UTSpeaks: A medicated nation (Part 1: Prof Shalom Benrimoj)


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UTSpeaks: A medicated nation
Has Australia lost its way in a pharmaceutical love affair?

Professor Charlie Benrimoj and Associate Professor Mary Bebawy from the University of Technology, Sydney present at this public lecture on prescription medication held on 13 September, 2011.

How many pills will you take today? Do you really need them? What good (and bad) will they do you?

For many of us prescription medications mean the difference between good and ill-health. There’s no denying their important place in fostering well-being for many. But is it time to reflect on the complex forces at work when managing disease and medications and how this impacts you the consumer?

Featuring leading UTS researchers in pharmacy and using example case studies, this public lecture takes a critical look at how medications are prescribed and consumed in Australia. It considers whether we are getting value for money, the ideal health outcomes we hope for and whether new approaches to the responsible use and explanation of medications could be adopted.


Professor Shalom (Charlie) Benrimoj
Charlie Benrimoj is head of the newly-created UTS School of Pharmacy. Formerly he was Foundation Professor of Pharmacy Practice then Dean of the Faculty of Pharmacy and then Pro-Vice Chancellor (Strategic Planning) at the University of Sydney. He is a visiting professor at the University of Granada with research interests in the future of community pharmacy. He is widely published - co-authoring Community Pharmacy: Strategic Change Management in 2007. He was Australian Pharmacist of the Year in 2000 and received the Andre Bedat award in 2010 from the International Pharmacy Federation.

Associate Professor Mary Bebawy
Mary Bebawy has spent more than 14 years in research and teaching positions in academia and two years in industry as a post doctoral preclinical drug development scientist with Johnson and Johnson, Research. She has consulted to academia and industry on assay development, drug discovery and cancer resistance mechanisms. At the UTS School of Pharmacy she specialises in the role and regulation of the xenobiotic cascade in drug disposition and in cancer multidrug resistance (MDR).

UTSPEAKS: is a free public lecture series presented by UTS experts discussing a range of important issues confronting contemporary Australia.

Use the hashtag #utspeaks to tweet about the lecture on Twitter.

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UTSpeaks: A medicated nation (Part 1: Prof Shalom Benrimoj)

  1. 1. A MEDICATED NATION<br />THINK.CHANGE.DO<br />Prof S.I. (Charlie) Benrimoj<br />Head Graduate School of Health<br />& Prof of Pharmacy Practice<br />September 2011 <br />
  2. 2. Major Points : Medications<br /><ul><li>Cheapest form of therapeutic treatment
  3. 3. Benefits but also risks
  4. 4. At least 2% to 4% of hospital admissions are drug related (75 years or over greater 30%)
  5. 5. 50 to 60% of patients are non-compliant
  6. 6. Patients taking multiple medications (PolyPharmacy) at risk
  7. 7. Pharmacist can reduce medication costs, reduce morbidity and mortality</li></li></ul><li>Demographic Changes & Disease Patterns & Consumer expectations<br />Increase in no of people with complex chronic disease<br />Many will be elderly and have multiple health problems<br />Shift to self management<br />Increase to health promotion and disease prevention (increased demand for screening)<br />Increased demand for access to health services<br />
  8. 8. Health and Disease Patterns<br />Prevention<br />Disease changing definition<br />Detection of disease<br />New diseases <br />Risk factors<br />(obesity, physical inactivity)<br />Better management leading to longer survival <br /><ul><li>Source: AIHW (2004). Australia’s Health. Canberra: AIHW</li></li></ul><li>National Medicines Policy<br />
  9. 9. PHARMACEUTICAL BENEFITS SCHEME - 2007 to 2010: Number of Prescriptions<br />Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS<br />
  10. 10. PHARMACEUTICAL BENEFITS SCHEME - 2007 to 2010: Government Costs<br />9.3%<br />Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS<br />
  11. 11. PHARMACEUTICAL BENEFITS SCHEME - 2007 to 2010: Government and Patient Costs <br />Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS<br />
  12. 12. 22 million Australians (2009)<br /> 8.3 medications per person (excludes private prescriptions and below $34.20 for general)<br /> $316 per person cost Government<br />Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS<br />
  13. 13. Questions:<br />Cost effectiveness?<br />Improve compliance<br />As well benefits of medication how can we minimise the negative clinical outcomes ?<br />Medication Management reviews<br />Monitoring Adverse effects<br />
  14. 14. Critical issues: Medications<br />Compliance<br />40 to 60% of patients do not take their medications<br />Adverse Effects<br />2 to 4% of hospital admissions drug related<br />Greater 30% in patients 75 years or older<br />10.4% of GP patients in previous 6 months<br />Poly-pharmacy<br />Patients of more than 5 medications<br />Resistance in a specific disease: Cancer<br />
  15. 15. Role of the Pharmacist<br />Quality use of medicines<br />Consumer Medication Information<br />Compliance (DAA)<br />Clinical Intervention (Meds check)<br />Home Medication Review (HMR)<br />Residential Review (RMMR)<br />Basic and clinical research <br />
  16. 16. MedsCheck: Medicines Review Program<br />In-pharmacy, patient centred service: aims to enhance the quality use of medicines:<br />educating community based patients about their medicines<br />identifying any problems they may be experiencing with their medicines; and <br />understanding interactions between medicines. <br />
  17. 17. Compliance<br />Source : PSA 2006 <br />
  18. 18. Horne et al (2006)<br />
  19. 19. Home Medication Reviews (HMR)<br /><ul><li>available to people living in the community setting where their medical practitioner determines that an HMR is clinically necessary to ensure quality use of medicines or to address the consumer’s needs.</li></li></ul><li>Aims of HMR <br /><ul><li>Take your medicines correctly
  20. 20. Explaining why and when
  21. 21. Storage
  22. 22. What to expect when taking them
  23. 23. What problems you should report to the GP
  24. 24. Checking that prescription medicines, over-the-counter medicines and vitamins are appropriate to take together
  25. 25. Clarifying any confusion with generic medicines
  26. 26. Compliance
  27. 27. Changing your medicines. </li></ul>Source:Http://www.nps.org.au/consumers/ask_an_expert/home_medicine_review<br />
  28. 28. Eligibility for HMR<br />Source : NPS<br />
  29. 29. Numbers of HMRs Over Time<br />
  30. 30. N= 224 964 recommendations<br /><ul><li>Castelino, Bajorek & Chen. Journal of Evaluation in Clinical Practice , 17,(20110 104-110.</li></li></ul><li>Conclusion<br />Medicines have great benefits but “ care”<br />Greatest at risk group , over 65 with more than 5 medications<br />Ask questions about your medications to health care professional<br />Shared Responsibility <br />