ITK August/September 2014 - Edition 37

ISSUE #37 : August / September 2014

P r a c t i c a l I n f o r m at i o n f o r T o d a y ’ s C o m m u n i t y P h a r m a c i s t

IN THE KNOW

• Allergy and hayfever

• the modern day pharmacy

• competition

• training and education

• CPD – osteoporosis

• women and healthy bones

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CONTENTS

SPECIAL FEATURE 10 CPD – Osteoporosis 22 Woman and Healthy Bones

WELCOME

PROFFESSIONAL REVIEW 8

18

Weak bones, weak bladder

18 Dental Health – Babies and Toddlers

OTHER ARTICLES

BY SEAN TUNNY Editor, Gold Cross Products & Services Pty Ltd

WELCOME to the thirty-seventh edition of In the Know for 2014. With pharmacies reporting one of their busiest cough and cold seasons in a number of years, we hope that you personally have been well and, in particular, staying warm.

In this edition of ITK, we have a special focus on Osteoporosis, along with a must-read editorial titled “The Modern Day Pharmacy” regarding the important role Pharmacy plays in mental health care.

6

Category Review – Allergy and Hayfever

36 Mystery Shopper – Pharmacy vs Supermarket

30 Soothe burning and irritated eyes 31 Help to prevent hayfever symptoms this Spring 32 Treating dry scaly scalp conditions

GUILD NEWS 4

Pharmacy feedback gets results

BUSINESS PROFILE

This edition is loaded from front cover to back full of features, reviews and editorial, including a Business Profile from Lease1. A 16-page Gold Cross “First in Aid” feature booklet is your valuable resource and is exclusively Pharmacy-only, covering allergy, baby, asthma and hay fever.

Product spotlights, training and education, 60 seconds with Calum Brownie, classifieds and pharmacy reviews are all featured as part of this edition of ITK. Finally, with APP2015 rapidly approaching, we invite you to save the date of 12 March 2015.

AFTER HOURS

Best Regards, Sean Tunny Editor

34

14 GuildLink – Providing the tools to empower Australian Pharmacies

As this edition goes to print, the final touches of the “Brisbane Ekka” are underway and, as it commences, the timing also signals the start of the westerly winds, allergies, hay fever and sinus. Wide media reporting has identified that this winter has been particularly severe and again we acknowledge the work of pharmacists and pharmacy staff during this time. We invite you to turn to our category review on allergy and hay fever.

Thank you to all the contributors, partners and supporters of ITK — wishing you an enjoyable read of this edition.

22

TRAINING AND EDUCATION

16 Phillip Chapman – Lease 1

DOWN TO BUSINESS 20 How does your team stack up?

26 The Modern Day Pharmacy

36

34 Partnerships – The most challenging management structure 41 How to sell your pharmacy

44 Toowoomba Carnival of Flowers

REGULARS 38 What’s new and Company news 42 Product Spotlight – includes competition

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45 Health Calendar 46 60 Seconds Interview

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47 Classifieds

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PLEASE USE THIS PUBLICATION TO KEEP YOUR PHARMACY IN THE KNOW. EDITOR: Sean Tunny

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PUBLISHED BY: Gold Cross Products & Services. PO Box 505 Spring Hill Qld 4004.

Contact Candice Radford Email: Candice.radford@goldx.com.au In The Know is produced for the information of Australian Pharmacists. The presence of the logo of the Pharmacy Guild does not constitue endorsement of a product. The Pharmacy Guild of Australia accepts no responsibility for claims made by advertisers. Opinions and views expressed in articles do not necessarily reflect those of Gold Cross.

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4

NEWS FROM THE GUILD PRESIDENT

Pharmacy Feedback gets results George Tambassis

“The retail landscape is forever changing, with growing competition from grocery outlets and price disclosure placing pressure on pharmacy margins.”

National President of The Pharmacy Guild of Australia

There are lots of surveys conducted in and around the pharmacy industry — so much so that sometimes I have heard complaints about the onset of ‘survey fatigue’.

Surveys have their place for gathering information, but to my mind the most useful surveys are the ones where the information gathered is converted into action and improvement.

One of the best survey exercises I know of explored customer experiences of their local pharmacy through the Quality Care Pharmacy Program (QCPP) ‘Pharmacy Patient Questionnaire’.

The survey has been offered as a member benefit to QCPP accredited pharmacies in three phases over the past three years. An evaluation of the survey for its reliability and validity has recently been published in the International Journal of Healthcare Management .

Now with over 70,000 patient responses over the three phases, there was lots of positive feedback for pharmacies about individualised and respectful care, reinforcing the frequent finding of high levels of trust in community pharmacists and their staff.

That’s all good, but what I really want to focus on is the concerns expressed about some aspects of care, and the positive way pharmacies reacted and responded to this information.

For example, the lowest scoring area in patient responses revolved around privacy issues. The perception that pharmacies do not provide adequate privacy for some patients to ensure discreet and private discussions of health issues continues to get traction, and is something the industry must address.

Many patients also expressed:

•• a desire for their pharmacies to be opened for longer hours, and on Sundays

•• a desire to be asked whether they wanted a generic medicine rather than it being assumed •• a preference for clearer pharmacy layout, specifying where to go for scripts, drop off, pick-up and general inquiry •• a preference for dispensary counters to have less clutter.

When these patient responses (and many more) were conveyed to the participating pharmacies, the positive response was very promising: 87 per cent of pharmacies took action to respond to their patients’ wishes.

Maybe a sign on the counter making it clear that such a facility is available would be an easy first step. Certainly all staff should be trained to watch for circumstances in which the offer of a private place to talk might be beneficial and comforting for the patient.

My congratulations to the Quality Care Pharmacy Program for commissioning this survey work, and to those pharmacies involved who have turned survey data into tangible action to deliver better quality services to patients.

Another reported: ‘We have reinforced to staff the protocols relating to privacy whilst speaking with customers. Even though we have a consulting area, our customers don’t seem to realise that – so now we can address this issue with signage.’

The retail landscape is forever changing, with growing competition from grocery outlets and price disclosure placing pressure on pharmacy margins. The Gold Cross brand is here to help you. By stocking Gold Cross products you are in fact investing in the long-term health of your industry, as we are committed to reinvesting in, supporting and protecting pharmacy. A proportion of sales from the traditional and new Gold Cross branded ranges (Cough & Cold, Analgesics, Allergy, Digestive Health and more) goes directly to fund our actions to promote the value of community pharmacy and build a stronger future. All you need to do is stock and recommend these quality products that proudly display your professional mark – the Gold Cross.

I believe pharmacy owners and managers — indeed all staff — should work at ways to promote the availability of private areas or consultation rooms.

Gold Cross is owned, operated and endorsed by the Pharmacy Guild of Australia.

That’s why we say that Gold Cross is Pharmacy only, forever.

One respondent reported: ‘We are now separating our prescriptions counter to have a script-in and script-out area, and putting up barriers so all customers get served in order. We can relieve some of the congestion that we agree is a problem during peak times.’

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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Category Review

Allergy and Hayfever

By Nate Hentschel Pharmacist, B.Pharm.

As Spring follows Winter, so too does the Allergy and Hayfever season follow the Cold and Flu season, so what are the differences between Cold and Flu symptoms in patients opposed to those that present with Allergy and Hayfever?

The differences between colds, flus and allergies are important to distinguish as the therapeutic options can vary significantly.

Colds and flus are usually self-limiting and present with fever, headaches, body aches and pains, sore throats and coughs, more frequently in winter. Hayfever and allergies are often seasonal, occurring at a particular time each year, or perennial, occurring yearlong.

Allergic rhinitis is an inflammatory condition caused by the body responding to an allergen or irritant. The production of histamine causes inflammation and congestion in the nose, leading to the classic allergy symptoms we see in pharmacy: rapid onset of sneezing, runny nose, congestion and itching. While there can be a cough with allergies due to postnasal drip, allergies do not present with the fever and pains associated with influenza, or sore throats often linked to common colds. Nasal discharge with allergies is usually thin and clear, while an infection may present as a thicker or coloured discharge. The easiest sign of allergy to pick up is itchiness, particularly itchy, watery or red eyes, which rarely presents with infections.

Apart from looking at the symptoms, the other major difference is in the causes – allergies are often triggered by dust, pollens, animals and smoke, and removing the trigger of the allergy will generally relieve the symptoms. People with chronic allergies might also suffer from asthma or eczema.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

Category Review

“Hayfever and allergies are often seasonal, occurring at a particular time each year, or perennial, occurring yearlong. The easiest sign of allergy to pick up is itchiness, particularly itchy, watery or red eyes, which rarely presents with infections.�

Considering the various treatment options for allergic rhinitis including antihistamines, corticosteroids, leukotriene antagonists, and immunotherapy, a Pharmacist needs to be able to differentiate these when talking with a customer.

Many patients will come in asking directly for an antihistamine. Determining what is most appropriate for someone is simply looking at the patient, their symptoms, and how severe they are. Most patients benefit from antihistamine tablets and short term nasal sprays, whether saline, corticosteroid or decongestant.

Oral antihistamines are often the most requested product and the easiest to use, with many offering once-daily dosing. Patients who do not benefit from one antihistamine may achieve symptom relief from a different medication. Sedating antihistamines can be useful for more severe short-term allergies.

Non-sedating antihistamines may be more effective in seasonal sufferers if they begin taking the product before their allergy season begins, and continue taking it throughout the season.

Patients presenting with severe nasal congestion may benefit from a decongestant nasal spray for short-term use, usually less than 5 days, and then beginning a nasal corticosteroid or antihistamine tablet.

For those who suffer chronic or severe allergies, they may benefit from seeing their doctor and testing to find what might be causing the allergy so they can avoid it, or investigate options such as immunotherapy, which involves a long-term desensitisation program.

Treatment options for all types of patients with allergic rhinitis differ for various ages and profiles including newborns, babies and pregnant women.

For patients trying to conceive or already pregnant, consider saline or steroid nasal sprays, as these are the safest options.

You may also recommend Polaramine or Phenergan, as they are ADEC category A in pregnancy. Wherever possible, avoid using decongestants and less sedating antihistamines as these are not category A. In breastfeeding, consider that the adverse effects of some of the sedating antihistamines could be excreted through the breast milk and affect the baby.

For newborns and babies below 6 months, the majority of antihistamines are not recommended. Saline drops and aspirators can be used to help with blocked or runny noses, as well as limiting exposure to potential triggers. Fexofenadine can be used from six months of age and above, while loratadine, desloratadine and cetirizine can be used for ages one year and above. For young children, liquid formulations or chewable tablets are easier options.

With an ever increasing range of OTC Allergy and Hayfever Products available in supermarkets, the role of the pharmacist and counselling in this category has never been more important.

The pharmacist is there to not only counsel on the medication, but also to point the patient in the right direction for managing chronic allergies, as well as provide lifestyle advice and refer for further treatment.

Keeping customers loyal to the pharmacy is essential, with small packs of some antihistamines already available in supermarkets, pharmacists will benefit from being more pragmatic in forming rapport with the patient and giving them the time and information they want and need so that they will come back for your service. Pharmacists can offer a range of advice on allergies and provide non-medicated options which can really benefit the patient, making allergies an area which pharmacists can really excel at.

The category is changing/evolving.

There is always the possibility for supermarkets to gain access to some pharmacy-only allergy treatments, which makes the schedule 3 category even more important from a business perspective.

As far as treatment goes, only a handful of new medications appear to be in the pipeline; however, in the near future, access to more affordable immunotherapy and biological drugs such as omalizumab may provide these typically expensive options to people with allergies.

Medications such as monteleukast, a leukotriene receptor antagonist, might also become more common in the repertoire of treatments for allergic rhinitis. There seems to be an upward trend of people suffering from allergies, so this is certainly a category of growth where pharmacists are very well positioned to help treat this often frustrating condition.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

7

8

professional review

Weak bones weak bladder

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Osteoporosis weakens more than just your bones. New research suggests it is closely linked to incontinence in older women.

Finding a balance

“I suggest there is substantial need to widen our embrace of holistic practice to ensure it includes fall prevention and counselling women about osteoporosis.”

While there are some conditions where the link to incontinence is logical, such as pregnancy, childbirth or weak pelvic floor muscles, there are some where the connection is less obvious. One of these is the link between osteoporosis and urinary incontinence. A 2009 Canadian study found that middle-aged and older women suffering from osteoporosis had a much higher incidence of incontinence than women without osteoporosis1.

Associate Professor Pauline Chiarelli, a physiotherapist and University of Newcastle researcher, is a research associate assisting in a 15-year Australian longitudinal women’s health study of more than 30,000 women, undertaken by the University of Queensland and the University of Newcastle.

Dr Chiarelli provided further evidence that middle-aged and older women diagnosed with osteoporosis are at increased risk of developing urinary incontinence when she presented the Australian study’s findings at the 2013 Continence Foundation of Australia’s National Conference on Incontinence.

There is also a body of research suggesting that curvature of the spine increases the risk of pelvic organ prolapse as the result of the subsequent altered positioning of the organs, muscles and bones within the abdominal cavity2.

This, Dr Chiarelli said, lends support to the hypothesis that the altered forces pushing down from the abdomen onto the bladder as a result of the spinal deformity may be implicated in incontinence. The link, however, would not be as strong for mid-aged women who would be unlikely to have spinal deformity in the early stages of the disease, she said.

Osteoporosis occurs predominantly in women aged 55 and over, with 1.2 million Australians estimated to have the condition3.

In Dr Chiarelli’s view, women who are diagnosed with osteoporosis need to be screened for, and informed about, their increased risk of urinary incontinence and pelvic organ prolapse.

She said that certain physical correlations between the two conditions were being examined; in particular height loss associated with curvature of the spine.

“Currently, an average of one osteopathic fracture takes place in Australia every eight minutes, and this is expected to more than double in seven years’ time if the trend continues,” Dr Chiarelli said.

It is well understood that women with osteoporosis lose height because of the spinal deformity associated with vertebral fractures – the most common osteopathic female fracture.

“Osteoporosis is life changing, debilitating, painful and associated with high morbidity and some mortality, but it’s very common and very preventable.”

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

Both women agree that the maintenance of bladder and bowel control becomes even more critical as women age, with women facing a delicate dietary and exercise balance past the age of 50.

“They need to reduce their calorie intake but need more of certain nutrients, so that means their food needs to be specifically targeted as well as nutrient-rich,” Dr Chiarelli said.

“And some women might be put off exercising if they find they leak during physical activity.”

The Continence Foundation of Australia advises women to protect their pelvic floor when undertaking any exercise program and directs them to pelvicfloorfirst.org.au for further information.

Dr Chiarelli’s believes preventing osteoporosis post-childbearing age incorporates a wide spectrum of health, age and lifestyle issues and, as such, needs a more holistic approach.

“I suggest there is substantial need to widen our embrace of holistic practice to ensure it includes fall prevention and counselling women about osteoporosis.”

Health professionals and consumers can go to continence.org.au for more information or phone the National Continence Helpline (1800 33 00 66), which is staffed by continence nurse advisors who provide advice, referrals and resources about incontinence.

REFERENCES 1 Sran MM, Prevalence of urinary incontinence in women with osteoporosis, J Obstet Gynaecol Can. (2009);31(5):434-9.

2 Mattox TF et al, Abnormal spinal curvature and its relationship to pelvic organ prolapse Am J Obstet Gynecol, ( 2000) 183(6):1381-4.

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10

CONTINUING PROFESSIONAL DEVELOPMENT

Osteoporosis

BY Margaret Robinson B.Pharm.Hons, Dip Comp Sci – AM Pharmacy Guild of Australia

Background: Osteoporosis literally means porous bones, or bones that have lost their solidity and are more likely to fracture1. In women over 80 years with hip fracture, approximately 1 in 4 of will die within 3 months of having the fracture2. In Australia, one in 2 women, and 1 in 3 men over 60 years, will have an osteoporotic fracture3.

Description

Measuring bone density (bone mineral density, BMD)

Bone is not a solid static structure but is constantly being re-built and renewed.

Osteoclasts resorb (dissolve) the bone while the family of osteoblasts help form and maintain bone.

A bone mineral density test compares the bone density of the patient to a healthy 30-year-old adult.

Fractures due to osteoporosis can lead to changes in posture (e.g. developing a stoop or Dowager’s hump of the back), muscle weakness, loss of height and bone deformity of the spine.

Osteoporosis is a “silent” disease since there are no symptoms until a fracture happens4.

Dual-energy x-ray absorptiometry (DEXA) is the current “gold standard” for the diagnosis of osteoporosis3.

DEXA is reliable, with a precision of about 1%. In postmenopausal women, the rate of bone loss is generally 1–2% per annum, thus an interval of two years between scans is satisfactory3.

The BMD test results are given as a T-score.

The lower the T-score, the more likely a person is to have osteoporosis5.

T-score

Bone density

+1 to –1 –1 to –2.5 –2.5 or less

Normal Low bone density Osteoporosis

A web tool to assess osteoporotic fracture risk is at: http://garvan.org.au/promotions/bonefracture-risk/calculator/

Small blood vessel Newly deposited bone matrix Osteoblast lainng down new bone to fill tunnel dug out by osteoclasts Loose connective tissue

Normal bone

Osteoclasts digging a tunnel through old bone

Osteocyte

Old bone Osteoporosis

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

CONTINUING PROFESSIONAL DEVELOPMENT

“Fractures due to osteoporosis can lead to changes in posture (e.g. developing a stoop or Dowager’s hump of the back), muscle weakness, loss of height and bone deformity of the spine.”

Screening for osteoporosis Risks for developing osteoporosis include both non-alterable and alterable factors.

Risk factors for developing osteoporosis6

•• Age over 50 years •• Family history of osteoporosis •• Physical inactivity – exercising less than 3 times per week

•• Alcohol – more than 5–6 standard drinks daily if male

– more than 3–4 standard drinks daily if female

•• Delay of onset of periods at puberty

•• Short stature

•• Early menopause (before 45 years)

•• Low body weight

•• Missing menstrual periods for

•• Asian heritage •• Smoking

extended intervals

•• Low calcium intake – (of milk, yoghurt, cheese, sardines, broccoli)

•• Low vitamin D intake – (for adequate vitamin D, face and arms should be exposed to sun for 6–8 minutes per day 4–6 times per week)

•• Long-term medications such as corticosteroids

•• Never having taken oral contraceptives

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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12

CONTINUING PROFESSIONAL DEVELOPMENT

Pharmacological treatment of osteoporosis Bisphosphonates •• alendronate (Fosamax) – oral weekly •• risedronate (Actonel) – oral weekly •• *ibandronic acid (Bondronat) – oral daily and injection

•• zoledronic acid (Aclasta, Zometa) – yearly injection

•• *clodronate (Bonefos) – oral daily •• *pamidronate (Aredia, Pamisol) – injection 3–4 weekly

•• *tiludronate (Skelid) – oral daily for 3 months then cease

•• (*not on PBS for osteoporosis) This class of drugs works by inhibiting the activity of osteoclasts and shortening their lifespan, thereby reducing bone resorption8.

Bisphosphonates only act on bone with no other effects in the body8. The most common adverse effect of oral bisphosphonates is oesophageal and gastric irritation8.

Clinical trials have demonstrated that bisphosphonates significantly increase bone density at the spine and hip in a dose-dependent manner in women8.

Although administration of daily and weekly bisphosphonate therapy has been shown to be effective treatment for osteoporosis in postmenopausal women, compliance and persistence with therapy is often poor7. Some of the suggested rationale for this poor compliance is: having to fast overnight; doses having to be taken with lots of water and with no other food or drink; and having to remain upright for 30 minutes.

There are also the problems of lack of motivation in an asymptomatic disease.

Thus, many studies have been done which establish that compliance is much better with drugs which have a long duration of action.

Doses of bisphosphonates now can be given monthly or even yearly and have been shown to be preferred by patients 7, 8.

Because raloxifene is an oestrogen agonist, there is concern regarding its cardiovascular risk. However, the MORE-CORE and RUTH trials found that women regarded as being at cardiovascular risk suffered no adverse cardiovascular events with raloxifenre9, 10.

Parathyroid hormone Teriparatide is a parathyroid analogue, given by subcutaneous injection once daily, and is an anabolic agent that directly stimulates bone formation, resulting in substantial increases in bone density and connectivity in women with postmenopausal osteoporosis. This mechanism of action is very different from that of antiresorptive agents such as oestrogen and bisphosphonates, which reduce bone resorption.

Drug-related adverse effects include muscle cramps and infrequent hypercalcaemia, nausea and dizziness11 .

Oestrogens Because of the potential for cardiovascular risk, oestrogens should not be considered as first-line treatment for osteoporosis.

The Women’s Health Initiative study found that systemic oestrogen/progestogen at standard doses for 5-6 years in postmenopausal women ages 50 to 79 was associated with a statistically significant increased risk of breast cancer, stroke and thromboembolic events.

Strontium Strontium has two actions – it reduces the resorption of bone and promotes bone formation12. No other treatment for osteoporosis is able to have this dual action.

The efficacy of strontium in reducing the risk of hip fracture (a reduction of 36%) is similar to that of the bisphosphonate risedronate. Treatment with strontium is safe and well tolerated13, 14.

SERMs Raloxifene is an oestrogen agonist. Trials have shown that raloxifene can reduce the risk of vertebral fracture by 30–55%.

“There is the problem of lack of motivation in an asymptomatic disease. Thus, many studies have been done which establish that compliance is much better with drugs which have a long duration of action.”

Vitamin D analogues Calcitriol is a form of Vitamin D which is activated in the kidneys and usually used to correct the hypocalcaemia associated with kidney failure because the kidneys no longer activate calcitriol adequately.

A trial in postmenopausal osteoporotic women which compared calcitriol and elemental calcium demonstrated that calcitriol had a significantly lower rate of new vertebral fractures compared with patients receiving calcium15. While calcitriol is well tolerated, it can precipitate calcium in the kidneys causing kidney toxicity; however, trials have not shown any significant renal toxicity when used for osteoporosis.

Nevertheless, there is doubt regarding the efficacy and long-term safety of calcitriol when compared to other drugs.

Denosumab (Prolia) Denosumab is a monoclonal antibody which prevents the action of RANKL a ligand essential for the formation, function and survival of osteoclasts (which dissolve bone).

The recommended dose of denosumab is a single subcutaneous injection of 60 mg, once every 6 months16.

To reduce the risk of hypocalcaemia, patients must be adequately supplemented with calcium and vitamin D. The 3-year FREEDOM trial found that denosumab reduced the risk of non-vertebral fracture by 20% and hip fracture by 40%, relative to placebo16.

As with bisphosphonates, treatment with denosumab results in significant suppression of bone remodelling. Thus, long-term safety studies are needed to determine the effects of denosumab when given for longer than the 3-year study term of the Freedom trial.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

CONTINUING PROFESSIONAL DEVELOPMENT

REFERENCES

SELF ASSESSMENT QUESTIONS

1 North American Menopause Society. Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause 2010;(1) 25–54.

Question 1.

2 Bliuc D, Nguyen ND, Milch VE et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women.

JAMA 2009; 301:513–521 3 Sambrook PN, Seeman E, Phillips SR, Ebeling PR. Preventing osteoporosis: outcomes of the Australian Fracture Prevention Summit. MJA 2002; 176 (8 Suppl): 1–16.

4 Kenneth G, Saag KG, Piet Geusens P. Progress in Osteoporosis and Fracture Prevention: Focus on Postmenopausal Women. Arthritis Research & Therapy 2009; 11(5):251 5 Prevention and management of osteoporosis.

World Health Organ Tech Rep Ser. 2003; 921:1–164 6 O’Neill, McLennan A, Bass S et al. Guidelines for the management of osteoporosis for GPs. Osteoporosis Australia. Available at (cited 1st April 2013). http://www.osteoporosis.org.au/files/research/ postmenopausal_oneill_2004.pdf 7 McClung M. Bisphosphonates. Endocrinol Metab Clin North Am 2003; 32:253–271.

8 Ettinger B, Black DM, Mitlack BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial.

Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 1999; 282:637–645.

9 Barrett-Connor E, Cox DA, Song J, Mitlak B, Mosca L, Grady D. Raloxifene risk for stroke based on the Framingham stroke risk score. Am J Med 2009; 122:754–761.

Statistics have shown that in Australia: a. 1 in 2 men and women over 60 years will suffer an osteoporotic fracture b. 1 in 2 women and 1 in 3 men over 60 will suffer an osteoporotic fracture c. 1 in 4 women over 80 will die from an osteoporotic fracture d. 1 in 4 men over 80 will die from an osteoporotic fracture

Question 2.

Which of the following statements is TRUE: a. Osteoclasts are responsible for dissolving or resorbing bone b. Osteoblasts are responsible for dissolving or resorbing bone c. Most drugs for osteoporosis can alter the functioning of both osteoclasts and osteoblasts d. Biphosphonates alter the functioning of osteoblasts – responsible for dissolving bone

Question 3.

A patient comes into the pharmacy. You know her as an active 70 year old patient who is on several antihypertensive and antidiabetic drugs. She is to start on Fosamax (alendronate) 70mg once weekly. Your advice to her would include: a. She should regularly attend her general practitioner for blood glucose and hypertension testing as alendronate has been associated with cardiovascular adverse effects b. She should take her doses with lots of water, with no other food of drink and remain upright for 30 minutes after dosing c. Because of the interactions with her drugs, she would be better on a once yearly infusion of a bisphosphonate such as risedronate d. Because of her age she is ineligible for PBS remuneration on alendronate and would be better on ibandronic acid

Question 4.

10 Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001; 344:1434–1441

This patient also asks you what other measures she could take to help her reduce the risks of osteoporotic fracture. You would advise that she:

11 Grady D, Rubin SM, Petitti DB, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 1992; 117:1016–1037.

b. She should increase her dietary consumption of high fibre foods such as milk and yoghurt

12 Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis.

N Engl J Med 2004; 350:459–468.

a. She should keep her alcohol consumption to 5-6 standard drinks daily

c. She should exercise at least twice weekly d. She should ensure that she has sun exposure of her face and arms for about 6-8 minutes per day for 4-6 times per week

Question 5.

13 Reginster JY, Seeman E, De Vernejoul MC, et al.

Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J Clin Endocrinol Metab 2005; 90:2816–2822.

Which of the following drugs has been shown in trials to increase the risk of cardiovascular adverse effects

14 Seeman E, Eisman JA. MJA 2004; 180 (6): 298–303.

d. Oestrogen alone

16 Cummings SR, San Martin J, McClung MR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis.

N Engl J Med 2009; 361:756–65.

b. Raloxifene and oestrogen c. Denosumab and raloxifene

After reading this article, the reader should be able to: 1.

2.

3.

4.

Understand what is osteoporosis and the physiological changes that cause it Know how osteoporosis is measured and the values for the diagnosis of osteoporosis Know the risks associated with developing osteoporosis Be aware of the drugs used for osteoporosis, their efficacy and their adverse effects

ANSWERS: Question 1 – b/ Question 2 – a / Question 3 – b / Question 4 – d / Question 5 – d

15 Prolia Product Information. Amgen Australia Pty, North Ryde NSW. 2nd October 2012. Available at (cited 1st April 2013): https://www.ebs. tga.gov.au/ebs/picmi/picmirepository.nsf/ pdf?OpenAgent&id=CP-2010-PI-07242-3

a. Strontium and alendronate

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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14

GUILDCARE

GuildLink

– Providing the tools to empower Australian Pharmacies

BY ROMA CECERE General Manager – Strategic Business Performance, GuildCare

In light of recent changes, pharmacies need to develop strategies to effectively counteract the impact from the recent price disclosure changes. There are many untapped opportunities that community pharmacies have the potential to realise and, by simply identifying these opportunities, pharmacies can be provided with additional revenue streams.

Through technology, pharmacies have the ability to gain a true understanding of untapped opportunities and under-utilised resources in their pharmacy. Focusing on maximising revenue from professional services not only strengthens community pharmacy’s value, but can provide significant benefits to patients’ health.

Technology is merely an enabler, it assists pharmacy in tasks that might be otherwise time consuming. Utilising technology to its full potential is something that we all need to work on. Processes, KPIs, along with establishing clear goals and procedures, can assist with the implementation of technology in pharmacy.

GuildLink specialises in providing pharmacies with a holistic range of programs tailored to the many facets in pharmacy.

Professional Services (Patient Wellness) GuildCare programs is a purpose built software solution assisting Australian community pharmacies in identifying, recording and reporting of professional services. GuildCare’s program range has continued to expand over the years, aligning to the professional service needs in pharmacy. At present GuildCare comprises of four program streams:

•• 5CPA Pharmacy Practice Incentives and Medication Management: e.g. Clinical Interventions and MedsCheck Services.

•• Patient Services: monitoring, screening and documenting patient measurements in programs such as Blood Glucose Monitoring, Baby Progress Recording and, increasingly popular, Vaccinations Recording.

GuildCare leading the future of pharmacy with our Vaccinations Module: Recent media reports have brought to light the potential of expanding pharmacy’s role to a healthcare hub to include services such as vaccination.

In a recent radio interview in Perth, The National President of the Pharmacy Guild, George Tambassis, advises that vaccination is within the scope of pharmacy and, with proper training, pharmacists can administer vaccines, starting with flu vaccinations as the first step.

He also mentions the current Queensland Pharmacist Immunisation Pilot (QPIP) where 8,500 patients since April 2014 have been administered the flu vaccine safely by a pharmacist.

GuildCare’s Vaccination Recording Service was used to document the vaccinations as part of this pilot.

•• Patient Adherence Programs: sponsored and generic programs targeting patients that are non-compliant or newly initiated to therapy. Pharmacists are reimbursed with professional service fees for additional time spent on delivering the services.

•• Admin Module: Brand new range of programs including Leave Certificate Request, Patient Plan and Adverse Events Recording. GuildLink is the first to provide an integrated link to the TGA’s new adverse event reporting web service.

Adverse Drug Reactions for medicines and vaccines recorded within GuildCare can now be submitted electronically directly to the TGA. Visit TGA website for additional information.

Patient Engagement and Loyalty While professional services are a perfect way to engage with patients and ensure patient loyalty, communicating and enabling a direct link between patients and pharmacy is another way to build this loyalty.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

“Processes, KPIs, along with establishing clear goals and procedures, can assist with the implementation of technology in pharmacy.”

MemoCare and medAdvisor provide a unique product offering that strengthens the pharmacy/patient relationship. MemoCare is perfect for sending SMS, Voice, Email script reminders, whereby medAdvisor gives patients the authority to drive their medication management through Smartphone application linked with medAdvisor pharmacy.

Front of Shop and Dispensary Let’s not forget front of shop. Through technology, pharmacies can identify new untapped opportunities that will provide additional revenue required to maintain sustainability of pharmacy.

Our business intelligence tool, GuildSmart, provides users with a suite of dashboards displaying missed opportunities unique to their pharmacy. At a click of a button the software displays opportunities in OTC generic conversion, companion product sales, identify dead stock and low margin products, as well as invalid GST items. Pharmacies can compare different time periods and analyse promotional goals activity to determine what worked well in their pharmacy.

Each has its own dashboard revealing what their pharmacy has missed or captured during a selected period. The GuildCare dashboard oversees the use and value of patient adherence programs by displaying the number of patients that have qualified for New to Therapy or Compliance program and the number of patients that have missed this professional service including the value behind it.

Your One Software Solution…

Imagine all of this available on one platform, removing the need to switch between software packages. GuildLink are committed to enhance sustainability of pharmacy by providing smart technology solutions that are perfect for creating efficiency.

If you would like to know more about our products or subscription details, either call us on 1300 647 492, email us support@guildcare.com.au or visit our website www.guildlink.com.au.

16

BUSINESS PROFILE

Worth the paper it is written on

BY SEAN TUNNY Editor, Gold Cross Products & Services Pty Ltd

“We are the only national firm of its kind working exclusively on behalf of retail tenants in their lease negotiations with centre managers and landlords.”

Lease1 is Australia’s leading Retail Shop Lease specialist, providing a unique tenant-only representation service to ensure business owners achieve the best commercial outcomes on their leases. Serving tenants Australia Wide since 1997.

Lease1 recently celebrated 15 successful years of serving Australian Retailers. We had the pleasure to speak with Phillip Chapman, founder and Chairman of Lease1 about the company, its growing footprint within the pharmacy industry and strategies moving forward.

Editor: Can you tell us a little more about the uniqueness of Lease1?

How did the business begin?

Phil: Lease1 provides a unique tenant-only representation service to ensure retailers achieve the best commercial outcomes with their leases. We are the only national firm of its kind working exclusively on behalf of retail tenants in their lease negotiations with centre managers and landlords.

The Lease1 team is committed to providing personal, timely and cost-effective services to save retail tenants time, money and stress in their lease negotiations and ongoing administration and management.

Lease1 has unique industry experience gained from both sides of the Lessee/Lessor relationship. We can advise and assist any Retailer (from 1 to 100 plus sites), be it from “the roof is leaking” to “the centre is redeveloping”.

Lease1 is there to support the Retailer.

Having developed a strong retail management career before entering into the Retail Property sector as a Centre Manager and Leasing Manager, it became obvious that Retailers (of all sizes) were grossly under resourced and out leveraged when managing and negotiating retail leases.

I realised something needed to be done.

It was just how to go about a start-up retailer focused lease advocacy business, as at the time these services really didn’t exist.

In 1997 I made the decision that for such a service to be truly representative of Retailers and to make these services readily available they needed to be aligned with the Retailer Member Associations. So, after securing our first client (who as it turns out was a small group of Pharmacies), I developed a relationship with the Retail Traders Association.

And, over time, by providing all Retailers a high level of affordable (outsourced) retail lease advice and hands-on practical negotiation methods, our reputation has grown to deliver our services to a range of Retailer/Lessee Associations, including of course the Members of the PGA.

Editor: Lease1 has a track record in delivering positive results for business owners and retailers. Can you tell us more about this, including the key elements behind the continued growth and success of the business?

Phil: We offer lower costs, more favourable terms, strategic forward planning and dispute resolution. From individual stores, to large retail groups and franchise systems — Lease1 always puts tenants first.

Phillip Chapman, founder and Chairman of Lease1

ensures a high level of Client satisfaction.

We have also given a lot back to the industry, being probably the most active Retailer advocates in the reviews and development of retail lease legislations in the country. Not to mention the numerous education initiatives we undertake with the Associations, State Departments and Small Business Commissioners (and Retailer/Franchisee conferences).

The culmination of nearly 17 years representing only Retailers reflects that almost all our Clients are referred to us.

Editor: Your partnership with the pharmacy industry in Australia, how did this commence and how has it evolved?

Lease1’s unique services are based on providing a high level of free (no obligation) advice to Members regardless of their specific issue or problem. We then strive to back this up with a risk-free structure based on performance of outcomes (business savings).

In essence, we needed to give Retailers/ Lessees the peace of mind that the best deal on the day was achieved, taking the risk out of the decision to appoint Lease1.

Phil: We have been representing Pharmacy Clients since our inception, with our very first client being a small group of 4 Pharmacies.

But it wasn’t until I was presenting a submission to the Productivity Commission on the Market for Retail Leases that I was introduced to Kos Sclavos and Tim Logan who were there representing the Members of the PGA, that a more formal relationship began to immerge.

To this day, our percentage of savings performance fee structure remains unique and

Over the next 12 months, we developed a closer relationship through sharing industry

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

BUSINESS PROFILE

17

“We can advise and assist any Retailer (from 1 to 100 plus sites), be it from ‘the roof is leaking’ to ‘the centre is redeveloping’. Lease1 is there to support the Retailer.”

endorsed BY

intelligence and providing assistance to Members, which has culminated in a Member service agreement and endorsement via Gold Cross.

and takes a proactive involvement in the vital area of Retailer education through seminars, workshops and webinars.

the MiLease-Strategic Lease Management program to provide ongoing high level advice, benchmarking and strategy to their ongoing lease management.

Since this relationship has evolved, Lease1 is committed to providing support to the PGA in preparing the Rental Reports, Sales Reporting Guidelines, Submissions and attendances on legislative (retail leases) reviews as well as presentation at APP and the PBN.

Editor: What are some of the specific goals and objectives for Lease1 business in the future? How do you hope to achieve these?

So the future for us is not only to reposition our service delivery from lease events (see list above), but to also provide strategic lease management throughout the entire critical path of your lease.

Such is the profile developed between Lease1 and the PGA that retail leases has become a key performance indicator in the success of the Pharmacy Channel.

So much so that some of the Pharmacy Brands have developed relationships with their own leasing personnel. We still of course represent these Brands but via our commitment to serve all PGA Members.

This gives us a very broad and intimate knowledge of the Pharmacy Retail Channel.

Lease1 provides Members of the PGA with initial FREE advice on any issue or matter they have with regard to their lease and the relationship between Lessee and Landlord. Further, Lease1 works closely with the Executive of the PGA on industry matters, including reviews and changes to legislation,

Phil: All businesses need to evolve over time and, unique as Lease1 is, we must reassess our strategies constantly. Where the industry has an enormous void is the ongoing strategic management of a retail lease. The perception is that a retail lease is set and we forget this cannot be further from the truth.

Hence our clients have begun to realise this and are seeking how they can access and resource these skills.

To fill this void, we have developed

www.lease1.com.au

After an extensive trial period, the MiLease program has developed significantly with input from PGA Members and we are proud to say MiLease was recently endorsed

by Gold Cross.

Over time, the intelligence that will become available for Retailers under MiLease, we trust will prove to be the game changer the industry needs to level the playing field in the Lessee & Lessor relationship.

Retailer House Level 1, Unit 3, 321 Kelvin Grove Road Kelvin Grove QLD 4059 Tel: 1300 766 369 Email: info@lease1.com.au

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18

Professional review

Dental Health Babies and Toddlers

BROUGHT TO YOU BY

How pharmacists can help during Dental Health Week 2014

From August 4 – 10, the Australian Dental Association will hold its annual Dental Health Week (DHW) which will be focused on babies and toddlers. Pharmacists can play a crucial role during DHW by educating parents about how to maintain their children’s oral health.

Pharmacists are often asked by parents for advice when their babies start showing teething symptoms. In these situations, pharmacists can suggest that parents should start brushing their babies’ teeth once the first tooth erupts, generally around 6 months of age.

Additionally, pharmacists may also recommend the use of a low-fluoride children’s toothpaste, suitable for babies from 18 months. Because babies and toddlers cannot spit the toothpaste out, only a small smear is needed.

First, avoid brushing teeth for at least one hour after vomiting, as brushing immediately will accelerate enamel damage. The acidity from stomach acid contained in vomit softens enamel (tooth mineral) and brushing will only remove more of it.

During pregnancy, women are at greater risk of dental erosion. Dental erosion is a form of tooth wear and refers to the irreversible loss of tooth mineral due to the exposure of acid.

Rather, rinse with plain water or water mixed with baking soda, as this will help neutralise the acidic environment in the mouth. Also, patients should always be advised to use soft toothbrushes. Extra soft toothbrushes should be used by patients who are already suffering from dental erosion.

The pregnant patient is at higher risk of tooth erosion primarily through the exposure of stomach acid to their teeth when morning sickness occurs.

There are a number of options pharmacists can recommend to pregnant women to reduce this risk.

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There are also a number of toothpastes on the market that aid in enamel protection, lowering dental erosion risk. These toothpastes protect enamel from erosion and promote remineralisation. Remineralisation increases the resistance to acid attacks and also helps reduce tooth sensitivity, which is a common symptom of tooth erosion.

For more information on dental care for babies and toddlers, pharmacists can refer patients to the DHW 2014 website (www.dentalheatlhweek.com.au)

Professional review

19

Dobbing in the Sugar Bandit In addition to oral health information dedicated towards babies and toddlers, DHW 2014 has adopted the theme, “Who is spoiling your kids rotten?

Dob in your family’s sugar bandit.”

“Using food to reward, bribe or to comfort children sends an inappropriate message about food from an early age and undermines other efforts to build healthy eating habits.”

This theme aims to inform parents, relatives and children about the risks of sugary food, and in particular how certain eating habits put oral health at risk.

Every time we eat, our teeth are exposed to an acid attack. The bacteria in our mouths (plaque) ferment the food to make acid, and if teeth are exposed to this acid long enough cavities develop - this is known as tooth decay.

Consumption of sugary foods and drinks on a regular basis is the number one cause of tooth decay, and increases the risk of obesity and diabetes.

“Family and friends can literally spoil your kids rotten if sugary treats are given every time they spend time with your kids. Parents need to understand the risks and put some boundaries around access to treats. This does not mean that parents have to take the fun out of rewarding their kids altogether.

Parents should ask, is there a better option?”

Chair of the Oral Health Committee, Dr Peter Alldritt, said: “It’s common for parents and extended family to offer children a ‘treat’ to reward good behaviour or simply in response to children’s ‘pester power’.

Using food to reward, bribe or to comfort children sends an inappropriate message about food from an early age and undermines other efforts to build healthy eating habits.

Sometimes the Sugar Bandit may not know they are harming your kid’s teeth. In fact many snacks that are marketed as ‘healthy’ are actually high in sugar and get stuck in kids’ teeth, increasing acid attacks which cause decay. Because parents think these snacks are healthy, they often allow their children to graze on them all day which makes things worse.

Some of the major ‘healthy’ snack culprits are:

12–14 September 2014 Crown Conference & Events Centre, Melbourne Three days focusing on your business at pharmacy’s most practical event!

dried fruit, biscuits (sweet and savoury), fruit juice, muesli bars, crackers, children’s cereals, flavoured milk, sweetened yoghurt, fruit bars, fruit slice, flavoured popcorn, canned fruit, baked goods and banana bread.

However Dr Alldritt was quick to add: “Don’t worry; it’s not all bad news. No one is saying children should never be allowed to eat these foods again. Rather, when choosing snacks, be aware of how much sugar is in them. More importantly, reduce the number of times they eat these foods and make sure they are eaten in one go, preferably as part of a meal. Grazing should be avoided and only allow high sugar snacks in moderation.”

Dr Peter Alldritt is Chair of the Australian Dental Association’s Oral Health Committee.

Pharmacy Business Network—the most exiting business event for all current and aspiring pharmacy owners, pharmacy and retail managers, key pharmacy staff, students, interns and pharmacy industry stakeholders.

Manage your business—ensure you acquire the practical tips to make your pharmacy more profitable and successful.

Manage your people—hear from people management specialists and learn practical tips to take back with your team.

Not a single clinical session ... guaranteed!

www.pharmacybusinessnetwork.com

20

RETAIL FOCUS

How Does Your Team Stack Up?

BY SIMON HAMBRECHT Director of Pharmacy Essentials

Have you ever taken the time to measure the performance of your Team? This is a question I like to ask as wages are one of the first things we look to cut when we experience challenging times and profits are falling.

The ironic thing is, cutting wages is one of the worst things you can do (the second is cutting marketing expenditure – but that’s another conversation). You see, cutting wages only results in reduced service levels being offered to your customers, leaving you with only one area to compete on – price – and we all know where that ends up! A battle you can’t (and shouldn’t try) to win!

What you need to be asking yourselves is, “Are my Team giving me a return on my investment?” Put simply, are they covering the cost of their wages?

In today’s pharmacy environment, you need to ensure you have a high performing team which not only meet their cost, but exceed it to create business growth. No longer do we have the luxury of “carrying” poor performing Team Members. Every single

one of them needs to deliver results and if they are not doing this, you as the business owner/manager need to address the matter through additional training or coaching, or if that has not been successful, performance management of the individual in question.

So how do you measure the performance of your Team? Firstly, I would say this – don’t use individual sales targets to measure productivity.

My experience with this sort of management is that it destroys the culture within your business as it sets people against each other.

Everything needs to be measured as a team effort as it fosters a group achievement and is better for you culturally. Having a strong team culture will achieve great things as well as improving the accountability of your Team – especially if they can see everyone working toward a common goal.

“Having a strong team culture will achieve great things as well as improving the accountability of your Team – especially if they can see everyone working toward a common goal.”

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To effectively measure your Team’s sales performance you can use a very simplistic formula of multiplying your hourly wage bill by three (3). For example, if you are spending $250 per hour on wages, you need to achieve approximately $750 in sales to break even.

If you’re achieving more than this – fantastic – as it means your Team are working well for you.

If you aren’t achieving growth through your wages, and you wish to further analyse where the shortfall is, then you can look at individual performances (without setting individual targets). Most point of sales (POS) systems will allow you to monitor individual performance through their operator numbers. However, for this to be effective, you need to ensure your Team only uses their operator number and not anyone else’s.

Another way you should measure this as an owner/manager is through observation.

This is something I see very few people doing.

It is as though they think it is wasting valuable time and detracting from completing another task. Can I say, taking the time out to observe how your Team are serving customers is invaluable! It allows you to see where their shortfalls are and for you to coach them on how to perform better.

Remember, it is more expensive for you in the long run to let someone go and retrain a replacement than it is for you to invest more time and effort in someone you already have.

RETAIL FOCUS

If however, they do not respond to the additional coaching and development, then you can use all the individual data you have used for analysing team performance in a performance management discussion.

These performance discussions though are to be used to address, and make a Team Member aware of, the areas they are not delivering in.

The result of these discussions should be an agreed action plan for improvement as well as informing the individual what the consequences will be if poor performance continues.

In today’s industry, as an owner/ manager, you should be testing and measuring the results of everything to ensure your business is performing at its optimum potential. Your wages are (typically) your first or second biggest expense so if you are not getting a return on them there is something wrong.

Finally, you should be using Weekly Sales Targets with your Team. Look at what your sales were for the same week last year, apply a predetermined growth target, and have this figure as your Weekly Sales Target. Break it down into daily amounts – the smaller the number, the easier your Team will feel they can achieve it.

As an example a $20,000 weekly target sounds huge; however, if you broke it down into a daily target of $3,636 approximately (based on a business who trades 5.5 days per week) or an hourly figure of $363.60 (if you trade 10 hours per day) it sounds really achievable to a group of Team Members.

At Pharmacy Essentials, we provide personalised support in not only budgeting and sales generation, but many other elements of your business.

We sometimes see wages as a necessary evil; however, if you manage them correctly and see them as an investment to achieve growth, they can be your biggest asset.

If you would like to know more and are interested in getting real value for money from your fees, contact us at http://www.pharmacyessentials.com. au/pharmacists/free-information-pack/ or call me directly on 0412 219 916.

21

22

professional review

Pharmacists – Front Line Advice for

Women and Healthy Bones

BROUGHT TO YOU BY

Osteoporosis is a common, silent and chronic disease affecting over 1 million Australians.

For women, menopause has a significant impact on bone health and signals a good time for women to get their bones checked.

Osteoporosis and Menopause

“The higher a woman’s bone-density is before menopause the better and menopause signals a good time to assess bone health and take prevention action like getting more calcium.”

Osteoporosis occurs when bones lose minerals such as calcium more quickly than the body can absorb them. One of the risk factors for osteoporosis is menopause. Menopause is a time of rapid decline in oestrogen levels for women and this decline in oestrogen leads to bone loss or density.

Oestrogen is an important hormone for bone health because it aids with the maintenance of bone density. When oestrogen levels decrease, bones lose calcium and other minerals at a much faster rate.

During the first 3–6 years after menopause, bones go through an accelerated rate of bone loss (bone loss is approximately 1–5% per year after menopause), this then gradually resumes to premenopausal bone loss (after the first 3–6 years). After 70, the bone loss will accelerate again so it is vital women reach optimum bone density levels in their 20s to avoid osteoporosis later in life.

Early menopause can seriously affect bone health — particularly later in life and it is something that is often overlooked.

Discussing bone health with women experiencing early menopause can set them on a healthy bone path early and save poor bone health complications later.

The higher a woman’s bone-density is before menopause the better and menopause signals a good time to assess bone health and take prevention action like getting more calcium.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

professional review

Calcium and Vitamin D for Healthy Bones We all need adequate calcium and vitamin D for healthy bones. During menopause, a woman’s calcium requirements increase from 1000 mg to 1300 mg per day to account for the decline in bone density. In general, Osteoporosis Australia recommends women may require a calcium supplement of 500–600 mg per day if the 1300 mg daily requirement of calcium is not met by diet alone.

We need vitamin D to activate the absorption of calcium in the bones. Doctors tend to test vitamin D levels in at-risk patients before recommending supplementation. Low vitamin D levels are increasingly common in Australian adults.

Hormone Replacement Therapy and Bone Health HRT is a useful treatment to improve bone density in younger women (under 60) who have low bone density. The risks of stroke and heart disease associated with HRT are very low in women below 60, so current thinking is that HRT is a good choice for young women who need relief from their menopausal symptoms and also need treatment to improve their bone density.

•• Adequate vitamin D supplementation when levels are low.

•• Avoid excessive alcohol.

•• Stop smoking.

Osteoporosis Australia and Pharmacy Guild A partnership has been formed to create awareness about bone health. The campaign highlights the key role pharmacists play in the prevention of osteoporosis by ensuring optimal calcium and vitamin D intake in Australia.

Prevention Pharmacists can play an important role in encouraging women to take care of their bone health while young to reduce the likelihood of developing osteoporosis later in life. Osteoporosis Australia’s preventative initiative Healthy Bones Australia has an online calculator to help Australians calculate whether they are getting enough calcium + exercise + sunshine on a daily basis to take care of their bone health.

calcium Osteoporosis Australia and the Pharmacy Guild of Australia have partnered for an online learning module for pharmacists. This activity has been accredited for 0.25 hours and 0.25 Group 1 CPD credit or 0.5 Group 2 CPD credits upon successful completion of assessment.

These credits are suitable for inclusion on an individual pharmacist’s CPD plan.

Go to http://osteoporosis.org.au./ pharmacists/ for a link to the online assessment.

+ exercise +

sunshine

Reducing Osteoporosis Risk During and Post-Menopause

Toll-free helpline for osteoporosis information: 1800 242 141

•• Ensure women are having 1300 mg

Healthy Bones Australia resources: Web: www.healthybonesaustralia.org.au Email: healthybonesaustralia.org.au

calcium per day.

•• Weight-bearing exercise 3–5 times a week for 30 mins + resistance training.

www.osteoporosis.org.au

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23

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Single unit dose vials

Compatible with contact lenses

Fast acting long lasting formula

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26

down to business

The Modern Day Pharmacy The important role pharmacy can play in mental health care – Let’s start by reducing the stigma

BY vanessa lontos Community Pharmacist and Director at the Care Project

I want to begin by sharing with you a story about a young woman I encountered some years ago while working in London. She was a pharmacist, 25 years old and had just arrived on what she hoped would be 1 year of fun and adventure.

We met briefly while I was working in a hospital dispensary, but within 2 months of her arriving, things dramatically changed due to an unexpected illness and she was forced to head back home. She’d fallen into a deep depression and was also experiencing severe anxiety. I heard that she’d had experiences with anxiety throughout her life, but this time it was very serious. She hadn’t talked to anyone about it because she was embarrassed and ashamed.

I met with her recently to discover she had fully recovered but it was the stigma that she felt that prevented her from opening up.

Then there was Ms MM — she was a lady I visited during my time as an accredited pharmacist in 2009 while conducting home medicine reviews. She was on a large number of medications and was seeing a number of different health professionals for various mental health disorders. I carried through the medication review as I always did, giving information and asking her questions about her medicines while I took some notes.

She seemed happy with the service and thanked me for my time, but before I left she asked me one question that has changed

my perception of our role as pharmacists.

She said, “All that information is very helpful, but when am I actually going to start to feel better?”. We spoke a little longer about what that meant for her but I was ill prepared for this question.

Most recently there was Mr K — he was a patient I looked after between 2010 and 2012 who was on our opioid substation program and was also being managed with staged supply for major depression and anxiety. He was a wonderful person who very sadly overdosed, and forever etched in my mind will be one of the last things he said to me when he was removed from one of the medications he felt was ‘really helping him’.

“I feel like everyone’s given up on me,” he said. I told him I hadn’t, and I contacted his prescriber to suggest considering his wishes, but her decision was final as to what would be best for him.

Could I have done more for these people?

Is it the stigma that exists around mental health issues that holds us back?

The World Health Organisation (WHO) describes health as a state of complete

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

physical, mental and social wellbeing and not merely the absence of disease or infirmity.

Furthermore, mental health is defined as a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community1.

These two definitions greatly exemplify the importance of mental health in total health and wellbeing, as well as its role in everyday life. When you think about mental health care in pharmacy what do you think about?

In response to the Australian Mental Health Reform Agenda, I’d like to suggest here that the focus extends beyond our roles as medication experts and builds towards a partner providing education, support, guidance and referral.

The Roadmap for National Mental Health Reform 2012–2022 has a vision to ‘build a society that values and promotes the importance of good mental health and wellbeing, maximises opportunities to prevent and reduce the impact of mental health issues and mental illness and supports people with

down to business

So how can we make a difference?

“Could I have done more for these people?

Is it the stigma that exists around mental health issues that holds us back?”

1. Get involved in as many campaigns as possible

The National Suicide Prevention campaign “R U OK” (11 September 2014) is a wonderful example of how 3 simple words can be life changing for someone. The RUOK campaign aims to inspire Australians to have meaningful conversations throughout the year to help anyone who might be struggling with life. It is often in the little, incidental, daily interactions and conversations we have that can carry the greatest influence for someone. Build an awareness in your community that you support mental health.

2. Accept that mental health care is everyone’s responsibility — we each have a role mental health issues and mental illness, their families and carers to live full and rewarding lives.’ It aims to do this through six priority areas — shown here in blue. Through increased awareness around these definitions and actions already being taken through other services, pharmacists and pharmacy assistants can align themselves with this national vision and adopt ways to help better manage mental health care in their local communities.

Each one of the above mentioned encounters, as well as the many others I have experienced in between, all have a common lesson in them. Mental health is a very real and increasingly prevalent issue, and pharmacy, as the most accessible primary health care service, is uniquely placed to make a difference. One in five (20%) Australians aged 16–85 experience a mental illness in any year, the most common mental illnesses being depression, anxiety and substance use disorder2. Alarmingly, 65% of people with mental illness do not access any treatment3.

This is a lot of people potentially walking into pharmacies every day with serious concerns and not talking to anyone about them.

“By sharing personal experiences we take small steps to further reduce the stigma associated with mental illness. The feeling of being the ‘only one’ is often what keeps people suffering in silence.”

Regardless of what your technical role is in the pharmacy, believing that you have a role to play in improving mental health care is critical. By learning simple, effective communication skills, you are better able to connect with all people entering the pharmacy.

Simple actions such as an awareness of privacy, eye contact, and smiling all go a long way toward communicating care and compassion. One significant risk factor to the development of mental illness is social isolation and exclusion. By promoting openness, people begin to feel included and this can be hugely beneficial.

3. See the mental health in all the people you serve — Ask caring questions In any given day, pharmacies across the country serve many different people, all with unique experiences and from different walks of life. While on first impression you may be discussing a set of symptoms or the details of a prescription, there is a person with a story here that may need mental health support. A person who has good mental health has good emotional and social wellbeing and the capacity to cope with change and challenges4. Open-ended questions do just that, they encourage people to open up. Think for a moment about the new mum coming in to buy some nappy rash cream. Her life has changed dramatically. She’s most likely sleep deprived, feeling overwhelmed, uncertain about this new rash and feeling quite lonely. A simple, “How are you and baby settling in?” or “Do you have any extra support to help you?” can go a really long way.

4. Focus on Follow up

This is not something we do routinely in pharmacy. Think about it like a boomerang-type conversation where the person is encouraged to come back to let you know how they are going. It may be a simple phone call to see how someone is managing with their new medication or asking them to return the next day. Sometimes those patients you see regularly may have recently had a new diagnosis and this is causing them stress or concern. By checking in with people regularly you can keep updated with changes in their life.

A simple suggestion around a support walking group for a patient newly diagnosed with diabetes can be hugely beneficial for their mental health.

5. Share your own experiences

By sharing personal experiences we take small steps to further reduce the stigma associated with mental illness. The feeling of being the ‘only one’ is often what keeps people suffering in silence. It is the 21st century, and though evidence-based research has shown us that mental illness is a real medical disorder, stigma is also still on the rise instead of on the decline.

A recent study by SANE found that 4 out of 10 Australians who take sick leave for depression keep it hidden from their employer with almost half fearing their job would be compromised if they revealed their illness5. The more we promote open discussion and people feel safe to share their experiences the quicker people can access the help they need.

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down to business

In conclusion, the young pharmacist I discussed in the beginning of this article was actually me. Sharing my own story to patients has helped me connect with them on a much more significant level and has better enabled me to help them get the help and support they need. Being on the other side of the dispensary has helped me appreciate the healing power of someone who cares. If your story can help one person or give a family member hope, and we each reached out in this way, together we can make a difference to the mental health of all the people we serve

Roadmap vision and priorities

References 1 Viewed at : www.WHO.int 2 Viewed at: http://www.blackdoginstitute.org.au 3 Viewed at: http://www.blackdoginstitute.org.au 4 Viewed at: www.headspace.org.au 5 Viewed at: www.SANE.org

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TRAINING AND EDUCATION

Soothe burning and irritated eyes Top tips from Murine Sore Eyes® to care for strained and tired eyes Pollution, air borne dust and allergens, air conditioned environments and staring at a computer for hours at a time – all affect and irritate a person’s eyes on a daily basis, making them dull and bloodshot.

While it would be great to have a quick power nap whenever one’s eyes need a rest, unfortunately during a working day, this isn’t always possible. Murine Sore Eyes® refreshes tired eyes and helps give them back their sparkle during a busy and overloaded day.

Murine Sore Eyes® is a specially formulated ocular decongestant with Tetrahydrozoline to relieve burning, irritated and strained eyes. Just one to two drops into each eye, a few times a day, is all that is required to refresh tired eyes.

Simple Steps to administer your eye drops • Wash your hands • Tilt your head back and look upwards • With eye open from the side, look upwards and squeeze one to two drops into the pouch, nearest to the nose. Do not let the tip of the dropper touch the surface of the eye, eyelashes, or any other surface to avoid contamination.

• Let go of eyelid and close eye for 30 seconds looking left and right

• Repeat the process on the other eye • You can administer eye drops up to four times a day

Top tips from Murine to help look after eyes during a busy day: •• Drink plenty of water to keep the whole body, including eyes, hydrated

•• Take regular breaks from the computer screen – look away from the screen at least every 5 minutes and focus on something further away

Eye health tips for when not at work or on the go •• Remove contact lens with clean hands •• When possible, try and get plenty of sleep by avoiding repeated late nights

•• Eat a balanced diet, filled with fresh vegetables

•• Give up smoking •• Be aware of family eye health history •• Have regular eye check-ups with an optometrist Keep a bottle of Murine Sore Eyes® on hand in a desk drawer, in one’s handbag or suit pocket to quickly refresh tired eyes when on the go or at work.

•• Avoid glare from computers by reducing screen brightness or using a screen shield

•• Wear sunglasses to avoid ocular damage or strain caused by harsh sunlight

•• When driving long distances take a break every 2 hours

•• Always wear safety glasses when doing DIY or gardening to protect eyes from injury or dust particles

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

Stockists information, please call 1800 788 870 For more information about Murine Sore Eyes®, please visit www.murine.com.au

TRAINING AND EDUCATION

Help to prevent hayfever symptoms this spring 1 in 5 Australians suffer from allergic rhinitis As the spring months result in increased levels of pollen, it can be a cruel time for hayfever sufferers with barbecues, picnics and day trips all potentially filled with tortured hours of streaming eyes and runny, itchy noses.

Although a person can’t prevent themself from becoming allergic to environmental allergens, there are ways to reduce the effects. Here, Dr Lozynsky outlines some top tips for treating hayfever and reducing the symptoms.

1

Antihistamines block the effects of histamine by preventing the receptors from binding with histamine. It is important to take it before exposure to allergens, so as to help prevent symptoms before they develop.

For children, it is advisable to use a sugar and colour free antihistamine such as Little Allergies.

Hayfever or ‘allergic rhinitis’ is a common condition from which one in five Australians suffer. It is caused by an allergic response primarily to airbone particles and symptoms are similar to that of the common cold. Prevelance is highest for those aged 25-34 and slighty higher for females1 but no-one is immune.

“Hayfever occurs when the immune system mistakes a ‘harmless’ airborne allergen as a ‘threat’, explained Dr Alex Lozynsky.

“As the immune system thinks the ‘allergen’ is harmful it produces an antibody called IgE specifically against it. This reaction results in the release of various chemicals from mast cells, including histamine which causes most of the allergic symptoms.”

“Tree pollens in the early part of spring and grass and weed pollens later in the spring and summer makes this time of year a difficult time for many sufferers,” added Lozynsky.

“However, some people suffer all year round and your location does play a role. House dust mite is a common indoor allergen especially in coastal regions and those allergic to dust mites can have symptoms throughout the year.”

References: 1 www.myvmc.com 2 Market Research QAI December 2014 n=1011

Use an antihistamine

2

Cleanse the nose with a nasal spray As the nose is a ‘filter’, it is important to cleanse the nasal passages regularly with a saline solution or spray, especially after exposure to airborne allergens, to reduce the potential for an allergic reaction happening. Over 50 per cent of allergy sufferers believe they have a sensitive nose2 and using a nasal spray will help clear and soothe the nasal passages.

3

Wear protective eyewear Sunglasses, particularly the wrap-around design, help to protect the eyes from direct contact with pollens, especially on hot windy days. They also protect against solar damage to the sensitive eye tissue. Young children should wear eye wear when playing outdoor sports.

4

Avoid the outdoors An allergy sufferer needs to be aware of the pollen count during susceptible months or on humid windy days when it tends to be higher and if possible, don’t go outdoors and keep doors and windows closed. Also avoid situations where one may be exposed to high levels of allergens such as vaccuming carpets and mowing grass and choose low pollen days for gardening and outdoor activity.

Preventing Hayfever FESS® Sensitive Noses is a preservative free nasal spray designed to help with the prevention of allergies and hayfever. Made from natural seawater, it gently washes away excess mucus and allergens such as dust and pollen. It is particularly suited to people who suffer from Allergic Rhinitis and are prone to nasal congestion, runny noses and itchy eyes because of their allergies. It is preservative free and can be used as often as required. The 30ml bottle fits easily in a handbag so you can use it on the move as needed. Allergy sufferers should make sure their medical cupboard is well stocked ahead of time to help with symptons of hayfever this Spring.

For more information about the FESS® product range, please visit www.fess.com.au

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TRAINING AND EDUCATION

Treating dry scaly scalp conditions Coco-Scalp

What is COCO-SCALP and what is it for?

COCO-SCALP is a unique formulation, originally developed by dermatologists at St John’s Hospital in the United Kingdom, as a steroid-free way to treat irritating, itchy scalp conditions such as seborrhoiec dermatitis (red scaly scalp), eczema (itchy scalp), psoriasis and severe dandruff. COCO-SCALP is an ointment which contains ingredients (Coal Tar Solution 12% w/w, Salicyclic Acid 2% w/w, Sulfur-precipitated 4% w/w) that break down the scale that builds up on the scalp, allowing the active ingredients to penetrate to the scalp and effectively treat these conditions at the roots.

What makes COCO-SCALP different?

COCO-SCALP is different to many shampoos and other available treatments for dry scaly scalp conditions. For these conditions effective treatment is difficult because hair can trap the dead skin cells and build up a barrier between shampoos or lotions and the scalp that they struggle to penetrate. Clinical trials have proven that COCOSCALP is significantly more effective at removing scale than coal tar shampoo1, because the steroid-free formulation in COCO-SCALP stays in contact with the scale that builds up on the scalp, allowing the active ingredients to break down and penetrate the dry scale.

How does COCO-SCALP work?

COCO-SCALP is not a shampoo and it’s not a steroid – it is a specially formulated coconut oil compound ointment that shifts scale and effectively treats irritating and itchy scalp conditions. COCO-SCALP was formulated by dermatologists for stability and ease of use in treating psoriasis, eczema, seborrhoeic dermatitis and dandruff, and the ointment formulation stays in contact with the scale that builds up on the scalp allowing the salicylic acid to break down the scale. The coal tar and sulphur in COCO-SCALP penetrates the skin, and the special coconut oil base also gently conditions the hair and moisturises the skin.

How do you use COCO-SCALP to get best results?

COCO-SCALP is formulated for a one hour use - on wet hair, simply apply to the affected area using the included applicator nozzle, leave for one hour, and then wash out with mild shampoo. Patients should treat daily for 3-7 days, and then use COCO-SCALP occasionally to maintain the improvement.

References: 1. : 1. Monk B E et al., J Derm Treatment 1995; 6: 159-161.

Contact your local AFT representative directly or call the AFT Pharmaceuticals Sydney office on (02) 9420 0420.

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DOWN TO BUSINESS

Partnerships the most challenging management structure?

Peter Saccasan FACP FCA CTA Director of Pharmacy Services, RSM Bird Cameron Chartered Accountants

“Identify the abilities of each partner and which area of the business they are more suited to and have them focus their energies on that area.”

“The problem with partnerships,” someone once remarked to me, “is that no-one is in charge”. I have seen this statement being borne out in many partnerships that I have worked with over the years. It generally stems from the efforts to maintain equality between the partners and the inability of partners in a business to distinguish between management roles and entitlement to profits.

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DOWN TO BUSINESS

The company structure is able to achieve this differentiation merely by the differentiation between the position of director and that of shareholder, although in a small private company these positions can be generally blurred and you are back to the problem of partnerships. In addition to how the partnership runs, there should be an agreement in place which covers entry in to, exit from, and various other aspects of the partnership.

Defining Roles When we employ staff, we easily recognise that each staff member has different skills and is employed to do a specific set of tasks.

Yet partners seem to assume the ability to do everything and to the same level of ability – which is, of course, an aberration.

The more efficient way of approaching this issue is to work to your strengths. Identify the abilities of each partner and which area of the business they are more suited to and have them focus their energies on that area. At the same time, each partner should respect the allocation of duties and not override decisionmaking in the other areas. If the partners work to their strengths, then that should improve the outcomes for the business.

This then leaves just one question – who is in charge? The best thing partners can do is to put just one of the partners in charge.

Whether you call it managing partner, CEO, or General Manager, someone is responsible for bringing it all together. And the role can be rotated if you want — if the partners really feel they all want a go at it and don’t feel that there is one more suited to this role than another.

The CEO’s role is NOT to ignore blithely the wishes or aims of his or fellow partners.

The role is to manage the overall direction of the business and to report back to the partners. If you like, the partners make up the board and the CEO is to report back. At the other end, the partners should be reporting in to the CEO on the areas under their charge.

There are various other aspects that should be covered. The issues set out below are not exhaustive and most legal advisers can provide you with a more comprehensive checklist that will drive the production of your partnership agreement.

Partners’ Salaries: What should partners be paid for their work in the business?

What constitutes work for the partnership?

Partners’ Roles: As discussed earlier within this article.

Partners’ Capital: What happens if the business needs more funds and not all partners can contribute their proportionate share?

Partners’ Leave Entitlements: How much time can partners spend away from the business? If not all partners work in the business, then what leave entitlements shall be granted to the working partners?

Income Protection: Are working partners required to take out income protection insurance so that, in the event of accident or illness, the working partner does not lose out on income and the partnership is not in the position of having to pay out income to a working partner who is unable to come to work?

Life Insurance: If the partnership has a large amount of debt, the partners might consider taking out life insurance so that, in the event of death, the remaining partners become entitled to funds which can pay out the debt. There are complex provisions which can sit around these types of policies and the partners should ensure they are clear as to how this mechanism works and what they are trying to achieve.

Entry to the Partnership: On what basis can a new partner join the business?

Exit from the Partnership: How do you get OUT of the partnership? There should be a defined path for a partner to exit the business. Too often this aspect is ignored and suddenly there are as many different opinions on how this should work as there are partners. The exit rules should govern the notice period, the valuation mechanism and the timing of payments and all taking into consideration the rules and process around change of pharmacy ownership. A well-thought-out partnership agreement will ensure that there is a logical progression of events that enable both the remaining and leaving partners to be clear and certain as to what takes place. And, in the event of acrimony arising, the agreement should ensure that something (i.e. dissolution or exit) can be made to happen. The worst set of circumstances is where one side holds up the inevitable by simply not making a decision.

The Partnership Agreement

Clarity is Necessary

Would you buy a house or a business without a contract? No? Then why go into partnership without a partnership agreement?

The agreement, if done well, should be able to assist the partners in managing most aspects of their business relationship. This will include decision-making around partners’ roles as discussed above, in particular the role of CEO or managing partner.

It is inevitable that, without clear guidelines, each partner will form their own opinion about what is fair and what was agreed. Partners should take advice about putting in place a comprehensive partnership agreement. At the same time, the partners should leave their egos at home and set to work on defining business roles including the position of CEO. The agreement should be reviewed regularly and the CEO should be able to accept a review of his or her performance on a regular basis. At the end of the day, if the partners all want to be in charge and there are no guidelines, the outcome will be a business that is pulled in different directions and won’t maximise its performance.

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MYSTERY SHOPPER

Pharmacy vs.

Supermarket HELEN STRACHAN Pharmacy Practice Officer The Pharmacy Guild of Australia, Queensland Branch.

Every week during my grocery shopping, pushing the trolley around aisle after aisle picking fruit, vegetables and cleaning products — that I probably already have an abundance of under the sink — I always stop when I reach the “healthcare/beauty” section and week after week the thought still crosses my mind, “Who is going to educate a customer who chooses to buy some of these items?”

I am referring, of course, to paracetamol, ibuprofen and aspirin.

While it is ok to have these medications at home in case a headache appears or you’re suffering from some sort of pain, but do customers really know if there is another product that could be more beneficial to the actual pain they are experiencing? Would they know to take ibuprofen for muscle aches or sprains to assist with inflammation?

Would they know to be aware of other medications they take which may contain paracetamol? – Maybe! Maybe not!

In this day and age, we are all price savvy with everything we purchase, but when it comes to healthcare, we really can make a difference by educating our customers about the medications they take, lifestyle advice and over-the-counter product selection. Every year in Australia, each man, woman (and child) visits a pharmacy more than 14 times. Approximately 3.9 million Australians ask their pharmacist for healthcare related advice every year, representing a huge opportunity to educate customers about their medication (ref).

By taking advantage of these 14+ visits per year, hopefully we can assist our customers to think twice while supermarket shopping.

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How can we make a difference?

Pharmacy is a healthcare destination which is evolving each and every year, and by promoting this instore and setting continuous high customer service standards, why would a customer not return for their medication and advice? — whether it’s for over-the-counter or complementary medicines. Customers like to be cared for and remembered — there’s a reason why they walked into the pharmacy in the first place.

As I have mentioned in previous articles, more than 93% of pharmacies in Australia are QCPP accredited and part of this process is being mystery shopped. Each QCPP accredited pharmacy is mystery shopped at least once a year; The scoring system used in mystery shopping is based around scenarios on pharmacy and pharmacist-only medicines.

It is important that all staff are using a protocol system e.g. What Stop Go, Ask Assess Advise or Carer when supporting the sale of these medicines. Using a protocol system sets a standard and ensures every customer is being asked the same questions to have the best possible healthcare outcome. If we are not asking these questions then there is no difference between the services we supply and self-selecting off a supermarket shelf.

Asking a customer a question such as, “Are you taking any prescription or over-the-counter medicines?” can be a major difference in what the customer thought they needed as to what is actually recommended and supplied?

MYSTERY SHOPPER

“Customers like to be cared for and remembered — there’s a reason why they walked into the pharmacy in the first place.”

Build a strong team •• Create a healthcare environment •• Promote instore professional services e.g. Blood pressure monitoring, Webster packing, blood glucose testing …

•• Train staff on why protocols are so important and how to overcome supermarket barriers

•• Set a high customer service standard •• Ensure pharmacists are accessible to customers

•• Educate the customer about over-thecounter medicines and explain any side effects and interactions they could have

•• Train staff on referring a customer to the pharmacist

•• Evaluate the mystery shopping score, acknowledge what is going well and identify any improvements needed

•• Communicate current industry topics with all staff

•• Ensure staff are fulfilling refresher training requirements for s2/s3 medicines

Educating and assisting the customer Although some of these medicines that are available in supermarkets come in smaller pack sizes to those available in pharmacy and may be convenient, are customers using the right product for the right condition?

•• Find out their actual ailment or condition.

•• Is the current medication they are using working for them?

•• How long have they had symptoms?

•• What is the actual medicine they are using?

•• How long have they been using it?

•• Have they spoken to their doctor or pharmacist about their condition?

•• Explain the benefits of the medicines.

•• Ensure they know why they can only take the maximum daily dosage.

•• Provide lifestyle advice.

•• Provide printed information (CMI) or factsheets.

•• Offer additional useful products e.g. Heat packs, topical preparations and cold packs.

•• Explain the difference between pharmacyonly products and those available in supermarkets.

•• Always invite the customer to return and ensure they are aware a pharmacist is available at all times.

•• Tell them you care for their health.

Reference Serving Australians: A system of Community Pharmacy (The Pharmacy Guild of Australia – October 2012) GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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WHAT’s NEW & company news

INTRODUCING PHARMACY FORWARD: THE NEXT INSTALMENT OF THE PAINSMART CHALLENGE RB launches new national program designed to help community pharmacy build their Pharmacist Only department.

Nature’s Own release new Superfoods range, blended by experts Nature’s Own has taken the best that nature has to offer and carefully selected and combined a variety of superfoods into a new, expert range, available now.

Mike Abbott, Head of Marketing, Sanofi Consumer Healthcare (makers of Nature’s Own) said the range was developed by in-house experts and based on extensive consumer insights.

“Our consumers told us they were after a fast and convenient way to reach their daily nutritional intake,” he said. “Superfoods are a wide variety of foods that contain key potent nutrients that may contribute to general well-being and are an easy way to top up our daily nutritional intake.

The range features:

•• Nature’s Own Superfood Blends Berry. Contains over 40 different superfoods including blueberries, acai berries and pomegranate, all rich in the antioxidants anthocyanidins.

•• Nature’s Own Superfood Blends Chia with Fibre and 2 Billion Probiotics. This is a powerful blend of prebiotic and probiotic chia that is gluten free. It contains Inulin, a natural source of soluble dietary fibre and prebiotic.

This product creates a digestive superblend.

•• Nature’s Own Superfood Blends Cocoa. This is a delicious chocolate flavour that contains over 40 different superfoods, including digestive enzymes, organic whole grains, multimineral complexes and prebiotics and probiotics.

•• Nature’s Own Superfood Blends 6 Supergreens.

Contains Spirulina, Alfalfa, Barley grass, Kelp, Wheat grass and Chlorella, six of the most nutrient rich foods on the planet and helps achieve a well-balanced diet.

In addition, a Superfood Tonic 2-in-1 is included in the range, which is a delicious berry flavoured liquid containing Chloryphyll and Spirulina. The tonic helps cleanse, alkalise and detoxify the body and is perfect for those who like a liquid format, as well as vegetarians who are after a natural protein source.

“The entire Superfood Blends range is naturally sweetened with stevia, suitable for vegetarians and free from artificial colours, flavours and preservatives,” Mr Abbott said.

For more information about the Nature’s Own range or great options for ranging Nature’s Own in store, speak with your Sanofi Consumer Healthcare Representative or call 1800 732 273. >> www.naturesown.com.au

RB introduces a new online training program Pharmacy Forward.

The project is available nationwide for all community pharmacies and accessible online via RBHealthHub.com.au. Pharmacy Forward is designed to help pharmacists and pharmacy assistants build their Pharmacist-Only offering.

In completing the Pharmacy Forward program, pharmacists will learn how to adapt their business to stay ahead of the current reliance on dispensary income to a much greater focus on services and front-of-shop income.

The program will assist pharmacists in improving their customers’ health outcomes, boost staff professional satisfaction, maximise sales of Pharmacist Only medicine and improve their business’s overall profitability.

“Pharmacy Forward was created to replicate the mentorship offered through Pain Smart and assist pharmacists to further their educational and business advantage.”

The main aim of the Pharmacy Forward program is to support pharmacists through the process - from video tutorials, role plays designed to sharpen counselling skills, and tools and tips to download to help them implement the program in store.

Pharmacy Forward was created to replicate the mentorship offered through Pain Smart and assist pharmacists to further their educational and business advantage. The results from PainSmart Challengers, proved how supporting S3 brands can increase customer loyalty and profitability by achieving an average gross profit increase of 22 per cent.

The Pharmacy Forward training is broken down into six steps to ensure every opportunity for business growth is explored. Pharmacists will gain greater insights into the need for change, assess their current operations, draft and implement their personalised action plan, train their staff for change, review progress and results and submit their results anonymously online for a look at how other pharmacies have fared.

RB is also offering all pharmacists who complete the program and anonymously submit their results online by 1 May 2015, the chance to win a Business Builder program from the Next Level consultancy, led by Glenn Guilfoyle.

Pharmacy Forward is available FREE to all pharmacies online 24/7. >> www.rbhealthhub.com.au References: 1 Sigma Pharmaceuticals Pty Ltd. AUSTRALIA: Sigma Pharma Unveils Revamp Plans.

[Press release] 27 March 2014.

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WHAT’s NEW & company news

Pharmacy Only Brands A Catalyst for Pharmacy Growth

Ethical Nutrients Mega Magnesium Powder – now in Citrus flavour

As concerns are raised over the huge impact of the price disclosure cuts to Australian pharmacy profits, more pressure is building on OTC categories to drive profit in pharmacy.

To strengthen the success of one of your most popular products, ethical nutrients is proud to annouce a brand new flavour plus an improved flavour upgrade to the mega magnesium range.

There is also an exciting new evidence based product to support students and executives, and any customer looking for brain support.

Skincare category leader Ego Pharmaceuticals is driving a continuing significant increase in growth across its brands in correlation to their ongoing commitment to pharmacy.

Ego’s strongest performing brand QV is delivering 75 per cent of the market growth of the skincare category within pharmacy, recording a market share of 52 per cent .

Alan Oppenheim, Managing Director at Ego Pharmaceuticals believes the strong growth is a direct reflection of the strategic focus to remain in pharmacy exclusively.

“Our relationship with Australian pharmacy is stronger than ever and our commitment is beneficial for the success of both our brands and pharmacy.

“We’re working closer than ever with dermatologists, nurses and GP’s, while increasing our marketing to continue to drive consumers into pharmacy to purchase our products,” Oppenheim added.

Every marketing dollar that Ego spends directs people to visit pharmacy and to no other retailer.

The sun care category grew in pharmacy by 12 per cent overall with Ego’s SunSense range increasing by 32 per cent the highest contributor to category growth .

The annual loss to the average Australian pharmacy due to the price disclosure cuts is estimated at approximately $30,000 by The Pharmacy Guild.

Ethical Nutrients Mega Magnesium Powder is now also available in a delicious Citrus flavour. Containing the exclusive and highly absorbable Meta Mag® Magnesium diglycinate, Mega Magnesium Powder may be of benefit during times of stress and for relief of muscular aches, pains, cramps and spasms. Sweetened naturally with stevia, the addition of Citrus flavour to the Mega Magnesium range will ensure compliance for customers requiring this essential mineral.

The popular Mega Magnesium Powder Raspberry Flavour has been upgraded to taste even better and is naturally sweetened with stevia.

The Ethical Nutrients Mega Magnesium range is supported with a TV campaign that highlights the many benefits of this important nutrient.

For professionals, students and customers seeking enhanced concentration, focus, attention and mental alertness, recommend the new Ethical Nutrients Calm, Clear and Focused. Each capsule contains 800 mg of an advanced extract of Panax quinquefolius to temporarily support mental performance. Recommend just 1 to 2 capsules as required to help your customers keep up with the mental demands of modern life.

Ethical Nutrients is only available in Pharmacies and Health Food stores where customers can receive informed advice about improving their health through diet, lifestyle and quality supplements. For more information on the products featured contact Health World’s Technical Support Team of Naturopaths on 1800 777 648. >> www.ethicalnutrients.com.au

“Make your time spent on recommendation of product focus on pharmacy only brands. Support your business,” Oppenheim said.

“Do you want your staff recommending a brand that the consumer will buy next week at grocery? Make a difference to your business where the government decisions cannot affect you,” he added. >> www.egopharm.com References: 1 Aztec Pharmacy Data, 5/5/14, Cleansers, Moisturises & Sensitive Skin Market 2 Aztec Suncare Pharmacy, Value MAT to 04/05/14.

Gold Cross launches new product range Gold Cross is proud to announce the launch of its pharmacy exclusive range of medicines spanning through the Cough, Cold & Flu, Analgesic, Allergy and Digestive Health categories.

With all of today’s pharmacy business pressures, Gold Cross is here to help safe guard your future. A proportion of Gold Cross product sales fund the Guild in its important role of protecting pharmacy in Australia.

With a line-up of powerful pharmacy strength formulations with attractive margins, you can be confident that this new range is primed to deliver efficacy for your patients and profitability for your pharmacy.

“Every marketing dollar that Ego spends directs people to visit pharmacy and to no other retailer.”

The range is proudly endorsed by The Pharmacy Guild of Australia and you can rest assured knowing that this range is pharmacy only forever.

This year Gold Cross has proudly partnered with iNova Pharmaceuticals (a Valeant Company) to distribute the entire range Gold Cross medicinal products.

For more information and amazing net-into-store prices call your iNova Representative or Customer Service on 1300 363 212. >> www.trustgoldcross.com.au

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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WHAT’s NEW & company news

Pharmacy teams can play vital role in helping people with mitochondrial disease The Australian Mitochondrial Disease Foundation (AMDF) is urging Australian pharmacists to be more aware of the symptoms of mito to ensure proper diagnosis and healthcare.

get a diagnosis because of the widespread range, type and severity of symptoms and the varying onset and impact the disease has on patients’ lives.” SAMDF CEO Sean Murray said.

Needing to stay in bed to rest and recharge is a common outward symptom of the debilitating and potentially fatal genetic disorder mitochondrial disease (“mito”). Depending on which parts of their bodies are affected and to what extent, people with mito can lose their sight or hearing, be unable to walk, eat or talk normally, have strokes or seizures, or develop heart problems, liver disease, diabetes, or respiratory or digestive problems.

“We welcome the involvement of pharmacists to improve understanding of mitochondrial disease and to support affected individuals and families. Unfortunately, there are very few effective treatments for mito and doctors can currently only offer symptom management and advice on nutrition and exercise to support the mitochondria. Pharmacists and pharmacy assistants may be able to advise customers regarding prescribed medication or doctors’ recommendations on pharmacy products or nutritional supplements.”

The AMDF was set up in 2009 by family members, friends and doctors of sufferers to fund essential research into the diagnosis, treatment and cure of mitochondrial disorders, and to connect and support affected individuals and families to improve their quality of life.

“Many people with the genetic mutations implicated in mito are symptomatic but undiagnosed or misdiagnosed, some are not yet symptomatic, and others are unknowingly at risk of passing the disease on to their unborn children. For some patients it takes years before they

“We welcome the involvement of pharmacists to improve understanding of mitochondrial disease and to support affected individuals and families.”

New study results show correlation between speed of absorption and actual relief with Ibuprofen Faster acting analgesic formulations provide earlier onset of pain relief, better overall pain relief and a less frequent need for additional analgesia, indicating longer lasting pain relief, according to the results of a clinical study in acute pain published in the European Journal of Pain (11 April 2014).

The study results validate the findings of previous studies that show rapid reduction of pain intensity in the first hour is associated with better overall pain relief and longer lasting analgesia with a reduced need for re-medication.

In the clinical study, involving 322 patients, individuals were treated with placebo, paracetamol 1000mg, ibuprofen sodium 400mg and ibuprofen-poloxamer 400mg following third molar extraction.

Analysis of all patients showed that rapid VASPI (visual analogue scale pain intensity) reduction in the first hour was strongly correlated with good overall pain relief, and with lesser need for additional analgesia within 6 hours. Both Ibuprofen formulations, VASPI scores fell rapidly during the first hour and were then typically maintained until later re-medication.

The analysis of data demonstrated a strong relationship between the speed of reduction of pain intensity and overall pain relief, as well as need for additional analgesia. >> www.nurofen.com.au

Celebrity supporter Jamie Durie says: “My life has been touched by mito through a close friend’s daughter. I have seen first hand the impact it has on this little girl physically and mentally, plus the flow-on effect to the entire family. It’s a truly devastating situation.”

Pharmacists may refer customers to the AMDF website for further information (or the AMDF Help Line, 1300 977 180). >> www.amdf.org.au

New MOVICOL Orange Liquid MOVICOL Liquid is a new, easy to prepare laxative product in the MOVICOL range that provides gentle, effective relief from constipation in adults and children over 12 years of age.

MOVICOL Liquid is available to pharmacies as an over the counter (Schedule 2) medicine in a pleasant-tasting orange flavour. In a 500ml bottle format, offering 20 dosages, MOVICOL Liquid is targeted towards patients who experience chronic constipation.

MOVICOL Liquid contains the active ingredient Macrogol 3350 plus electrolytes, which is the most commonly prescribed laxative in Australia2.

MOVICOL Liquid works by bringing water to the hard, dry stool to soften, rehydrate and bulk it up slightly. As the stool expands, it triggers colonic activity in a natural and effective way of achieving comfortable bowel movement.

When prepared as directed, MOVICOL Liquid is an iso-osmotic solution with respect to the bowel contents, meaning there is no net gain or loss of electrolytes or water. The reduced likelihood of dehydration can be of particular benefit for patients with chronic constipation.

Preparation is simple and easy using the supplied measuring cup to pour 25 mL of MOVICOL Liquid to a glass then add 100 mL of water.

No further mixing is required and the prepared solution of 125 mL is one dose of MOVICOL Liquid.1 MOVICOL sachets are also available in adult and pediatric formulations with a choice of three flavours: Lemon-Lime, Chocolate and Flavour Free.

Contact Norgine for more information: 1800 636 000. >> www.movicol.com.au References: 1 MOVICOL Liquid Approved Product Information, July 2013 2 PBS data accessed at https://www.medicareaustralia.gov.au/statistics/pbs_ item.shtml on 26/5/2014 confirms that Macrogol plus electrolytes (PBS codes 5389P, 5390Q and 9612G) are the most commonly prescribed items in the A6A laxative category (Moving annual total May 2013 – April 2014).

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

DOWN TO BUSINESS

How to sell your Pharmacy TO CANDIDATES

Graham Howard Agency Owner, Frontline Health

High-performing employees are in demand in the healthcare industry, and Pharmacy is no different. It can be frustrating spending time sifting through applications from candidates who just don’t meet the standards you are looking for. In an increasingly competitive marketplace, just how do you attract and recruit the best candidates?

You may need to proactively take steps to make your Pharmacy more appealing for them – including demonstrating to them that your Pharmacy is equipped to meet their long-term goals and nurture a positive working environment.

CREATE AN EMPLOYEE-FRIENDLY ATMOSPHERE What do your current and previous employees say about your Pharmacy? Disgruntled employees can be damaging to your reputation and this can deter the best candidates from applying to work for you, particularly in a small community town. The best candidates often have their choice of where they work, and they are likely to choose a pharmacy they believe will give them a positive work experience over those who have a less employee-friendly reputation. Are there ways you can create a more employee-friendly workplace culture?

If so, it may pay off in terms of the quality of candidates you attract.

MAKE APPLYING EASY An overly complicated or time-consuming application process may put potential candidates off. If you don’t have a formal application process in place, it may be worth looking at how you can streamline your recruitment process. Keep application forms short and to the point, and make sure you communicate with candidates every step of the way. If they have had a positive experience from the start, they are more likely to choose you over any other job offers they get.

SELL YOUR PHARMACY IN YOUR ADS Many employers use job ads as a way of listing what they want from candidates without giving them any idea of what’s in it for them.

It’s a good idea to list a few of the benefits of working for you near the top of the ad as a way to gain attention. Benefits can include a great location, public transport nearby, opportunities for career advancement or the chance to work with a supportive team.

GIVE CANDIDATES A GOOD EXPERIENCE Candidates will form an impression of your pharmacy from the very start and this may influence whether they eventually accept a job offer. To make a good impression, ensure your application process is straightforward and communicate with them regularly at each stage of the process. Candidates will talk about their experience online and to friends and colleagues. If their experience is negative, this can discourage high quality candidates from applying to work for you. By showing that you look after their needs from the start, you can help present your organisation as a positive one that looks after employees.

PRESENT A CONSISTENT BRAND IMAGE Candidates should be able to recognise your brand on all your communications. Presenting a consistent brand image makes you instantly recognisable and lets people know what to expect. If you have a strong brand, which aligns itself on clear values, candidates who can identify with those values are likely to seek you out as an employer.

High quality candidates are in demand, and if you want to attract them you will have to give them a reason to choose you over everyone else. Branding yourself to be more employee and candidate friendly may seem like hard work, but it can pay off in the long-term as it can help you attract better quality candidates.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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PRODUCT SPOTLIGHT

Gold Cross Diarrhoea Relief – Loperamide with Simethicone

FESS® Sensitive Noses Seawater Spray

Gold Cross is proud to announce the launch of its pharmacy exclusive Gold Cross Diarrhoea Relief tablets – Loperamide with Simethicone. Each tablet contains 2mg of Loperimide and 125mg of Simeticone for the treatment of acute diarrhoea and associated gas-related abdominal discomfort.

When the nose is exposed to pollen and other allergens, it can react and produce hayfever symptoms. Daily use of preservative free FESS® Sensitive Noses Seawater Spray, helps to wash away these allergens, so the nose can be protected from hayfever this spring.

For more information call your iNova Representative or Customer Service on 1300 363 212.

Always read the label. Use only as directed. If symptoms persist see your healthcare professional.

Stockist Inquiries: 1800 788 870. >> www.fess.com.au

>> www.trustgoldcross.com.au

Calm, clear, forcused – HELP WITH THE MENTAL DEMANDS OF MODERN LIFE For professionals, students and customers seeking enhanced concentration, focus, attention and mental alertness, recommend the new Ethical Nutrients Calm, Clear and Focused. Each capsule contains 800 mg of an advanced extract of Panax quinquefolius to temporarily support mental performance. Recommend just 1 to 2 capsules as required to help your customers keep up with the mental demands of modern life.

Ethical Nutrients Calm, Clear and Focused RRP: $29.95 (30 caps) Supplier: Health World Limited Tel: 1800 777 648 (toll free) >> www.ethicalnutrients.com.au

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

PRODUCT SPOTLIGHT

DOWARD ASTHMA spacers with Butterfly Valve Technology e-chamber spacers with Butterfly Valve Technology, are designed to optimize drug delivery of all respiratory medication types. e-chamber is the only spacer range in Australia to be dual branded with Asthma Australia. e-chamber spacers come in two sizes for children and adults. The spacers can be adapted to masks, which are sold separately. RRP $12.80. >> Exclusive to Doward Ph 1800 DOWARD (369 273) www.doward.com.au

0 0 3 a mper

winduct ha $

prosponsored by

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Competition Question: Who do you buy the e-chamber asthma spacer from?

Email or Fax your answer to Candice Radford on email: Candice.radford@goldx.com.au or Fax: 07 38397806 All correct entries will go into a draw to win a hamper of goodies sponsored by Doward – The draw will take place on 1 September 2014. – The winner will be notified by phone so please make sure you provide all necessary contact details in your entry.

Clear Eyes by Murine Wipes For effective, gently cleaning of the eyelids and lashes.

Ezy-Ups Ezy-Ups is designed for people of all ages with flexibility issues due to age, injury, pregnancy and arthritis. This simple and inexpensive tool allows users to undress and dress themselves without assistance. This frees them from dependence on a carer which increases their privacy and dignity.

FERRO-TAB...

Need Iron?

RRP $16.95

Ferro-tab is for the treatment and prevention of iron deficiency and iron deficiency anaemia. It provides a high dose of elemental iron (Ferrous Fumarate 200mg, equivalent to 65.7mg elemental iron) without vitamins or minerals that can affect absorption.

It also provides dosage flexibility where iron absorption varies by person and their level of deficiency.

>> www.murine.com.au

>> www.aftpharm.com

Free of alcohol, fragrances, preservatives and enriched with chamomile extract, Clear Eyes by Murine Wipes can be used daily to remove secretions, crusted matter, residue and makeup from around the eyes.

>> www.ezyups.com

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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After Hours

AFTER HOURS August–September 2014

Toowoomba Carnival of Flowers Since its inception in 1949, the Toowoomba Carnival of Flowers has flourished and, is now, a truly Queensland event. The brainchild of Essex Tait and the Toowoomba Chamber of Commerce, Carnival was introduced as a way for the city to use their “Garden City” reputation to promote increased economic activity following the recent hardships of war.

On October 21, 1950 the Toowoomba Carnival of Flowers commenced with a street procession that stretched three miles in length. Led by a bullock team and watched by a crowd estimated to be 50,000 strong, the Parade was a resounding success. The Toowoomba Carnival of Flowers subsequently became firmly cemented as an annual event in the region’s community calendar.

As the years passed, Carnival’s appeal widened, attracting tourists from across Queensland, interstate and internationally.

2012 represented another milestone in the event’s rich history, as Toowoomba and its surrounding regions commemorated 63 years of Carnival celebrations. More than 100,000 spectators lined the inner city streets to experience the Grand Central Floral Parade.

The Ergon Energy Flower, Food & Wine Festival attracted visitors from a broad range of ages, families and young couples through to mature aged travellers and retirees. The Carnival Ambassador Program raised more than $30,000 for RACQ Careflight.

Toowoomba & Surrounds is the perfect country touring destination and group touring is welcomed. For some great Road Trip ideas for travel to and around Toowoomba, view the RACQ ROAD TRIPS for some great itinerary ideas.

This year from 19-28th of September Toowoomba Carnival of Flowers will once again celebrate all the “Garden City” has to offer.

Highlights include the Ergon Energy Flower, Food & Wine Festival and the ever-vibrant Grand Central Floral Parade. With hundreds of parks & blossoming gardens to explore, the Toowoomba Carnival of Flowers has something for everyone.

The official coach carrier Stonestreets Coaches is offering a selection of daily garden tours ranging from 3 hours to full day.

There are a number of options available to visitors wishing to experience this year’s Toowoomba Carnival of Flowers.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

Visit the website for more to see and do, details and bookings: http://www.tcof.com.au/visitor-info

HEALTH CALENDAR

HEALTH CALENDAR August–September 2014

Jeans for Genes Day First Friday in August Is a national day when people wear their jeans to raise much-needed funds for research into birth defects and diseases such as cancer, epilepsy, and a range of genetic disorders. > www.jeansforgenes.org.au/-About-Us

Healthy Bones Action Week - Nationwide 3-10 August For 2014, the theme is “Stronger Together” and we are calling on mothers, daughters, colleagues and friends to take three simple actions to protect their bones. > www.healthybones.com.au

Dental Health Week - Nationwide 4-11 August Australian Dental Association NSW > www.dentalhealthweek.com.au/

ATF GOLD BOW DAY 1St September The ATF Gold Bow Day highlights the increase in thyroid cancer and gives support to thyroid cancer patients. > www.thyroidfoundation.com.au/atfawareness-events/gold-bow-day.html

National Asthma Awareness Week – Nationwide 1-7 September Asthma Foundation > www.nationalasthma.org.au/

Eczema Awareness Week – Nationwide 8-14 September Eczema Association of Australasia Inc

Daffodil Day - Nationwide

> www.eczema.org.au

22 August Cancer Council Australia > www.daffodilday.com.au

R U OK? Day – Nationwide

Parkinson’s NSW Unity Walk & Run

11 September By getting more people to ask ‘are you ok?’ we hope to create a world where everyone is connected and is protected from suicide.

31 August Parkinson’s Australia

> www.ruokday.com/about-us/

> www.unitywalkandrun.com.au

Parkinsons’ Walk in the Park – South Australia & Western Australia

Parkinson’s Walk in the Park – Victoria, QLD & ACT

14 September Parkinson’s Australia

31 August Parkinson’s Australia

> www.parkinsonswa.org.au/support-us/walk

> www.parkinsonswalk.com.au

Geelong Memory Walk & Jog Why BLUE? Blue September Blue is for men and we lose too many of them to prostate, lung, skin, bowel and testicular cancer.

14 September 2014, 07:00 AM - 11:30 AM It’s all about coming together with your friends and family to raise vital funds to support people affected by dementia.

> www.blueseptember.org.au or call 1300 300 817

> http://givealzheimersaustraliavic.org.au/ event/memorywalk2014geelong GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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60 SECONDS WITH...

Calum Brownie Pharmacist Busiko’s Amcal Pharmacy

I decided to become a pharmacist because...

I wanted to help make a difference in the community.

I have been working as a pharmacist for...

4 years.

What I like best about my job is...

Being able to help achieve positive outcomes for patients.

My favourite hobby is...

Sport. I’m heavily involved in lawn bowls and play 8-ball as well. I will watch any sport that is on TV. My favourite book is...

Anything with Robert Ludlum as the author.

My best getaway ever was...

A family holiday through Scotland, London and Dubai a few years ago.

How I keep myself updated to the market news...

Through journals and talking with reps.

Over the next 3 years in pharmacy, I predict...

Some hard times for the profession, but if the profession can present a united front it will come out as strong as ever.

If I could give any advice to someone starting a career in pharmacy, it would be...

Make sure that you are doing it because you want to because you won’t last long if you don’t.

CLASSIFIEDS FOR SALE 2 x Strattera 25mgm x 28 Exp 01/15 – Cost: $50 each

2 x Singulair 4mg 28 tabs Exp 11/14 – Cost: $23

3 x Strattera 40mgm x 28 Exp 11/14 – Cost: $50 each

2 x Andriol testocaps 40mg 60 caps Exp 09/15 – Cost: $20

1 X Sensipar 30mgm x 28 Exp 04/17 – Cost: $200

1 x Risperdal 1mg 60 tabs Exp 10/15 – Cost: $15

Postage free.

1 x Premia 5 continuous 28 tabs Exp 10/15 – Cost: $21

Contact: Bill, Bill Williams Chemist, Ph. 02 66627191

1 x Reminyl 8mg 28 tabs Exp 04/15 – Cost: $32 1 x Edronax 4mg 60 tabs Exp 01/15 – Cost: $21

2 x Nexavar 200mgm (60) Exp 11/14 - Cost $500.00 each, normal price $3190.00 Contact: Solly Lew, Ph: 03 9534 8084, Email: solly.lew@nunet.com.au

Gondola shelving 1.65m height 5 x 1m bays, 2 x 0.6m bays. Powder coated metal, Amcal ‘beige’. Includes all brackets and spines. Some pegboard backings. Good condition – Cost: $500 Contact: Pete, LiveLife Peregian Springs, Ph. 07 54712011, Email: pete.ashenden@livelifepharmacy.com

1 x Glucobay 50mg 90 tabs Exp 01/16 – Cost: $18 1 x Revia 50mg 30 tabs Exp 01/15 – Cost: $88 1 x Clexane 60mg 10 0.6ml P/F syringes Exp 09/16 – Cost: $50 Contact: Rowan Conn, Texas Pharmacy, Ph: 07 4653 1367 8x Neocate LCP Baby Powders Exp: 11/14 cost: $165.56 ex GST (50% off cost price) BN: 100383381 Contact: Bec, UDC St Johns Park, Ph: 02 96105010 or Email: stjohnsparkpharmacy@yahoo.com.au

3 boxes of Temodal Caps (Temozolomide)100mg Batch: 2DZAA04007 Exp: 12/2014 50% off

1 x Karvezide 150/12.5 Exp: 09/2014 – Cost: $5.80 discount 40%

4 boxes of Temodal Caps Batch: 2DZAA39005 Exp: 08/2015 10% off

1 x Avapro HCT 150/12.5 Exp: 10/2014 – Cost: $5.80 discount 40%

Contact: Hamza, Pharmacy Depot Hurstville, Ph: 02 9579 4633 or Fax: 02 9579 3043

1 x Desowen Lotion 60 ml Exp: 10/2014 – Cost: $22.19 discount 20% 1 x Genoptic eye drop Exp: 112014 – Cost: $8.01 discount 20% 1 x Kliovance Exp: 11/2014 – Cost: $21.50 discount 20%

1 x Eltron Orion label printer, in good working condition – Cost: $60 ono.

3 x Brother fax rolls PC – 301 Drop ins. Cost: $30 ono

1 x Levitra 10mg Exp: 11/2014 – Cost: $43.31 discount 20% 2 x Persantin SR 200mg 11/2014 – Cost: $20.09 discount 20%

3 x Brother fax rolls PC – 302RF (2 refill rolls/ box) Cost: $30 ono 4 x single Brother Fax rolls – Cost: $60 ono

1 x Exforge 10/160/12.5 Exp: 12/2014 – Cost: $16.15 discount 20% 1 x Seroquel 100mg Exp: 12/2014 – Cost: $56.60 discount 20%

3 x drop in Rolls PC – 301 Cost: $10 ea.

Printer toner kits for Kyocera FS-C5200DN – Brand New

Contact: Mark, Rosen’s Pharmacy Perth WA, Ph. 08 9325 2843, Email: rosenspharmacy@iprimus.com.au

2 x TK554K Black – Cost: $70 2 x TK554M Magenta – Cost: $85

6 x Timber Gondolas, very solid and almost brand new, complete with adjustable shelves, brackets and slat in middle and sides. Cost $3500 Will accept any reasonable offer.

1 x TK554Y Yellow – Cost: $85

10 x Metal Gondolas, very solid with adjustable shelves - Will accept any reasonable offer.

Contact: Louise or Jude, Vienna Road Family Chemist, Ph: 07 38248282 Email: viennachemist@hotmail.com

2 x TK554C Cyan – Cost: $85

1 x Perfume Cabinet.

Contact: Sam, Shopsmart Wholesale Pharmacy, Newtown on Ph: 0414921694 or Ph: 07 95574511 Email: drmegalli@optusnet.com.au

1x Kyocera Toner TK-310 toner kit for fs-2000d selling for $100 plus postage Contact: Sandra Abbott, Tweed Night and Day Pharmacy, Ph: 07 55365638 Email- yourchemist@bigpond.com

2 x Rimycin 150mg capsules qty 10 (Exp. Oct 2014) Cost: $ 14.95 (Free Postage) 1 x Methylpred 500mg vial (Exp 02/15) Cost: $ 19.95 1 x Forteo Pen 250mcg/mL (Exp 05/15) Cost: $ 349.95 2 x HumulinR 10mL Vials (Exp 02/15) Cost: $19.95 (Free delivery to local area) Contact: Blanche Morrissey, Whitebridge Pharmacy, Ph: 02 4943 3798, Email: whitebridge@optusnet.com.au

PLACE YOUR FREE CLASSIFIED ADVERT If you would like to place your free classified ad, forward any items for sale to Candice.

Email: Candice.radford@goldx.com.au

BROUGHT TO YOU BY:

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 37 : August / September 2014

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Business directory

Business Directory AFT PHARMACEUTICALS Level 1, 296 Burns Bay Road Lane Cove NSW 2066 Tel: 02 9420 0420 Website: www.aftpharm.com

BAYER 875 Pacific Highway Pymble NSW 2073 Tel: 02 9391 6000 Website: www.bayer.com.au

CARE PHARMACEUTICALS Suite 302 Level 3 75 Grafton Street NSW 2022 Tel: 02 9300 1900 Website: www.carepharma.com.au

HEALTH WORLD 741 Nudgee Road Northgate QLD 4013 Tel: 07 3117 3300 Website: www.healthworld.com.au

INOVA PHARMACEUTICALS Level 10, 12 Help Street Chatswood NSW 2067 Tel: 02 8918 6322 Website: www.inovapharma.com

Would you like to advertise in our new Business Directory?

PETRUS PHARMACEUTICALS P.O. Box 1808 West Perth WA 6872 Tel: 08 9368 5954 Website: www.petrus.com.au

Contact Candice on Ph: 07 30404415 or Email: Candice.radford@goldx.com.au to enquire about our

early bird rates for the remainder of 2014.

TRELLIS DOORS LEASE1 Retailer House – Level 1, Unit 3 321 Kelvin Grove Road Kelvin Grove QLD 4059 Tel: 1300 766 369 Website: www.lease1.com.au

Unit 5/1 Canal Road St Peters NSW 2044 Tel: 02 9519 0844 Website: www.trellisdoors.com.au

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• 2 times greater than magnesium carbonate.1 This means superior results for supporting healthy muscles, nerve function and energy production for your customers. Ethical Nutrients Mega Magnesium Powder is now sweetened with stevia for an even better tasting formula. Available in Raspberry and the new Citrus flavour, your customers will enjoy this easy to take Natural Medicine. Tablets are also available for convenience.

Ethical Nutrients Mega Magnesium is only available at Pharmacies and Health Food stores where your customers can receive informed advice about their health.

www.ethicalnutrients.com.au BEST PRODUCTS BEST EDUCATION Industry Pulse independent research shows Ethical Nutrients, yet again, as the leading BEST SERVICE supplier to Pharmacy providing unparalleled service excellence and product training for the 4th consecutive year!

Ethical Nutrients offers professional Natural Medicine training for all staff in your store in a variety of formats to suit the varied needs of your staff: • Online Learning • In-Store Trainings • Training Evenings • iTherapeutics References available on request.

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