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PharmaCon2007 Congress, Dubrovnik, Croatia "New Technologies and Trends in Pharmacy, Pharmaceutical Industry and Education" http://www.pharmacon2007.com ...

PharmaCon2007 Congress, Dubrovnik, Croatia "New Technologies and Trends in Pharmacy, Pharmaceutical Industry and Education" http://www.pharmacon2007.com
Abstract is available at http://www.pharmaconnectme.com

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BY HELPING PEOPLE MY DREAM IS BECOMING TRUE BY HELPING PEOPLE MY DREAM IS BECOMING TRUE Presentation Transcript

  • By helping people my dream is coming true A community pharmacist, the Story Dr. Herbert Cabana
  • Topics
    • Introduction
    • Cases
    • Can our wo r k influence public health?
    • What polls say about our reputation
    • Summary
  • Topics
    • Introduction
    • Cases
    • Can our work influence public health?
    • What polls say about our reputation
    • Summary
  • Introduction
    • Before I started with my studies my dream was:
      • As a pharmacist to support people to stay healthy and help them very effective when they are ill.
  • Introduction
    • At university
      • I realised that we had to learn quite a lot of physics, botany, chemistry, pharmacology and pharmaceutical technology.
      • At that time I could not imagine how my knowledge of university studies once could be combined with my imagination of the pharmacist profession.
  • Introduction
    • In the community pharmacy:
      • How I experience my life as pharmacist to day I will show you by means of some cases.
  •  
  •  
  •  
  • Topics
    • Introduction
    • Cases
    • Can our wo r k influence public health?
    • What polls say about our reputation
    • Summary
  • Case history one The Patient
    • 66 years old
    • male
    • He wants a remedy for dizziness
  • Case history one the first conversation
    • Do you have tabletts against hypertention at home?
    • Do you think your blood pressure is high?
    • Good morning. How can I help you?
    • Do you suffer from hypertention?
    • Very often I am so dizzy. Please give me some tabletts.
    • Yes .
    • Yes .
    • Yes.
    Cabana Patient
    • But please give me some tablets against dizziness!
  • Case history one What – for example – can cause dizziness:
    • High blood pressure
    • Low blood pressure
    • Shortsightedness – Longsightedness
    • Problems with the spinal column
    • Ear problems
    • Tumour
    • Endocrinology problems
    • Etc. Etc. Etc. .....
  • Case history one Results of the first conversation
    • What did he tell me?
      • He suffers from dizziness
      • He suffers from hypertension
      • His hypertension is treated with tablets
      • He thinks his bloodpressure is high
    • I suspected
      • Hypertension might cause the dizziness
    • My action:
      • Measurement of blood pressure
  •  
  • Case history one
    • Result of measurement:
      • Blood pressure = OK
    • My decision:
      • My patient told me, he was under medical treatment, so
      • I planned to give him
        • an antivertiginosum and
        • detailed advice
  • Case history one the second conversation
    • I will give you something against your dizziness.
    • Would you like anything else?
    • Yes; fulfil this prescription please
    Cabana Patient Prescription Name Hubert Miller Date of birth: 24.12.1937 Insurance WGKK RP) Diamicron 80 mg I OP Dr. John Helpful Common Practitioner Gliclazid (Antidiabeticum; Sulfonylurea)
  • Case history one the second conversation
    • A new situation occur r ed!
      • He is diabetic!!!
    • My action:
      • Measurement of blood sugar
  • Case history one the second conversation
    • A new situation occur r ed!
      • He is diabetic!!!
    • My action:
      • Measurement of blood sugar
  • Case history one the second conversation
    • A new situation occur r ed!
      • He is diabetic!!!
    • My action:
      • Measurement of blood sugar
  • Case history one the second conversation
    • A new situation occur r ed!
      • He is diabetic!!!
    • My action:
      • Measurement of blood sugar
    • The result:
      • Glucose much higher then 200 !
  • Case history one the second conversation
    • Yes
    • When did you take your diamicron lately?
    • No. I mean when did you take your dimicron lately?
    • When did you take your dimicron lately?
    • Sorry?
    • I ran out of the tabletts
    Cabana Patient
  • Case history one the second conversation
    • Please te l l me when did your dizziness start
    • I see.
    • That was Friday so it was about 10 days ago
    • When was that?
    • When did you run out of di a micron?
    • When did your dizziness start?
    • Yes
    • 2 we e ks ago
    • Yes
    Cabana Patient
  • Case history one Results of the second conversation
    • Again I got new information:
      • He is not only diabetic but
      • He also is hard of hearing
    • I revised my decision!
  • Case history one
    • I simply fulfilled the prescription
      • Diamicron
    • Gave detailed advise to my customer
      • not only verbal
      • but also written
    • Told him to visit the doctor
    • Asked him to come back after a week
  • Case history one One week later
    • He really came back
      • Told me that
        • He did not visit the doctor but
        • Took his tablets regular l y and
        • Checked his blood sugar by himself
        • His dizziness became much better
  • Case history one Reflection
    • Was my approach the best possible one?
    • Was there something I could have done better?
    • Did I loose sight of something?
  • Case history one Reflection
    • Remember the first conversation!
    • How were my questions?
      • The questions were „closed questions“
    • How were the answers of my patient?
      • He nearly always answered : yes
    • Were these answers logical?
      • Yes they were.
      • Therefore I could not notice that he was hard of hearing
  • Case history one Reflection
    • Remember the first conversation!
    • I thought I got the right information from the patient (that he suffers from hypertension).
    • But I did double check it by monitoring the blood pressure.
    • I didn`t bear in mind that there are much more possible reasons for dizziness in this special case.
    • I thought I had all necessary information.
    • Without having all information I made my 1 th decision.
  • Case history one Reflection
    • Remember the second conversation
    • How were my questions?
      • I used open questions
    • How were the answers of my patient?
      • Again he nearly always answered : yes
    • Were these answers logical?
      • No they were not.
      • So I had the chance to recognise his disability:
        • hardness of hearing
  • Case history one Conclusion
    • Using closed questions makes it very difficult to recognise weather a customer has really got what we wanted to bring forward
    • That can lead to severe mistakes
    • Therefore:
      • Use open questions whenever you can !!
      • Bare in mind as many causes as possible!!
  • Case history two The Patient
    • 39 years old
    • female
    • She hands me over her prescription
  • Case history two
  • Case history two Prescription Name Mary Taylor Date of birth: 24.12.19 68 Insurance WGKK RP) Beloc Tbl 50mg 50 St I OP Marcoumar Tbl 3 mg 100 St I OP Diovan Ftbl 80 mg 28 St I OP Sedacoron Tbl 200 mg 50 St I OP Dr. John Helpful Common Practitioner
  • Case history two Composition: Metoprolol Pharmaceutical form: Tabletts Clinical data: cardiac insufficiency (slight) RR  etc. Dosage Warning notices
  • Case history two
  • Case history two Field of application: hypertonia c ardiac insufficiency (slight) Mode of application ; unchewed Dosage : 100-200mg Contraindication : hypotension c ardiac insufficiency (severe) Gravidity and breastfeeding Composition: Metoprolol
  • Case history two Side effects Interactions Warnings
  • Case history two
  • Case history two
  • Case history two
  • Case history two Phenprocoumon
  • Case history two Anticoagulans
  • Case history two
  • Case history two Valsartan
  • Case history two Angiotensin II Receptor Antagonist
  • Case history two
  • Case history two
  • Case history two Amiodaron HCl
  • Case history two Gravidity : Contra indication!!! 1 year contraception !!!
  • Case history two Avoid insolation !!!
  • Case history two Reflection
    • We have information concerning
      • 4 drugs
    • Each of it with
      • Effects
      • Side effects
      • Adverse reactions
      • Interactions
      • Etc., etc.
  • Sidestep interactions:
  • Sidestep interactions: Additive cardiodepressiv effect increased effect of the anticoag. Risk of bleeding
  • Sidestep interactions (IA):
    • There is nearly no combination of drugs without IA!
    • How can we deal with this situation in the pharmacy?
    • An IA does not basically mean that a combination is forbidden.
    • Check the importance of IA for the individual patient.
    • In some cases (severe IA) we should avoid combination s
    • In frequent cases we should give detailed advice.
    • We should keep in mind that normally GP`s are aware of IA and accept them as the minor problem.
  • Sidestep interactions (IA):
    • There is nearly no combination of drugs without IA!
    • How can we deal with this situation in the pharmacy?
    • An IA does not basically mean that a combination is forbidden.
    • Check the importance of IA for the individual patient.
    • In some cases (severe IA) we should avoid combination
    • In frequent cases we should give detailed advice.
    • We should keep in mind that normally GP`s are aware of IA and accept them as the minor problem.
    A good pharmacist never blames the doctor for ignoring an important IA! If necessary we contact the doctor with a proposal on a proper solution!
  • Case history two Problem
    • The number of information is huge
    • We cannot convey more then 3 facts
  • Case history two Solution
    • We have to check all information and
    • Try to find the t h ree most important facts
  • Case history two Solution
    • For our lady that could be:
    • „ Be shure that you take your medicine regularly“
    • „ Beware of glare of the sun! It will burn your skin!“
    • „ Be sure that you use safe contraception!“
  • Case history two
  • Case history three The patient
    • Age: 30 years
    • Sex: female
    • Her problem: She suffers from vomiting attacs and wanted to have her bloodpressure checked
  • Case history three The next step
    • I asked my assistant to check the blood pressure
  • Case history three A problem occured
    • My assistant informed me that she always got an error message on the device
  • Case history three A problem occured
    • My assistant informed me that she always got an error message on the device
  • Case history three A problem occured
    • My assistant informed me that she always got an error message on the device
    • I tried it myself and got the same result -> „error“
  • Case history three A problem occured
    • My assistant informed me that she always got an error message on the device
    • I tried it myself and got the same result -> „error“
  • Case history three The next step
    • My assistant informed me that she always got an error message on the device
    • I tried it myself and got the same result -> „error“
    • Then I made a n acouophonia measurement
  • Case history three The next step
    • My assistant informed me that she always got an error message on the device
    • I tried it myself and got the same result -> „error“
    • Then I made a n acouophonia measurement
    • The result I found:
    • Diastolic parameter:
    • 270 mm Hg
    • Systolic parameter:
      • 150 mm Hg
  • Case history three What could be done ?
    • It is an emergency situation!
    • So time is an important factor!
    • If you have no chance to get a doctor quickly you could help the patient for example by
      • Let her chew a NIFEDIPIN capsule or
      • Use a NITRO spray
    • Watch the patient carefully
    • Try to get a doctor as soon as possible
  • Case history three My decision
    • I called the ambulance
    • I prepared to give her a nitro spray
    • Then the ambulance arrived within a few minutes
    • The emergency physician told me that my results were right
    • She injected a calcium antagonist and brought the patient to the hospital immediately
  • Case history three Conclusion
    • If my assistant would have told the patient that there is a failure in the device and sent her home she might have passed away
    • But my assistant noticed that the ladies skin was extremely pale and
    • My assistant was very familiar with the blood pressure unity
  • Case history three Conclusion
    • Sometimes patient`s problems are not directly drug related
    • Never trust a technical device if something looks strange
    • Always use your broad knowledge combined with your experience of life
    • Be proactive if necessary
  • Topics
    • Introduction
    • Cases
    • Can our woo r k influence public health?
    • What polls say about our reputation
    • Summary
  • Can our work influence public health? 3 examples
    • Blood pressure under control?
    • Disease prevention starts inside your head!
    • 10 Minutes for my health
  • Can our work influence public health? 3 examples
    • Blood pressure under control?
    • A project of community pharmacists, general practitioners and the City of Villach
  • Starting position Patients unaware of their hypertonia
  • Our activities:
    • Measurement of blood pressure
    • Supported by
    • Regional GP`s and
    • City officials
  • Advantage:
    • Access to the 75 % of hypertonia patients who are not treated
    • Drafting of risk profiles
    • Targeted prevention campaigns
    • „On-medication“ – Study (Adherence)
    • Raising awareness of the public
  • Result:
    • We could satisfy the expectations
  • Health Promotion - joint initiatives
    • Blood pressure under control?
    • A project of community pharmacists, general practitioners and the City of Villach
    • Disease prevention starts inside your head!
    • A project of the Chamber of Pharmacists and the Chamber of Medical Doctors in Vienna
  • Starting position
    • More than half of all deaths in Austria result from cardio-vascular diseases
    • About 50 % of cardio-vascular diseases are due to risk factors that could be reduced by prevention
    • Every Austrian citizen is entitled to an annual medical check-up paid by social insurance
    • Only 12 % throughout Austria, in Vienna only 7,9 % made use of this opportunity in 1999
  • Aims
    • Motivate patients to make their annual medical check-up
    • Raise patient awareness and responsibility
    • Early detection of risk factors and hidden diseases
    • Early treatment of cardio-vascular diseases
  • How it worked
    • Pharmacists and GPs promoted
    • “quick-check” of weight, blood pressure, blood sugar and cholesterol in pharmacies
    • referral to the doctor if results were above / below standard
    • referral to the doctor for the regular annual check-up
  • Results
      • The number of patients who made use of their right to an annual medical check-up increased by 36 % within half a year
      • Public awareness of community pharmacist´s health promotion projects increased
      • Scientific evaluation by University
  • Health Promotion - joint initiatives
    • Blood pressure under control?
    • A project of community pharmacists, general practitioners and the City of Villach
    • Disease prevention starts inside your head!
    • A project of the Chamber of Pharmacists and the Chamber of Medical Doctors in Vienna
    • 10 Minutes for my health Preventing screening campaign in pharmacies
  • „ 10 minutes for my health“
    • In 2006 nearly all 1200 pharmacies all over Austria r a n a campaign offering a free health check
    • Intensive PR efforts result ed in about 130 media reports in the first month alone
    • Some proponents of the Medical Chamber were not really amused about the pharmacy campaign
    • Pharmacies became visible in the area of „preventive checks“
  • „ 10 minutes for my health“ Measurement of health parameters
    • The preventive screening includes:
      • weight,
      • abdominal girth,
      • blood sugar,
      • cholesterol and
      • blood pressure
  • „ 10 minutes for my health“ Results:
    • 68.000 persons were checked whereof more than 1/3 were males.
    • 54 % of the screened persons were referred to a physician due to their alarming health parameters.
    • In 2 out of 100 persons manifest diabetes was detected.
    • More than half is overweight.
    • Every third is suffering from elevated blood pressure.
  • „ 10 minutes for my health“
    • After the campaign has finished :
    • The screening is continued in community pharmacies
    • With campaigns like these we proved that our work in community pharmacies is an important contribution to public health
    Can our wo r k influence public health? Yes!
  • Topics
    • Introduction
    • Cases
    • Can our work influence public health?
    • What polls say about our reputation
    • Summary
  • What polls say about our reputation
    • Poll by Reader`s Digest 2006 [2005] (2004)
    • Question: How much do you trust in the following professions:
    • Very much
    • Quite a lot
    • A little
    • Not very much
    • Not at all
  • What polls say about our reputation
    • The table shows the percentage of respondents who trust in the several professions „very much“ and „quite a lot“.
    • (In Brakets the results of 200 5 and 2004 )
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 2006 [2005] (2004) 2006 [2005] (2004) 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen Europe Austria
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 2006 [2005] (2004) 2006 [2005] (2004) 92 [ 90 ] (90) 97 [ 95 ] (90) Pilots (aircraft) 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen Europe Austria
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 2006 [2005] (2004) 2006 [2005] (2004) 92 [ 90 ] (90) 97 [ 95 ] (90) Pilots (aircraft) 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen 89 [ 89 ] (89) 96 [ 96 ] (93) Pharmacists Europe Austria
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 2006 [2005] (2004) 2006 [2005] (2004) 86 [ 88 ] (88) 94 [ 98 ] (93) Nurses 92 [ 90 ] (90) 97 [ 95 ] (90) Pilots (aircraft) 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen 89 [ 89 ] (89) 96 [ 96 ] (93) Pharmacists Europe Austria
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 2006 [2005] (2004) 2006 [2005] (2004) 86 [ 88 ] (88) 94 [ 98 ] (93) Nurses 92 [ 90 ] (90) 97 [ 95 ] (90) Pilots (aircraft) 85 [ 83 ] (83) 91 [ 91 ] (88) Physicians 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen 89 [ 89 ] (89) 96 [ 96 ] (93) Pharmacists Europe Austria
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 2006 [2005] (2004) 2006 [2005] (2004) 86 [ 88 ] (88) 94 [ 98 ] (93) Nurses 92 [ 90 ] (90) 97 [ 95 ] (90) Pilots (aircraft) 7 [ 9 ] (10) 8 [ 12 ] (11) Polititians 85 [ 83 ] (83) 91 [ 91 ] (88) Physicians 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen 89 [ 89 ] (89) 96 [ 96 ] (93) Pharmacists Europe Austria
  • What polls say about our reputation Source: Reader`s Digest European Trusted Brands 2005 Reputation of community pharmacists is excellent ! 2006 [2005] (2004) 2006 [2005] (2004) 86 [ 88 ] (88) 94 [ 98 ] (93) Nurses 92 [ 90 [ (90) 97 [ 95 ] (90) Pilots (aircraft) 7 [ 9 ] (10) 8 [ 12 ] (11) Polititians 85 [ 83 ] (83) 91 [ 91 ] (88) Physicians 95 [ 95 ] (95) 97 [ 100 ] (97) Firemen 89 [ 89 ] (89) 96 [ 96 ] (93) Pharmacists Europe Austria
  • Topics
    • Introduction
    • Cases
    • Can our wo r k influence public health?
    • What polls say about our reputation
    • Summary
  • Summary
    • University education is essential for our professional work
  • Summary
    • University education is essential for our professional work
    • Comprehensive knowledge of medicines is very important
  • Summary
    • University education is essential for our professional work
    • Comprehensive knowledge of medicines is very important
    • Satisfaction of patients is closely linked on how we conduct the conversation with them
  • Summary
    • University education is essential for our professional work
    • Comprehensive knowledge of medicines is very important
    • Satisfaction of patients is closely linked on how we conduct the conversation with them
    • Success of pharmacotherapie depends very much on our skills
  • Summary
    • University education is essential for our professional work
    • Comprehensive knowledge of medicines is very important
    • Satisfaction of patients is closely linked on how we conduct the conversation with them
    • Success of pharmacotherapie depends very much on our skills
    • Pharmacists are important in public health projects
  • Summary
    • University education is essential for our professional work
    • Comprehensive knowledge of medicines is very important
    • Satisfaction of patients is closely linked on how we conduct the conversation with them
    • Success of pharmacotherapie depends very much on our skills
    • Pharmacists are important in public health projects
    • Polls proof that people all over Europe trust in pharmacists
  • Summary
    • Use your knowledge!
    • Watch your patient!
    • Listen to your patient
    • Serve your patient like your best friend
  • Summary
    • Use your knowledge!
    • Watch your patient!
    • Listen to your patient
    • Serve your patient like your best friend
    • I wish you that
    • You will fall in love with pharmacy
    • Your dreams will become true
  • Your questions please