the state.

The challenges of our time require innovative solutions developed and informed by all key stakeholders

18 | PHARMACYNEWSIRELAND.COM

across the medicines supply chain. MFI stands at the forefront of advocating for policies that promote a stronger, collaborative, and innovative landscape in which generic and biosimilar medicines play an even more significant role in enhancing patient and healthcare system outcomes.

Our association consists of generics and biosimilar medicine manufacturers working towards a shared goal; however, we recognise that change is a process.

It takes time, effort, and resilience.

It requires us to be adaptable, creative, and forward-thinking.

There are many untapped areas of reform within the medicine pricing and reimbursement system in Ireland that can deliver further value for patients and the state, and Medicines for Ireland can help deliver these changes quickly.

Failing to address the high cost of medicines with more sustainable generic or biosimilar options will ensure that funding constraints remain a millstone around the neck of an already overstretched healthcare system in Ireland.

The EU Pharmaceutical Package will be an important milestone in addressing many of the challenges we face across Europe. It must be done right to ensure it has the confidence across the member states, healthcare services, industry, and patients. There are

several concerns that need to be addressed to ensure the package has the best possible outcomes for patients and the overall healthcare system in Ireland. The legislation and directive must ensure immediate entry of generic and biosimilar medicines after patent expiry, enhanced solidarity across member states, and a more explicit focus on reducing shortages and supporting greater access to medicines by digitalising and optimising regulations.

Generic medicines are now 70% of prescribed medicines in Europe while only accounting for less than 30% of pharmaceutical expenditure. The Irish Government, like others across Europe, needs to focus its attention on optimising generic use, ensuring long-term competition rather than further lowering their price. These are the areas that can be addressed through the reforms we are suggesting and will feature during the discussions that take place when we welcome our European colleagues from Medicines for Europe to Ireland in June for their Annual General Assembly.

We are enthusiastic about driving forward our ambition, which is to have the most progressive generic and biosimilar ecosystem in the EU, and we remain committed to working effectively at national and European levels to achieve it.

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IPHA End of Year Review Key Turning Points in 2023 As we approach the end of 2023 a glance over the last year will identify key turning points, both domestically and internationally, which will have long-lasting consequences for patients and the industry. These have brought challenges but also opportunities as we move into 2024.

Written by Eimear O’Leary, IPHA Director of Communications and Advocacy

For so long we had awaited the publication of the Mazars Report, which was commissioned by the government in 2019 to examine the governance arrangements around the HSE’s drug assessment and reimbursement process. In February 2023, we welcomed the publication of this report

by Minister Donnelly and his commitment to establish a Departmental Working Group to examine the Mazar’s recommendations. We have actively engaged with this Working Group throughout the year and welcomed the opportunity to collaborate as a key stakeholder.

While we look forward to seeing this review process come to a close, we are particularly keen to see how improvement to the reimbursement system will be achieved going forward. Our ultimate aim is to provide faster access to life changing medicines for Irish patients through a more efficient and reformed system.

In April, the European Pharmaceutical Legislation was published by the European Commission, the largest reform of the industry in two decades.

“Scientific innovation has advanced significantly over the past number of years bringing new hope and therapies to patients around the globe.

Unfortunately, as a result of a decision to not allocate new funding for new medicines in Budget 2024, patients in Ireland may now have to wait even longer for these innovative medicines”

We share the common goals of providing equitable access to medicines throughout EU Member States, reducing shortages and ensuring that Europe can be a world leader in medical innovation. Our industry welcomes the proposals to future-proof and upgrade the EU regulatory system, making it more efficient and competitive, and many of the measures outlined in the proposals to deal with shortages.

However, we sincerely believe that some of the actions outlined in the package will go against the stated

20 | PHARMACYNEWSIRELAND.COM

objectives of equal access to medicines across Member States.

Rather, the introduction of some of the proposals around IP rights may lead to unpredictable conditions, degrade the environment for research, development and ultimately, the production and provision of innovative new medicines in Europe and in Ireland.

As an industry, we want to work on practical and effective initiatives for Member States that have particular challenges in their health services.

The root causes for these difficulties are not about IP rights.

They are mostly at national level, so changing European law in this area of competence won’t address these challenges.

Scientific innovation has advanced significantly over the past number of years bringing new hope and therapies to patients around the globe. Unfortunately, as a result of a decision to not allocate new funding for new medicines in Budget 2024, patients in Ireland may now have to wait even longer for these innovative medicines.

This has presented a significant challenge for the industry by effectively interrupting the normal flow of new Exchequer funding for new medicines. We know that over 4,000 patients may potentially be affected by this decision as medicines planned for launch in 2024 across many types of cancers, cardiovascular diseases, HIV, auto-immune diseases and kidney disease may not happen unless efficiency savings are found. Without new treatment options, Irish patients will have lower standards of care, disappointed hopes and greater disease progression.

Our challenge, and that of the Government, is to ensure this does not occur. There needs to be an uninterrupted flow of medicines for Irish patients from January 2024.

A key part of our mission at IPHA is to shine a light on the impact that medical innovation has on the lives of real people. Our annual Innovate for Life campaign aims to tell the story of innovation by

focusing on patients who share their lived experience of how medical innovations have positively impacted on their own journey.

The theme of this year’s campaign is Innovate Today, Transform Tomorrow which explores how innovating in new medicines today can provide Irish patients with a healthy and happy future.

As an industry, we are committed to maintaining high ethical standards. Since 2016, IPHA has worked to develop and deliver a centralised database for Transfers of Value (ToV) to ensure transparency between biopharmaceutical companies, Healthcare Organisations and Healthcare Professionals. The most recent data, which was published in June this year, saw the highest ever rate of disclosure from HealthCare Professionals with the rate of transparency at 79% up 10% from 2021. This is a very positive step forward for openness and transparency.

Self-care empowers people to manage important elements of their own and their loved ones’ lives. Research recently undertaken by IPHA, in association with Ipsos, indicates that Self-Care is the first step and first choice for most Irish people who are taking an increasingly active role in their healthcare. The research found that 82% believe that treating minor health conditions at home would put less pressure on the health system and that confidence in self-treating minor health conditions is very high, at 84%.

In the midst of ever-increasing pressures on our health system, and GP care becoming more and more difficult to access, the benefits of Self-Care are clear to see and need to be acknowledged and built upon.

As with everything in life, with challenges comes opportunities.

The seminal events of 2023 pave the way for reform during 2024 and beyond. Through collaboration and forward thinking, we hope these changes will make a real difference in the lives of patients.

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IIOP End of Year Review Supporting the Pharmacy Agenda 2023 was a busy year for the team in IIOP characterised by a real sense of movement back to in-person events while seeing the continuing desire for virtual and online training offerings.

Mentoring Programme 2023 The IIOP’s award-winning Mentoring programme relaunched recently. This evidence based, formal yet flexible programme is for pharmacists, by pharmacists.

Designed to suit the life of a busy pharmacist, a structure is provided which is flexible and personalised to the mentoring pair. It is tailored for pharmacists working in all practice areas and is the first of its kind offered to all pharmacists in Ireland. Together, we are working to create a culture of mentorship within the Irish pharmacy profession. As we work through times of change and innovation, we can support each other in a way that is difficult to achieve through other means.

Interested in finding out more or getting involved? Find out more on our Mentoring Homepage or get in touch with us at mentoring@iiop.ie.

In October 2023, the IIOP communicated with those pharmacists selected for the 2023-2024 ePortfolio Review.

CPD Statutory processes This cohort, comprising >1400 of ePortfolio Review and pharmacists, will be invited to Practice Review submit their CPD ePortfolios in In January, the ePortfolio Review January 2024. Support resources process are available on the IIOP website Pharmacy da Agendaprogressed as usual, for RCSI Charter Day 2023 the 2022-2023 ePortfolio Review (iiop.ie) to support those who have cohort.

Over 1,300 (approx.

20% Collaborating with the perations h Chambers, Director, Operations Irish Institute Director,ofIrish Pharmacy Institute of Pharmacy been selected. of the register) submitted their CPD Antimicrobial Resistance and Training ePortfolios forIIOP review. am yearinfor IIOP the characterised team in by characterised a Outcomes real senseby of amovement real senseProgrammes back of movement to in- and back to in- Infection Control (AMRIC) team, were released in May with 97% Information Resources the IIOP launched the Pharmacist hile continuing seeing the desire continuing foroutcome virtual desire and online for virtual training and online offerings. training offerings. receiving an of “Standard Antimicrobial Stewardship Network The IIOP continued to support Met”, indicating the profession’s (PAMS-net) in August 2022. This pharmacy practice, by delivering ePortfolio processes Review of ePortfolio and Practice Review Review and Practice Review commitment to CPD. network, consisting of over 350 a variety of training programs and w Portfolio process Review progressed process as usual, progressed theas2022-2023 usual, for the ePortfolio 2022-2023 Review ePortfolio Reviewpharmacists, aims to promote The IIOP conducted twofor Practice resources, including 27 online responsible use of antimicrobials % 00of(approx. the Review register) 20%events of submitted theinregister) submitted CPD ePortfolios their CPD for programs. ePortfolios review. Afor review.

Apriltheir 2023 training variety of live and combat antimicrobial and October held at of thean yreleased with 97% in May receiving with2023, an 97% outcome receiving “Standard outcome Met”, of “Standard indicating Met”, the covering indicating the resistance. In February 2023, workshops took place, RCSI York St. campus. For the topics such as Managing Conflict mmitment D. to CPD. the IIOP participated in RCSI April Practice Review, 97% of in Pharmacy Practice, Critical Charter Week with a session titled pharmacists received an outcome Appraisal Skills, Mentorship Skills ted e Review two of Practice events Review in April events 2023 and in April October 20232023, and October held at the 2023, RCSI held at the RCSI “Empowering all pharmacists to “demonstrated competence”. for Pharmacists, Trainingof deliver antimicrobial stewardship,” ractice For theReview, April Practice 97% ofremediation Review, pharmacists 97%support of received pharmacists an outcome received of anand outcome Individualised for Pharmacists appointed to in collaboration with HSE AMRIC was provided to thesupport pharmacist competence”. ndividualised remediation Individualised remediation was provided support to was the provided pharmacist to the pharmacist HSE committees and Working team, followed by a panel allocated an outcome of “further er come review of “further required”. review required”.

Groups. A new online training discussion. Over 40 pharmacists review required”. program on Pharmacy and from various practice areas Medicines Legislation, as well as attended this event. a Polypharmacy and Medication Peer Support Pharmacist (PSP) Review workshop, were launched Event in January 2023. In October 2023, the IIOP offered a new online Engagement activities throughout workshop on Giving and Receiving 2023 included a Peer Support Effective Feedback.

Pharmacist Event, which took place in October 2023 for those The “In Conversation with…” pharmacists who are actively webinar series continued involved in IIOP projects. The throughout 2023, with 18 webinars day featured discussion on the delivered on a variety of topics, anticipated changes arising from such as Medicines Shortages, and the launch of the PSI’s revised the Launch of the Revised Core Core Competency Framework Competency Framework. There for pharmacists, as well as are now over 60 recorded webinars a Masterclass on Giving and available for pharmacists to watch Receiving Effective Feedback. back on the IIOP website.

Insights on the RPS Consultant Irish Institute of Pharmacy Team

municated , the IIOP communicated with those pharmacists with those selected pharmacists for theselected 2023-2024 for the 2023-2024 w. comprising This cohort, >1400 comprising pharmacists, >1400will pharmacists, be invited to willsubmit be invited theirto CPD submit their CPD nuary pport resources 2024. Support are available resources on are the available IIOP website on the (iiop.ie) IIOP website to support (iiop.ie) to support 22 | PHARMACYNEWSIRELAND.COM been selected.

Pharmacist Credentialing Process were provided by pharmacist Niamh McMahon, demonstrating how competency frameworks and feedback processes can be used to support and promote professional development and growth.

Revised Core Competency Framework (CCF) for Pharmacists The Core Competency Framework underpins the Continuing Professional Development (CPD) system for pharmacists in Ireland.

A revised CCF was launched by the PSI in 2023. To assist pharmacists with the move to the revised CCF, the IIOP hosted the “Launch of the Revised Core Competency Framework for Pharmacists” webinar with the PSI on 13 September 2023. The IIOP also hosted five regional “CPD & The Revised Core Competency Framework for Pharmacists” Roadshows during Autumn 2023.

All Ireland Pharmacy Conference The 10th All Ireland Pharmacy Conference took place in the Ballymascanlon House Hotel, Dundalk on the 6th and 7th November 2023. The theme of the conference was ‘Creating Momentum & Building Capacity’.

A diverse range of attendees from both North and South, across all areas of practice, attended to share and discuss ideas for pharmaceutical service development in the North and in the Republic of Ireland. The main conference proceedings took place on Tuesday 7th November 2023 with a keynote address delivered by Andrew Evans, Chief Pharmaceutical Officer, Wales, who spoke about developments in the pharmacy sector from the Welsh perspective. The remainder of the conference included parallel oral sessions and poster presentations providing examples of practice from both sides of the border.

As the year draws to a close, we are grateful to all our stakeholders for their ongoing engagement and support, and we are looking forward to supporting the wider pharmacy agenda as we move into what looks like an exciting year ahead for Irish pharmacy.

™

*when applied twice daily

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 Please refer to the Summary of Product Characteristics (SmPC) for full details of Prescribing Information.

Motusol Max (diclofenac sodium) 2% w/w gel Abbreviated Prescribing Information. Presentation: White to almost white, homogeneous gel. 1g of gel contains diclofenac as 23.2mg diclofenac diethylamine corresponding to 20mg of diclofenac sodium. Indications: Local symptomatic treatment of pain in acute strains, sprains or contusions following blunt trauma. For short term treatment only. Dosage and administration: For cutaneous use. Apply to affected parts of the body thinly and gently rub into skin.

Wash hands after application unless area to be treated. Allow gel to dry on skin before applying bandages. Adults and adolescents aged 14 years and over: depending on the size of the affected site, apply a cherry to walnut size quantity 2 times a day (preferably morning and evening). Should not be used for longer than 1 week without medical advice. Children: no data in children and adolescents under 14 years of age. Elderly: no dosage adjustment required. Monitor patient carefully. Renal and hepatic impairment: no dosage adjustment required. Contraindications: Hypersensitivity to active substances or excipients; patients with a history of hypersensitivity reactions such as asthma, bronchospasmus, urticaria, acute rhinitis in response to acetylsalicylic acid or non- steroidal anti-inflammatory drugs (NSAIDs); open injuries, inflammations or infections of the skin as well as on eczema or mucous membranes; in the last trimester of pregnancy; in children and adolescents under 14 years of age. Precautions and warnings: Systemic undesirable effects cannot be excluded if applied on larger areas of skin over a prolonged period of time. Must only be applied to intact, not diseased or injured skin.

Must not come into contact with eyes and oral mucous membranes. Must not be taken orally. May be used with non-occlusive bandages, but not with airtight occlusive dressing. Consult doctor if symptoms worsen or do not improve after 3-5 days. Patients suffering from asthma, hay fever, swelling of nasal mucous membranes (so called nasal polyps) or chronic obstructive pulmonary disease, chronic respiratory infections (particularly associated with hay fever-like symptoms), and patients with hypersensitivity to painkillers and anti-rheumatic medicinal products of all kinds are rather at risk to asthma attacks (so called analgesic intolerance / analgesic asthma), to local skin or mucous membrane swelling (so-called quincke edema) or to urticaria than other patients when treated with Motusol Max. In these patients, Motusol Max may only be used under certain precautions (emergency preparedness) and direct medical supervision. The same applies for patients who are also allergic to other substances e.g. with skin reactions, itching or urticaria. Discontinue treatment if skin rash occurs. Photosensitivity can occur with the appearance of skin reactions after exposition to sunlight. Avoid children coming into contact to the skin areas where the gel has been applied. Contains butylhydroxytoluene which may cause local skin reactions or irritation to the eyes and mucous membranes. Contains fragrance with benzyl alcohol (0.15mg/g), citral, citronellol, coumarin, eugenol, farnesol, geraniol, d-limonene and linalool which may cause allergic reactions. In addition, benzyl alcohol may cause mild local irritation. Interactions: None known. Pregnancy and lactation: Should not be used during first and second trimester unless clearly necessary. Contraindicated during third trimester. Should only be used during breast-feeding under advice from a healthcare professional and should not be applied on the breasts, nor elsewhere on large areas of skin for a prolonged period of time. Effects on ability to drive and use machines: No or negligible influence. Adverse reactions: Hypersensitivity, angioedema, dermatitis bullous, Common: dermatitis (including contact dermatitis), skin rash, erythema, eczema, pruritus. Consult the Summary of Product Characteristics in relation to other side effects. Overdose: Wash skin with water where applied. If ingested, apply general therapeutic measures normally adopted to treat poisoning with non-steroidal anti-inflammatory medicinal products. Gastric lavage and use of activated charcoal should be considered. Legal category: Pharmacy. Marketing Authorisation Number: PA1986/093/002. Marketing Authorisation Holder: Teva B.V., Swensweg 5, 2031GA Haarlem, Netherlands.

Job Code: MED-IE-00036. Date of Preparation: June 2021.

Job Code: MOT-IE-00001. Date of Preparation: November 2023.

Vimovo® 1 tablet, 2 active ingredients...

Sequential release of: • Esomeprazole (in the stomach) for gastroprotection; followed by • Naproxen (in the small intestine) for relief of inflammation and pain associated with osteoarthritis.1-5

Esomeprazole 20mg Enteric coating Naproxen 500mg

Scan QR code to view VIMOVO MODE OF ACTION VIDEO

1 tablet twice daily at least 30 minutes prior to food intake.2 Swallow whole with water.

Do not split, chew or crush.2

Vimovo® is indicated in adults for the symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, in patients who are at risk for developing non-steroidal anti-inflammatory drug (NSAID)-associated gastric and/or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient.2

RECEIVE A CALL FROM A MEDICAL REPRESENTATIVE

RECEIVE INFORMATION FROM GRÜNENTHAL

Reference: 1. Goldstein JL et al. Aliment Pharmacol Ther. 2010; 32(3):401-413. 2. Vimovo Summary of Product Characteristics. 3. Wang-Smith L et al. J Clin Pharmacol. 2012 May; 52(5):670-80. 4. Hochberg MC et al. Curr Med Res Opin. 2011; 27(6):1243-1253. 5. Moore RA et al. Pain Pract. 2014; 14(4):378-39.

VIMOVO 500mg/20mg modified-release tablets (naproxen, esomeprazole magnesium trihydrate) Prescribing Information Refer to the Summary of Product Characteristics (SmPC) before prescribing.

Presentation: Modified-release tablet (oval, biconvex, yellow, marked 500/20 in black ink) containing enteric-coated naproxen (500 mg) and film-coated esomeprazole (20 mg).

Indication: In adults for the symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, in patients who are at risk for developing non-steroidal antiinflammatory drug (NSAID)-associated gastric and/or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient.

Dosage and method of administration: Adults: Oral use. Swallowed whole (not split, chewed or crushed) with water. Recommended to take at least 30 minutes prior to food intake. One tablet twice daily. Use lowest effective dose for shortest duration possible.

Patients not treated with NSAID previously, or when 1000mg/day of naproxen is not considered appropriate, alternative therapeutic treatment with lower strength of naproxen or of other NSAIDS as non-fixed combination should be utilised. Review at regular intervals and discontinue if no benefit or if worsening. Not intended for relief of acute pain conditions. Flares of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis may be treated. Renal / Hepatic impairment: Use cautiously in mild to moderate renal/hepatic impairment and monitor closely. Consider reduction in total daily naproxen dose. Elderly (>65 years): older people are at risk of serious consequences of adverse reactions. Paediatric population: Safety and efficacy not established in 0 to 18 years. Contra-indications: Hypersensitivity to ingredients, history of asthma, urticaria or allergic-type reactions induced by administration of acetylsalicylic acid or other NSAIDs, third trimester of pregnancy onward, no breastfeeding if you are taking VIMOVO, severe heart failure, severe renal impairment, severe hepatic impairment (Child-Pugh C), active peptic ulceration, gastrointestinal (GI) bleeding, cerebrovascular bleeding or other bleeding disorders, must not be used concomitantly with atazanavir and nelfinavir.

Special Warnings and precautions: Avoid concomitant NSAIDs use. Can be used with low dose acetylsalicylic acid. Undesirable effects may be minimized by using lowest effective dose for the shortest duration necessary. Assess at meaningful intervals to prevent overtreatment. Risk-factors to develop NSAID related GI complications include high age, concomitant use of anticoagulants, corticosteroids, other NSAIDs including low-dose acetylsalicylic acid, debilitating cardiovascular disease, Helicobacter pylori infection, and a history of gastric and/or duodenal ulcers and upper GI bleeding. In Inducible porphyries and systemic lupus erythematosus and mixed connective tissue disease use only after rigorous benefit-risk ratio. Contains very low levels of methyl and propyl parahydroxybenzoate. Patients on long-term treatment should be kept under regular surveillance. Elderly: Naproxen: Older people have an increased frequency of adverse reactions especially GI bleeding, and perforation, which may be fatal. Gastrointestinal effects: Naproxen: GI bleeding, ulceration or perforation, which can be fatal with or without warning symptoms or a previous history of serious GI events. Risk is higher with increasing NSAID doses, patients with history of ulcers and in older people. Start with low dose and consider combination therapy with protective agents. Caution in patients receiving NSAIDs with concomitant medications which could increase risk of ulceration or bleeding. Withdraw treatment if GI bleeding or ulceration. Caution in patients with a history of GI disease. Esomeprazole: In the presence of any alarm symptom and when gastric ulcer is suspected, malignancy should be excluded. Dyspepsia could still occur.

May lead to increased risk of GI infections. May reduce absorption of vitamin B12 due to hypo- or achlorhydria. Cardiovascular and cerebrovascular effects: Naproxen: Appropriate monitoring and advice for patients with history of hypertension and/or mild to moderate congestive heart failure. The use of coxibs and some NSAIDs may be associated with a small increased risk of arterial thrombotic events. Patients with uncontrolled hypertension, congestive heart failure, established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease should only be treated with naproxen after careful consideration. Consideration should be made before initiating longer-term treatment of patients with risk factors for cardiovascular events. Renal effects: Naproxen: Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.

Renal toxicity has been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. Patients at greatest risk of this are those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, those taking diuretics, angiotensin converting enzyme (ACE) inhibitors, or angiotensin II receptor antagonists and older people. Use with great caution in patients with impaired renal function and monitoring of serum creatinine and/or creatinine clearance is advised.

Contraindicated in patients with baseline creatinine clearance less than 30 ml/min.

Assess renal function before and during therapy in patients with compromised renal blood flow. Acute tubulointerstitial nephritis (TIN) has been observed in patients taking esomeprazole and naproxen containing products and may occur at any point during Vimovo therapy. Acute tubulointerstitial nephritis can progress to renal failure. Hepatic effects: Borderline elevations of liver tests may occur, due to hypersensitivity rather than toxicity. Rare cases of severe hepatic reactions, including jaundice and fatal fulminant hepatitis, liver necrosis and hepatic failure, some with fatal outcomes have been reported.

Hepatorenal syndrome: Use of NASAIDs may be associated with acute renal failure in patients with hepato-cirrhosis. These patients frequently also have concomitant coagulopathy related to inadequate synthesis of clotting factors. Antiplatelet effects associated with naproxen could further increase risk of severe bleeding. Haematological effects: Naproxen: Careful observation when administered to patients who have coagulation disorders or are receiving drug therapy that interferes with haemostasis.

Increased risk of bleeding if given to patients with high risk of bleeding and those on full anti-coagulation therapy. Naproxen decreases platelet aggregation and prolongs bleeding time. If active and clinically significant bleeding from any source occurs, withdraw treatment. Eye effects: Naproxen: recommend ophthalmic examination if any change or disturbance in vision occurs. Dermatological effects: Naproxen: Discontinue at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity.

Esomeprazole: associated with very infrequent cases of subacute cutaneous lupus erythematosus (SCLE). If lesions occurs and if accompanied by arthralgia, seek medical help promptly and consider stopping treatment. SCLE after previous treatment with a PPI may increase the risk of SCLE with other PPIs. Anaphylactic (anaphylactoid) reactions: Naproxen: anaphylactic (anaphylactoid) reactions may occur in patients with and without a history of hypersensitivity or exposure to acetylsalicylic acid, other NSAIDs or naproxencontaining products. They may also occur in individuals with a history of angio-oedema, bronchospastic reactivity, rhinitis and nasal polyps. Pre-existing asthma: Naproxen: Use with caution and should not be administered to patients with aspirin-sensitive asthma.

Inflammation: Naproxen: may reduce fever and other signs of inflammation thereby diminishing their utility as diagnostic signs. Female fertility: not recommended in women attempting to conceive. Combination with other medicinal products: Must not be used with atazanavir. Esomeprazole is a CYP2C19 inhibitor. When starting or ending treatment, the potential for interactions with drugs metabolised through CYP2C19 should be considered. Concomitant use with clopidogrel should be discouraged. Hypomagnesaemia: Severe hypomagnesaemia has been reported in patients treated with Proton Pump Inhibitors (PPIs). Consider measuring magnesium levels before starting PPI treatment and periodically during treatment in patients expected to be on prolonged treatment or those on concomitant digoxin or drugs that may cause hypomagnesaemia. Bone fracture: PPIs, if used in high doses and over long durations (>1 year), may increase the risk of hip, wrist and spine fracture, predominantly in older people or in presence of other recognised risk factors. Patients at risk of osteoporosis should receive care according to current clinical guidelines and have an adequate intake of vitamin D and calcium. Interference with laboratory tests: Increased Chromogranin A (CgA) level may interfere with investigations for neuroendocrine tumours. To avoid this interference, treatment should be stopped for at least 5 days before CgA measurements. Fertility: VIMOVO may make it more difficult to become pregnant. Interactions: Antiretroviral agents: Concomitant use of atazanavir and nelfinavir with esomeprazole is not recommended and concomitant administration with Vimovo is contraindicated. Concomitant use with precaution: Other analgesics including cyclooxygenase-2 selective inhibitors: Concomitant use with other NSAIDs except for low-dose acetylsalicylic acid (≤ 325 mg/day), is not recommended. Acetylsalicylic acid: Can be administered with low dose acetylsalicylic acid (≤ 325 mg/day). In clinical trials, Vimovo in combination with low-dose acetylsalicylic acid did not have increased occurrence of gastric ulcers. However, concurrent use may still increase risk of serious adverse events. Clinical pharmacodynamic data suggests concomitant naproxen usage for more than one day consecutively may inhibit the effect of low-dose acetylsalicylic acid on platelet activity and this inhibition may persist for up to several days after stopping naproxen. Clinical relevance of this interaction is not known. Tacrolimus: A

reinforced monitoring of tacrolimus concentrations as well as renal function should be performed and dose of tacrolimus adjusted if needed. Ciclosporin: caution when coadministered because of increased risk of nephrotoxicity. Diuretics: NSAIDs can reduce natriuretic effect of furosemide and thiazides in some patients. Observe patient closely for signs of renal failure as well as to assure diuretic efficacy. SSRIs: Concomitant use of NSAIDs, including COX-2 selective inhibitors, and SSRIs increases the risk of GI bleeding.

Corticosteroids: Increased risk of GI bleeding when combined with NSADIs including COX2 selective inhibitors. Caution when NSAIDS are concomitantly administered with corticosteroids. ACE-inhibitors/Angiotensin II receptor antagonists: caution when combined with NSAIDs in patients who are older, volume-depleted, or with renal impaired renal function as NSAID may diminish antihypertensive effect and increase risk of renal impairment associated with ACE-inhibitor or angiotensin II receptor antagonists. Digoxin: NSAIDs may increase plasma cardiac glycoside levels when co-administered with cardiac glycosides such as digoxin. Lithium: NSAIDs have produced an elevation of plasma lithium levels and a reduction in renal lithium clearance. Observe carefully for lithium toxicity.

Methotrexate: esomeprazole and naproxen could enhance the toxicity of methotrexate.

Caution when administered concomitantly with methotrexate. In high-dose methotrexate administration a temporary withdrawal of Vimovo is recommended. Sulphonylureas, Hydantoins: Naproxen is highly bound to plasma albumin; thus a theoretical potential for interaction with other albumin-bound drugs (sulphonylureas, hydantoins). When coadministered patients should be observed for adjustment of dose. Clopidogrel: Concomitant use should be discouraged due to inconsistent data on clinical implications of a PK/PD interaction of esomeprazole in terms of major cardiovascular events reported from observational and clinical studies. Anti-coagulants and thrombocyte aggregation inhibitors: NSAIDs may enhance the effects of oral anti-coagulants, heparins and thrombocyte aggregation inhibitors. Close monitoring when initiating and ending treatment with warfarin or other coumarine derivatives. Beta receptor-blockers: Naproxen and other NSAIDs can reduce the antihypertensive effect of propranolol and other betablockers. Probenecid: Probenecid given concurrently increases naproxen anion plasma levels and extends its plasma half-life significantly. Drugs with gastric pH-dependent absorption: gastric acid suppression during treatment with esomeprazole, and other PPIs might decrease or increase the absorption of drugs with a gastric pH dependent absorption. The absorption of drugs such as ketoconazole, itraconazole, posaconazole and erlotinib can decrease while the absorption of drugs such as digoxin can increase.

Concomitant use with posaconazole and erlotinib should be avoided. Other Information Concerning Drug Interactions: Studies evaluating concomitant administration of esomeprazole and either naproxen or rofecoxib did not identify any clinically relevant interaction. Concomitant administration of cholestyramine can delay absorption of naproxen. In healthy volunteers, concomitant administration esomeprazole resulted in an increase in area under the plasma concentration-time curve and prolonged elimination half-life but no significant increase in peak plasma levels of cisapride. Esomeprazole has been shown to have no clinically relevant effects on the pharmacokinetics of amoxicillin and quinidine. Esomeprazole inhibits CYP2C19, the major esomeprazole metabolising enzyme. Esomeprazole is also metabolised by CYP3A4. Drugs known to induce CYP2C19 or CYP3A4 or both (such as rifampicin and St. John's Wort) may lead to decreased esomeprazole serum levels. Omeprazole and esomeprazole act as inhibitors of CYP2C19.

Animal data indicate that NSAIDs can increase the risk of convulsions associated with quinolone antibiotics. Patients taking quinolones may have an increased risk of developing convulsions. Drug/Laboratory Test Interaction: Naproxen may decrease platelet aggregation and prolong bleeding time. Naproxen may result in increased urinary values for 17-ketogenic steroids. Suggested therapy with naproxen be temporarily discontinued 72 hours before adrenal function tests are performed if the Porter-Silber test is to be used. Naproxen may interfere with some urinary assays of 5-hydroxy indoleacetic acid (5HIAA). Pregnancy, lactation and fertility: You should not use VIMOVO during the first 6 months of pregnancy unless absolutely necessary and advised by your doctor. From the 20th week of pregnancy onward, VIMOVO use may cause oligohydramnios resulting from foetal renal dysfunction. This may occur shortly after treatment initiation and is usually reversible upon discontinuation. Antenatal monitoring for oligohydramnios and ductus arteriosus constriction should be considered after exposure to VIMOVO for several days from gestational week 20 onward. Do not breast-feed if you are taking VIMOVO. Fertility: The use of NSAIDs like naproxen may impair female fertility. The use of VIMOVO is not recommended in women attempting to conceive. Refer to full SmPC for further information.

Undesirable effects: Reported from Vimovo clinical trials: Very common (≥1/10): dyspepsia.

Common (≥1/100 to <1/10): dizziness, headache, taste disturbance, hypertension, abdominal pain, constipation, diarrhea, esophagitis, flatulence, gastric/duodenal ulcers, gastritis, nausea, vomiting, skin rashes, arthralgia, oedema. Other important undesirable effects: paraesthesia, syncope, arrhythmia, GI bleeding, stomatitis, urticaria, (Uncommon (≥ 1/1,000 to < 1/100), diverticulitis, hypersensitivity reactions, myocardial infarction, tachycardia, rectal bleeding, renal failure, (Rare (≥ 1/10,000 to < 1/1,000). Naproxen: adverse experiences reported during trial and through postmarketing reports: Common (≥1/100 to <1/10): diverticulitis, depression, insomnia, dizziness, drowsiness, headache, lightheadedness, vertigo, visual disturbances, tinnitus, hearing disturbances, palpitations, dyspnea, dyspepsia, abdominal pain, nausea, vomiting, diarrhoea, constipation, heartburn, peptic ulcers, stomatitis, pruritus, ecchymoses, purpura, skin rashes, fatigue, oedema, sweating, thirst. Other important undesirable effects: sepsis, agranulocytosis, eosinophilia, granulocytopenia, Pancytopenia, thrombocytopenia, anaphylactic reaction, anaphylactoid reactions, hypersensitivity reactions, coma, convulsions, optic neuritis, paresthesia, syncope, corneal opacity, papilloedema, arrhythmia, myocardial infarction, tachycardia, eosinophilic pneumonitis, pneumonia, respiratory depression, gastric/duodenal ulcers, gastrointestinal bleeding and/or perforation, pancreatitis, exacerbation of inflammatory bowel disease (ulcerative colitis, Crohn's disease), rectal bleeding, cholestasis, hepatitis, jaundice, liver failure, exanthema, urticaria, bullous reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis, erythema multiforme, systemic lupus erythematosus, pseudoporphyria, nephrotic syndrome, renal failure, renal papillary necrosis, tubular necrosis, Uncommon (≥ 1/1,000 to < 1/100), Rare (≥ 1/10,000 to < 1/1,000).

Esomeprazole: adverse drug reactions identified or suspected in clinical trial for entericoated esomeprazole and/or post marketing. None were found to be dose-related: Common (≥1/100 to <1/10): headache, abdominal pain, diarrhea, flatulence, nausea/ vomiting, constipation, fundic gland polyps (benign). Other important undesirable effects: paraesthesia, pruritus, urticaria, fracture of the hip, wrist or spine (Uncommon (≥ 1/1,000 to < 1/100). leukopenia, thrombocytopenia, hypersensitivity reactions e.g. fever, angioedema and anaphylactic reaction/shock, depression, paraesthesia, syncope, arrhythmia, gastrointestinal bleeding, stomatitis, pruritus, urticaria, (Rare (≥ 1/10,000 to < 1/1,000)). agranulocytosis, pancytopenia, hepatic failure, hepatic encephalopathy in patients with pre-existing liver disease, erythema multiforme, Interstitial nephritis, Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), , drug reaction with eosinophilia and systemic symptoms (DRESS) (Very rare (< 1/10,000)). Overdose: Effects of overdose expected to reflect the effects of naproxen overdose. Significant naproxen overdosage may be characterized by lethargy, dizziness, drowsiness, epigastric pain, abdominal discomfort, heartburn, indigestion, nausea, transient alterations in liver function, hypoprothrombinemia, renal dysfunction, metabolic acidosis, apnea, disorientation or vomiting. GI bleeding can occur. Hypertension, acute renal failure, respiratory depression, and coma may occur, but rare. Anaphylactoid reactions have been reported. A few patients have experienced convulsions. It is not known what dose of the drug would be life-threatening. The symptoms in connection with esomeprazole overdose are transient. Patients should be managed by symptomatic and supportive care following a NSAID overdose, particularly with respect to GI effects and renal damage. Haemodialysis does not decrease the plasma concentration of naproxen because of the high degree of protein binding. Emesis and/or activated charcoal and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose. Forced diuresis, alkalinization of urine or hemoperfusion may not be useful.

Esomeprazole is not readily dialyzable. There are no specific antidotes for naproxen or esomeprazole. Prescribers should consult the SmPC in relation to all adverse reactions.

Legal classification: POM, CD (Part VIIIA Category C). Marketing Authorisation numbers, pack sizes: PA 2242/014/001, 60 packs. Marketing Authorisation Holder: Grünenthal Pharma Ltd 4045 Kingswood Road Citywest Business Park Citywest Co. Dublin Ireland.

Date of preparation: July 2023. JN: M-VMO-IE-07-23-0001.

Adverse events should be reported. Reporting forms and information can be found at www.medicines.ie/adverse-event-reporting.

Adverse events should also be reported to Grünenthal Ltd. Free phone: +44 (0)870 351 8960.

M-VMO-IE-07-23-0006 – July 2023

IPU End of Year Review 2023 - Pivotal Year for Pharmacy 2023 has been a pivotal year for Ireland’s community pharmacy sector. After many years advocating for our potential to be acknowledged there is now a process underway to deliver reforms that are sorely needed.

Written by Dermot Twomey, President, Irish Pharmacy Union

In July this year, Minister Donnelly established an Expert Taskforce with the objective of exploring opportunities to expand community pharmacy.

This followed a concerted and determined campaign by the Irish Pharmacy Union (IPU) to highlight the plight of pharmacies and the challenges of the sector. As a result of these efforts, separate and in parallel to the work of the taskforce, the IPU is now also engaged in meaningful discussions with the Department of Health.

We are already witnessing the positive impact with the Minister for Health announcing the Government’s intention to introduce legislation enabling pharmacists to supply contraception without prescription following a structured consultation and therapeutic substitution by pharmacists for drug shortages.

This is a long-awaited and warmly welcomed development.

In November, the Minister announced plans to enable pharmacists use their clinical expertise to extend repeat prescriptions for up to 12 months, where appropriate to do so. This, the first recommendation by the

“The increasing costs impacting on the sector and rising levels of administration foisted on pharmacies are making it increasingly difficult to run a viable business and to maintain and retain pharmacists.

Immediate measures need to be taken”

a medicine is in short supply.

This would be a significant development allowing pharmacists to deal in a meaningful way without having recourse to the prescriber.

While these are positive developments, the financial challenges facing pharmacies remain a critical concern.

Pharmacies remain the only healthcare profession to have not had funding restored in the last 15 years. In fact, the fees paid by the State to pharmacies, are lower today than they were in 2009.

The increasing costs impacting on the sector and rising levels of administration foisted on pharmacies are making it increasingly difficult to run a viable business and to maintain and retain pharmacists. Immediate measures need to be taken to address this serious situation.

There is now an imperative need for the restoration and reform of pharmacy fees. Addressing adequate funding for Ireland’s pharmacies remains an absolute priority together with tackling absurd levels of administration and bureaucracy.

Expert Taskforce, acknowledges the IPU position and supports an enhanced role for pharmacists.

This change will improve the care provided to patients in their communities. We look forward to the next recommendation due by the end of January.

As with each year our profession welcomed new entrants in 2023 and I wish all pharmacy graduates a successful and fulfilling career.

But it is clear that in Ireland we are simply not training enough pharmacists. With a growing and ageing population, there is a significant shortfall of pharmacists working in the sector. Historically, Ireland has relied on other countries, primarily the UK, to educate our pharmacists. Last year saw just 155 new pharmacy graduates from Ireland less than half of the total new entrants to the profession and a quarter of the number that is needed.

2023 has also been characterised by the growing challenges of medicine shortages, which remain a major concern both for us and our patients. It is our hope that through the draft legislation mentioned above serious shortage protocols will be introduced that will allow pharmacists to therapeutically substitute when

On a positive note, a report from the HEA in June found that there is potential capacity for almost 200 new pharmacy undergraduate education places in Ireland. This would include the expansion of existing programmes as well as the establishment of new education courses in the Atlantic Technical University and the South-East

26 | PHARMACYNEWSIRELAND.COM

Technical University and the University of Galway.

While there is now an action plan to train more pharmacists, this will take time. There is a pressing need to deal with the shortages within the profession today. Many pharmacist vacancies remain unfilled. This is having a negative impact on patient experiences.

One short term action we would like is to make it as easy as possible for pharmacists from nonEU countries to relocate and work in Ireland.

A highlight and source of great pride for our profession is the continued good work exhibited through the rollout of the Safe Pharmacy programme. Launched in July last year, Safe Pharmacy now has 1,087 participating pharmacies nationwide. These pharmacies provide a safe and secure environment for individuals experiencing domestic violence and coercive control, allowing them to seek support. This initiative received international recognition as the best health promotion campaign by the International Pharmaceutical Federation (FIP) in September.

No look back on a year in community pharmacy would be complete without my paying tribute to my colleagues across the country. In every small town and village in Ireland, (often) on evenings and weekends, they go above and beyond in the name of patient service. Our unique profession continues to inspire the utmost confidence and trust from the people of Ireland.

The potential of our sector is undeniable. Tapping into that potential is vital for the health service and our communities.

Addressing the fees and administration issues are of paramount importance and once addressed will make way for the development and delivery of the many new services our patients need and deserve. We will remain committed to the delivery of the changes to which I refer and look forward to your continued support in doing so.

PSI End of Year Review Areas of Focus for the Pharmacy Regulator Joanne Kissane, Registrar and Chief Officer of the PSI provides an overview on some of the key achievements and areas of focus for the Pharmacy Regulator in 2023.

2023 has been a busy year for PSI as we continue to progress the commitments under our corporate strategy and respond to evolving and emerging developments across the health system that impact pharmacy. As the regulator, the PSI is committed to ensuring that the public has access to trusted pharmacy services.

We need to make a clear and demonstrable contribution to assist registrants in assuring the availability and quality of those services. Our current corporate strategy, ‘Assuring Trust in Pharmacy Through Effective Regulation,’ which runs until the end of 2024, has provided us with an important roadmap for addressing current challenges and opportunities. It focuses on three strategic areas: 1. Advancing the role of pharmacy and pharmacists in the future integrated healthcare system 2. Evolving a more effective regulatory model for community pharmacies 3. Building our capability and performance as a regulatory organisation Launch of the Workforce Intelligence Report This year we were pleased to launch the Workforce Intelligence Report, the first report of its kind for pharmacy in Ireland. It is the culmination of a significant body of work undertaken in collaboration with a range of multi-disciplinary stakeholders from across pharmacy and healthcare. The report, commissioned by the PSI and developed by Grant Thornton, marks a significant milestone as it is the first time a baseline view of the pharmacist workforce has been established. The report also identified emerging risks and mitigating actions for the continued supply of pharmacists in patientfacing settings. Additionally, it provides a basis for pharmacy input into strategic workforce planning initiatives across the broader health system.

Our motivation to examine this issue was multi-factorial and fundamentally driven by an absence of any previous national strategic workforce planning

initiatives for pharmacy in Ireland.

We are seeing trends emerging in relation to difficulties with retention and recruitment of pharmacists within patient-facing roles, despite an increasing number of pharmacists registered with the PSI. Furthermore, the World Health Organisation estimates a shortfall of over 10 million healthcare workers globally by 2030. The WHO attributes the predicted global shortfall to retention and recruitment challenges, rising healthcare demands, more complex health conditions and more challenging work environments. It was therefore important that action was taken to ensure that there are sufficient pharmacists available so that patients and the public continue to have access to safe and effective pharmacy care, now and into the future.

It was important that the issue was explored in an evidencebased manner. This was achieved through conducting an evidence review, gathering robust data and insights via a Workforce Survey and conducting a series of focus groups with pharmacists and pharmacy students. The resulting evidence provides a baseline view of the workforce and insights from pharmacists on their views about the profession.

This in turn facilitated discussion with stakeholders about the issues identified and supported the development and agreement of a series of recommendations necessary to address the identified risks.

The recommendations within the report sit under six key pillars: Strategic Workforce Planning; Leadership of and for the Profession; Innovation and Technology; Attracting and Recruiting Pharmacists; Career Sustainability and Progression and Working Conditions. Workforce planning is complex and multifactorial, requiring a multistakeholder approach to address the issues. In collaboration with the Department of Health, we have committed to creating a multi-agency Pharmacy Workforce Working Group. We will hold the first meeting of this group before the end of the year, with the initial

Joanne Kissane, Registrar and Chief Officer, PSI

focus on progressing the actions contained within the report.

Pharmacist training and education The PSI is responsible for accrediting and approving educational programmes for pharmacy and for setting the accreditation standards that the approved pharmacy programme providers must meet on an ongoing basis. Earlier this year, we were pleased to play an active role along with other stakeholders as part of the Higher Education Authority process to examine the issue of building capacity in the higher education sector. If the resulting recommendations are implemented, there is the potential to create an additional 190 undergraduate places for pharmacy students annually. This in turn would support a sustainable future supply of pharmacists for the health system and improve accessibility for students aspiring to secure an undergraduate place, within a school of pharmacy in Ireland.

Expanded scope of practice for pharmacists The establishment of the ‘Expert Taskforce on the Expansion of the Scope of Practice for Pharmacy,’ under the direction of the Department of Health, was a significant development in 2023.

The Expert Taskforce is charged with considering and examining how pharmacists can expand their current scope of practice for the benefit of patients, the public and the wider healthcare system. This aligns closely with our strategic objective to facilitate evidence-based practice by pharmacists where this is required by patient need and public policy.

As its first recommendation, the Taskforce recommends that pharmacists in Ireland be enabled to extend the validity period of a given prescription from a period of 6 months up to a maximum period of 12 months if, in their professional judgement, it is safe and appropriate to do so. The new measure, which will take

effect from 1 March 2024, will be supported by legislation, regulatory and clinical guidance and appropriate supportive educational materials. This recommendation will play a significant role in alleviating pressure in the health system, improving patient access, healthcare delivery and leading to better patient outcomes. Further, it will facilitate healthcare delivery at the lowest point of complexity, in line with the principles of Sláintecare.

Additionally, the Taskforce will advise on a comprehensive approach to facilitate prescribing by pharmacists, including common minor ailments, in a community pharmacy setting. We look forward to further contributing to the work of the Taskforce in partnership with other pharmacy and healthcare stakeholders over the coming months and playing our part in responding to its outputs and recommendations.

We at the PSI have been involved in areas of significant development for the pharmacy sector in 2023, with the depth and breadth of activity reflecting the evolving role pharmacists are playing within the health system and the challenges and opportunities facing the sector. One of the highlights for us as an organisation was returning to running in-person events as part of our regional roadshows held during October, providing an important opportunity to engage and interact with registrants. We look forward to continuing to work with registrants and all pharmacy and health stakeholders in 2024 to support the ongoing delivery of safe, quality pharmacy services for the public and patients.

PHARMACYNEWSIRELAND.COM | 27

28

IBS

Irritable Bowel Syndrome (Diarrhoea/Constipation/ Wind/Bloating) Common Problems Presenting to the Pharmacy at Christmas Time Written by Aoife McDonald, Consultant Dietitian and Founder, The Digestive Clinic

consumed over Christmas can be problematic for some. The physical stretching of the stomach and intestines alongside the gut hypersensitivity associated with IBS, can lead to people feeling bloated and uncomfortable, and even in pain.

As a result of the above, more people with IBS are likely to be dealing with uncomfortable gut symptoms during the Christmas and New Year celebrations.

Stress

Introduction Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder affecting up to 20% of the Irish population. It manifests with a range of symptoms, including diarrhoea, constipation, wind, and bloating, and is diagnosed using the Rome IV criteria, which are outlined below: Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:

symptoms. During the Christmas period, a number of challenges may arise for those who are sensitive to certain foods due to changes in diet and routine.

During the few weeks we are celebrating Christmas and New Year, we often eat out a lot more frequently, consume more alcohol, and indulge in more rich and creamy foods than we normally

• Related to defecation • Associated with a change in frequency of stool • Associated with a change in form (appearance) of stool IBS symptoms can vary in severity and can be triggered by a number of factors, which I will touch on below.

What causes IBS? The exact cause of IBS is unknown, and may be linked to genetics, imbalances in the gut microbiota, stress, or it may be caused by an infection, as is the case in post-infectious IBS. IBS tends to affect more men than women, and factors that exacerbate symptoms can vary from person to person, ranging to hormonal changes related to the menstrual cycle for many women, to the foods we eat, as well as stress.

Challenges at Christmas Time Diet For many individuals with IBS, dietary factors are a common trigger for worsening of

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would. In addition to this, we also tend to visit other people’s homes more, where control over food choices can be limited. These factors can make it challenging for those with IBS to avoid known trigger foods, which can lead to more IBS flare-ups over the festive season.

Irrespective of the particular foods we eat, the volume of the foods

As well as diet potentially worsening IBS symptoms in some individuals, stress is also a well-established trigger for gut symptoms. This is primarily due to the bidirectional communication that occurs between the gut and brain, often referred to as the gut-brain axis.

While Christmas is a joyful time, the associated stress of planning, social obligations, and spending time with friends and family can

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IBS

intensify symptoms for some.

For those with food sensitivities, even the worry of trying to avoid a trigger food can itself cause gut symptoms, regardless of whether a trigger food is eaten or not.

Alcohol acts as a gut irritant, which can affect gut motility, while carbonated drinks (with or without alcohol) can introduce excess air into the digestive system, leading to increased wind and bloating.

Increased stress and anxiety may also be experienced by individuals with IBS who may be dealing with more urgent or loose stools, and who may feel anxious about whether they will have access to a toilet if they are out, or they may have anxiety surrounding using the toilet at the home of a friend or family member due to a lack of privacy. Again, even the anxiety around the potential ‘what-ifs’ can be enough can induce gut symptoms in certain individuals.

Excess alcohol intake is also associated with dehydration, which of course can hinder optimal gut function. Alcohol consumption can also influence our food choices, leading us to choose more highfat and high-sugar options more frequently and in larger quantities.

Changes in routine Alterations in meal timing and routines can also provoke symptoms in some individuals.

Those with IBS-C (constipationpredominant IBS) may be particularly sensitive to factors such as changes in their usual meal pattern, reductions in movement and changes in their sleep schedule, leaving them at greater risk of less frequent and more difficult to pass bowel movements during the Christmas period. Due to constipation, many people are also coping with the increased wind and bloating that often accompanies it.

Alcohol intake Certain beverages, notably alcohol and carbonated drinks, can be a common cause of heightened gut symptoms.

Common problems presented at the pharmacy Over-the-counter (OTC) products can assist individuals in managing their symptoms as effectively as possible during the Christmas period.

For those with constipation, fibre supplements or osmotic laxatives may be helpful for promoting more regular and comfortable bowel movements.

On the other hand, for individuals experiencing increased loose stools, having anti-diarrhoeal medication readily available can provide a sense of control and comfort, especially when away from home.

Indigestion and heartburn presentations are also frequent during this period, often due to increased alcohol intake, eating more fatty foods & larger portions.

The pharmacist may recommend an antacid medication to help the individual get fast relief from their symptoms.

Due to a higher intake of particular trigger foods (e.g. high FODMAP foods) or more carbonated drinks, increased wind or trapped wind can be a common issue, and simethicone-based products may help alleviate this discomfort.

Hydration: staying adequately hydrated, especially if alcohol is being consumed, is an important aspect of IBS management.

Aiming for a daily intake of about 2 litres of water daily can help to support digestion.

Taking all this into consideration, it is fair to say that pharmacists play an extremely important role in helping IBS sufferers to manage their gut symptoms, especially at this time of year.

Movement: planning regular movement into the day can help to keep digestive symptoms at bay. It does not have to be anything strenuous, even just a gentle walk or some yoga can help to support digestion and calm the gut-brain axis.

Quick tips to minimise gut symptoms over Christmas Fibre: maintaining a certain level of fibre intake may be particularly beneficial for those who are more sensitive to the effect of fibre.

Incorporating more fruits and festive vegetables into meals, adding seeds to cereal and yoghurts or snacking on nuts are all simple strategies to help maintain a good fibre intake when out of our normal routine. In some cases, temporarily enlisting the help of a fibre supplement can be helpful if access to high fibre foods is an issue.

Minimise triggers: every person with IBS will have different triggers for their symptoms, whether that be FODMAPs, fatty foods, caffeine, alcohol, stress, lack of exercise, and so on. In order to reduce the risk of a severe flare-up, it is advisable to avoid or minimize known triggers as much as possible, and make a realistic plan of how to do so over the Christmas period.

Chew food well: savour food and chew it thoroughly, to a puree consistency if possible. This can help slow down eating, prevent overeating, and reduce the risk of feeling overly full.

Self-care: taking some time each day for self-care is important to prioritise. Embracing moments of relaxation and recovery where possible to help ensure we are starting the New Year feeling refreshed and recharged.

Conclusion Irritable Bowel Syndrome is a common condition that can be exacerbated during the holiday season due to dietary changes, increased stress, and disrupted routines. Pharmacists have a vital role to play in helping individuals with IBS manage their symptoms effectively during Christmas time.

By providing education, guidance, and support, pharmacists can help patients enjoy the festive season with greater comfort and peace of mind.

News

European Communication on Medicine Shortages European community pharmacists have welcomed the Communication on medicines shortages adopted today by the European Commission.

PGEU has long been calling for bold and ambitious measures to address the problem of medicines shortages. We hope that the initiatives outlined in the Communication will help to avoid another period of severe medicine shortages like the one we experienced with antibiotics last winter which could compromise not only public health but also citizens’ trust.

PGEU supports the Commission’s call to Member States to monitor and enforce companies’ obligations to supply the market with adequate quantities of

medicines, the creation of a Union list of critical medicines and of a voluntary solidarity mechanism.

We also support the effective use of regulatory flexibilities to mitigate shortages, the strengthening of EU coordination, the improvement of demand and supply forecasting as well as the proposed long-term measures to enhance supply security.

Regarding the common strategic approach to stockpiling, it should be guaranteed that stocks will not be to such an extent as to jeopardize the general supply of medicines, nor they should

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generate unnecessary waste. This can be addressed by ensuring progressive requirements for rolling buffer stocks, allowing for these to be built over time rather than all at once and through proper stock management.

PGEU President Koen Straetmans said, “We welcome the shortand long-term measures proposed today by the European Commission to address medicine shortages. PGEU’s annual survey confirms that shortages exist in all EU countries across all types of medicines, causing detriment to patients’ health, waste of

resources and frustration. Every day, we spend hours managing shortages and finding solutions to guarantee continuity of treatment for our patients. We need more timely and effective communication on shortages to allow us to better manage patient care, reassure patients and promote the safe and rational use of medicines.

As community pharmacists we stand ready to use our knowledge and experience to help mitigate medicine shortages in every way we can, including through compounding pharmaceutical preparations when authorized to do so by the national authorities.”

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31

Viatris scores victory for Irish charity!

Viatris employees joined the Irish Wheelchair Association last month in the Sport Ireland Campus, Blanchardstown, Dublin, for a fast-paced and entertaining wheelchair basketball event. The experience raised over EURO 6,000 for the registered charity, which runs corporate team building days with the underlying aims of changing attitudes and facilitating access to sports and support facilities for people with disabilities.

The event is part of a pan-European #BuildingHealthierCommunities initiative at Viatris, a global healthcare company, which aims to engage employees and local healthcare communities across Europe to support social and environmental projects. The unique, fun-filled experience was enjoyed by 100 employees from Ireland and across Europe.

Melissa Fisher, Country Manager Commercial for Viatris Ireland explained, “We’re privileged to join the Irish Wheelchair Association in this wonderful Sport Ireland facility today and to experience adapted physical activity through wheelchair basketball.

“Our value is to empower people to live healthier at every stage of life and the team within Viatris decided to take this value one step further. When we think about what a community means, it means all of us collectively; it’s where we live, where we work, where our families are.

“If we localise our global mission, what that translates into is ‘let’s try and make the whole community healthier’ and if we can, it has a natural impact.”

Melissa went on to say, “In Ireland we support approx. 30 Irish charities and organisations each year, nominated and chosen by our employees. We are humbled by these partnership efforts as we see they can make a real difference in the local community. People can truly be empowered to live healthier when their communities are thriving.

However, these collaborations also influence our employees, helping them not only understand the challenges of the communities we serve, but also embrace what makes individuals unique and realise their own potential.

Viatris in Ireland has a large footprint: with over 1600 colleagues across the island and five manufacturing sites, Melissa believes it is important therefore, to understand the key issues at the forefront of communities up and down the country.

Christopher Hoey, Acting Chief Executive Officer, Irish Wheelchair Association commented: “One in four people in Ireland lives with a disability. As a population we are living longer and, consequently, the likelihood of acquiring a physical disability is higher. In times of funding challenges for Irish charities, we welcome the continued support of companies like global healthcare company,

Viatris, which help us to maintain our much-needed services in the community. Our wheelchair basketball activities are open to all to avail of and have fun playing, while building on the fundamental values of being a team and raising vital funds. We’re delighted that the funds donated at the Viatris event today will help us in our efforts to expand our sports programme in the West of Ireland.”

“Ireland is synonymous with the word ‘community’ and it is imperative for Viatris that we can showcase how we support that.

Fundamentally, our core isn’t just about medicine, it’s about what else we can do to bring real value to people’s lives and to their health.

“Our ecosystems must evolve and be more deliberate if we are to be a truly inclusive society. Perhaps we start with doing simple things but we do those simple things consistently – and if we do them consistently well – we can connect a little bit better and a little bit more.”

Viatris’ #BuildingHealthierCommunities initiative supporting social and environmental projects across Europe. Image: Viatris/Roger Kenny

Wheelchair basketball teamwork in action, as Viatris colleagues aim for a basket. Image: Viatris/Roger Kenny

The winning Viatris wheelchair basketball team, cheered on by Irish Wheelchair Association representatives. Image: Viatris/Roger Kenny

PHARMACYNEWSIRELAND.COM

32

Seasonal Ailments

Seasonal Ailments in Pharmacy It’s no coincidence that more people get ill over the holiday period than any other time of year. Parties, late nights, bad weather, over-indulgence in food and drink, not to mention concerns about the bank balance, all take their toll on people’s bodies.

With the winter season just around the corner, now is the time for community pharmacists and their teams, to be promoting the message that consumers should visit them first, for advice and treatment of common winter ailments.

Research shows that 18% of GP appointments are for minor ailments. Community pharmacists are in fact, best placed to advise on these conditions and over-the-counter available and appropriate medications.

Furthermore, the winter months provide the perfect opportunity for pharmacy to drive home the self-care message and ease the pressure on GP surgeries and A&E departments.

The Government has previously stated that the range of medicines provided without a prescription will continue to expand as part of the drive towards a National Health Service that promotes self-care and greater public choice. However, self-medication may not be appropriate for every patient in view of preexisting medical conditions or because of interactions with other prescription and non- prescription medications. This reinforces the importance of pharmacists, who have been trained to ask the right questions so they can give appropriate advice.

It has been previously revealed that treatment results for common ailments such as coughs and sore throats were equally good regardless of whether patients were treated at a pharmacy, A&E or GP practice, highlighting community pharmacy as a solution to the increasing burden on a stretched health service.

Community pharmacy can have an extremely positive impact on the health of the communities it serves due to the engagement pharmacy teams have with their patients every day. Pharmacists will offer advice on conditions and medications, and if appropriate, they will refer a patient to their GP if they feel it necessary.

Emphasis of Self-Care Research indicates that, despite good intentions, many people do not know how to self-treat conditions such as coughs and colds and therefore visit their GP or A&E for advice.

Visiting pharmacy as an alternative could save up to 950,000 GP consultations every year. Pharmacies need to be aware of the crucial role they can play in educating customers about relieving symptoms of minor winter ailments.

Self care is a healthcare philosophy which emphasises the role of ordinary people in taking ownership of their health and wellbeing and includes taking actions to prevent and decrease the likelihood of disease and to restore health after illness or injury.

It is the first step and first choice for Irish people who are taking an increasingly active role in their healthcare and looking to improve their health and wellbeing.

Research from Behaviour & Attitudes confirms that there is a clear desire from the majority of people (92%) to be involved in decisions about their own health and medication, with 80% expressing their view that they see their pharmacist as a key partner in maintaining their health.

The role of community pharmacists is pivotal to the successful development of self care and its more widespread adoption, according to the Irish Pharmacy Union (IPU) and the Irish Pharmaceutical Healthcare Association (IPHA), who, at the end of last year, launched a self care awareness campaign, entitled ‘Be Well this Winter – Think Pharmacy’.

The campaign was rolled out through the extensive deployment of social media, as well as a series of posters displayed nationwide in retail pharmacies.

Winter campaigns are frequently run on an annual basis by many major pharmaceutical companies, encouraging customers to selfcare when suffering from colds, flu, sore throats and other associated symptoms. It is important therefore

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that pharmacists are aware of these and educated in the key, core messages.

cold, so that they can treat themselves accordingly with the right OTC medicines if they fall ill.

Preparing monthly displays about particular subjects, or a dedicated winter health display could be a perfect opportunity to promote self-care for colds, coughs and other winter ailments. Look out for printed leaflets and booklets that can be displayed on a healthy living pharmacy display table and handed out to customers or attached to prescription bags.

If someone has a lot of symptoms and asks for advice on what medicines to take, it might be worth recommending an OTC medicine that can treat a number of symptoms e.g. temperature and muscle aches at once. However, it’s important to remind them not to ‘double dose’ on paracetamol or ibuprofen if the flu medication also contains these.

Engage with those ‘at-risk’

Efficient Merchandising

Using Self-Care and targeted campaigns as a tool to drive footfall to the pharmacy also gives you the perfect opportunity to engage with those people who are most at risk of flu.

The cough and cold season could also provide the perfect opportunity to reorganise fixtures in your pharmacy with a clear merchandising plan featuring beacon brands in both the P and GSL sections.

For people aged 65 and over and those with long-term health conditions, including diabetes and kidney disease, flu can be particularly dangerous. If you feel that a customer falls into one of those categories, it might be worth advising them to book in for a flu jab as soon as possible to reduce their risk. Remind them that your pharmacy can offer this service, particularly if they are eligible for a free vaccine.

Although the World Health Organisation works to produce timely vaccines based on information available at the time, if the strain of flu mutates it may not be as effective. That’s why it’s also important that you take the time to advise people on how to tell the difference between symptoms of flu and symptoms of a common

You really need to think about the winter season and make a proper planogram, that provides a merchandising tool on a tablet, so that any member of staff can scan the fixture and see what it should look like. Make sure that you feature the national bestsellers, as these beacon brands act as visual clues for customers and direct them to the products they are looking for.

There needs to be some offers that make the pharmacy look competitive and it is crucial that staff are trained to provide advice on seasonal ailments and OTC products.

Staff should also deliver public health messages by reminding customers to have a flu jab (see

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34

Seasonal Ailments

Panel) and, for example, when selling cough medicine finding out if the customer is a smoker and whether they would like help to quit. They won’t necessarily think the water tablets they are taking for their blood pressure are important but they could react with the decongestant in a cold remedy and cause problems. This could be a cue for the pharmacist to check through their medication records to ensure they are getting appropriate advice.

AILMENT OVERVIEW Common Cold The common cold is a condition that is prevalent in the community and is associated with a variety of symptoms. Typically, it is an acute, self-limiting viral infection of the upper respiratory tract that is most frequently caused by rhinoviruses.

Symptoms commonly associated with the common cold include coughing, nasal congestion, low-grade fever, and fatigue, usually presenting 1 to 2 days after exposure. Generally, most symptoms subside within 7 to 10 days, although some symptoms can persist for up to 3 weeks.

The common cold is often mistaken for the flu. The flu is caused by the influenza virus, classified as type A, B, or C. Types A and B affect humans, with type A generating more severe symptoms. The influenza virus can be dangerous in older people and in those patients who are immunocompromised.

Nevertheless, people with influenza are sicker than those experiencing common cold symptoms and commonly manifest such signs and symptoms as temperatures greater than 102°F, chills, headaches, myalgia, and malaise.

Sore Throat Sore throat is a hallmark symptom of both viral and bacterial infections of the upper respiratory tract. Sore throat is a self-limiting complaint, resolving within three days in 40% of sufferers and within one week in 85% of people - even in those cases with a bacterial aetiology. The key symptom of sore throat is pain at the back of the mouth, which can vary from localised mild discomfort to intense pain on swallowing.

For sore throat sufferers presenting in pharmacy, regular use of paracetamol or ibuprofen-based products can be recommended to relieve pain (soluble analgesics can be gargled to provide targeted pain relief).

Customers can also be advised to use simple mouthwashes at frequent intervals (e.g. warm, salty water) until the discomfort and swelling subsides. Sucking

MEDICATION SUMMARY: Decongestants - These help to reduce nasal congestion by constricting the dilated blood vessels in the nasal mucosa. This reduces swelling and oedema of the nasal mucosa, making it easier to breathe.

Decongestants are not suitable for pregnant and breast-feeding women and patients with hypertension.

Nasal sprays and oral tablets should not be used concurrently.

Oral analgesics - Analgesics and antipyretics help to reduce pain and fever associated with sore throats and colds. Ibuprofen also reduces inflammation, which can help if sinuses are inflamed. Paracetamol and ibuprofen can be used in conjunction with one another but should be taken two to three hours apart for maximum benefit.

Combination products - Can contain ingredients such as a decongestant, analgesic, cough suppressant, antihistamine or an expectorant. These can be used up to their maximum dose for up to seven days unless they contain sedating antihistamines, when they should only be used for up to three days. Antihistamines work by drying up nasal secretions and should be used with a decongestant as they are relatively ineffective on their own. They can also cause drowsiness, so are often found in combination products to aid insomnia associated with having a cold.

Inhalants, vapour rubs and saline products - Inhalants work by helping to clear the nasal passages, while steam inhalation will help ease nasal congestion by loosening mucus. Saline preparations relieve congestion by helping to liquefy mucous secretions. Inhalants, rubs and saline products can be used daily until symptoms are cleared.

They can be used as an alternative by patients who cannot tolerate decongestants.

Sore throat treatments - Most sore throats are caused by a viral rather than a bacterial infection, so don’t need antibiotics. Medicated lozenges or anaesthetic sprays can help relieve the symptoms of sore throat. Gargling regularly with an antibacterial mouthwash or warm, salty water can reduce any swelling and inflammation, while sucking pastilles or lozenges will stimulate saliva secretion to lubricate the throat and help relieve irritation.

Cold sore treatments - Cold sores usually clear up without treatment within seven to 10 days but antiviral creams, such as aciclovir or penciclovir, can be used to ease symptoms and speed up the healing time.

Antiviral tablets are generally more effective than creams at treating severe cold sores, but are usually only prescribed in more intractable cases. Patches that contain a hydrocolloid gel can be placed over the cold sore to hide the affected area while it heals.

pastilles or lozenges stimulates saliva secretion, which lubricates the throat, and many throat sweets also contain soothing ingredients, such as glycerine and honey, to help relieve irritation.

Nasal Congestion Nasal congestion is a blocked, stuffy or bunged-up feeling in the nose. Depending on the cause, it can last a short while (a few days) or can be persistent. In adults and children it is usually an annoying symptom rather than a serious one. In babies, however, a blocked-up nose may make it difficult to breathe or feed.

Some of the causes of nasal congestion include: • Infections: the common cold and other respiratory tract infections, including influenza (flu) and sinusitis.

• Allergies, including hay fever.

• Persistent rhinitis.

Sinusitis The sinuses are small, air-filled spaces inside the cheekbones and forehead which drain into the nose.

Sinusitis means inflammation of a sinus. Most bouts of sinusitis are caused by an infection. Most cases of sinusitis are acute (lasting 1-4 weeks) but some may go on to a more persistent (chronic) sinusitis.

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The symptoms of sinusitis are mainly nasal congestion, and pain in the area of the affected sinus.

This is most commonly in the forehead or cheeks on one or both sides of the nose. The pain may be worse on bending down. Other symptoms which may occur are dizziness and fever.

Sinusitis is usually treated with painkillers and decongestants.

Indigestion The holidays aren’t the holidays without an overload of food.

Indigestion can cause heartburn, nausea and discomfort or even pain in the chest shortly after eating. Over-the-counter remedies can relieve the pain, but those getting regular bouts or experiencing other symptoms such as loss of weight, persistent vomiting, difficulty swallowing or blood in their vomit or stool, should be referred.

Alcohol Consumption The festive season often means endless parties, catching up with old friends, eating and drinking.

Research has found people drink much more than the annual monthly average during December.

Regularly drinking above the daily unit guidelines during Christmas can cause temporary effects, such as headaches, sickness, diarrhoea and may also negatively affect mood, weight and sleep.

Frequently consuming alcohol can also lead to liver damage.

Advise on drinking responsibly, staying within the safe daily unit guidelines, to drink water or soft drinks between each alcoholic drink and to eat a filling meal before alcohol consumption.

Olbas helps relieve congestion so you can breathe more easily.

For the relief of congestion.

Always read the label.

New

New

For more information please contact your local BR Healthcare representative or our office on 01-885 0800.

Abbey House, Main St, Clonee, Co. Meath | www.brmarketing.ie

The Two Biggest issues in the Irish Pharmacy Sector Today Fitzgerald Power›s office on Catherine Street, Waterford

The biggest issue in the market right now A survey conducted by the Irish Pharmacy Union (IPU) has shown that Irish pharmacies are suffering and even considering closure due to a chronic lack of qualified pharmacists available to work in community pharmacies. This, together with ongoing absences due to COVID-19, is resulting in some pharmacies being required to reduce hours, or in some cases close for certain days as they struggle to cope with staff shortages. This is affecting hundreds of pharmacies across the country, creating huge pressure and stress for owneroperators. The locum market is making it very difficult to recruit permanent staff as locum pharmacists can earn more in locuming three days per week than they can in full-time employment. Some of the hourly locum rates being paid are eye-watering and completely unsustainable. For this reason, the profile of vendors (pharmacists disposing of pharmacies) is getting younger and younger. Labour resourcing and the impact on owner operator worklife balance is the number one reason that pharmacists are considering selling their businesses. This shortage of pharmacists comes at a time when the demands on pharmacies have never been higher. Describing the shortages as “chronic,” IPU President Mr. Dermot Twomey recently said: “If we can’t increase the supply of qualified pharmacists, the sector will be unable to keep up with demand and patient care will suffer. Pharmacies areFitzgerald strivingPower to maintain services to patients and the public, but reduced hours and Stuart Fitzgerald, CEO temporary closures cannot be ruled out.”

The pharmacy sector

The second biggest issue in the market right now Drug shortages have given rise to real fear among both medical professionals and patients

In 2023, the Irish pharmacy sector continued to face significant challenges. Foremost, shifting healthcare economics have alike. Medicine shortages and reduced availability represent an increasing issue across the disrupted long-standing industry norms, particularly in the realms of labour and supply chain management. The COVID-19 and the globe, amplified by the pandemic.

It may have significant impact on patient pandemic has altered the landscape,EU transforming the relationships among patients, pharmacists, anda general practitioners.

care by causing medicine rationing and the delay of critical treatments. Due to medicine

These changes accompany changingshortages, customer demands technological ultimately redefiningand the they sector’s patientsand may need to useadvances, less effective alternatives could risk using standard operating procedures. The sector must also grapple with a relentless pace of change, giving rise to novel business medication incorrectly. Just last month, Kathy Maher, Chair of the PCC Committee of the models and operational approaches, not only within Ireland but also on the global stage, requiring adaptable strategies for Irish Pharmacy Union (IPU) told Newstalk Breakfast that one pharmacist could not give a continued success.

palliative care patient their medicine in solid form due to a lack of supplies. This is creating huge pressure on pharmacists who are managing patient concerns at the community level.

Often patients don’t understand the vagaries of the medicine supply chain system and Revenue and item trendssometimes pharmacists are wrongly blamed for not having the medicine in stock. The EMA hasour published guidereport, for patients and of healthcare professionals’ organisations with key Each quarter, Fitzgerald Power publishes Pharmacya Pulse an analysis the key trends in the Irish Community principles and examples of good practices to support them preventing and managing Pharmacy sector. In it, we discuss the current forces shaping the market, such as medicine shortages andinlabour cost inflation. shortages of medicines. While a secondary concern to patient safety, shortages in the In our 2023 Q1 edition, we noted that the top five major OTC classes by value were: pain relief, respiratory, VMS and tonics, supply having aninimpact on 7% pharmacy procurement digestive, and skin treatment accordingmedicine to IQVIA. In Q1, RXchain sales is were up 6% value and in volume compared tomargins. the same We are starting to see the full impact of drug price reductions in the State reimbursed market. Given period last year. the size of our population, our peripheral geographical location on the edge of Europe and Similarly, our Q2 edition reported that the top five major OTC classes remained unchanged in the second three months of the our drug pricing structure, Ireland is a less compelling market for medicine manufacturers year, again according to IQVIA. In Q2, RX sales were up 6% in value and 5% in volume compared to the same period last year. than some of our European neighbors.

At the time of writing this article our Q3 Pharmacy Pulse report was being drafted. However, based on PSI data, we estimate the following opening and closures so far this year:

New Openings and Closures

Pharmacists first clients and our founder’s family New Openings 1st January 2023 –were 1st our November 2023 25business. is more than a sector to us –27 it’s our DNA Closures between 1st January 2023 –Pharmacy 1st November 2023 Today we arebetween the leading theNovember Irish community pharmacy sector and the Net Closures 1stfinancial Januaryadvisor 2023 –to1st 2023 2 leading pharmacy sales brokerage firm in Ireland.

Source: PSI

Our exclusive pharmacy team are not just financial experts in this market but are passionate advocates and creative thought leaders helping to drive the sector forward.

The Two Biggest Issues in the Irish Pharmacy Sector Today Pharmacists and those working in the sector have found 2022 a year stranger than fiction.

Whether we like it or not, the winds of healthcare economic change have upended most of what those working in the industry have known to be true, particularly when it comes to the labour and supply chain markets.

Relationships between patients, pharmacists and GPs are forever shifting in a COVID-19 The Pharmacy team, Fitzgerald Power world. New regulations, complex customer needs and technological advances have changed the industry utterly. The pace of change is relentless with new business models and ways of operating emerging in Ireland and across the globe. We in Fitzgerald Power try to combat that, by routinely checking in on the community pharmacy landscape and unpacking the needs, wants and desires of those working in the sector to understand what can be done to make things better.

The biggest issue in the market right now As with last year, a lack of qualified pharmacists and wage inflation

Key trends in the Irish Community Pharmacy sector is still the most important issue in the pharmacy sector. The locum

continues to seeofrelatively high wage costs which, when Each quarter, Fitzgerald Power publishes our Pharmacy Pulsemarket report, an analysis the combined with a low supply of graduates working in the pharmacy key trends in the Irish Community Pharmacy sector. In it, we discuss the current forces sector, makes it difficult to recruit permanent staff. This shortage shaping the market, such as medicine shortages and labour cost inflation. comes at a time when the demands on pharmacies of pharmacists In our 2022 Q1 edition, we noted strong community pharmacyhave itemnever performance, been higher.as the prescription market grew in unit terms by 4.65%, according to HMR Ireland. According to For this reason, the profile of pharmacists disposing of pain relief, digestive, VMS IQVIA the top five major OTC classes by(pharmacies value were; respiratory, We We noted the following transaction activity pharmacies continues getting younger. Anecdotally, we see labour noted the following Transaction activity (pharmacies and tonics & skin treatment. bought and sold) in the 9 months to 1st October 2023: 2022 resourcing and the impact on owner operator work-life balance as bought and sold) in the 9 months to 30th September Similarly, our Q2 edition reported that the prescription market the continued to grow, number one reasonexpanding that pharmacists are considering selling Pharmacies soldagain by region in unit terms by 3.92%, according to HMR Ireland. The top five major OTC classes their businesses. remained largely unchanged Region Q1 in the Q2second Q3 three Total months of the year. key trends in the Irish Community Pharmacy sector.

1 7 2 10 Dublin At the time of writing this article our Q3 Pharmacy Pulse report was being drafted, however 1 4 4 9 Leinster based on Rest PSI of data, we estimate the following opening and closures so far this year: 1 0 4 5 Munster The second biggest issue in the market

Ulster/Connacht

1

5

1

7

right now

4 202116 1st11 31 2022 New OpeningsTotal 1st December October

Drug 12 shortages and supply chain issues remain the second most important issue facing the sector. This is creating huge Closures between 1st December 2021- 1st October 2022 14 pressure on pharmacists to manage patient concerns at the community level.

Net Closures between 1st December 20211st October 2022 (2) Pharmacies sold by Pharmacy type Source: PSI (note: this data runs from Q1 1st December the available PSI data) Medicine shortages and reduced availability represent an Type Q2 2021 Q3due to Total increasing issue across the EU and the globe, giving rise to Corporate Group 0 2 0 2 real fearalways amongtended both medical professionals and patients alike.

This is an interesting development as the number of pharmacies has to grow In efforts to tackle the on-going Indigenous group 1 0 1 year-on-year since deregulation.

Many of0 the pharmacies that have closed are greenfield medicines shortages, the EU is preparing to stockpile drugs and oblige manufacturers to units, i.e. new pharmacies that in21the last 5 years.guarantee supplies. Earlier in the year, 212 products were out of Independent 3 have 10 opened 7 stock, including cough syrups and vital antibiotics.

0 4 4 7 Source: Fitzgerald Power

Symbol group

The suppliers of the majority of medicine in Ireland has urged 16 11 Pharmacy 31 Key reasons for Irish4Community closures Total the Government to heed warnings from GPs and pharmacists

nationwide on thePSI growing As part of a piece of research we recently carried out for the IPU we analysed and risk of medicines shortages. 60% of respondents to an Azure Pharmaceuticals poll answered they had PCRS data to identifysold theby types pharmacies that had closed.been Of the 38 voluntary Pharmacies HSEoffee list position impacted by medicine shortages in the past year. It may identify 76.3% (29patient care by causing medicine cancellations noted by the PSI during 2019 and 2020, we were have ableatosignificant impact on Feepharmacies bracket Q1 Total to pharmacies list (we focused on 2019 units) of these on theQ2 PCRSQ3payments rationing and the delay of critical treatments. and 2020 as the published PCRS <€100k 1 2data only 0 ran3 to 2020 at the time of our research). We estimated more than 50% of these pharmacies (15 units) were greenfield sites, with most €100k-€174k 1 2 4 7 closing within 5 years of opening. €175k-€249k 0 5 1 6 This suggests the following: it is difficult for new pharmacies to reach profitability and €250 + above 2 7 6 15 unviable pharmacies have a life cycle of at least 3–5 years before they are closed.

4 16 11 31 Total The de-regulated nature of the Irish pharmacy market encourages bullish entrepreneurs to Source: Fitzgerald Power take risks and open new units. The evidence suggests that there is often little commercial Thisfor analysis include the Uniphar rationale these does new not units, particularly since/ McCauley the advent of Healthmail. Where they do www.fitzgeraldpower.ie transaction, which is subject to Competition and survive, they merely capture a portion of the localConsumer market putting increased pressure on Protection and Commission according the Irish Times. incumbents in someapproval, cases forcing theirtoclosure.

Source: Fitzgerald Power

Transaction data for the first three quarters of 2022 is

38

News

Factors Linked to Erectile Dysfunction Personality traits and mental health problems are among the factors linked to erectile dysfunction (ED), a condition that affects up to 80% of men over the age of 60. However researchers often overlook these psychological causes and their treatments in favour of biological components of ED, according to a new article in Current Directions in Psychological Science.

“It is important to remember that erectile dysfunction is a common problem affecting individuals of all ages. Bringing psychological treatments such as couples therapy into the treatment regime could really be beneficial” In a review of existing research, the authors call for research to better integrate biological and psychological components of and treatments for ED. Erectile dysfunction (also known as impotence or ED) is a very common condition, which affects the majority of men at some point in their lives. Up to 50% of men aged 40 - 70 and up to 70% of men over the age of 70 suffer from erectile dysfunction to some

extent. There are several treatment options, which are currently licensed for the treatment of erectile dysfunction in Ireland.

It is estimated that at least 150 million men globally have ED. It is difficult to obtain accurate values for the true prevalence of erectile dysfunction however, as many patients fail to seek medical attention, and many clinicians are reluctant to ask patients about their sexual health.

ED is defined as a consistent or recurrent inability to attain or maintain an erection that is sufficient for sexual satisfaction.

Biological origins range from heart conditions, drug use, or injury, while stress, depression, and intrusive thoughts represent some psychological causes.

However, researchers often attribute causes to one or the other rather than taking into account how these factors interact, the authors explained.

Chronic stress and depression can also contribute to ED, as stress can elevate cortisol levels and increase nervous system activity that can disrupt the erectile processes, the researchers wrote.

Other underlying causes include performance anxiety, which can

distract from brain signals that initiate and maintain an erection.

For example, men who score high on the personality measure of neuroticism and low on extraversion face a heightened risk of ED, studies suggest. Those men are also more likely to engage in unhealthy behaviours such as smoking and physical inactivity, health behaviours known to contribute to ED, the authors report.

Ultimately, “It is important to remember that erectile dysfunction is a common problem affecting individuals of all ages. Bringing psychological treatments such as couples therapy into the treatment regime could really be beneficial in treating erectile dysfunction and improving the psychological states of affected individuals and their partners,” they added.

All-Star Accreditation for Brennans Donegal based Brennan’s Pharmacy has achieved a second consecutive Business All-Star Accreditation and the title of Community Pharmacy Team 2023 by the All-Ireland Business Foundation.

Fergus Brennan, Managing Director, Brennans Pharmacies with his pharmacy team

of our Brennans Teams recognised.

Our aim is to consistently go above and beyond in looking after the pharmacy needs of our valued patients and customers, so this accolade means a lot to us.”

Managing Director of the AllIreland Business Foundation Kapil Khanna said the accreditation, which is now held by over 650 firms, is needed by the thousands of small and medium businesses which operate to their own standards but have nothing to measure them by.

Established by Fergus Brennan in Buncrana Co. Donegal in 1992, Brennan’s Pharmacy Group provides personalised healthcare solutions to communities around the county. The popular local business has earned a reputation for its exceptional customer service and commitment to community well-being.

The All-Ireland Business Foundation Accreditations highlight and celebrate organisations that exhibit excellence, innovation, and commitment to their respective industries. Winning this accolade for the second time underscores Brennan’s Pharmacy Group’s continuous pursuit of excellence

PHARMACYNEWSIRELAND.COM

and its role as a healthcare leader in the community.

Reacting to the news of his company’s achievement, Fergus Brennan said, “We are absolutely delighted to be named Business All-Star Community Pharmacy Team 2023. We are very grateful to have the hard work and dedication

He added, “We evaluate a company’s background, trustworthiness and performance, and we speak to customers, employees and vendors. We also anonymously approach the company as a customer and report back on the experience.

The business goes through at least two interviews and is scored on every part of the process against set metrics.”

The end of erectile problems?

Touch wood.

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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. Women. Not intended if no erectile dysfunction.

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: 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.

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: Aug 2022 Date of preparation: (10-22) CCF: 25156

Supply status: Supply through pharmacies only.

40

Research

83% of Over-65s Living with a Medical Condition New research from Pfizer Healthcare Ireland has revealed that 83% of over 65-year-olds are living with a medical condition in Ireland.

Janis Morrissey, Director of Health Promotion, Information and Training, Irish Heart Foundation, Deb Mangone, Pfizer Healthcare Ireland Country Manager and Orlaith Gavan, Pfizer Healthcare Ireland Country Medical Director

The Pfizer Health and Science Index shows that 83% of over 65-year-olds are living with at least one medical condition, while almost one in three are living with either Heart disease, COPD or Diabetes.

(36%) have experienced it over the last two years. COVID-19 has been particularly invasive with over three in five suggesting they have had the disease over the past two-year period.

In the general population, a higher proportion (60%) of the public are living with an enduring or persistent medical condition. The research found that 60% of Irish adults are living with a medical condition such as arthritis or high blood pressure, with approximately six in ten (59%) of these attending a healthcare facility regularly for treatment or a check-up. Blood pressure (High or low), high cholesterol and depression & anxiety continue to be the most pervasive conditions. The research also revealed that there has been a 14% fall in participation rates in public vaccination programmes (not including the COVID-19 vaccine) in the past year.

COVID related conditions such as long COVID have had a severe impact on adults’ ability to work and higher numbers (56%) are seeking private treatment for COVID-related conditions, highlighting the importance of the COVID-19 booster programme this winter.

The research, carried out by Behaviour and Attitudes, also indicates that a positive learning from the pandemic is the public’s positivity towards further utilising pharmacies for expanded healthcare services such as vaccinations. The percentage of the population endorsing utilising community pharmacies for expanded healthcare services increased from 29% in 2022 to 41% in 2023.

The research results also show that most have experienced flu at some stage while over a third

Many feel that the lack of access to healthcare services during the pandemic has resulted in their condition deteriorating. 36% of people living with a medical condition believe that they have been negatively affected over the past couple of years due to a lack of access to healthcare professionals, with a quarter also believing that their condition has worsened due to a lack of access to diagnostics. Two in three adults who have experienced delays in accessing healthcare state that delays in access made them less likely to seek healthcare treatment.

Pfizer Healthcare Ireland called on the public at the launch of the annual Pfizer Health and Science Index to ensure that they are prepared this winter by attending appointments and availing of vaccines to minimise personal risk and to avoid putting undue pressure on the health system.

PHARMACYNEWSIRELAND.COM

This year’s Index also asked the general public about their opinions of the Irish healthcare system.

Almost half (47%) of adults believe that health outcomes have improved over the last decade and in the event of developing a serious illness, two thirds (66%) of adults have confidence in the medical care they would receive.

Looking at how the cost-of-living crisis and its potential impact on healthcare services, household budgetary pressures has led to an increased trend of people putting off going to the doctor, with almost a quarter of adults (24%) admitting that they decided against a visit due to financial concerns.

Commenting on the 2023 Pfizer Health and Science Index findings, Deb Mangone, Pfizer Healthcare Ireland Country Manager, said, “With research showing that more than 80% of those aged 65 and older are living with an enduring or persistent medical condition, this is a key time of year for maintaining our health. There is additional pressure put on the health system during the winter, and it is imperative vulnerable and older people protect their health. As we enter the winter period, we strongly urge the public, particularly the most vulnerable, to attend all medical appointments and take the necessary precautions to protect their health this winter.”

Janis Morrissey, Director of Health Promotion, Information and Training, Irish Heart Foundation,

commented, “People continue to be worried about heart disease with 45% of Irish adults indicating that they worry about developing heart disease as they age. Fortunately, up to 80% of cardiovascular disease is preventable and people can take action to do so. Taking proactive lifestyle steps such as controlling blood pressure and cholesterol levels, maintaining a healthy weight, eating a healthy diet, getting regular exercise, limiting alcohol intake, and not smoking.

These steps towards maintaining a healthy lifestyle are even more important for older people and we would strongly recommend all older people to ensure they attend all healthcare appointments and take the necessary precautions to protect their health.”

Orlaith Gavan, Pfizer Healthcare Ireland Country Medical Director said, “This year’s research shows the importance of older people taking precautions to protect their health this winter with the results indicating that 83% of over 65-year-olds are living with a medical condition. We know that over 65 years old are more likely to be negatively affected by winter respiratory illnesses and those living with a medical condition are even more vulnerable to these illnesses. We would urge those people in this vulnerable cohort to take the necessary precautions to protect against respiratory illness this winter.”

Looking at the public’s attitudes to science, over half (56%) of Irish adults believe that people leaving university with a STEM (Science, Technology, Engineering and Maths) qualification have a better chance of getting a job than those with a non-STEM qualification.

Given the significant presence of STEM multinationals in Ireland, 35% of the public believe that there are more job opportunities in these sectors in Ireland, compared to other countries. From an educational perspective, three quarters (76%) of adults would like to see more of a focus on science at primary school level. In terms of societal benefits, four in five agree scientific research has significantly improved health outcomes.

Lung Cancer

41

Lung cancer awareness at the Irish Cancer Society November was Global Lung Cancer Awareness Month. As part of its annual awareness campaign, the Irish Cancer Society (the Society) highlighted the importance of early detection and the many barriers that prevent it, including stigma.

Lung cancer is one of the most common cancers worldwide. In Ireland, lung cancer is the fifth most common cancer, with almost 2,700 people diagnosed each year.

Less than a third of lung cancer patients are diagnosed at an early stage. Later diagnosis means more challenging disease management and little chance of cure. Sadly, more Irish people die from lung cancer than from any other form of the disease.

Early detection is vital. Multiple global large-scale studies have conclusively shown that lung cancer screening works in detecting more lung cancers at earlier stages. However, in the absence of a national screening programme, early detection in Ireland is reliant on patients presenting to their GP sooner rather than later. Despite multiple annual awareness campaigns,

recent data shows people are often still unclear of the signs and symptoms. When they do notice something wrong, it is well documented that patients can delay presentation because of the stigma associated with lung cancer and smoking.

The Global Lung Cancer Coalition (GLCC) is an alliance of patient organisations committed to increasing awareness and understanding of lung cancer and campaigning to improve lung cancer outcomes for all. In 2023, the GLCC commissioned a multi-national study to understand attitudes towards lung cancer, levels of symptom awareness among the public and views on lung cancer screening. The study was undertaken in 29 countries, including Ireland. Responses were received from at least 1,000 adults per country. Data was weighted

Written by Aoife Mc Namara, Education and Engagement Manager

using age, gender and region to produce a representative sample in each country.

Over 28% of Irish respondents said they did not know any symptom of lung cancer.

Worryingly those at highest risk, people who currently smoke/ have smoked were more likely to report not knowing any symptoms compared to people who have never smoked (30.69% v 23.58%).

To understand attitudes to lung cancer, participants were told that: “Lung cancer is mainly caused by smoking cigarettes and other tobacco products”. They were then asked, whether they have less sympathy for people with lung cancer than other types of cancer. In Ireland, 39.92% agreed with the statement that they had less sympathy for people with lung cancer.

Public health campaigns around the world have traditionally highlighted the link between tobacco and lung cancer in an effort to educate on risk reduction.

However, many now argue that this public health approach has in fact led to the stigmatisation of lung cancer patients. Stigma is not normally associated with other cancers, yet on hearing a lung cancer diagnosis, people often respond with ‘Did they smoke?’ The strong association between tobacco and lung cancer has created the belief that it is a self-inflicted disease. No other cancer suffers from the same level of blame.

Early detection of lung cancer is vital, now more than ever.

Preliminary data from the National Cancer Registry of Ireland earlier this year confirmed that 14% less lung cancer cases were diagnosed in 2021 than projected because of the impact of the pandemic. Our clinical colleagues are reporting more delayed diagnoses and

poorer survival outcomes because of this. Our message all year round, but especially during Lung Cancer Awareness Month, is that members of the public should to be aware of the signs and symptoms of lung cancer and if or when they notice any of these symptoms, they should engage with their GP immediately.

The Irish Cancer Society has long supported the introduction of lung cancer screening to save lives and continues to call for the Government and the National Screening Service to work together to launch lung cancer screening.

In the GLCC study, 88.82% people agreed there should be a national lung cancer-screening programme to help people with lung cancer get diagnosed early.

Throughout November and into December, the Irish Cancer Society will be hosting a series of Lung Cancer Awareness Road Shows and is calling on the public in these locations to come along, ask questions and meet with our cancer nurses. Our Support Line nurses are available to talk to anyone who is concerned about lung cancer on Freephone 1800 200 700, Monday – Friday.

For more information and support, visit www.cancer.ie/lung For more information about this study and the work of the GLCC please visit: www.lungcancercoalition.org

PHARMACYNEWSIRELAND.COM

Oromucosal spray, solution

Can be used to treat a chesty cough

For relief of painful, irritated sore throats

(productive cough)*

Contains thyme liquid extract

180ml

pack size

30ml

Local Anaesthetic effect

pack size

Medithyme Cough Syrup contains liquid extract from Thymus vulgaris L., herba (Thyme herb). Contains: ethanol, maltitol (E965) and benzoate salt (E211). For oral short-term use only. Indicated in adults and adolescents aged 12 years and over. Contraindications: Hypersensitivity to thyme or to other members of the Lamiaceae (mint) family, or to any of the excipients. For supply through general sale. TR 126/319/001. *Medithyme Cough Syrup is a traditional herbal medicinal product, for use in case of productive cough associated with cold, exclusively based on longstanding use.

Medispray is indicated for the symptomatic relief of painful, irritated sore throats. Additional therapy is required in the event of bacterial infection accompanied by fever.

Adults, adolescents and children over 12 years. The dose is 3 to 5 sprays (0.3 - 0.5 ml). This can be repeated 6 to 10 times per day. The lowest effective dose should be used for the shortest duration necessary to relieve symptoms. Repeat the dose every hour as needed up to a maximum of ten times in 24 hours.

Supply through pharmacy only. PA 126/300/001 A copy of the summary of product characteristics for both products is available on request or alternatively please go to www.clonmelhealthcare.ie PA/TR Holder: Clonmel Healthcare Ltd., Clonmel, Co. Tipperary. Date prepared: June 2023. 2023/ADV/MED/137H

CPD: Coughs and Colds Continuing Professional Development

CPD

43

AUTHOR: Written by Jane Fleming, MPSI

60 Second Summary A cold is a mild viral infection of the nose, throat, sinuses and upper airways. It can cause nasal stuffiness, a runny nose, sneezing, a sore throat and a cough. For most people, a cold will get better on its own within a week of the symptoms starting without any specific treatment.

However, there are a number of treatments that can help to ease your symptoms and make you feel more comfortable. These include nasal sprays, vapour rubs, cough bottles which are all available from your local pharmacy.

There are some self-help measures that may help to ease the symptoms of a cold.

These include drinking enough fluids to prevent dehydration, sucking sweets or lozenges which contain menthol or eucalyptus may sooth your throat & gargling with salt water may also help a sore throat. Hot drinks (particularly with lemon), hot soups and spicy foods can help to ease irritation and pain in your throat too. Of course getting some well needed rest is also key.

There is no cure for colds.

Antibiotics, which treat infections caused by bacteria, don’t work on cold viruses.

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

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.

3. PLAN - If I have identified a knowledge gap - will this article satisfy those needs - or will more reading be required?

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

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.

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

Coughs and Colds A cold is a contagious upper respiratory tract infection that affects your nose, throat, sinuses and windpipe (trachea). Colds spread easily from person to person through infected droplets from the mouth and nose. They can be passed on through coughs and sneezes. The most common cold virus is the rhinovirus, causing up to 50% of common colds. There are more than 100 different rhinoviruses, however other types of viruses, such as coronaviruses, can also cause colds.

Usually a cold is a self-limiting infection – this means it gets better by itself without the need for treatment. On average, adults have two to five colds each year and school-age children can have up to eight colds a year. Adults who come into contact with children tend to get more colds. This is because children usually carry more of the virus, for longer.

Symptoms of a common cold in adults Common cold symptoms typically appear in stages - early, active & late.

Stage 1 Early (Days 1-3) Within one to three days of picking up a cold virus, you may notice a tickle in your throat.

About half of all people with colds report a loose or sore throat as their first symptom.

Other common cold symptoms you may experience during this early stage include: • sneezing • runny nose • stuffy nose (nasal congestion) • cough • hoarseness Stage 2: Active (Days 2-4) Symptoms typically worsen or peak during this stage. In addition to the symptoms in stage 1, you may experience: • body aches • headache • fatigue • runny eyes and nose • fever (more common in children)

44

CPD: Coughs and Colds

• Wheezing

it, then touches their mouth, eyes or nose, the germs can infect them.

• Ribs showing with each breath.

Diagnosis

• Blue lips

Your GP will ask you about your symptoms and perform a physical exam. During the exam, your GP will check for signs, such as:

• Fast or laboured breathing.

• Not eating or drinking, which could mean dehydration • Ear pain • Excessive crankiness or sleepiness.

• A cough that lasts more than 3 weeks.

• Your baby seems to be getting sicker The common cold is highly contagious, and spreads easily from person to person. For you to become infected, the virus has to get to one of your mucous membranes — the moist lining of your nostrils, eyes or mouth.

That happens when you touch a surface or breathe moist air that contains the cold virus. For example, when a person who’s sick sneezes or coughs, they launch droplets of fluid containing the cold virus into the air. If you breathe in those droplets, the cold virus takes root in your nose. You can also leave virus particles on surfaces you touch when you’re sick. If someone else touches those surfaces and then touches their nostrils, eyes or mouth, the virus can get in. You can be contagious for up to two weeks, even spreading a cold a day or two before you have symptoms.

But you’re most contagious when your symptoms are at their worst — usually the first three days you feel sick.

Stage 3: Late (Days 8-10)

• Loss of appetite

Colds usually begin to wind down during this stage. You may be free and clear at this point, however some symptoms can persist.

Some people develop a nagging cough that can last after your cold has cleared.

• Increased drooling because of sore throat and difficulty swallowing

Symptoms of a common cold in babies • Runny nose (the discharge may start clear. Later, it becomes thicker and may be grey, yellow or green).

• Sneezing.

• Fever of 38.3 to 38.9 degrees Celsius.

• Cough • Irritability • Slightly swollen glands More serious symptoms that may mean it is more than just a cold: • Fever in an infant 2 months or younger.

• Difficulty breathing (especially if your baby’s or child’s nostrils widen with each breath).

The common cold in children and babies occurs more often because they haven’t been exposed to as many viruses as adults. Their immune systems have to learn how to fight new germs. Before turning 2 years old, a baby can get as many as eight to 10 colds a year. By the time you become an adult, you’ve had many colds. It’s easier for your immune system to identify and attack similar viruses. In addition, children are in close contact with other children. Kids typically don’t cover their coughs and sneezes or wash their hands before touching their faces — steps that prevent the virus from spreading. Cold viruses can live on objects for several hours. Babies often pick up objects that other babies have touched. If a baby touches something that has cold germs on

• Swelling in your nostrils • A stuffy nose • A red, irritated throat • Swollen lymph nodes in your neck • Clear lungs Management & Treatment Firstly there’s no cure for a cold.

You have to let it run its course.

Most colds go away on their own within seven to 10 days and don’t turn into anything more serious. Common cold treatment includes over-the-counter (OTC) medications to help reduce your symptoms and keep you comfortable until you recover.

Antibiotics are medications that fight infections caused by bacteria.

Because viruses cause colds, antibiotics don’t work for colds.

OTC Cough & Cold Medications • Paracetamol & Ibuprofen These can ease aches and pains, headaches and fever. Both are available in pharmacies in liquid form for children. Fever itself isn›t harmful. A fever is one of the body›s defences against infection, and helps to fight off infections.

Having a fever often makes people feel unwell. If that is the case, anti-fever medicines such as paracetamol and ibuprofen can help them feel better.

• Anti-Histamines These stop runny noses and sneezing.

• Saline drops for blocked nose A popular treatment for a blocked nose in a baby is to put a few drops of salt water (saline) into the nose just before feeds. Some people feel that this helps to clear the nose to make feeding easier.

There is little scientific evidence as to how well this works, but it may be worth a try if feeding is difficult.

• Vapour rubs Vapour rubs are another popular treatment. They can be applied to the chest and back. Avoid application directly to the nostril

45 area. Again, there is little scientific evidence as to how well they work.

• Steam inhalation Inhaling steam can also help relieve congestion and coughing. The safest way to do this with children is to sit in the bathroom with a hot shower/hot taps running.

• Cough sweets Sucking menthol or other medicated sweets can help ease irritating coughs and sore throats in older children.

• Cough bottles - Expectorants: loosen mucus in your lungs so you can cough it up - Cough Suppressants: quiet a hard barking cough In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency (MHRA). It said that parents and carers should no longer use overthe-counter (OTC) cough and cold medicines in children aged under 6 years. For 6 to 12-year-olds these medicines continue to be available (due to the fact that there is less risk of side-effects in older children). However, they are only sold in pharmacies, with clearer advice on the packaging and from the pharmacist.

However, paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.

A warm drink made with honey and lemon juice can be as soothing to an irritated or sore throat as a cough medicine.

Please note that honey should not be given to babies under 12 months old.

Cough is a difficult symptom to control. Sometimes it seems as if your child is coughing all the time.

They may cough so hard that they are sick. This is distressing but it does not necessarily indicate that they need additional treatment from a doctor.

severity of cold symptoms, when taken within 24 hours of the first symptoms of a cold. Zinc supplements may also help to prevent colds. However, there were possible side effects such as unpleasant taste and nausea.

The review concluded that it is not yet clear whether zinc should be recommended as treatment for colds.

Vitamin C There has also been research looking at vitamin C for preventing or treating colds. A recent review found that taking vitamin C regularly did not seem to prevent colds in the ordinary population.

However, it did seem to reduce the length and severity of symptoms.

Also, in trials where people were exposed to short periods of extreme physical stress (for example, marathon runners and skiers) vitamin C halved the risk of developing a cold. More research is needed to answer the question of whether vitamin C can help once the cold symptoms have already started.

Vitamin D A study published in early 2017 revealed that vitamin D is also useful for preventing colds. Many people in the UK have low levels of vitamin D during the winter, and Public Health England now recommends that everyone should consider taking a vitamin D supplement during the winter.

Herbal remedies Echinacea and garlic have traditionally been used for treating colds. However, recent reviews of research could not find any evidence that either is helpful.

The MHRA also advises that echinacea should not be given to children under 12 years old. This is because of rare allergic reactions, which can be severe.

Black elderberry extract is another natural remedy that has been used traditionally. There is some evidence that it can help to prevent and shorten colds.

Other treatments

Self-help

Zinc supplements

There are a number of self-help measures that may help to ease the symptoms of a cold:

Previous research studies suggest that a mineral called zinc appears to reduce the severity of cold symptoms in healthy children. A recent review of the research on zinc supplements and the common cold found that zinc supplements may reduce the length and

• Drinking enough fluids to prevent dehydration • Steam inhalations with menthol, salt water nasal sprays or drops may be helpful

• Vapour rubs may help relieve symptoms for children • Hot drinks (particularly with lemon), hot soups and spicy foods can help to ease irritation and pain in your throat • Sucking sweets or lozenges which contain menthol or eucalyptus may sooth your throat • Gargling with salt water may help a sore throat • You should try to make sure you get enough rest if you have a cold. It’s not usually necessary to stay off work or school Treatment of common colds in babies Unless prescribed by their provider, don’t give your baby any over-the-counter cough or cold medicines. To treat common cold in babies:

• Keep your baby comfortable.

• Give your baby fluids. For babies 6 months or younger, let them drink breast milk or formula. At 6 months, your baby can also have some water.

• Let your baby get plenty of rest Since most children can’t blow their nose until about age 4, the following methods may help ease your baby’s stuffy nose: • Saline and suction: About 15 minutes before a feeding, use over-the-counter saline (salt water) drops to loosen up the mucus in your baby’s nostrils.

Suction out the liquid and mucus a few minutes later with a rubber bulb or oral suction device. This will clear the mucus out of your baby’s nose and allow them to breathe and suck at the same time.

46

CPD: Coughs and Colds

When to see your GP: Contact your GP if you have any of the following symptoms: • High fever • Chest Pain • Ear pain • Asthma flare-up or difficulty breathing • Petroleum jelly: Dab petroleum jelly on the outside of your baby’s nostrils to reduce irritation. Don’t block the inside of your baby’s nostrils.

• Humidifier or vaporiser: Moisten the air in your baby’s room with a humidifier or vaporiser. The clean, cool mist will help moisten the air and decrease the drying of your baby’s nasal passages and throat. Clean and dry the humidifier thoroughly before using it to get rid of bacteria or mould that may have collected in the device. Ensure you have the appropriate filter, and check if it needs to be replaced.

Don’t use hot water vaporisers because of the risk of burns.

• Steam: If you don’t have a humidifier, take your baby into a steamy room such as a bathroom. Turn on the hot water, close the door and sit together in the steamy room for about 15 minutes. Don’t leave your baby alone in the room. Be safe around water. Giving your baby a warm bath may also work.

Babies can continue their normal activities if they seem well enough to do so. If they have a fever or complications, it’s best to keep them at home.

Prevention There are several steps you can take to prevent a cold in adults, including: • Washing your hands: Wash your hands frequently, especially before eating or preparing food.

Also, wash your hands after using the bathroom, wiping your nose or coming into contact with someone who has a cold.

• Avoiding touching your face: Cold viruses spread from your hands to your eyes, nose and mouth.

• Cleaning frequently used surfaces: Viruses can live on doorknobs and other places people often touch.

them away from people who have colds. If possible, keep your baby home. A virus that causes a mild illness in an older child or an adult can cause a more serious one in an infant.

Hand washing is the most important way to reduce the spread of colds: • Adults who have contact with babies and young children should wash their hands after coughing, sneezing or wiping their nose.

• Wash your hands after touching someone who has a cold.

• After wiping your baby’s nose, wash your hands and your baby’s hands.

• Using hand sanitisers: When you can’t wash your hands with soap and water, use alcoholbased hand sanitiser.

• Clean toys regularly and avoid sharing toys that babies place in their mouths.

• Strengthening your immune system: Get enough sleep, eat a healthy diet and exercise so your body is ready to fight off germs.

• If soap and water aren’t available, use pre-moistened hand wipes or hand sanitisers.

(Be sure to keep hand sanitisers away from children. They may be harmful if swallowed.)

• Staying home: To make sure you don’t spread the cold to others, stay home when you’re sick.

The best way to prevent your baby from catching a cold is to keep

Keep your baby up-to-date on all of the recommended vaccinations.

They won’t stop colds, but they can help prevent some complications, such as bacterial infections of their ears or lungs.

• Symptoms lasting more than 10 days or getting worse When should my baby see their GP for the common cold?

Call your baby’s GP or go to the nearest emergency room if your baby: • Develops a high fever • Stops eating • Is vomiting • Has ear or stomach pain • Cries more than usual • Is sleepier than usual • Starts wheezing • Has trouble breathing We as community pharmacists and pharmacy teams are in an ideal position to identify the signs and symptoms of the common cold in our patients. We are most often the first one’s they seek help or advice from. We therefore play a pivotal role in our patients care by offering sound advice & treatments to allow them to recover at home without needing to see their GP. We, as one of the most accessible healthcare resources in Ireland can empower patients to look after their own health and wellbeing References available on request

Awards The Irish Pharmacy

2024

Save the Date Irish Pharmacy Awards

Saturday, 25th May, 2024 The Clayton Hotel, Burlington Road, Dublin To register your interest in entering the awards, email aoife@ipn.ie

48

Heart Health

Irish Heart Foundation Patient Support Services Cardiovascular disease is responsible for some 9,000 deaths in Ireland each year – around 30% of all mortality. Over half a million people are living with a cardiovascular condition, with 80,000 being discharged from hospital each year, often returning home to a bleak and uncertain future.

Written by Chris Macey, Director of Advocacy and Patient Support with the Irish Heart Foundation

we have access for the first time to patients when they need help most – in the weeks after discharge or step down from their clinical support. This has enabled us to develop pathways for both stroke and heart failure from the hospital gates for as long as people need us.

These services are delivered separately – reflecting differing patient needs and in order to maximise the proven impact of peer support. Despite this, the main service elements are the same.

They incorporate:

- Short duration interventions meeting specific needs

- Cognitive therapy

Against this backdrop, the Irish Heart Foundation established specific pathways of support for stroke survivors and heart failure patients that are impactful, cost-effective and can be delivered at scale.

In the last 12 months these services, launched following the outbreak of Covid-19, have enjoyed enormous growth and now

support around one in every three stroke survivors returning home from hospital nationally, along with thousands of heart failure and other cardiac patients.

- Online support

Our services prevent hospital readmission among heart failure patients, reduce the requirement for long-term care among stroke survivors and remove a significant burden from frontline services.

They empower patients to take control of their own health and wellbeing but ensure that where their conditions are deteriorating, they are appropriately escalated without delay. It’s important to stress that the Irish Heart Foundation provides non-clinical psychosocial support services that don’t overlap with any other clinical services.

Stroke Connect and Heart Connect

Whilst stroke and heart failure supports are our primary focus, we are also developing services across a broad range of cardiovascular conditions, including heart attacks, people with cardiomyopathies and congenital heart disease, families affected by sudden cardiac death and people with ICDs. Thanks to a system of referral that is strongly supported in stroke units and heart failure services,

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In the course of these calls patients are offered counselling if appropriate and when they have concluded, we discuss further service options, including a menu of short programmes where a specific need has been identified, which typically run for between 6-12 weeks and include: - Fatigue Management

- Face-to-face groups

Meanwhile, heart failure patients must endure the revolving door syndrome of a 90-day readmission rate to hospital of 30% which is seriously detrimental to their quality of life, often for the want of basic information and support.

Short programmes

- Nurse-led needs assessments and regular support calls through our Stroke Connect and Heart Connect programmes

- Younger patient networks

Among stroke survivors, there’s a widespread sense of abandonment resulting from a dearth of rehabilitation and other crucial services and supports in the community crucial to meet the challenges of often significant physical, communication, social and psychological difficulties. In the last decade stroke mortality has fallen by around a third whilst stroke incidence is up by around 25%. But there has been no significant investment in post-discharge services to meet the rapid rise in numbers returning home.

also actively signpost our members to other community supports and organisations such as the HSE community programme, Family Carers Ireland, Social Prescribing and Citizens Information.

- Peer-to-peer phone support - Stay Connected low support programme

- Back to Work - Mindfulness

- Physical Exercise - Psychological support - Communication - Art and Music therapy We also facilitate referral to the HSE Living Well, Living Well with a Cardiac Condition and Building Better Caregivers programmes.

Online support programmes

Both services start with a nurseled needs assessment conducted by phone. Stroke survivors receive up to eight weekly phone calls from our support coordinators and trained volunteers who provide emotional support, quality information and guidance, help to meet recovery goals and signposting. The heart failure calls are monthly and involve a greater emphasis on reiterating consistent health messages from heart failure clinics in relation to symptom recognition and self-care, along with information and emotional support. Our nurses remain available to provide general health advice and information as required.

Members are given access to a suite of online support programmes. These include information sessions and social groups which are very popular in older age groups. We have three moderated closed Facebook groups for heart failure, stroke and our carers networks, which provide a vibrant source of peer support, evidenced by high daily engagement rates. Specific online supports for heart failure patients include a fluid tracker app; symptom checker and an online cardiac rehab programme developed with the Irish Association of Cardiac Rehabilitation.

The service includes a traffic light system to escalate calls where there is a medical concern.

This has provided a robust early warning system for patients who may turn out to be at risk of recurrent stroke or deterioration among heart failure patients. We

We provide peer-to-peer support delivered one-to-one by phone by fully trained stroke survivor and heart patient volunteers, many of whom have been through our services and who give their time both to give something back and to help meet their own recovery goals.

Peer-to-peer phone support

49 Working age support networks We have a dedicated working age stroke support network to meet the needs of survivors who now account for more than a quarter of all strokes in Ireland. The HSE estimates that 1% of under 65s in Ireland have heart failure – as many as 43,000 people and a support group to meet their needs in now being established.

Face-to-face support groups Our face-to-face stroke groups are back in action after Covid, along with our nationwide series of heart failure information meetings.

We currently have 20 face to face stroke groups around the country, including two for younger survivors.

in touch and have the option to re-connecting fully at a later date. They receive a low support service intervention that includes a quarterly newsletter, access to our nurse support line, our full range of digital and print resources and our calendar of events. Crucially, they can also access our services if their circumstances change.

Information Providing access to accurate, authoritative and easy to understand information is one of the most important services we can deliver.

Stay Connected programme

- A team of nurses work on our Nurse Support Line, supporting the public, along with our service users.

Stay Connected is for members who are not actively using our services but who want to stay

- We distribute over a half a million leaflets and educational materials each year that

give people affected by cardiovascular disease the information they need to live well.

- And our website and social media platforms are key resources for patients, families and carers, together with healthcare professionals and the general public. We have over 100,000 followers on our social media platforms and there are more than 250,000 annual visits to our website.

Carer supports We provide specific support for carers of both heart and stroke patients through Facebook and other online services. These include: - Support Pack - Peer Facebook community

- Information Zoom Sessions - Signposting to external supports - Access to Nurse Support Line Our services are proving their impact through significant reductions in requirement for long-term care and hospital readmission; they cost a fraction of the increased capacity they are providing in hospitals and nursing homes; and they are built to be delivered at scale.

Our next objective is to forge a long-term partnership with the HSE to deliver sustainable high grade support. This will ensure that at last cardiovascular patients emerge from the lowest rung of priority in the provision of essential community services and supports perhaps of any serious chronic condition, enabling them to live the best life possible with the effects of heart disease and stroke.

Illuminating heart health on World Heart Day 2023 Croí, the heart and stroke charity, was delighted to collaborate for a second year with some of the most iconic and historic buildings, organisations and landmarks throughout the west to celebrate World Heart Day on 29th September 2023.

World Heart Day is a reminder to everyone around the world to take care of their hearts. This year’s World Heart Federation campaign focuses on the essential message of knowing our hearts first, because when we know more, we can take better care.

The illumination of The Galway Hooker, last year, docked at the Claddagh basin was a sight that brought much attention to the campaign, and encouraged many more organisations to come on board for this year’s illumination.

The illumination campaign draws a close on the many events organised by Croí throughout September in recognition of World Heart Month. Details of events can be found on www.croi.ie Croí not only encourages people to ensure their heart health is a priority, but also those around them, friends, family, and colleagues.

Croí’s aim is to educate and empower individuals, families, and communities to take control of their heart health and to make and maintain the changes that can lead to a longer and healthier life.

Croí would like to extend thanks to the public, the many healthcare professionals, organisations, and volunteers who worked to ensure World Heart Month was an outstanding success.

Meanwhile, the charity have also announced an impending change in leadership which will mark a new chapter in the history of the organisation. With effect from January 1st next year, current CEO Neil Johnson will step down after almost 32 years at the helm and will be succeeded by Tipperary native Mark O’Donnell.

Announcing details of the new appointment, Croí Chairman Mark Gantly paid tribute to Neil Johnson’s long service and leadership which has seen Croí make an enormous contribution to the fight against heart disease and stroke in the west of Ireland.

Mr Gantly said, “This is a change that has been carefully planned as part of the organisations succession planning and we are delighted to announce that Mark O’Donnell will take over as CEO from the beginning of next year. Mark joined the Croí team in January of 2022, as Chief Operations Officer and Head of Foundation. A native of Tipperary, he has lived in Galway for over thirty years, working primarily at senior level in the public service within city, county, and regional government organisations. During this time, he has also gained leadership experience working in the not-for-profit sector. Mark is a graduate of University of Galway,

Pictured at the announcement of leadership changes at heart and stroke Charity Croí are incoming Croí CEO, Mark O’Donnell, Croí Chairman, Mark Gantly, and outgoing CEO Neil Johnson

and has academic qualifications in Law, Finance, Management and Corporate Governance”.

Speaking about his appointment, Mark O’Donnell said, “It is a genuine honour to be appointed to the senior leadership role in Croí from next January, and one that comes with a substantial weight of responsibility. Neil has shown exemplary leadership over the past thirty years, working with an outstanding team and a committed Board, to develop a fantastic organisation with a critically important mission as its focus. Reducing the burden of heart disease and stroke on our communities is a considerable challenge. However, building on the strong foundations that have been laid, and with the exceptional team in Croí, I have no doubt that we can collectively make a significant positive impact. It has been a great introduction to Croí

to have worked closely with Neil, our team, Board, and our many volunteers over the last two years and I’m very much looking forward to the next chapter.”

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50

Finance

Would you like your children to have a pension worth ¤2,000,000 when they turn 50?

Signed into law by President Michael D Higgins in early January this year The Finance Act 2023 brought into effect the single biggest and most significant change to pension legislation in Ireland for 30 years. The act now provides a significant opportunity for business owners to transfer unlimited surplus funds from their business into a pension in their children’s name without impacting the parent/child inheritance tax threshold.

Written by Kieran Moore QFA, SIA Moore Wealth Management has been advising members of the pharmacy community for over 20 years and preferred providers of advice to IPU members corporate funds at which point we explained the new option to them to compare and contrast.

Option 1 - Corporate Investment • Invest in an appropriate investment fund and pay tax on any gains at a rate of 25% as non-trading income.

This may sound like an unbelievable scenario but Finance Act 2023 enacted the following changes with effect from Jan 1st, 2023 • An employer can contribute to an employee PRSA without taking into account the age-related tax relief contribution limits.

• Employer contributions to a PRSA are no longer treated as benefit in kind (BIK).

• There is no limit on employer contributions to an employee’s PRSA. However, the overall maximum tax-efficient standard fund threshold of ¤2m still applies and needs to be considered.

Before 1st January 2023: • Employer pension contributions to an employee PRSA were calculated based on the agerelated percentage limit for tax relief on pension contributions.

For example, an individual under the age of 30 could only have had a contribution of ¤17,250 under the old rules.

• Eventually, extract these funds as salary from the business and pay tax at over 50%.

• Once extracted and passed to their child on death this would then be taxed at 33% after the relevant inheritance tax threshold was breached.

• Surplus nontrading income if left in the company would be subject to the close company surcharge at 20%.

• The PRSA will grow tax-free in the child’s name up to at least age 50 when the funds could be accessed if needed.

By selecting option 2 they have bypassed numerous layers of penal taxation and made a planning move that will likely benefit not only their child but their grandchildren as well. They are now looking at intergenerational wealth transfer courtesy of Finance Act 2023.

Contribution In this case, John and Jane contributed ¤350,000 as we had projected with long-term full equity allocation return assumptions that this would be worth circa ¤2,000,000 after 31 years when their child reached 50 taking longterm inflation at 2.5%. This target fund is the revenue-approved maximum tax-efficient fund threshold under current legislation.

Not just for Children

• Receive Tax Relief at 12.5% on the unlimited contribution to the PRSA

As you will see there is a significant opportunity here for cash extraction that we have not seen before. This will be particularly attractive to those who are sitting on cash reserves and

• The company funds move into beneficial ownership of the child with no inheritance tax implications

1. Have an underfunded pension and do not run a high salary so cannot contribute any additional funds.

Option 2 – Set Up a PRSA for their Child

• If a company made a contribution to an employee’s PRSA that exceeded these age-related limits, the employee would be liable for BIK. Real Life Example John and Jane Pharmacist have fully maxed out pensions. They have a child John Jr, working in the pharmacy part-time at the weekend who is aged 19 and still in college. They approached us intending to invest surplus

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2. Have a maxed-out pension but also have a spouse employed on a small salary who previously could only contribute a small amount.

3. Those close to business exit looking to extract cash tax efficiently.

As mentioned above this is a change from revenue practice and is the current situation for this year and anyone availing of it is following the legislation as written. There was no indication in this year’s budget that this is under review but we will not know for certain until Finance Act 2024 is published. Chief among any concerns about the interpretation of the legislation would be revenues view on the spirit of the act and this needs to be factored into any decision made and be a part of the conversation with your financial adviser.

Do bear in mind that any changes in government in the coming years may see a curtailment of this opportunity.

There are of course many more variables to factor into someone putting such a lump sum into their pension and clients need to be advised accordingly to ensure this is the right course of action for their circumstances. This is where holistic advice by a CERTIFIED FINANCIAL PLANNER™ can prove invaluable in conjunction with a lifetime cashflow model.

www.mwm.ie

IRELAND FINDINGS

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IRISH PHARMACY NEWS JANUARY

FEBRUARY

 Medicines for Ireland urged the Government to heed warnings from GPs and pharmacists nationwide on the growing risk of medicines shortages as inflation, energy and transport costs continue to rise, and global supply chain disruptions persist.

 Uniphar was given the go-ahead to complete the acquisition of the Sam McCauley pharmacy chain.

 A new report was published which found that over half of pharmacists experience burnout, with higher prevalence since Covid-19, with retention and patient care implications.  The Future of Pharmacy event took place in Dublin with keynote speakers including Sharon McCabe, Oonagh O’Hagan and Paul Reilly discussing wholesaling, mergers and acquisitions and pertinent issues to community pharmacy in Ireland.  New research from Pfizer Healthcare Ireland confirmed that lingering COVID-19 concerns are continuing to impact access to healthcare, which may have a longer-term impact on people’s health due to missed diagnoses.

 Disappointed at a lack of action from government to advance the role of pharmacy in Ireland, Milltown totalhealth Pharmacist, Sheena Mitchell initiated a petition, calling for an enhanced role of community pharmacists to support her ambition of the introduction of Patient Group Directives and Minor Ailment’s Scheme.  Ocean Healthcare celebrate 20 years in business with a corporate interview article detailing the company’s progression and future opportunities within this Irish market.  The finalists were announced for the 2023 OTC & Retail Pharmacy Product Awards.

2023 & Retail Pharmacy Product Awards

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YEAR END REVIEW

53

MARCH  Keane’s CarePlus Pharmacy Group were recognised as the Best Place to Work in Ireland. In addition, the company has also received two notable accolades - the highest-ranked pharmacy group overall and the 16th best place to work in the small business category.  The Annual Guaranteed Irish Pharmaceutical Forum, hosted by Guaranteed Irish featured an industry leading line-up as the panel called on Government and key stakeholders to collaborate to achieve more timely access to medicines for Irish patients.  The decision by Minister for Health, Stephen Donnelly T.D. to publish the Mazars Report has been welcomed by the Irish Pharmaceutical Healthcare Association as a positive step towards providing Irish patients with faster access to lifechanging new medicines.  Minister for Health, Stephen Donnelly called on the Higher Education Authority (HEA) to increase the number of training places for pharmacy. The HEA is said to have issued an expression of interest to education institutes to provide additional training.

APRIL  The Joint Oireachtas Committee on Health was told that there is significant untapped potential in Ireland’s community pharmacy sector.

Addressing the Committee the Irish Pharmacy Union (IPU) outlined a series of proposals to expand the range of services available at pharmacies, which will improve patient care and relieve pressure on the health system.  A new report for the World Health Organisation identified five core national targets for UN member states aimed at reducing diabetes risk and ensuring that people with diabetes have equitable access to comprehensive and affordable care and prevention. The lead author on the report was Professor Edward Gregg, Head of RCSI’s School of Population Health.  IPHA held its Annual Conference, urging the Government and other EU member states to request the Commission to amend its proposals and to back science, jobs and innovation by supporting the protection of the IP rights that underpin R&D investment and the scaled-up manufacturing of innovative new medicines in Ireland and Europe.  IPN learned that there were still ‘no proposals’ for the appointment of a Chief Pharmaceutical Office during a Dáil Éireann Debate.

MAY  United Drug, LloydsPharmacy and TCP announced their new company holding name which changed from McKesson Ireland to PHX Ireland Group in April.  The Finalists were announced for the 2023 Irish Pharmacy Awards.  Pharmacists welcomed the European Commissions long-awaited proposal to reform the EU pharmaceutical legislation, in particular the important provisions to improve patient access to medicines regardless of where they live in the EU.  We featured an article which looked at how pharmacists in Ireland are embracing ways to pro-actively look at their business and do things in a more sustainable way. We spoke to Meaghers Pharmacy Group who introduced a sustainability strategy across their 9 stores.

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YEAR END REVIEW

JUNE  The winners were announced of the 2023 Irish Pharmacy Awards following a hugely successful night in the Clayton Hotel Dublin celebrating dedication and innovation in community pharmacy.  A consistent failure to invest in pharmacy services will have serious consequences for community healthcare if not urgently addressed, warned the Irish Pharmacy Union (IPU). The Association said that community pharmacies are now at a ‘tipping point’.  The Cerebral Palsy Foundation (CPF) announced the launch of a Programme of Excellence to revolutionise the delivery of cerebral palsy care in Ireland.  McCabes Pharmacy announced the successful acquisition of three new pharmacies from in Dublin, Stanley’s Mountview Blanchardstown, Ellis Pharmacy, Woodstown & Ellis Pharmacy, Springfield, Tallaght.

JULY  60% of Ireland’s population has been impacted by medicine shortages in the last year, with almost half of the country’s population deeply concerned by the deteriorating situation, new research found.  The Pharmaceutical Society of Ireland (PSI) - The Pharmacy Regulator has published its annual report for 2022, outlining the significant work undertaken by the regulatory authority to protect the health, safety and wellbeing of patients and the public by regulating pharmacists and pharmacies in Ireland.  The HSE Diabetic RetinaScreen programme has launched a new screening initiative for women who have diabetes and become pregnant.

8

 Heart & Stroke Voice Ireland (HSVI), the newly launched patient and carer led alliance, addresses the unmet needs of patient centred care by championing patient engagement and involvement.

News

ThoretaO gesTC Market in Ireland: Hitting ‘The Sweet Spot’ in Innovation

Stepping up to Prevent Sh

icines Age (HMA) and the European Med Heads of Medicines Agencies ry infe iotics used to treat respirato The European Commission, the antib key of tages shor avoid to actions developed issued recommendations for mmendations, which have been reco e Thes on. seas r winte next lement the for European patients in the icinal Products (MSSG), comp on Shortages and Safety of Med States, the Comm ber Mem EU the the Executive Steering Group with on medicines. In close cooperati to develop an EU list of critical ible joint procurements. ns, including, if necessary, poss take operational follow-up actio

Emer Cooke, EMA Executive Directo

AUGUST  Minister for Health Stephen Donnelly declared his intention to set up an Expert Taskforce to support the expansion of the role of pharmacists in Ireland.

Fertility Treatment

News

5

Boots launch new Liver Service

Ireland has launched a new Liver Scanning Service to help check liver health by  Boots Ireland launched a new Liver Scanning Service to help Boots measuring potential scar tissue and fatty change in the liver.

Services check liver health by measuring potential scar The tissue andpublicly fatty change HSE will introduce Caoimhe McAuley, Director of funded fertility treatment services Pharmacy and Superintendent from September 2023. This in the liver.

Pharmacist of Boots Ireland includes treatments such as IVF,

with Professor Suzanne Norris, Irish Pha rmacy New&s has been workin Consultant Hepatologist g with data analyst Professor of companGastroenterologist, y, IQVIA, Gastroenterology/Hepatology for the last eight years to comprise this  The European Commission, the Heads of Medicines Agencies (HMA) Dr Clíona Murphy, Clinical annual rep ort which highlights the Director, HSE National Women Boots recognises its unique tion.

Top 100 Over-t measures to increase produc and Infants Health Programme position local primary and the European Medicines Agency issued recommendations forcyas abra pharma nter n Recommendations to ensure he-Cou (NWIHP), said, “This is the healthcare provider,nds and thisin Ireland.

Early action ahead of the autum ent supply for EU patients give IUI and ICSI for people who meet the access criteria, as announced by the Minister for Health.

they are not effective. Citizen es are awareness-raising initiativ also advised. and winter season should time h enoug rs steps coming Next manufacture If the demand in the nt is similar to an il to ensure they have sufficie winter domseason an important step ain expe In line with the European Counc rtise IQVinIA Conmanuf to support people who need widely acce acturing capacity to meet nected level of consum.ption EMA averag address our imme health, while increasing access to pted as Inteleligen conclusions of June 2023, the industry fertility treatments. ed ce™ collect stan deliv data ds. dard the ers deman years, pow the from s preventative care across erful insights previou which brand key antibiotics, co the Commission through and perf with EU orm the spee to ance the country. d and agility — enabling is measured across the “We are delighted to see suggest that supply and the on-going proc continue to closely will supply of HERA ring Monito • investment in this area to ease secto of key first OTC cust ations formul From July 2023, selected Boots rs r. oralome supply of to and d acce an EU list of critic the deman lerat r and e the clinical monito the financial burden for public demand: EMA tics for pharmacies in Dublin, Cork and second deve and lopm-line Operational follow entantibio patients and it will significantly and and interact with marketing ission, together with com Galway will provide this Liver Comm merc We match spok ializ will ns ation e to infectio hout Gen tory eral Manager of IQVIA, respira increase access to services and EMA will now of Scanning Service. will continue inno authorisation holders throug States vativ er e Memb med winter ical Gwynne Morley, to gain treatments that for many. We have designed demand in the coming year to detect matter of priority. and the d of rest deman the the furth r impr Commenting on the new service, er monito an insights ove heal caring and efficient pathways Europe the re andthca lls of outc into how Caoimhe season. EMA omes forto these stati McAuley, Director of early any unexpected shortfa for patients, ensuring a safe and stics are compiled and supplies in cooperation with patie Preparedness “Based on the da nts. ency ary With Emerg Pharmacy and Superintendent necess Health appr any oxim quality service, so that on fertility the valu ately supplies and take e of this nies. Given that the ) will 86,00 0 compa mark (HERA ity Pharmacist of Boots Ireland said, are working to en et Author to nse phar emp issues are addressed through macy. loyees, IQVIA conducts and Respo are designed measures. A dedicated HERA “The overall health of our liver is measusres operation prepared f the public health system at intaken nt supply, all e to work with marketing The continu with representatives better Top mor g 100 often overlooked when in fact, it e meetin than Over Board 100 the sufficie coun Counter the lowest level of clinical to ensure streng. then winter season,” holders to tries ies isation Ministr should be prioritised, so we are (OTC) ’ author States er Mar to Memb ed ket the intervention necessary.” of Repo rt istobase stakeholders are remind Broich, chai the supply of e dtoon delighted be able bring our total valu Karl increas the to and res ission Pres measu ent in Ireland since e the Comm l, withMorof Gwynne of wholesal Liver Scanning Service to fruition ley,Health Gen,eral e sales order medicines as norma of Medicines Ag People who are experiencing for OTC prod Man place on intravenous antibiotics.1990, IQVIA some pion on a pilot basis in selected stores. ucts into the industry will takeager, eere d the country as a hub retai fertility issues should talk to l pharmacy need to stockpile medicines.IQV “These early pro Innovationover and expansion of se IA Irela for no the cour clini 20 July to discuss cal ay, nd ed for the Thursd of want their GP, who can do initial prepar the to avail of theresea ines can put better rch.

To be In addi allow the Europe healthcare is key at Boots and prev to a combination of eating more Stockpiling medic service into tion on to agree supp and ortin tests. Patients can then be ious 12 months to April 2023 further g matter life strain on supplies and the , the EMA’s being the first pharmacy in Ireland (May season calories than the body needs store over the coming weeks.” winter scien further regulatory netwo ces in referred by their GP to2022 their local their steps.

- Aprilto2023 clini nal on cal offer this effor and leading a more sedentary g Group ). as a private fee-based Apart from exercise, there possible additio ts across Steerin Execu stakeholders to Regional Fertility Hub, where cause or worsen shortages. aretive Euro service is a prime example of that. pe or inactive lifestyle.

It occurs and inal Medic the of IQV glob Safety e, r and ges they can expect to avail of a issione IA’s many other ways in which the liver Shorta Comm activ in advance and at Boots recognise the need ity awareness and prudent It’s a rollinWe commonly in association with Stella Kyriakides, g annu in the on Irela al valu nd wide range of investigations and agreed ) can be inflamed.

For example, inclu e Public whic (MSSG said, ts des to raise customer awareness of h includes being overweight.

High levels of supportin Produc shortages for p g Health and Food Safety, the for life the used be 5 majortheOTC interventions including: relevant for non-alcoholic fatty liver disease, should tics tions importance of liver health, its NAFLD are also seen in those living menda scien categories including Pain use: Antibio recom ces ng indu followi of medicines stry upcoming winte ility from availab blood tests, semen analysis, y R&D or NAFLD as it’s more commonly “The efficac contribution to long-term health with diabetes, more often Type 2 thro their ugh relief, Cough and Cold to tly to maintain s: action pruden tive a of com pro-ac nent fertility-related surgeries and merc known, is an umbrella term reme compo l and healthy aging, and the lifestyle diabetes (T2D), or earlier stages ializ dies, crucia ation, as well as healthcaavoid antimicrobial resistance. is a Vita mins “It is important medical managementand of fertility Minerals used to describe prov liver disorders choices we can all take to protect of altered glucose handling in theand re , Skin and iders, e the Diges strong European Health Union. production of key ve a

new service connects pharmacy first and very exciting phase in actions to avoid shortages of key antibiotics used to treat respiratory to multidisciplinary healthcare the rollout of Assisted Human colleagues promote awareness Reproductive Services inThe Irelandinfor mationtocont d over the of the importance ofaine liver health infections for European patients in the next winter season. and an important development following andpage how itscan isaffect overall

 We published the annual IQVIA Top 100 over-the-counter pharmacy products in Ireland featuring an exclusive interview and in-depth look into the market with General Manager Gwynne Morley.

PHARMACYNEWSIRELAND.COM

“The availa of medicin crucial comp a strong Eu Health Un is essential take actio to prepare of next w and ensu potential sh antibiotic m are avo

suffici

55 SEPTEMBER  Budget 2024 should be used as an opportunity to address the underfunding of Ireland’s community pharmacy sector, to prepare it for future growth. This was the central message of the Irish Pharmacy Union’s (IPU) Pre-Budget Submission.  A sister company of one of Ireland’s most trusted pharmacy chains, Pure Pharmacy, has announced the launch of its DNA testing service, that will analyse patients’ genes and identify variants that may affect their reaction to commonly prescribed medications.  Community pharmacists and their teams are being urged to remind the public that the unregulated substance Melanotan 2 is not safe for use and may cause serious, long-term damage to health.  Dr Cormac Mullins authored an article which looked at Opioid Prescribing updates from the recently revised CDC Opioid Prescribing Guidelines.

OCTOBER  Pharmacy leaders attended a meeting with the Department of Health as part of ongoing discussions on pharmacy services and pay restoration.  In association with Heart Month, Healthy Meath launched a free chronic disease risk management programme in community pharmacies in Kells and Oldcastle.  Pharmacy leaders across Ireland have shown they are the cream of the retail crop, with shortlisting across a number of categories within the Retail Excellence Awards 2023.  Dr Frank Moriarty, Senior Lecturer at RCSI School of Pharmacy and Biomolecular Sciences, has received a ¤2.4 million Career Development Award from Wellcome to advance new methods to research deprescribing.

NOVEMBER  Community pharmacy welcomed the report that Government is set to introduce legislation to allow pharmacists to supply contraception without prescription following a structured consultation.  Minister for Health Stephen Donnelly, Minister for Public Health, Wellbeing and the National Drugs Strategy, Hildegarde Naughton, and Minister for Mental Health and Older People, Mary Butler, announced a ¤22.5 billion health budget.  Medicines for Ireland (MFI) are highlighting the role of inflation, rising energy and transport costs, and persistent global supply chain disruptions which have combined to create a real and serious risk of medicine shortages in the year ahead.  The Pharmaceutical Society of Ireland published the first report of its kind for pharmacy - ‘The Workforce Intelligence Report’.  A new collaborative campaign between Diabetes Ireland and the Irish Childhood Diabetes National Register was launched to raise awareness among the general public about the symptoms of Type 1 diabetes.

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Overactive Bladder

Overactive Bladder: Diagnosis and Treatment Overactive bladder syndrome is a chronic disabling condition that significantly reduces the quality of life of millions of people worldwide. We recently spoke to Theresa Lowry Lehnen PhD Clinical Nurse Specialist and Associate Lecturer South East Technological University to learn more about its management and impact in Ireland.

An interview with Theresa Lowry-Lehnen, RGN, RNP, PhD, Clinical Nurse Specialist and Associate Lecturer with South East Technological University

The symptoms of OAB include urgency, frequency, nocturia and urgency incontinence, and many patients experience combinations of these symptoms. Urgency incontinence is more common in women, and urgency and frequency more common in men.

The ICS define overactive bladder as “urinary urgency, usually accompanied by frequency and nocturia, with or without UUI, in the absence of UTI or other obvious pathology”. The definition of overactive bladder (OAB) has undergone changes over time, and currently the most commonly accepted definition is that of the International Consultation on Incontinence Research Society (ICI-RS): ‘overactive bladder syndrome is characterised by urinary urgency, with or without urgency urinary incontinence, usually with increased daytime frequency and nocturia, if there is no proven infection or other obvious pathology’.

Theresa says, “The diagnosis of OAB can be challenging due to the lack of a specific diagnostic test and the overlap of symptoms with other lower urinary tract disorders.”

Diagnosis The diagnosis of OAB is based on the presence of urinary urgency, with or without urge incontinence, usually associated with frequency and nocturia, in the absence of urinary tract infection or other obvious pathology.

She adds, “The evaluation of OAB should include a detailed medical

Theresa told us, “Overactive bladder syndrome affects approximately 350,000 people over the age of 40 in Ireland. Although the condition is more common in adults over the age of 40, it can also affect children and young people. The prevalence of OAB increases with age, affecting up to 17% of the population over the age of 18, and 30% of those over 65 years of age.

“OAB can impact significantly on quality of life and is responsible for several other comorbidities, including falls and fractures, depression, and increased risk of admission to hospitals and nursing homes,” she adds.

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history, physical examination, and laboratory tests to exclude other causes of lower urinary tract symptoms, such as urinary tract infection, bladder stones, or malignancy.

“Dipstick urinalysis should be carried out, and a sample may also be sent to the lab to rule out haematuria, infection, and glycosuria, which could indicate the presence of diabetes. Blood tests including levels of creatinine and glycosylated haemoglobin (HbA1C) can also provide additional information.

“A detailed medical history can highlight possible risk factors for OAB. The history should focus on voiding and lower urinary tract symptoms, the severity of symptoms and their impact on the patient’s quality of life.

Symptom questionnaires can be used to highlight the impact of the condition on quality of life and to determine whether the patient requires treatment. There are numerous validated questionnaires available, however, they are not widely used.

“Examination should include assessment of urinary, gynaecological, and neurological systems. A focused clinical examination can highlight risk factors and pre-existing

conditions and should include an abdominal examination, digital rectal examination of the prostate in males and a vaginal examination in females.”

Theresa notes that abdominal palpation and vaginal examination enables identification of a palpable bladder and prolapse or pelvic mass in females. Symptoms of OAB in men are often attributed to bladder outflow obstruction resulting in misdiagnosis and delays in treatment.

“A digital rectal exam is imperative to rule out the presence of prostatic hypertrophy, malignancy, and poor rectal tone. Neurological causes of OAB can include spinal cord injury, myelodysplasia, or multiple sclerosis. Out ruling neurological causes is important, as these patients may be at risk of upper tract deterioration/renal failure.

“A voiding diary is a useful tool for assessing the frequency and volume of voids, urgency, and episodes of urge incontinence.

Uroflowmetry can assess voided volume, flow rate, and post void residual urine volume.

Cystoscopy and urodynamics are usually not necessary for the diagnosis of OAB, but may be helpful in selected cases, such as when there is suspicion of bladder outlet obstruction or neurogenic bladder.”

50mgs once daily

BETMIGA 25 mg prolonged-release tablets & BETMIGA 50 mg prolonged-release tablets.

Her 10th shopping trip since the day she started BETMIGA1

Prescribing Information: BETMIGA™ (mirabegron) For full prescribing information, refer to the Summary of Product Characteristics (SPC). Name: BETMIGA 25 mg prolonged-release tablets & BETMIGA 50 mg prolonged-release tablets. Presentation: Prolongedrelease tablets containing 25 mg or 50 mg mirabegron. Indication: Symptomatic treatment of urgency, increased micturition frequency and/or urgency incontinence as may occur in adult patients with overactive bladder (OAB) syndrome. Posology and administration: The recommended dose is 50 mg orally once daily in adults (including elderly patients). Mirabegron should not be used in paediatrics for OAB. A reduced dose of 25 mg once daily is recommended for special populations (please see the full SPC for information on special populations). The tablet should be taken with liquids, swallowed whole and is not to be chewed, divided, or crushed. The tablet may be taken with or without food. Contraindications: Hypersensitivity to the active substance or to any of the excipients listed in section 6.1 of the SPC. Severe uncontrolled hypertension defined as systolic blood pressure ≥ 180 mm Hg and/or diastolic blood pressure ≥ 110 mm Hg. Warnings and Precautions: Renal impairment: BETMIGA has not been studied in patients with end stage renal disease (eGFR < 15 ml/min/1.73 m2 or patients requiring haemodialysis) and, therefore, it is not recommended for use in this patient population. Data are limited in patients with severe renal impairment (eGFR 15 to 29 ml/min/1.73 m2); based on a pharmacokinetic study (see section 5.2 of the SPC) a dose of 25 mg once daily is recommended in this population. This medicinal product is not recommended for use in patients with severe renal impairment (eGFR 15 to 29 ml/min/1.73 m2) concomitantly receiving strong CYP3A inhibitors (see section 4.5 of the SPC).

Hepatic impairment: BETMIGA has not been studied in patients with severe hepatic impairment (ChildPugh Class C) and, therefore, it is not recommended for use in this patient population. This medicinal product is not recommended for use in patients with moderate hepatic impairment (Child-Pugh B) concomitantly receiving strong CYP3A inhibitors (see section 4.5 of the SPC). Hypertension: Mirabegron can increase blood pressure. Blood pressure should be measured at baseline and periodically during treatment with mirabegron, especially in hypertensive patients. Data are limited in patients with stage 2 hypertension (systolic blood pressure ≥ 160 mm Hg or diastolic blood pressure ≥ 100 mm Hg). Patients with congenital or acquired QT prolongation: BETMIGA, at therapeutic doses, has not demonstrated clinically relevant QT prolongation in clinical studies (see section 5.1 of the SPC). However, since patients with a known history of QT prolongation or patients who are taking medicinal products known to prolong the QT interval were not included in these studies, the effects of mirabegron in these patients is unknown.

Caution should be exercised when administering mirabegron in these patients. Patients with bladder outlet obstruction and patients taking antimuscarinics medicinal products for OAB: Urinary retention in patients with bladder outlet obstruction (BOO) and in patients taking antimuscarinic medicinal products for the treatment of OAB has been reported in postmarketing experience in patients taking mirabegron. A Date of preparation: January 2023

controlled clinical safety study in patients with BOO did not demonstrate increased urinary retention in patients treated with BETMIGA; however, BETMIGA should be administered with caution to patients with clinically significant BOO. BETMIGA should also be administered with caution to patients taking antimuscarinic medicinal products for the treatment of OAB. Interactions: Caution is advised if mirabegron is co-administered with medicinal products with a narrow therapeutic index and significantly metabolised

by CYP2D6. Caution is also advised if mirabegron is co-administered with CYP2D6 substrates that are individually dose titrated. In patients with mild to moderate renal impairment or mild hepatic impairment, concomitantly receiving strong CYP3A inhibitors, the recommended dose is 25 mg once daily. For patients who are initiating a combination of mirabegron and digoxin (P-gp substrate), the lowest dose for digoxin should be prescribed initially (see the SPC for full prescribing information). The potential for inhibition of P-gp by mirabegron should be considered when BETMIGA is combined with sensitive P-gp substrates.

Increases in mirabegron exposure due to drug-drug interactions may be associated with increases in pulse rate. Pregnancy and lactation: BETMIGA is not recommended in women of childbearing potential not using contraception. This medicinal product is not recommended during pregnancy. BETMIGA should not be administered during breast-feeding. Undesirable effects: Summary of the safety profile: The safety of BETMIGA was evaluated in 8433 adult patients with OAB, of which 5648 received at least one dose of mirabegron in the phase 2/3 clinical program, and 622 patients received BETMIGA for at least 1 year (365 days). In the three 12-week phase 3 double blind, placebo controlled studies, 88% of the patients completed treatment with this medicinal product, and 4% of the patients discontinued due to adverse events. Most adverse reactions were mild to moderate in severity. The most common adverse reactions reported for adult patients treated with BETMIGA 50 mg during the three 12-week phase 3 double blind, placebo controlled studies are tachycardia and urinary tract infections. The frequency of tachycardia was 1.2% in patients receiving BETMIGA 50 mg. Tachycardia led to discontinuation in 0.1% patients receiving BETMIGA 50 mg. The frequency of urinary tract infections was 2.9% in patients receiving BETMIGA 50 mg.

Urinary tract infections led to discontinuation in none of the patients receiving BETMIGA 50 mg. Serious adverse reactions included atrial fibrillation (0.2%). Adverse reactions observed during the 1-year (long term) active controlled (muscarinic antagonist) study were similar in type and severity to those observed in the three 12-week phase 3 double blind, placebo controlled studies. Adverse reactions: The following list reflects the adverse reactions observed with mirabegron in adults with OAB in the three 12-week phase 3 double blind, placebo controlled studies. The frequency of adverse reactions is defined as follows: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000) and not known (cannot be established from the available data). Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness. The adverse events are grouped by MedDRA system organ class. Infections and infestations:

Common: Urinary tract infection, Uncommon: Vaginal infection, Cystitis. Psychiatric disorders: Not known (cannot be estimated from the available data): Insomnia*, Confusional state*. Nervous system disorders: Common: Headache*, Dizziness*. Eye disorders: Rare: Eyelid oedema. Cardiac disorders: Common: Tachycardia, Uncommon: Palpitation, Atrial fibrillation. Vascular disorders: Very rare: Hypertensive crisis*.

Gastrointestinal disorders: Common: Nausea*, Constipation*, Diarrhoea*, Uncommon: Dyspepsia, Gastritis, Rare: Lip oedema. Skin and subcutaneous tissue disorders: Uncommon: Urticaria, Rash, Rash macular, Rash papular, Pruritus, Rare: Leukocytoclastic vasculitis, Purpura, Angioedema*. Musculoskeletal and connective tissue disorders: Uncommon: Joint swelling. Renal and urinary disorders: Rare: Urinary retention*. Reproductive system and breast disorders: Uncommon: Vulvovaginal pruritus. Investigations: Uncommon: Blood pressure increased, GGT increased, AST increased, ALT increased. * signifies adverse reactions observed during post-marketing experience. Prescribers should consult the SPC in relation to other adverse reactions. Overdose: Treatment for overdose should be symptomatic and supportive. In the event of overdose, pulse rate, blood pressure, and ECG monitoring is recommended. Basic NHS Cost: Great Britain (GB)/Northern Ireland(NI): BETMIGA 50 mg x 30 = £29, BETMIGA 25 mg x 30 tablets = £29.

Ireland (IE): POA. Legal classification: POM. Marketing Authorisation number(s): (GB): PLGB 00166/0415-0416. NI/IE: EU/1/12/809/001-006, EU/1/12/809/008-013, EU/1/12/809/015018. Marketing Authorisation Holder: GB: Astellas Pharma Ltd., 300 Dashwood Lang Road, Bourne Business Park, Addlestone, United Kingdom, KT15 2NX. NI/IE: Astellas Pharma Europe B.V. Sylviusweg 62, 2333 BE Leiden, The Netherlands. Date of Preparation of Prescribing information: January 2023. Job bag number: MAT-IE-BET-2023-00001. Further information available from: GB/NI: Astellas Pharma Ltd, Medical Information: 0800 783 5018. IE: Astellas Pharma Co. Ltd., Tel.: +353 1 467 1555.

For full prescribing information, please see the Summary of Product Characteristics, which may be found at: GB: www.medicines.org.uk; NI: https://www.emcmedicines.com/en-GB/northernireland/; IE: www.medicines.ie.

United Kingdom (GB/NI) Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Astellas Pharma Ltd. on 0800 783 5018.

Ireland Adverse events should be reported. Healthcare professionals are asked to report any suspected adverse reactions via: HPRA Pharmacovigilance, Website: www.hpra.ie or Astellas Pharma Co. Ltd. Tel: +353 1 467 1555, E-mail: irishdrugsafety@astellas.com.

References: 1. Freeman R, et al. Current Medical Research and Opinion 2017. https://doi.org/10.1080/03007995.2017.1419170.

MAT-IE-BET-2023-00002

58

Overactive Bladder

Anticholinergic drugs and properties

Treatment and Management of OAB Treatment and management of OAB is based on a stepwise approach, including lifestyle modifications, behavioural therapy, pharmacotherapy, and in selected cases invasive therapy, Theresa says.

“First line treatment is lifestyle modification, including bladder training exercises, pelvic floor exercises and fluid management strategies. Bladder training exercises involve gradually increasing the time between voiding to increase bladder capacity and reduce urgency.

“Pelvic floor exercises aim to strengthen the pelvic floor muscles, which can improve bladder control and reduce urinary incontinence. Fluid management strategies include reducing caffeine and alcohol intake, as these can irritate the bladder and exacerbate OAB symptoms.

Reduction in fluid intake by 25% may help improve symptoms of OAB but not UI. Advice on fluid intake should be based on 24hour fluid intake and urine output measurements. Patients should be advised that fluid intake should be sufficient to avoid thirst and that an abnormally low or high 24-hour urine output should be investigated. If overweight, weight loss is encouraged as weight loss has a significant positive effect on leakage. Patients should also be advised to stop smoking if applicable and increase dietary fibre to avoid constipation.”

Theresa says that pharmacological therapy is often required when lifestyle modifications are ineffective or insufficient.

“Antimuscarinic drugs are the first line pharmacological treatment for OAB. These drugs work by blocking the muscarinic receptors in the bladder, reducing detrusor muscle contractions, and increasing bladder capacity. There are several antimuscarinic drugs available including oxybutynin, tolterodine, trospium, solifenacin, darifenacin, and fesoterodine.

“The choice of drug depends on the patient’s individual characteristics, including age, co morbidities, and medication interactions. Absolute contraindications to anticholinergic use include urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, and known

https://irishpharmacist.ie/2022/10/05/treatment-and-management-of-oab/

hypersensitivity to the individual drugs or their ingredients. Elderly patients should be monitored for drug interactions or polypharmacy of drugs with anticholinergic effect i.e., antidepressants, antipsychotics, anxiolytics, as the overall anticholinergic load is associated with confusion, falls, and fractures Mirabegron is a β3-adrenoceptor agonist with a mechanism of action that is distinct from anticholinergics.

“It has a lower risk of adverse effects compared to antimuscarinic drugs, although it is associated with hypertension and tachycardia in some patients and is considered as a secondline therapy when patients are intolerant to anticholinergics.

“Desmopressin treatment may improve nocturia and urgency episodes. Desmopressin improves quality of sleep by prolonging the period of sleep until the first void and is shown to have an acceptable safety profile in certain patients with overactive bladder syndrome. “ If medications are not effective, intravesical botox injections are another option. Intravesical botulinum toxin A prevents acetylcholine release at the neuromuscular junction, resulting in temporary chemo denervation and muscle relaxation for up to 6 months.

Theresa explains, “The technique places multiple injections under cystoscopic guidance directly into

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the detrusor. Complete continence can be achieved in 40% - 80% of patients, and bladder capacity improved by 56% for up to 6 months.

“Maximal benefit is achieved between two and six weeks, maintained over six months. The injections can be repeated when required according to the degree of improvement or relief of symptoms.

“Surgical intervention may be required in severe cases of OAB that are unresponsive to pharmacological therapy. Sacral nerve stimulation (SNS) is a surgical technique that involves implanting a device that delivers electrical impulses to the sacral nerves which regulate bladder function. SNS is associated with risks, including infection, device malformation, and nerve damage, and patients should be fully informed of the benefits and risks before undergoing the procedure.

Current indications for sacral nerve stimulation include refractory urge incontinence, refractory urgency and frequency, and idiopathic urinary retention.”

More radical treatments include augmentation cystoplasty and urinary diversion. Augmentation cystoplasty is an operation to enlarge the bladder and allow it to hold more urine, by attaching a piece of the body’s own tissue (usually from the bowel) to the bladder. Urinary diversion involves rerouting the ureters. This allows the bladder to be bypassed and

the ureters to be routed directly to the outside of the body allowing urine to be collected in an ostomy bag worn on the abdomen. Urinary diversion should be considered only when conservative treatments have failed, and if sacral nerve stimulation and augmentation cystoplasty are not appropriate or unacceptable to the patient.

Emerging Therapies Theresa notes that PDE1 and PDE5 inhibitors have demonstrated improvement in urodynamic parameters, however, PDE 5 inhibitors are not currently approved for OAB. “Percutaneous radiofrequency neurotomy has demonstrated feasibility in patients with neurogenic detrusor overactivity secondary to spinal cord injury, with significant improvement in patient symptoms scores. However, there is currently no evidence that transurethral radiofrequency improves patient reported symptoms of incontinence.

“Support for people with OAB Useful information and support for people in Ireland living with OAB is available at www.oab.ie.

The Continence Foundation of Ireland (CFI) improves the quality of life for people with incontinence and pelvic floor dysfunction, by raising awareness, and providing information and education.”

More information is available at: http://www.continence.ie/

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60

Smoking cessa�on: An Essen�al but Under-U�lised Pillar of Irish Healthcare Smoking Cessation Writen by Dr S Griffiths, Dr D Breen, Department of Respiratory Medicine, Galway University

Smoking cessation: An Essential but Under-Utilised Abstract: Pillar of Irish Smoking Healthcare remains the single leading cause of preventable disease, disability and death worldwide

18% of Irish adults are ac�ve smokers, and recent years have seen an upward trend of young pe developing a nico�ne addic�on, in part due to the rise in popularity of electronic nico�ne delive (ENDS). cessa�on services are an essen�al of tobaccoCurrently control,18% and of play a ke Abstract: Smoking remains the singleSmoking leading cause of preventable disease, disabilitycomponent and death worldwide. mee�ng the goal of a Tobacco-Free Ireland.

Irish adults are active smokers, and recent years have seen an upward trend of young people developing a nicotine addiction, in part due to the rise in popularity of paper electronic nicotine delivery systems (ENDS). and Smoking cessation services areinanIreland, essential In this we will analyse current prevalence trends in smoking habits and disc component of tobacco control, and play a key role in meeting the goal of a Tobacco-Free Ireland. of ENDS in the market, par�cularly the impact on Irish teenagers and poten�al legisla�on to tack In this paper we will analyse current prevalence and in smoking habits in Ireland, and discuss the impact of ENDS in discuss t challenge.

We aim totrends iden�fy successful smoking cessa�on frameworks worldwide and the market, particularly the impact on Irish teenagers and potential legislation to tackle this novel challenge.

We aim to identify both the pa�ent and the health system. A local audit conducted in Galway University Hospital pr successful smoking cessation frameworks worldwide and discuss the benefits to both the patient and the health system. A intoUniversity current Hospital smokingprovides cessa�on prac�se and wesmoking have iden�fied poten�al to improve loc local audit conducted in Galway insight into current cessation practise methods and we have review thesystems.

Na�onalWe Stop Guideline 2022,Smoking in par�cular it’s applica�on to the hospita identified potential methods towill improve local willSmoking review the National Stop Guideline 2022, in particular it’s application to the hospital setting and discuss the need for increased training among all healthcare staff in smoking discuss the need for increased training among all healthcare staff in smoking cessa�on provision cessation provision.

Mee�ng the goal of being tobacco-free by 2025 is dependent on accelera�ng progress with smo Meeting the goal of being tobacco-free 2025 dependent progress with smoking Ireland, in Ireland,byand thisis paper aimson to accelerating iden�fy current challenges to Irishcessation smokinginhabits and iden�fy and this paper aims to identifyapproach current challenges to Irish smoking habits and identify an effective approach to improving our to improving our smoking cessa�on services.

Written by Dr S Griffiths, Dr D Breen, Department of Respiratory Medicine, Galway University Hospital

smoking cessation services.

Introduc�on: Current prevalence and trends in

‘vapes’ is increasingly prevalent,

expansion of this habits: Tobacco use is the leading causesmoking of preventable death, diseasewith anda major disability worldwide.

(1) The market in Ireland over the past The HI survey also reflects WHO Organisa�on (WHO) describes current tobacco usage worldwide a global epidemic. twoas decades.

Overall, 6% of theThe Healt data on long term health effects population reported using ENDS Report 2022 (HI) reports that 18% of the popula�on of Ireland are current smokers.

There has b of tobacco use, reporting that regularly, with the highest use 32% of smokers and 39% of significant shi� in demographics in Ireland with the Central Sta�s�cs reported Office in those publishing under the agedata for th ex-smokers suffer from longof 25 (11%).4 ENDS are highly 2022, showing the largest 12-month increase in thehealth popula�onvariable, of Ireland since 2008, in part acc term illness and chronic without a strict regulatory problems, compared with 27% of framework, andaatmajor presentimpact there on smo 15-year high in immigrant arrivals (2). These demographic shi�s will have never smokers.4 Year on year, the is no definitive research on the HI Survey identifies 25–34-yearprevalence; for example the rapid increase in Ukrainian na�onals to Ireland will ul�mately result long-term impacts of ENDS use, olds as the age group most likely or second-hand exposure.adult As the popula� in overall smoking numbers; it was es�mated in 2022, 27.4% of the Ukrainian to smoke, and thethat proportion popularity of ENDS grows, there is of smokers in this group has (3). concern about their use in younger

experienced a 4-point increase people. The Public Health (Tobacco to 24%, significantly higher than Products and Nicotine Inhaling 4 Current prevalence and trends in habits: thesmoking national average.

Smoking Products) Bill 2023 is currently by ageterm and gender The HI survey also reflects WHOprevalence data on long health effects ofDáil tobacco repor�ng that before Éireann,use, and proposes is illustrated in Figure 1 and of to introduce aproblems, regulatory framework and 39% of ex-smokers suffer from long-term illness and chronic health compared wit note highlights the persistent Introduction: for the retail sale of ENDS, termed have a major impact on smoking high smoking rates within young (4)forYear on year, the HIadults, Survey iden�fies 25–34-year-olds as inhaling the age group These most likely t ‘nicotine products’.

Tobacco use is the leading cause smokers. prevalence; example the rapid particularly males, and the measures focus on reducing access of preventable death, disease increase in Ukrainian nationals smoking prevalencea 4-point increase to 24%, significantly the propor�on of smokers in thisdecrease group inhas experienced to ENDS for children by restricting and disability worldwide.1 The to Ireland will ultimately result in among older adults. sale of these World Health Organisation (WHO) na�onal average.

Smoking prevalence by age and gender isthe illustrated inproducts, Figure 1andand of note an increase in overall(4) smoking plans to prohibit advertisement describes current tobacco usage The use of electronic nicotine numbers; it was estimated that in high smoking young adults, and the decrease worldwide as a global epidemic. persistent ofmales, ENDS around schools and on in smoki delivery systems (ENDS),par�cularly often 2022, 27.4% of the Ukrainianrates adult within 3 The Healthy Ireland Report 2022 among population smoked. referred to as e-cigarettes or public transport. older adults.

(HI) reports that 18% of the population of Ireland are current smokers. There has been a significant shift in demographics in Ireland with the Central Statistics Office publishing data for the year ending 2022, showing the largest 12-month increase in the population of Ireland since 2008, in part accounted for by a 15-year high in immigrant arrivals.2 These demographic shifts will Dr Sally Griffiths

Dr David Breen

Figure 1: Data from the Healthy Ireland Report 2022 on prevalence of smoking by age and gender4

Figure 1: Data from the Healthy Ireland Report 2022 on prevalence of smoking by age and gende PHARMACYNEWSIRELAND.COM

that 29% of smokers are either trying to quit or are ac�vely planning a stop date. (4) However, only 18% of smokers who saw their GP over a 12-month period discussed methods of smoking cessa�on, a decline of 50% compared to data from 2019. (4) The NSSG recommends that all healthcare professionals ask and document an individual’s smoking behaviours, and, inSchools turn advise smokers harms of pilot smoking and benefits The European Project all on ac�ve suspected lungabout cancer.the A recent ward as partthe of the admission Alcohol and other Drugs (ESPAD) bundle, aiming to document analysis highlights the benefit of cessa�on.

Healthcare professionals should discuss the individual treatment needs Ireland 2019 Report5 provides smoking status on admission to overall survival of stopping information about substance use to hospital and encourage smoking any time a patient and preferences, and advise that at making anforunsupported quit atempt is less brief among Irish teenagers attending advice, and, in addition, all with lung cancer.9, 10 effec�ve using recommended supports. This is supported bysmokers WHO data secondary school, than and reported identified were referred smoking that thewhich declinedemonstrates in smoking has that Effective to smoking cessation services brief advice from health professionals can increase cessation framework halted in Irish teenagers for with their consent. These simple by up to 30%, while intensive advice increases the chance the firstqui�ng time in 25success years. This interventions includingofthe There is precedent for the correlated with a higher prevalence introduction of a standardised implementation of smoking qui�ng by 84%.

61

of e-cigarette use among Irish approach to identification of cessation frameworks within teenagers than smoking tobacco, smoking status and an opthealthcare settings, as evidenced The iden�fies askingbyabout smoking and out offering quit with 39% of NSSG 15- to 16-year-olds referraladvice of activeto smokers the success of thebehaviour Ottawa reporting having used ENDS, to smoking cessation services Model for Smoking Cessation as a key element of health behaviour change that should be u�lised by compared with 32% smoking significantly improved practice.

(OMSC) which was first developed tobacco.

There are concerns This project was supported healthcare professionals inin their day-to-day Some�mes referred to as aby the early 1990s. Theprac�ce.

OMSC about the potential role of ENDS encouragement of nursing staff is conversa�ons a validated, evidence-based ‘teachable moment’, these aim to mo�vate individuals to adopt providing new routes into nicotine during the daily safety-pause, and process to embed comprehensive addiction, 68% of adolescents a poster campaign onby the pilot riskwith reducing health behaviours.

5 A’streatments model (figure 2), recommended smokingThe cessation in a 2019 study reporting they had ward. During the pilot programme, and support as an integral aspect the tobacco Centre prior for Disease (CDC) and WHO, summarises the ac�vi�es thatrate a never used to first Control smoking documentation of routine patient care. Since its 6 use of e-cigarettes. increased to 85.7%, and 95% of healthcare provider can do withinthe 3-5OMSC minutes during a consulta�on. Mul�ple Figure 2: Adapted from Centre inception has continued Figure 2: Adapted from Centre for tobacco users were referred to for Disease Control Best Practise to expand.

In 2020 the OMSC had In the adolescent population, studies have shown the benefits of a brief interven�on program, delivered by local smoking cessation services, Disease Best Practise Users UsersControl Guide - Cessation in Tobacco been implemented in over 500 e-cigarettes are rarely cited as a a significant improvement from the Prevention and Control 2014 outpatient, primary significant staff who are appropriately trained,inpatient with a and sta�s�cally difference in smoking cessation technique, with reported pre-intervention results Guide - Cessation in Tobacco care sites across Canada. A only 3% of adolescents reporting smoking cessa�on and con�nued abs�nence.

(14) 2015 study reported that 35% of quitting smoking as the reason HSE National Stop Smoking Prevention and Control 2014 patients who received the OMSC for first using e-cigarettes.6 This Guideline interventions were smoke-free at 6 contrasts with the high ENDS In Ireland, the HSE implemented months, and had a 40% reduction use as a smoking cessation tool the National Stop Smoking in risk of death over 2 years.11 in adults; the HSE National Stop Guideline (NSSG) in 20227 aimed Smoking Guideline reports 38% of In 2017, the OMSC was adapted at improving the identification and can do within 3-5 minutes during people choosing e-cigarettes as a in the Greater Manchester Area treatment of tobacco addiction a consultation. Multiple studies quit smoking aid in 2019.7 in the UK as the CURE project; a across all healthcare settings. have shown the benefits of a brief comprehensive secondary care Tackling tobacco use Healthy Ireland reports that 29% of intervention program, delivered by treatment program for tobacco smokers are either trying to quit or staff who are appropriately trained, Tackling tobacco use has become addiction. The CURE project has are actively planning a stop date.4 with a statistically significant a priority for government policy been shown to be cost-effective, However, only 18% of smokers difference in smoking cessation makers worldwide. In 2008 the with a highly significant return on who saw their GP over a 12-month and continued abstinence.14 WHO implemented the MPOWER investment.12 The CURE project period discussed methods of policy as a worldwide tobacco The British Thoracic Society estimates a 50% reduction in smoking cessation, a decline of control strategy, aiming to assist in readmissions at 30-days (3,273 50% compared to data from 2019.4 (BTS) and the National Institute the country-level implementation for Health and Care Excellence admissions), and a reduction in of effective interventions to reduce The NSSG recommends that (NICE) recommend that all frontline re-admissions at 1 year from the demand for tobacco. all healthcare professionals ask healthcare staff should receive 38.4% to 26.7%. This project is training to identify smoking status estimated to save 30,880 bed days and document an individual’s In 2004, Ireland became the first smoking behaviours, and, in turn and to offer very brief advice, as per year in the Greater Manchester country to pass a smoke-free advise all active smokers about well as the local referral process Area. Furthermore, it has been law8, and furthermore in 2021 the harms of smoking and the for behavioural support.15,16 proven to deliver high-quality care was recognised by the WHO as a benefits of cessation. Healthcare for patients by providing access to global leader in tobacco control.

Additional options for behavioural professionals should discuss highly effective interventions and The Department of Health has set support include individual or the individual treatment needs providing individualised smoking the goal of being tobacco-free group counselling, telephone or 13 and preferences, and advise cessation treatment. The success by 2025, defined as a smoking text-message support. Currently, that making an unsupported quit of the CURE project has led to a prevalence of less than or equal behavioural support is available attempt is less effective than using commitment from the NHS that to 5%. However, as the HI Survey through specialist smoking recommended supports.

This is by 2023/24 all active smokers shows, ongoing improvements cessation officers, both in hospital supported by WHO data which admitted to hospital will be offered in smoking cessation policy and and community-based facilities, demonstrates that brief advice NHS-funded tobacco treatment practise are required to maintain who can also provide prescription from health professionals can services, based on the successful progress towards this goal. for NRT if required. Novel methods increase quitting success by up and favourable results from the of delivering counselling for to 30%, while intensive advice As demonstrated in the HI OMSC and CURE models. smoking cessation have been increases the chance of quitting Survey 2022, a large proportion developed including the digital Local data by 84%. of smokers suffer from chronic counselling service ‘Florence’, an illness (4) which in turn often In Galway University Hospital we The NSSG identifies asking about artificial intelligence bot developed results in hospital admissions and conducted a review of current smoking behaviour and offering by the WHO. Florence is a 24/7 prolonged inpatient stays. This smoking prevalence and smoking advice to quit as a key element virtual health worker, capable of was demonstrated in a 2016 study cessation services. An initial of health behaviour change that providing brief conversations by which attributed 309,117 bedchart review revealed that 19.7% should be utilised by healthcare voice or text, and can signpost days to smoking related illnesses. of audited patients were active professionals in their day-to-day patients to other digital cessation The HSE recommends that each smokers; overall in line with the practice. Sometimes referred to programmes in their country, and patient encounter in the hospital national data. However, initially, as a ‘teachable moment’, these can found at https://www.who. setting is used as a valuable only 64.4% of patients had conversations aim to motivate int/campaigns/Florence. This opportunity for a brief intervention smoking status documented, and individuals to adopt risk reducing technology was developed in 2021, to discuss smoking cessation. only 13% received brief advice, health behaviours. The 5 A’s primarily aimed at overcoming the with the same percentage referred model (figure 2), recommended barriers arising from the COVID-19 In our service, this is particularly to smoking cessation services. A by the Centre for Disease Control pandemic such as easy access to applicable in the Rapid Access standardised smoking cessation (CDC) and WHO, summarises the smoking cessation services. The Lung Clinic, a service for diagnosis and treatment of patients with proforma was implemented on a HSE has also developed a digital activities that a healthcare provider

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Cessation 62 3:Smoking Figure Stop Smoking medications recommended by the HSE National Clinical Guideline Figure 3: Stop Smoking medications recommended by the HSE National Clinical Guideline

cessation service, and offers a 28-day plan including personalised daily support via email and text message through the QUIT.ie website, with a personalised web page to track progress.

For patients who wish to use pharmacological therapy in combination with behavioural supports, the NSSG recommends that combination NRT treatment or NRT monotherapy should be prescribed. NRT is available in multiple forms and prescription can be tailored to the patient’s preference (figure 3). A recent Cochrane review confirmed

the effectiveness of NRT in smoking cessation.17 Conclusion The development of an effective smoking cessation framework in the hospital setting has been proven by the Ottawa Model (Canada) and the CURE project (UK) to be a cost-effective intervention, which benefits patients at any stage of a disease course, and in addition can equal the benefit of costly pharmacological or surgical interventions. Recent data indicates a slowdown in the

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momentum towards the target of a tobacco-free Ireland by 2025.

Meeting this goal is dependent on accelerating progress with smoking cessation programs across all healthcare settings.

Additional challenges are also appearing, for example, the smoking habits of Irish people are evolving with the increasing popularity of e-cigarettes and this will require the adaptation of current smoking cessation practise and legislation to tackle these changes particularly amongst younger people.

Providing standardised clinical care to patients in healthcare is

challenging, due to the diversity in environments of care and patient presentations. However, there is an opportunity during all patient encounters to provide a brief intervention and in turn direct patients to appropriate smoking cessation treatments.

Improvements in smoking cessation services in Ireland are dependent on adequate access to behavioural and pharmacological supports for all patients, irrespective of chronic illness or socioeconomic status.

At present, we risk reversing the gains which have been made to date in Ireland towards the goal of a tobacco-free nation. The impact of the COVID-19 pandemic, novel nicotine delivery systems, and the rise of tobacco addiction among young people cannot be underestimated, and additional funding and training of healthcare professionals is required for smoking cessation services to maintain momentum in tackling tobacco addiction in Ireland.

References available on request

News

63

Calls for National Osteoporosis Programme An international research team has revealed that between 300,000 and 500,000 men and women in Ireland are living with osteoporosis.

The findings were released by University of Galway to coincide with World Osteoporosis Day held recently on Friday October 20th.

Although the burden of illness related to osteoporosis - morbidity, mortality and economic costs - is similar to cardiovascular disease and cancer, the importance of osteoporosis is often not understood, and therefore care is neglected.

Researchers from the schools of Engineering, Computer Science and Medicine at the University of Galway carried out their analysis in collaboration with Tsinghua University in China, Oxford University in England, and Galway, Manorhamilton and Sligo University Hospitals.

The research used data from the health service in Ireland spanning 20 years to reveal: • More than 50,000 osteoporotic fractures occur each year in Ireland.

• 1 in 3 men and 1 in 5 women die within 1 year following a hip fracture.

• The number of osteoporosisrelated deaths in Ireland is similar to, or greater than, the number of deaths related to Covid-19.

• Fewer than one fifth of people admitted to public hospitals with an osteoporotic fracture are discharged with a diagnosis of, or treatment for, osteoporosis.

• More than 1 million people in Ireland have low bone mineral density putting them at greater risk of fracture.

• Although men have a lower risk of fracture, they account for almost 1 in 3 public hospital admissions for osteoporotic fractures in Ireland.

Professor John Carey is Professor in Medicine at University of Galway and Consultant Physician in Medicine and Rheumatology

• Less than 50% of older people who suffer an osteoporotic hip fracture will return to their baseline level of function.

• Fractures are one of the leading causes of long-term admissions to nursing homes.

The research team noted that public hospital bed days for fragility fractures among adults aged over 50 have risen almost 50% since 2008 and are at a higher level than those for ischemic heart disease, solid cancers, or diabetes mellitus - conditions where national programmes exist.

Clinicians, computer scientists and engineers at University of Galway are using Dual-energy X-ray Absorptiometry (DXA) technology to measure bone density and develop new screening and testing strategies for early identification of osteoporosis.

Funded by the Health Research Board, the Dual-energy X-ray Absorptiometry Management Application Project (DXA MAP) uses state of the art machines to develop a personalised, patientcentred tool for osteoporosis screening and fracture prediction.

The international research team said novel osteoporosis-screening could reduce the number of unnecessary requests for a DXA test and increase referrals for those in need.

Early data suggests the financial cost of poor quality DXA scans in Ireland may be greater than the cost of providing high quality DXA which adheres to national and international standards, in particular avoiding testing and treating those at low risk and improving diagnosis and management of those with prior fractures.

Professor Carey is Professor in Medicine at University of Galway and Consultant Physician in Medicine and Rheumatology and Clinical lead in DXA, Osteoporosis and Fracture Liaison Services, Galway University Hospitals.

“The key to prevention is the early detection of those most at risk.

But what we require is a better use of current resources to benefit those at greatest risk, preventing more fractures, and eventually lead to substantial cost savings,” Professor Carey said.

“DXA is the clinical test used to diagnose osteoporosis before a fracture occurs, as well as to estimate fracture risk and to monitor the effects of treatment.

Access to quality DXA is a global problem, and Ireland is no different.

“Although Ireland has one of the highest rates of osteoporotic fracture and will have the one

of the greatest increases in cost and incidence over the coming decade, it does not have a national programme or consider osteoporosis a national priority.

It is very clear to those of us who lead treatment and research of the disease that we should. A national programme could greatly focus efforts to enhance current care and further improvements can be made without additional funding.”

The research team validated the Osteoporosis Self-assessment Tool Index (OSTi) - one of the oldest and simplest methods for the identification of those at risk of osteoporosis - for the Irish population. They then compared it with new modelling, using artificial intelligence, which outperformed OSTi.

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patient home takes a lot of work in the background, whether it is the validation of our vans, providing patient counselling on the appropriate use of medicines or problem solving so that we help our patients with fridge emergencies. Our patients are scattered all around the country, which can provide logistical challenges at times. I will always remember the big storm of 2018 when our drivers left Dublin early morning for some very long days in dreadful snow, just on the cusp of the red weather alerts to get all of the medicines to all of our patients on time. That was a proud day, and I felt our drivers were phenomenal.

f People and Excellence

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Representing the communities we live in through our CSR initiatives.

So what is changing at LloydsPharmacy?

Pillar 1

dynamic Hillary Collins, People and Culture Director at PHX Ireland

understand and embrace our differences,” she adds.

Some examples of the Diversity and Inclusion Initiatives include:

Hillary explained how she is creating a workplace where all staff feel comfortable to be their authentic selves all year round.

“We already have a culturally diverse workforce with many of our employees coming from international markets and its key we help our employees

• Pride Campaign June: education-based initiatives with guests speakers like Nigel Owens • Female Centric Mentoring to support our female teammates grow in confidence and role • Partnership with Trinity Centre for People with Intellectual difficulties seeking to offer student work placements and internships

Diversity and Inclusion Hillary Collins

Many of our pharmacy patients are lifelong, and although we don’t see them face to face, we build up a rapport with them over the phone, so that we feel we have known them forever. It means a lot when we hear good reports back from patients. It is not uncommon for our patients to tell us their positive news stories. It’s heartening to hear from a patient who let us know that she can’t live without her treatment and that is has been life changing for her.

At Christmas time the pharmacy is swamped with thank you messages, cards, and boxes of chocolate and biscuits.

Female Centric Mentorship Program

PEOPLE LEADER

Never Looking Back

Sometimes standing in the fridge checking TPN for a patient seems so ordinary and mundane, when you receive a thank you card of that nature, it brings it all home – how much we support our patients, and how the little things are actually big things.

A Career with Baxter Working in homecare pharmacy with Baxter Healthcare offers a unique opportunity for pharmacists to provide vital services to patients requiring aseptically compounded parenteral therapies in the comfort of their own homes. As a registered pharmacy with the Pharmaceutical Society of Ireland, Baxter Pharmacy adheres to the same regulatory requirements as a standard community pharmacy. However, it exists within the infrastructure of a pharmaceutical industry environment and is situated onsite in Baxter Healthcare Ltd, the global multinational healthcare company.

Homecare Pharmacies providing Outpatient Antimicrobial Services (OPAT) enable patients who would have required hospital care to receive care at their home. Nurses either administer the antimicrobial to the patient for the full course of treatment or train the patient to administer it to themselves. This facilitates admission avoidance, frees up resources within hospitals through reduced bed use and increases patient satisfaction as they can recover in the comfort of their home.

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Every day is different in my role.

I have been working as the One of the days that stands out Superintendent Pharmacist in TCP for me over the years include the for 10 years now, and the role is day we got a thank you card from as interesting and rewarding now, the family of a patient my own age Overall, What sets our homecare as it was when I started. I have who had passed away tragically vital serv pharmacy apart from community never looked back in my career before his time from cancer – how within th is; (i) that we are dispensing choice. The key thing that has our service had allowed him to environm to patients at a distance and kept me motivated throughout spend his final months at home pharmac (ii) the types of medications this time, is that patient care and with his family children and closeand communica�on with both internal departments andfulfilling extern quality of service is at the heart ofin constant that are dispensed, which are avoid hospital – how much that for pharm what we do. primarily aseptically compounded include communica�on been carried email. Internal departments Cu time meant to his family and out viaintravenous of oppor (IV) therapies. Some We are no “normal” pharmacy, and dev how grateful they were for that.

Compounding, Pharmacovigilance, Quality Dispatch teams. External stak of theseand medications include, in that some of the drugs we IV antimicrobials, subcutaneous nursing providers and hospital mul�disciplinary teams. dispense are only available Every day is different in my role.

(SC) iron chelator products, SC One of the day through ourselves and nowhere methotrexate, and parenteral me over theas; years include the day we got a tha Pharmacists are trained in quality areas such document else! We specialise in moving nutrition products.

Prescriptions family of a pa�ent my own age who had passed patients out from the hospital review, control and access, correc�ve and preventa�ve ac�ons are received via healthmail or post setting to the community, the his �me from cancer – how our service had allo and(NCRs). medications are dispensed (CAPAs) and nonconformance reviews Pharmacists can medicines we supply include final months at home with his family and childr and delivered directly to patients’ orphan drugs, IV therapies, then use this to training, as well as their own clinical how much that �me meant to his family and ho homes, without patients ever haemophilia blood clotting knowledge, to con�nuously improvefor on processes andstanding presenting themselves to the in the fridge chec that.

Some�mes factors, and immunotherapies. pharmacy inprojects person.

These medicines are generally so ordinary andwith mundane, when you rec procedures, as well as engaging on seems important

not available in the patient’s local role of a pharmacist that nature, it brings it at allBaxter home – how much commercial and marke�ng teams. ofThe community pharmacy and may

involves and completing morethings are actually b pa�ents, how thealitle James possesses exceptional ability to understand the experiences ofofhis patie not even bean available in hospital in comprehensive review The atrac�ve career path of homecare pharmacy clinical with Baxter some cases. prescriptions than community. health conditions. He is a true team player who treats everyone with respect.

Durin Healthcare gives pharmacists an insight into all the services Prescription referrals provide us I’m lucky to work with an Superint significantly more information delivery of medicines, initially carrying them himself and with later implementing a struc amazing team of pharmacists, and roles involved in both a homecare pharmacy service as on the patient’s medical history drivers, warehouse, pharmacy well as a compounding company. It gives the opportunity delivery. whichthem enables a more holistic care technicians, quality, and customer service. Delivering specialised cold chain medicines to the

Maeve Magner, Owen Bo of of thethe patient with their service transitionas well to develop skills both clinically as part HomeCare as in Superintendent Pharmacist TCP Supervis from hospital to community care.

Pharmaceu�cal Company.

The role of a pharmacist has evolved significantly in recent years, demanding spec A Career withon Baxter Overall, the focus providing vital servicesskill, to pa�ents in need within qualities, including humility, character, empathy, knowledge, accuracy, andthepap environment makes homecare with Baxter offers Healthcare a fulfilling Working in homecare pharmacy with Baxter a PHARMACYN unique opportunit standards. His professionalism, innovative spirit, andpharmacy ability toHealthcare communicate with ca provide vital serviceswith to pa�ents asep�cally the pharmacists in Ireland lots ofrequiring opportuni�es forcompounded progressionparenteral and develop approachable, jargon-free manner have notably thewith store's atmosphere. of their own homes. Asenhanced a registered pharmacy the Pharmaceu�cal Society of

Pharmacy adheres to the same regulatory requirements as a standard community

Superintendent/S

exists within the infrastructure of a pharmaceu�cal industry environment and is si James has played a pivotal role in the local Covid-19 Vaccination programme, spe Healthcare Ltd, the global mul�na�onal healthcare company. into ensuring the service's accessibility thro the store. He invested significant effort Homecare Pharmacies providing Outpa�ent An�microbial Services (OPAT) enable dedication has extended to various have other services educational initiatives.

Work required hospital careand to receive care at their home.

Nurses either administe the pa�entand for the Fertility full course of treatment or train the pa�ent to administer it to t focused onloveessential topics customers calling in to the shop and meetinglike Norma. Diabetes Her talent in organizing the dispensary to make to it easyequip them with the knowl admission frees up resources within hospitals through reduc access for all staff and pharmacists is outstanding. She is there tofacilitates make sure we have all theavoidance, correct high-tech customers. sa�sfac�on as section they can medication in stock to ensure our customers receive them on timeincreases each month.pa�ent She orders our veterinary to recover in the comfort of their home.

ensure that all stock is rotated regularly. Her relationship with the surgeries is great as she has daily contact with them What sets our homecare pharmacy apart from community is; (i) that we are dispe

to ensure that any changes are updated on our patient medication records. Our shop is supported by Norma every day Jameswhere isheran invaluable McCauley, his and most his patia distance andand (ii) the store, offace medica�ons that areimportantly, dispensed, which are primarily knowledge on the products isasset amazing, sheto reassures our customers offers atypes friendly to make our

feel at ease. compounded intravenous (IV) therapies. Some of these medica�ons include, IV an Norma coordinates our community blister every week and set up asubcutaneous system to ensure(SC) that all staffchelator know what week we SC methotrexate, and parenteral nutri� iron products, are working on, and which customers are due for the blisters eachPrescrip�ons week, this system the risk via of blisters being or post and medica�ons are dispensed an arestops received healthmail forgotten and makes sure the relevant paperwork is up to date and signed. She helps in the training of new staff and pa�ents' homes, ever presen�ng themselves to the pharmacy in summer staff by helping them understand how the shop runs, where paperwork is kept without and wherepa�ents to put orders away,

she has a friendly manner to help all new staff feel welcome and confident their new roles. at Baxter involves comple�ng a more comprehensive clin The roleinof a pharmacist

prescrip�ons than community. Prescrip�on referrals provide us with significantly m the pa�ent's medical history which enables a more holis�c care of the pa�ent with hospital to community care.

Counselling is completed with pa�ents remotely via phone and any adverse events resolved quickly by working and repor�ng of any issues with internal or external te

INTERNAL USE ONLY

INTERNAL USE ONLY

64 | PHARMACYNEWSIRELAND.COM

PHARMACYNEWSIRELAND.COM | 65

66

Dynamic 100 Rana Al Damin, Chief II Pharmacist, HSE & Pharmacist Store Manager, HSE Rana is an experienced Pharmacist Store Manager, with a track record within the retail industry. With a BSc focused in Pharmacy and Medical Technology from Al-Patra University, and a degree in Regulatory Affairs in (Bio) and Pharmaceuticals from University of Limberneck her skill set spans the domains of Business Planning, Coaching, Sales, Sales Management, and General Management.

In the face of the COVID-19 pandemic, Rana has demonstrated exceptional dedication through her involvement in the HSE COVID-19 Vaccination Centres, receving the “Challenge Coin” from Chief of Staff of Ireland Defence Forces Mark Mellett.

Rana has been a Peer Support Pharmacist with the Irish Institute of Pharmacy since 2016 and has played a pivotal role in supporting the Continuing Professional Development (CPD) needs of the profession. Her contributions include delivering online webinars and information events for newly registered pharmacists and those selected for ePortfolio Review as well as contributing to the delivery of the IIOP Roadshow for the Core Competency Framework.

Sara-Jane Allen, Director of Operations, McCauley Pharmacy Sara-Jane was promoted to the Retail Operations Director role with McCauley in 2022. She is a passionate, respectful leader with a deep understanding of the community pharmacy sector in Ireland having worked in community pharmacy management for over 15 years. Sara-Jane is really proud of all the McCauley team and their achievements this year. In March, McCauley’s Pharmacy in Mahon Point were shortlisted in the 2023 Retail Excellence Top 100 Stores Award. McCauley is also a proud partner to Guaranteed Irish - the first pharmacy to do so - a label awarded to businesses that create quality jobs, contribute to local communities and are committed to Irish provenance in the products that they stock. McCauley recently announced its partnership with Just A Minute (JAM) Card to support inclusion and accessibility within communities around Ireland.

Dave Barrett, Country Manager, Haleon Recently, Haleon partnered with Tesco to donate much needed funds to local charity Children’s Health Foundation Ireland. Children’s Health Foundation raises vital funds to support sick children and their families in Children’s Health Ireland hospitals and urgent care centres in Crumlin, Temple Street, Tallaght and Connolly.

He said, “It is vital we continue to shine a light on the invaluable work that charities like The Children’s Health Foundation do. Haleon is passionate about positively impacting the people living in the communities we actively operate in, and we look forward to collaborating on similar campaigns in the future.”

Dave Barrett headed up the formation of new company, Haleon, following the demerger of Consumer Healthcare from GSK. Dave leads a team delivering world-leading brands and is a champion of the emergence and growth of the Self-Care OTC market.

Ireland’s leading healthcare provider. www.udw.ie

United, we do better

67 Dr Harriet Bennett-Lenane, Lecturer in Clinical Pharmaceuticals, University College Cork Harriet’s dedication to the field is not limited to the classroom or the research lab. Notably, she continues to serve as a locum community pharmacist. This hands-on role in the community allows her to maintain and enhance her clinical skills and knowledge. This direct patient contact also informs and enriches her research by offering a firsthand understanding of the challenges and nuances of community pharmacy.

At UCC, Harriet has made significant contributions as an educator in Clinical Pharmaceutics. By integrating real-world scenarios and current research into her teachings, she prepares her students for practical challenges in the field. Beyond UCC, Harriet’s involvement with the Future University in Egypt’s summer school on Advanced Topics in Pharmacy Summer School showcases her commitment to international educational collaboration.

The evolving landscape of pharmacy is significantly influenced by technology. Harriet’s work in leveraging artificial intelligence (AI) in drug formulation is both pertinent and forward-thinking. Her research project, “Applying Artificial Intelligence Tools in Drug Formulation Development: A Machine Learning Approach for Novel Formulation Design,” hints at the transformative potential of technology in the realm of pharmacy.

Furthermore, Harriet’s collaboration with the National Council for the Blind in Ireland emphasizes her dedication to ensuring accessibility in healthcare. Through this initiative, she seeks to identify and address the challenges faced by visually impaired individuals in accessing pharmacy services.

Ciara Berry, Supervising Pharmacist LloydsPharmacy Glasnevin Ciara is a dedicated and loyal Pharmacist, working in LloydsPharmacy for +10 years. She is their Hello Health Champion and is continuously looking at ways to help her patients proactively manage their health. She is a great advocate for making positive lifestyle changes to improve and protect your health- from smoking cessation, daily exercise and healthy diet as is acutely aware of the high rates of cardiovascular disease, diabetes and obesity levels in Ireland today. Ciara recently attended our Summer health summit and presented the many benefits of a proactive health approach to enhance patient care and make positive impacts to patients lives. Store colleagues were highly engaged with her messaging and as a team we are focusing efforts on communicating this proactive health message to customers via our Marketing communications under the tagline “Make your health matter”. All the marketing messages now carry this theme as the LloydsPharmacy team want to remind and challenge the public about how they can take positive action to make their health matter.

Stephen Bradley, Managing Supervising Pharmacist, Meaghers Pharmacy Baggot Street, Dublin Stephen Bradley has been at the heart of the Meaghers Pharmacy on Baggot Street, Dublin and nearby surrounding area for a number of years providing attention, time and most importantly clinical expertise to all those who come into the pharmacy. He was a finalist for the 2023 People’s Pharmacist Award.

One nominee says of him, “Stephen has a wealth of experience in all aspects of pharmacy from general pharmacy management, clinical knowhow, and is a keen advocate of services including many ran by the Meaghers Pharmacy Group, such as 24 blood pressure monitoring, flu, pneumonia, shingles and COVID vaccinations, and compounding extemporaneous products.

“He makes a point going above and beyond for those who ask to speak with him, finding solutions whether that be immediate or not. Not only that but he inspires all staff within the pharmacy to show a similar interest in serving the community.

“Stephen goes the extra mile when he’s on site, always with a positive attitude. Recently there have been two cases of anaphylaxis within a small number of weeks apart in his workplace. Both these were expertly dealt with. Stephen delivered emergency medicine in both cases and ensured safe transfer to urgent care with the help of emergency services.

“Having been lucky enough to work alongside Stephen for more than two years both as a student and support pharmacist, I find it appropriate that he’s shown the appreciation he deserves for incredible dedication to the community. I think a people’s pharmacist should not only look after patients or customers, but also his staff and truthfully Stephen is an example of this.”

Working collaboratively with manufacturers, customers, patients and colleagues.

United, we do better

01 463 2300

68

Dynamic 100

Rachel Brazier, Pharmacy Counter Assistant, Bantry Pharmacy PCC Rachel joined the Bantry Phharmacy team in 2022 and it became apparent immediately that her background in hospitality would make her a hit with the public. Keen to increase sales from the previous year, she has actively embraced new brands and products which has given customers a wider variety of products and has subsequently generated new custom. With a keen flair for social media, she has taken to this platform to advertise these new products and in doing so, has reached out to a younger clientele in the process. She is currently in the process of expanding our Instagram page (in it’s infancy) to accompany the already well established Facebook page. In addition to highlighting new products on the social media channels, Rachel highlights various health awareness days to the public and encourages the public to attend the pharmacy for free health checks (blood pressure/pulse/healthy eating advice etc.). Having completed her counter assistant course with flying colours, she has embraced her new role as a counter assistant with positivity. Her new found skills and knowledge have greatly helped with the day to day running of the pharmacy and in addition have equipped her with the confidence to help out in the dispensary when the need arises.

Deirdre Butler, Pharmacist & Owner, Higgins Pharmacy Deirdre and her team at Higgins Pharmacy, Sligo won the 2023 United Drug Business Development (Independent) Award.

The initial key challenge for Higgins Pharmacy was to define their own identity and objectives in order to become known to the Sligo people as kind and trusted professionals, like the Higgins family, who had started the business.

The team had a goal to maintain and then grow the business, whilst facing another challenge of having never run a business without support. One of the most important issues for the owners was to ensure a great team, which they feel is core to running a successful pharmacy business.

All of the business initiatives which they have started have all impacted greatly on the business and the community they serve.

Nuala Carey, Pharmacist & Owner, Glengarriff Pharmacy and Beauty Lounge, Glengarriff To develop the probiotic supplement category both in-store and online over the last 12 months, Glengarriff Pharmacy has employed several strategies such as promotions, information, education, and discounts.

To begin with, Glengarriff Pharmacy provided information and education on the benefits of probiotic supplements through various channels. By providing valuable information on the benefits of probiotic supplements, they have positioned themselves as a trusted source of information and have attracted customers who are interested in improving their health. Additionally, Glengarriff Pharmacy ran promotional campaigns that offered discounts or bundle deals on probiotic supplements and offer educational resources, such as brochures and blog posts, in-store and online to help customers understand the different types of probiotic supplements available and which ones may be best suited for their needs.

Nuala’s innovation and forward thinking led to a shortlisting at the Irish Pharmacy Awards 2023 for the Uniphar Category Development Award.

Getting the right product to the right patient at the right time. www.udw.ie

United, we do better

69 Nick Carpenter, Operations Manager, McCabes Pharmacy Group Nick ensures any operational enhancement will always deliver a benefit to the customer. Nick has demonstrated this by delivering a fully functioning IVR system throughout the McCabes Pharmacy stores. This provides insights into why customers are calling and allows the company to understand customers’ needs and be more responsive.

With this one change, the company has improved Customer Service, streamlined operations, increase efficiency and tailor McCabes marketing messages.

Nick uses Lean methodology which we have seen in new systems and processes that he has introduced. Nick has led many operational changes, working with third party partners, instore teams, on stock and team protection.

Nick approaches challenges with a logical perspective and possesses excellent foresight in problem-solving strategies. His ability to remain calm, think analytically and problem solve to deliver a solution is exceptional and a real strength in our fast-paced sector.

2023 is Nick’s first full year with McCabes Pharmacy and his impact and influence on the wider team has been exceptional.

John Carroll, Owner/Founder/Ceo, Navi Group John Carroll, a pharmacist by trade, is the owner, founder and CEO of Navi Group. From humble beginnings in 2009 with the creation of Axium Buying Group, John has led the Navi Group to consistently bringing new and innovative products, services, and IT solutions to the pharmacy market. John has built a Support Team of over 70 people who are all focused on the same vision of making pharmacy life easier and more efficient for our continuously growing group of over 500 business partners. Navi Group is now Ireland’s largest and most influential IT solutions provider and retailer of pharmaceutical products in the community pharmacy sector in Ireland.

Niamh Colleran, Supervising Pharmacist, Colleran’s Life Pharmacy Niamh was this year voted as The People’s Pharmacist 2023. This nominee told Irish Pharmacy News, “We have been served by this wonderful pharmacy since moving to the area. They have always gone above and beyond their duties but in the last few moths while I’ve receiving chemotherapy they have been remarkable.

“I can’t say enough about how supportive, friendly and professional they are. Niamh and her pharmacy team have really helped to make an unpleasant and difficult situation so much easier to get through.

f People and Excellence “Our daughter fought cancer for 5 years sadly passing after Christmas. She and my son had the same care

and support. They will drop prescriptions to the house when needed, offer advice, call the hospital pharmacy

eing regarding introduced byon Hillary Collins, prescriptions my behalf and so much more; Nothing is too much trouble.

“This extendsencompassing right down to the entire team, the experts at makeup advice who have spent considerable time HX Ireland: with me testing pencils powders and so on to replace now, non-existent eyebrows, thanks to my complete hair d TCP. loss from chemotherapy. Niamh truly deserves this honour.”

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Hillary Collins, People & Culture Director, PHX Ireland This year, Hillary introduced the new “Our people” strategy for PHX Ireland. Hillary’s goal is to ensure the workplace culture is one where “our people” can truly do their best work, be their true self and feel supported, valued, and listened to every day.

.

Hillary re-joined the business late 2022 having worked there for 6 years earlier from 2011 – 2017.

She previously spent 6 years at United Drug citing them as being “most formative years in career”, as well as the vast international experience gained from working for her previous company, in outsourced healthcare solutions and express logistics, as CHRO supporting 6,000 employees across 12 different countries, and 8 different languages.

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Delivering over 18,000 totes per day to Hillary Collins, People and Culture our valued customers.

Director at PHX Ireland

Representing the communities we live in through our CSR initiatives.

So what is changing at LloydsPharmacy?

United, we do better understand and embrace our

Pillar 1

differences,” she adds.

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Dynamic 100 Colette Commons, Community Pharmacy Technician, Ballisodare Pharmacy Colette was shortlisted as a finalist for the TouchStore Community Pharmacy Technician of the Year Award in 2023. Colette has a keen eye for detail and is meticulous in her work.

Colette led the implementation of new contracts, forming strong relationships with all the healthcare professionals involved in these services. Colette took ownership of the pharmacy input to ensure it runs smoothly. Colette is also the expert in Pharmacy claims and reclaims assisting other stores and transferring good practice across the group. Colette has also made changes in the way the team prepare paperwork to ensure full compliance and a complete audit trail.

Colette shows her commitment by staying up to date with the latest updates and changes to the profession. She is proactive in seeking out training to enhance her knowledge and skills.

This benefits the pharmacy team to ensure they can take advantage of the recent updates to their dispensing software.

Tom Concannon, Superintendent Pharmacist, Uniphar In 2023, Tom won the Perrigo Superintendent Pharmacist of the Year Award.

Tom is the Superintendent Pharmacist for the Uniphar owned pharmacies within the Allcare, Hickey’s and most recently the McCauley group. He is passionate about delivering high quality and safe pharmacy services across the network.

Tom has overseen a large project to standardise processes across what is the largest network of owned stores. He is particularly interested in the role technology can plan in enhancing safety and improving both the patient and pharmacist experience.

Tom is an IPU committee member and works on a number of steering and working groups within the union. He is passionate about supporting the next generation of pharmacists through their Teacher Practitioners and by organising an annual OSCE preparation day for all Pharmacy Interns.

Tom is a strong advocate for the scope of services Pharmacists can offer and has led numerous health campaigns including most recently a school vaccination programme.

James Coughlan, Pharmacist, Hickey’s Pharmacy, Johnstown James is the Supervising Pharmacist in Hickey’s Pharmacy, Johnstown and has been actively involved in the promotion and provision of vaccination services in the pharmacy including flu, covid, pneumococcal, shingles as well as travel vaccines and vaccinated 1,000 patients last year. He has helped to promote and facilitate numerous other pharmacy services such as. blood pressure screening, diabetic screening, inhaler technique assessment as well as the new medication service. He also helped train and motivate staff to provide these pharmacy services, ensuring they were carried out successfully to their patients.

James also strives to deliver exceptional customer service and sees this as an ongoing priority whilst also growing the pharmacy business.

Access wide range of products 24/7. www.udw.ie

United, we do better

71 Audrey Cunningham, Operations Co-ordinator, Irish Institute of Pharmacy Audrey Cunningham works as a CPD Operations Coordinator in the Irish Institute of Pharmacy. She has a background as a pharmacy technician in community pharmacy, and has also worked in other healthcare settings. Audrey’s dedication and expertise are evident in her participation in various IIOP projects and agendas, where she consistently demonstrates her understanding of, and commitment to the pharmacy profession. In particular, Audrey oversees the IIOP support inbox, where she offers guidance and assistance to pharmacists across a broad range of topics. She reliably provides comprehensive responses in a timely manner, ensuring pharmacists receive the support that they need. Audrey also plays an important role in the organisation of a wide array of IIOP workshops and other events for pharmacists, both in-person and virtual, helping to ensure their successful delivery.

Edel Cullen, Pharmacy Assistant, Lannon Late Night Pharmacy, Sligo In 2023, Edel won the Thea Pharma Counter Assistant of the Year Award. Edel has been a part of the Lannons Pharmacy Team for 12 years. As their skincare expert Edel has taken on the organisation and promotion of events within all our stores. Edel would identify brands to promote and organise events, coordinate with suppliers, set up displays and stands and advertise in store and on all social media channels.

Edel also liaises with suppliers to identify new products that may do well and introduces them into the group as a trial. The pharmacies recently joined Allcare as a franchisee and Edel led the implementation of the changes to the front of shop for ordering, promotions, POS and planograms. She has trained the teams in others stores and assisted with their roll outs transferring good practice across the group.

Professor Annie Curtis, School of Pharmacy, Royal College of Surgeons in Ireland Due to funding awarded to Professor Curtis by the Science Foundation Ireland Career Development Award (CDA) programme and by the Irish Research Council through a Laureate Award, a new study is heralding great success.

Researchers led by professor Curtis at RCSI University of Medicine and Health Sciences have discovered how disruption of the circadian clock can lead to increased inflammation in the lungs, which may have negative effects on chronic lung diseases and respiratory infections.

The paper looked at the molecular clock in fibroblasts, a cell type which is abundant in the lung. When the regular rhythm of the fibroblast clock was lost, it resulted in an increased inflammatory response and therefore, worse symptoms.

This could have implications for individuals such as shift workers or people with erratic sleeping/eating patterns in that they are more likely to experience more severe respiratory infections.

Eoin Deasy, Superintendent Pharmacist, Bantry Pharmacy PCC Eoin uses his wealth of knowledge and experience to deliver the highest quality of care to his patients.

No matter how busy the environment, Eoin will always take the time to see the patient story behind each prescription, never failing to take time to offer a word of reassurance or advice to those in need of it. Regular patients will always go to Eoin first with any healthcare query they may have, as they trust his knowledge and expertise. His ability to work efficiently and accurately whilst under pressure yet still making the patient his primary concern is unparalleled. Brimming with practical ideas and relevant information, he will always endeavour to come up with a reasonable and speedy solution no matter what situation arises. An encouraging mentor and tutor, he will regularly give up his time to go through coursework and offer insight and advice, consequently ensuring staff are well trained and confident in their roles.

Delivering to every corner of Ireland.

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Michelle Dempsey, Pharmacist, Ballisodare Pharmacy, Sligo Michelle has been described as someone who continually impresses with her dedication, skills and expertise as a pharmacist. She has always demonstrated a commitment to patient care that goes above and beyond what is expected. Michelle is always willing to go the extra mile to ensure patients receive the medication they need often calling in on her way home with medication if they haven’t been able to attend the Pharmacy.

Michelle is also committed to professional development often discussing recent courses she has completed and highlighting the learning points to the rest of her pharmacy team.

Chris Doherty, Managing Supervising Pharmacist, McCauleys Pharmacy Group Chris, holding the roles of Supervising Pharmacist and Store Manager at McCauley Pharmacy in Greystones, Co. Wicklow, is deeply ingrained in the local community. Beyond his responsibilities as a pharmacist, he passionately supports local charities and healthcare providers. Evident in events such as “Women’s Night” conducted within the store every December, Chris displays a resolute commitment to giving back to the community and championing important causes.

His efforts extend to providing informative sessions for the Greystones Retirement Group, wherein he educates members about the pharmacist’s pivotal role in safeguarding their health and wellbeing, as well as potential complications stemming from polypharmacy.

By enlightening the local retirement group about these concerns and the support that pharmacists can offer, Chris contributes to better health outcomes and an improved quality of life for its members. Furthermore, Chris’s proactive involvement with local prescribers and ensuring the adequacy of resources and supplies for their clinics is invaluable.

Laura Downey, Category Manager, Navi Group Laura is the Category Manager with Navi Group and in 2023, the team she leads won the Uniphar Category Development Award at the Irish Pharmacy Awards for their innovative thinking. Navi identified an opportunity in the market to educate female customers on hormonal health and how pharmacies can assist in identifying their specific nutritional needs based on their age and current symptoms.

By arming the pharmacy staff with up-to-date knowledge on women’s health and specific products available, CarePlus pharmacies became an important destination for women’s to get advice and to improve their lives. The key areas focused on were periods, perimenopause and menopause-covering the full female customer base.

Striving for the highest standards in operational excellence and quality. www.udw.ie

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73 Adrian Dunne, Managing Director, Adrian Dunne Pharmacies Adrian is the Managing Director of the Adrian Dunne group of Pharmacies and together with his team, he has chalked up a number of notable achievements during 2023. The Adrian Dunne Pharmacy Group were this year named as one of Ireland’s Best Workplaces™ 2023.

Certification as a Great Place to Work™ is based on direct feedback from employees as part of an independent, extensive and anonymous survey about the workplace experience.

Since opening its first branch in Whitehall in 1999, the Adrian Dunne Pharmacy team have dedicated themselves to developing a great place to work. The tremendous team spirit, enthusiasm, and positive attitude has created an award-winning culture and Best Workplace for all the team, whilst also providing a great experience for the customer.

Orlagh Dunne, Allcare Operations Manager, Uniphar Orlagh joined Uniphar in April 2018 as an Area Manager with the Life Symbol brand and has held her current role as Allcare Operations Manager for almost 4 years. This role oversees all the operational and sales functions in 63 owned stores. During this time, she has had many successes during a challenging pandemic period and built resilience in her teams, developing them to become experts in their field. The most recent success was leading the Allcare Brand to be the number 1 pharmacy brand in the CXi results. An achievement she prides herself and her team on.

Suzy Farrell, Pharmacist, The Rye Pharmacy, Leixlip Suzy recently organised the for The Rye Pharmacy to become part of the Safe Pharmacy Initiative to allow the pharmacy consultation room to become a safe space for victims of domestic abuse to call for help. She also provides a compression stocking measurement service and participates in all of the HSE vaccination programs, constantly managing stock levels and appointments as well as administering the vaccines themselves. She is also a tutor pharmacist, a role she thrives with.

Suzy has been described as an excellent worker who is efficient, fast and manages her dispensary extremely well. Despite constant HSE cuts she has managed to increase revenue since she started.

Backed by size and scale, part of PHOENIX Group, we deliver health.

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Dynamic 100

Professor Patricia Fitzpatrick, Pharmacist, School of Public Health, Physiotherapy & Sports Science, University College Dublin Professor Patricia Fitzpatrick and a research team from UCD, the HSE Tobacco Free Ireland Programme, specialist cancer hospitals and patient representatives, conducted a research programme funded by the Irish Cancer Society entitled “Smoking cessation for cancer patients in Ireland: a scoping and feasibility initiative.”

Professor Fitzpatrick is a former Chair of the Steering Committee for Healthy UCD 2016-2023 (www. ucd.ie/healthyucd/; #healthyucd) UCD & Healthy UCD awarded Irish Heart Foundation active@work Gold award 2018.

Tony Fitzsimmons, Pharmacist & Owner, Collon Pharmacy, Collon Tony was a finalist for the 2023 People’s Pharmacist.

“It’s the simple things that can really make a difference,” said his nominee. “From always having a kind and welcoming smile, no matter what else is going on, to taking time out of what is obviously an incredibly busy schedule to always explain medication queries and advising on wellness and health condition management, Tony sums up the saying that community pharmacists are the heart of the community.

“When my entire family came down with Covid during Christmas of last year and my mother who was visiting from out of the country ran out of her medication, Tony was on hand straight away to organise an emergency supply. He even travelled himself to another pharmacy when he did not have enough of certain stock. No matter the issue is, he will go out of his way to help. He is a credit to our village and we would be lost without him.”

Colin Galligan, CEO, Chemist Warehouse Ireland Chemist Warehouse is currently Australias largest pharmacy retailer offering discounted prices on health and pharmaceutical products. Now established in Ireland the brand offers Irish consumers leading brands and affordable healthcare at the best price and with a high level of customer service. Colin leads with professionalism and a passion for retail pharmacy. To date the chain has outlets in Blanchardstown, Henry St., Dun Laoghaire, Ashbourne, Navan, Ballincollig and Mallow. The Irish public have really embraced Chemist Warehouse as a one stop shop for all their healthcare and beauty needs and with plans to grow the number of stores in Ireland over the next couple of years Chemist Warehouse is indeed a progressive company with a dynamic leader at the forefront.

Dedicated, experienced customer care team. www.udw.ie

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75

Karen Gibney, Brand and Digital Marketing Manager, United Drug Karen has been nominated for her role in enhancing customer communications and supplier relations with United Drug network. Karen is in the role just under one year and has already made changes to enhance the added value offering of United Drug with customers including our buying groups, Ostomy and Elements. She is currently working on the new PHX Ireland website and is developing a Podcast series for United Drug inviting guest speakers to advise and inform the Pharmacy sector about changes in legislation, new services, and advice on key topics to help pharmacies advance and provide better patient care and quality of life for patients.

Sean Gleeson, Digital Manager, McCabes Pharmacy Group Sean ensures that McCabes Pharmacy’s exceptional customer service is delivered not only in stores but throughout all digital customer touchpoints. Sean has a drive to ensure online customers receive the best service we can provide ensuring we are true market leading.

Sean starts every service offering and project from the customer perspective, ensuring we put the customer before the technology. He is an innovative and dynamic digital leader, always looking for ways to enhance the digital offering. Sean led McCabes to be the first to offer oral contraceptive online and giving customers the ability to book vaccination and health check appointments on our digital booking platform. He has also brought Intelligent Guided Selling to Pharmacy.

Furthermore, he has been instrumental in developing Easy Script which enables customers to send their script direct to their pharmacist via the website or the McCabes App. This has been transformational for customers’ busy lives.

Garret Harrington, Pharmacy & Owner, Harringtons Pharmacy, Ballincollig For many people, caring for an elderly relative at end-of-life care can be incredibly challenging.

Garret Harrington at Harrington’s Pharmacy in Ballincollig was able to ensure that for one of his patients, the experience was less stressful.

His work led to a nomination from his community for the 2023 People’s Pharmacist Award.

We received a nomination for Garret which told us, “I have to say that all of the staff at our local pharmacy of Harringtons are unbelievably helpful at all times; kind friendly faces and always willing to help. But I have to talk about Garret who goes above and beyond.

“Garret always has time for you as a customer no matter how busy he is, he always asks the right questions and listens to your answer, and more importantly, is interested in you answer “Garret and his team really touched our lives when our mother was very ill and dying. They were a great help to us with her medication which in turn allowed us to keep her at home until she passed away, which was so important to her and to all of the family.”

Delivering best in-class products, service, and support for optimum patient care.

United, we do better

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Dynamic 100 Raymond Hinds, Supervising Pharmacist, McCauley Pharmacy Ray is a community pharmacist and the Pharmacy Services / Vaccination lead for McCauley Health and Beauty Pharmacy. Ray has worked tirelessly to support pharmacists and pharmacies across the group with vaccination services and further developing on and off-site vaccination clinics. Ray’s understanding of the challenges community pharmacists face daily has allowed him develop new and more efficient ways for pharmacists to deliver services to their patients.

Martin Hynes, Clinical Governance Manager, LloydsPharmacy Martin plays a pivotal role in driving the patient first agenda for LloydsPharmacy. He is dedicated to supporting the LloydsPharmacy network with SOP’s, processes, and advice, and supports and guides the pharmacy team with the introduction of new services and processes, keeping them updated with news and updates from IPU, HSE and PSI etc. He has supported pharmacy teams and support office by administering the winter vaccines especially Flu and Covid19. Martin leads the APPEL, TCQR programme for Pharmacy students ensuring there is an excellent mentoring programme in place, sets up the OSCES to imitate real life clinical scenarios and a valuable training support for students.

Martin has also been a great support to the Marketing and digital projects from representing the brand on Radio and press, supporting digital developments and enhancements by testing from patient and store perspective.

Peter Hynes, Chief Procurement Officer, Navi Group Peter joined Navi in 2019 with responsibility for the ethical purchasing for the Axium Buying Group. During this time Peter has built a strong team, servicing our members through improved terms and margins for pharmacy. More recently Peter has been promoted to Chief Procurement Officer taking responsibility for all strategic sourcing activities on behalf of the Axium, aXel, CarePlus and StayWell partners. Peter is now working with a new team to bring the benefits and logic that has been so successful in the ethical side of the business, to the OTC / FOS side of the business to maximise our members returns.

Mark Jordan, Supervising Pharmacist, Ballina Life Pharmacy, Mayo In 2023 Mark was successfully re-elected to his position on PSI Council where he continues to work towards his initial aim in helping improve the role of the Pharmacist through better regulation. He continues to work hard at PSI as a member of the council and at subcommittee level to represent the Pharmacist and Pharmacy as a profession and help in the safe keeping and continued health of the public through enhanced services and experiences. As Mark progressed through his career and learned more on patient experience and his regulatory role he began to involve himself in guest lecture posts, writing and podcasting for Pharmacists and Pharmacy students in Ireland. He noticed through this work that Pharmacy in Ireland was on the cusp of a workforce crisis. In order to learn more on professional registration and workforce issues Mark applied and was successfully appointed to the Registration Committee of the NMBI. During the pandemic, Mark started an Instagram account which later grew to over eleven thousand followers.

Marks aim online is to highlight the value of Pharmacy and Pharmacists, promoting accessibility to the profession and helping the public in a time of great uncertainty. Here he continues to educate the public on health, medicine and wellness to improve their patient experience.

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77 Fathimah Kara, Pharmacist, Reidy’s Pharmacy, Rathcoole Fathimah has engaged and ensured the pharmacy has engaged with local sports clubs and causes to give back to the community as a way of showing appreciation to the people of the locality for their continued support over the past 20 plus years in business in the village. First aid kits to the local soccer club and the sponsoring of jerseys and pitch and training facilities and fundraising events for local charities have been at the forefront of the community engagement.

Fathimah’s love of the pharmacy profession has not dimmed in the slightest and being nominated along with the pharmacy at for two awards at this years Irish Pharmacy Awards was a great highlight, not only for the pharmacy but also for the local community. It shows how committed Fathimah and the team are and the passion to providing excellent services to all is unmatched. Fathimah organised a special ‘Customer Appreciation Day’ in which she ordered cupcakes and had fruit juice served as a way of saying thank you to all the patients who use and trust the pharmacy.

2023 was a big year for Fathimah and she is already working hard assessing what else can be done to improve patient care and provide support of the highest standard possible to all existing patients and the local community which she is so proud to serve.

John Keane, Pharmacist & Owner, Keane’s CarePlus Pharmacy John Keane’s HealthPoint Pharmacy has been named ‘Ireland’s Best Workplace for Menopause.’

Winning this Award has meant a great deal, as Managing Director John says, “This award helps us understand what our team members and customers are going through. It’s about being there for them in more ways than one.”

Furthermore, John added that for the pharmacy to be recognised amongst larger companies adds further value to the accolade. Keane’s have recently rebranded, but their commitment to caring remains the same.

They have a strong team of 80 people working across seven different sites, all dedicated to serving their communities.

Emily Kelly, Superintendent Pharmacist, McCauley Pharmacy Group Emily is a community pharmacist with the McCauley Health & Beauty Pharmacy Group, where she was also a Superintendent Pharmacist from 2019-2020. Emily received her Masters of Pharmacy from the University of Brighton and has since held senior management operational roles for several large pharmacy groups throughout Europe including Ireland, Italy, Belgium and Czech Republic. Emily has been a Peer Support Pharmacist for the Irish Institute of Pharmacy since 2017 and is active in the Peer Support agenda by delivering ePortfolio Review information webinars and playing a leading role in facilitating the Peer Support Event in October 2022. Emily is a strong advocate for creating a mentoring culture in pharmacy, and in 2021, she supported the implementation of the IIOP Mentoring Programme. She is an active mentor and member of the Mentoring Steering group.

Joe Kelly, Pharmacist, Kelly’s Pharmacy, Dungarvan Dungarvan pharmacist Joe wrote and recorded a charity Christmas single. All proceeds from his song, ‘Santa, I love you,’ went towards supporting sick children and their families in CHI hospitals and urgent care centres.

Joe wrote the festive tune as an antidote to the constraints of the pandemic, ‘’It’s very much a children’s’ take on Christmas’’ he says, brought to life under the auspices of musical director David Hayes and performed by the David Hennessey stage school in Dungarvan.

Over 650 dedicated and experienced colleagues.

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Dynamic 100 Joanne Kissane, Registrar & Chief Officer, Pharmaceutical Society of Ireland Earlier this year, the Pharmaceutical Society of Ireland published the first report of its kind in Ireland examining the emerging risks to the future availability of pharmacists in patient-facing settings. It was launched in the Department of Health by Secretary General Robert Watt.

The Workforce Intelligence Report commissioned by the PSI -the Pharmacy Regulator, examines the current challenges to the recruitment and retention of pharmacists in community and hospital settings and provides, for the first time, baseline data on emerging risks specific to this cohort.

Its aim is to provide for a sustainable supply of pharmacists to meet current and future needs in patient- facing settings, and to enable pharmacy to play a full role in the development of the future integrated healthcare system.

Adam Lee, Country Manager, Reckitt Adam is Chairperson of IPHA’s Self-Care Division. In November of this year, this division published new research which showed that pharmacies are the source most likely to be used by the public for help regarding minor health conditions.

As a former pharmacist, Adam understands how important it is that Reckitt provides valuable support to healthcare professionals nationwide. Adam’s pharmacist background is helping him in his current role to the needs of healthcare professionals in Ireland.

Adam doesn’t only have a keen mind for the commercial side of his role, his passion for helping people and making a difference in a positive way through healthcare ensures the passion for the work he does shines through.

Agnese Liepina, Community Pharmacy Technician, O’Rourke’s Allcare Pharmacy, Monasterevin Agnese is a very self-motivated lady who has completed several courses outside of work including OHANA zero suicide training, Hollister ostomy care course and is currently completing the IPU Safe pharmacy understanding domestic abuse and coercive control course. She also is currently completing her Bachelor of Science in Pharmacy Technician studies in order to bring wealth of knowledge to her pharmacy team and customers. She enhances patient care by ensuring that our most vulnerable patients always have up to date prescriptions and takes the initiative to contact prescribers when a medicine is in short supply to try to obtain an alternative medication; and goes to great lengths to source such alternatives from different suppliers. She is always happy to help other members of the team and has become the point of contact in the dispensary for the shop’s large customer base.

In 2023, she was a finalist for the TouchStore Community Pharmacy Technician of the Year Award.

COVID-19 Response Award Winners for storing and distributing all vaccines. www.udw.ie

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us their positive news stories. It’s (OPAT) enable patients who would heartening to hear from a patient have required hospital care to who let us know that she can’t receive care at their home. Nurses live without her treatment and that either administer the antimicrobial is has been life changing for her. to the patient for the full course At Christmas time the pharmacy of treatment or train the patient to is swamped with thank you administer it to themselves. This messages, and boxes of Pharmacist, Elaine cards, Lillis, Superintendent Meaghers Pharmacy Group facilitates admission avoidance, chocolate and biscuits. frees up resources within hospitals

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The attractive career path of homecare pharmacy with Baxter Healthcare gives pharmacists 79 an insight into all the services and roles involved in both a homecare pharmacy service as well as a compounding company. It gives them the opportunity to develop Elaine Lillis MPSI is Superintendent pharmacist for the Meaghers Pharmacy Group. Having joined the through reduced bed andand in each skills both clinically as part of Meaghers team years agoinasmy an intern Elaine has grown with the use company Every day is 12 different role.pharmacist role, she has held in that time contributed to its success.

Leadingpatient a team ofsatisfaction 20 pharmacistsas across the HomeCare service as well increases One of the that standsrespect, out and the nine stores shedays inspires confidence, admiration of her colleagues. Dedicated to as in quality while working in a they can recover in the comfort of delivering excellence in patient care Elaine for me over the years include thehas introduced many new health services to the Meaghers Pharmaceutical Company. group including an innovative partnership with Health Beacon to drive patient compliance for those their home. day we got a thank you card from using injectable medications. Her innovative approach earned Meaghers the title of Winner of

innovation services at IPN awards.

As age well as adding additional services to the Meaghers portfolio Overall, the focus on providing the familyin of a patient my own What sets our homecare for the benefit of our local community Elaine has worked hard to engage with community groups to who had passed away tragically vital services to patients in need pharmacy apartthe from community deliver education and her expertise to help their members and reinforce special position of the pharmacist the community.

Elaine is about the future of Irish Pharmacy and within the pharmaceutical industry before hisintime from cancer – incredibly how passionate is; (i) that we are dispensing works with TCD educating and developing future pharmacists. our service had allowed him to environment makes homecare to patients at a distance and spend his final months at home pharmacy with Baxter Healthcare a (ii) the types of medications d with his family and children and andstakeholders attractive career patha lot o both internal departments andfulfilling external with ofin constant close communica�on with that are dispensed, which are avoid hospital – how much that for pharmacists in Ireland with lots primarily aseptically compounded include Customer Services, Transport communica�on been carried email. Internal departments time meant to his family and out viaintravenous of opportunities for progression (IV) therapies. Some and development. how grateful they were for that.

Compounding, Pharmacovigilance, Quality Dispatch teams. External stakeholders include home of theseand medications include,

IV antimicrobials, subcutaneous nursing providers and hospital mul�disciplinary teams.

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(SC) iron chelator products, SC One of the days that stands out for Maeve Magner, Pharmacist, methotrexate, and parenteral me over theas; years include theSuperintendent day we got a thank you card from the Pharmacists are trained in quality areas such document TCP Homecare nutrition Prescriptions family of aproducts. pa�ent my own age who had passed away tragically before review, control and access, correc�ve and preventa�ve ac�ons In her capacity as Superintendent Pharmacist, Maeve shoulders significant responsibility in ensuring are received via healthmail or post his cancerPharmacists, – how our service had allowed himstaff, to spend his that our�me entire from team, including Pharmacy Technicians, Warehouse and Delivery and medications are dispensed (CAPAs) and nonconformance reviews canstandards set by our organisation. Her leadership in this Drivers, (NCRs). consistently Pharmacists meet the highest clinical final atdirectly home with his family and children and avoid hospital – regard is months truly exceptional. and delivered to patients’ then use this to training, as well asMaeve’s their own clinical how much �me meant to his family how were homes, without patients ever impact onthat the TCP Homecare organisation extendsand beyond hergrateful immediate they role. She serves as a pivotal member ofthemselves the Clinical Governance Team, where her contributions are extremely valued and knowledge, to con�nuously improve on processes and presenting to the for that.

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Maeve’s unrelenting dedication scrutiny pharmacy in person. ensures that every element of patient care is subject to rigorous assessment.

This commitment, in seems so ordinary andwith mundane, when you receive a thank you card procedures, as well as engaging onturn, important projects contributes to the continuous improvement of our clinical standards, setting benchmarks for within role ofthea industry. pharmacist ofThe that nature, it brings it at allBaxter home – how much we support our commercial and marke�ng teams.excellence A prime example of the direct impact of her work isare evident as she carries the responsibility of ensuring involves completing a more pa�ents, and how the litle things actually big things. the safe storage, precise dispensing, and meticulous support for the administration of millions of euros n

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Maeve Magner Healthcare gives pharmacists an insight into all referrals the services Prescription provide us Superintendent Pharmacist TCP withpharmacy significantlyservice more information and roles involved in both a homecare as on the patient’s medical history well as a compounding company.

It gives the opportunity whichthem enables a more holistic care er Maeve Magner, Owen Boland, Superintendent/ of of thethe patient with their service transitionas well to develop skills both clinically as part HomeCare as in quality while working in a Superintendent Pharmacist TCP Supervising Pharmacist Baxter from hospital to community care.

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Louise Martin, Retail Director, Uniphar A Career withon Baxter Overall, the focus providing vital services to pa�ents in need within the pharmaceu�cal industry Louise joined Uniphar three years ago, initially joining as Consumer Business Unit Manager and environment makes homecare pharmacy with Baxter Healthcare and career was appointedin Retail Director last year. In her role, Louise is responsible for the largest Irish owneda fulfilling Working homecare pharmacy with Baxter Healthcare offers a PHARMACYNEWSIRELAND.COM unique opportunity foratrac�ve pharmacists to path f community pharmacy network of over 270 pharmacies across the Allcare, Hickey’s, McCauley provide vital services toLife pa�ents asep�cally compounded therapies in the comfort pharmacists in symbol Ireland with lots ofrequiring opportuni�es progression and development. and independent partners Pharmacy.

Prior to Uniphar, Louisefor held several senior parenteral commercial positions in McKesson UK, LloydsPharmacy Ireland, and Tan Organic. During her time of their own homes. As a registered pharmacy with the Pharmaceu�cal Society of Ireland, Baxter as Head of Category Management for McKesson UK, Louise built a strong team, grew retail sales inPharmacy what was a challenging the same timerequirements as managing an aggressive store adheresretail to environment the sameatregulatory as a standard community pharmacy. However, it refit programme. As Consumer Business Unit Manager in Uniphar, Louise doubled the company’s existsand within the infrastructure of passion a pharmaceu�cal industry and is situated onsite in Baxter turnover profit. Louise brings an energy and for pharmacy retail, customerenvironment focus, brilliant basics, and cross functional collaboration to the Uniphar retail business. She fosters a Healthcare Ltd,within thethe global mul�na�onal company.focused and positive work culture retail team and is focused healthcare on building a commercially highly motivated team.

Owen Bola Superintendent/Supervising Pharmacist Baxt

Homecare Pharmacies providing Outpa�ent An�microbial Services (OPAT) enable pa�ents who would have required hospital care to receive care at their home. Nurses either administer the an�microbial to the pa�ent for the full course of treatment or train the pa�ent to administer it to themselves. This facilitates admission avoidance, frees up resources within groups hospitals through reduced bed use and Added Value services from buying increases pa�ent sa�sfac�on as they can recover in the comfort of their home.

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Dynamic 100 Caoimhe McAuley, Director of Pharmacy/Superintendent Pharmacist, Boots Ireland Caoimhe’s leadership has pioneered affordable pharmacy services to communities across the country and has overseen record numbers of patients accessing services and prescriptions at Boots. Under Caoimhe’s direction, more patients than ever before can now access vaccinations in their local Boots community pharmacy. She continues to lead innovation in community pharmacy, recently launching a national liver scanning service at Boots, connecting pharmacy to multidisciplinary healthcare colleagues to promote awareness of the importance of liver health.

A champion of women’s health issues, including menopause and fertility, Caoimhe has spearheaded the ‘Let’s Make Menopause Visible’ campaign at Boots.

Passionate about community pharmacy, Caoimhe works to ensure it plays a key role in the ever-evolving healthcare landscape. She currently sits on the Executive Committee of the Irish Pharmacy Union and the HSE Community Pharmacy Planning Forum. Under Caoimhe’s stewardship, Boots Ireland has been named Ireland’s most reputable pharmacy in the Ireland RepTrak® 2023 annual study.

Sharon McCabe, Managing Director, McCabes Pharmacy Group During 2023, McCabes Pharmacy Group announced the successful acquisition of three new pharmacies from in Dublin, Stanley’s Mountview Blanchardstown, Ellis Pharmacy, Woodstown & Ellis Pharmacy, Springfield, Tallaght. Towards the end of the year they announced that McCabes was being acquired by LloydsPharmacy, with Sharon to head up the merger of these pharmacy stores.

Furthermore, McCabes Pharmacy Clarehall, Pharmacy team members Noleen Murray and Mia Keavney were recognised in the 2023 Retail Excellence Awards.

Finn McCann, Chief Technology Officer, Navi Group In 2021, Finn spearheaded the development of DispenSense, Ireland’s newest dispensary software system. DispenSense was created with one main goal: making pharmacy easier.

DispenSense is a cloud-based system making dispensing to patients reliable, safe and efficient. Some of the most recent dynamic features of the system allows for Healthmail integration, claiming of the free contraceptive scheme and is owing’s compliant for the PCRS. This dynamic innovation is a welcomed improvement allowing our users to direct their time to more patient-focused priorities. DispenSense has been successfully installed in 25 pharmacies this year, with a target of 100 installs in 2024.

DispenSense is not just the dispensary system for today but the dispensary system for the future.

Mary McCartan, Pharmacist, Donaghmede Pharmacy, Donaghmede Mary is the lead vaccinator in the pharmacy and organizes the service in such a professional manner, with arranging the appointments, maximising the usage of the vials. Her organizational skills have meant that the pharmacy team have been able to provide hundreds of covid and flu vaccines, with little impact on the busy dispensing service.

Mary has also driven the pharmacy blister pack service, working closely with the technicians, she has identified patients who would truly benefit from having their medicines dispensed in blister packs and she has taken the time to explain the benefits of the service and this has demonstrably improved compliance among the patients who need it the most.

Mary was a finalist for the 2023 JPA Brenson Lawlor Young Community Pharmacist of the Year Award.

Mary has been an extremely strong performing pharmacist within a great team. She has been an integral part of the dispensing team and a leader who stands right up with the very best in the industry.

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Ruth McCarthy, Pharmacy Practice Educator, University College Cork Ruth is a Practice Educator at UCC, boasts an impressive career spanning over two decades in various facets of academia, industry, and community pharmacy across Ireland, the UK, New Zealand, and Australia. Her extensive journey has encompassed notable positions at institutions such as the School of Pharmacy at the University of Auckland and University College Cork.

Ruth’s professional background extends to international pharmaceutical marketing and distribution, business management as well as online pharmacy ventures.

Ruth’s commitment as a Peer Support Pharmacist for the Irish Institute of Pharmacy is a testament to her invaluable contributions in championing the professional growth of pharmacists.

Daniel McCormack, Pharmacist, McCauley Pharmacy, Dublin Daniel is the 2023 JPA Brenson Lawlor Young Community Pharmacist of the Year. His proactive approach to administering Covid-19 vaccinations and providing flu vaccinations demonstrates his dedication to improving the health and well-being of his community. By offering weekend clinics for children’s flu appointments, he is accommodating busy parents who may have difficulty attending during the week.

Furthermore, Daniel’s free blood pressure monitoring service shows his commitment to preventing and managing chronic diseases such as hypertension. Overall, Daniel’s actions show his commitment to providing excellent healthcare services to his community and his willingness to go above and beyond to meet their needs. His efforts will undoubtedly have a positive impact on the health and well-being of those he serves.

John McCourt, Superintendent Pharmacist, Millmount Pharmacy, Drogheda As which is common in the majority of pharmacies throughout the country, the role of community Pharmacists played a major roll on out the Covid Vaccination programme. This was and continues to be very challenging for all involved and in particular Superintendent pharmacists whom implement safe practice and constantly reviewing the logistical side of ensuring adequate supplies to the stores and ultimately the timetabling of Vaccination Clinics to correspond with the sheer volume enquiring and requesting their vaccine/booster.

As a well respected Pharmacist, John has been exponential due to his approach. He also introduced the 24-hour blood pressure monitoring across his pharmacy stores.

In 2023, John was a finalist for the Perrigo Superintendent Pharmacist of the Year Award.

Cormac McKenna, Founder, PharmacyConnect Recognising a pressing demand for a top-tier app to enhance communication within Irish pharmacies and streamline the patient pharmacy experience, Cormac embarked on the ambitious journey of conceiving, developing, and successfully launching the PharmacyConnect platform.

This versatile platform can be adapted and customised to cater to the unique needs of any independent pharmacy or pharmacy group, revolutionising the landscape of pharmacy-patient relationships in Ireland. From facilitating Healthmail communication to managing prescription payments and collection or delivery, the PharmacyConnect platform functions as an instinctive communication centre that covers tasks such as order handling, storing patient information, facilitating two-way communication, managing payments, and coordinating deliveries.

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Dynamic 100 Keith McLernon, Managing Director, McLernons Keith has been at the helm of McLernons for almost 40 years, overseeing the company’s rise from simple automated labelling systems to fully integrated pharmacy IT business solutions, and expanding beyond Ireland to GB and South Africa.

Central to the success of McLernons has been the high levels of personal attention given to each customer, and Keith has been instrumental in ensuring that this ethos is echoed from Directors, including Robin Hanna in Dublin, through to trainers, engineers and Customer Support team.

His insistence that trainers and engineers are deployed on a regional basis has meant that there is a real and genuine connection between a community pharmacy and ‘their’ first port of call, whether that be for a hardware issue or some additional training.

He is constantly encouraging everyone in the McLernons team to bring forward ideas for new ways of working which would benefit the pharmacy – such as the development of MPS Script Finder which came about after an internal suggestion that there must be an easier way for customers to store and dispense medicines, especially with the increased volumes of patient contacts since the Covid epidemic.

He has supported the Irish Pharmacy News Awards since their inception, seeing the value they afford the profession with the opportunity to shine a light on the hard work and dedication of community pharmacies across the country.

Liz McMahon, Learning and Development Specialist, PHX Ireland Liz is responsible for the learning and development pillar within LloydsPharmacy People strategy whereby continuous training and access to information and tools is readily available for all employees.

Liz helps coordinate and oversee the training programmes including Induction, LloydsPharmacy Winter and summer store manager training summits as well as a range of management development programmes for United Drug, LloydsPharmacy and TCP employees. Recently the Marketing team attended an Insights training course facilitated entirely by Liz, which was extremely useful to creating a highly collaborative and communicative work environment amongst the team and wider Business. This training gives colleagues a chance to discover how best to work with their teammates as well as learning about their own strengths and weaknesses. Other teams across the Businesses will now also be eligible for this Insights training.

Mark McPhillips, Pharmacist & Owner, Mark’s Pharmacy, Ardee During this year, Mark not only won the Point of Care Testing Award, but also the Viatris Community Pharmacy Team of the Year Award. Mark’s community pharmacy team exemplifies exceptional team spirit and dedication to enhancing patient care at all levels.

Working together efficiently and effectively, they create a collaborative and supportive environment, fostering trust and respect among team members and empowering each individual to contribute their unique expertise towards shared goals.

Further to that, Mark was a finalist for the 2023 People’s Pharmacist Award.

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Breege McTigue, Director of Customer Engagement, Navi Group Breege is responsible for overseeing and optimising the company’s interactions with its customers to build long-term relationships and enhance customer satisfaction.

She most recently collaborated with other departments such as sales, operations and product development to ensure a cohesive and integrated approach to customer engagement using CRM software. She is passionate about continuous improvement and stays at the forefront of industry trends, ensuring that customer engagement strategies remain innovative and effective.

Jessica Millar, Pharmacist, Grant’s Pharmacy, Arklow Jessica was a finalist for the 2023 People’s Pharmacist Award. She was nominated by a customer for going above and beyond in her care of a sick family member. Jessica offered to pre-pack medication and liaised with the local doctors when the extent of medicines became too confusing for the family. On one occasion, Jessica was able to source a hi-tech specific medication and have it ready for when the patient was discharged from hospital, a feat the family previously thought could be impossible.

Jessica has been described as someone who is the ‘epitome’ of her profession and an example of the high esteem in which the pharmacy profession is held in by communities and patients across Ireland.

Sheena Mitchell, Milltown totalhealth Pharmacy, Milltown Over the last 12 months, Sheena Mitchell has prioritised the profession of pharmacy over everything else in the name of safe patient care. She has garnered huge support from her equally frustrated pharmacy colleagues and has been humbled by the unity of that support. As an individual it can be difficult to gather the necessary support amongst a profession, but Sheena refused to see that as an obstacle and the impossible became possible.

Sheena has shown dedication to her cause and the pharmacy profession but most importantly to all patients in Ireland. Patients deserve easy access to healthcare and have welcomed Sheena’s motivation to break down historical barriers.

Susan Moloney, Superintendent Pharmacist, Coens Pharmacy Susan has a lovely manner and is very bubbly to all her co-workers and all the customers with a caring manner to help everyone. She is responsible for most of the ordering in the front of shop where she can keep a close eye on items moving quickly or slowly and make sure that stock has a good rotation. She also works at our Clarins counter, spending the time helping customers choose the right items and making hampers. She has a great eye for displaying the products in the shop and keen sense making the shop feel warm and welcoming.

She also helps in and around the dispensary, taking calls from customers and directing them to the right area. She is very helpful to customers that may be going through a hard and difficult time where she will take the time to go the extra mile and make them feel reassured and comfortable when they leave the shop.

Susan gives a helping hand to the new staff members and our summer staff where she carefully helps and guides them in the right direction.

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Dynamic 100 Hugh Moore, Support Pharmacist, McCabes Pharmacy Upon joining McCabes, Hugh embraced his first role as part of a large dispensary team, absorbing every piece of information and developing extensive expertise and a deep passion for addressing customer needs in Citywest. He is now adept and self-assured, cherishing his job and the opportunities it brings. His journey has included supporting area managers in training and development, and he has recently taken on a mentor role for a trainee technician.

As part of his patient-centered approach, he prioritises face-to-face interactions to ensure that each individual receives personalised care and attention.

In response to the pressing demand for Flu and Covid Vaccinations in the local community, he has taken proactive steps to provide these essential services. Leveraging his expertise and knowledge in the field, he has worked diligently to administer vaccinations efficiently and safely, ensuring the well-being of community members. Recognising the importance of a well-organised system, he has garnered the support of the store team, collaborating with them to implement an efficient online booking system. This teamwork has streamlined the vaccination process, making it more accessible and convenient for patients and increasing sales in the process.

Dr Frank Moriarty, Pharmacist/Senior Lecturer, School of Pharmacy & Biomedical Scieneces, Royal College of Surgeons in Ireland Dr Moriarty’s collaboration with the Irish Institute of Pharmacy stands as a testament to his unwavering commitment to advancing the continuous professional development of pharmacists. His specific contributions include the delivery of workshops on Critical Appraisal, and Polypharmacy and Medication Review.

He has a significant body of research in the area of medicines optimisation and pharmacoepidemiology, and is Secretary of the Network of European Researchers in Deprescribing. In August of 2023, Frank achieved a significant milestone by securing a ¤2.4 million career development award from Wellcome. This prestigious award will enable him to advance novel research methodologies in the field of deprescribing.

Katherine Morrow, Director/National Co-ordinator, APPEL/President, The Pharmaceutical Society of Ireland Katherine is the President of the Pharmaceutical Society of Ireland and earlier this year they launched the first ever pharmacy intelligence workforce report. Katherine is Director and National Coordinator of APPEL (Affiliation of Pharmacy Practice Experiential Learning) with responsibility for the experiential learning placements of the integrated pharmacy programmes of the three Schools of Pharmacy in Ireland. A graduate of the School of Pharmacy, Nottingham University, Katherine has over 25 years’ experience, acquired from working across a breadth of sectors including primary care, secondary care, regulation and academia.

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John Myers, Pharmacist, McCabes Pharmacy, The Crescent Dooradoyle John has actively engaged with his local community over the last 12 months. Given the location of his pharmacy in the Crescent Shopping Centre, a lot of John’s patients live in local rural communities outside of Limerick and many of the elderly customer base were unable to come into the store to collect their medication during COVID. John has built up extraordinarily strong relationships with his customers, his level of customer service is second to none and he ensures that he speaks to every customer who comes through the door with a prescription. He has a knack of identifying when a customer has a query or concern that is really bothering them and always displays strong listening skills and empathy to the customer’s needs, ensuring that when they leave the pharmacy, they feel that their concerns have been listened to.

Marie O’Brien, Pharmacist, Brogan’s Pharmacy, Loughrea Marie is an experienced pharmacist skilled in pharmacy management, customer service and patient education. Marie was one of the only pharmacists in Ireland to complete the HSE diploma in Integrated Care this year. She is passionate about delivering improved healthcare outcomes through interventions and integrated care and has a clear vision for how community pharmacy can play an integral part in Integrated Care. Marie also is a huge advocate for empowering patients and regularly delivers talks to organisations such as Age Action educating patients on Knowing their medications and the importance of the HSE Know Check Ask Campaign. Marie is also a Peer Support Pharmacist with the IIOP.

David O’Brien, Supply Chain Lead, Ireland, Uniphar David O’Brien David joined Uniphar in December 2016 as Wholesale Commercial Director.

Prior to Uniphar he held a number of senior FMCG commercial positions in both the Kerry Group and Coca-Cola Hellenic. David was promoted to a new role Supply Chain Lead Ireland in May 2022. As part of the Supply Chain Lead role David take has responsibility for the overall management and leadership of the Operations, Pre-Wholesale and Wholesale business within the Irish Supply Chain business. David has been a key member of the Supply Chain Retail Leadership Team since he joined Uniphar. He has led the Uniphar wholesale business to deliver significant market share growth to become the leading full line wholesaler in the Irish market. David has also been instrumental in building our consumer business which has delivered exceptionally strong growth over the last six years.

David has always had a strong focus on people, on building great teams and leveraging the expertise from his peers and colleagues. He brings a wealth of Commercial and Operational experience to this position.

Siobhan O’Brien, Pharmacy Counter Assistant, Bantry Pharmacy PCC Siobhan, always smiling and incredibly kind, has been a member of the pharmacy team for the past couple of years. Siobhan always has a positive impact on her customers, who leave the pharmacy feeling valued, which is largely due to her considerate and kind manner. She uses her skills and knowledge obtained over years of experience in various public facing roles to enhance the services she provides as a counter assistant and she always encourages more junior staff members in a way that is always well received. Always striving to better herself and her knowledge, Siobhan always participates in any and all opportunities to learn, be that engaging in on-line learning or making contact with various reps for documentation on a particular product or range. In addition to our regular seasonal flu vaccination programme last year, we also undertook the task of providing the covid vaccine.

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Margaret O’Doherty, Pharmacist & Owner, Raphoe Pharmacy Margaret advocates for pharmacists, pharmacies and patients at all levels from the PSI to the HPRA and is a regular on Highland Radio where she always presents the facts in a clear and level headed way. She is a shining example of a professional pharmacist and has been a mentor to many younger members of the profession through the IIOP mentoring scheme. She regularly takes on students from the pharmacy technician course in Atlantic Technological University and once they graduate, they are snapped up by employers which is a testament to the standard of pharmacy practice in her pharmacy.

As a former member of PSI Council, she is a font of knowledge when it comes to dealing with PSI issues.

Rory O’Donnell, Pharmacist, O’Donnell’s totalhealth Pharmacy, Derrybeg Earlier this year, Rory was appointed Chair of the Regulatory and Professional Policy Committee by the Council of the Pharmaceutical Society of Ireland.

Rory is Chair of the totalhealth pharmacy group, is Deputy Chair of a nursing home and has served on several commercial boards as well as having experience in the charity sector. He has lectured on the RCSI Leadership in Pharmacy programme and on the Pharmacy Technician course in Letterkenny I.T.

Leon O’Hagan, Senior Pharmacist, iSIMPATHY Project Ireland Leon is one of the pharmacist leads for the iSIMPATHY Project (implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years), a European project funded in the EU Interreg VA programme, and managed by the Special EU Programme Body, that involves a partnership between the HSE, the Scottish Government, and the Medicines Optimisation and Innovation Centre (MOIC) in Northern Ireland. iSIMPATHY pharmacists are delivering holistic personcentred medicines reviews, focussing on patient needs and wants, as well as addressing clinical and safety considerations.

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Michelle O’Hagan, Superintendent Pharmacist, Pharmacy Hub, Killinarden The Pharmacy Hub won the McLernons Independent Pharmacy of the Year accolade at the 2023 Irish Pharmacy Awards.

Pharmacy Hub has collaborated on a number of projects and initiatives within the community. They recently offered a comprehensive health check for a local business and completed a seasonal flu campaign in local schools. The major annual collaboration is Tallaght Health Awareness Month, which is every October.

Pharmacy Hub is driven by passion, hard work, dedication, exceptional customer service and innovative thinking. Pharmacy Hub has been recognised and awarded for its attributes within the local community and comprises of a proud team built on traditional core values, considering themselves as a ‘pharmacy family’ within the Hub. Pharmacy Hub fosters a positive learning culture within the team, and we are willing to adapt our service to meet the changing health needs of the local community. Recently the team engaged with Pharmacy Connect to develop their own Pharmacy App - the next step to help transform the pharmacy to a paperless service thereby providing a more sustainable service.

Joanne O’Hagan, Director of Retail, Meaghers Pharmacy Group Joanne O’Hagan is a qualified marketing professional specialising in Digital Marketing. With 20 years’ experience working in Meaghers Pharmacy group in a variety of roles including area manager and retail director, Joanne led the retail transformation of the Meaghers business through a digital strategy and in store activity.

After gaining a certification in Training and Continuing Education with Maynooth University Joanne has coupled her passion for training with her background as a qualified skincare specialist to design and deliver specialised bespoke training courses for pharmacy teams across the country. Working with large symbol groups, small independent pharmacies and with the Irish Pharmacy Union. Joannes courses aim to meet the needs of individual businesses and draw on her experience in retail pharmacy, the science of cosmeceutical skincare and digital media to enable teams to promote their businesses, gain insight into their customer needs and improve the profitability of their business through sales and promotion.

Oonagh O’Hagan, Owner/Managing Director, Meaghers Pharmacy Group Oonagh O’Hagan MPSI is the owner and Managing Director of the Meagher’s Pharmacy Group, a group of nine pharmacies in Dublin and the thriving online store www.meaghers.ie, which was named Online pharmacy of the year by IPN. Leading a team of 140 Oonagh is a driven Entrepreneur and was named as Businesswoman of the year 2023 by Irish Tatler and was one of the 24 finalists in the Ernest and Young Entrepreneur of the Year program in 2021.

Meaghers has been recognised as one of Ireland’s Great Places to Work for the past three years and a Deloitte Best Managed Company for nine consecutive years. They were named as Employer of the Year at the Retail Excellence awards in 2022 and most recently Meaghers was named Online Pharmacy of the year and the winner of Retail Excellence by Chambers Ireland in 2023.

Oonagh is keen to promote and champion other female business entrepreneurs and as such is a Lead Entrepreneur on the Going for Growth programme which supports Irish female entrepreneurs grow and scale their businesses. Also passionate in supporting and contributing to the SME sector in Ireland Oonagh is a member of the SME and entrepreneurship taskforce set up by Government to develop a strategy to support Irish SMEs to grow.

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Dynamic 100 Shane O’Neill, Superintendent Pharmacist, McCauleys Pharmacy Within just two years of his return to Ireland to pursue his pharmacy career, Shane’s performance and contributions led to his appointment as the Superintendent Pharmacist for the McCauley Pharmacy Group. Stepping into this role during the peak of the Covid-19 Pandemic, Shane’s primary focus on safeguarding the health and well-being of customers and colleagues ensured that the group maintained its high standards of customer care, even in the face of the numerous challenges brought about by this trying time.

Shane continued to expand vaccination services within McCauley’s, further showcasing his dedication to healthcare excellence. His significance was notably highlighted as a vital member of the Senior Management Team that successfully facilitated the acquisition of the McCauley Group by Uniphar PLC in 2023. Shane’s extensive experience and potential were recognised further as he was recently appointed as the Operations Manager for the Allcare and Hickeys Brands, in addition to his role as the leader of Dispensary Operations for all owned Uniphar Pharmacies.

Katie O’Neill, Supervising Pharmacist, TCP Homecare Katie is a leader who exhibits resilience and a positive can do attitude all of the time. The pharmacy was exceptionally short staffed for 5 months in 2023, the team were down to 50% of staff on many days. During that time Katie has she has singlehandedly trained in 2 new members of staff, while balancing every activity without dropping any of the pharmacy standards during this period.

Katie has grown in her time in the role of Supervising Pharmacist, and has not remained static. This year she took on the line management of two key members of staff, becoming a first time manager.

It’s clear that Katie feels passionate about putting the patient first, and constantly strives to deliver meaningful healthcare to patients. By her example Katie sets a really positive culture in the pharmacy.

Suzanne O’Reilly, Pharmacy Manager, North Road Pharmacy, Drogheda Suzanne is the Pharmacy Manager of North Road Pharmacy and together with her team, they won the 2023 Haleon Self Care Award. The team at North Road Pharmacy have focused in the last 2 years on achieving a healthy lifestyle through exercise, healthy eating and taking positives steps in self-care, whether that is taking vitamins and supplements, taking up a sport or seeking advice from the local GP if struggling with life in general. This has led patients and customers awareness to alternative ranges they currently stock. The alternative route has been a key focus moving forward and the introduction of a Sports and wellbeing department has been instrumental in the growth of the other areas in the front of shop sales overall as proven from the positive feedback from customers which translated into strong growth in terms of sales in these particular areas.

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89 John O’Shaughnessy, Pharmacist, Woods CarePlus Pharmacy, Mullingar This year, John was crowned the Reckitt Community Pharmacist of the Year. John has been a senior pharmacist for five years in Woods Pharmacy – a Keanes’ CarePlus store –on Mullingar’s main street. He is fully invested in the Keane group’s values in relation to the importance of patient wellbeing, and accordingly leaves no stone unturned to ensure that patients receive the best possible care. During the covid years, he introduced antigen testing, followed by covid vaccinations, showing courage at a time of great uncertainty.

John is totally selfless by nature, and puts others before himself, no matter if they are a patient or a staff member. He may be doing 100 jobs at once - but will drop them all to help anyone with anything, whether that be needing help with a prescription - or taking out the bins from the dispensary.

Brian O’Sullivan, Pharmacist, Gannon’s Life Pharmacy, Coolscart Brian O’Sullivan is a Pharmacist from Gannons Life Pharmacy in Limerick. He was nominated for the 2023 People’s Pharmacist Award several members of his local community for always going above and beyond.

For one customer in particular, this meant providing care and out-of-hours advice for one patient after an accident at work. They told Irish Pharmacy News, “My husband suffered an injury whilst at work during the weekend. As we couldn’t get an appointment with the local GP practice, we turned to Brian.

“He was able to give excellent advice which allowed my husband to be able to get home as Brian provided all the necessary medications and support until he was able to see his Doctor on the Monday morning.

“Despite the pharmacy being closed on the Sunday, Brian made the extra effort to call and check-in to ensure everything was OK.”

Christina Bender Potolzhi, Pharmacist, Newtown Pharmacy, Newtown Christine joined the pharmacy this year, and quickly became a very important member of staff, she is soon to be taking on the role of supervising pharmacist at one of the stores. Christine has a wonderful nature which a caring attitude to all staff, she is very warm and funny and supports them by putting them through courses. She puts in extra time to ensure the staff understand all courses and asks for help when needed. Her talent does not end there, she is also fluent in several languages. This means she can communicate with people from Spain, Germany, Italy and numerous other European countries who may not have English as their first language. She is originally from Germany and has adapted well into the Irish pharmacy system. She has a great way of speaking to the customers and reassuring them with the extra knowledge of the medications and helping them feel comfortable in the store.

Lisa Power, Pharmacy Manager, Hickey’s Pharmacy, Gorey Lisa has not only increased profit in her store this year, but become a beacon of care in her local community and within the Hickey’s Pharmacy chain. Her positivity and creativity has changed Hickeys Pharmacy in Gorey. She has shown more than ever how important to have a reliable face and ear in your local pharmacy. She drives passion within her colleagues and has become a person who can be relied on. Lisa has been a store manager for 18 months and worked within pharmacy 18 years, and has won local Person of the Year Award twice and was also a winner at the Retail Excellence Emerging Leader of the Year, bringing her work in pharmacy to the retail national stage.

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Dynamic 100 Ruth Proctor, Commercial Manager, Uniphar Having joined the Uniphar Supply Chain & Retail team as a Retail Buyer in 2017, Ruth has continued to grow in tandem with the extensive growth that the business has seen. Now working as the Commercial Manager for the retail business, Ruth is responsible for the Front of Shop Commercial strategies for Allcare, Life and Hickey’s Groups. A graduate of DCU with a degree in Business through the Irish Language, Ruth has worked in buying roles in the Pharmacy industry for the last 11 years. During this time, she has taken part in many key retail projects including the acquisition and rebranding of all retail acquisitions and is now focusing on the commercial integration of the McCauley Pharmacy group into Uniphar Supply Chain & Retail.

Ger Rabbette, CEO, Uniphar Ger Rabbette is CEO of Uniphar, a diversified healthcare services provider, headquartered in Ireland, but operating across 160 countries worldwide. An accountant by training, Ger has spent most of his career in senior roles in the pharmaceutical and healthcare sectors. In 2009, Ger was appointed CEO of Uniphar and took on the onerous job of saving a large Irish business, which was loss-making and carrying over ¤200M in debt. Today, Uniphar is a great Irish success story with a market capitalisation of ¤600M and annual revenues in excess of ¤2BN. Its 3,000+ employees operate across Europe, the US, MENA and APAC. In 2019, Uniphar plc listed on the Irish & London Stock exchanges and since then has continued to grow both organically and by acquisition, purchasing more than 15 companies worldwide.

Paul Reilly, Chief Executive Officer, PHX Ireland As the Chief Executive Officer of PHX Ireland, Paul has overseen a number of notable events during 2023, including the acquisition of McKesson Ireland by Phoenix IRL and the new branding towards PHX Ireland. Notably in 2023, PHX Ireland, via its subsidiary of LloydsPharmacy agreed to acquire McCabes Pharmacy, bringing together two of the best known retail pharmacy brands in Ireland. In May of this year, United Drug partnered with Locus Robotics to introduce ground-breaking warehouse automation. The deployment of 21 LocusBots at the Baldonnel Distribution Centre has enhanced productivity and accuracy while improving operational efficiency and scalability.

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Laura Romero, Managing Director, PharmaConex Laura is a qualified pharmacist who first moved to Ireland over 15 years ago. She has experience in all pharmacy sectors in the Irish market. Laura’s passion is for training and continuous professional development of pharmacists. Laura has personally supported an incredible number of pharmacists over the years transition to working successfully in Ireland through her role as pharmacist trainer in Pharmaconex. With the sad passing of her dear husband Paolo Iacovelli ( RIP) founder of Pharmaconex, Laura took on the running of the company along with her trainer role. She is incredibly proud of how she and the team have remained the number 1 locum and recruitment agency in Ireland despite the difficult personal time. This year alone she supported over 100 European and third country qualified pharmacists with training to work and settle successfully in Ireland. And while doing all this she also managed to get her Degree in Nutrition. She is an inspiration to us all.

Dermot Ryan, Chief Operating Officer, Uniphar Dermot Ryan joined Uniphar 11 years ago as Financial Director of the Allcare Pharmacy business, taking over as Managing Director of the Retail Services business in 2017. Since, then, he has overseen the growth and expansion of the Uniphar Supply Chain & Retail business to become market leader in wholesale to pharmacy in Ireland with a market share of c.53%, a 10-point jump in five years, and built a network of 413 symbol and owned community pharmacies, from just 45 in 2017, creating the largest buying group in the country. In March 2022, Dermot was appointed Chief Operating Officer for Uniphar, overseeing Uniphar global operations, in addition to continuing to manage Uniphar’s significant Irish operations and retail business. In his new role, Dermot has responsibility for global supply chain networks, ensuring that Uniphar moves towards common technology platforms, building a globally connected distribution and warehousing network, and maximising our service offering to clients.

Susan Sheehan, Superintendent Pharmacist, The Rye Pharmacy, Leixlip Susan was a finalist in 2023 for the Perrigo Superintendent Pharmacist of the Year Award. The people of Leixlip know Susan and her reputation precedes her as someone who is caring and extremely knowledgeable on a wide range of topics. She is constantly getting involved in community organisations and contributing time and resources when she can. Customers will often go out of their week to seek her opinion and advice.

The major challenges of the past 12 months have included the ongoing Covid 19 pandemic as well as the war in Ukraine. There has been a major impact on all aspects of business with rising costs and widespread product shortages. Susan used her business savvy and her knowledge of the political climate to help her to predict and plan so that the staff could be prepared for any eventuality.

Susan in her role of superintendent pharmacist has successfully guided the pharmacies through the pandemic and unstable political climates to allow her team to continue to deliver impeccable customer service and play a vital role in the community. She has a real vision for what she wants her pharmacies to become in the future and the services she wants to provide in the community.

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Dynamic 100 Martin Slattery, Commercial Director, Uniphar Martin joined Uniphar in June 2022 as Commercial Director having previously spent the last 15 years holding Director roles in Musgraves and Lidl Ireland. Martin has brought a wealth of commercial experience to the sector along with a passion for meeting customers needs and growing good business which has culminated in Uniphar delivering their highest ever month of wholesale sales in their history this year. That coupled with delivering double digit growth in their consumer division along with the market charge Uniphar’s own brand Aya vitamin range has made this year off the back of a significant range development and slick marketing campaign has seen Uniphar’s performance on the island of Ireland produce some very healthy returns.

Martin has also been recently appointed as acting Supply Chain Director whilst also continuing in his role of Commercial Director to steer the ship through what will no doubt be a very busy Q4 2023.

Aisling Smith, Head of Brand Relationship Management, Navi Group Aisling Smith has been part of the Navi Group since 2017, when she entered via the graduate programme, moving up the ranks every year since. Most recently Retail Operations Manager for a group of CarePlus and StayWell Pharmacy franchisees, in 2023 she took up the role of Head of Brand Relationship Management.

In her new role, Aisling has taken on responsibility for managing all of Navi Group’s customer relationships across franchise, broker, IT and marketing functions. Aisling brings a plethora of practical experience from her time on the road that is utilised to develop Navi’s continuously evolving strategy. Aisling’s key areas of focus for Navi customers centre around utilising pharmacy business intelligence to ensure greatest turnover and margin for independent pharmacies within the group.

Professor Judith Strawbridge, Deputy Head, School of Pharmacy, Royal College of Surgeons in Ireland Professor Judith Strawbridge, Deputy Head, School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences In July of this year, Professor Strawbridge was appointed to the Expert Taskforce to Support Expansion of the Role of Pharmacy.

Established by Minister for Health Stephen Donnelly, the taskforce will examine how pharmacists in Ireland can be enabled to operate at the top of their licence for the benefit of patients and the wider health service.

Professor Strawbridge was a founding lecturer on the pharmacy degree programme at RCSI and is currently Deputy Head (Education) of the School of Pharmacy and Biomolecular Sciences and Director of the Masters of Pharmacy (MPharm) Programme. She is widely recognised nationally for her scholarly expertise and passion for standards in pharmacy education and practice.

Adrienne Stack, Pharmacist & Owner, Stacks Pharmacy Group This year, Stacks Pharmacy Group were finalists in the BOIPA Payments Acceptance Innovation & Service Development Award. A dedication to medication management has become a particular interest for Adrienne Stack and the team. Adrienne has launched Digicare, which is an intelligent workflow solution for medication management in a nursing home/hospital setting. The mission is to increase the safety and the efficiency through automating the daily task list, provide live feedback to the users and access to superior analytics.

Digicare is a cloud-based software and has a mission is to dramatically reduce medication errors and the need for investigations. We accomplish this by increasing the safety and time efficiency by automatically updating all stakeholders when a change is made, or a new patient is admitted.

It also records all safety related information of patients in one place so at the point of prescribing, administration and dispensing the information is available.

Delivering best in-class products, service, and support for optimum patient care. www.udw.ie

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Norma Sullivan, Community Pharmacy Technician, Newtown Pharmacy Norma is near the completion of her technician’s course, and it is shown in her work every day. Her talent in organising the dispensary to make it easy access for all staff and pharmacists is outstanding.

She is there to make sure we have all the correct high-tech medication in stock to ensure customers receive them on time each month. She orders our veterinary section to ensure that all stock is rotated regularly. Her relationship with the surgeries is great as she has daily contact with them to ensure that any changes are updated on our patient medication records.

Norma co-ordinates the pharmacy community blister every week and set up a system to ensure that all staff know what week we are working on, and which customers are due for the blisters each week, this system stops the risk of blisters being forgotten and makes sure the relevant paperwork is up to date and signed.

James possesses an exceptional ability to understand the experiences of his patients, part health conditions. He is a true team player who treats everyone with respect. During the pa delivery of medicines, initially carrying them himself and later implementing a structured po delivery.

The role of a pharmacist has evolved significantly in recent years, demanding specific attrib qualities, including humility, character, empathy, knowledge, skill, accuracy, and patience, a standards. His professionalism, innovative spirit, and ability to communicate with colleague approachable, jargon-free manner have notably enhanced the store's atmosphere.

James has played a pivotal role in the local Covid-19 Vaccination programme, spearheadin effort into ensuringBantry the service's accessibility the Amanda store. He invested Tringle, significant Supervising Pharmacist, Pharmacy PCC throughout t dedication has extended to various other services and educational initiatives. Working clos During this year, Amanda has put two members of her pharmacy staff through the over the counter focused on essential topics like Diabetes and Fertility to equip them with the knowledge to courses and she is also helping two pharmacy technicians further their career. As a new mum she customers. has huge knowledge on baby health and care, where offers great reassurance to any new mum customer that comes into the shop. She sets up a stress-free system for all the staff to checking off the James community blister and updating medication recordsand ensuring changes are his updated. is an invaluable assetthetopatient McCauley, his store, mostallimportantly, patients.

She also helps patients set up the drugs payment scheme so to ensure to reduce medication costs, she is great in helping the patients that would have mobile problems by ensuring they have the right information of where to get any extra aids and help.

James Tully, Support Pharmacist, McCauley Pharmacy Group James possesses an exceptional ability to understand the experiences of his patients, particularly those with mental health conditions. He is a true team player who treats everyone with respect.

During the pandemic, he initiated the delivery of medicines, initially carrying them himself and later implementing a structured postal service with next-day delivery.

James has played a pivotal role in the local Covid-19 Vaccination programme, spearheading its implementation within the store. He invested significant effort into ensuring the service’s accessibility throughout the entire week. This same dedication has extended to various other Closing date for applications is Monday 2nd of Octobe services and educational initiatives. Working closely with his team, he has focused on essential topics like Diabetes and Fertility to equip them with the knowledge to provide the utmost support to customers.

Working collaboratively with manufacturers, customers, patients and colleagues.

United, we do better

Closing date for applications is Friday the 7th of October.

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Dynamic 100 Dermot Twomey, Pharmacist, Cloyne Pharmacy/President, Irish Pharmacy Union Dermot is President of the Irish Pharmacy Union. During this year he has campaigned on behalf of the organisation to increase recognition of the vital role played by community pharmacists in Ireland. In March, he presented to the Oireachtas Health Committee on the urgent need for the appointment of a Chief Pharmaceutical Officer, and outlined a series of proposals to expand the range of services available at pharmacies, which will improve patient care and relieve pressure on the health system.

Dermot established Cloyne Pharmacy in 1997.

Sean Twohig, Associate Director, Healthcare Strategy, Teva Ireland Over the past year, Sean has moved into Teva’s Irish business taking the role of Associate Director, Health Strategy having been part of the UK cluster for the previous four years. Using his knowledge and experience of working in healthcare environments he is shaping Teva’s strategic approach to serve as a dynamic force within the industry. One of Sean’s most significant accomplishments in the last year has been the instrumental role he has played in strategic drug launches in close collaboration with other Teva colleagues and the Health Service Executive (HSE). These initiatives have expanded access to transformative medicines and treatments for patients throughout Ireland. Another key priority has been the elevation of Teva’s profile within the pharmaceutical landscape in Ireland. Through strategic partnerships, and effective communication strategies, Sean is continually propelling the company into the forefront of industry recognition, ensuring that Teva’s voice is heard and understood both amongst policy makers, HCPs and within the HSE. As Chair of the EU Pharma committee, Sean has championed the generics and biosimilars pharmaceutical industry in a challenging and dynamic environment, facilitating the exchange of knowledge, regulatory updates, emerging trends, and best practices with the Department of Health and other key stakeholders. In his capacity as Chair of the Medicine Shortages committee, Sean has undertaken the critical task of addressing the pressing issue of medicine shortages, a challenge directly impacting patients.

Beverly Walsh, Pharmacy Manager, Hickey’s Pharmacy Group Beverly Walsh joined Hickey’s as a Pharmacy Healthcare advisor in 2012 before commencing the IPU Technician course in 2016, After completing her course, she was promoted to Pharmacy Manager and following that, she took on one of the busiest dispensaries in the country, Hickey’s Northside in 2019 as Pharmacy Manager. During her time there she has built a team that always strive to deliver best in class patient care and customer service. Working closely with the pharmacist, they have built close ties to other pharmacies and doctors in the area to ensure that our patients in our local communities are well looked after.

Beverly has been integral in training and developing other pharmacy managers, ensuring they have that patient first approach and she also applies the same passion when training and developing her pharmacy technicians.

Congratulations to the Dynamic 100.

United, we do better

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Ray Walsh, Pharmacist, Ray Walsh totalhealth Pharmacy, Tipperary Ray, of Ray Walsh Pharmacy, was put forward for the 2023 People’s Pharmacist Award by members of his community who feel their health, and lives, would simply not be the same without him care and support.

After one such customer had to give up their career in 2017 to look after elderly and unwell parents, Ray stepped up to the mantle.

They said, “Having to deal with a number of chronic conditions between both parents, such as diabetes, heart disease, COPD and colostomy, Ray offered tremendous support with information, exceptional service even up to staying back late to facilitate a meds pick up as I would get delayed with caring duties.

“He even delivered the medicines and incontinence supplies himself. Then in 2012 I ended up fostering my baby niece and nephew. Ray and all his staff were so supportive and gave amazing service, professionalism, and above all empathy. My caring duties have now ended but I could not have been able to get through those times without Ray Walsh and his staff. I cannot commend Ray Walsh enough for his help.”

Dominika Wikowicz, Pharmacy Technician, Adrian Dunne Pharmacy, Balbriggan Dominika is the 2023 TouchStore Community Pharmacy Technician of the Year winner. She is a Senior Technician in Adrian Dunne Pharmacy Balbriggan. She qualified as an EU Pharmacy Technician in Poland and joined Adrian Dunne group in 2019. In this short period of time she has become the most valuable part of the team. She is hard working and she is totally committed to her job. Her gentle personality has won the hearts of everybody around her in the Pharmacy. The main way Dominika has enhanced the role of the Pharmacy Technician is through her commitment and attention to detail when it comes to stock accuracy. She has achieved the highest live-stock accuracy score in the company.

Rob Wood, Supervising Pharmacist, McCauleys Pharmacy In 2021, Rob became a vital part of the McCauley Pharmacy Group, assuming the role of Supervising Pharmacist Store Manager at one of the group’s newly acquired stores. Rob wholeheartedly dedicated himself to supporting his new colleagues and customers during this transformative phase. His remarkable leadership skills and patient-centred approach not only ensured the continuity of care for his customers but also elevated it through the optimisation of the pharmacy’s operational setup. He established crucial relationships with other healthcare professionals in the area and introduced new pharmacy services within the store. Rob’s unwavering passion for showcasing the capabilities of the pharmacy profession has been a constant throughout his tenure with the McCauley Pharmacy Group. Over the past year, he successfully launched Flu and Covid-19 Vaccinations, 24 Hour Blood Pressure Monitoring, Lipid and Glucose Testing within his pharmacy. His leadership abilities were so impressive that he was chosen to lead one of the busiest stores when the company supported the opening of a new adjacent doctor’s surgery, resulting in his appointment as the new Supervising Pharmacist.

01 463 2300 www.udw.ie

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HIV

World AIDS Day: Remember, Commit, and Thrive The Gay Health Network: World AIDS Day stands as a poignant reminder of an ongoing global battle against the HIV/AIDS pandemic. It’s a day when we pause to reflect on our progress, remember those we’ve lost, and recommit ourselves to the fight. In 2023, the theme for World AIDS Day is “Remember and Commit,” highlighting the importance of acknowledging our past while renewing our commitment to ending the HIV epidemic.

Written by Pádraig Burke in conversation with Robbie Lawlor and Enda McGrattan aka Veda.

diagnosis. At that time, he was living a vibrant life, active on the social scene, and completely unaware of the presence of HIV in Ireland. “I had never discussed it with my sexual partners or friends,” he admits. The lack of awareness was a glaring issue. He recalls, “I was like a deer in the headlights.”

As with many others, Robbie’s initial response to his diagnosis was marked by shame and the fear of being deemed “unlovable” and “disgusting” by others.

The 1980s marked the onset of the HIV/AIDS pandemic, a seismic event that sent shockwaves throughout the global health landscape. The initial response was characterised by confusion, fear, and prejudice. Stigma and discrimination shrouded those affected, and misinformation ran rampant. However, amid the trauma and crisis individuals from diverse backgrounds united in a common cause—the fight for their lives and the lives of others.

Pioneering organisations like the AIDS West (now Sexual Health West), Act Up, Dublin AIDS Alliance (now HIV Ireland) and Gay Health Network (GHN) were established during this period and continue their invaluable work to this day. HIV stigma and discrimination remain significant barriers to effective HIV testing, prevention, and care.

Today, two people are blazing a trail in the field of HIV activism.

Enda McGrattan, aka Veda, and Robbie Lawlor have emerged as champions in the fight against HIV stigma and discrimination. Through their platform, the PozVibe Podcast, Robbie and Veda have made a significant impact, confronting HIVrelated stigma, dispelling myths, educating people and inspiring a brighter and more compassionate future for people living with HIV. Their success and influence have been so profound they were invited to attend Mardi Gras in Sydney in February 2023, and they were recently honoured with the Noel Walsh HIV Activism Award at the 2023 Gala Awards. GHN sat down with Robbie and Veda to talk about their journeys and where we are at and where we need to go with HIV and HIV stigma.

Robbie Lawlor, an HIV activist, advocate, PhD student and cofounder of Access to Medicines Ireland, takes us back to 2012 when he received his HIV

PHARMACYNEWSIRELAND.COM

However, a turning point came when he disclosed his status to loved ones and connected with a friend living with HIV. A moment of clarity struck when he saw a hurtful message sent to his friend.

The message read “‘You AIDSriddled C-U-N-T. I can’t believe I even touched you, let alone kissed you. I’m going to tell everyone about your status.” Robbie shaken with anger, recognised his role in perpetuating the problem, that silence was a serious issue, and he decided to take action.

He shifted his mission towards educating and humanising the experience of living with HIV, providing support for those newly diagnosed, and being the person he himself once needed when faced with his own diagnosis.

Meanwhile, Veda, a drag superstar who has been captivating audiences for over a quarter of a century, is a beloved and wellknown entertainer in the gay and wider Dublin scene. Growing up during the 80’s AIDS epidemic, her generation endured the trauma of media portrayal and moral outrage surrounding the virus. Grim TV ads featuring tombstones left a lasting impact on society’s perception of HIV that lingers to this day.

Veda received her HIV diagnosis in 2009 and her immediate reaction was to keep it a secret. She describes her response as being in an “HIV closet,” compelled by internalised shame and fear. This response was shared by many,

driven by the overwhelming stigma associated with the virus. It was years later when inspired to make a change, Veda created a song titled “I Came Out One Night,” which she posted on World AIDS Day in 2019. The overwhelmingly positive response and outpouring of love encouraged her to delve deeper into HIV activism.

This marked her “second coming out,” unleashing a wave of love and support from the community.

It was around this time that Veda conceived the idea of a pozcast which would provide a safe space for individuals living with HIV to share their stories and truths, breaking the silence that had persisted for far too long.

Robbie, who had built up years of knowledge about HIV, was the perfect bedfellow to complement Veda, and so their successful partnership began.

The central theme of PozVibe is encapsulated in the concept of humanising experiences and storytelling. Each story shared on the platform challenges stereotypes, empowers individuals, and breaks down the barriers of stigma. It exemplifies the power of storytelling and human connection in the fight against HIV stigma.

The podcast celebrates the transformative power of knowledge and understanding, a key element in breaking the shackles of stigma surrounding HIV. By sharing these stories and advocating for the U=U message (Undetectable equals Untransmittable), they are not only lifting those around them but also paving the way for others to do the same. U=U essentially means, when a person living with HIV is on effective treatment, their viral load is so low, they cannot pass the virus to others. It is a groundbreaking and game-changing development for people living with HIV. Much of the fear and trauma that once went with an HIV diagnosis is all but gone. “Imagine being told at the point of diagnosis, ‘It’s just one pill a day. You live as long as anyone else, you can’t pass it on. HIV affects no one but you.’ Imagine being told that at the point of diagnosis” Robbie tells us. What endures however is the stigma and this is something we must fight against.

97 The first episode of the PozVibe podcast coincidentally coincided with the filming of the awardwinning documentary titled “How to Tell a Secret.” This fantastic hybrid documentary film employs Robbie’s disclosure story as the core of the film and a springboard to explore themes of stigma, shame, and fear around HIV. Coincidentally Veda also features in the film portraying The Dice Man. The critically acclaimed film subsequently had a nationwide release in Ireland and won numerous awards.

HIV Activism and Ending Stigma

The Future of HIV Activism

The fight against HIV stigma extends beyond the personal journeys of Robbie and Veda.

Robbie emphasises that to truly end HIV stigma, we must also address broader societal issues such as homophobia, transphobia, and the shame surrounding sex. These intersect with HIV stigma, making it a more complex challenge. His vision is to create a supportive and inclusive environment for individuals living with HIV.

According to UNAIDS, in 2022:

The Power of Education and Empathy

Veda anticipates a future where more people openly share their HIV status with fewer consequences. This change will humanise the experience of living with HIV, promote self-love, and normalise discussions about HIV. Veda’s vision includes increased open dialogue reduced stigma surrounding the virus and openly talking about testing. “You need to test and you need to talk about testing, and talk about HIV and talk about STIs. And it’s as simple as that. And do that without any shame, and encourage other people around you to do the same and talk about it.”

In reflecting on their respective journeys, Veda and Robbie have gained valuable insights into the power of empathy and non-judgment. They celebrate the uniqueness of each person’s experience with HIV, recognising the beauty in how people process and share their experiences. Veda emphasises the importance of patience and active listening, recognising that we must embrace each individual’s distinct path to healing.

Robbie has learned that when you provide a safe space for people to share their stories without judgment or sensationalism, incredible things happen. The transformation of stigma is not just possible but profoundly empowering.

Veda encountered a couple of surprises on her journey. The first was the warm embrace of her podcast approach during World Pride in Sydney. The adaptability and positive response from a different city, culture, and people were entirely unexpected but incredibly promising for the future of the podcast and indeed activism.

The second, and perhaps even sweeter surprise, she describes is the rapid bonding and inclusivity that characterises their PozVibe community. Each new episode brings new members who seamlessly integrate into this supportive family-like atmosphere, forging close connections quickly and creating a tribe of people living and thriving with HIV. Robbie also mentions that in the beginning, he had concerns about finding enough people willing to share their HIV stories, given the long history of stigma and silence around the topic in Ireland.

However, he tells us, “If you can provide a safe space where people, you invite them to share their story with peers and have a good laugh, make sure it’s not sensationalist... people will come, people will come.” In fact, he says, if you are living with HIV and reading this – feel free to get in touch.

A Call to Pharmacists: We asked Veda and Robbie if they had any messages for pharmacists. Veda’s message to pharmacists on World AIDS Day is to encourage people to know their HIV status and provide information and support to those interested in accessing Pre-Exposure Prophylaxis (PrEP). By talking about HIV and other STIs in a nonstigmatising way, pharmacists can help reduce fear and encourage open discussions about sexual health. Encouraging the use of home HIV tests, which are discreet and free, is another critical step in reducing stigma.

 39.0 million people globally were living with HIV.  29.8 million people were accessing antiretroviral therapy.  1.3 million people became newly infected with HIV.  630,000 people died from AIDSrelated illnesses.

slogan encapsulates it all: “Get tested, get treated, no drama” As we mark World AIDS Day in 2023, Robbie and Veda’s reflections imbue the theme “Remember and Commit.” We remember the struggles of the past, the lives lost, and the battles fought. We commit to a future where HIV stigma is eradicated, compassion prevails and equity and justice are achieved.

UNAIDS’ targets for 2030 include zero new HIV infections, zero AIDS-related deaths, and zero stigma. While some regions are making substantial progress, there is still work to be done in Ireland.

Beyond merely suppressing the virus, Robbie believes in improving the overall quality of life for people living with HIV, addressing social networks, point-of-care in healthcare settings, and holistic well-being. He emphasises the need for global health equity and universal justice, ensuring that everyone, regardless of their geographic location, has access to the care and support they need.

For information on HIV prevention and testing visit man2man.ie. You can catch the PozVibe Podcast on Spotify and Apple and the film “How to Tell a Secret” is currently available to view on Netflix and the RTÉ Player.

Veda anticipates a future where more people openly share their HIV status with fewer consequences.

Her vision includes increased open discussions about HIV on social media, more people sharing openly about their diagnosis, and a reduction in the stigma associated with HIV. PozVibe’s Pride 2023

A standout initiative of GHN is the impactful man2man.ie program, operating in collaboration with the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP).

This program has become instrumental in providing essential resources and support to the GBTQ community.

The Gay Health Network (GHN) is a community-based organisation dedicated to championing the health and well-being of gay and bisexual men in Ireland. Established in 1994, GHN emerged in response to the pressing need to address the unique health challenges faced by this community.

Robbie echoes the importance of creating a supportive and inclusive environment when dealing with individuals living with HIV. By treating HIV as a normal health condition, avoiding stigmatising language, and promoting a supportive atmosphere, pharmacists can play a pivotal role in the fight against stigma. Additionally, they can work toward improving the delivery of PrEP in Ireland, involving GPs and pharmacists in stakeholder discussions to streamline services and make PrEP more accessible.

HIV Activist Aoife Commins

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Clinical Profiles

IRISH SURVEY SHOWS ACNE EFFECTS ARE MORE THAN SKIN DEEP Despite marketing pleas to have us ‘love the skin we’re in’, it seems the wellbeing and confidence of people in Ireland is seriously affected by problem skin.

Recent research commissioned

by Citrine Healthcare indicates a significant three in five of the adult population (63%) have felt self-conscious in public, due to an adverse skin condition.

Females are more likely to report that problem skin, like acne, has affected their confidence (63%), as against 56% of males. And, worryingly, 71% of those aged 1824 have suffered feelings of anxiety on account of their skin.

Problem skin is relatively common, and is frequently caused by hormonal factors, Sarah O’Leary, a Director at Citrine Healthcare says.

Dermatologists indicate that acne affects over 80% of the teenage population and lasts for 8-10 years on average. Pregnancy and menopause can prompt renewed outbreaks too.

The new Irish survey showed over two thirds of the population suffer, or have suffered with, a skin condition. 50% say feeling self-conscious on account of the appearance of their skin has held them back, particularly females and young adults aged under 35.

Females were more likely than males to report being worried about people judging them, because of how they look (42% vs 34%).

20% of females and 17% of male respondents avoided social activities because of poor skin, and 11% of males said skin problems stopped them making friends. Playing sports, getting a part-time job, or participating fully in school or college can also be avoided by sufferers.

Sarah O’Leary of Citrine Healthcare says some people who no longer have acne, or never suffered, may think anxiety, lack of confidence, and limited social engagement are extreme reactions.

“In fact, these are very real emotions that can severely affect individuals, and their development, especially young adults. Skin health is more than achieving a flawless complexion; it is about self-care and self-esteem.”

Acne is the second most common skin condition after dermatitis, according to the research. Almost 40%, 2 in 5, in Ireland, have

suffered with acne at some point in their lives. Six in ten say over-thecounter (OTC) medications to treat acne were effective.

Sarah O’Leary says the research findings, especially the emotional stress revealed, underscores the importance of a proactive approach to skincare.

“Improving acne is absolutely possible, with a skincare routine tailored to the person’s specific skin type and issues. Pharmacists can suggest suitable remedies, and good advice is to stick to a couple of specialist acne products, use them consistently, and give them time to work.

“There are no overnight miracles, but the majority of those who follow a simple topical regime for up to 12 weeks will see improvement and get breakouts under control.”

Washing your face just twice a day, and after sweating, is also advised; but never scrubbing, so as to avoid irritating acne-prone skin. While, touching, picking or popping is also strictly off-limits, the experts at Citrine Healthcare say.

The Irish skincare company, launched in 2021, produces a specialist range of four OTC products to help manage the symptoms of acne prone skin.

Triboclense Cleansing Gel and Ceboderm Moisturising Cream are for daily use, and, depending on the type of acne, Triacine Control, an exfoliating cream, and Benoxor Clear cream, which helps keep bacteria at bay, may be recommended for periodic use.

Pharmacy ranges for psoriasis, rosacea and dermatitis (eczema) are also produced by the west Dublin company.

NEW SAFETY DATA SUGGESTS ESKETAMINE NASAL SPRAY IS MORE TOLERABLE AND EFFECTIVE COMPARED TO QUETIAPINE EXTENDEDRELEASE (XR) IN ADULTS WITH TREATMENT-RESISTANT MAJOR DEPRESSIVE DISORDER1,2 The Janssen Pharmaceutical Companies of Johnson & Johnson

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have announced further findings for esketamine nasal spray [NS] from the ESCAPE-TRD study.

Data on treatment-emergent adverse events (TEAEs) suggest a more favourable tolerability profile in adults with treatmentresistant major depressive disorder (TRD) receiving esketamine NS than quetiapine XR. Across all reported TEAEs experienced with esketamine NS, 92.1 percent were transient and resolved the sameday vs 12.1 percent of TEAEs experienced with quetiapine XR.1 The findings were presented at the 36th European College of Neuropsychopharmacology Congress (ECNP 2023) which took place from 7 October to 10 October in Barcelona, Spain.

While more TEAEs were observed with esketamine NS than with quetiapine XR, a greater proportion of esketamine NS-treated patients (82.6 percent) reported a TEAE that resolved same-day day vs quetiapine XR patients (15.5 percent)1 in TAES that occurred in ≤ 5% of patients. Fewer esketamine NS-treated patients (53.6 percent) reported a TEAE that persisted for more than one day vs quetiapine XR-treated patients (74.7 percent) and TEAEs leading to treatment discontinuation were more frequent with quetiapine XR (11.0 percent) than with esketamine NS (4.2 percent).1 Dr Lorcan Martin, Consultant in General Adult Psychiatry said, “When formulating the most effective treatment plans for a patient, the utmost priority remains ensuring patient safety.

The findings from the ESCAPETRD study give confidence to healthcare professionals treating those living with TRD. By definition, TRD is challenging to treat, and it is critical to have treatment options with robust safety data that are less likely to lead to discontinuation for this patient population.”

While Major Depressive Disorder (MDD) affects nearly 40 million people in Europe3, Ireland has one of the highest rates of mental illness as it is estimated that approximately 150,000 people per year are living with severe depression (also known as Major Depressive Disorder or MDD) here.4,5 Approximately onethird of people who experience MDD do not respond to treatment and are considered to have TRD – a term for people living with MDD who have cycled through two or more antidepressant treatments within the current depressive episode without experiencing symptomatic relief.6,7

Patients Report Superior Efficacy with Esketamine NS vs Quetiapine XR In addition, patients enrolled in the ESCAPE-TRD study reported treatment effectiveness, using the nine-item patient health questionnaire (PHQ-9) scale. PHQ9 is a widely used and effective tool for the detection of depression, and for monitoring its severity.8 Findings presented at ECNP 2023 showed that esketamine NS significantly increased the proportion of patients achieving, and shortened time to, PHQ9 remission versus quetiapine XR, with patients being 1.21 times as likely to experience remission at Week 32.2 From the patients’ perspective of their own symptoms, esketamine NS showed superior short and longterm efficacy in TRD compared to quetiapine XR.2 Significantly more patients in the esketamine NS arm achieved PHQ-9 defined remission (56.8 percent versus 43.3 percent [p<0.001]) at Week 8, with numbers increasing by Week 32 (68.9 percent versus 57.2 percent [p<0.01], respectively) compared to patients in the quetiapine XR arm.2 These findings were consistent with results of the primary endpoint analysis, which showed a significantly higher remission rate measured using the clinician-rated Montgomery-Äsberg Depression Rating Scale (MADRS) in the esketamine NS arm versus the quetiapine XR arm.9 SITAGLIPTIN / METFORMIN CLONMEL Clonmel Healthcare is delighted to announce the launch of Sitagliptin / Metformin Clonmel 50/850mg and 50/1000mg film-coated tablets.

Sitagliptin / Metformin Clonmel in indicated for adult patients with type 2 diabetes mellitus.

Full prescribing information is available on request or alternatively please go to www.clonmel-health. ie. Medicinal product subject to medical prescription.

99 Please contact Clonmel Healthcare on 01-6204000 if you require any additional information.

PA 126/327/1-2. PA Holder: Clonmel Healthcare Ltd., Clonmel, Co. Tipperary. Date prepared: October 2023. 2023/ADV/ SIT/197H. NEW PRODUCT LAUNCH: BRILLPHALAC (LECTULOSE) SOLUTION

issued a stark warning that Ireland is not making satisfactory progress on lung cancer, stating that “lung cancer death rates remain shockingly high, while symptom awareness is alarmingly low”.

Lung cancer continues to claim more lives annually, among both men and women, than any other cancer, with 1,850 people dying from the disease in Ireland each year. However the new research, compiled for the charity

by Empathy reveals that less than one third of the population (29%) feel they know the signs and symptoms to watch out for in relation to lung cancer, while more than a third of adults (36%) admit that not being aware of the symptoms of lung cancer would deter them from getting symptoms checked.

The Marie Keating Foundation, one of the leading voices in Ireland for early detection, claims it doesn’t have to be this way, and is calling on the Government, stakeholders and the public to ‘change how we see lung cancer’.

Windzor Pharma Ltd are please to announce the launch of Lactulose oral Solution under the brand, Brillphalac, on November 9, 2023 into the irish market.

As part of its ‘Big Check Up 2023’ campaign, the charity has outlined

a three-point action plan that it says will save countless lives now and in the future.

The action plan aims to: 1) change how we see lung cancer, countering the misbelief that there are more dangerous cancers for both men and women and highlighting the fact that lung cancer still claims more lives than any other cancer; 2) raise lung cancer symptom awareness, harnessing the use of innovative, specially developed, new mobile technology in partnership with Snapchat, to spotlight symptoms and urge people to get checked; 3) renew pressure on the Government to introduce a National Lung Cancer Screening programme, similar to breast, bowel and cervical cancer screening, to help save lives.

Launching the campaign, Liz Yeates, CEO of the Marie Keating Foundation, said, “It’s been five years since we last carried out this significant research into public attitudes and awareness around

lung cancer and very little has changed in that time. I’m deeply disappointed to say that in Ireland today, lung cancer death rates remain shockingly high, largely due to late diagnosis, while symptom awareness is alarmingly low and a stigma still persists in relation to lung cancer.

“The time has come to change how people see lung cancer, to raise public awareness and encourage those with lung cancer signs and symptoms to get checked, because early detection, combined with all of the new treatments available, significantly improves chances of positive outcomes.”

Currently in Ireland, the 5-year survival rate for lung cancer patients is just 24%. This is extremely low compared with other five-year survival rates for common cancers such as, Prostate: 93%, Breast: 88% and Colorectal: 66%.

Furthermore, the National Cancer Registry of Ireland has predicted that rates of lung cancer will rise rapidly by 2045, with lung cancer diagnoses expected to increase by as much as 176% among women, and by 94% among men.

Liz Yeates, CEO Marie Keating Foundation, lung cancer patient, Ted O’Driscoll, and awareness advocates, Venetia Quick and Catherine O’Flaherty. Picture Andres Poveda

There will be two packs, 500ml and 300ml. The 500ml product is reimbursed on the various HSE schemes, and the 300ml will be available as an OTC in pharmacies only.

There will be two pack sizes available, 500ml x 6, shrink wrapped, 300ml x 10, shrink wrapped.

The product will be available from both United Drug Wholesale, and Uniphar PLC. The products will be listed in both wholesaler websites from November 1st onwards.

Please forward any questions to info@windzorpharma.com MARIE KEATING FOUNDATION ISSUES URGENT CALL TO CHANGE HOW WE SEE LUNG CANCER Only 5% of Irish people are aware that lung cancer is the leading cause of cancer related deaths among women, while just 20% know that it is the cancer that claims the most lives among men.

The figures were revealed in new research commissioned by the Marie Keating Foundation who have

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Buscopan 10mg Coated Tablets contains hyoscine butylbromide and is indicated for the relief of spasm of the gastrointestinal tract and for the symptomatic relief of Irritable Bowel Syndrome. For adults and children 12 years and over. Swallow the tablet whole with water.

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