An antimicrobial stewardship programme drives appropriate use of antibiotics

The overuse of antibiotics and other antimicrobial medicines has precipitated one of the biggest threats to global health today – antimicrobial resistance – which is leading to longer hospital stays, far higher medical costs and increased mortality.
An antimicrobial stewardship programme drives appropriate use of antibiotics
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According to the World Health Organisation (WHO), antibiotic resistance is exacerbated by poor infection prevention and control practices, which compromises the ability to treat infections.

The WHO World Antibiotic Awareness Week (14-20 November) aims to increase awareness of antibiotic resistance and to encourage best practices amongst the general public, all health workers and policy makers to avoid the further emergence and spread of antibiotic resistance, with the theme: Handle Antibiotics With Care. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance.

Fighting microbial resistance in a hospital setting

“There are multiple drivers of antimicrobial resistance which have a major impact in a hospital setting. A doctor led, multidisciplinary approach in each hospital is key to the success of an AMS (antimicrobial stewardship) programme to ensure that dynamic and wide-spread practices are in place to minimise pathogen resistance while providing quality patient care,” says Shirley Leadbeater, national pharmacy practice manager for the Life Healthcare Group.

The group has placed a strong focus on tackling this threat in their hospitals. In 2011 Life Healthcare implemented an antimicrobial stewardship (AMS) programme to ensure its hospitals act responsibly with regard to the use of antibiotic medicines. The approach is aligned to the national department of health’s AMR National Strategy Framework 2014 – 2024 in response to the World Health Assembly’s endorsement of a global action plan to tackle antimicrobial resistance (AMR).

A multifunctional approach

Although antimicrobial resistance is a global issue, it must be tackled at a local level. It takes focused effort at an individual hospital to alter antimicrobial utilisation and impact on pathogen resistance. Multifunctional review of antimicrobial utilisation as well as robust infection prevention practices effectively manage the issue.

“Pharmacists are the primary custodians of medicines and as part of the multidisciplinary healthcare team, focus on evaluating patient medication treatment to assist in achieving the best possible clinical outcomes and championing stewardship. The value of their in-depth knowledge of pharmacology and pharmacotherapy has globally proven to be valuable in the hospital environment,” she says.

The core elements to a successful AMS programme are:

Leadership commitment;

Comprehensive infection prevention and control;

An effective multifunctional stewardship approach. AMS committees at hospital level with AMS doctor champions; and

Effective communication, and timely and regular reporting.

Hygiene measures are an all-important, yet often undervalued aspect to infection prevention as well. The easiest and most important method to prevent the transfer of bacteria that everyone can apply in healthcare settings is appropriate hand hygiene. This should be practised conscientiously by all healthcare workers, patients and hospital visitors alike. “Infection prevention is taken extremely seriously and is a high priority for all hospitals, as one failure can transfer bacteria and increase the spread of hard to manage infections,” she explains.

Finally, patient education and provision of information and counselling are important in keeping antibiotic resistance in check. “All parties – the patient, the doctor and the entire multifunctional team should be aware of how their behaviour impacts this growing threat and how we can work together to prevent antibiotic resistance from spiralling out of control,” she concludes.

WDD: Strides made in diabetic research

Two people pass away every five minutes due to diabetes-related causes, and 14 adults are newly diagnosed with diabetes every five minutes, according to the Centre for Disease Control and Prevention in the United States. While there were an estimated 2,28m diagnosed cases of diabetes in South Africa in 2015.
#WDD: Strides made in diabetic research
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Diabetes is often referred to as the silent killer as many people remain unaware that they are suffering from the disease until it is too late. Diabetes is caused by the pancreas not being able to produce enough insulin, or the cells of the body not responding to the insulin which is produced. Dependent on the type of diabetes, it may be treated with either insulin injections or medications (with or without insulin).

Diabetes is a challenging disease to live with for the patient, as it requires a strict diet, accurate dosages of insulin and/or medication, exercise, and the continuous testing of blood sugar levels. Unfortunately, diabetes may also lead to various long-term complications if not treated properly, including permanent damage to the eyes, kidneys, nerves, and heart.

So, the race is on to develop treatment protocols and drugs that make the disease easier to manage for sufferers.

The US Patent and Trademark Office has recently granted a patent for a potential functional cure for diabetes. In accordance with this patent, the University of Technology in Sydney genetically engineered cells, called Melligen cells, which can produce, store and release insulin in response to human blood sugar levels.

However, during animal testing, a barrier arose when the mice who were receiving these Melligen cells experienced an immune response. This barrier has however been overcome with the recent involvement of PharmaCyte Biotech, a US clinical stage biotechnology company, which has developed a product, Cell-in-a-Box®, which encapsulates the Melligen cells and thereby hides them from the immune system inside the human body. The Melligen cells will then detect when the blood sugar is low and thereby produce and release the required insulin. The result of this ground-breaking combination may be a long-term solution for diabetics who cannot produce insulin at all. The research will now be moving into clinical trials stage, in so far as the patent has been granted.

In terms of South African research in the diabetic field, a team of researchers from the department of human physiology at the University of KwaZulu-Natal have recently developed a way of administering insulin into the bloodstream without the need for injections.

This comprises a transdermal patch that releases insulin through the skin into the bloodstream at a constant rate. As such, there is no longer a need for painful injections. Some diabetics inject up to eight times a day. Insulin is at times injected in large amounts and it may lead to hypoglycamia. The transdermal patch provides a solution and prevents hypoglycaemia in the patient, as insulin is delivered in a controlled and constant manner. This imitates the natural release of insulin in someone not suffering from the disease.

The staggering results obtained to date in terms of new developments continues to motivate researchers across the globe to better current inventions and to create new breakthrough treatments which is sure to dramatically improve the quality of life, and life expectancy of millions of diabetic patients in the future.

Chronic medication collection model showing results

A model to facilitate a better chronic medication dispensing in the North West Province is producing positive results.
The Central Chronic Medication Distribution and Delivery (CCMDD) model is aimed at reducing the cost of accessing free healthcare, says health MEC Magome Masike.

Patients on chronic medication in the province are able to collect their medication at their nearest pharmacy, general practitioner and supermarkets like Shoprite.

Chronic medication collection model showing results
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“The model will help reduce long queues at our health facilities, generally caused by people collecting chronic medication. We are happy that our people understand and have welcomed the new changes,” says Masike.

The department says the headcount for chronic patients collecting medication at health facilities has dropped, with more patients electing to collect medication at convenient pickup points at no cost to the patient.

“Since the inception of the CCMDD model, a sizable number of dispensary points have been established across the province and are dispensing medication to over 80,000 chronic patients.

“Chronic patients, who are interested in collecting medication at a convenient pick-up point, need to register to collect the same medication previously collected at a health facility.

“Once the registration process is complete, a patient will receive a SMS to collect medication from the chosen pick-up point. Patients will have to go back to the health facility after six months for a check-up and a new prescription,” said the department.

However, the department said patients are free to visit a health facility should they have a health problem at any time.

Prescription Drugs From Canada. Pharmacy Online or Pharmacy in Canada?

If you are reading this article it is because you are thinking of buying your prescription medications from a Canadian pharmacy. You may have heard that Canadian pharmacies sell their drugs 50-80% cheaper than ones in the U.S. The reason that the prices are so much cheaper in Canada is that over there prescription medicines have price limits imposed on them. In fact, the United States is one of the only industrialized countries in the world not to use price-limits on prescription medicines. Accordingly, Americans pay some of the highest prices anywhere for their medications. A recent poll, carried out on behalf of The Wall Street Journal, showed that more than 80% of Americans were in favor of importing drugs from Canada and more than one in ten Americans already do so. The Food and Drug Administration (FDA) has said that it does not intend to go after individuals buying prescription medications from Canada. And the State of Michigan has been running seniors, free of charge, into Canada to obtain their drugs, as reported on CBS News. The question for you is, when buying prescription medications from Canada, do you use a pharmacy online or make the trip yourself into Canada? Canada Pharmacy Online The advantage of using a Canadian pharmacy online is one of simple convenience. Using an online pharmacy means you not have to make the expensive and time consuming trip into Canada. If you live a long way from the border, or if you are too ill to make the journey, then the simplicity and ease of going online to find a Canadian pharmacy to serve your needs is obviously attractive. Some people are wary of Canadian pharmacies online, worried that they might be scammed in some way. This is understandable as there are a tiny minority of unscrupulous people in cyberspace willing to prey on the sick and vulnerable. However, there are precautions you can take to avoid being ripped off. A genuine online pharmacy will have its physical address and telephone number in Canada displayed clearly on its website. You can telephone the number and check that they are for real. Additionally, all reputable Canadian online pharmacies will bear the Canadian International Pharmacy Association (CIPA) logo on their website. You can contact the CIPA to check that the pharmacy you are thinking of using truly is a member of their association. Visiting a Pharmacy in Canada Making a trip into Canada to visit the pharmacy in person may ensure that you don’t fall prey to some bogus pharmacy online. However, this trip will be costly and since you can only buy a 90 day supply at a time, you will have to make four trips a year. People who live a long way from the border, or are too sick to travel, or need long term medication will find a using a pharmacy online much easier. Making a trip into Canada to visit the pharmacy in person may ensure that you don’t fall prey to some bogus pharmacy online. However, this trip will be costly and since you can only buy a 90 day supply at a time, you will have to make four trips a year. People who live a long way from the border, or are too sick to travel, or need long term medication will find a using a pharmacy online much easier. Published at: https://www.isnare.com/?aid=679145&ca=Travel

Pharmacy Technology Changes the Way Sunflower Pharmacy Serves Local Community x

The sunflower is a hardy plant that stands tall and drops seeds where it stands. That also describes the Sunflower Pharmacy in Ruleville, Mississippi. Set in the rural Mississippi Delta, 100 miles from the nearest metropolitan area, the Sunflower Pharmacy is part of the North Sunflower Hospital. It was just ten years ago that the North Sunflower Hospital was on the verge of closing its doors. Folks would drive past it and go to a hospital 10 miles away. The local governing body was at a loss as to how to fix it. Enter Billy Marlow, a respected Ruleville businessman with no prior background in the healthcare industry. His field was land development and construction. He was named Chairman of the Board as well as interim hospital administrator. Hospital is Saved by Local Businessman “I was born in that hospital,” says Marlow, “so it had a special place in my heart. “ Closing the hospital could have been a community travesty. The unemployment rate runs 15% or higher, with agriculture, the prison system and the hospital as the main employers. Marlow saw a lot of potential and had some innovative but common-sense ideas. These stemmed from a simple formula his business-minded father-in-law shared with him: you better bring in more money than you send out. Sunflower Hospital and Pharmacy are Born Marlow’s rallying cry was “the Sunflower way.” He increased the cash flow by purchasing more nursing home beds. The clinic, which had been hidden behind the hospital and was underused, is now placed prominently out front. It stays open until midnight, 7 days a week, 364 days a year, keeping non-emergency patients out of the emergency room, which saves money for both hospital and patient. Marlow convinced three separate pharmacies to join forces to become the Sunflower Pharmacy. He promised the owners who partnered with him a brand new, state-of-the-art facility complete with the latest automated pharmacy management system. The Automated Pharmacy Makes Facility Contemporary Michael Gilbow, Director of Pharmacy, can hardly hide his enthusiasm. “We’re in the top 40 cleanest hospitals in the nation. We have a state-of-the-art surgery center, swing beds, a clinic open 18 hours a day, and the only pharmacy in Mississippi with an RxMedic robot.” As owner of his own drugstore, Gilbow had long been a QS1 software client. Although QS1 software can interface with other systems, he felt better about staying with the RxMedic robot because of the reputation for quality and service. “We are connected to the clinic,” says Gilbow. “Our patients can see the doctor, and by the time they check out and walk down the 40 foot hall, their medications are automatically dispensed and ready.” So far, the automated dispensing system has filled as many as 550 prescriptions in one day, and Gilbow has confidence it will do much more as the business continues to grow. Sunflower Pharmacy is expanding into compounding medications. “This,” says Gilbow, “is the art of pharmacy taken to another level. We will give our patients the best service, the best medical care, the best price. We are willing to go that extra mile to make people happy, make them come back.” Whether they walk down the 40 foot hall from the clinic, come inside the pharmacy, use the drive-up window, or receive free delivery within a 20-mile radius by The Medicine Dropper, they do come back. Now people in the community in need of medical care drive 10 miles to North Sunflower Hospital and the Sunflower Pharmacy. Published at: https://www.isnare.com/?aid=1852923&ca=Medical+Business

Pharmacy Automation Has Cut Wait Time in Half at a Family-owned Pharmacyx

Marcum’s Pharmacy has served the Kingsport, Tennessee area for over 50 years, providing everything from personalized compounding to free deliveries. . They also offer a selection of innovative pain-management products, and products for new mothers. A family-owned facility run by a grandfather/grandson team, many of their customers also represent families who have considered Marcum’s their hometown pharmacy for over five decades. Those decades have been witness to the evolution of pharmacy technology, culminating in last year’s purchase an RxMedic ADS (Automatic Dispensing System). ADS technology: so many prescriptions, such little time (to dispense them) Pharmacist Colton Marcum—echoing the sentiments of many professionals who have made the switch to pharmacy automation—says the difference the ADS has made has been significant. Because the machine counts and dispenses pills from individual chutes (it can hold up to 256 medications simultaneously) directly into labelled vials utilizing vacuum dispensing and a unique HEPA filtration system, it eliminates the risk of cross-contamination. It also substantially expedites the process of getting prescriptions to customers. “Wait times are cut in half,” says Marcum. “And the machine is a real benefit around the first of the month, which is usually our busiest time: on the first day of this month, we filled 700 scripts. The pharmacy robot helped us out with that a lot.” Many professionals have praised the time the ADS has allotted for them to spend with patients; Marcum, too, cites this as one of RxMedic ADS major benefits. “Our customers know us,” he says, “and they rely on us for advice: this place is like that…a ‘neighborly’ kind of atmosphere. So it’s nice to have that extra time to work with.” Customer support: there when needed As every professional knows, busy pharmacies don’t have time for downtime. RxMedic approach to customer service means that the pharmacy can often get an immediate resolution via in-system video capabilities. Customer service can also be reached online or on the phone and, if necessary, a technician can be quickly dispatched to the pharmacy. Marcum stresses that the customer service team is always prompt and helpful. “We’ve had just a few incidents,” he says. “But they’ve been dealt with quickly and professionally. The customer service is a hundred percent, and it means a lot not to have to worry about that part of things.” Pharmacy technology: easy to learn, easy to use Marcum also agrees that the RxMedic ADS is easy to use. “We didn’t have any problems learning to work with it,” he says. “A lot of people might think it’s complicated, but it’s actually designed to be the opposite way, I think.” RxMedic has an intuitive touch screen operator interface, so prescriptions can be checked out easily. Even changing the contents of a cell can be handled in just a few minutes by on-site pharmacy staff. With its unprecedented safety components and “hands-on” features, ADS pharmacy robots are fast becoming a valuable tool in pharmacies both big and small. The system is designed to be easy to use, yet it is designed to encompass the intricacy and complexity of managing and dispensing medicine. Pharmacy robots and ADS innovations can also provide patients—many of whom, like pharmacists, worry about the possibility of cross-contamination—with an unprecedented amount of security, which can only improve confidence between patients and the pharmacists they trust. Published at: https://www.isnare.com/?aid=1888535&ca=Internet

Rhoads Pharmacy Uses High Tech Pharmacy Robot on Main Street

Rhoads Pharmacy in Hummelstown, Pennsylvania, is, like its creed, “where hometown is a philosophy, not just a destination”. Established in 1931 and re-christened Rhoads Pharmacy in 1953, the pharmacy has the distinction of also being a gift shop, marketplace, and gallery. Hence, the locals have come to think of it as a home away from home, and patients have been relying on its services for decades. Automatic Dispensing System (ADS) technology has been able to make things even better for current owner and pharmacist Dave Lutz, who took over ownership of the pharmacy with his wife, Jeanne, in 1973. Lutz has a large customer base of over 15,000 patients, and most of his staff (including four pharmacist technicians and ten support staff) has been with Rhoads for over 25 years. Since implementing the pharmacy robot (affectionately known as “Flo” to the staff) two years ago, Lutz says he and his staff’s relationship with patients has gotten even better. The robot is programmed to cap, photograph, count, and sort pills, thus acting—in some ways literally—as the hands of personnel. “We named our robot Florence because we wanted to use the nickname Flo. There can be low flow or high flow, but there’s got to be flow. And the flow of what this technology has been able to accomplish is definitely unprecedented, as far as it relates to our time management,” said Lutz. Automated Dispensing Maintains Accuracy in Counting Pills “Before Flo, on a typical workday, we were counting up to 12,000- 15,000 pills a day, which is a huge number,” says Lutz. “And it was all by hand. Now Flo does 65% of that. The time she’s freed up for the staff is just incredible. We can’t imagine not having the ADS technology now. It’s made all the difference.” “ADS is ‘third generation technology’, in my phrase”, says Lutz. “And by that, I mean that it does things that nothing else before it has done. There are pharmacy robots that don’t cap the prescriptions like Flo does, that don’t take photos of the prescription to ensure accuracy. This is the only technology that does all that. As a pharmacist, it has given me enormous peace of mind and made me feel better about the safety and accuracy of what we do, which is always, of course, our first priority. ” Ensuring correct pill counts is of paramount importance, as is making certain that prescriptions have been labeled and distributed correctly. The complexities of handling medications are, paradoxically, simplified in complex technology that is easy to learn and use. Pharmacy Staff has More Time to Develop Relationships with Patients “Our endeavor is to create a “hometown” environment, just like our logo,” says Lutz. “We want to make the community feel like they’re dealing with a friend. When it comes to talking about their health conditions and the medications they require, customers are very particular, and say they’re often very uncomfortable going somewhere else. They put their trust in me and are appreciative of my counseling and suggestions. ADS technology has made it possible for me to go out on the floor, to actually talk to them, because I don’t have to spend that time doing what the robot is able to do for us now.” The ADS system has enabled pharmacies to be much more than just a business where people come to pick up their medications. Now, it’s possible for them to better balance technical work that requires scrupulous attention to detail with essential, one-on-one communication with patients. Superhuman technology for a human profession “I like to say that the technology is superhuman”, says Lutz. “But at the same the ADS is something that lets the human aspects of being a pharmacist shine through. Every pharmacist should have access to this. As far as I’m concerned, it’s the responsible thing to do. In my book—and surely in my staff’s—ADS is the future of this industry.” ADS might indeed be considered a breakthrough in the industry, as the system is able to handle such high and diverse volumes of medications without cross-contamination, and multitask so effectively, safely, and accurately. Robots like Flo represent the changing face of the hometown pharmacy. The remarkable ways in which they’ve been able to integrate the most important aspects of the profession are only beginning to be understood. As this technology continues to improve and become affordable more pharmacists will begin to embrace ADS robotics. They will discover how it can help them be better at what they do and the horizons of the industry will begin to expand in ways they never have before. Published at: https://www.isnare.com/?aid=1761985&ca=Computers+and+Technology

Mental And Emotional Paralysis: Debilitated By Depression

We have all experienced days when we felt so sad that it drove us to tears — even if we do not even know the reason for our sorrow. We become uninterested in our daily routines, and find ourselves struggling with sluggishness and melancholy. At times, we can be so overcome with emotional distress that we do not even want to go out of the room and choose to just sleep all day. These periods of sadness are but normal for any human being. Still, these feelings of sadness should not come on a regular basis. If one regularly suffers from sadness, it may be possible that that person is already suffering from clinical depression.

At present, depression afflicts at least 17 million adults in the United States alone. Clinical depression usually starts even without the person noticing it. Some are lulled into a cycle of despair even without the slightest hint that they already have an emotional and psychological problem. Clinical depression is a medical condition that affects the mind, often leaving the person suffering from feelings of hopelessness, loss of ambition, and loss of the ability to focus on tasks and on life itself. People suffering from chronic and acute depression become so sad and apathetic that it is often extremely difficult for them to even get out of bed in the morning. The depressed person reaches a state where even the simplest activity is performed with great difficulty. Depression has both physiological and sociological causes. It may be brought on by a physical illness, an emotional trauma or experience, use of various drugs and medications, alcohol abuse, or a combination of various factors. If depression is left untreated, this condition can adversely affect academic achievement, family life, friendships, careers, and may even lead to broken relationships.

Examination of this psychological problem in physio-chemical terms would show that depression is closely linked to abnormalities or changes in brain chemistry. Poor nutrition, lack of exercise, and negative attitudes also worsen a person’s depression.

People with psychological problems usually seek help from a mental health professional who, in turn, prescribes mood balancing drugs or anti-depressants such as citalopram or flouextine. Intense psychotherapy and counseling may also be required. However, there are others who use an alternative form of medicine for a more natural treatment. Milder cases of depression can be treated solely with natural remedies without the need for antidepressant prescriptions.

Therapy that involves personal expression has been found to provide an outlet for pent-up feelings and can be a positive way to articulate deep emotions. This can take many forms such as dance, martial arts, or art lessons. Relaxation techniques can also help a person focus and gain a sense of serenity. Ancient exercise and stress relief methods such as yoga, meditation, acupuncture, and hypnosis are also popular means to treat depression.

A change in diet and the use of supplements have been found effective in dealing with depression. Adding fish oil, Zinc, and B vitamins help the body regulate chemicals that may trigger depression. Exercise is very important for physical, emotional, and mental health. Keeping active will rejuvenate the body and keep it fit, promoting a healthier lifestyle and better self image. Working out several times per week can calm the senses and invigorate the body.

Although depression has increased dramatically in today’s world, the problem of depression is as old as time. It still continues to debilitate many lives despite the availability of 21st century technologies and conveniences. We can learn on the wisdom of many different healing traditions in our quest to overcome the burden of depression. Though there are modern tools to overcome depression, one should try to seek and discover the vibrant energy and personal empowerment that everyone of us can discover, even without using drugs.