|
Friday 15
December
Special Edition Newsletter
Codeine changes: Are you prepared?
|
|
From 1 February 2018, all medicines that contain low-dose codeine will no longer be available from pharmacies without a script.
This scheduling change affects all codeine-containing products that are currently available over-the-counter (OTC). This includes combination analgesics (Schedule 3) and cough and cold preparations (Schedule 2). After 1 February 2018, codeine containing medicines will only be available to consumers by prescription (Schedule 4).
|
|
|
Pharmacists: your 'Codeine Pack' is in the mail
|
 |
| |
All pharmacies in our catchment will receive a 'Codeine Pack' from SEMPHN in the next few days. It contains resources developed and curated by pharmacists and other health professionals to help you and your patients prepare for the codeine changes.
What’s in the pack?
-
200 pharmacy bags with simple codeine rescheduling messages
-
200 TGA consumer resources with comprehensive codeine rescheduling information
-
Codeine Rescheduling Resource Pack for Pharmacists.
Three things you can do:
-
Use a pharmacy bag + TGA consumer resource with each codeine sale to help communicate the upcoming changes to your patients.
-
Refer to the Codeine Rescheduling Resource Pack for information on training and resources.
-
Contact the Area 4 Pharmacotherapy Network for support, to request more resources or to arrange a visit to your pharmacy via A4PN@semphn.org.au or 0428 785 371.
If you haven't received a 'Codeine Pack' by the end of the year, please get in touch with the Area 4 Pharmacotherapy Network.
|
|
|
thinking about pain differently
Pain management: non-pharmacological approaches
|
 |
| |
Pain is one of the most common problems treated by primary health care providers.
Today, effective diagnosis and clinical management requires a whole person, patient-centred approach. And, there's growing realisation that active rather than passive management strategies have a greater power to ‘retrain the brain’ with a view to reducing pain1.
Chronic non-cancer pain management should involve a combination of approaches, with an emphasis on non-pharmacological methods. These can include:
-
physical techniques both active (exercise, weight reduction) and passive (thermotherapy, massage, TENS)
-
mind-body techniques such as meditation, biofeedback and mindfulness
-
mind-based techniques including cognitive behavioural therapy and hypnosis
-
use of aids/orthotics and occupational therapy including home and workplace/work practice modification
-
social/environmental interventions such as community support groups and work retraining
-
referral to a multidisciplinary pain service.
The Pain Management Network and the Hunter Integrated Pain Service have a number of resources for both health professionals and consumers about these non-pharmacological options for pain management.
Emerging evidence has also shown that nutrition, including the consumption of highly processed foods and alcohol, can have an impact on pain.
|
|
|
Pain management: pharmacological approaches
There has been a substantial increase in opioid use in Australia in recent years, including for chronic non-cancer pain 2.
However, there is very little evidence to support the use of long-term opioid therapy.
If opioids are prescribed for chronic pain they should be clearly seen as only one part of the management, with critical consideration of the risk:benefit ratio for each patient 3.
Consider trialing non-opioid analgesics and adjuvants before using opioids. Paracetamol, NSAIDs and analgesic adjuvants such as tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors (SNRIs) and anticonvulsants can be used instead of or in combination with opioids 4.
|
|
|
Pain management: Patient education
Patient education is an integral part of chronic pain management and it's important to involve patients in the decision making process.
A pain management plan such as the template developed by NPS can be useful in helping the patient set goals and better understand their treatment.
These video resources for patients help explain the different ways that pain is now being thought about, including:
More information about talking to your patients about pain management, in view of the upcoming codeine changes, can be found here:
More resources available for health professionals:
Scriptwise Pharmacist Toolkit
Scriptwise Prescriber Toolkit
|
|
|
Key online education for pharmacists
PSA-Guild Codeine Rescheduling Online Modules
-
The first five modules are now live.
-
This training is available to all pharmacists and pharmacy staff (members and non-members).
-
Non-members will need to create temporary login details and some resources are restricted to members only.
PSA Victorian Opioid Pharmacotherapy Training for Pharmacists
This training is available in two parts:
-
Part 1 is available online at all times, and at scheduled times face-to-face or via webinar.
-
Part 2 is available at scheduled times face to face or via webinar.
The next Part 2 training is available via webinar on 23 January 2018. Other 2018 training dates will be released soon.
|
|
|
Key online education for GPs
|
|
|
Useful websites and resources
|
|
|
References
1. Flor H. Maladaptive plasticity, memory for pain and phantom limb pain: review and suggestions for new therapies. Expert Rev Neurother 2008;8:809–18
2. Leong M, Murnion B, Haber PS. Examination of opioid prescribing in Australia from 1992 to 2007. Int Med J 2009; 29: 676-81.
3. WA Drug and Alcohol Office, WA Department of Health. Quick clinical guideline for the use of opioids in chronic non-malignant pain. 2009.
4. Expert Group for Analgesics. Therapeutic Guidelines: Analgesic version 6. Melbourne: Therapeutic Guidelines Ltd, 2012.
|
|
|
|
|
