Chronic Conditions
“The needs of people with CF now extend beyond the clinic.”
Dr Andrew Wilfin Page 03
Targeted Care for Joint Wear & Tear ..
“Living with IBD isn’t solely about managing flare ups or periods of remission.”
Victoria Spillane Page 07
Targeted Care for Joint Wear & Tear...
Two major milestones in diabetes care in Ireland
In May 2026, two important national initiatives marked a significant step forward for diabetes care in Ireland. Together, they highlight a growing commitment to improving both the services available to people living with diabetes and the way care is delivered..
The first was the launch of the ‘Diabetes Policy and Services Review Report: A Strategy for Better Care’ by Minister for Health Jennifer Carroll MacNeill TD. The report provides a detailed assessment of diabetes services across the country and identifies priorities for future development.
Addressing service gaps
While the review recognises many strengths within existing diabetes services, it also highlights areas where access remains inconsistent. These include psychological support, diabetes technology, structured education programmes, transition services for young people , and specialist diabetes staffing.
The report identifies regional differences in service provision and workforce shortages, providing a roadmap to help standardise care and reduce inequalities. Its long-term goal is to ensure that everyone living with diabetes can access high-quality, evidence-based care regardless of where they live.
Words matter too
The second milestone was the publication of ‘Language Matters: Guidance for Person-Centred Diabetes Communication in Ireland.’ Developed by people living with diabetes, healthcare professionals and researchers, the guidance recognises that language plays a vital role in healthcare experiences and outcomes.
Research shows that judgemental or stigmatising language can negatively affect wellbeing and engagement with care. In contrast, respectful, person-centred communication helps build trust, supports self-management and encourages partnership between individuals and healthcare professionals.
Looking ahead
Together, these initiatives reflect an important shift towards more equitable and person-centred diabetes care. Improving outcomes for people living with diabetes depends not only on access to services and treatment, but also on ensuring that every interaction is supportive, respectful and focused on the person rather than the condition.
The vital role of community pharmacies in managing chronic conditions
Community pharmacies are a vital first point of contact for healthcare in every town, village and community.
The Irish Pharmacy Union (IPU) is the representative and professional body for community pharmacists in Ireland, with a membership of approximately 2,400 pharmacists working in more than 1,850 community pharmacies throughout the country. IPU members are committed to delivering a quality, accessible, personal, and professional service that puts the patient first and optimises society’s health and wellbeing.
How community pharmacists help manage chronic conditions
Community Pharmacy has demonstrated the ability to respond quickly to public health needs, expand services at pace and deliver measurable results — all while maintaining safe and trusted patient care. Through their daily interactions with patients and carers, community pharmacists provide an essential link in the safe and effective management of chronic conditions.
Conditions Service. Whilst not a service designed to support the management of chronic conditions this service enables community pharmacists to provide treatment, including prescription treatments, for eight common conditions. This private and confidential consultation service is available at participating pharmacies. This service provides faster access to trusted healthcare in their communities while freeing up capacity within the health system for patients with more chronic conditions.
Through their daily interactions with patients and carers, community pharmacists provide an essential link in the safe and effective management of chronic conditions.
Since 2011 legislation has supported pharmacists to administer vaccinations in the community pharmacy setting. Pharmacists can supply and administer influenza, COVID 19 and pneumococcal vaccinations to eligible patients as part of national immunisation programmes - all of which provide protection to patients with chronic conditions. Some pharmacies also provide private vaccination services including shingles vaccination.
Expanding the role of pharmacists
In 2023, the Government recognised the unique role of community pharmacists and created an Expert Taskforce to support the expansion of their role.
In 2025, the first of their recommendations was implemented with the launch of the Common
Pharmacists and pharmacy teams continually engage and support their patients, providing timely interventions and supporting continuity of care through medicines counselling, advice and information, along with preventative care and health promotion.
Beyond their core strength in dispensing and medicines advice, community pharmacists now play a broader clinical and public health role. They administer vaccines, engage in health promotion and suppport in the management of chronic conditions, delivering person-centred, evidencebased services that improve outcomes. Disease management services support patients with chronic or complex conditions by enhancing medication use, therapy adherence, and self-care. These interventions reduce hospital admissions, boost adherence, and particularly benefit people with multiple conditions or those living in underserved areas.
The academic paper published in Diabetic Medicine can be found at the QR Code
Sinead Powell
Senior Dietitian, Education and Support Co-ordinator, Diabetes Ireland
Susan O Dwyer MPSI PhD Head of Professional Services, Irish Pharmacy Union
Children and adults with CF now have better health, longer life expectancy and opportunities that were once thought not possible.
A new era for cystic fibrosis: Why the work is not done
Cystic fibrosis (CF) care in Ireland, the country with the highest incidence of CF in the world, has been transformed by medical progress, advocacy and scientific breakthroughs. The determined work of the CF community has delivered real improvements in life expectancy, quality of care and support systems.
Dr Andrew Wilfin
MBChB MRCGP MFPM Senior Country Medical Director, Vertex Pharmaceuticals
However, the evolving needs of people with CF reinforce one clear message: the work is not finished.
People with CF now live longer and healthier lives. Yet longer life brings new challenges.
Care is no longer only about survival. It must support wellbeing at every stage of life and respond to issues that go well beyond the lungs.
Transforming the early years
Children are diagnosed at birth, through screening, and access to advanced therapies allows clinicians to act quickly. Early intervention helps protect organ function and gives children a stronger foundation for better long-term health.
“As a respiratory doctor looking after children with CF, I have witnessed a remarkable transformation in care over the past decade,” explains Professor Des Cox, Consultant in Paediatric Respiratory Medicine, Children’s Health Ireland. “Children and adults with CF now have better health, longer life expectancy and opportunities that were once thought not possible.”
Sponsored by Vertex Pharmaceuticals
Early progress matters, but CF remains a complex, lifelong condition. Despite advances in treatments, regular monitoring and daily care routines remain a reality for many families. Effects on the gastrointestinal system and pancreas also continue for many people with CF.
Navigating new stages of life
A new generation is growing up with CF and redefining expectations. As life expectancy has increased, many people now plan for adult lives, including education, careers and families. That progress requires health and social systems to adapt to a very different reality.
National outcome data reflect this shift. Godfrey Fletcher, CEO, Cystic Fibrosis Registry of Ireland (CFRI), observes, “CFRI has been collecting CF patient outcome data for over 26 years. The change in outcomes over those years is nothing but miraculous, and with developments in disease management, the mean predicted survival age for individuals with CF born today is very close to 63 years (for those born between 2020 and 2024) – a dramatic improvement, although still younger than the national average. We believe this positive trend will continue. People with CF are now busy planning for a future!”
The needs of people with CF now extend beyond the clinic. As adults represent the majority of Ireland’s CF population, there is growing focus on supporting independent living, including financial planning, pensions, health insurance, housing and workplace accommodations. Greater attention on mental health, fertility, family planning and the pressure of lifelong treatment also needs to continue.
Emerging medical challenges
As the CF community ages, services and care models are adapting to support older adults living with a
complex, multisystem disease. In several centres, CF practitioners now help coordinate care, while virtual clinics reduce the need for some in-person appointments. These changes help direct specialist time where it is needed most.
However, this shift also creates fresh challenges. As some CF care moves toward primary care, general practitioners and community healthcare professionals need stronger CF awareness and training. Important questions also remain. There remains a need for better management of abdominal symptoms, pancreatic issues, inflammation and bronchiectasis.
Researchers are also exploring whether early treatment can prevent long-term complications in other organs. Unresolved issues around adherence and maternal outcomes need continued focus.
A commitment to the future
Progress in CF care comes from collaboration. Scientists drive innovation, clinicians tailor care and patient organisations help ensure evolving needs are heard in policyand practice-shaping discussions. That team effort has delivered real gains, but the journey is far from over.
While significant progress has been made in Irish CF care, important challenges remain. At Vertex, we are committed to working alongside the CF community to address remaining gaps in care and help improve quality of life for people living with CF.
IE-02-2600004 (v1.0) | 06/2026
How to reduce the daily pain of osteoarthritis and stay active
Osteoarthritis causes severe joint pain and restricts movement, but certain treatments and lifestyle changes can target the underlying causes and get you moving again.
Biresh Roy, CEO at AH Consumer Healthcare, which markets FlexiSEQ gel, outlines the causes of joint pain and osteoarthritis – and how sufferers can find both pain relief and improved joint mobility.
What is osteoarthritis?
Osteoarthritis is a chronic condition that causes joints to become inflamed, painful and stiff — most commonly the knees, hips, shoulders and small joints in the hands. It’s chronic in that it is always present, and is mainly associated with ageing, affecting people aged 55 onwards. But it can affect younger people regularly taking joint impact exercise like running. It’s also linked to obesity and joint trauma.
What causes it?
Inside a healthy joint, moving bone surfaces are covered by cartilage bathed in synovial fluid containing lubricating molecules to reduce friction from rubbing together during movement. However, with osteoarthritis, the cartilage wears thin over time, and sometimes altogether — while the levels of lubricating molecules become depleted. In such cases, friction from joint movement causes inflammation, pain, even when resting, and joint stiffness, leading to reduced mobility.
How does this affect everyday life?
can affect a person’s quality of life and independence — and their emotional wellbeing by affecting sleep, inducing mood swings, irritability and depression.
What’s the treatment for it?
When bone rubs on bone, the result is inflammation, joint stiffness, reduced mobility and pain when moving.
Unfortunately, there’s no cure because joint deterioration by its nature is progressive. Drugs are often used to manage pain but only provide temporary relief. What’s needed is a treatment that targets the underlying causes as well as symptoms. The FlexiSEQ range comprises two drug-free gels designed to do just that. Because of their formulations, they’re able to lubricate the joint so that it moves more freely, causing less friction and less pain. We recommend these be used as part of an overall therapy to keep people active, together with lifestyle changes. Join our extensive user community on our website to read about and share experiences.
What lifestyle changes can help?
As the condition progresses, symptoms become more severe and debilitating. The resulting pain and reduced mobility
Regular non-high-impact exercise such as walking, cycling, swimming, gardening and even daily house chores keeps joints moving, burns calories and strengthens joint muscles. Make sure your diet is rich in omega-3 fatty acids, like salmon. Take ginger and turmeric, which have naturally anti-inflammatory properties. And eat superfoods such as broccoli, which contain calcium, vitamins C and K and sulforaphane, which can slow down joint deterioration.
INTERVIEW WITH Biresh Roy CEO, AH Consumer Healthcare Ltd. (FlexiSEQ)
WRITTEN BY Tony Greenway
Improving childhood asthma outcomes
Childhood asthma affects thousands of families across Ireland. Early intervention and the right support can transform long-term outcomes
Asthma is one of the most common chronic conditions affecting children in Ireland, with an estimated one in ten children currently living with the condition.
For many, asthma is part of everyday life, from managing symptoms and medication routines to disrupted sleep, missed school days and the fear of serious flare-ups.
This year, childhood asthma was the theme of Asthma
Awareness Week, reflecting the Asthma Society of Ireland’s focus on improving outcomes for children and young people living with asthma.
Recognising the signs of uncontrolled asthma
While many children manage their asthma well, too many continue to experience symptoms that affect their daily lives. Night-time coughing, wheezing, regular chest infections and frequent use of reliever inhalers can all be signs of uncontrolled asthma.[RO3.1]
Early intervention is critically important. When asthma is identified early and treated effectively, children are more likely to stay active, participate in school and sport and reduce their risk of serious asthma attacks and hospitalisation.
Why MART is important
One important development in asthma care is the increasing use of MART (Maintenance and Reliever
A hidden inheritance: Why early
diagnosis
of hereditary ATTR amyloidosis matters
A rare genetic disease linked to Donegal is often missed until serious damage is done. Greater awareness could help families seek treatment sooner — and improve lives.
For many families, hereditary ATTR amyloidosis is more than a rare disease — it is a hidden inheritance, passed quietly from one generation to the next. In Ireland, that threat has particular resonance. A mutation known as T80A has long been linked to north-west Donegal and, through family lines, has travelled far beyond its place of origin. Caused by a faulty transthyretin (TTR) protein, the condition triggers a build-up of amyloid protein that can gradually damage the heart, nerves and digestive system.
Therapy) inhalers for adolescents aged 12-17. MART combines preventer and reliever medication in one inhaler, helping treat symptoms while addressing the underlying inflammation that causes asthma.
Clinical evidence shows MART can improve asthma control, reduce severe flare-ups, support treatment adherence and reduce overreliance on reliever inhalers.
The Asthma Society of Ireland is currently calling on the Government to make MART inhalers free for children and young people aged 12-17 as part of a phased expansion of access to best-practice asthma care.
Support for families
Trusted information and practical support are essential for families managing asthma. The Asthma Society provides a wide range of free tools and resources through asthma.ie, including educational guides, videos, practical management tips and webinar recordings.
Families can also access expert support through the Society’s free Asthma Adviceline (1800 44 54 64) and nurse-led WhatsApp messaging service (086 059 0132), helping parents and carers access trusted advice and reassurance when needed.
Importance of early diagnosis and awareness of symptoms
Early diagnosis can make a real difference. Treatments can slow the disease and improve quality of life for longer — but only if the warning signs are recognised in time. Those signs include tingling or numbness in the hands and feet, a history of carpal tunnel syndrome, unexplained weight loss, persistent digestive problems, dizziness, shortness of breath, swelling in the legs or worsening balance and walking difficulties. Unfortunately, these symptoms can be mistaken for more common illnesses. That is why awareness
matters — especially in families with a history of amyloidosis, unexplained heart problems, nerve symptoms or Irish roots linked to Donegal. When symptoms seem unusual, keep worsening or affect more than one part of the body, it is vital to ask a GP whether specialist assessment is needed.
Genetic counselling and testing: key to early treatment and support Hereditary ATTR amyloidosis is passed from parent to child, and every child of a parent carrying the mutation has a 50% chance of inheriting it. Honest conversations, genetic counselling and testing could open the door to quicker diagnosis and a better chance of treatment before irreversible organ damage takes hold. In Ireland, improved access to testing is offering families a real opportunity to act sooner.
Rare diseases are often pushed to the margins, but this is one that deserves to be brought into the light. The sooner hereditary ATTR amyloidosis is identified, the sooner treatment, support and hope can begin. For families in Ireland, and for people around the world with Donegal roots, knowing the signs, sharing family history and seeking help early could make all the difference.
DS-IRL-00006 June 2026
Philippa Quigley Country Business Lead, Ireland
Sponsored by Alnylam Pharamaceuticals
WRITTEN BY
Mary McDonald, Patient Services Manager, Asthma Society of Ireland
WRITTEN BY Ruth Morrow
Respiratory Nurse Specialist, Asthma Society of Ireland
Poor sleep can heighten pain sensitivity, while chronic pain can disrupt sleep quality, continuity and restorative sleep stages.
Sleep and chronic pain: A complex relationship
Sleep disturbance is increasingly recognised as a key factor in chronic pain and other long-term health conditions
Research consistently demonstrates a bidirectional relationship — poor sleep can heighten pain sensitivity, while chronic pain can disrupt sleep quality, continuity and restorative sleep stages.
How pain and sleep are connected
Evidence published in The Journal of Pain shows that insufficient or fragmented sleep can increase pain sensitivity the following day and impair endogenous pain inhibition systems that help regulate pain perception. This contributes to a self-reinforcing cycle wherein pain and sleep disturbance interact over time.
Systematic reviews, including research published in BMC Musculoskeletal Disorders, indicate that a substantial proportion of people living with chronic pain experience clinically significant sleep disturbance, including insomnia symptoms, frequent night waking and nonrestorative sleep. These findings are consistent across longterm conditions, highlighting sleep as a cross-cutting issue in chronic illness.
Beyond pain conditions, population-based research, like The Irish Longitudinal Study on Ageing (TILDA), has shown that poor sleep is associated with reduced physical functioning, lower quality of life and increased multimorbidity. This reinforces the broader relevance of sleep across chronic disease management.
Evidence-based pain models highlight that thoughts, emotions and behavioural responses can influence symptom experience. Patterns such as worry about pain, fear of movement or reduced activity due to anticipation of symptoms, may contribute to pain persistence and sleep disturbance.
These patterns are frequently reflected by people living with chronic pain, including those engaging with Chronic Pain Ireland support services, where sleep disruption, fatigue and pain-related anxiety are commonly addressed, states Christina Donnelly, Executive Director, Chronic Pain Ireland.
Interventions for sleep disturbances
Cognitive Behavioural Therapy for Insomnia (CBT-I) is recommended as a first-line treatment for chronic insomnia. Systematic reviews have shown that it can improve sleep outcomes in people with long-term conditions.
Non-pharmacological strategies, including consistent sleep routines and other behavioural approaches, are also supported in clinical guidance. Broader cognitive behavioural therapies are also used within chronic pain management to support coping and adjustment.
Improving sleep is an important component of chronic pain and chronic illness care, alongside physical and psychological approaches to support overall wellbeing.
WRITTEN
BY Christina Donnelly Executive Director, Chronic Pain Ireland
IBD is more than gut
Inflammatory bowel disease (IBD) isn’t confined to the gut. For many, symptoms appear throughout the body long before they’re recognised.
IBD, including Crohn’s Disease and Ulcerative Colitis, is commonly understood as a gut condition. Yet for many people living with IBD, symptoms extend far beyond the digestive tract.
More than digestive symptoms
Extraintestinal manifestations, known as EIMs, occur when inflammation affects other parts of the body and can involve joints, skin, eyes, liver, bones and overall energy levels. As awareness grows, it’s becoming increasingly clear that many people aren’t just managing bowel inflammation but a systemic whole body condition that impacts daily life in complex, often unexpected ways. EIMs can arise at any stage of the disease. For some, symptoms such as joint pain, fatigue, mouth ulcers or eye inflammation/ulcers may appear long before an IBD diagnosis is made. For others, they persist during active disease or continue even when gut symptoms appear well controlled. Because manifestations often present outside gastroenterology clinics, they may be treated in isolation. This disconnect means many people don’t realise their symptoms are linked to IBD, leading to delayed diagnosis, fragmented care and increased physical, emotional and psychological burden.
Need for whole person care
Living with IBD isn’t solely about managing flare ups or periods of remission. It involves navigating uncertainty, understanding a broad range of symptoms and advocating for coordinated healthcare that reflects the full impact of the condition.
Effective management requires a multidisciplinary approach, where gastroenterology teams work in partnership with rheumatology, dermatology, ophthalmology, primary care and allied health professionals. Recognising EIMs as an integral part of IBD allows for earlier intervention, more appropriate treatment pathways and better long term outcomes for people living with the condition.
Awareness empowers people
At Crohn’s & Colitis Ireland, we regularly hear from individuals who are surprised to learn that symptoms they’ve lived with for years are connected to IBD. Education is empowering.
Understanding IBD as a systemic condition helps people seek timely support, communicate more effectively with healthcare providers and feel validated in their lived experience.
Understanding IBD means looking beyond the bowel and recognising the person behind the diagnosis.
WRITTEN BY
Victoria Spillane
Acting Chief Operating Officer,
Crohn’s & Colitis Ireland
Why you should never ignore bleeding gums when you brush, floss or eat
Bleeding gums can be a sign of gingivitis, which, left untreated, can worsen and lead to tooth loss. At an early stage, it’s reversible — if you take steps to improve oral care.
We’re probably familiar with the need to brush twice a day and go for regular dental checkups to keep our teeth healthy. But how many of us regularly think about our gum health?
Say you discover that your gums are bleeding after brushing or flossing, or when you bite into hard foods like apples. What would you do? You might be tempted to assume that it’s ‘just what happens sometimes’ and ignore it.
Bleeding gums could be a sign of gum disease
But it isn’t, and you shouldn’t — because healthy gums don’t bleed. In fact, bleeding gums could be a symptom of gingivitis, which is caused by a buildup of plaque close to the gum line. It isn’t always accompanied by pain, so you might not notice it immediately. Other symptoms can include red or inflamed gums, swollen gums and bad breath.
Take action to improve your oral care routine
Anyone can develop gum disease, but people living with diabetes might be at a higher risk. That’s because their condition, along with certain medications, can reduce saliva production, which helps protect teeth and gums. Diabetes can also increase sugar or glucose content in saliva, which can feed harmful plaque-forming bacteria.
Bleeding gums could be a symptom of gingivitis, which is caused by a buildup of plaque close to the gum line.
The trouble is, if you leave gingivitis untreated, it can develop into periodontitis, a more advanced stage of gum disease. “If plaque isn’t removed by brushing the teeth thoughtfully at least twice a day, inflammation can spread to the tooth socket and the soft tissues there, causing gums to recede and teeth to become loose,” explains Dr Kate Fabrikant, Medical Director in Haleon, the company behind oral care brands like Corsodyl.
The good news: if you act quickly enough, gingivitis is reversible (unlike more serious gum inflammation — periodontitis). There are steps you can take to treat it or, better still, prevent it from becoming an issue in the first place.
First, brush twice daily with a specialist toothpaste designed to fight plaque buildup along the gum line, such as Corsodyl Active Gum Repair. Second, use a mouthwash to help remove plaque bacteria that brushing alone can’t reach. Third, clean between your teeth daily, using interdental brushes or floss. And fourth, see your dentist if symptoms don’t go away.
“Acting on the early signs of gingivitis is important,” says Dr Fabrikant. “Visit your dentist regularly, as they may spot problems with your gums before you have any noticeable symptoms. A professional oral hygiene, which you might also know as “scale and polish” can help get your teeth properly clean in areas that are difficult to reach at home.”
Paid
Haleon
Dr Kate Fabrikant Medical Director, Haleon
WRITTEN BY Tony Greenway