MONDAY 22 AUGUST 2016
BE MEDICINEWISE WEEK: HELPING AUSTRALIANS TAKE CHARGE OF THEIR MEDICINES
Be Medicinewise Week (22-28 August) kicks off around Australia today, with the theme of ‘take charge’ of your medicines.Now in its sixth year, this NPS MedicineWise initiative reminds Australians about the importance of using medicines safely and appropriately.
A new survey of 1,000 Australian adults* shows that many people are taking medicines regularly and often managing multiple numbers of medicines. The results of this survey provide a snapshot on the use of medicines in Australia, and are a reminder to prescribers and dispensers about why it is important to talk to patients about being medicinewise.
Dr Lynn Weekes, CEO of NPS MedicineWise, says “This Be Medicinewise Week we’re encouraging everyone to take charge of their medicines by asking the right questions, asking the right people and following the right advice. We want to see people having conversations with their health professionals and to seek evidence-based information to help them make better decisions about their health.”
Key findings about medicine use:
w Three in four surveyed Australians (77%) are taking medicine (including prescription, over-the-counter and alternative or complementary forms) on a weekly basis.
w Surveyed women are more likely than men to be taking any medicine in a week (82% compared to 73%) and more likely to be taking medicine on a daily basis (61% compared to 46%).
w Many respondents aged 50 and older are taking multiple medicines. Twenty-eight per cent said they were taking 5 to 9 medicines each week and 13% were taking ten or more.
Key findings about where medicine is purchased:
w When asked where they usually buy over-the-counter and complementary medicines, the majority of respondents (80%) bought them from a pharmacy, 36% from a supermarket, or 13% from online Australian websites. Only 3% of respondents said they would buy these medicines online from an overseas website.
Key findings about consumer behaviours
w Among the respondents who said they always or sometimes ask questions when starting a new medicine, 49% said they would ask a doctor, 23% said they would ask a pharmacist, and 14% would use an internet search engine.
w Respondents aged 35-64 years (29%) are more likely than those aged 18-34 (16%) or 65 and over (19%) to go to a pharmacist first if they have a question about a medicine. This compares to 49% of people of all ages (41% of 18-34 year olds, 47% of 35-64 year olds and 64% of those aged 65 and over) who would go to a GP as their first port of call.
The survey also revealed that men and young people are more likely to feel too nervous or embarrassed to ask their health professional a question when they’ve been prescribed a new medicine.
“Be Medicinewise Week reminds Australians of the importance of getting into good habits with their medicines, and this includes good communication with health professionals. It’s in everyone’s interests to be better informed to help make better health decisions,” says Dr Weekes.
To find out more and to download our campaign toolkit and other resources, including posters to display this week in your health service, go to www.nps.org.au/bmw2016
*The survey of 1,007 Australian respondents aged 18 and over was conducted online by Galaxy Research in July and August 2016. Full survey findings are available upon request.
ABOUT BE MEDICINEWISE WEEK
Be Medicinewise Week is an initiative of NPS MedicineWise and is on from 22-28 August 2016.
This year is the sixth annual Be Medicinewise Week, a national awareness week promoting the safer and wiser use of medicines by all Australians.
‘Take Charge!’ is this year’s theme and encourages Australians to have conversations with health professionals about their health to get the most out of their prescription, over-the-counter and complementary medicines, and to seek out evidence-based information to help them make better decisions about their health.
The 2016 campaign is encouraging people to:
- Ask the right questions
- Ask the right people
- Follow the right advice.
To find out more and to download our campaign toolkit and other resources, including Be Medicinewise Week posters to display in your health service, please go to www.nps.org.au/bmw2016
12 AUGUST 2016
MEDICINES AND AN AGEING POPULATION: NEW CHOOSING WISELY AUSTRALIA RECOMMENDATIONS RELEASED
The latest lists developed by specialties from the Royal Australasian College of Physicians (RACP) as part of the Choosing Wisely Australia® initiative deliver a strong message on appropriate use of medicines for older Australians.
Older Australians may not be aware that they are on a ‘prescribing cascade’, where they take one medicine and have an adverse reaction, so are put on another medicine. One common example is when a patient is prescribed a non-steroidal drug for pain, and is then prescribed a proton pump inhibitor (PPI) to reduce the risk of stomach side effects caused by the first prescribed medicine.
The new recommendations on appropriate use and prescribing of medicine include:
- recognising and stopping the prescribing cascade, to avoid adverse drug reactions in older people
- reducing the use of multiple medicines
- to not prescribe medicines without conducting a drug review, to avoid adverse outcomes for people on 5 to 20 medications, and
- to stop medicines when no further benefit will be achieved, particularly for older patients with a limited life expectancy where the treatments are unlikely to prevent disease.
Recommendations from the Australian and New Zealand Society for Geriatric Medicine include:
- do not use antipsychotics as the first choice to treat behavioural and psychological symptoms of dementia
- do not prescribe benzodiazepines or other sedative-hypnotics as first choice for insomnia, agitation or delirium
- do not prescribe antibiotics for asymptomatic bacteriuria in older adults
- do not prescribe medication without conducting a drug regimen review
- do not use physical restraints to manage older adults with delirium.
RACP President and The Australian and New Zealand Society for Geriatric Medicine (ANZSGM) member Dr Catherine Yelland says, “Care principles need to reflect the latest evidence and science, so that unnecessary tests, treatments and procedures are avoided. Equally important is the doctor-patient conversation to support informed and sound decision making to support high-quality care for older Australians.
“One of our recommendations is to not use antipsychotics as the first choice in treating behavioural and psychological symptoms of dementia, including aggression, resistance to care and disruptive behaviour. The use of antipsychotics is of dubious benefit and can lead to serious side effects that can be life-threatening. We recommend trying non-drug interventions first as they are an effective option. Ensuring a workforce is trained to be able to deliver non-pharmacological interventions is critical to being able to provide high quality care.”
Professor Jennifer Martin from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) (experts in the use and toxicity of medicines) says, “Many of our recommendations today will help patients avoid unnecessary tests and procedures and lead to discussions on reducing waste and overuse of medicines.
“One of our recommendations is to reduce the use of multiple medicines, common in older patients. Hyper-polypharmacy is where people may be on as many as 15 to 20 medicines at a time. Research has confirmed a significant association between polypharmacy and adverse outcomes among older people and an association with decreased physical and social functioning; increased risk of falls, delirium, hospital admissions and death. With an ageing population, use of many medicines at the same time is something we need to be having conversations about to avoid potentially harmful implications.”
Dr Lynn Weekes, CEO of NPS MedicineWise who facilitate Choosing Wisely Australia says, “We are delighted to launch two more lists of Choosing Wisely Australia recommendations today. Choosing Wisely Australia is all about kick starting conversations about unnecessary tests, treatments and procedures, and that more is not always better. The adoption of these recommendations by health professionals will improve care.
“With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together.”
To date, 98 recommendations have been released by Choosing Wisely Australia from 21 colleges, societies and associations, who have united for the initiative.
ASCEPT identified the following five recommendations:
- Recognise and stop the prescribing cascade
- Reduce the use of medicines when there is a safer or more effective non-pharmacological management strategy
- Avoid using a higher dose than is necessary for the patient to optimise the ‘benefit-to-risk’ ratio and achieve the patient’s therapeutic goals
- Stop medicines when no further benefit will be achieved or the potential harms outweigh the potential benefits for the individual patient
- Reduce use of multiple concurrent therapeutics (hyper-polypharmacy).
ANZGM identified the following five recommendations:
- Do not use antipsychotics as the first choice to treat behavioural and psychological symptoms of dementia
- Do not prescribe benzodiazepines or other sedative-hypnotics to older adults as first choice for insomnia, agitation or delirium
- Do not use antimicrobials to treat bacteriuria in older adults where specific urinary tract symptoms are not present
- Do not prescribe medication without conducting a drug regimen review
- Do not use physical restraints to manage behavioural symptoms of hospitalised older adults with delirium except as a last resort.
To read the lists in full, go to www.choosingwisely.org.au/recommendations.
The Australian and New Zealand Society for Geriatric Medicine is the professional society for geriatricians and other medical practitioners with an interest in medical care of older people. The society acts to represent the needs of its members and the wider community in a bid to constantly review and improve the care of the older people in Australia and New Zealand.
The Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) is the professional and independent Society in Australia and New Zealand with expertise in the use and toxicity of medicines and chemicals.
About Choosing Wisely Australia
Choosing Wisely Australia® is enabling clinicians, consumers and healthcare stakeholders to start important conversations about tests, treatments and procedures where evidence shows they provide no benefit and in some cases, lead to harm. The campaign is being led Australia’s medical colleges, societies and associations and is facilitated by NPS MedicineWise. Join the conversation on twitter @ChooseWiselyAU or email email@example.com.
About RACP EVOLVE
The lists from ANZGSM and ASCEPT are part of the RACP EVOLVE program, a physician-led initiative to ensure the highest quality patient care through the identification and reduction of low-value practices and interventions. To find out more go to www.evolve.edu.au.