Australian pharmacists' perceptions and practices in travel health

Worldwide, pharmacists are playing an increasing role in travel health, although legislation and funding can dictate the nature of this role, which varies from country to country. The aim of this study was to explore the current and potential future practices in travel health for pharmacists in Australia, as well as the perceived barriers, including training needs, for the provision of services. A survey was developed and participation was sought from a representative sample of Australian pharmacists, with descriptive statistics calculated to summarise the frequency of responses. A total of 255 participants, predominantly female (69%), below 50 years (75%) and registered less than 30 years completed the survey. Although over two-thirds (68%) provided travel-related advice in their current practice, the frequency of advice provision was low (less than 2 travellers per week) and limited to responding to travellers questions. Although Australian pharmacists are currently unable to administer travel vaccines and prescription only medications without prescription, they still consider travel health to be an appropriate role and that their clients would seek travel health advice from pharmacies if offered. Currently, key roles for Australian pharmacists are advising travellers who do not seek advice from other practitioners, reinforcing the advice of other health practitioners and referring travellers needing vaccinations and antimalarials. In order to expand these services, the barriers of workload, time, staffing and the need for training in travel health need to be addressed. In summary, the travel health services provided by pharmacies in Australia still have a way to go before they match the services offered by pharmacies in some other countries, however Australian pharmacist are keen to further develop their role in this area

The TREAT-NMD advisory committee for therapeutics (TACT): an innovative de-risking model to foster orphan drug development

Despite multiple publications on potential therapies for neuromuscular diseases (NMD) in cell and animal models only a handful reach clinical trials. The ability to prioritise drug development according to objective criteria is particularly critical in rare diseases with large unmet needs and a limited numbers of patients who can be enrolled into clinical trials. TREAT-NMD Advisory Committee for Therapeutics (TACT) was established to provide independent and objective guidance on the preclinical and development pathway of potential therapies (whether novel or repurposed) for NMD. We present our experience in the establishment and operation of the TACT. TACT provides a unique resource of recognized experts from multiple disciplines. The goal of each TACT review is to help the sponsor to position the candidate compound along a realistic and well-informed plan to clinical trials, and eventual registration. The reviews and subsequent recommendations are focused on generating meaningful and rigorous data that can enable clear go/no-go decisions and facilitate longer term funding or partnering opportunities. The review process thereby acts to comment on viability, de-risking the process of proceeding on a development programme. To date TACT has held 10 review meeting and reviewed 29 program applications in several rare neuromuscular diseases: Of the 29 programs reviewed, 19 were from industry and 10 were from academia; 15 were for novel compounds and 14 were for repurposed drugs; 16 were small molecules and 13 were biologics; 14 were preclinical stage applications and 15 were clinical stage applications. 3 had received Orphan drug designation from European Medicines Agency and 3 from Food and Drug Administration. A number of recurrent themes emerged over the course of the reviews and we found that applicants frequently require advice and education on issues concerned with preclinical standard operating procedures, interactions with regulatory agencies, formulation, repurposing, clinical trial design, manufacturing and ethics. Over the 5 years since its establishment TACT has amassed a body of experience that can be extrapolated to other groups of rare diseases to improve the community's chances of successfully bringing new rare disease drugs to registration and ultimately to marke

Pharmaceutical care model to assess the medication-related risks of travel

Background: People are at greater risk of health problems when travelling and a significant number of travel-related health problems are associated with the effects of travel on pre-existing chronic diseases. Medications play a key role in the management of these conditions. However, there is a notable lack of research evaluating the potential medication-related risks associated with travel.\ud \ud Objective: To apply a systematic pharmaceutical care model developed to evaluate potential pharmaceutical risks (PPRs) and pharmaceutical care issues (PCIs) in travellers.\ud \ud Setting: Adult travellers leaving Cairns International Airport, Australia, for an international destination.\ud \ud Method: A cross-sectional survey using semi-structured interviews, including a systematic medication history, followed by the application of a pharmaceutical care model to evaluate each participant for PPRs and PCIs. \ud \ud Main outcome measure: Evaluation of standard clinical and travel-related PPRs and PCIs. \ud \ud Results: Medications for chronic diseases were being taken by 47.7% of the 218 travellers interviewed. Although 75.2% of participants presented with no PPRs, a total of 274 PCIs were identified across 61.5% of the participants, with an average of 2.04 PCIs per participant. The most prevalent PCIs related to the inadequate precautions taken by some travellers visiting malaria-endemic regions. Although 91 participants recognised that they were travelling to malaria-endemic regions, 65.9% of these participants were not using malarial chemoprophylaxis, and only 16.5% were using chemoprophylaxis that fully complied with standard recommendations. The second most prevalent PCI was the need for 18.8% of participants to be educated about their medications. Other PCIs identified have the potential to increase the risk of acute, travel-related conditions, and complicate the care of travellers, if they inadvertently became unwell while overseas. \ud \ud Conclusion: PPRs and PCIs were not identified in all participants. However, the impact of many of the identified medication-related issues could be substantial to the traveller. This study represents the novel application of a pharmaceutical care model to identify potential PPRs and PCIs in travellers that may not be identified by other pre-travel risk assessment methods

Australian pharmacists' perceptions and practices in travel health

Worldwide, pharmacists are playing an increasing role in travel health, although legislation and funding can dictate the nature of this role, which varies from country to country. The aim of this study was to explore the current and potential future practices in travel health for pharmacists in Australia, as well as the perceived barriers, including training needs, for the provision of services. A survey was developed and participation was sought from a representative sample of Australian pharmacists, with descriptive statistics calculated to summarise the frequency of responses. A total of 255 participants, predominantly female (69%), below 50 years (75%) and registered less than 30 years completed the survey. Although over two-thirds (68%) provided travel-related advice in their current practice, the frequency of advice provision was low (less than 2 travellers per week) and limited to responding to travellers questions. Although Australian pharmacists are currently unable to administer travel vaccines and prescription only medications without prescription, they still consider travel health to be an appropriate role and that their clients would seek travel health advice from pharmacies if offered. Currently, key roles for Australian pharmacists are advising travellers who do not seek advice from other practitioners, reinforcing the advice of other health practitioners and referring travellers needing vaccinations and antimalarials. In order to expand these services, the barriers of workload, time, staffing and the need for training in travel health need to be addressed. In summary, the travel health services provided by pharmacies in Australia still have a way to go before they match the services offered by pharmacies in some other countries, however Australian pharmacist are keen to further develop their role in this area

Development of a benchmarking tool for pharmacy students using threshold learning outcomes

Methods: Benchmarking is crucial for ensuring the quality of the learning experience offered by a curriculum. This project aimed to develop, refine and validate a tool based on the pharmacy threshold learning outcomes (TLOs) to facilitate benchmarking of students' performances in verbal 'capstone' assessments in Australian pharmacy programs.\ud A pilot tool was developed and trialled by local and external examiners during the University of Tasmania (UTAS) 2013 Bachelor of Pharmacy Fourth Year verbal examinations. Usability and acceptability were assessed using a survey and the tool was evaluated for validity and inter- and intra-rater reliability using Pearson correlation coefficients (R). The tool was refined using these results, and a validation exercise is planned for late 2014.\ud \ud Results: In the initial evaluation, agreement on TLO scoring was excellent between UTAS examiners (R values 0.73-0.88; n=29 comparisons); and very good between the Tasmanian and external examiners for most TLOs (R=0.59-0.68; n=12). Agreement between allocated marks and TLO scores were also very good (R=0.62-0.85; n=29). Survey results recommended improving alignment of the TLOs with the assessment activity, simplifying the rating scales and providing training regarding the tool.\ud \ud Discussion: Progress is underway towards the development of a relatively simple, flexible and validated benchmarking tool to facilitate high quality student outcomes across Australian pharmacy programs. Training in the use of the tool has been identified as a major enabler of its successful and consistent application, and a scenario-based training video is currently being produced. The tool and training video will be showcased in this presentation

The application of Inca khipuas an accountability and managerial control tool

Purpose – This study aims to present the mechanisms of control and accountability used in the Inca society. Design/methodology/approach – For this purpose, a bibliographical and documental analysis regarding the use of khipus in this civilization was carried out, applying a qualitative approach. Findings – The results of the study indicate that the Inca khipu was the main instrument of tax registration and management adopted by the Inca empire. The Khipucamayocs were responsible for the production of the Khipu, asserting that the information generated and consolidated in the imperial khipu was correct, considering that these professionals paid with their lives in case of errors. Originality/value – The main contributions to accounting are related to the understanding of the origin of the development of tax control and accountability tools created in the Inca Empire, before the Spanish invasions, that contributed significantly to the development of the first American societie

Aboriginal & Torres Strait Islander Sexual Health Promotion Initiatives in NSW

This report is a description of Aboriginal sexual health in NSW as seen by the workers themselves. It also incorporates current understandings of sexual health promotion, especially those in the National Indigenous Australians' Sexual Health Strategy 1996/97-1998/99 (NIASH), and the National HIV/AIDS Strategy 1996-97/ 1998-99 (NHS). The workers discussed and reflected upon their everyday experiences of sexual health program delivery, selecting particular health promotion initiatives and resources to illustrate what programs they believed to be effective and why. The report thus builds on sexual health workers' existing expertise