Technicians over the border. - jppr - The Society of Hospital ...

itself (rather than how to teach evidence-based practice),
the same group also run an introductory 3-day workshop
in November each year.
I would like to acknowledge the assistance of SHPA
(WA State Branch) in funding my attendance at the
workshop via the DBL Professional Development Grant
and the GSK Travel Grant.
Jane Carpenter, BPharm (Hons),
GradDipHospPharm
Drug Information Pharmacist
Sir Charles Gairdner Hospital
Hospital Avenue
Nedlands WA 6009
Australia
E-mail: Jane.Carpenter@health.wa.gov.au
Pharmacists and Complementary
Medicine in Australia
To the Editor,
Annual public expenditure on complementary medicines
in Australia is currently estimated to be around $2.3
billion, with the vast majority spent on complementary
products and non-prescription medications. 1 Evidence
suggests many patients are not informing their
conventional care givers (including pharmacists) of their
complementary medicine use 2 —circumstances that have
implications for all healthcare professionals, none more
so than professional pharmacy.
Both hospital and community pharmacists provide
a major interface between the patient and the world of
medicine and there is an important role for pharmacists
in informing and influencing patient behaviour and
practice regarding prescription and non-prescription
medications. The complementary medicine/pharmacy
interface is particularly important given the emerging
issues of complementary medicine safety and quality.
Complementary medicine-drug interactions are a
significant consideration that can be overlooked in some
cases 3 and it is essential for optimum patient care that
pharmacists are educated and informed regarding this
growing practice issue.
Complementary medicine is slowly but surely
accumulating an evidence base 4 and clinical efficacy is
indeed an important focus for future research. However,
there is also a need to conduct supplementary studies
drawing upon the approach of health social science,
public health and health services research to help
understand the role and place of complementary medicine
in health-seeking behaviour and decision making. Some
early work investigating these issues in relation to
pharmacy overseas has begun. 5 Unfortunately, we still
know very little about the relationship between
pharmacists and complementary medicine, what types
of practices pharmacists undertake regarding
complementary medicine, and how much information
they have and utilise about these medicines in Australia.
The study of these issues—essential to helping provide
optimum patient care, informing professional pharmacy
and helping deliver a health care system based upon
best evidence—remains underdeveloped.
In order to address these significant research gaps,
we have begun designing and piloting research that
explores the details of the pharmacy/complementary
medicine interface and the practices, information seeking,
level of knowledge and experiences of pharmacists
regarding complementary medicine in Australia. One
outcome of our study will be to help identify the needs
of professional pharmacists regarding this practice issue
in a bid to move towards ever safer and more effective
patient care that incorporates an understanding of
complementary medicine.
Jon Adams, BA (Hons), GradDip, MA, PhD
Co-Director
UK-Australian Complementary Medicine Research
Group
University of Newcastle, Australia
University of Leeds, UK
Senior Lecturer
Janine M Duke, BPharm, GradDip, PhD
Lecturer
Centre for Clinical Epidemiology and Biostatistics
School of Medical Practice and Population Health
Faculty of Health
University of Newcastle
Level 3 DMB
Newcastle NSW 2300
Australia
E-mail: jon.adams@newcastle.edu.au
References
1. MacLennan AH, Wilson DH, Taylor AW. The escalating cost and prevalence
of alternative medicine. Prev Med 2002; 35: 166-73.
2. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, van Rompay M, et
al. Trends in alternative medicine use in the United States, 1990-1997: results
of a follow-up national survey. JAMA 1998; 280: 1569-75.
3. Braun L. Herb-drug interaction guide. Aust Fam Physician 2001; 30: 685-6.
4. Freeman LW, Lawlis GF. Mosby’s complementary medicine and alternative
therapies: a research-based approach. St Louis: Elsevier; 2000.
5. Howard N, Tsourounis C, Kapusnik-Uner J. Dietary supplement survey of
pharmacists: personal and professional practices. J Altern Complement Med
2001; 7: 667-80.
Technicians over the Border
To the Editor,
As the recipient of the Amgen Technician grant I was
given the opportunity to spend a week in August 2003
with pharmacy technicians at the Geelong Hospital,
Victoria. Geelong Hospital with 350 beds is much larger
than the Lyell McEwin Health Service, currently 172 beds,
where I am employed. The main focus of my visit was the
technician training program and the implementation of
the Pharmaceutical Benefits Scheme.
The Geelong Hospital Pharmacy Department has
implemented their own in-house training program
including formal written guidelines and evaluation
processes. Competency assessment plays a large role in
the training program. Technicians are required to fill 1000
consecutive items under the supervision of a pharmacist.
These items can be achieved in a combination of
processes. The interpretation of medication charts and/
or prescriptions, the producing of medication labels and
the actual packaging of the medications and, if available,
sterile production are all areas in which performance can
be assessed. To be deemed to be competent to fill the
role of Ward Technician, there must be zero type A errors
and no more than five type B errors.
Errors are classified as:
Journal of Pharmacy Practice and Research Volume 34, No. 1, 2004 73

Type A: Incorrect drug, incorrect strength of drug,
incorrect dose form/formulation. Incorrect storage
conditions and any drug missing and not readily
available after hours.
Type B: Unnecessary drug, inadequate quantities,
drug missing but readily accessed from an after hours
area or an alternative ward.
Technicians are assessed for competency
approximately every six months by a pharmacist randomly
selecting and reviewing 100 items.
Formalisation of training for technicians is yet to be
implemented in Australia. Currently in South Australia
the availability of certificates III and IV and/or a diploma
are being considered. Suggestions are also being made
for changes in legislation to enable technicians to
dispense with checking by other technicians, following
pre-checking of the order by a pharmacist.
As discussions are currently in progress for the
possible introduction of the Pharmaceutical Benefits
Scheme to a number of hospitals in South Australia, the
implementation of the Pharmaceutical Benefits Scheme
at the Geelong Hospital was of great interest to all staff at
the Lyell McEwin Pharmacy Department. From my
observations, the Pharmaceutical Benefits Scheme offered
a number of advantages with the most obvious being
that patients are issued with a minimum of one month
supply of medications covered by the Pharmaceutical
Benefits Scheme, and also the ability of the pharmacy to
claim for reimbursement of medication costs through the
scheme. The major disadvantage appeared to be the
increase in record keeping. The administrative side of
the Pharmaceutical Benefits Scheme appeared to be fairly
involved which made me aware that the issue of an
increase in staffing would need to be addressed if the
scheme was implemented. However, many of the problems
observed were minor and I feel could be dealt with by the
provision of training and advice.
During the week I spent at the Geelong Pharmacy, I
gained valuable insight into a number of areas of the
Pharmaceutical Benefits Scheme and I feel that I have a
much clearer idea of the process and issues. In addition,
formalisation of a training regime for technicians is currently
in the process of being addressed in South Australia, and
I hope that the knowledge and understanding of other
hospital regimes gained at Geelong will enable me to
contribute to this process in my hospital and state.
I would like to express my appreciation to Amgen for
the opportunity to interact, discuss and thoroughly enjoy
the time spent in the Geelong Hospital Pharmacy
Department. Additionally, my thanks go to the SHPA for
the advice and guidance I received while applying for
the Technician Grant. My thanks and appreciation also
go to the many staff at Geelong who allowed me to watch
and learn how they carried out daily duties, patiently
answered my many questions and made me feel welcome.
Sandy Bollenhagen
Senior Pharmacy Technician
Pharmacy Department
Lyell McEwin Health Service
Haydown Road
Elizabeth Vale SA 5112
Australia
E-mail: Sandra.Bollenhagen@nwahs.sa.gov.au
Medimate: Medicines without the Mix-ups
To the Editor,
Early in 2004 the Society of Hospital Pharmacists of
Australia (SHPA) and the National Prescribing Service
(NPS) sent a letter to all hospital pharmacists to inform
them about the Community Quality Use of Medicines
Program. This is a new NPS program to help consumers
better understand their medicines.
Bulk supplies of Medimate (the brochure for the
program) were also sent to hospital pharmacy
departments in mid-January. However, we have heard that
many of these have not been received.
SHPA and NPS encourage pharmacists to provide
Medimate to inpatients at risk of medication misadventure,
patients about to be discharged, outpatients, and patients
in emergency departments. Medimate may usefully
accompany hospital computer-generated (or pharmacist
written) medicines lists that are prepared for individual
consumers.
Medimate can be ordered from the specific web site
. Simply give your details and
the number required.
NPS has also received feedback from SHPA regarding
Medimate for future consideration. This includes:
addressing the issue about a medicine name versus
brand;
highlighting issues relating to allergies and previous
adverse reactions to medicines;
ensuring consumers understand that the medicines
list can be extended by printing off a page from the
NPS web site;
ensuring SHPA reviews future drafts.
Other feedback from pharmacists has identified the
importance of increasing the space provided for listing
medicines—to ensure that Medimate is actually used and
retained by consumers.
It is pleasing to note that initial results from our
consumer survey, looking at the uptake and awareness
of this program, are very positive with 58% of Australians
aware of our key messages. We hope we can continue to
improve this awareness both at the national and local
level.
NPS will continue to work with SHPA and we will
keep pharmacists informed about the progress of this
program via our newsletters and publications, web sites
and via the Journal.
If you have any comments or would like more
information please telephone NPS on 02 8217 8700 or email
info@nps.org.au. We look forward to your support.
Lynn Weekes, BPharm, MSc, PhD
Chief Executive Officer
National Prescribing Service Limited
Level 7, 418A Elizabeth Street
Surry Hills NSW 2010
Australia
E-mail: lweekes@nps.org.au