Mother Launches EpiPen campaign

Mother of teenager who died after suffering from anaphylactic shock from a nut allergy has launched a campaign to free up access to EpiPEn injections.

The Pharmaceutical Society of Ireland (PSI) will not object to a mother's campaign for wider availability of the life-saving devices.

It has made its decision despite assurances by the society that it has not made any directions to its members in relation to banning petitions.

More than 7,000 people have signed the online petition since it was launched.

Emma Sloan died on a Dublin pavement from an allergic reaction to peanut sauce in a buffet restaurant just days before Christmas.

Her mother is now sending petitions to businesses all over the country as part of her campaign to allow EpiPens to be freely available in schools and restaurants.

She said she hoped her campaign would make injections available for use by restaurant staff and teachers who could use them to help counteract the potentially fatal effects of an allergic reaction to certain foods, such as nuts.

She told The Irish Independent, “"Parents of those children should be given identity cards which would allow them to get an EpiPen in a pharmacy.”

Tamiflu found to be ineffective

According to a report by the Cochrane Review on trials involving more than 24,000 people; Tamiflu does not reduce complications such as pneumonia, it doesn't prevent the transmission of flu, and it has a number of adverse effects.

Dr David Tovey, Editor-in-Chief of The Cochrane Library, commented on the release of the updated Cochrane Review, “We now have the most robust, comprehensive review on neuraminidase inhibitors that exists. Initially thought to reduce hospitalisations and serious complications from influenza, the review highlights that neuraminidase inhibitors are (Nis) not proven to do this and it also seems to lead to harmful effects that were not fully reported in the original publications. This shows the importance of ensuring that trial data are transparent and accessible.”

Evidence from treatment trials confirms increased risk of suffering from nausea and vomiting.

When the drug was used for prevention the trial revealed there was an increased risk of headaches, psychiatric disturbances and renal events.

The review also found that compared with a placebo, or dummy pill, Tamiflu led to a quicker alleviation of flu-like symptoms of around half a day in adults, but the effect in children was more uncertain.

The worldwide use of Tamiflu has increased dramatically since the outbreak of H1N1 virus in April 2009 and has led to stock piling in a number of jurisdictions in anticipation of an influenza pandemic.

It was initially believed that it would reduce hospital admissions and complications of influenza. However, the original evidence presented to government agencies was incomplete. The Cochrane Review has benefited from access to more complete reports of the original research, now made available by the manufacturers, Roche and GlaxoSmithKline.

Healthwave to use Courier Service

First of its kind nationwide ‘door-to-door’ delivery service for prescription medicines has been introduced by the controversial pharmacy Healthwave.

Shane O'Sullivan, Healthwave

The Irish Pharmacy market experienced a big shake up in January this year, when new Dundrum-based pharmacy, Healthwave, introduced its HealthPass subscription service guaranteeing the best pricing for medication, prescriptions and over the counter (OTC) drugs in Ireland by charging prices similar to that of Northern Irirish Pharmacies and having no dispensing fee.

In Ireland, posting medication or drugs is not permitted, however courier delivery is permitted with conditions. Healthwave is working with DPD Ireland, which is authorised by the Irish Medicines Board (IMB) under GDP regulations to transport medications to patients nationwide. Cost of delivery is free to the patient because Healthwave cover the cost.

Healthwave founder, Shane O’Sullivan said, “By law, pharmacies can only supply medication when they have the original prescription in hand and the patient has received the relevant advice from the pharmacist.”

He added, “Once a patient has visited Healthwave, our pharmacists complete a therapeutic review of their medication, provide counselling on the safe and appropriate use of each product, stamp their prescription and hold it for repeat dispensing, as do other pharmacies. However we can now provide the repeat dispensing via secure courier, and using our online re-ordering and proof of delivery signing, we will be compliant with guidelines issued by the Regulator.”

Healthwave has hired a team of pharmacists to ensure every patient or carer availing of the new service is offered the appropriate counselling on the proper use of their medication in line with current legislation. The new free service will include an automated text service, door to door courier and follow up phone call from a qualified pharmacist to offer further information, advice and support.
“The premise of Healthwave is to provide transparent pricing and universal access to affordable medication in Ireland,” explains Shane O’Sullivan, Pharmacist and CEO Healthwave. We are committed to providing a superior level of care than currently exists in Ireland. We have removed the price barrier, now we removing the location barrier while maintaining the same level of care experienced in the pharmacy.

E-cigarettes banned in health service facilities

The Health Service Executive has banned the use of e-cigarettes in all health service facilities meaning the use of e-cigarettes will not be permitted in any HSE building or on any HSE Tobacco-Free Campus.

The HSE have said this move is because e-cigarettes resemble ordinary cigarettes, their use may promote or re-normalise smoking, disrupt the environment for non-smokers, make it harder for smokers to quit and for the HSE to support smoke-free policies.

There is not enough evidence for or against the use of e-cigarettes as a smoking cessation aid, and e-cigarettes are not yet recognised internationally or licensed as a smoking cessation aid. 

Preliminary studies indicate that electronic cigarettes are probably less toxic than conventional cigarettes, but there is no evidence of their being useful as a possible strategy for harm reduction, nor is there good evidence for their effectiveness as a tool for smoking cessation. 

There is no conclusive evidence for or against the safety of e-cigarette use, especially long-term, or the potential effects of passive exposure to emissions from electronic cigarettes.

The World Health Organisation (WHO) is of the view that the safety of e-cigarettes has not been scientifically demonstrated and the potential risks they pose for the health of users remains undetermined

The HSE made a commitment that all its campuses will be tobacco-free by 2015.  The majority of public hospitals now operate smoke-free campuses, as do many primary care and administrative facilities.

Dr. Stephanie O’Keeffe, National Director, Health and Wellbeing, HSE said today ‘The Tobacco Free Campus Policy helps to change social norms around tobacco use and actively encourages and supports people to quit smoking. The decision to ban the use and sale of e-cigarettes in HSE facilities follows a detailed review of their safety and the impact of e-cigarettes on the smoke-free campus policy.’

‘The HSE can only recommend safe and effective products and strategies for quitting smoking, and there currently is no conclusive evidence that e-cigarettes are safe for long-term use, or are effective as a smoking cessation aid.  While we will keep this evidence under ongoing review, the e-cigarettes ban is being introduced as e-cigarettes pose a challenge to smoke-free campus enforcement and come with safety concerns for a healthcare environment.’

Childhood vaccination rates highest levels

More children in Ireland are being vaccinated than ever before.

While welcoming the fact that more children in Ireland are now age appropriately vaccinated than ever, HPSC specialist in public health medicine, Dr Suzanne Cotter said that it was still important to remind parents that children needed to fully complete the childhood immunisation schedule to be protected against a range of serious vaccine preventable diseases.

All childhood vaccines and the administration of these vaccines are free of charge to all children in the country. The early childhood vaccines are given by GPs and the booster vaccines are provided by HSE School vaccination teams in most parts of the country, with a small number of regions providing these vaccines through the GP service.

At 12 months of age 92% of Irish children are appropriately vaccinated.  This means that they have had the recommended 3 doses of the 6 in 1 vaccine.

Two vaccines are recommended for children at the time of school entry- the booster dose of the ‘4-in-1’ vaccine (combined vaccine to protect against diphtheria, tetanus, pertussis, and polio) and a dose of MMR (usually 2^nd dose) vaccine. The booster doses are given in the school setting (by HSE school immunisation teams) in most HSE regions, but in some HSE regions GPs administer the vaccine to the children.

Dr Suzanne Cotter said, “The fact that more children in Ireland are now protected against vaccine preventable diseases than ever before reflects the confidence parents have in vaccination to prevent what used to be the most common infectious diseases of childhood. The work of many health professionals including GPs, practice nurses, community medicine and public health doctors and nurses needs to be recognised in bringing about the  increased uptake, all of whom support and strive to improve the national immunisation programme.

Pharmacists have an opportunity to be more involved in with vaccinations as they expand the services they already offer. The provision and delivery of vaccination services through the network of community pharmacies has occurred in other jurisdictions. In 1998, pharmacists in 25 states in the US were authorised to administer immunisations with over five million doses of influenza vaccine administered in pharmacies. By 2003, 35 states in the US had legalised the administration of vaccines by pharmacists on the basis of certain training requirements and specific protocols.

The Pharmaceutical Society of Ireland (PSI) Pharmacy Ireland 2020 interim report says; National standards and protocols for the delivery of vaccination and immunisation programmes through community pharmacy should be developed, as well as national training programmes to address the requirement for additional skills and specialisations of currently registered pharmacists.

The HSE commented, “Pharmacists can help by supporting discussions about vaccination in general and by informing their clients about the role that vaccinations play in preventing disease in children and adults. As frontline health workers pharmacists are often the source of information and guidance for the public on preventing disease and how to maintain good health. In addition pharmacists are already directly supporting the influenza vaccination programme.

Asthma and COPD first for Ireland

GlaxoSmithKline (GSK) and Theravance, Inc (NASDAQ: THRX) have announced the launch, the first inhaled corticosteroid/long acting beta2-agonist (ICS/LABA) combination to provide continuous 24-hour efficacy for the treatment of asthma and chronic obstructive pulmonary disease (COPD) in Ireland.

Respiratory disease is a growing problem in Ireland, which has the fourth highest prevalence of asthma in the world.   It is estimated that one in every eight or 470,000 people in Ireland have asthma. Despite medical advances, 92% of asthma patients outside of clinical trials still remain uncontrolled and efficient inhaler technique is demonstrated by only 46 – 59% of patients.

Chronic Obstructive Pulmonary Disease (COPD) is highly prevalent and has a large impact on quality of life for patients and their families.  Based on international figures, over 180,000 people in Ireland have moderate or severe COPD disease, only half of whom may be diagnosed.

Commenting on the launch of Relvar Ellipta, Professor Richard Costello, Consultant Physician in Respiratory Medicine at Beaumont Hospital, Dublin, and Associate Professor of Medicine at the Royal College of Surgeons in  Ireland said, “Asthma and chronic obstructive pulmonary disease are chronic lung diseases that affect thousands of people in the Ireland. They can severely affect a person’s ability to lead a normal life.

He added, “Both diseases are associated with attacks - exacerbations of the underlying disease, often triggered by infection, where symptoms worsen, breathing becomes even harder and treatment with high dose oral steroids can be required. People with attacks often require an admission to hospital to treat their disease. The mainstay of treatment for improving symptoms and reducing attacks for both asthma and COPD is inhaled medication; the release of Relvar Ellipta is a welcome addition in the fight against these chronic lung diseases.”

Relvar is administered via the straightforward Ellipta inhaler device. Ease-of-use handling studies have shown that over 95% of asthma and COPD patients used the Ellipta inhaler device correctly for the first time and after 6 weeks in COPD patients and 4 weeks in asthma patients.

New programme to reduce pharmacy wastage

The School of Pharmacy at University College Cork (UCC) and Irish-owned company, Leading Edge Group have launched a new initiative to deliver a new educational and consulting programme to all pharmacies across the South/South West Hospital Group.

Professor John Higgins, UCC, Joe Ahern, CEO Leading Edge Group, Deirdre Lynch, Chief Pharmacy Department CUH, Caroline Reidy, Pfizer Health Care Ireland, Professor Stephen Byrne, Head of School of Pharmacy UCC and Pat Field, Pfizer Manufacturing Ireland at the launch of the centre of excellence project in UCC

The programme aims to educate and empower pharmacists and pharmaceutical technicians in the use of techniques and methodologies that will improve pharmacy processes within hospitals and deliver better patient care.

Prof. Stephen Byrne, Head of School of Pharmacy and Chair of Clinical Pharmacy Practice at University College Cork emphasised the significance and importance of the Lean programme.

Byrne said, “This is the inaugural partnership between the School of Pharmacy, UCC, the Academic Health Centre and the Leading Edge Group. The School of Pharmacy will work with the Leading Edge Group and project teams in a mentoring capacity, with the aim of publishing case reports on the success of such implementations. We are proud to be the first healthcare group working collaboratively in Pharmacy to improve patient care using an integrated Lean approach.”

The Leading Edge Group has successfully worked with the Pharmacy Department at University Hospital Galway and recently embarked on a 6-month pharmacy project with the Northern Health Authority in British Columbia, Canada.

 Joe Aherne, CEO, Leading Edge Group said, “Our results in Canada and Ireland to date have been really impressive. Improvements have incorporated reduced times to fill orders; reductions in cycle times for managing returns of unused medicines; time spent by pharmacists checking and correcting medication orders and paperwork and standardisation of core processes across pharmacies. We have seen a paradigm shift in Pharmacy through the adoption of a culture of continuous improvement.”