Home' Australian Pharmacist : Australian Pharmacist December 2013 Contents 18 Australian Pharmacist December 2013 I ©Pharmaceutical Society of Australia Ltd.
When is a
disease a risk
Macquarie University will receive
$820,156 over four years towards an
investigative study into the evaluation of
disease and cost burdens of over diagnosis
in Australian health care.
The project, led by Professor of Clinical
Ethics Wendy Rogers, has received a Future
Fellowship from the Australian Research
Council, and will define the limits of
physical disease to answer questions about
when a presentation is a disease, and when
it is simply a risk factor or mild condition.
In this way it will make a practical
contribution to debates about the scope
of healthcare, and yield findings that can
help to reduce associated cost burdens.
Professor Rogers said that the project
aims to develop an account of disease
that will help guide practitioners and
policy makers about which abnormalities
or conditions should be labelled
The ensuing account of disease
will make a practical contribution
to growing international concern
about asymptomatic people being
diagnosed and treated for conditions
that will not cause any health problems
The research will provide grounds for
evaluating disease claims. Results will
reduce the harm caused by people
receiving treatment that they do not
require, make a practical contribution
to debates about the scope of health
care, and yield findings that can help to
reduce the cost burdens associated with
'There has been quite a lot of attention
on over-diagnosis, which includes a
range of situations in which people
without symptoms are investigated
and treated, for what are probably
harmless abnormalities. At the same
time, the thresholds for defining diseases
such as type 2 diabetes or chronic kidney
disease have been falling, so that more
and more people are being diagnosed.
'So we get the situation in which
otherwise healthy and asymptomatic
people are turned into patients by
performing investigations, allocating
diagnoses or providing treatments that
do not improve patients' health, and may
actually harm them.
'In this situation, it's important to be
clear about what we mean when we
say a condition is a disease, but at the
moment, there is little agreement on
this. So there are philosophical questions
to answer here, about defining disease,
as well as ethical questions about the
benefits and harms of defining disease in
different ways, and the costs of treating
people who are unlikely to benefit,
Professor Rogers said.
Research by Sydney University pharmacy
researchers Kim Hamrosi and Parisa
Aslani has been included a in the
American journal Research in Social
and Administrative Pharmacy as part of
themed issue on Pharmacy, Medication
Use, and the National Action Plan to
Improve Health Literacy.
In a statement about the issue, the
Journal said that limited health literacy
can lead to difficulties in patients'
self-care activities such as taking
'Since a considerable amount of
health information changes hands
in the pharmacy setting, research by
pharmacists into evaluating which tools
are effective in practice can make a
valuable contribution to goals set by the
2010 US National Action Plan to Improve
Health Literacy and lead to improvements
in communications and health care.'
The Australian researchers contribution,*
examined practices in Australia.
They found that Australian clinicians
often refrain from distributing Consumer
Medicine Information (CMI), which was to
be dispensed with prescription medicine,
due to its shortcomings.
Lead author, Kim
'The challenge for
industry is providing
is usable, flexible,
and user-friendly and available in diverse
technological and multimedia avenues
to improve access and communication.
Future research should focus on
ascertaining practical and cognitive
ways in which health care professionals
can be supported in embracing written
medicine information, including CMI as
an information-sharing tool to improve
patient health literacy and outcomes,'
*Hamrosi K, Raynor D, Aslani P. Pharmacist and general
practitioner ambivalence about providing written
medicine information to patients -- A qualitative study.
How cells interact
Researchers at the University of Tasmania
will receive more than $500,000 from the
National Health and Medical Research
Council (NHMRC) to fund a project which
could uncover crucial information about
how to treat neurological conditions such
as Multiple Sclerosis (MS).
Dr Kaylene Young and her team at the
Menzies Research Institute are exploring
how cells interact within the body and
whether 'immature' cells within the
central nervous system can develop and
repair myelin, the nerve sheath that is
damaged in neurological conditions
Dr Young said it is a completely unique
avenue of research into MS and it is
hoped the project sheds some light on
the complexities of the condition.
'The aim of the project is to identify how
nerve cell communication is altered.
If we achieve what we hope, this would
identify a completely novel aspect of
the disease that we could target with
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