Home' Australian Pharmacist : Australian Pharmacist December 2015 Contents Australian Pharmacist December 2015 I ©Pharmaceutical Society of Australia Ltd.
Competency standards review
The Pharmacy Practitioner
Development Committee (PPDC)
has started consultations with its
member organisations on a revised
draft of the profession's competency
standards framework. PPDC chair
Dr Shane Jackson said that the current
document, the National Competency
Standards Framework for Pharmacists
in Australia, was published in 2010.
The review is also considering
the integration of the Advanced
Pharmacy Practice Framework into the
revised draft of the 2010 framework
to produce a single competency
standards framework. On completion,
a broader consultation with
members of the profession and other
stakeholders including consumers will
be conducted in 2016.
Osteoporosis resource launched
NPS MedicineWise has launched
a learning program and health
professional resources on osteoporosis
to assist in identifying patients
at increased risk of osteoporosis,
to choose and initiate therapy in
patients particularly following
minimal trauma fractures, and
to encourage adherence to
medicines. NPS MedicineWise
Clinical Adviser, Dr Andrew Boyden
said: 'Health professionals have an
important role to play in preventing
the health burden associated with
fractures due to osteoporosis.
Unfortunately osteoporosis is a silent
condition -- under-recognised and
under-treated in many Australians over
the age of 50, even after a minimal
Pharmacy-based INR service
delivers high control
BY ANDREW DANIELS
A community pharmacy-based anticoagulation management service
funded by the New Zealand Government has been found to provide
safe and reliable anticoagulant care with a consistently high level of
The results of a clinical audit of the
program were published in the
September issue of the New Zealand
The authors found only a modest
change in the time in therapeutic
range (TTR) from 76.4% to 74% during
the audit period, despite the growth
in patient numbers from 850 to 4,350.
There was no change in the proportion
of INR results above 4.0 and bleeding
was reported in less than 4% of visits.
Of these, 82% of bleeds were minor.
The interval between tests remained
constant at approximately 19 days.
They concluded that the Community
Management Service (CPAMS)
provided safe reliable anticoagulant
care with a consistently high level of
A leading Australian pharmacy
anticoagulation service researcher,
Associate Dean (Research) and
Co-Director, Health Services Innovation
Tasmania at the Faculty of Health,
University of Tasmania, Professor
Gregory Peterson, told Australian
Pharmacist that achieving a time in
the INR therapeutic range of 74% for
warfarin was very good and superior to
that achieved with most models of care.
Co-author of the NZMJ article, Ian
McMichael, told Australian Pharmacist
that as soon as the service began
patients liked it and no one wanted to
go back to the previous system.
He said the feedback from politicians
indicated they were impressed with
'The Ministry of Health are happy but
concerned about what pharmacy will
try to do next, even though they keep
speaking about pharmacists "working to
the top of their scope of practice."
'From local health funders, depending
on the funder, they are either stalling
the degree of uptake or accelerating
the uptake by giving more contracts
and increasing the number of patients,'
Mr McMichael said.
Professor Peterson said: 'It is better than
in the pivotal trials that have compared
the newer oral anticoagulants with
warfarin. It often gets overlooked that
warfarin management has progressed
substantially in recent years with INR
self-monitoring and other approaches
such as the NZ pharmacy-based model
improving anticoagulation control
and reducing both embolic stroke
and bleeding risk in patients with
'When applied more widely, it means
that warfarin is still the most cost-
effective and safest anticoagulant for
Harper P, McMichael I, Griffiths D, Harper J, Hill C. The
community pharmacy-based anticoagulation management
service achieves a consistently high standard of anticoagulant
care. NZMJ 2015 Sep 25;128(1422)35--44.
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