ITK October/November 2014 - Issue 38

ISSUE #38 : OCTOBER / NOVember 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

• Building Efficiencies and Services • Business Profiles • Patient Engagement

• CPD – Dose Administration Aids • The Power of the Gold Cross • Training and Education

What can Tony Ferguson do for your TOTALLY NEW! Pharmacy?

Growing pressure on dispensary means that now is the best time to be looking for options to:

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✓ Completely redesigned program, based on the latest Australian Dietary Guidelines

✓ Renewed focus on Consulting ✓ Expanded Product Range ✓ National Relaunch Advertising Campaign ✓ Backed by Terry White Chemists and Symbion Terry White Chemists automatically qualify to have a Tony Ferguson Weight Loss Clinic in their store, but they are also available in limited numbers, in certain locations, to independent pharmacies too.

To enquire about becoming a Terry White Chemist franchisee, call (07) 3238 0222.

To see if your independent pharmacy qualifies for a Tony Ferguson Clinic, contact Julie-Ann Wharley on 0410 417 135.

For more information about the new Tony Ferguson Program go to tonyferguson.com

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CONTENTS

THE VALUE OF A BRAND

Special Feature Centre: MPS Australia – Your key to better health outcomes

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

As this edition of ITK is distributed to Pharmacies, we are excited to announce the endorsement by Gold Cross of MPS Australia.

As we put together key elements of the publication, including our featured Gold Cross booklet, one of the key underpinnings in business is brand value or equity.

Who do you think has the most powerful and valuable brand in the World? Well, if you answered Apple then you were correct.

This brand is worth $104.3 billion, with brand revenue of $156.5 billion, which is astonishing.

So what is brand value? A brand includes the name, logo, image, and overall perceptions that identify the product, service and owner of the brand in the minds of customers.

This takes the shape of advertising, packaging, and other marketing communications, and becomes a focus of the relationship with consumers. In time, this brand comes to encapsulate a promise about the goods it identifies—a promise about quality, performance, or other dimensions of value, which can influence consumers’ choices among competing products. In dealing with dozens of direct and indirect partners in our profession each week through ITK, we strive together to ensure that the brand and the value attached to it is accurate and promoted.

10 CPD – Dose Administration Aids

7 Training and Education 38 Coco – Scalp 39 Optifresh 30 Hydralyte

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41 Murine

Business Profile 6

MPS Australia

18 Tony Ferguson 32 PARA’KITOTM

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Down to Business 22 Building Efficiencies and Services 28 Patient Engagement 36 Using Personal Selling Skills

24 After Hours

MPS, founded in 1997 is a company who has strived tirelessly to build and represent a brand that delivers high quality solutions that create efficiencies and market leading incident-free rates of dose administration.

50 Melbourne Cup Day

Fittingly, this edition has a key focus on dose administration aids extending to continuing professional development along with a host of independent editorials. We also feature informative Business Profiles, including the pharmacy exclusive Tony Ferguson weight loss program. Thank you to all the contributors, partners and supporters of ITK, wishing you an enjoyable read of this edition.

44 Product Spotlight

Best of Health.

Sean Tunny Editor

Regulars

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

0457 029 052 sean.tunny@goldx.com.au DESIGN: Megan Hibberd

0408 452 133 www.artbymegan.com.au PRINT & DISTRIBUTION: APN Print

1300 134 628 www.apnprint.com.au

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

Contact Jessica O’Connor – Email: jessica.oconnor@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 constitute 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.

DOWN TO BUSINESS

Are you hiring the best employees?

Graham Howard Agency Owner, Frontline Health

It all starts at the interview Behavioural interviewing is a style of interviewing that was developed in the 1970s by industrial psychologists.

Behavioural interviewing asserts, “the most accurate predictor of future performance is past performance in a similar situation”.

Behavioural interviewing, in fact, is said to be 55 percent predictive of future on-the-job behaviour, while traditional interviewing is only 10 percent predictive.

Unlike traditional interviews, which include such questions as:

•• Tell me about yourself?

•• What are your strengths and weaknesses?

•• Why are you interested in working for us? behavioural interviewing emphasises past performance and behaviours where candidates must rely on past experiences as opposed to predicting how they would behave.

Typical behavioural-based interview questions include:

•• Describe a situation in which you were

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able to use persuasion to successfully convince someone to see things your way.

Describe a time when you were faced with a stressful situation that demonstrated your coping skills.

Give me a specific example of a time when you used good judgement and logic in solving a problem.

Give me an example of a time when you set a goal and were able to meet or achieve it.

Give me a specific example of a time when you had to conform to a policy with which you did not agree.

Tell me about a time when you had to go beyond the call of duty in order to get a job done.

Tell me about a time when you had too many things to do and you were required to prioritise your tasks.

•• Give me an example of a time when you had to make a split-second decision.

•• What is your typical way of dealing with conflict? Give me an example.

•• Tell me about a difficult decision you have made in the last year.

The ‘Performance-based’ Interview While the behavioural interview is able to focus on the way in which the candidate dealt with situations in the past, indicating how they would deal with similar situations in the future; there still needs to be a way for the interviewer to determine how the candidate will react in a future situation. This is where the ‘performance-based’ interview comes in.

Rather than focusing purely on questions that guide the candidate through a review of their skills and experience, the performancebased interview asks the candidate to describe two or three of their accomplishments, and, with the aid of the interviewer, discuss these accomplishments in detail. By allowing the candidate to choose the accomplishments to discuss, the interviewer is effectively asking the candidate to discuss those aspects of their working lives that they feel they achieved the most, and have the greatest pride.

This discussion, however, should not be brief. While the candidate will be able to give an indication of their performance within their accomplishment, it is up to the interviewer to actively listen to what is being said, and delve into those areas where more information is needed. Deep questioning should allow the interviewer to uncover indications of candidate commitment, motivation, cultural fit, interest, motivation, experience, and willingness to learn; and allow the interviewer to evaluate how the candidate will work in a similar environment.

Further depth can be gained by asking the candidate to describe their accomplishments

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DOWN TO BUSINESS in chronological order. Again, through in-depth questioning, the interviewer should be able to extract an understanding of the candidate’s progression and improvement over time.

By allowing the candidate to discuss specific accomplishments or failures, and by developing questions from these examples, the interview is less likely to follow a pre-determined format, removing the smokescreen that can be thrown up by a well pre-prepared candidate. This sort of questioning will allow the interviewer to make the recruitment decision in light of what

is best for the business, rather than by how well the candidate was able to perform at the interview; a key factor in an increasingly competitive industry. “In the competitive candidate market, it is crucial that employers are able to make the best recruitment decisions for the organisation, particularly as a ‘bad’ hire can result in more than just the lost time spent in selection and training.

Matching the needs of the job to the skills and behaviours of the candidate is clearly vital so that your business can gain and maintain a competitive edge,” says Peter Davis, Managing Director, Frontline Recruitment Group.

The interview is one of the most powerful tools that you have to ensure that the person you hire is suitable for the role and for your business. While it is not possible to gain the full measure of the candidate’s ability as a result of the interview, it is critical that the interviewer is able to ensure that the interview process is as vigorous as possible. By using an interview technique that draws on both behavioural and performance-based methodologies, you will have a better chance of securing the right person for your organisation.

NEWS FROM THE GUILD PRESIDENT

The Power of the Gold Cross

George Tambassis National President of The Pharmacy Guild of Australia

I am very pleased that the ‘Discover more. Ask your pharmacist.’ advertising campaign has such a strong focus on the Gold Cross symbol. I believe – and significant research confirms – that most Australians identify the Gold Cross with their local pharmacy, and therefore with trust and professional care. We are building on a strength.

When the Guild decided to embark on a new consumer advertising campaign, we were shown a wide range of creative concepts – all of them focused on telling people that there is a lot more available to them at their local pharmacy beyond the dispensing of medicines. We were looking for a way to reinforce the already high perception of the value of community pharmacy.

so we were starting from a point of strength in terms of public perceptions and familiarity.

And the winning pitch focused very heavily on the power of the Gold Cross.

The Guild worked with the creative Sydney agency, Jack Watts Currie, to build what I believe is an engaging awareness campaign.

It is comprised of television and online advertisements supported by a new website and Facebook page. Pharmacies around Australia have an opportunity to be involved, further informing their customers of what is on offer.

This is a symbol which has previously been the subject of branding campaigns,

It is well known that Australians appreciate the important role that community pharmacy

“Many Australians are surprised when they discover just how much their local pharmacy can do. Now it is time to let everybody know how much more we can do.”

plays in health care, providing advice and guidance regarding medications. Yet many Australians are surprised when they discover just how much their local pharmacy can do.

Now it is time to let everybody know how much more we can do.

A comprehensive suite of materials for display in pharmacies, amplifying the campaign message, has been created and is available to order and customise online.

The Gold Cross features prominently in the television commercial and other materials.

The Guild has been in regular contact with pharmacy banner groups, management groups and wholesalers about this campaign and is hoping for a strong level of support from across pharmacy.

As part of the campaign, Guild Member pharmacies were sent a new ‘tile’ version of the Gold Cross for display in their pharmacy.

I certainly hope it is being displayed with pride, tying all participating pharmacies in with the national advertising campaign.

As we are now well into the final year of the Fifth Community Pharmacy Agreement, it is an important time to be spreading the word about the value of community pharmacy.

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Business Profile

Better Medication Management

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

Founded in 1997 by pharmacists, MPS (Medication Packaging Systems Australia Pty Ltd) provides Medication Management Solutions to pharmacists enabling them to better serve both their community patients and Aged Care Facility residents.

“In 2008, we were the first to recognise that pharmacy needed software to allow it to lockdown its workflow processes to keep up with the demand of patients and customers.”

MPS operates three, TGA licensed, Dose Manufacturing Facilities nationally and is Australia’s leading provider of automated Dose Administration Aid solutions. MPS has recently received endorsement by the Pharmacy Guild of Australia for its Community Medication Management System. In this edition of ITK, we had the opportunity to speak with Chairman and Founder, George Castrisos, to outline a little about the company and its history, its interface with the pharmacy profession and to also share some insights about the future of Medication Management in Australia.

Editor: MPS is Australia’s leading provider of automated Dose Administration Aids (DAAs). Can you outline a little of the MPS background?

George: Prior to founding MPS, I had the opportunity to go to the States in 1993 on a home health discovery tour with a number of pharmacists from various specialist areas.

The Aged Care Facilities that we were servicing at the time were extremely happy with us but

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the manual nature of the business meant it was becoming ever harder, and we knew what we were doing was not ultimately sustainable.

We simply had to find another way, and after seeing some of machinery available, we knew automation was the way to go.

The next significant consideration however was how to get ‘clean’ information as with any automation clean data is absolutely imperative, otherwise what is packed is not going to be accurate. We therefore identified a need for an IT solution and began coding for what became HealthstreamTM in 1997.

Editor: Can you highlight some of the key milestones to date for MPS and what do you believe are the key underpinnings for MPS that allows it to continue to better serve community pharmacy?

George: In 2000, we opened our first 3rd party packaging facility, the first ever in Australia. Up until this point, DAA preparation was generally conducted in the

Business Profile

back of pharmacy. That year we were also the first to provide hard copy signing sheets and charts that were from exactly the same data set as our software. Until this point, and often still to this day, most solutions don’t use pharmacy controlled data and / or are reliant on sending and receiving data between different systems.

In 2002, we voluntarily elected to seek TGA approval for our facility as we required a set of standards that would set us apart and also drive continuous quality improvement.

In 2006, we were the first to introduce automated checking technology. This is where a machine, following packing, takes a photograph of each and every Packette™, compares what it ‘sees’ versus the medication record, and then confirms that it is correct.

In 2008, we recognised that every pharmacy dealing with Aged Care needed software to allow it to lockdown its workflow processes to keep up with paperwork associated with patient administration and script management.

2013 saw the introduction of our Electronic Administration Interface called Dosedge™.

What’s most unique about this product is that it still continues to use the one pharmacy controlled data set, and loops back to that single point of truth. Our philosophy has, and continues to be, about striving for the highest possible levels of compliance.

“It’s in our DNA that a process of constant improvement increases efficiency and helps decrease medication incidents.”

Editor: MPS Australia is the only provider with 12 consecutive years of Therapeutic Goods Administration licensing. How significant is this to your business and community pharmacy?

George: It’s hugely significant as you always want your team to strive to be innovative, to become more efficient and to progressively decrease the number of potential medication incidents. In striving for good manufacturing practice through the TGA, the annual audits just make sure it happens. You know you are going to get a visit and that you must be able to demonstrate improvement on the previous audit.

We also follow the Code of Good Manufacturing Practice, use a number of lean Six Sigma principles and have benefited from over 12 years of continued workflow improvements in all aspects of our production processes. It’s in our DNA that a process of constant improvement increases efficiency and helps decrease medication incidents.

Editor: MPS has enjoyed a privileged and professional relationship with Pharmacy. The Pharmacy Guild of Australia recently announced that they have endorsed the MPS Community Medication Management Aystem.

Appreciating the infancy of the endorsement, how does this strengthen your relationship with Guild members?

George: As a pharmacist I am extremely proud of the endorsement. More so, I am thrilled for the wider MPS team as they are now being recognised for a system that we know improves the lives of tens of thousands of Australians. It is the result of 15 years of hard work and continued investment in people, process and technology. We have been through an exhaustive review process and we hope the Guild endorsement provides confidence to Guild members that the product and service they receive from MPS is first class.

MPS is a proven and uniquely automated medication management solution and one that we believe pharmacy can embrace with complete confidence.

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Business Profile

“MPS is a proven and uniquely automated medication management solution, and one that we believe pharmacy can embrace with complete confidence.”

Editor: At APP this year, you delivered a key note address titled “The future of medication management – how it will impact your pharmacy and what you can do about it?” If there was just one key take home message from the many outlined that you would like to reinforce, what would that be?

George: I guess the headline would be – let’s try and remove wasteful processes in the back of pharmacy. Ultimately, this would enable the pharmacist to increase patient contact time which has to be the primary goal. If we look at the statistics we know that we are going to be asked to dispense more prescriptions, albeit for less return.

That’s going to be a challenge for all of us.

As a pharmacy owner I know that I need to be continually reviewing my business to be as efficient as possible but also to focus my key staff, my pharmacists, on what

they do best. To do this, they need both the experience and expertise to be able to provide professional services but also the time and freedom to be able to provide the service.

MPS automates, and allows the pharmacist to delegate, unproductive administrative activity which in turn increases patient contact time.

In conjunction with the work being done by the Guild, this allows community pharmacists to fulfil their primary role of providing professional services to the community.

Editor: George what are some of the goals and objectives for MPS as it continues to strengthen its relationship with the profession in the future?

George: Our primary objective is to work with the industry to meet the challenges ahead. To continue to add value and develop our proprietary software solutions – Healthstream™, Quantum and DosEdge™ - to help lock down workflow improvements.

MPS long ago ceased to be just a “packing” solution for pharmacy and the fact we have this technology means we are able to tailor our offer to key customers. This has provided us with great traction in the market and allowed us to partner with a number of key groups and deliver our medication management solution to their members.

If we can remove 70% of “unproductive” administrative time in pharmacy and help the pharmacists to spend that time improving the lives of their patients, than that makes it all worthwhile.

8 Clunies Ross Court Eight Mile Plains QLD 4113 Tel: 1800 003 938

mps-aust.com.au

Email: customer-service@mps-aust.com.au

CUSTOM DISPENSARY SOLUTIONS New Flowsell ® Dispensa™ Solutions make it easy to design the most optimal and efficient layouts for small to large pharmacies.

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flowsellpharmacysolutions.com.au

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CONTINUING PROFESSIONAL DEVELOPMENT

Dose Administration Aids: The Right Dose, at the Right Time Introduction

Tim Roberts B.Pharm (Hons), AACPA, DipBusMgt Professional Development Manager; Pharmacy Guild of Australia QLD

Learning Objectives After reading this article, the learner should be able to:

•• quantify the cost-benefits in optimising medication management and reducing medication related hospitalisations •• describe the different types of Dose Administration Aids available, including the differences in properties between them •• recognise and understand the eligibility requirements for participation in the Pharmacy Practice Incentives for Dose Administration Aids •• identify the types of medications which may not be suitable for Dose Administration Aid packing due to physical stability issues.

Competencies Addressed 1.1, 1.2, 1.3, 1.4, 2.3, 3.4, 4.1, 4.2, 4.3, 7.1, 7.2

In addition to providing patients with professional advice about their medications, one of the core tenants of the pharmacists’ role is to ensure that all patients are taking their medications safely and appropriately to achieve optimal health outcomes – the right dose, at the right time with the right advice. As we know, many of our patients are taking a number of medications at once, with the complexity of medication regimes often increasing as disease states progress. Dose Administration Aids (DAA’s) are one of the most widely used tools in the professional services arsenal of many pharmacies, both in Australia and abroad.

A systematic review of DAA’s published in the Bulletin of the World Health Organization in 2004 concluded that ‘DAA’s significantly improve medication compliance and management of hypertension and diabetes1’.

While this review was only focused on two chronic disease states, the published national and international evidence supports the use of DAA’s in elderly patients and those on long-term therapy for several chronic conditions, as well as patients with unintentional poor compliance.2 It is this wealth of favourable evidence which led to the consideration for community pharmacy funding for the provision of DAA’s across both the 4th and 5th Community Pharmacy Agreements, recognising the valuable role that DAA’s may play in reducing medication-related hospitalisations and adverse effects through improving medication management.

In 2002, an Australian Commission on Safety and Quality in Healthcare report estimated that between 2 and 3 per cent of all hospital admissions are related to problems with medicines which may originate in the community or in hospital – this includes over-use, under-use and medication adverse effects.3 The cost impact of these medicine-related hospitalisations in Australia is believed to be $660 million per year in the public hospital system alone (from hospital admissions data)4, representing a significant opportunity for healthcare-savings through better management of medications in the community. On a global scale, a Responsible use of Medicines report from IMS Health describes that research estimates approximately 8% of total health expenditure (or around US$500 billion) per year worldwide, can be avoided through optimised use of medications.4 IMS Health identified a number of levers by which these healthcare savings could potentially be made, specifically including: non-adherence to medication, untimely medication use, medication errors and mismanaged polypharmacy.4 Linking our patients into medication management initiatives such as DAA’s is not just good for their health, but it can also contribute to a more sustainable healthcare system in Australia – so let’s explore our options and ensure our patients get the right dose, at the right time…

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CONTINUING PROFESSIONAL DEVELOPMENT

DAA Basics – Options for Medication Packaging Compartmentalised plastic boxes (e.g. Dosette boxes)5 Dosette boxes are re-usable stand-alone units which allow the packing of medications, often packed by the user (or sometimes by a pharmacy). There are multiple varieties available – some comprise of one compartment, others spilt into AM–PM doses and some have upwards of four compartments for each day of the week. Some brands come with additional features such as braille writing for the vision impaired. These types of packing options are typically not tamper-evident.

Blister or bubble packs (e.g. Webster-Pak, MedicoPak)5 Blister packs are held within a plastic or disposable cardboard device with four compartments for each day of the week.

These are hermetically sealed packs (either cold-seal or thermal seal foils), which are tamper-evident upon sealing. Typically, these are prepared by the pharmacy for use by the patient. Medication information (e.g. name/ active ingredient, strength, dose frequency, tablet descriptions etc.) is typically printed either on a header card for the pack or directly on to the foil (or both). Some variances in types may include options for patients with low vision or multi-lingual varieties for those who don’t read English.

Sachet Systems (e.g. MPS packettes, APHS ‘My Sachets’)5 Sachet systems are typically small, tamperevident plastic packs which hold the medications required for a particular date and dosing time. These sachets can hold multiple medications in the one sachet and the medicine information (e.g. name/active ingredient, strength, dose time/date, tablet descriptions) is printed on the front of the sachet. These sachets come to the patient as a roll (in chronological date and time order) and are often provided in a container for storage and easy access. Sachets are prepared using automated packing technologies, thus usually these services are outsourced to largescale packing facilities and then delivered to patients through the community pharmacy.

Automated dispensing devices (e.g. Medido, TabTimer)5 These devices dispense medications for a particular (user-nominated) dose-time, typically with a built-in alarm functionality to alert users to when a dose is required (or if a dose has been missed). Devices may need to be manually filled or they may

dispense pre-filled medications. Some devices have additional functionality such as sms-text or email notification messages to a designated person if the user does not respond to the alarm reminder within a certain time period.

Getting started – Identifying Patients and Pharmacy Eligibility for Incentives Who will benefit from DAA’s?

There are no specific criteria for who will ‘benefit the most’ from utilising a DAA service; some patients on a single prescribed medicine may derive benefit from the service whilst other patients who are prescribed multiple medications may be able to handle them quite effectively without a DAA! However, some studies that assessed the patient viewpoint on DAA’s report that users often like the fact that the devices simplify their medication-taking routine, and reduce the stress associated with managing multiple medications. They generally improved medication adherence in patients with unintentionally poor compliance.2,6 With those patient perspectives in mind, pharmacists can take a proactive approach in identifying patients who may derive the most benefit from participating in a DAA service. Some patient characteristics which pharmacists may try to identify include:7

•• patients taking 5 (or more) medications daily (including non-prescriptions medications) •• patients with a medical history suggesting problems managing medications (e.g. prior hospitalisation due to poor adherence) •• patients with complex medication regimes •• patients with signs of cognitive or physical impairment which may affect their ability to manage medications.

Identifying patients who might benefit from a DAA service can also be linked into a number of opportunities which pharmacies already participate in; the first and foremost opportunity being the patient engagement at the point of sale whilst counselling on medications. Making sure that pharmacy staff are well educated on the benefits of a DAA service and having appropriate informative collateral available are tried and tested mechanisms of increasing awareness about the service. Other opportunities to promote a DAA service may include:

•• identifying patient need through existing

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Medication Management Review (MMR) services, such as: MedsCheck/Diabetes, MedsCheck and Home Medicines Reviews linking in to Pharmacy Practice Incentives such as Primary Health Care, and promoting good medication management through Health Promotion activities and also identifying DAA service candidates through Disease State Management initiatives for patients with major chronic disease states (Respiratory, Mental Health, Diabetes and Cardiovascular) patients who identify as recently discharged from hospital – often multiple medication changes occur, including the prescribing of new medicines and the changing of medication regimes promotion of the DAA service to family members or carers who pick up prescriptions. Also, ensure that all local prescribers are aware of your DAA service so that they may recommend it to patients target local seniors support groups, Rotary/Probus clubs, RSLs and other relevant community organisations to spread the word to your customers about the medication management services on offer in the pharmacy.

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CONTINUING PROFESSIONAL DEVELOPMENT

Pharmacy Practice Incentives: Dose Administration Aids The Pharmacy Practice Incentives (PPI), under the 5th Community Pharmacy Agreement, commenced in 2011 and recognised 6 priority areas of practice with incentives for community pharmacy participation. The DAA priority area allows for an incentive payment for eligible pharmacies to be paid four times per year, and for the provision of DAA services to patients residing in the community. For a pharmacy to be eligible for these incentive payments, they would need to meet the program requirements and the Quality Care Pharmacy Program (QCPP) accreditation requirements for providing a DAA service (see QCPP Dose Administration Aids Checklist – T3B).

For the purposes of the PPI programme the PPI Program Specific Guidelines defines a DAA as: a sealed, tamper-evident device that allows medicine doses to be organised according to the prescribed dose schedule.8 As such, there are a number of suitable packing options available commercially, however, devices that are not ‘tamper-evident’ as described by the program guidelines are not eligible for incentive claiming (e.g. compartmentalised plastic boxes or ‘dosette’ boxes). The PPI program definition states that DAAs are a Sheet of hermetically sealed blisters or medicines set out in a calendar pack which must be tamper-proof once packed.

Should a pharmacist choose to provide a non-tamper-evident DAA, the service provided must still meet the criteria in the PSA Professional Practice Standards – Standard 7: Dose Administration Aids Service.

To claim incentive payments for the DAA priority area under the PPI program, DAA’s provided must meet the following criteria:8

•• The patient’s medicine/s in the DAA

General Eligibility for Participation in the PPI Programs requires a pharmacy to:8 •• be a Section 90 Pharmacy •• be accredited by an approved Pharmacy Accreditation Program such as the QCPP •• agree to publicly display and comply with the Community Pharmacy Service Charter and Customer Service Statement •• register for one or more of the PPI priority areas via the 5CPA Registration and Claiming portal •• continue to meet the above eligibility criteria while participating in any priority areas of the PPI Programme •• deliver the PPI priority area services in accordance with the PPI Programme Specific Guidelines.

For more information about the PPIs and to register online for priority areas, please visit www.5cpa.com.au. For QCPP support please visit www.qcpp.com or contact your local state Guild branch.

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are dispensed and packed by the claiming Eligible Community Pharmacy in accordance with the quality Standard in the pharmacy; or •• The patient’s medicine/s in the DAA are dispensed by the claiming Eligible Community Pharmacy but are packed at another site (DAA packing warehouse, another pharmacy, etc.) which meets the pharmacy approval authority requirements in the relevant state or territory as well as the relevant quality Standard; and •• The DAA patient is not living in a Government funded Residential Aged Care Facility (RACF) or a correctional facility.

Further information about the eligible claiming periods and the procedures for claiming for payment can be accessed through www.5cpa.com.au

CONTINUING PROFESSIONAL DEVELOPMENT

Department of Veterans’ Affairs DAA service The Department of Veterans’ Affairs (DVA) DAA service provides veterans, war windows and other eligible DVA patients a DAA at no cost to the patient along with ongoing support and care from both their pharmacist and doctor. For a veteran to be eligible for this service, they must:9

•• hold a Gold, White or Orange card •• live in the community and not in a

“The PPI program definition states that DAAs are a Sheet of hermetically sealed blisters or medicines set out in a calendar pack which must be tamper-proof once packed.”

residential care facility

•• be likely to benefit from the DAA service.

As part of this service, GPs are able to prescribe (on authority from VAPAC) a six month prescription for one weekly DAA Service (written as an original with 25 repeats). Pharmacists are also eligible to receive a payment for a Veteran Six Month Review (VSMR) after 20 weeks of DAA use, to assess whether the service is still of benefit and identify if any further information or assistance is needed. VSMR interviews may take place either in the pharmacy or in the patient’s home.9 The DVA DAA service is separate to the practice incentive payments available under the 5CPA, so participation in this service won’t preclude patients from being eligible in PPI claims.

Pharmacy Considerations: Getting Set-up to provide DAA’s Alongside the PPI Program Specific Guidelines and the QCPP accreditation standards for DAA service provision, pharmacies should also refer to the Pharmaceutical Society of Australia’s Dose Administration Aid Service – Guidelines and Standard July 2007 and the Professional Practice Standards – Standard 7: Dose Administration Aids (available for download from www.5cpa.com.au).

Prior to establishing a DAA service, the following considerations are recommended for pharmacists providing the service to take into account:7

•• Understand the full extent of what is

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required in a DAA service, including the consumer expectations.

Determine if there are consumers for whom the provision of a DAA service would provide benefits over existing methods of supplying medications.

Estimate the number and type of consumers for who the DAA service may be provided and plan appropriately for packing facilities and requirements.

Anticipate (as far as practicable) the demand a DAA service will have on pharmacy resources and the expected number of DAA’s likely to be supplied.

Ensure that adequate time and resources are allocated for the packing of DAA’s.

Additionally, State and Territory pharmacy authority guidelines may require that a pharmacy have a designated area (or minimum space) to pack DAA’s and store patient medications in an assigned space which is free from interruption and ensure that only suitably trained personnel (under the direct supervision of a pharmacist) be able to pack the DAA.

DAA Dilemmas – Ensuring Best-Practice Protocols

Third-Party Packaging

QCPP Dose Administration Aids Checklist (T3B) is a great starting point for developing store procedures that meet the quality standard and considering the personnel, resource, space and time requirements that will be needed to run the service. Some major considerations to take into account while putting together DAA procedures should include (but are not limited to) the following:7,10

For pharmacies that feel they do not have adequate space, staff or time to package medications for a DAA service, engaging with a third-party automated dose packing provider may be a viable option. The Pharmacy Board Guidelines on Specialised Supply Arrangements state that pharmacists who use an automated dose packaging system (packing pharmacist) to pack sachets on behalf of another pharmacist (supply pharmacist) may need licencing by the therapeutic goods administration in jurisdictions that have laws to complement the Therapeutic Goods Act 1989 (cwth).10 Some considerations that should be addressed prior to engaging a thirdparty packaging provider include:7

•• an agreement between both parties (packaging and supply) describing aspects such as dispensing, packing, and compliance with relevant legislation •• the right of the consumer to privacy is understood by each party •• consent is obtained from the consumer for this arrangement.

The ultimate responsibility and liability for the integrity of the DAA process, however, will rest with the pharmacist who accepts the prescription from the consumer.7 As per the eligibility criteria for the PPI incentive payments for the DAA service, a third-party packaging service does not preclude a pharmacy for claiming the incentive payments for DAA’s provided that the other patient eligibility criteria are met.

Whilst the benefits for both patients and pharmacies in instituting a DAA service are quite evident, in order to ensure that the service runs smoothly and meets the QCPP accreditation standards, it is imperative that robust protocols and procedures are considered.

•• Hygiene: Ensure that handwashing facilities are accessible and that equipment such as gloves, tweezers and tablet counters are made available to ensure hygienic contact with packed medicines. Components of a DAA which are re-usable should be regularly cleaned and maintained.

•• Storage: Ensure that procedures and mechanisms are in place for the appropriate storage of dispensed original packs of medicines used for patient DAA’s and the storage of completed DAA’s awaiting receipt. After packing, DAA’s should be stored in a cool, dry place and protected from light •• Labelling: The label on a DAA should maximise compliance, promote usability and minimise error. It should clearly identify the name of the patient, pharmacy name/address and the name, strength and dose form of the medicines.

Best practice is to include both the active ingredient and brand name of medications, but when space is limited the active ingredient/Australian approved name should be used.10

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CONTINUING PROFESSIONAL DEVELOPMENT

“A Medication Management Review (such as a MedsCheck, Diabetes MedsCheck or Home Medicines Review) may be a valuable undertaking for eligible patients, to make a suitable determination of the patient’s suitability for a DAA.”

•• Record Keeping: Records should be maintained of each DAA packing, including the consumer’s name and date of packing, date of provision, details of the medication provided (with cross reference to prescription numbers where appropriate) and some form of identification of the pharmacist involved.

•• Staff Training: Staff involved in the packing of DAA’s should have the necessary training and practical experience.

Procedures for the service should also assist staff involved with understanding DAA requirements. Pharmacists should have an understanding of the legal and professional requirements of a DAA service whilst all dispensary staff should have a general understanding of the overall DAA service offered by the pharmacy.

For a more comprehensive list of QCPP considerations, consult QCPP Dose Administration Aids Checklist (T3B) and the PSA Dose Administration Aid Service – Guidelines and Standards July 2007.

Eternal Vigilance: Reducing Medication Packing Errors Recent media attention placed a spotlight on DAA services and dispensing errors (Medicine Mix-Up, A Current Affair; Air date – Friday 20 June 2014), describing a pharmacy error in the DAA packaging of methotrexate. The report highlighted the need for robust protocols in pharmacy to minimise packaging errors and also prompted a re-issuing of guidance from the Pharmacy Board of Australia (PBA) surrounding the dispensing of medicines with a narrow therapeutic index, such as methotrexate.

The task of filling DAA’s is repetitive, yet it requires significant and focused concentration to minimise error. The role may be delegated to suitably trained pharmacy students, interns and dispensary assistants – with the work subjected to checking by a pharmacist.10 Ensuring that the DAA packing area is tidy,

orderly and well lit, and providing freedom from interruption, are necessary for safely performing the task and minimising the risks of medication packing errors.10 Maintaining effective collaboration and communication between the GP, Pharmacist, patient and carer(s) is imperative in the delivery of a safe and efficient DAA service.7 Putting in place a system which ensures good communication between these parties may help minimise the need for re-working DAA’s and also reduce the chance of medication errors arising through a DAA service. Providing regular patient follow up is also imperative to ensure that any issues identified by the user of a DAA service can be addressed and rectified if necessary.

Problematic Pills– The Suitability of Medications for Packaging When considering commencing a patient on a DAA, it is prudent for a pharmacist to review the patient’s most current list of medications, medication history and their current medication management in order to ascertain the benefits of a patient taking part in a DAA service. A Medication Management Review (such as a MedsCheck, Diabetes MedsCheck or Home Medicines Review) may be a valuable undertaking for eligible patients, to make a suitable determination of the patient’s suitability for a DAA. Additionally, there are a number of considerations that a pharmacist may take into account in regards to the medications which are packed into a DAA. Stability of Medications in DAA’s: Because the transfer of medicines into a DAA pack is outside the individual product licence registration terms from medicine manufacturers, pharmacists must consider the drug stability impacts of medicines in a DAA.7 Typically, non-solid dosage forms would not be packable in a DAA; other commonly used medications that may not be suitable for inclusion in a DAA could include:

•• medicines that deteriorate when removed from manufacturer packaging;

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effervescent, dispersible, buccal and sublingual preparations •• hygroscopic medications which absorb moisture from the air when removed from packaging •• medicines that degrade when exposed to light or require significant protection from light •• medications taken ‘when required’ or in variable doses.

Ideally, a DAA should be used within as short a time frame as possible, as the manufacturer cannot guarantee quality and safety after removal from the original packaging. As an example, some medications such as frusemide and prochlorperazine can be light-sensitive and may discolour if removed from the original packaging and placed in packaging exposed to light for a long period of time (e.g. longer than 4 weeks).11 This does not necessarily preclude the packing of these tablets into a DAA, however, consideration needs to be given for the time frames in which the medicines will be administered. A hygroscopic tablet, however, such as chewable sodium valproate, undergoes significant changes to physical stability (weight variation and change in dissolution profile) and could pose an issue when packed in a DAA11 – in this case an alternative dose form would ideally be used.

For pharmacies utilising a heat seal system from DAA packs, consideration should also be given to the amount of heat (and time applied) when sealing packs, so as to not compromise the quality of packed medicines due to exposure to heat. Special consideration should be given to medications which may not be suitable in a heat seal system, such as softgel capsule-type medications.

Ultimately, a pharmacist engaging in a DAA service should make informed judgements as to the suitability of patient’s medications to be included into a DAA pack, adopting a ‘riskassessment’ policy and weighing the risks of poor compliance against the potential issues of medication instability.

Cytotoxic Medicines in DAA’s: If a cytotoxic medication is to be included in a DAA pack the medication should be handled in a manner which avoids skin contact and the contamination of other drugs (e.g. all equipment used in handling should be labelled and used solely for that purpose).7 Ideally, cytotoxic medications should be packed in a separate unit dose pack (and labelled appropriately), unless there is significant enough compliance concern, warranting inclusion in a multi-dose pack.

Relevant state occupational health and safety standards should be observed when cytotoxic substances are handled.

Controlled Drugs in DAA’s: The dispensing and packing of Controlled Drugs (Schedule 8

CONTINUING PROFESSIONAL DEVELOPMENT

medicines) and the storage of DAA containing Controlled Drugs must be in compliance with relevant State/Territory legislation.

The pharmacy conditions in which DAA’s containing Controlled Drugs are stored must meet relevant legislative requirements and should accommodate the packed DAA without physical damage.7

ASSESSMENT QUESTIONS

Taking the plunge: Implementing a DAA Service

What is the estimated annual cost of medicine-related hospitalisations in Australian public hospitals?

While DAA’s are a commonplace service in many community pharmacies, their benefits to our patients in effectively managing their medications cannot be underestimated! By proactively identifying the patients who will derive the most benefit from medication management services such as DAA’s, community pharmacy can continue to contribute to the betterment of patient health and the optimisation of medication taking.

So, take the plunge, offer your patients a medication management solution that is not only good for their health, but can also grow goodwill and loyalty in your pharmacy.

Give your patients the right dose, at the right time…

QUESTION 1

a. $60 million b. $660 million c. 3% of total health expenditure d. 8% of total health expenditure

QUESTION 2 a. Which one of the following types of Dose Administration Aids is NOT considered to be ‘tamper-evident’ once packed? b. Hot-Seal Blister Pack c. Disposable Blister Pack d. Dosette Box e. Plastic Sachet

QUESTION 3 a. Which one of the following patients would be eligible for payment, claiming under Dose Administration Aids priority area of the Pharmacy Practice Incentives?

REFERENCES 1 Connor, J., N. Rafter, et al.”Do fixed dose combination pills or unit-of-use packaging improve adherence? A systematic review.” Bulletin of the World Health Organisation. 2004. 82: 935-939.

2 Quality Medication Care Pty Ltd and Therapeutics Research Unit. Effectiveness and cost effectiveness of dose administration aids (DAA’s). Final Report.

2004. Brisbane, University of Queensland and Princess Alexandra Hospital.

b. A patient on a cold-seal blister pack, living in an aged care facility. c. A patient who receives a roll of sachet packs, in a correctional facility. d. A patient who lives at home (community) and is delivered a weekly dosette box that is prepared by the pharmacy (using their prescriptions on file). c. A patient who receives a roll of sachet packs, picked up from their local pharmacy, who dispenses the prescriptions but utilises a third-party packaging provider.

3 Australian Council for Safety and Quality in Healthcare. Second National Report on Patient Safety-Improving Medication Safety. July 2002

QUESTION 4

4 IMS Institute for Healthcare Informatics. Advancing the Responsible Use of Medicines: Applying Levers for Change. October 2012

b. Dose Administration Aids guarantee an improvement in compliance in all patients using more than 5 medications.

5 Elliott R. Appropriate use of Dose Administration Aids. Australian Prescriber. 2014; 37:2

c. When space on a Dose Administration Aid label is limited, it is preferable to use the active ingredient name of the medications in the pack.

6 Nunney J, Raynor DK, Knapp P, Closs SJ. How do the attitudes and beliefs of older people and healthcare professionals impact on the use of multi-compartment compliance aids?: a qualitative study using grounded theory. Drugs Aging 2011;28:403-14.

d. Dispensary technicians and Intern Pharmacists can be delegated to check Dose Administration Aids, provided they have undertaken appropriate training.

a. Which of the following statements about Dose Administration Aids is CORRECT?

e. Patients who hold an orange, white or gold repatriation card are not eligible to be included in claiming for Dose Administration Aid PPI payments.

7 Pharmaceutical Society of Australia – Dose Administration Aid Service, Guidelines for Pharmacists July 2007

QUESTION 5

8 Program Specific Guidelines – Pharmacy Practice Incentives – February 2014

a. Which one of the following tablet properties makes chewable sodium valproate physically unstable in a Dose Administration Aid?

9 Dose Administration Aid Service – the right dose: Pharmacist information booklet. Accessed from www.dva.gov.au (20/8/2014)

b. Tablet discoloration when exposed to light

10 Pharmacy Board of Australia. Guidelines on Specialised Supply Arrangements. 2012

d. Tablet degradation when exposed to heat e. Tablet degradation when exposed to moisture in air

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

11 Haywood A, Llewelyn V, Robertson S, Mylrea M, Glass BD. Dose Administration Aids: Pharmacists’ Role in Improving Patient Care. AMJ 2011, 4, 4, 186192 http//dx.doi.org/10.4066/AMJ.2011.693

c. Tablet degradation when exposed to light

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GUILDCARE

Pharmacy Software Solutions

BY ROMA CECERE General Manager – Strategic Business Performance, GuildCare

It is apparent that most community pharmacies in Australia are feeling the financial effects of the PBS reforms. Aligning with one of GuildLink’s core strategies, enhancing sustainability of pharmacy, GuildLink provides pharmacy with business tools and software solutions designed to optimise their front of shop and professional services by identifying opportunities with real-time insights.

GuildCare programs is a purpose-built software solution assisting Australian community pharmacies in identifying, recording, and reporting of professional services. GuildCare was originally designed to support pharmacies in meeting the requirements of the 5th Community Pharmacy Agreement (5CPA) Pharmacy Practice Incentive and Medication Management Programs. GuildCare has expanded its offering profoundly since its humble beginnings in July 2011, with many new programs developed since launch. During this time, GuildCare pharmacies have accumulated over 6 million recorded pharmacy-led interactions through the software.

Through GuildCare, pharmacists can identify patients who may be eligible for a professional service, whether it is a 5CPA program such as MedsChecks, or a patient adherence program which is designed to

address patient compliance issues. GuildCare works with the pharmacy’s dispensing software and triggers a prompt at dispense for patients that may meet the program criteria. This feature ensures busy pharmacists are spending less time analysing a patient’s potential fit and focusing on delivering the service.

Program Streams 5CPA Pharmacy Practice Incentives – Programs designed to unlock funding under the 5CPA. GuildCare programs cover five out of the six categories offered by 5CPA PPIs:

•• Clinical Interventions – also available •• •• •• ••

on iPad Dose Administration Aids Patient Detect Staged Supply Inter-Professional Collaboration MedScreens (Primary Health Care)

“GuildSmart allows managers to set profit generating goals for their pharmacy, track progress in real-time and maximise the pharmacy’s’ profitability by utilising opportunities as they happen.”

5CPA Medication Management which covers MedsChecks/Diabetes MedsChecks (also available on iPad) and Home Medication Reviews.

GuildLink’s technology is aligned with the future needs of pharmacy, including development of new 6CPA programs that may require technology for recording the service.

As always we will enhance the GuildCare platform to accommodate any new initiatives that arise.

Patient Services are also a perfect way to gain patient loyalty to your pharmacy.

GuildCare offers pharmacies an easier way of recording patient services which they have been delivering for many years such as blood pressure, lipid and blood glucose monitoring, baby weight recording, and vaccinations.

Patient Adherence Programs are tailored to the needs of the molecule to ensure that patients are provided specific information about their medication/condition that will help to improve their knowledge and adherence to treatment. Our figures show that when a patient has been enrolled in one of GuildCare’s adherence programs, their adherence increases by 1.5 to 2 additional scripts per year. Most of these programs are sponsored which means the pharmacy will be reimbursed for the additional time spent on counselling the patient.

Admin Module is a new section available in GuildCare. Patient Plan is designed to help

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GUILDCARE

pharmacists raise awareness of the various pharmacy services on offer and to provide the patient with a more holistic, patient-centric model of care by suggesting services that cater to the patients’ needs. Leave Certificate allows pharmacists to provide the patient a certificate and record the request.

GuildLink is also pleased to announce the establishment of a direct electronic web services link for pharmacists to submit Adverse Events to the Therapeutic Goods Administration (TGA) through GuildCare, eliminating the need to fax.

Other Products MemoCare + MedAdvisor MemoCare joins forces with MedAdvisor to bring a complete patient communication system to pharmacy.

MemoCare + MedAdvisor are available through additional tabs within the GuildCare suite with real-time integration with dispense software which reduces data entry errors and saves time.

This communication platform builds loyalty and adherence beyond your pharmacy with different types of communication options – SMS/Voice/Email/Fax (perfect for healthcare communications), Smartphone application (MedAdvisor).

GuildSmart GuildSmart offers a bespoke solution to maximise front of shop by showcasing a pharmacy’s potential at the click of a button. The software works with pharmacies’ point of sale and GuildCare software to analyse available opportunities such as OTC generic conversion, companion products and GuildCare professional services.

GuildSmart allows managers to set profit generating goals for their pharmacy, track progress in real-time and maximise pharmacy’s profitability by utilising opportunities as they happen. The software also recognises dead stock items from dispensary and front of shop, along with items that are marked incorrect GST.

If you would like to know more information about these services please contact GuildLink at support@guildcare.com.au or visit www.guildlink.com.au.

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BUSINESS PROFILE

“You’d be hard pushed to find another company in pharmacy-land as committed to the pharmacy channel as us!”

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

In this edition of ITK, we had the pleasure to speak with Peter Rogers, Managing Director of Weight Loss for Tony Ferguson. We invited Peter to share a little more about the company and its relaunch into pharmacy along with a number of strategies for the year ahead.

Editor: Tony Ferguson is a leading weight loss program sold through Terry White Chemists and other leading Independent pharmacies Australia-wide.

Can you provide a little background into the company; how the program first began and importantly, where it is progressing in the Pharmacy profession?

Peter: Tony Ferguson launched eight years ago and it became a massive business very quickly. Tony Ferguson helped to establish weight as a core pharmacy service because it was ideally suited to demand for a convenient, supported weight loss solution.

However, rapid growth saw the company become distracted by opportunities outside the Australian pharmacy market and that contributed to its decline. It has always been a great brand but the program and products had become pretty outdated.

The company was bought in December 2013 by a JV, owned by Symbion, and Terry White Chemists – both of whom have a deep commitment to health care – and we have been working on redeveloping the program since then. The new Tony Ferguson weight loss program is one for the now, and for the future.

It is designed to realign weight with a safe and sustainable approach to healthy eating.

Editor: Can you tell us a little bit about your established and privileged partnership with the pharmacy industry in Australia?

Peter: Pharmacy has been a loyal supporter of Tony Ferguson, and Tony Ferguson has been a loyal supporter of pharmacy. We value that relationship greatly. Tony Ferguson is aligned to health and sits well within the pharmacy setting.

You’ll never see Tony Ferguson in a supermarket.

Our new ownership structure sees Symbion and Terry White Chemists driving the brand – both parties are committed to health, to pharmacy, and to the resurrection and growth of Tony Ferguson. You’d be hard pushed to find another company in pharmacyland as committed to the pharmacy channel as us! We have clinics installed in almost all of Terry White Chemists, 175 pharmacies, and in 140 community pharmacies outside that group.

We are working towards having more installations – there’s plenty of space in Australia to put in hundreds more clinics.

But we are quite selective when it comes to additional locations for a couple of reasons: the operation does require a total commitment to consulting, so it’s not the sort of program that suits all pharmacies and, importantly, we don’t want to cannibalise the catchment of existing successful clinics.

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Changes to the pharmacy landscape mean the timing has never been better for a resurrection of the Tony Ferguson brand. It is a front-ofstore category, capable of extraordinarily high volumes (the average store used to do sales of over $900,000 p.a. in Tony Ferguson), high margins, and a foundation in consultancy based health services. All those things contribute to the new Program being a fairly promising proposition.

Editor: At the beginning of September you launched a totally NEW Tony Ferguson Weight Loss program.

Can you outline a little more about this new program and how it is different to the previous Tony Ferguson program?

Peter: We have kept the brand, but pretty much replaced the program.

In 2013, the Federal Government released ‘Eat for Health’, the Australian Dietary Guidelines, providing scientific evidence for healthier Australian diets and setting out the guidelines for the type and quantity of food we should be eating. The new Tony Ferguson program is designed around these guidelines.

The new program is a re-education process for clients, helping them to not just understand food groups and portion control, but how to apply that understanding to their lives.

BUSINESS PROFILE

Long-term success needs to take account of eating out, family circumstances, individual health and pre-existing conditions, together with exercise.

We’ve incorporated meal replacements – as the latest evidence shows meal replacements are still the most effective means to losing weight. But where meal replacements are incorporated we have done so in the context of the daily contribution they make to the new food groups.

The program is presented in a folder, with each topic building week by week and regular in-pharmacy visits. We’ve also rebuilt the product range. A new range of meal replacement bars, lots of new snack foods and side dishes and reconfigured shakes – no fructose, less sugar, more protein, more micronutrients.

Editor: With an apparent ever increasing choice of weight loss and weight management programs on the market, what is the Tony Ferguson point of difference?

Editor: What are Tony Ferguson’s goals and objectives for the remainder of 2014 and beyond, particularly as we enter one of the key weight loss periods for consumers? How do you hope to achieve these?

The next few months are about relaunching the brand. We have saturation levels of TV advertising coming up over the spring launch period and we intend to be very focused on providing outstanding operational support to our pharmacy members and weight loss clients during this period.

But there’s lots more to come, so stay tuned.

It’s an iconic Australian brand that can deliver great things, exclusive to the pharmacy channel!

Peter: It’s convenient in-pharmacy location, combined with our commitment to our members’ health and long-term success is Tony Ferguson’s point of difference.

The evidence consistently shows successful weight loss is all about support, and the pharmacy channel is just so perfectly suited to Tony Ferguson as a consultancy-based, supported weight loss program. Pharmacy has an expert understanding of weight loss as a positive health outcome and is able to offer additional meaningful support based on an individual’s medication regime and pre-existing conditions. Another major point of difference for Tony Ferguson is its longevity and proven success. The weight loss market is swamped with gimmicks and false hope but Tony Ferguson offers a genuine, long-term, weight loss solution.

“It’s convenient in-pharmacy location, combined with our commitment to our members’ health and long-term success is Tony Ferguson’s point of difference.”

As well as a great program and great products, we have a defined practitioner range that can only be sold through consultation. They can’t be bought in any other way, even by members, and this contributes both to the integrity of the brand, and also to the level of support we offer.

At the end of the day success at weight loss is what will drive success for the pharmacies and we have a program which will be very successful at helping people lose weight.

Julie-Ann Wharley – Tel: 0410 417 135

www.tonyferguson.com

E-mail: julie-ann.wharley@tonyferguson.com

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case study

case study: Sunny Park Discount Drug Store

A purposeful and deliberate pathway to

Improving Professional Services

“We have deliberately chosen to proceed down the path of using MPS for all our community packing as we wanted to consider ways we could measurably increase efficiencies in-store.”

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

Sunny Park Discount Drug Store is a community pharmacy that prides itself on its professional service offering. Robyn Craig and the entire team always strive to expand on their pharmacy professional services for the future while working to balance and improve on their current provisions.

In June, they won the National Professional Services Pharmacy of the Year at the Discount Drug Store pharmacy conference, which is a tremendous accolade.

The manager of the pharmacy, Robyn Craig, recently explained, “We have deliberately chosen to proceed down the path of using MPS for all our community packing as we wanted to consider ways we could measurably increase efficiencies in-store. The primary objective was to allow our pharmacists more time to step from behind the dispensary to talk with customers, providing and offering more services, rather than being tangled up in unproductive and time-consuming activities.”

“Sunny Park DDS wanted to increase this area of the business as we understood there were potential customers that would benefit from a DAA. Therefore, to make this service available to more customers, but not increase staffing or pharmacy space (which is always a challenge), we decided to look at outsourcing with MPS,” Robyn further outlined.

The results following the outsourcing of this function to MPS saw an increase of DAAs completed, rise from 62 to 112 in the space of 3 short months. Importantly, they also saw a reduction in administration time and, without having to physically pack in-store, it has reflected in a significant staff saving – the equivalent of 0.58 FTE in time.

Robyn proudly commented, “This has been a great result for a number of reasons – it means we have been able to allocate the saving in staff time to other key areas of the pharmacy. Our pharmacists have been able to spend more time with customers providing additional services, such as Medscheck, asthma inhaler technique training and cardiovascular health assessments”.

“Additionally, spending more time talking to customers about the benefit of DAAs has helped us to increase these DAA numbers measurably,” Robyn elaborated.

As a direct result of taking on MPS packing, their community DAAs now work more

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efficiently and, as a result, have increased the number of DAAs. As outlined, this has been done without increasing overhead costs or the space required and, importantly, they have been able to help more customers achieve better compliance with their medications, which ultimately helps improve their health.

It is also important that pharmacy profitability and viability is maintained, and this has certainly been achieved and echoed by Robyn.

The introduction of MPS has also allowed the pharmacist more time to focus on the in-store specific health clinics that are conducted multiple times a year. Sunny Park DDS has been most successful in embracing these clinics and working with the local community to help educate and/or vaccinate.

This year, they have held a Flu Vaccination Clinic that recorded over 70 attendees. This was coupled with a Hearing Clinic, a Preparing for Pregnancy Clinic, a Men’s Health Clinic and, lastly, Sunny Park will host a Bone Density Clinic in September — exciting times ahead.

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DOWN TO BUSINESS

Building Efficiencies and Services – part of the new Game Plan Peter Saccasan FACP FCA CTA Director of Pharmacy Services, RSM Bird Cameron Chartered Accountants

With pharmacy profits moving around, owners should be taking steps to tweak many areas of their business to rebuild profits. The usual game plan of just doing more scripts won’t be enough. Looking across the various areas of the business, owners should have on their radar areas of efficiency as well as income from other sources.

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DOWN TO BUSINESS Time and space is money An adaptation of an old adage that can be very applicable in business. And in the pharmacy business, what is probably most of the time spent doing? Preparing for and attending to the dispensing of scripts. If a pharmacy dispenses 70,000 scripts a year and in the whole process of ordering goods, receiving them, packing them, logging them into stock, dispensing them and talking to the customer they can save 1 minute per prescription, this is a saving of 70,000 minutes, or 1,167 hours, or 31 weeks of labour.

Alternatively, instead of “cutting the labour”, what if the time available was spent actually talking to customers.

One of my key quotes from APP 2014 was from the presentation given by Glen Guilfoyle who has made a habit of studying the dispensing transaction and what it yields.

One of his findings was that by increasing the time spent with customers in the dispensing process by less than a minute you might increase the average sale by more than $7.

So if we take say $5 and 70,000 minutes, that’s a lot of potential sales. And most likely at strong margins on add-on health products.

What if, in driving to efficiency in the dispensary, you could also return 8m2 of space back to retail. And from that retail space you could generate say just $8,000 per square meter (well below the averages) of retail sales? This translates to $64,000 in sales and probably $20,000 in gross profit.

I’m talking obviously of automating the dispensary and installing a dispensing robot.

The first inclination is to look at the cost of acquisition and ongoing maintenance costs and then to think – what costs can I cut to cover this? But as I have outlined above, there is much upside to be gained in other areas and, for example, to cut labour would not enable other opportunities to be taken up.

Strengthening Revenue Streams The traditional streams of dispensary and retail will by no means disappear. Certainly, though, owners need to ensure they are maximising performance. There has been much press lately about the role of the pharmacist in the primary care space. If this is a position of

“By increasing the time spent with customers in the dispensing process by less than a minute you might increase the average sale by more than $7.”

strength for pharmacists, then more needs to be done in the pharmacy to demonstrate this and bring professional services to customers.

The problem generally is lack of focus as well as lack of clarity of what is on offer.

Are pharmacy owners focused on who is visiting the pharmacy and what kinds of ailments they bring with them? Can you identify a stream of customers who are coming to your pharmacy and who have a common need? What is the offer in your pharmacy that meets those needs and are you maximising the return to you from their visit? I am talking here of ensuring that you have the right stock and right services on offer to meet an identified illness or need.

Too often the stock weight in particular health areas is too modest. In order to rise above the “location” driver, a pharmacy needs to become known for something so that you are top of mind for your customers. Do you have consulting rooms available that will enable you to provide personalised treatment of wounds or sleep apnoea, or provide consulting services around weight loss?

Do you have stock weight in the categories that support these consulting services?

Back to basics Too often in the search for that magic solution we can overlook the basics. Pharmacists are educated in pharmacology and medicines and we common folk often need things spelt out and kept simple. To that end, owners should look at how well they are promoting services such as DAA’s to the community. It is often the simple things that can make life easier and DAA’s can ease a lot of angst for the patient and their out-of-home relatives.

Offering to hold prescriptions is not something new but I have seen an enterprising pharmacist who has the script filing cabinet

on display behind a glass wall under a sign where customers can see the number of files and be prompted to consider keeping their own scripts there. This is instead of keeping them out the back, hidden in a draw and no-one knows you are offering the service.

It’s one of those things you see, and think “now there’s a good idea”.

Targeting top prescription customers for a Medscheck should be Customer Management 101. There is no point in patients going to all the trouble of seeing a doctor and then not taking the medicine in the prescribed manner. And yet this is what many patients do. Improving adherence not only achieves a better health outcome for the patient but also ensures that all scripts that are prescribed are in fact fulfilled.

Having a rounded approach Other services have been available through the Pharmacy Practice Incentives and owners should ensure they maximise these revenue opportunities. No doubt the 6th Agreement will bring a new stream of possible services.

Moving to efficiencies such as automation is part of the solution to improving pharmacy profitability but the cost-cutting road does not run on forever. Growing revenue has to be part of the solution to a sustainable business.

Owners should ensure they have a pharmacy premises that is capable of delivering services meaningfully and ensure that they put processes in place that will maximise the customer visit to the pharmacy. Having the customer walk into the store is generally the hard part, yet the evidence is that in many cases little attention is given to the easy part – providing additional services and products that enhance their experience and improve their health outcomes.

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Professional review

“The aim of this program was to reduce medication-related hospitalisations and adverse events through improved medication management and adherence by people in the community.”

Dose Administration Aids Evidence and Guidelines for their use

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

What are dose administration aids?

Dose administration aids can range from the very simple to sophisticated.

•• Compartmentalised plastic boxes (e.g. Dosette) These devices have one, two or four compartments for each day of the week and are usually filled by the patient or the patient’s carer from original prescription medications.

•• Blister or bubble packs (e.g. WebsterPak) These are plastic or cardboard packs which have four compartments for each day of the week. They are mostly filled

manually by pharmacies for patients but can be filled by automated dispensing machines. For nursing homes where medication is given by nursing staff, the pack can be further identified with a patient photo.

•• Sachet packs (e.g. MPS sachet) Sachet packs have individual tablets or capsules packed as single doses in a sachet labelled with a particular time and date, and the patient details.

The sachets are rolled and provided in chronological order. The sachets are packed by automated dispensing

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machines. These machines are expensive and many pharmacies outsource their sachet packaging.

•• Automated dispensing devices (e.g. TabTime) These devices dispense a particular dose after the patient has responded to an alert for a particular time.

The device can either be manually filled or provided with sachet filling. The device can also be linked to a capability whereby an email or phone alert is sent to a carer if the device detects that the patient has not responded to the alarm and taken the medication.

Professional review

Adherence rates Low adherence to prescribed medication can be particularly problematic in chronic conditions.1 Reported rates of adherence vary from 4.6% to 100% of patients of all age classes with different medical conditions and on long or short term treatments.2 Not surprisingly, mean adherence rates are very different for specific diseases – 88.3% for HIV infection, 76.6% for cardiovascular disease, 67.5% for diabetes mellitus and 58% for psychosis patients.2 Adherence depends on patients’ capability (physical, cognitive and economic) and willingness to initiate and execute their treatment plan.3 Thus, the introduction of dose administration aids, which try to improve adherence difficulties, seems to be an appropriate solution to solving adherence problems.

Implications of poor adherence The implications of poor adherence are substantial at both the individual and population levels. For the patient, the benefits of treatment are reduced, leading to under treatment of their condition and difficulties for the prescriber in assessing efficacy and appropriate dosage. At the population level, non-adherence results in medication wastage, increases in health-care costs, and drug resistance in the case of incompletely treated infectious conditions.

Evidence for use of dose administration aids (DAA’s) Adherence should theoretically lead to improved clinical, as well as economic, outcomes. In a study across five European countries, increasing the percentage of patients adhering to antihypertensive treatment to 70% was estimated to lead to a reduction of cardiovascular related healthcare costs by AUD461 million.4 Interestingly, there have been few well-designed controlled trials evaluating the impact of dosing aids on medication adherence and clinical outcomes. A meta-analysis of both adherence and clinical outcomes found that while adherence improved with DAA’s, this was not always followed by an improvement in clinical outcomes.5 Of seven out of 13 studies (53%) which reported a statistically significant improvement in adherence to medication, only four of these studies examined if there were improvements in clinical outcomes.

One found an improvement in tuberculosis measures, two studies recorded significant improvements in diastolic (but not systolic) blood pressure, while one study in patients with diabetes showed a reduction in both diastolic blood pressure and HbA1c. In trials of patients with chronic mental illness,

there was no improvement in clinical outcomes despite improved adherence. Furthermore, in well patients taking vitamin C and vitamin E supplements, there was also no improvement in clinical outcomes. Disappointingly, however, these trials were often too small or had inadequate follow-up time, and were therefore likely to miss small to moderatesized effects which may have had clinical significance. Trials of this size were only able to detect very large improvements in adherence and therefore unable to identify smaller reductions which may be worthwhile from a clinical and public health viewpoint.

Who should be using DAA’s?

The most significant reasons for nonadherence to medication is an increasing complexity of the medication regimen and the appearance of unwanted side effects.6 Not all patients are suitable for dose selfadministered aids. While it is known that the more complex the drug regimen the more likely the patient is to be non-adherent with their medications, not everyone will benefit from having their drugs packed into dose administration aids.6 Those patients who have cognition problems (such as dementia) and do not have a carer overseeing their medication may not be able to selfmedicate appropriately.7 Physical frailty such as poor eyesight, lack of dexterity due to age or medical conditions such as arthritis and Parkinson’s disease may also hinder self-medication.7 The patient must also be motivated to want to take their medication and be counselled regarding the complexity of the dose medication aid apparatus itself.7 Australian guidelines for dose administration aids states that prescribed medicine should always be supplied in the original containers unless a compelling reason exists to supply a dose administration aid.8 A simple tool to assess whether a patient would have improved adherence with a medication aid is in the table below.

How stable are drugs once packed in dose administration aids?

Very few studies have examined the stability of medications once they have been removed from their original packaging and repacked into a dose administration aid. Drugs that have been investigated include atenolol, paracetamol, frusemide, prochlorperazine, sodium valproate, aspirin and clozapine.11 Removal of a drug from its original packaging invalidates the stability guarantee of the manufacturer. An Australian study examined the stability of common drugs repacked for use into dose administration aids and made the following recommendations:11

•• Select an appropriate brand of DAA for repackaging medicines that affords appropriate protection against air and moisture.

•• Protect the DAA containing drugs susceptible to photo degradation from light in the pharmacy and in patients’ homes, achieved by either storing the DAA protected from light and/or placing the DAA into a light-protecting sleeve (e.g. foil, cardboard).

•• Carefully remove tablets to prevent accidental rupture of adjacent blisters, thus exposing tablets to air and moisture.

•• Monitor the integrity of the DAA during repackaging, dispensing and throughout the in-use period.

•• Consider an appropriate location to store the DAA to avoid unnecessary exposure to light, heat, humidity and away from children if the device is not child-resistant.

•• Counsel patients on correct use and appropriate storage locations for their DAA.

•• Follow appropriate professional

Question

practice guidelines.

Question score

1 Do you ever forget to take your medicines?

Yes(0)/No(1)

2 Are you always careful about taking your medicines?

Yes(1)/No(0)

3 When you feel better do you sometimes stop taking your medicines?

Yes(0)/No(1)

4 Sometimes, if you feel worse when you take your medicine, do you stop taking them?

Yes(0)/No(1)

Total score of 0

Patient score

Adequate adherence

Total score of 1 – 4 Inadequate adherence (partial adherence or non-adherence) Consumers who score ‘2’ from the first two questions may benefit from a DAA more than consumers who score less than ‘2’ from these two questions.

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Professional review

Despite stability concerns, certain drugs should not be repackaged into dose administration aids unless there are compelling reasons. These include liquids, sublingual tablets (e.g. glyceryl trinitrate), cytotoxics, effervescent tablets (e.g. soluble aspirin), wafer presentations (e.g. olanzapine), hygroscopic tablets (e.g. sodium valproate), chewable tablets (e.g. Vitamin C).8,11

The Australian scene In Australia in 2006 a community based DAA program was considered by the Australian Government Department of Health and Ageing PPSAC (Professional Programs and Services Advisory Committee), with the first phase of this program implemented in October 2007. The program was established under the Better Community Health Initiative of the 4th Community Pharmacy Agreement between the Pharmacy Guild of Australia and the Commonwealth Government.

The aim of this program was to reduce medication-related hospitalisations and adverse events through improved medication management and adherence by people in the community. Guidelines were developed by the Pharmaceutical Society of Australia and the Australian Pharmaceutical Advisory Council to appropriately provide a safe and efficient service to patients using DAA’s.8,9 A statement issued by the Australian Government’s Department of Health for the information of consumers states that their continuing support for the scheme to provide DAA’s to patients will be a priority for the government in the 5th Guild Government agreement.12

“The aim of this program was to reduce medication-related hospitalisations and adverse events through improved medication management and adherence by people in the community.”

SELF-ASSESSMENT QUESTIONS QUESTION 1 Which of the following statements is TRUE a. Clinical outcomes always improve once adherence rates improve b. All patients with non-adherence issues would benefit by the introduction of a dose administration aid c. Adherence rates to medication regimens vary depending on the medical condition d. Patients with cognitive problems would benefit with of a dose administration aid

QUESTION 2 Which of the following patients would benefit most from the introduction of a dose administration aid which they supervise themselves: a. A 75 year old male with early onset Parkinson’s disease and who is on 3 different medications b. A 75 year old female with cardiac failure, diabetes and hypertension who is on 7 different medications c. A 40 year old male with type 1 diabetes who uses four different insulins d. A 75 year old male with late stage dementia who is on 7 different medications

QUESTION 3 Which of the following medications would not be suitable for re-packaging into a dose administration device: a. Atenolol b. Paracetamol c. Diazepam d. Finasteride

QUESTION 4 The daughter of one of the pharmacy’s patients comes in to query her 80 year old mother’s potential to have her medication re-packaged into a dose administration aid that she will selfmedicate. She is on four antihypertensive medications but her daughter says she often finds some of medications unopened. Her mother dislikes being ill and resents having to take her medication. Your advice would be: a. Patients who are intentionally non-adherent are not good candidates for a dose administration aid b. She would benefit from a simple Dosette-type dose administration aid c. She would benefit from a dose administration aid that would alert her via an alarm to take her medication d. The daughter should start overseeing her mother’s medication

QUESTION 5 Which of the following results in the most non-adherence to medication: a. Addition of antihypertensive drugs to a medication regimen

Further reading • Elliott RA. Appropriate use of medication aids. Australian Prescriber 2014;37(2):46-50.

Available at (cited 27 August 2014): http://www. australianprescriber.com/magazine/37/2/46/50 • Pharmaceutical Society of Australia. Dose administration aids service. Available at (cited 27 August 2014): http://www.psa.org.au/download/ community-pharmacy-agreements/doseadministration-aids/DAA_Appendix2-1.doc

b. Increasing age c. *Increased complexity of the drug regimen d. Increased seriousness of the medical condition suffered by the patient

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

26

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down to business

While as pharmacists our unique and specific role is to provide medication advice and primary health care, as a pharmacist that drives engagement, a new approach is also necessary.

Patient Engagement – Could It Be The Block Buster Drug Of The 21st Century?

BY vanessa lontos Director – The Care Project

Recently I read an article called “The Blockbuster Drug of the Century: An Engaged Patient”.

The article, written in August 2012 by Leonard Kish1 very quickly caught my eye and very profoundly opened my mind. In the article the author makes the statement “…it’s surprising that it has taken us this long to focus on patient engagement because the results we have thus far are nothing short of astounding. If patient engagement were a drug, it would be the blockbuster drug of the century and malpractice not to use it.” Confronting? Possibly.

I see a very unique opportunity – the triple whammy for building sustainable pharmacies of the future. A blockbuster drug that provides better patient outcomes, improves professional satisfaction and a pharmacy business built on providing total health solutions.

In the article the author makes a very interesting comparison between the well-known blockbuster drug Lipitor and its effectiveness at preventing heart attack, and the less known, but equally compelling, studies that explore patient engagement, such as coordinated cardiac care and the prevention of heart attack. He makes the claim that “the strange discrepancy we see between lowering cholesterol and fewer heart attacks may lie somewhere in patient engagement and behavior change”.2 As pharmacy continues to navigate the new world of an ageing population, increased external pressures and the emerging mega trends of wellness and alternative lifestyle medicine, a new type of pharmacist is beginning to emerge – a healthcare partner who is knowledgeable, trustworthy, accessible and now can drive engagement.

So what to do?

Like most things in life and in business, overcoming periods of doubt and uncertainty lies in your ability to know what to do and when to do it. The Sigmoid Curve provides a perfect illustration of cycles that businesses, and indeed individuals, go through, and more importantly how to grow through them.

Pharmacy Success Health Partner Fear Confusion Doubt Uncertainty

• knowledgeable • trustworthy • accessible • drives engagement

Health Provider • knowledgeable • trustworthy • accessible

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

Time

The curve initially declines through periods of experimentation and learning, then rises in periods of growth and prosperity and finally declines leading to the end.3 The key to sustaining a healthy business is to start a new curve before the current one is too far in decline. It’s suggested that the key to driving successful transformation is to begin when the initial curve is still on the rise, since resources, energy and confidence are high.4 In pharmacy today the key transformation lies in pharmacists making individual commitments and focused actions to shift from simply being a health provider to building themselves as health partners.

Although transformation is much harder when it is attempted during the peak time as this is where complacency and burnout can also begin to impact, and many could argue that pharmacy businesses and staff are deep within the ‘burnout and resource depletion’ zone, there is one resource that we are still to apply – our ability to drive patient engagement.

down to business

What is patient engagement?

Patient engagement has been defined as a person’s sustained participation in managing their health in a way that creates the necessary self-efficacy to achieve physical, mental and social wellbeing.5 In pharmacy it could be further defined as an active process bringing the patient, their family and the pharmacist together as partners to help improve patient outcomes.

This is specifically achieved by creating a positive experience for the customer through:

•• satisfying their immediate needs •• exploring and educating them for a deeper understanding of their situation, health concerns, challenges and goals •• building and growing relationships.

While as pharmacists our unique and specific role is to provide medication advice and primary health care, as a pharmacist that drives engagement, a new approach is also necessary. A switch from the question and answer linear approach where everyone gets a similar experience, to more of a dance where the individual patient circumstances are explored and they feel delighted to be part of the discovery of the right health solutions for their needs.

Finally, the digital boom has given rise to information parity, combine this with the emergence of the smart phone, and people are now accessing side-effects and interactions of all medications while they are waiting for you to dispense their script!

While this convenience and accessibility is appealing, it also gives rise to confusion.

An accessible, trustworthy pharmacist, who provides relevant, evidence-based advice AND encourages you to be engaged in your health outcomes, suddenly stands out among the crowd and the confusion.

3 simple ways to engage more effectively:

1 2

Often when we don’t do something it’s usually due to either not knowing how or simply not wanting to do it. At the core of these actions there is usually a degree of burnout, boredom or a lack of self-belief. Understanding who you are, what you love about your work, and identifying any triggers that are preventing you from embracing engagement are keys to your success.

Preparation – learn as much about health as you can Develop a hunger for learning and personal growth in the following areas: a) Relevant, up-to-date clinical knowledge, complimentary and alternative lifestyle medicine and self-care principles – your knowledge is your greatest lever. b) Interpersonal skills – such as communication, building partnerships, collaboration and even leadership. The key strategies here are in expanding your ability to ask effective questions that encourage the patient to open up. An ability to share insights and explore your patients in a way that empowers them to be engaged in their health on an ongoing basis, is critical.

Will you embrace the next blockbuster drug? Can you afford not to?

References 1 Leonard Kish is the Principal and Co-Founder at VivaPhi, an agency that solves multi-disciplinary business problems involving data science, software, biomedical science, behavioural science, health care, product design, community development, marketing, consumer engagement and organisational design. He has been quoted in Forbes and other top-tier publications for thought leadership on patient and consumer engagement.

2 Viewed at: http://www.hl7standards.com/ blog/2012/08/28/ 3 Viewed at: www.forbes.com/The Key to Growth – transformational change 4 Viewed at: www.forbes.com/The Key to Growth – transformational change 5 Viewed at www.betterpatientengagement.com

by Ian Wordan

Performance – be the best you can be

3

Patient Experience – delight your customers every time Like all great partnerships, it’s important to remain focused and committed on achieving the desired outcome. In pharmacy we often see ourselves as in the business of selling prescriptions, therefore building patient experiences where collecting prescriptions in a timely (and low cost!) manner is too often the desired outcome we focus on.

It is my suggestion that it’s more accurate to see ourselves as in the business of selling health and wellbeing, medication management, chronic disease prevention and even self-care. Therefore, creating consistent experiences for our patients, where their unique health outcomes are the focus, is integral to driving patient engagement.

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training and education

The Totally New Tony Ferguson Weight Loss Program

Weight Loss for Life Tony Ferguson is one of Australia’s leading weight loss brands that has helped nearly 1 million people lose weight and lead healthier lives. Developed by pharmacist, Tony Ferguson, the Tony Ferguson Program incorporated meal replacements and customer support to help people lose weight. Now after nearly 10 years, the Tony Ferguson program has had a major review and restructure of its company, team and program.

Tony Ferguson believe weight loss programs should be based on current evidence, so have developed a new program influenced by the latest weight loss thinking1 and Australian Dietary Guidelines2. This is to ensure its members are receiving the best possible advice and support on their weight loss journey.

The Obesity Epidemic is Getting Worse Over 60% of Australian adults are overweight or obese and this number is steadily rising. Tony Ferguson satisfies the need for a supportive weight loss program that aims for slow, steady weight loss that is realistic and transitions into successful long-term weight management.

What is the new Tony Ferguson Program?

The new program is a structured, support based weight loss program that is influenced by the Australian guidelines for nutrition and weight management set by the Australian Government. The program supports and educates its members through:

•• Weekly consultations with trained consultants

•• Education on the five food groups and •• •• •• ••

portion control Addressing hunger Personalised meal plans New, improved meal replacements and an expanded food range A private and easily accessible environment in a pharmacy based Tony Ferguson Weight Loss Clinic

What makes the Tony Ferguson Program different?

Is Tony Ferguson Suitable for Everyone?

Quick fix, off-the-shelf weight loss programs don’t work. At Tony Ferguson, we believe it is important to provide credible, evidence based information, encouragement and support to our members to assist in successful, healthy, sustainable weight loss.

The new Tony Ferguson Program is for anyone over the age of 18 looking to lose weight and keep it off for life. The program is suitable for both men and women who are generally healthy (anyone with a specific medical condition should discuss their situation with a Tony Ferguson consultant to see if the program is right for them). Women who are currently pregnant or breastfeeding are not suitable to join the program.

The new Tony Ferguson Program is delivered over a series of compulsory consultations to ensure members have the time to learn and understand the key principles of successful weight loss and make small but realistic adjustments to their lifestyle. The first 5 weeks on the program set the foundation of knowledge needed, and covers important topics such as:

•• •• •• •• •• ••

Gauging and addressing hunger Making healthy meals Involving the household Healthy supermarket shopping Eating out and socialising Exercise

After 5 weeks, members have access to a large range of further topics as part of their personalised program.

We differ from many off-the-shelf weight loss products as we understand most people find weight loss hard, and everyone’s weight loss journey is different. So it’s critical that our members feel supported and their consultant understands any challenges and how to overcome them. The program also acknowledges that there are many benefits of changing to a healthier lifestyle – weight loss being just one of them.

(Endnotes) 1 Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia (2013) (NHMRC) 2 Australian Dietary Guidelines 2013 (NHMRC) GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

It doesn’t matter if a member has a lot of weight to lose, or a little. The program is suitable for individuals looking for a supportive program.

What is the Role of Tony Ferguson Consultants?

The Tony Ferguson Program is a pharmacy-only weight loss program which is delivered by trained Tony Ferguson Consultants. The best Tony Ferguson consultants are typically highly valued pharmacy staff who are passionate about health and helping others. Consultants receive detailed training from Tony Ferguson which provides them with additional skills to help, coach and support members to achieve their weight loss goals.

To reflect, Tony Ferguson’s status is a ‘consultation-only’ program, as many of the new Tony Ferguson products are only available via appointment with a trained consultant.

You can find more information on the new Tony Ferguson Program at www.tonyferguson.com. If you would like to discuss having a Tony Ferguson Weight Loss Clinic in your pharmacy, contact one of our State Managers by calling 1800 612 644.

Red Eye Relief

Murine速 Clear Eyes. Clears away the redness and brightens eyes for up to 8 hours.

Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. 速Registered Trademark of Prestige Brands Inc. USA. Distributed by Care Pharmaceuticals Pty Ltd. ABN 30 009 200 604.

www.murine.com.au

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Business Profile

“Our success has come about through continued innovation and bringing new and exciting products to market that consumers desire.”

Collaborate...

Innovate... Achieve

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

Optica Life Accessories (Optica) was established in May 1958 to provide the best possible service to the optical industry in New Zealand. More than 50 years on, Optica continues to be a leading distributor of innovative lifestyle accessories in the New Zealand and Australian markets. an exciting addition to this product range is the all natural mosquito protection product called PARA’KITOTM. Optica’s aim is to design and source the very best in quality and innovative life accessories.

We recently spoke with John Nichol, Managing Director of Optica, following a successful consumer awareness campaign for their Pharmacy focused PARA’KITOTM product.

Editor: John, can you tell us a little about your time at Optica – the early days of the business and how it has evolved over the years?

John: Optica initially began distributing audio and optical products through the wholesale channel.

We then moved to a more direct approach, servicing the independent retailers directly.

This allowed us to be more reactive to the market needs, which remains one of our strengths.

More recently we enhanced our product range focusing on health, wellbeing and the environment. It is an exciting time for Optica with our diverse product range and some excellent new products in the pipeline.

In pursuing our products, we focus on those products we consider to be environmentally friendly. In brief, the first barrier for us to

consider a new product is, “Does the product co-exist with nature?” If yes, then we’re keen – if not, move on!

Editor: Optica is a leading supplier of life accessories, can you tell us about your new Pharmacy focused product PARA’KITOTM and the marketing/ promotional strategies that you are employing?

John: PARA’KITOTM is a groundbreaking, innovative, natural and long-lasting mosquito protection product.

After 6 years on the market in France and Spain, it is now the number one natural mosquito protection product in both countries and has been launched in 39 countries over the last 3 years.

PARA’KITOTM has been available to the Australian market for just under two years and is sold widely throughout the pharmacy channel. We are excited by the opportunity PARA’KITOTM represents given the successes achieved in Europe.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

We are the exclusive distributors of PARA’KITOTM in Australia and have a great sales team covering the country, with offices in Melbourne and Brisbane. In 2012 we engaged the services of a Melbourne based PR company to launch PARA’KITOTM in Australia and we continue to work with them to this day.

The product has gone from strength to strength.

Editor: PARA’KITOTM has recently aligned with the National Breast Cancer Foundation (NBCF), this sounds like a great fit.

John: Yes, we are excited to be partnering with NBCF, a Pink Ribbon band. There was a natural fit given PARA’KITOTM is perfect for people with sensitive skin, people recovering from some cancer treatments, and those people that choose to avoid exposure to chemicals.

With PARA’KITOTM being all natural rather than chemical based, we share many desirable values with NBCF and the partnership seems a natural extension. We are excited as we establish this relationship and are optimistic that many pharmacies will get behind and support this promotion.

Business Profile

Q4 Editor: Can you tell us a little bit about your partnership with the pharmacy profession in Australia?

John: Ongoing change in our industry highlights the need for strategic business partnerships. We believe that these partnerships, as opposed to conventional supplier/customer relationships, provide a sound platform to enhance and strengthen our respective businesses.

We refer to our approach as operating in a ‘blue ocean’ environment (as opposed to ‘red ocean’), but whatever you call it, from our perspective it is essential to maintain critical relationships by interacting with our stakeholders in a collaborative manner.

We are working with our growing number of pharmacy partners with the launch of PARA’KITOTM and look forward to bringing them new retail opportunities as we launch new innovative life accessories. Our focus of supporting our ever-expanding list of retailers remains.

“In brief, the first barrier for us to consider a new product is, “Does the product co-exist with nature?”

If yes, then we’re keen – if not, move on!”

John: We have some very strong relationships with a number of Australia’s largest retail outlets through our wide portfolio of existing life accessories. A highlight for me has been the immediate success of PARA’KITOTM. At Optica we are passionate about the product and it is great to see retailers and consumers alike sharing our enthusiasm.

It is not often that you come across a blue ocean product like PARA’KITOTM. From a consumer perspective, it is natural, convenient and long-lasting. From a retail perspective, the packaging looks great and it is becoming recognised by consumers nationwide.

Our continued success will come about through continued innovation and bringing

Our experience to date and the relationships we’ve established over the past two years indicates that this approach is respected within the pharmacy profession.

Editor: Can you highlight for us some of the milestones of the business to date? What do you believe are the key elements behind the continued growth and success of Optica?

new and exciting products to market that the consumers desire. The Optica motto remains strong: collaborate… innovate… achieve.

Editor: Finally, what are the specific goals and objectives for the Optica business in 2014 and beyond?

John: PARA’KITOTM is available through API, SIGMA, Symbion and SWAPS. We expect to have it ranged in over 1,000 pharmacies by the end of summer.

We have aspirations to be the leading supplier of consumer-friendly life accessories to the pharmacy channel in Australia. The future is very bright as we begin to build a portfolio of these health and wellbeing products.

Tom Nichol SALES MANAGER

http://au.parakito.com

MOB: 0411 311 861 SKYPE: tom_nichol EMAIL: tom.nichol@opticaaccessories.com

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

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RETAIL FOCUS

Further Maximising Team Performance –

Appraisals

BY SIMON HAMBRECHT Director of Pharmacy Essentials

As Pharmacy Owners and Managers, people management is not necessarily a component of our business that we embrace, or in all honesty, excel in.

People naturally don’t like conflict and seek to actively do everything possible to avoid it at all costs. I empathise, but it is no less reason to avoid it, as it will certainly not go away. The skills required for conflict resolution are mostly acquired and learnt directly on the job. Yes, you have access to courses and degrees that will equip you with certain skills in this area, but it is perhaps not an area high on our priority list.

Ironically, if we were to address matters positively as they occurred, there would be less chance of conflict – encouraging a discussion on how to improve, and/or avoid a repeat of the situation.

The use of performance appraisals is considerably under-utilised in our industry – mainly due to a level of inexperience and a significant lack of a process in administering and facilitating the tool.

Before I share a simple way of how to conduct an appraisal with your Team Members to ensure that both parties gain

mutual benefit, it is important to gain an appreciation of WHY we conduct performance reviews/appraisals.

The wider opinion is that they serve to address the poor performance of a Team Member. Now while this may be in part the reason, there are many more objective reasons that we should conduct them. Some of these include:

•• gauging a level of confidence the Team Member has in his/her role

•• identifying what motivates them •• determining areas of interest and passion •• discussing their aspirations for their business/career in the short and longer term.

Discovering that someone lacks confidence allows the opportunity to peel away the layers and delve deeper in identifying why. This then allows you to determine how you can assist the Team Member to build their confidence as you work through the element/s that are causing the issue/s.

“If we were to address matters positively as they occurred, there would be less chance of conflict – encouraging a discussion on how to improve, and/or avoid a repeat of the situation.”

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Finding out what intrinsically and extrinsically motivates them allows you to tailor any incentives that may be offered when they achieve the respective Key Performance Indicators (KPIs) they are accountable for. From experience, if the incentive relates strongly to their interest, the staff member is more inclined to strive harder to achieve it. People have different motivators. Quite surprisingly, it’s not always monetary, and knowing what these are is very powerful information.

Knowing what their out-of-pharmacy interests are, along with their career aspirations, often provides a greater insight into what training they need and what development they need to undertake to achieve these aspirations. There’s little value for employee or employer if someone works at a register and they really want to become a Dispensary Technician and have the skills to do so. They will not give 100% when working in a role that fails to ignite them and they will often become disillusioned, which presents its own complexities. If someone can see you are prepared to invest time in them, they are more inclined to reciprocate this behaviour and they will make an investment into your business – as they feel like a valuable and integral part of your business and their place of employment.

At this point, I hope appraisals are starting to sound like they would be a valuable tool in your business. If they are, you are probably wondering what the next step is in implementing these.

RETAIL FOCUS

If you currently have these in place, and there are KPIs in place which you can measure the Team’s performance, these are the recommended steps for you to follow: 1. Create a Performance Appraisal form (templates are available in your QCPP manuals).

2. Have a one-on-one discussion with each Team Member (individually) and provide them with a copy of the Appraisal form and request they fill out their relevant section.

3. Make a time with the Team Member to conduct the Performance Appraisal.

4. Complete your copy of the Appraisal form for each Team Member.

5. When you meet with the Team Member, run through each section of the Appraisal form. Ensure you approach one section at a time, having them run through their responses first, followed by yours.

6. While completing each section, ask the Team Member to explain their response if it varies from yours.

7. Discuss with the Team Member an Action Plan on how to improve/develop the section/skills in question.

8. At the end of the Appraisal, run through the agreed Action Plan with the Team and assign a time frame. Make sure it is reasonable as you don’t want to burden them with an unreasonable expectation.

9. Both parties need to sign off the Performance Appraisal and a copy needs to be given to the Team Member for their reference.

10. If there is any follow-up required, schedule a follow-up meeting with the Team Member.

a representative from your banner/brand.

It is strongly recommended not to use another member of staff or peer.

Performance Appraisals are an excellent staff development and you will notice a marked difference in Team Member performance after conducting them. Further, there is often an improvement in the culture throughout your business as the team witnesses firsthand you investing in them.

At Pharmacy Essentials, we provide personalised support to assist you in, not only the implementation of Performance Appraisals, but also the execution of them. If you would like to know a little more and are interested in getting measurable 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.

An important recommendation is to make sure you have another person present when you are conducting the appraisal. We suggest another member of your Management Team or

30 0

If you don’t have a Position Description in place already for each role in your pharmacy, you need to use your first appraisal to introduce them to the Team and explain how they will be measured. There is a lot of material to assist in putting these together in your QCPP manuals, including templates. I find these to be a good starting point, however, they need to be tailored further to your business model.

If you’re part of a banner or brand they should provide these for you, or alternatively request this from them.

35

s - 10ml op dr

can be used months after opening preservative-free phosphate-free compatible with all contact lenses

36

down to business

“The main trick to it all – listen and identify your customers’ needs.

Never dismiss what a customer tells you and always invite them to tell you more about any concerns they may have.”

Using personal selling skills to promote pharmacy services and engage your customers

Jane Larter Professional Practices Pharmacist

Everyday encounters with patients offer valuable opportunities to build demand for pharmacy services and impart the value of pharmaceutical care. Without our customers we don’t have a business, therefore satisfying our customers’ needs should be central to everything we do. Pharmacies that have won the Community Engagement Category for the Pharmacy of the Year award all look to meet the needs of their community and treat customers with care and respect.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

I have had the privilege to work with one of the best pharmacists who does this – my dad. Having worked in the pharmacy industry since I was 14, he was the best mentor to teach me that customers who walk through the pharmacy door are not just dollar signs.

Most customers like to be asked how they are, how their family is, their dog and so on.

By taking those few minutes with those customers makes their day (and yours) that bit better. Just remembering a person’s name can put a smile on their face!

down to business

Whether you are new to pharmacy, or you’ve been working in it for years, you will know that not every person is the same.

For those who are new, it takes time to build a rapport with customers, but that doesn’t mean you can’t start with the basics. Senior pharmacy assistants and pharmacists like me still get new customers that we have to start an initial rapport with, and the general formula generally starts with some form of acknowledgement.

Whether you are unpacking an order or serving another customer, don’t forget to acknowledge the new customer who has approached the counter. This can be with a warm welcome as you stop unpacking the order – an “I’ll be with you in a minute”, or a smile and nod of the head should you still be with a customer. Acknowledgement is always key though. My dad refused to believe that his staff didn’t have the time to at least look up and smile at the customers waiting in-store. I know when I have been in other pharmacies or retail stores that the quick smile and, “Won’t be long”, has made me stay, rather than receiving no acknowledgement, causing me to feel invisible. At that stage I know I can walk out and take my time and money elsewhere!

I have found over the years that ‘marketing’ services and suggesting the best product for a person’s symptoms is a lot easier if you already have that rapport. Some customers you will know well enough to know they don’t want the entire ‘medical pharmacological lab tested supplier information’ but rather your opinion – they trust in your judgement and recommendation.

Due to this trust, I find more customers are willing to ask about services in-store – whether it’s a health promotion with posters everywhere or whether it’s a vague memory of the last time they talked with the pharmacist and were given some information/flyer about something that would help them manage their medication. This is your ideal time as pharmacy assistants, intern pharmacists or forward dispensing pharmacists to engage your customer by showing them the display of a sample dose administration aid (DAA) you have on the counter and further explain and describe the DAA to them and how it would work for them.

Your customers might not even know about the services or products available to them.

Here is your time to really shine as their first point of contact when they enter the pharmacy.

Plan and rehearse the pharmacy service offers.

Be prepared to describe the services and their benefits as this is where written information for the customer to read later as they make up their mind becomes very useful.

Below are some useful ways to identify and approach customers who might benefit from the services your pharmacy offers:

•• A customer enters your pharmacy and wants 12 prescriptions dispensed. They make a half-hearted joke that they rattle when they walk and find it difficult to remember to take some of their medication.

•• A customer approaches the professional services counter and hands in a prescription for blood pressure medication.

•• You notice a customer enters the pharmacy and makes their way to the weight loss category of the pharmacy. You go over to offer your assistance and they tell you they’ve recently been diagnosed with diabetes and know they need to lose weight – but they feel so lost!

“Our ph ar help pe macy offers a special ople ma s nage th There is eir med ervice to a small ications fee, but worry o . ut it will t ak daily an of organising your ta e the d think blets ing – D pressur id I e medic ation th take my blood is morn ing?”

“We off er pharma a service here cy to he at the lp blood p ressure people monit or their . Do you blood p mo res like to h sure regularly nitor your ? Would ave you r you as you wait for blood pressur e taken your pr escript ion?”

etes macy? r a diab we offe re in the phar ht w o n k u he eig “Did yo ent program ts of w uremen sist with em s g a a e n m a m ne as e baseli e levels, and ase We tak os n incre c a c lu g u o d y o w lo o b h d an and advice dietary ical activity.” s y your ph

These are just a few examples of ways to approach people about professional services. The main trick to it all – listen and identify your customers’ needs. Never dismiss what a customer tells you and always invite them to tell you more about any concerns they may have. If they have feedback on the service, take note – it is always important to include customers in the development and improvement of professional services. If your pharmacy already does this (and more), why not take a look at nominating for Pharmacy of the Year (POTY)? Nominations close 7 November.

As my dad always taught me, make sure you provide that ‘personal professional care’ to your customers. It’s a great motto that I’ve come to work by.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

37

38

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. 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.

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

TRAINING AND EDUCATION

39

“Optifresh is specially formulated to moisturise, comfort and protect dry eyes.”

Optifresh.

Soothing relief from dry eyes Optifresh Hydrates. Lubricates and Protects.

Optifresh is specially formulated to moisturise, comfort and protect dry eyes.

Optifresh is now available in preservative free sterile single dose vials - Optifresh Tears (carmellose sodium 0.5%) and Optifresh Plus (carmellose sodium 1%). Optifresh Eye Gel (carbomer 0.2%) also available.

PBS Listed

For effective dry eye protection recommend Optifresh!

Use only as directed.

Petrus Pharmaceuticals Pty Ltd Tel 08 9368 5954 Fax 08 9368 6692 www.petrus.com.au.

Preservative Free eye drops

Single unit dose vial eye drops

Compatible with contact lenses

Wholesaler

Contact your Strategic National Pharmacy Representative for more information & special deals

Fast acting long lasting formula

Pharmacy only

PDE Optifresh Tears

PDE Optifresh Plus

PDE Optifresh Eye Gel

Symbion

355917

356131

356085

Sigma

143263

143180

143255

API

555509

555568

555592

NSW & ACT 02 9899 9800 VIC 03 5972 0222 QLD 07 3291 7070 SA & NT 08 8352 9200 WA 08 6140 1200 TAS 03 6244 3640

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

40

TRAINING AND EDUCATION

Australia’s Experts in Managing Dehydration 1.0 Indication Q. What is the product used for?

Short outline of condition.

suffering from kidney or heart disease, hypertension should consult their doctor before taking Hydralyte.

aspect of treating dehydration. Hydralyte should be sucked/sipped slowly this is more effective than large amounts less often. Always follow the dosage instructions on packaging.

A. Hydralyte is used to treat dehydration.

4.0 Breastfeeding/Pregnancy

Dehydration occurs when the body has an imbalance of fluid & electrolytes. This can be caused by fluid loss (vomiting, diarrhoea, heavy sweating & urine) or lack of food and fluid intake.

Q. Can the product be used in pregnancy or breastfeeding?

Continue treatment while vomiting/diarrhoea persists and while symptoms of dehydration are present.

A. Hydralyte is safe to use in pregnancy & breastfeeding

To find out if a patient is dehydrated ask questions, such as:

Dehydration is often caused by:

5.0 Side effects

•• Vomiting & Diarrhoea: gastroenteritis,

Q. Are there any side effects to be aware of or is the product well tolerated?

•• •• •• •• ••

•• •• •• •• ••

food poisoning, vomiting associated with some medications & pregnancy Heavy Sweating Associated with: sports & exercise, manual labour, hot & dry environment Travel: long haul flights, travellers’ diarrhoea, increased time in sun Excess Alcohol Consumption: alcohol acts as a diuretic Fever & Nausea: during periods of illness people can often eat and drink less Not drinking enough fluid: paediatrics & the elderly both have a reduced thirst reflex

Common symptoms of Dehydration include:

•• •• •• •• •• •• ••

Sticky or dry mouth Increased thirst Fatigue Dizziness Headache Dark yellow urine Decreased urine output

2.0 Mode of Action Q. How does it work?

A. Hydralyte works by replacing both fluid & electrolytes, this is the most important part of managing dehydration. Hydralyte is scientifically formulated to contain the correct balance of glucose & electrolytes for rapid rehydration.

3.0 Precautions/ Contraindication/Interactions Q. Are there any patients who would not benefit from this product e.g. children?

A. Hydralyte is suitable for the entire family, including paediatrics.

Q. Is there any drug-drug interactions or drug-condition interactions?

A. The high level of sodium & potassium in an oral rehydration solution mean those

A. Hydralyte is generally well tolerated.

For those avoiding particular colourings the ice blocks and readymade solutions are now available in a colour free lemonade flavour.

6.0 Comparative Information Q. Where does this product sit with the current treatments available?

A. Water or sugary drinks (such as cordial, flat lemonade and sports drinks) are not as effective as Hydralyte, as they do not restore lost electrolytes (which help retain the fluid).

Standard sports drinks that claim to effectively hydrate are regularly high in sugar (often four times the glucose) and very low in the essential electrolytes, usually containing only a quarter of the electrolytes required for rapid hydration.

See table below for comparison.

Q. How is it different/better?

A. Hydralyte’s formulation is based on the World Health Organisation criteria for effective rehydration. The correct balance of glucose & electrolytes allows the activation of sodium glucose co-transporter pump. The solution is Hypotonic (lower osmolality than intracellular fluid) & allow the cells swell to readily accept the fluid.

7.0 Counselling Points Q. How to use the product?

A. Replacing lost fluids & electrolytes with an oral rehydration solution is the most important

Is your urine dark yellow?

Do you have a dry mouth?

Are you feeling tired/ weak/lethargic?

Do you have a headache?

Are you feeling dizzy?

Refer ALL patients to a doctor if vomiting or diarrhoea persist for more than:

•• 6 hours in infants under 6 months •• 12 hours in children under 3 years •• 24 hours in children aged between 3–6 years

•• 48 hours for children over 6 years and adults Or if any of the following symptoms are present:

•• •• •• ••

High fever Vomit contains blood, brown or green bile Blood or black stools The person has other medical conditions that may be affected (such as diabetes and epilepsy) •• The child is floppy and does not seem to be acting normally

Q. Time of day?

A. When sickness or dehydration strikes – offer fluid replacement (Hydralyte) immediately. Remind patients to be prepared and always have Hydralyte on hand. Hydralyte should always be part of every Australian family’s basic home first aid kit.

Q. With or without meals?

A. Once the patient is tolerating significant fluids by mouth, a more solid diet can be offered. Avoid sweet, fatty and spicy foods.

If hungry, try starchy food such as rice, potatoes, bread, cooked cereals and dry biscuits.

Ingredient

Function

Hydralyte

Standard Sports Drink

Sodium Potassium

Helps the body retain fluid Essential for nerve and muscle function Helps the body retain fluid Assists absorption of electrolytes

45-60 mmol/L 20 mmol/L (solutions)

10 mmol/L 4 mmol/L

45 mmol/L (solutions) 16 g/L

60-80 g/L

55 Calories 230 kJ

257-318 Calories 1074-1329 kJ

Chloride Glucose (anhydrous) Calories/kilojoules (from sugar) per litre

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

TRAINING AND EDUCATION

“The key active ingredient in Murine Clear Eyes is Naphazoline Hydrochloride, which is a decongestant and vasoconstrictor that helps reduce unsightly blood vessels to remove the redness and brighten eyes.”

Don’t let red eyes stop you from enjoying the party!

First comes the office Christmas parties, then the Christmas parties with family and friends, followed all too quickly by New Year Eve parties, and then Australia Day. From November to the end of January, the party season is one you need to prepare for.

Indication

Breastfeeding/Pregnancy

Murine® Clear Eyes is the perfect party season survival secret, clearing away the redness from the night before and brightening eyes for up to eight hours, making sure that while you might feel tired, at least your eyes won’t show it!

Our registered Product Information does not contain any warnings regarding use during pregnancy or breastfeeding.

If it is needed during pregnancy or breastfeeding a healthcare professional should be consulted.

Red or bloodshot eyes are caused by widening or dilation of blood vessels in the white part of the eye. The blood vessels look prominent and give the white of the eye a pink/red appearance.

Mode of Action The key active ingredient in Murine Clear Eyes is Naphazoline Hydrochloride, which is a decongestant and vasoconstrictor that helps reduce unsightly blood vessels to remove the redness and brighten eyes.

Precautions/ Contraindication/ Interactions If irritation persists discontinue use and consult a physician. This product should not be used by individuals suffering from glaucoma or other serious eye diseases.

Prolonged use may be harmful. Consult a doctor of pharmacist if using other eye products. Discard contents 4 weeks after first opening the container. A sterile isotonic solution. Not for use in children.

Counselling Points Top tips from Murine to looking after your eyes during the coming party season: • Drink plenty of water to keep your whole body, including your eyes, hydrated

Side effects The product is well tolerated however is contraindicated

• Try and get plenty of sleep by avoiding repeated late nights (or make up for it by sleeping in late)

1. Narrow angle glaucoma or anatomically narrow occludable angle glaucoma

• Ensure you remove contacts, eye make-up

2. Known hypersensitivity to any of the ingredients/excipient in the formulation

• Keep a bottle of Murine Clear Eyes on hand

Should not be used prior to peripheral iridectomy in eyes capable of angle closure because mydriatic action may precipitate angle block.

Comparative Information Murine Clear Eyes is the number 1 selling product in Australia, and number 1 in eyecare category and allergy and decongestants category.

and/or false eye lashes before sleeping in your handbag or top drawer to refresh your eyes when they are feeling tired or looking bloodshot

• Make sure you wear sunglasses while in high UV or glary environments

• Take regular breaks from your computer screen – look away from the screen at least every 5 minutes and focus on something further away (Try holding your mobile phone away as far as possible while looking at facebook photos from the night before)

• Stop, Revive, Survive – When driving long distances, take a break every 2 hours to rest your eyes and refresh yourself

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

41

PBS Liste d 1st April 2014

Hydrates. Lubricates. Protects.

Single unit dose vial eye drops

Compatible with contact lenses

Wholesaler

Fast acting long lasting formula

Pharmacy only

PDE Optifresh Tears

PDE Optifresh Plus

PDE Optifresh Eye Gel

Symbion

355917

356131

356085

Sigma

143263

143180

143255

API

555509

555568

555592

Purchase

Receive

6-11 units

5% discount

12 or more

10% discount

44

PRODUCT SPOTLIGHT

HYLO®- The Systematic Approach to Eye Lubrication HYLO®-FRESH and HYLO-FORTE® eye drops provide long-lasting lubrication for dry eyes that is preservative-free and completely sterile, delivered through the unique COMOD® multi-dose application system.

They last for 6 months after opening, can be used with all contact lenses, and contain at least 300 precisely measured drops per bottle. >> www.aftpharm.com/au

A Little Bit of Relief A Little Bit of Relief is a cooling gel for the temporary relief of arthritic pain, rheumatic pain, muscular aches, backache, cramps, spasms & sporting injuries. This pain relief gel is specially formulated with 100% natural active ingredients and is endorsed by Olympic champion Dawn Fraser .

A Little Bit of Relief is now available from Symbion, Sigma & API in two pack sizes 100g tube (RRP $ 19.95) & 150mL pump bottle (RRP $ 27.95) For more information visit >> www.alittlebitofrelief.com

Ethical Nutrients Mega Magnesium Ethical Nutrients Mega Magnesium is a high potency magnesium supplement available in a convenient tablet or delicious Raspberry or Citrus flavoured powder. Each product contains the proprietary and highly absorbable form of magnesium, Meta Mag®.

Mega Magnesium may be of benefit:

•• •• •• ••

During times of stress.

To relieve muscular aches, pains, cramps and spasms.

In assisting cellular energy production.

To relieve menstrual pain and cramping.

Restore your magnesium levels with Ethical Nutrients Mega Magnesium tablets or powder. Always read the label. Use only as directed.

If symptoms persist consult your healthcare professional.

•• 60 Tabs $22.50 •• 120 Tabs $39.95 •• 200g Powder $39.95

Hydralyte Hydralyte is an effective treatment of dehydration.

The formulation replaces fluid and electrolytes lost due to vomiting, diarrhoea, heavy sweating and other dehydrating conditions such as excess alcohol consumption. Hydralyte has recently launched their electrolyte ice blocks and readymade liquid solutions in an all NEW colour free lemonade flavour.

RRP $13.99-$15.99. Hydralyte is only available in Pharmacy.

Q. What NEW Flavour are Hydralyte ice blocks and ready to use solutions now available in? >> www.elevit.com.au

>> www.ethicalnutrients.com.au

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

PRODUCT SPOTLIGHT

Calm, clear, focused – 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

GLUCOJEL MEANS BUSINESS

AND IT IS MADE IN AUSTRALIA Still in the top ten when it comes to over-the counter pharmacy sales, and in pharmacy only. And that means good business for you.

Order from your preferred wholesaler: PRODUCT

API

SYMBION

SIGMA

70gm Glucojel x 36

598410

125946

078675

150gm Glucojel x 36

475254

193380

328179

1kg Glucojel x 6

594326

250937

686055

70gm Black Glucojel x 36

698229

591432

487637

Extra Strong Mints x 24

618934

119105

244210

or contact Gold Cross Products and Services for product enquiries.

T 02 6270 8950 F 02 6270 8999 enquiries@goldx.com.au

45

As ON seen TV

Fast relief from joint and muscle pain.

DAwn FRAseR. AO MBE World Athlete of the Century.

TM

‘A Little Bit of Relief’ is a 100% Australian owned pain relief gel, formulated from natural active ingredients including eucalyptus and peppermint oils.

‘A Little Bit of Relief’ is used for temporary relief from:

✓ Arthritic Pain ✓ Muscular Aches ✓ Backache ✓ Cramps & Spasms

Now available direct from Symbion, Sigma and API. AVAILABLE IN TWO PACK SIZES:

BBPP 25797_GITK

100g Tube and 150mL Pump.

Contact your Clear Sales representative on 1800 640 043 for special deals.

Petrus Pharmaceuticals Pty Ltd Level 3, 1060 Hay Street, West Perth WA 6005. Tel 08 9368 5954 Fax 08 9368 6692 www.petrus.com.au.

Active ingredients eucalyptus oil 0.2% w/w & peppermint oil 1.0% w/w. Contains diazolidinylurea. If symptoms persist seek the advice of a healthcare practitioner. Not recommended for use on children below 2 years of age. Always read the label. Use only as directed. CHC43279-11/13

Some people would pay anything for dignity and independence!

EZY-UPS Dignity & Independence

1.

Dressing aid for

2.

Underpants Disposable & Standard

Ezy-Ups $39.95rrp rrp

Skirts Tracksuits Trousers Slacks

3.

Ezy-Ups will be available in pharmacies from mid October More information from www.ezyups.com Email bill@ezyups.com Distributed Distributed by

by Doward Doward International International Pty Pty Ltd Ltd ** The The product product may may vary. vary.

NEW AUSTRALIAN DESIGN

Business directory

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

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

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

BLACKMORES 20 Jubilee Ave, Warriewood NSW 2102 Tel: 1800 808522 Website: www.blackmores.com.au

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

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

MPS

FLOWSELL

Would you like to advertise in our new Business Directory?

8 Clunies Ross Court Eight Mile Plains QLD 4115 Website: www.mps-aust.com.au

1/13 Network Dr, Carrum Downs VIC 3201 Tel: (61-3) 9708 2276 Website: www.flowsell.com.au

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

PO Box 9410 Tower Junction Christchurch 8149 New Zealand Website: www.opticaaccessories.com.au

Contact Jess O’Connor on Ph: 07 3040 4415 or Email: jessica.oconnor@goldx.com.au

49

50

After Hours

AFTER HOURS October–November 2014

Celebrate Melbourne Cup Day

Melbourne Cup Day is Australia’s best known horse racing event held on the first Tuesday of November every year. This event is popularly dubbed as “the race that stops the nation” and is an annual public holiday in the state of Victoria.

About Melbourne Cup Day Melbourne Cup Day has been observed in Australia since the first race was held at the Flemington Racecourse in Victoria in 1861.

The race was won by Archer, who won it again the following year. The event features races, including the handicap race which is run by about 20 thoroughbreds for a couple million Australian dollars. The story of Phar Lap, a legendary New Zealand thoroughbred who won the Melbourne Cup in 1930 and was nicknamed “Australia’s wonder horse”, was made into a movie. Some people believe he was poisoned when he died.

Bets are made on this day – even those who usually do not bet try their luck with a small wager or entry into a sweep, which is a lottery in which each ticket holder is matched with a randomly drawn horse.

There are similar races throughout Australia, as horse racing is popular, but Melbourne Cup Day is still the number one horse racing event in the country.

Melbourne Cup Day is one of Australia’s most popular social and racing events. The main racing event takes place at the Flemington Racecourse in Melbourne, Victoria. More than 100,000 people usually attend Flemington Racecourse. Local races are held throughout the country on this day and when the main race of the day occurs it is televised on screens at race tracks across Australia. The race is televised live to an audience of about 650 million people worldwide. Many people stop what they are doing shortly before 3pm on Melbourne Cup Day to watch or listen to the main race either via television, Internet or the radio.

At the races, people dress up – many women wear their best or most colorful hats and dresses, with some participating in fashion parades on the field. Marquees are set up for VIP guests, including local, national and international celebrities who attend this festive event. Champagne, wine and gourmet finger foods are usually served on this day.

Many offices across the Australia stop work closer to the time of the main race to celebrate the event. Activities include office parties that feature hat and dress competitions, staff lunches at restaurants and afternoon teas where a television is available so workers can watch the main race.

The Melbourne Cup Carnival is an unequalled world-class event that encompasses the finest racing, entertainment, fashion, culture, food and wine all in one place. Held across four days from 1 to 8 November, it is unrivalled in its prestige

GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

and tradition and is the unmissable social occasion of the year.

Renowned locally and internationally, the Melbourne Cup Carnival holds a unique position in world racing as there is no comparable week where crowds of such magnitude gather to celebrate thoroughbred racing. The Emirates Melbourne Cup is the iconic race of the Carnival, with increasingly the best thoroughbreds from around the world showcasing the very best of the sport.

Trackside, the event is a spectacle of fashion and entertainment, combining friends and families with corporates and celebrities. Firmly established as an unequalled international and Australian draw card, Melbourne embraces domestic and international visitors alike to bask in the excitement and revel in the glamour of the Birdcage, Flemington lawns, marquees and some of the finest hospitality and entertainment it has to offer.

As a cultural and sporting event its lure is magnetic and undeniable, attracting crowds who descend upon Flemington to be a part of the truly unforgettable experience that is…the Melbourne Cup Carnival.

To find out more or to book go to: http://premier.ticketek.com.au/ shows/show.aspx?sh=MELBCUP&utm_ source=web&utm_ medium=friendlylink&utm_ campaign=MELBCUP

CLASSIFIEDS

51

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* 1 x Clexane 60mg 10 0.6ml P/F syringes exp 09/16 $50 * 2 x Strattera 40mg 28 caps exp 07/16 $73 * 1 x Lipidil 48mg 60 tabs exp 01/16 $15 * 2 x Ursofalk 250mg 100 caps exp 05/16 $130

PLACE YOUR FREE CLASSIFIED ADVERT

* 1 x Twynsta 80/5mg 28 tabs exp 12/15 $13

If you would like to place your free classified ad, forward any items for sale to Jess O’Connor.

Email: jessica.o’connor@goldx.com.au

* 1 x Catapres 100mcg 100 tabs exp 04/15 $14 * 2 x Neoral 50mg 30 capsexp 07/15 $63 Items that are going out of date this year are 50% off (prices as marked):

BROUGHT TO YOU BY:

* 1 x Fosamax 40mg 30 tabs exp 11/14 $20 * 1 x Diovan 160mg 28 tabs exp 11/14 $7 * 1 x Caduet 5/80mg 30 tabs exp 12/14 $40 Contact: Rowan Conn, Texas Pharmacy, Ph: 07 4653 1367

Not All Probiotics Are The Same WHY RECOMMEND ND INNER HEALTH PLUS? US? Inner Health Plus is an exclusive probiotic, developed evelo ev eloped ped usive us ive and and by the probiotic experts. It contains the exclusive cidoph cid ophilu iluss extensively researched strain Lactobacillus acidophilus (NCFM®), and Bifidobacterium lactis (Bi-07).

Have your customers recently taken antibiotics?

Do your customers suffer from gas or bloating?

Want to improve general wellbeing?

Want to maintain healthy digestion and immunity?

Always read the label. Use only as directed.

If symptoms persist consult your healthcare professional.

Find out the full benefits, visit: www.ethicalnutrients.com.au

IHP2877 - 01/14 /14 1

Not all probiotics do the same thing and it’ss no nott just just the number of good bacteria that counts. Recommend omme mmend nd probiotics with scientifically researched and va validated valid lidate ated d strains such as Inner Health Plus, and help p restore restore rest ore your customers digestive balance and improve rove ro ve the theirir general wellbeing.

www.innerhealth.com.au

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HEALTH CALENDAR

HEALTH CALENDAR October–November 2014 Girls’ Night In October The Girls’ Night In concept is simple... invite your girlfriends over for a night in during October or November and donate the money you would have spent going out to Cancer Council instead. > www.girlsnightin.com.au

Haemophilia Awareness Week 12 – 18 October Haemophilia Awareness Week is an opportunity for Haemophilia Foundations and other organisations, as well as individuals and families to take part in a campaign and activities to raise awareness about haemophilia, von Willebrand disorder and related inherited bleeding disorders. > www.haemophilia.org.au/red-cake-day

Pink Ribbon Day 27 October 2014 One in every nine Australian women will be diagnosed with breast cancer by the age of 85.

She could be your mother, sister, aunt, cousin, niece or a friend. > www.pinkribbonday.com.au

Red Ball 2014 18 October The Palladium Ballroom at Crown will be transformed and our guests will enjoy a delightful 3 course dinner complemented by fine wines whilst entertained by celebrity hosts and show stopping performances.

All proceeds enable Fight Cancer Foundation to continue giving hope to children and adults with leukaemia and other cancers. > www.redball.com.au

Bloody Long Walk 19 October Statewide - Australian Mitochondrial Disease Foundation email Australian Mitochondrial Disease Foundation. > www.bloodylongwalk.com.au/

Great Strides 2014 Series 26 October Great Strides is a fun run and walk which raises awarenss and funds for cystic fibrosis organisations around Australia. Great Strides is our largest fundraising event, funds raised ensure that we can continue to provide essential programs and services to the CF community. > www.cysticfibrosis.org.au/vic/greatstrides-event GOLD CROSS PRODUCTS & SERVICES PTY LTD : ITK ISSUE 38 : OCTOBER / NOVEMBER 2014

National Bandanna Day 31 October We need to raise $1.1 million to continue our vital work supporting young people living with cancer. Join the fight and raise funds for CanTeen by selling bandannas - order your box now! > www.canteen.org.au/how-you-can-help/ events-calendar/national-bandanna-day/

Movember November Movember is all about bringing back the moustache, having fun and doing it for a serious cause; men’s health, specifically prostate cancer, testicular cancer and mental health. Mo Bros commit to grow a moustache for the 30 days of Movember, and in doing so become walking and talking billboards for the cause. The moustache is our ribbon, the symbol by which we generate conversations, awareness and raise funds for men’s health. > http://au.movember.com/get-involved/

National Skin Cancer Action Week 17 – 23 November Nationwide - Cancer Council Queensland. > www.cancer.org.au/preventing-cancer/ sun-protection/campaigns-and-events/ national-skin-cancer-action-week.html

Our TV ADVERTISING draws customers to your store.

Our TRAINING

enables you to give them the best advice.

Our COMMITMENT

to you ensures they come back to you!

CLINICALLY TRIALLED AND SHOWN TO: • Reduce the frequency and severity of allergy symptoms.

• Relieve symptoms of allergies including nose, eye and throat symptoms.

• Assist with house dust mite allergies.

• Relieve hay fever symptoms and environmental allergies.

HELP REDUCE THE FREQUENCY AND SEVERITY OF ALLERGY SYMPTOMS Clinically Trialled to Reduce the Frequency of Allergic Rhinitis Ethical Nutrients Allergy Control contains an exclusive probiotic strain, Lactobacillus paracasei LP-33™, which has been shown to help reduce the frequency and severity of allergy symptoms including a blocked, itchy, runny nose; sneezing; itchy and watery eyes; puffy and sore eyes and an itchy throat. Don’t just suppress their symptoms, help reduce the frequency and severity of allergic rhinitis by recommending Allergy Control to your customers.

The Ethical Nutrients Range is only available in Pharmacies and Health Food stores where your customers can receive informed advice and you can be sure they will come back to you, not a nearby supermarket.

www.ethicalnutrients.com.au BEST PRODUCTS BEST EDUCATION BEST SERVICE Industry Pulse independent research shows Ethical Nutrients, yet again,

as the leading supplier to Pharmacy providing unparalleled service excellence and product training for the 5th consecutive year!

YOUR NATURAL BUSINESS PARTNER

References available on request

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 Modules • In-Store Trainings • Training Evenings • itherapeutics.com.au

ETH6729 - 08/14

Always read the label. Use only as directed.

If symptoms persist consult your healthcare professional.

NEW