IPU National Pharmacy Conference - Be Well This Summer - Think Pharmacy Men's Health Matters - Irish Pharmacy Union
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IRELAND’S OFFICIAL PHARMACY PUBLICATION JUNE 2019 IPU National Pharmacy Conference Men’s Health Matters Be Well This Summer – Think Pharmacy CPD: EZCEMA | KNOW, CHECK, ASK MEDICATION SAFETY CAMPAIGN
Maintenance: Simple; one tablet, once daily*
whole
SEIZE THE DAY
MAINTENANCE: ONE TABLET, ONCE DAILY.
*ASACOLON® 1600 mg modified-release tablets are indicated for the treatment of OPTICORE® technology uses a unique
mild-to-moderate acute ulcerative colitis and for the maintenance of remission in combination of two triggers to allow targeted
patients 18 years and over. In acute disease, the dose can be increased to 4800 mg mesalazine delivery throughout the colon.
daily, once daily or in 2-3 divided doses. Once clinical remission is achieved, the OPTICORE® has been developed based on
dose should gradually be decreased to maintenance dose. Phloral® technology.1,2
ASACOLON® 1600 mg modified-release tablets: Red- hepatic impairment, gastric or duodenal ulcer. Not for excreted in breast milk. The clinical significance has not known: lupus-like syndrome, changes in weight
brown, oblong, film-coated tablets each containing use in patients with a history of mesalazine-induced not been determined. Hypersensitivity reactions such and blood parameters. Refer to Summary of Product
1600 mg mesalazine. INDICATIONS: Ulcerative cardiac hypersensitivity. Caution in patients with any as diarrhoea in the infant cannot be excluded. Use Characteristics for details. LEGAL CATEGORY:
colitis. For the treatment of mild-to-moderate acute previous myo- and pericarditis of allergic background. only if the benefit outweighs the risk. If the infant POM. MARKETING AUTHORISATION NUMBER:
disease. For the maintenance of remission. DOSAGE Monitor closely: Patients with pulmonary disease, develops diarrhoea, discontinue breast-feeding. ASACOLON® 1600 mg MR Tablets PA 2018/4/1. MA
AND ADMINISTRATION: Oral use. To be swallowed particularly asthma; patients sensitive to sulfasalazine. UNDESIRABLE EFFECTS: Common: Headache, HOLDER: TILLOTTS PHARMA GMBH, Warmbacher
whole (not chewed, crushed, or broken) with water, Stop treatment immediately if acute symptoms of abdominal pain, ulcerative colitis, dyspepsia, rash, Strasse 80, DE- 79618 Rheinfelden, Germany.
with or without food. Acute ulcerative colitis: Adults intolerance (e.g. abdominal cramps, acute abdominal haematuria, proteinuria. Uncommon: Eosinophilia DATE OF PREPARATION: March 2019.
and elderly: Adjust the dosage to the severity of the pain, fever, severe headache and rash). Caution in (as part of an allergic reaction), paresthesia, urticaria, CODE: 2019/7. FULL PRESCRIBING INFORMATION
disease and tolerance. During exacerbation, the dose elderly; use subject to renal and hepatic function. pruritus, pyrexia and chest pain. Rare: Dizziness, AVAILABLE ON REQUEST FROM THE MARKETING
may be increased to 4800 mg daily, once daily or in Limited data in children. INTERACTIONS: Caution myocarditis, pericarditis, diarrhoea, flatulence, nausea AUTHORISATION HOLDER OR FROM TILLOTTS
2-3 divided doses. Monitor by week 8. Maintenance of recommended for the concomitant use of mesalazine and vomiting, photosensitivity. Very rare: Altered PHARMA LIMITED, 25 SANDYFORD OFFICE PARK,
remission: 1600 mg once daily. Elderly: As for adults, with known nephrotoxic agents, including NSAIDs and blood counts (aplastic anemia, agranulocytosis, DUBLIN 18, IRELAND, TEL: (00 353 1) 294 2015.
provided renal or hepatic function is not severely azathioprine, or methothrexate as these may increase pancytopenia, neutropenia, leukopenia,
ASACOLON® is a trademark.
impaired. No study data. Children: Not for use in the risk of renal adverse reactions. Mesalazine can thrombocytopenia), blood dyscrasia, hypersensitivity
children or adolescents. CONTRAINDICATIONS: increase the myelosuppressive effects of azathioprine, reactions such as allergic exanthema, drug fever, References
Hypersensitivity to salicylates, mesalazine or any 6 mercaptopurine, or thioguanine. Life threatening lupus erythematosus syndrome, pancolitis, peripheral
excipient. Severe hepatic or renal (GFR < 30 mL/ infection can occur. Monitor closely for signs of neuropathy, allergic and fibrotic lung reactions 1. Varum FO, et al. Poster presented at AAPS
min/1.73 m2) impairment. SPECIAL WARNINGS infection and myelosuppression. Haematological (including dyspnoea, cough, bronchospasm, alveolitis, National Biotechnology Conference 2016;
AND PRECAUTIONS: Conduct blood count, liver parameters, especially the leukocyte, thrombocyte pulmonary eosinophilia, lung infiltration, pneumonitis), [Poster number 02WO200].
function tests, serum creatinine and urinary status and lymphocyte cell counts should be monitored interstitial pneumonia, eosinophilic pneumonia, 2. Ibekwe VC, et al. A new concept in colonic
(dip stick) prior to and during treatment. Follow up weekly, especially at initiation of combination therapy. lung disorder, acute pancreatitis, changes in liver drug targeting: a combined pH-responsive and
after 14 days, then every 4 weeks for 12 weeks, 3 May decrease the anticoagulant effect of warfarin. function parameters (increase in transaminases bacterially-triggered drug delivery technology.
monthly thereafter or immediately if signs appear. USE DURING PREGNANCY AND LACTATION: and cholestasis parameters), hepatitis, cholestatic Aliment Pharmacol Ther. 2008; 28(7):911-916
Not for use in patients with renal impairment. Limited data on use in pregnancy. One case of hepatitis, alopecia, myalgia, arthralgia, impairment of
Caution in patients with raised serum creatinine or neonatal renal failure was reported. Mesalazine renal function including acute and chronic interstitial
proteinuria. Stop treatment immediately if signs of crosses the placental barrier; use only if benefit nephritis and renal insufficiency, nephrotic syndrome,
renal impairment develop, or if there is suspicion or outweighs risk. Limited data on lactation are available. renal failure which may be reversible on early
evidence of blood dyscrasia. Caution in patients with N-acetyl-5-aminosalicylic acid and mesalazine are withdrawal, oligospermia (reversible). Frequency
JUNE 2019
07 A Note from the Editor
IPU News
20
The latest news and events
from Butterfield House
8 Dates for your Diary
8 Pharmacy in the media
10 Hello and Goodbye
Front cover shows Minister for
Health, Simon Harris TD, at the 10 Pharmacy: What does the future hold,
recent IPU National Conference. one year on
The IPU Review is published
10 IPU and DBS launch Executive Diploma
monthly and circulated to Irish 12 Be Well this Summer – Think Pharmacy
pharmacists. The views expressed
by contributors are not those 13 Thank you to all the IPU Conference
of the IPU nor is responsibility Sponsors and Exhibitors
50
accepted for claims in articles 13 UD Pharmacy Show
or advertisements.
14 Pharmacists demand reversal in FEMPI cuts
Subscription: 14 Pharmacists welcome Minister’s commitment
€100 (Ireland North & South) and to increase investment in pharmacy services
€150 (including postage overseas).
15 ‘Ridiculous’ red tape contributing to shortage
Publisher: of young pharmacists
Irish Pharmacy Union
(IPU Services Ltd), 16 Sláintecare requires more involvement from pharmacies
Butterfield House,
Butterfield Avenue,
Rathfarnham, Dublin 14,
D14 E126
E S
Tel: (01) 493 6401
D
Fax: (01) 493 6626
SI CT
Email: ipureview@ipu.ie
Website: www.ipu.ie
FE
Editor: Jack Shanahan MPSI
Editorial Associates:
Sinéad Fennell, Ciara Browne,
Siobhán Kane and Jim Curran
Advertising: Siobhán Kane
Features EF
Email: ipureview@ipu.ie
Tel: (01) 493 6401
18 Commercial Feature: Science
at the heart of Po-Ven
©2019
20 2019 IPU National Pharmacy
Copyright: All Rights Reserved,
Irish Pharmacy Union.
Conference
Printed by Ryson Colour Printers Ltd.
IPU Review is a Registered Trademark
of the Irish Pharmacy Union.
30 Men’s Health Matters
32 Commercial Feature:
35
Life Pharmacy
35 CPD: Eczema
IPUREVIEW JUNE 2019 3
46
39 President’s Dinner and Ball
42 Know, Check, Ask Medication
Safety Campaign
46 Analysis of the HSE PCRS
30
Annual Reports
50 Clozapine – monitoring News
for adverse events 67 Launch of third PHMP Annual Report
52 SeniorLine 68 Clinical trial activity in Ireland
68 Uniphar’s FIXXA First Aid gives
55 Politics hero’s welcome to Special Olympics
Ireland athletes
58 Studies 69 Janssen, Aware and See Change launch
mental illness awareness campaign
60 High Tech Medicines Update: 69 Boots becomes first pharmacy
in Ireland to offer a travel
Skilarence Gastro-resistant Tablets
52
vaccination service
70 Allcare launches new
61 Book Review: Drugs in Cancer Care eLearning platform
62 Clinical Tips: Oral Iron and 71 Classifieds
Levothyroxine
63 Product Information
65 International News
61
42
IPUREVIEW JUNE 2019 5
M M E N D
REC O
O TA
T EVERL
H AY F
NTROL
CO
61
GETS
TO WORK
3
in
in mins
RELIEF
DEFENCE RELIEF
Beconase Hayfever nasal spray 50 micrograms per spray contains beclometasone dipropionate. For the prevention and relief of symptoms of
Hayfever and other seasonal allergic conditions. Adults aged 18 and over: 2 sprays into each nostril twice a day. Max 8 applications per day (400
mcg). Seek medical advice if symptoms do not improve after 2 weeks. Do not use continuously for longer than 3 months without consulting a doctor.
Do not give to persons under 18 years. Pregnant and breastfeeding mothers should not use without consulting a healthcare professional. Caution:
Recent nasal injury or surgery. Side effects: Rare cases of hypersensitivity reactions. Unpleasant taste/smell, dryness/irritation of the nose and throat,
raised intra-ocular pressure, nasal septal perforation. PA 1186/8/1. P. MAH: Chefaro Ireland Limited, The Sharp Building, Hogan Place, Dublin 2, Ireland.
http://www.medicines.ie/medicine/7169/SPC/Beconase+Hayfever/ SPC: http://www.medicines.ie/medicine/7169/SPC/Beconase+Hayfever/. Further
information is available on request to the holder of the authorisation or certificate, or in the summary of product characteristics relating to the product.
Becodefence is a medical device.
A NOTE FROM THE EDITOR Jack Shanahan MPSI
Unease over the future
of our profession
Basking in the afterglow of the IPU conference last year,
I was feeling extremely grateful to my colleagues. Only for
a mixture of both exceptional footwork and the kindness
of friends, I would not have been able to attend.
I
reflected, at the time, statement of fact. The PCRS is Add into the mix one another example of a good
on the increasingly a behemoth. Ally this with the stressor that has darkened idea stifled by a lack of vision
precarious situation Department of Health and its all our worldviews: the and resources.
with locum cover. It subsidiary and related agencies proliferation of primary care Yet, looking at primary
has not improved and, such as PSI and HPRA, and we centres. It is a hard reality care centres, you have to
if anything, has deteriorated have a real squeeze. Relations that a co-located pharmacy speculate if something similar
further. On a personal level it with the PCRS blow hot and has the potential to hoover could work for pharmacy. It
has resulted in an inability to cold. It is an unfortunate up a substantial portion of is my view that the viability
commit to almost anything. I reality of Irish life that the the prescriptions generated of smaller community
am not alone; it is currently PCRS is always looking to save by a primary care centre. This pharmacies is limited in the
one of the most common money. This results in issues can severely distort the local medium term. The concept
refrains in Irish community large and small. For instance, pharmacy services. Again, this of a work life balance has
pharmacy. To my mind, it the process surrounding DOAC is government interference gone out the window. Most
reflects an exceptionally approval is beyond farcical. in a ‘free market’. Despite of us are at full tilt all
dysfunctional system. It is The hurdles placed in front of their obvious potential for day, with the regulatory
well past time to fix it. patients, and their pharmacies, improving patient care, it burden both oppressive and
The only clear view is that to get reimbursed for these is not clear that many of overwhelming. There is a
a multi-pronged approach is drugs are both petty and these centres are working shortage of professional
the only way. Over the last few obsolete. The initial intention as advertised. Part of the staff. The economics of new
months, I have been looking was to slow the adoption of business model was shared services require volume to
at the future of our profession these drugs, which has failed. services. From administration be profitable. There is a clear
in Ireland. While I received In my pharmacy, and I am no to medical, the doctors and logical imperative for fewer
considerable feedback, many outlier, it is almost rare to see patients were supposed to but larger local pharmacies.
comments were of the ‘I’m new warfarin prescriptions. benefit from economies of The debate has to be how to
glad that I am at the tail end Most, if not almost all, atrial scale. Yet, all we see is the get there.
of my career’ type. Perhaps fibrillation patients are equivalent of a suspension of
this is a normal dynamic in my started on one of the new medics: all the practices are
peers, reflecting an adversity generation anti-coagulants. discrete entities, dispersed
to change. It also reflects Indeed, looking at the 2017 inside a large building,
a heightened sensitivity to PCRS report, the frequency with only the address as a
threats. Most of the unease of prescribing of DOACs has common bond. One of the key
falls around our income exceeded warfarin. If this was attractions for developers was
model. Our exposure to a a solitary example, it would the notion of a pharmacy as
single dominant paymaster be seen as an aberration. On a prize asset, paying huge key
is an enormous vulnerability. the even more petty level, money and exorbitant rents.
It is also indicative of the any refusal of the PCRS to pay Those days are long gone.
greatest challenge that most non-dispensed fees, when it An additional issue and key
professionals face in the is clearly in the State’s best to sustainability are recent
health sector: governmental interests, is truly dysfunctional. reports that, where they can,
control. The State is pretty As initiatives like the High Tech the HSE is squeezing the rents
much at the driving wheel of Hub become more pervasive, it on their units. Given that they
all aspects of our professional is clear that our entanglement are pretty much the anchor
and commercial life. This is not with the PCRS is going to be tenants, the prognosis is poor.
a libertarian rant; it is merely a further tightened. The model is broken. It is
If you have any comments, queries or issues to raise, send
your “Letters to the Editor” by email to ipureview@ipu.ie.
IPUREVIEW JUNE 2019 7
Pharmacy in
the Media
IPU Executive Committee member Caitriona O’Riordan
was interviewed for an article in Woman’s Way magazine
in relation to how the public can get to know their
pharmacist for their health and wellbeing.
The IPU National Pharmacy Conference took place
last month in the Galmont Hotel in Galway. We issued
multiple press releases covering a range of different
topics over the weekend. Along with a general press
release to announce that the conference was coming to
Galway, we issued press releases on topics including the
demand to reverse FEMPI cuts; Pharmacists welcoming
the Minister’s commitment to increase investment in
pharmacy services; the shortage of young pharmacists;
and Sláintecare.
Addressing the delegates at the IPU’s National
Pharmacy Conference, Minister Harris committed to
delivering a new contract with pharmacists and moving
Dates fioarry
beyond FEMPI in a way that will see an increased
investment in pharmacy services and said, “There are
undoubtedly opportunities for community pharmacy
your D
contractors in the next decade and I look forward to
engaging with the IPU to enhance the delivery of primary
care services through community pharmacy.” The
Minister’s statements at the conference on pharmacy
19
JUNE 20
services and FEMPI received coverage on Newstalk.com
eek,
ealth W and the IPU’s Sláintecare statement was covered in the
Men’s H
June hfi.org Irish Daily Mirror. IPU President Daragh Connolly was
10 – 16 www.m
nor Day, interviewed across multiple regional radio stations,
lood Do
World B e while there was also coverage in several regional
14 June eblood.i
www.giv newspapers and the conference received online coverage
ent –
iness Ev on GalwayDaily.com and Galway Bay FM. IPU Vice-
IPU Bus oes
18 June : What d President Eoghan Hanly was also interviewed on
Pharmacy ld, CRC FM and Tipp FM in relation to FEMPI.
ho
the future bit.ly Also last month, Daragh Connolly was interviewed
ye ar o n,
one y
ofP harmac on Newstalk’s The Pat Kenny Show along with Medicines
Future for Ireland Chairman, Owen McKeon, in relation to
biosimilars and High Tech medicines.
There was an article in the Irish Farmers Journal about
19
JULY 20 epatitis
Day, exam stress and pharmacist advice about how to
World H hep atitis manage this stress.
28 July rld
www.wo
day.org
8 IPUREVIEW JUNE 2019
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IPU NEWS
Hello and Goodbye
Welcome back to Siobhán Kane, Press and
Communications Manager, IPU, who returned to
work last month from maternity leave. We are
delighted to have her back and you can contact
Siobhán at siobhan.kane@ipu.ie. Au revoir to
Sinéad Fennell, who covered for Siobhán during
that time. We wish all the best to Sinéad and
thank her for all that she has contributed to the
IPU in her short time here.
Pharmacy: IPU and Dublin
What does the Business School
future hold, launch Executive
one year on Diploma in Strategic
Following the success of our Business Seminar
Pharmacy Business
Management
in 2018, we are delighted to announce that,
in association with JPA Brenson Lawlor and
Pharmawealth Walfrid Private, we will be hosting
another Business Seminar on Tuesday 18 June in
the Newcastle Suite, Citywest Hotel, Dublin, from
9.30am – 1.30pm. Economist Dan O’Brien will We are delighted to team up with Dublin Business School to provide a
give us an overview of the economic factors that new Executive Diploma in Strategic Pharmacy Business Management
may affect pharmacy. Speakers from the HPRA, for IPU members. This programme will help you to learn the skills
Behaviour & Attitudes and MKC Communications required to succeed in the sector, while dealing with the challenges
will look at the medicinal, political and consumer and pressures that the Irish pharmacy sector is currently under. The
aspects that affect the pharmacy sector. This is primary objective of this programme is to build and enhance the retail
a free event but you must register to attend. business capability of pharmacists and business owners as part of both
Turn to page 29 for more information. the IPU’s and independent pharmacy strategic objectives for 2020 and
into the future. To find out more about this new Executive Diploma,
go to www.ipu.ie > Training & Events.
10 IPUREVIEW JUNE 2019IPU NEWS
Be Well this Summer –
Think Pharmacy – IPU/IPHA
Self Care Campaign
Following on from the very popular campaign Be Well this will place a major emphasis on the role of the pharmacist
Winter – Think Pharmacy that was launched last year, the IPU as a key component in assisting individuals to manage
and the Irish Pharmaceutical Healthcare Association (IPHA) their own health.
are now introducing a new campaign titled Be Well this Summer As part of the campaign, we decided to once again use
– Think Pharmacy, which will run over the summer months. the emoji characters to assist in getting our message to the
This new campaign highlights the benefits for members of public. The campaign consists of two distinct elements based
the public in looking after their health during the summer on a series of cartoon emojis, which includes a Be Well this
period, helping towards preventing common ailments and Summer – Think Pharmacy in-store poster, and a proactive
injuries that may occur during the summer months such as digital media campaign based on a series of common
hay fever, sunburn, insect bites and bumps and bruises. summer ailments and injuries.
At the centre of this concept is the promotion of self care, The campaign includes:
which can be defined as the care taken by individuals of their
n A hay fever video to run for one week on social media
own health and wellbeing at the lowest level of complexity
channels beginning 29 May;
with advice from a healthcare professional. The campaign
n A holiday video to run for one week on social media
channels beginning 19 June;
n A first aid video to run for one week on social media
channels beginning 17 July; and
n A music festival video to run for one week on social
media channels beginning 14 August.
The success of this ongoing campaign requires active
support from IPU members. This will encourage more people
to visit their local pharmacy this summer and to position
pharmacists as the healthcare professional perfectly
placed to support them.
If you would like further details of the ongoing campaign,
please email jim.curran@ipu.ie or philiphannon@ipha.ie.
12 IPUREVIEW JUNE 2019IPU NEWS
Thank you to all the IPU
Conference Sponsors
and Exhibitors
We would like to take this opportunity to thank all of our sponsors and exhibitors
for their support and participation in the 2019 IPU National Pharmacy Conference,
which took place in Galway last month. It was a very enjoyable weekend overall
and we hope you thought so too. For a full report on what happened during the
conference weekend, turn to pages 20-28.
O’CALLAGHAN
INSURANCES
UD Pharmacy Show
The United Drug Pharmacy Show took place on 14 – 15
April in the Aviva Stadium. The theme for this year
was United, We do Better. We were delighted to once
again take part and support this event and have the
opportunity to meet with our members face to face
and showcase the support the IPU can provide to
pharmacists. The show brought together a big range
of companies to showcase their products and services
to pharmacists. Thank you to our members who
stopped by our exhibition room during the weekend.
IPUREVIEW JUNE 2019 13IPU NEWS
Pharmacists Pharmacists
welcome
demand reversal Minister’s
in FEMPI cuts commitment
The future of pharmacies in communities across
to increase
investment in
Ireland will be threatened if the Government does
not urgently begin the process of reversing deep cuts
inflicted as part of the Financial Emergency Measures
in the Public Interest Act (FEMPI). This message was
pharmacy services
delivered to Minister Simon Harris at the IPU National
Pharmacy Conference in Galway.
Speaking in advance of the conference, President
of the Irish Pharmacy Union (IPU) Daragh Connolly,
said, “We’re delighted that Minister Harris is attending
this year’s conference. This will allow Minister Harris Minister for Health, Simon Harris TD, has committed to
to experience the enthusiasm of Ireland’s 1,900 delivering a new contract with pharmacists and moving
community pharmacists. We are ambitious for the role beyond FEMPI in a way that will see an increased investment
of Pharmacies in primary care and want to do more in pharmacy services. Addressing the delegates at the Irish
to alleviate the pressure on other areas in the health Pharmacy Union’s (IPU) National Pharmacy Conference,
service and our patients nationwide. the Minister said, “There are undoubtedly opportunities for
“However, Minister Harris will also hear a growing community pharmacy contractors in the next decade and I
sense of frustration and disappointment that FEMPI look forward to engaging with the IPU to enhance the delivery
cuts have yet to be reversed for pharmacists. We of primary care services through community pharmacy.”
now approach the third anniversary of when the Welcoming the Minister’s commitment, President of
Government’s own review recommended fees to the IPU Daragh Connolly, said, “The IPU and our members
pharmacists be re-examined. To date, nothing has strongly welcome Minster Harris’s clear commitment to
happened, and we cannot tolerate the laissez-faire begin a process that will bring about reform, modernisation
approach being taken any longer. and contractual overhaul for community pharmacy similar
“Irish pharmacists have experienced a decade- to his engagement with GPs. This will move the delivery of
long decline in resources for providing services on community healthcare to “higher terrain” that will ultimately
behalf of the State. The HSE PCRS statistics for 2009 bring huge benefits to patients and our communities.”
to 2017 show that pharmacy output and efficiency In his address, Minister Harris said, “The role community
have increased, as the costs of medicines reimbursed pharmacy plays in delivering health services to our citizens
to pharmacies has reduced by almost 36% per item. is a vital one. Expansion of community pharmacy services
Meanwhile, there has been a 17% drop in the fees paid is an important part of better primary care provision.” He
per item and the average annual fee amount paid stated his strong desire to work with pharmacists and to see
to each pharmacy has fallen by nearly a fifth (18%). negotiations swiftly concluded to ensure that pharmacists
Between 2009 and 2018 FEMPI cuts removed €1.5 move past FEMPI and he committed to providing investment
billion in revenue from the pharmacy sector.” to expand the role of pharmacies in primary care.
Mr Connolly concluded by outlining the desire Referring to the IPU’s repeated calls for the implementation
of pharmacists to expand the services provided in of a Minor Ailment Scheme, Minister Harris said that such
communities. “Pharmacists are ready, willing and schemes are proven to work. He went on to say there was no
waiting to enhance the levels of care we provide, need for any more pilots and that a wider implementation
and we hope the overdue negotiation process will was required.
allow us to implement additional services that our A Minor Ailment Scheme would allow medical card holders
patients require.” to receive treatment for a number of specified ailments
directly from their local community pharmacy, in a timely
manner, without the need for an unnecessary visit to the GP.
Pharmacists have consistently called for improved
accessibility of contraception for women. This includes the
provision of oral contraceptives (the pill), without prescription
and without charge. The Minister echoed this ambition and
committed to working with pharmacists to achieve this in the
coming months.
Minister Harris concluded by complimenting the role of
pharmacists and said, “In towns and villages throughout this
country, you can be the shopfront of Sláintecare.”
14 IPUREVIEW JUNE 2019IPU NEWS
‘Ridiculous’ red tape
contributing to shortage
of young pharmacists
A shortage of community pharmacists could are required to spend too much time on
become a critical problem for Irish healthcare, paperwork, which means time away from
the Irish Pharmacy Union (IPU) has warned. our patients. Almost half of pharmacists now
At the IPU’s National Pharmacy Conference believe the sector is over-regulated which is
the burden of excessive bureaucracy and creating constant pressure.
unnecessary regulation was identified as a “Ireland produces some of the most qualified
major frustration, particularly for younger pharmacists in the world”, according to Ms
pharmacists. O’ Loughlin, “and yet our system is content to
Sheila O’ Loughlin, pharmacist and member consign them to a career of administration.
of the IPU Employee Pharmacy Committee Expert healthcare professionals are being
(EPC), outlined some of the main findings hamstrung by meaningless paperwork and
of a new Behaviour & Attitudes report excessive bureaucracy.”
commissioned by the IPU, Perspectives of The impact upon the profession is becoming
Community Pharmacy. “The report found profound Ms. O’Loughlin continued. “Fewer
that excessive red tape, bureaucracy and and fewer pharmacists now say they would
administration is one of the biggest drawbacks recommend community pharmacy to a
to a career in community pharmacy. The student today. We are therefore calling on
research shows that this is making it difficult the Regulators, particularly the HSE PCRS
to attract new graduates into the community and Pharmaceutical Society of Ireland (PSI),
pharmacy sector and to retain pharmacists to work with us to review and reduce the
in their current roles. level of unnecessary bureaucracy foisted on
“The areas identified as the biggest concerns community pharmacists.
include the additional burden of dealing with “Doing so will signal a commitment to
the HSE PCRS and its attendant paperwork would-be community pharmacists, that their
and the pressure of ensuring compliance with role does matter as a key professional in
regulatory guidelines. the healthcare service and not just a quasi-
“We all recognise the importance of checks administrative role, which involves frustrating
and balances, and safety is something hours chasing paperwork and complying
a pharmacist would never compromise. with unnecessary bureaucracy”, concluded
However, 98% of pharmacists state that they Ms O’ Loughlin.
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IPUREVIEW JUNE 2019 15IPU NEWS Sláintecare requires more involvement from pharmacies A commitment within the Programme for Government to have always been, enthusiastic to work with Government expand the healthcare role of the pharmacist within two to implement real and relevant improvements in primary years, has not been delivered, according to the Irish Pharmacy healthcare. Union (IPU). The IPU is eagerly awaiting the commencement “In response to the capacity crisis in general practice, the IPU of negotiations with the Minister for Health so that a greater has long advocated for a Minor Ailment Scheme. This would role for pharmacists in the implementation of Sláintecare allow medical card patients to receive treatment for common can be realised. illnesses directly from their local community pharmacy without Each year in Ireland there are nearly 78 million visits to the need for a visit to the GP. Our research estimates that full community pharmacies, making pharmacists the most accessed implementation of a comprehensive Minor Ailment Scheme healthcare professionals in Ireland. The IPU has welcomed the would save 950,000 GP consultations in a single year. Following fact that the Sláintecare Action Plan 2019, published in March, a successful pilot in 2016 we are still awaiting action from the proposes to involve pharmacists in developing more local Department of Health.” services, however, action over words is now required. Speaking at the Conference, Minister Harris said that such Speaking at the IPU National Pharmacy Conference in Galway, schemes are proven to work adding that there is no need for any IPU Vice President Eoghan Hanly, said, “Three years ago we more pilots and that a wider implementation is required. welcomed the Government’s commitment to expand the role Mr Hanly argued that allowing women to access of pharmacists. We have consistently put forward proposals contraception direct from pharmacies, without the requirement that would help alleviate current primary healthcare deficits, for prescription, should be included in the Sláintecare offer significant savings and efficiencies to the health service. implementation. “There is a strong demand for pharmacists While many of our proposals have been met with apathy from to provide contraception and this is a service we are keen to the Department of Health, we continue to be enthusiastic about make available. HSE research has found that 47% of women the additional contribution we could make and hopeful that would prefer to access contraception through a pharmacy. Sláintecare will provide an opportunity for progress. We understand an expert review of access to contraception Speaking on Saturday at the IPU conference, Minister Harris is currently underway and so are hopeful that progress stated his strong desire to work with pharmacists and to see can be made.” negotiations swiftly concluded to ensure that pharmacists move He concluded, stating that there was “no shortage of ambition past FEMPI and to providing investment to expand the role of in the pharmacy sector. This is combined with a strong desire pharmacies in primary care. to innovate for our patients and deliver a primary care system Mr Hanly welcomed these commitments stating, “We for all. We hope the Government shares our ambition and desire appreciate the Minister’s renewed ambition and hope that and takes immediate steps to expand the scope of pharmacists, finally promises are followed by actions. We are, as we which is a win-win for everyone.” 16 IPUREVIEW JUNE 2019
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PG'SJFOEMZ#BDUFSJBCOMMERCIAL FEATURE Dr Nigel Plummer, Pro-Ven
Science at the heart
of Pro-Ven as it
develops probiotics
at the cutting edge
Pro-Ven founder Dr Nigel Plummer, with 35 years of research
experience in microbiology, continues to innovate in the world
of probiotics. In this interview, he explains how his company
Pro-Ven came to be, and what makes it different.
What led you to How can Pro-Ven What makes you Some probiotics have been
create Pro-Ven? probiotics help different from other criticised because much
Microbiology has been central pharmacy customers? probiotic brands? of the good bacteria they
to my work for more than In most European countries, Our focus on research and contain dies before it
35 years. My PhD was in the average use of antibiotics development. We have reaches the gut. Does this
microbial physiology and led in children and adults is 12 scientists including ever happen with Pro-Ven?
me towards the development one course per year. Taking microbiologists, biochemists
of our first probiotic aimed at antibiotics can lead to an and immunologists working The stomach is an acidic
alleviating antibiotic-related imbalance in the gut bacteria full-time on R&D, in addition environment and friendly
health issues in baby pigs and – a balance that may not be to a continuous programme bacteria need to be able to
calves in 1992. The success of restored once the course is of primary research out survive this to reach the
this made me consider how complete. Taking friendly in the field. microbiota in the intestines.
we could help people rather bacteria in the form of When looking for a probiotic, Pro-Ven’s probiotics are held
than animals, and four years probiotics during a course it’s critically important to look in suspension in their various
later we developed our first of antibiotics can reduce the for clinical studies published formats until they reach the
human probiotic. adverse effects on gut bacteria in peer-reviewed journals that stomach. Taking them with food
We began human clinical and help to restore this show a significant benefit will ensure that the pH of the
trials at the University of balance. for the condition you are stomach allows them to pass
Cambridge in 2001. These trials At Pro-Ven, we have looking to treat. To date we into the small intestine alongside
were based on our proprietary developed a product called have published more than 10 the food as it is digested.
probiotic consortium called Adult Acidophilus and Bifidus clinical trials, and a number Our extensive body of research
Lab4 – which now forms 50 Billion to provide a high of other in-vivo and in-vitro indicates that the Pro-Ven
the basis of our range. Since intake of friendly bacteria studies. bacteria are having positive
then, we’ve conducted 12 for 14 days, alongside These trials have studied effects on the microbiota and
studies looking at the impact and following a course of a variety of health issues, includes a study showing that
of Lab4 on several aspects of antibiotics. including immunity, digestion, the strains can be found in
human physiology. In 2012, The gastrointestinal tract mood, performance and stools, having passed through
we launched our own brand is also the main site of antibiotic use. We feel that the digestive tract.
incorporating Lab4 called interaction for our immune innovation is key to the future.
Pro-Ven. system, and our microbiome
exerts an immune influence as
a defence against pathogens.
Our clinical studies have also
shown that Pro-Ven – when
taken daily for six months
during the winter period –
can reduce the duration of
coughs and colds suffered
by children by 50%.
18 IPUREVIEW JUNE 2019Dr Nigel Plummer
presenting the
science behind
Pro-Ven
What is Lab4?
Lab4 and Lab4b are lactic acid bacteria
(LAB) and Bifidobacteria that have been
isolated from the gut microbiota of healthy
humans and then screened for appropriate
probiotic characteristics, ranging from
resistance to stomach and bile acids, to
Where and how are your products manufactured? robust capability for large-scale in-vitro
The products are produced the probiotics at each stage circulation and commercialisation.
at our approved GMP (Good of the process. StabilityMAX Since their inception, the Lab4 and
Manufacturing Process) combines the TriPhase treated Lab4b consortia have been the subject of
manufacturing facility active ingredients with more than 10 major human clinical trials
in south Wales using our optimised ‘gas-tight’ packaging as well as over 100 basic and mechanistic
proprietary manufacturing and ‘overage’ of (extra) scientific investigations. Most of this work
processes known as TriPhase bacteria. has been published in peer-reviewed
and StabilityMAX. These processes ensure that journals.
TriPhase is a unique the bacteria are stable for up
three-stage stabilising and to 18 months at temperatures
conditioning technology, of 25-30°C.
which increases stability of
Pro-Ven is
available exclusively
from Uniphar.
To order, contact
your local Uniphar
representative
or email
linkup@uniphar.ie.
IPUREVIEW JUNE 2019 19IPU CONFERENCE 2019 Ciara Browne, Communications and Events Executive, IPU
The 2019 IPU
National Pharmacy
Conference
The 2019 IPU National Pharmacy Conference took place
on 10 – 12 May in the Galmont Hotel in Galway, City of
Tribes. We were delighted to bring the IPU conference to
the west of Ireland and deliver one of the best conferences
yet. The weather did not disappoint and throughout the
weekend there was a great atmosphere throughout the
hotel. We had a very exciting and extensive agenda for
attendees to enjoy this year, which included the Plenary
Session, the Panel Discussion and all of the engaging
sessions in between. Ciara Browne, Communications and
Events Executive, IPU, gives an overview of the weekend.
T
he theme for the over the country travelled first Preceptors in Ireland
ninth annual IPU to Galway to enjoy the high- were able to undertake this
conference was level programme of events, training at the conference
Community Pharmacy: including our extensive to be able to support 4th-
Maximising Our business and clinical sessions year student pharmacists
Potential, a theme that that were delivered by on their journey to practice.
was chosen to reflect how engaging speakers. Our first business session
patients and the whole of the We coordinated with APPEL was from Alan McCormick
healthcare system can benefit to host a Preceptor training from hmR Ireland, titled
from community pharmacists session for community Maximising the Return from
working at their full scope pharmacists on the Friday your Dispensary Data – a hmR
of practice. Pharmacists afternoon. Pharmacists who Presentation, which showed
and pharmacy staff from all wanted to act as one of the how hmR’s Pharmacy Platform
20 IPUREVIEW JUNE 2019Above: Attendees at the IPU National Pharmacy Conference.
Right: Minister for Health Simon Harris TD and IPU
President Daragh Connolly.
can identify opportunities was titled The Pharmacist in Plc, delivering a fantastic the problems encountered
within the data to help Atrial Fibrillation Clinic . . . session on how to Transform around the availability of
pharmacists unlock hidden A Model of Care. This session your Business using People, palliative care medicines in
profit potential, including gave a better understanding of Process and Technology, which the community. After our
generic opportunities. Our atrial fibrillation, its diagnosis, looked at what is innovation, Plenary Session (which is also
first clinical session was complications and treatment what is value, what are detailed in this article) we
delivered by Séamus Ruane, and was delivered by Edwina customers and how you can had a session on Economic
community pharmacist in Morrissey, Senior Clinical keep your business lean and Trends in 2019 and How they
Galway on 5 Ways to Increase Pharmacist and Rónán Collins make your customers happy. May Affect the Pharmacy
Your Wellbeing at Work (No MD, Consultant in Geriatric Our parallel clinical session Sector, which was delivered
Matter How Busy You Are). Medicine and Co-Director of on Saturday morning was by Economist Jim Power
A key take-home from this the Interdisciplinary AF Clinic, delivered by Karen McKee, and was in association with
session was the Roadmap for both from Tallaght University Chief Pharmacist, Galway Moore Wealth Management.
Flourishing and how this can Hospital. During this session Hospice Foundation, and Jim addressed current
be achieved through Positivity, there was also a patient was titled The Role of the international issues,
Engagement, Relationships, advocate who discussed her Community Pharmacy Team Brexit, the Irish economy
Meaning, Achievement and experience with AF. in Supporting Palliative Care and domestic issues in
Vitality (PERMA-V). There was There was a great start at Home. This session was his presentation. We also
another clinical session on on Saturday morning, with in association with Galway had a session sponsored
Friday, which was sponsored Jay Patel, pharmacist and Hospice and explored the by A.Menarini on Eczema
by Bristol Myers Squibb and Executive Director, Day Lewis more commonly used Diagnosis and Treatment: Tips
palliative care medicines, the and Tricks for the Community
use of the syringe driver and Pharmacist, delivered by GP
and pharmacist Dr Paul Ryan.
This very informative session
explored the anatomy of
epidermis, eczema as a barrier
dysfunction, potencies of
topical corticosteroids, atopic
eczema, contact dermatitis,
seborrhoeic eczema and
emollients.
Our session on Saturday
afternoon was our keynote
address, delivered by
pharmacist and motivational
speaker Jack Kavanagh. Jack
gave an incredibly moving
and emotional talk, where
he let the audience hear his
own personal story from
surviving to thriving in life
– a session titled Leading
Through Adversity.
Sessions continued Sunday
morning with a talk from
Susan Madden, Principal,
South East College, on Leading,
Delegating, Communicating
– How will you Manage?
IPUREVIEW JUNE 2019 21This session focussed We also hosted a CPD Opening Remarks
on how, as a community session for pharmacy from IPU President
pharmacist, you are not just technicians, which covered
a health professional but Support and Care for Cancer Daragh Connolly
also a manager and a leader Patients. Qualified technicians ”Good morning everyone and a
of a team of people within arrived for the talk, which warm welcome to you all.
a pharmacy – the role of a was delivered by pharmacist Minister Harris, honoured
pharmacist is a position of and trainer Sheila O’Driscoll, guests, ladies and gentlemen,
responsibility and with it who gave an overview of colleagues and friends.
comes assumed obligation. the appropriate use of anti- Firstly, on behalf of the Irish
Our clinical session on Sunday emetics and other ancillary Pharmacy Union, I would
morning was The Challenges treatments prescribed like to thank the Minister for
Presented by Breast Cancer for patients receiving Health, Simon Harris TD, for
Survivors taking Antihormone chemotherapy or radiotherapy, travelling to be with us today
Medication and was presented as well as how to advise at our Annual Conference
by Elizabeth Summersby, patients on how to maintain here in Galway. We are truly
RANO Oncology, Our Lady of good general health and what delighted, Minister, that you
Lourdes Hospital. Elizabeth to do if they feel unwell. have made this effort to meet
highlighted the context of with community pharmacists,
breast cancer management IPU members, and our
in Ireland, the follow-up of Plenary Session invited guests, to listen to our
breast cancer patients post concerns and issues and, no
The Plenary Session was a
initial treatment, the potential doubt, to contribute to the Jim Power, Economist
huge success this year and
side-effects of Tamoxifen and lively debate and discussions
was delivered to a packed
Aromatase inhibitors and its that will take place this known by every pharmacist in
room. The theme for the
impact on patient’s HRQOL, morning. I also want to thank Ireland. Its weight is crippling
Plenary Session correlated
the issue of compliance our eminent speakers who our profession and our ability
with the overall conference
in this patient cohort and have travelled from Canada, as healthcare professionals
theme of Community
the management of side- Scotland and Northern to deliver the healthcare
Pharmacy: Maximising Our
effects arising from these Ireland in order to share their solutions our communities so
Potential. Darragh O’Loughlin
medications. experiences and expertise. You desperately need.
chaired the session and
A certificate of attendance are all very welcome to Ireland It is no exaggeration to
welcomed all of the attendees
will be sent to all pharmacists and to Galway. say that the ongoing FEMPI
and invited guests to the
who attended sessions for As the Minister for Health cuts, which to date have
session before welcoming IPU
their CPD ePortfolio. is someone who appreciates amounted to €1,500 million,
President Daragh Connolly to
deliver his opening remarks plain speaking, I am going have left many pharmacists
and the Minister for Health to speak plainly. There is an questioning whether they
Simon Harris TD to address elephant in this room. That see a future for themselves
attendees. elephant is called FEMPI and within the profession. In that
it is, unfortunately, too well time of austerity, the need for
IPU President Daragh Connolly; Dr Ross T. Tsuyuki, University
of Alberta; Minister for Health Simon Harris TD; Margaret Wing,
Alberta Pharmacists’ Association (RxA); Terence A. Maguire,
Pharmacist and Honorary Senior Lecturer, Queen’s University
Belfast; and Darragh O’Loughlin, Secretary General, IPU.
22 IPUREVIEW JUNE 2019Karen McKee, Chief Pharmacist, Galway Hospice Foundation our services has increased, the pharmacist within two others, including some of our to sustain a vital healthcare as has the regulatory and years, but little has been healthcare colleagues. We service providing accessible administrative workload, done. The IPU fought hard want to believe that there care and support to patients leading to a situation where for that commitment and is a higher road, and that it and the public in every town, pharmacists are now doing far has consistently put forward too will lead us to a positive village and community more work for considerably constructive proposals to outcome. throughout Ireland. less, an average of €200,000 the Department aimed at Minister, we warmly Minister, you have shown per pharmacy per year. enhancing access to care and welcomed the opportunity to that when you are determined Research carried out by improving patient outcomes finally meet with you in March to get something done, you EY-DKM in 2017 proved that and value for money – 30 this year. We outlined our get it done – whether that pharmacies located in areas of separate instances, generally willingness, our ability and is reforming reproductive highest social and healthcare without receiving any our determination to provide healthcare for Irish women; need were the most reliant on response. Like Cinderella. constructive and innovative securing a once-in-a- State fees for providing those Minister, you are probably solutions to many of the generation agreement with services to their communities. sensing the frustration that capacity and access problems general practice; or pushing As a result of the inadequacy my colleagues and I feel. We that bedevil the health back against the dangerous of those fees, they are the least have done everything to try service. The IPU and our falsehoods of the anti-vaxxers sustainable. 300 pharmacies and advance the case for members strongly welcomed and reversing the previous in rural, disadvantaged and supporting and resourcing your clear commitment at decline in uptake of the isolated areas are unviable pharmacists to practise to that meeting to begin, this HPV vaccine. The IPU is a and will close unless they see full scope and to enhance our September, a process to bring proud member of the HPV an increase in funding for contribution to healthcare about reform, modernisation Vaccination Alliance and their professional services. but have come up against and contractual overhaul for our members have played The impact of the a wall of inertia. By not community pharmacy – to their part in promoting and emergency legislation on allowing us to practise to the “move to higher terrain”. advocating for this and other pharmacy incomes and the full scope of our abilities, the We have had a very life-saving vaccines. failure to address the issue is very future of the profession positive and constructive In your own words, Minister, disproportionate, unfair and is threatened. Young engagement with Laura you have consigned FEMPI inequitable. pharmacists are not entering Magahy and her team in to the history books for GPs In light of the very community pharmacy due Sláintecare. We look forward and secured the future of substantial unwinding of to the health system’s failure to exploring and agreeing on their profession. We ask FEMPI cuts to public sector to allow them do what they a broader scope of practice you now to apply that same salaries and the recent have been trained to do, for pharmacists to provide determination to securing announcement of substantial particularly when they see Irish patients with access to the future of community increases in funding for how their colleagues in other safe, locally-provided, high pharmacy as a valuable, General Practice, pharmacists jurisdictions can work. quality healthcare, aligned accessible, healthcare hub at are now reminiscent of We need to avoid letting fully with the vision set out the centre of primary care and Cinderella. We have quietly our frustration become in Sláintecare – whether by at the heart of communities and efficiently laboured to disillusionment. We don’t expanding our vaccination nationwide. make Primary Care work for want to believe that the only services, by reducing barriers We look forward to those who need it most in the way to get Government’s for women accessing beginning our long-awaited communities where we are attention and to make contraception, or by rolling substantive engagement in the first point of contact for progress is through protest, out a pharmacy-based Minor September and continuing healthcare. obstruction, and non- Ailment Scheme. Most to work constructively with The 2016 Programme for cooperation, although it does importantly, we urgently need you and your Department. Government committed appear that this approach has to place community pharmacy We hope to have you back at to expanding the role of worked very well for many on a stable financial footing our conference this time next IPUREVIEW JUNE 2019 23
year, to announce significant community pharmacy. There is a principle that Service Development in
progress on developing and The role community many of you have heard me Community Pharmacy
future-proofing pharmacy pharmacy plays in delivering talk about – I mentioned it I know that there is an
services and a fair deal on health services to our citizens last time I was here – the need appetite in community
funding. Indeed, we expect is a vital one. for a decisive shift of health pharmacy to take on more
nothing less. We now have some 1,850 services to primary care, so clinical responsibility. The
Finally, Minister, on behalf contracted pharmacies, an that our citizens can receive standard of education
of myself and the IPU, I increase of about 15% in appropriate care close to their and career expectations
would like to thank you once the last decade, providing home communities. of pharmacists require
again for coming here this comprehensive national It is a cornerstone of Government to seriously
morning to hear us, to listen coverage and accessible local Sláintecare. And in towns consider how the potential of
and to officially launch the care, often with strong and and villages throughout this valuable resource might
2019 IPU National Pharmacy long-term relationships with this country, you can be the be maximised.
Conference. We all know patients. shopfront of Sláintecare. I will be the first to admit
that the tale of Cinderella The expertise and skills that Our patients should get that progress in developing
had a happy ending: Prince pharmacists bring to their safe and clinically effective pharmacy services has not
Charming saw past her sisters work provides care that is treatments early, at the been all that you or I might
to find where the shoe fit best. very much at the frontline – in lowest level of complexity wish for. However, there is
It is time now for all of us communities and face-to-face and as close to home as significant common ground.
to move beyond fairy tales with patients on a day-to- possible. People should also But we now need a
and get down to enacting day basis, as well as working have practical opportunities momentum. That is why I
real change.” closely with prescribers – to develop their self-care – am particularly pleased that
with the interests of looking after their own health Laura Magahy, Director of
patients to the fore. as far as possible. Sláintecare, will be with you
Minister’s Speech The theme for this year’s When we talk about this afternoon, because there
Plenary Session is Community providing patients with care are some things we have
“I am delighted to join you done on a pilot basis that we
Pharmacy: Maximising Our locally, that can no longer
this morning, and I thank your now know work. We know
Potential. For me, this applies mean that every pathway
Secretary General, Darragh the Minor Ailment Scheme
across all aspects of health must bring you to a doctor.
O’Loughlin, and President, works. I’m fed up hearing
service delivery in Ireland, I say this with the greatest
Daragh Connolly, for the about evaluating the Minor
but it is particularly apt respect to our GP colleagues,
invitation to address the 2019 Ailment Scheme. We know it
for contracted health with whom we have
IPU conference. works. We don’t need a pilot.
professionals. launched a massive package
I very much hear your We need a much broader
I note the strong Canadian of investment for General
frustrations, not just hearing Minor Ailment Scheme and
and Northern flavour to the Practice.
them today but also at our we need to very much embed
session, providing a focus But we have got to look at
most recent engagement in that in Sláintecare and we had
beyond clinical practice in the role that everybody plays
March. You refer to a wall of discussions when we met in
Irish community pharmacy. in the community, and we
inertia, and my commitment March on how we might do
I hope there will be robust can’t bring everything back
is to work with you to begin to that with the Health Research
discussions today, on the to what more work can the
dismantle the walls of inertia. Board’s assistance as well.
many directions available GPs do, when we know that
We have shown that when we There have been positive
for the development of groups like pharmacists have
both work collaboratively, we developments and very
community pharmacy and the competency, qualifications
have a real ability to get things welcome collaboration,
on its relationship to patients and scope of practice, and a
done. including on Brexit and
and healthcare delivery in willingness to do more.
I accept that we have a on the Falsified Medicines
Ireland, both professional and Community pharmacy has a
very big agenda of things that Directive, as well as on
commercial. I am confident key role in this type of health
we need to get done and the emergency contraception and
that the Irish pharmacy provision, for both private and
top of that agenda has to be flu vaccination, both of which
community has as much to public patients, and much is
ensuring the sustainability of have been very successful.
offer, as to absorb in this. already being delivered.
24 IPUREVIEW JUNE 2019You can also read
