• Opioid use in chronic pain: use a planned approach
• Codeine changes
• Colds and flu – winter is here
• Moving On program
• 2010 National Medicines Symposium – wrap up
• Feed your competency
• NPS publications

Opioid use in chronic pain: use a planned approach

The latest NPS therapeutic program, Opioid use in chronic pain: use a planned approach, explores ways of optimising the benefits of opioid use in chronic pain while minimising the harms associated with inappropriate use.

Health professionals are encouraged to:

• perform a thorough history and physical examination to determine if investigations are necessary
• prescribe an opioid as part of an agreed pain management plan
• initiate an opioid only as a short term therapeutic trial
• continue an opioid in those who demonstrate benefit from a trial and regularly reassess the need for ongoing therapy
• discuss options for managing breakthrough pain.

As part of the therapeutic program, nurses can participate in:

• Case study 64: Opioid therapy in chronic pain: use a planned approach
• Drug Use Evaluation (DUE) tool: Opioid therapy for chronic non-cancer pain
• an interactive workshop for residential aged care nurses
• one-on-one educational visiting and small group discussions by NPS facilitators.
  

Publications focusing on opioids include:

• NPS News 69: A planned approach to prescribing opioids
• Prescribing Practice Review 51: Opioids in chronic non-cancer pain: use a planned approach.

Find out more about therapeutic information and clinical activities to improve your practice. 

Codeine changes

Since 1 May 2010 over the counter (OTC) pain relief products containing codeine (e.g. Nurofen Plus, Panadeine) are now only available directly from a pharmacist and pack sizes will be reduced to 5 day quantities.

A number of people who suffer chronic pain caused by arthritis and serious injuries often turn to over the counter products to manage breakthrough pain, but over time may develop dependency and end up using more than is recommended.

Taking more than the recommended maximum amount of pain relief containing codeine can result in serious side effects. Overuse or misuse of products containing aspirin or ibuprofen can result in gastric ulcer perforation, or liver toxicity and death from products containing paracetamol.

Some people who have been using these pain relief products may not even realise they contain codeine. This is why it’s important to help them to get to know the active ingredient in their medicine.

Changes to the availability of codeine will help health professionals identify patients who require more support to use pain relief medicines safely and effectively. In turn, this will lead to improved outcomes for people experiencing pain.

Read more about NPS's position on OTC codeine.

Colds and flu – winter is here

Seniors, people with chronic health conditions and Aboriginal and Torres Strait Islander people are at higher risk of becoming ill this winter and should be encouraged to speak to their doctor about a seasonal flu shot even if they are in good health.

The seasonal flu vaccine changes slightly each year as it is designed to treat the specific virus that is circulating. Swine influenza is still a concern so this year’s seasonal flu shot includes protection against it as well.

However, while the flu vaccine protects against influenza it won’t stop people catching colds because they are different viruses.

Antibiotics work only on bacteria – they don't work on the viruses that cause colds, so they won't help colds get better faster, stop cold symptoms getting worse, nor will they stop colds spreading to others.

If someone does get a cold or the flu, recommend that they:

• take it easy so their immune system can fight the infection
• clear blocked sinuses by:
• • using saline (salt water) nose sprays or drops
  • having a hot shower and inhaling the steam
  • filling a bowl with hot water and inhaling the steam
  • drinking soothing liquids
• use an ointment to soothe dry and chapped skin around the nose
• gargle warm salty water
• suck an iceblock or throat lozenge.

For more information, visit our common colds: get the facts webpage.

Moving On program

NPS would like to clarify that the Moving On program is a self-management program for people with chronic diseases developed by Arthritis NSW and NPS. It is not only for people with arthritis, but for people with any form of chronic condition.

The program is currently at pilot stage and evaluation should be completed by late 2010.

We are asking health professionals to refer a patient to the program. The criteria for participants are that they must:

• be aged between 45 and 75 years
• be able to participate in light physical exercise
• have a reasonable understanding of their condition
• be able to speak, write, and understand English fluently
• not suffer from any degree of cognitive impairment, uncontrolled mental illness, or substance abuse. Participants suffering from co-morbid anxiety or depression are not excluded from the study.
  

For more information please contact Eloise Buggy at Arthritis NSW on 1800 332 131.

2010 National Medicines Symposium – wrap up

NPS hosted the 2010 National Medicines Symposium at the Melbourne Conference and Exhibition Centre on 26 – 28 May.

This year’s theme, Medicines in people’s lives, enabled us to address quality use of medicines in the wider context of changes within the health sector, including reforms and new prescribers.

Two key presentations by nurse practitioners were delivered; one by Lesley Salem – Patient-centred models of care and the evolution of nurses as new prescribers and the other by Barbara Harvie – Living with chronic kidney disease: a juggling act. Both were very warmly received.

The 2010 NMS online proceedings will be available for you to access on the NMS website.

Feed your competency

Case study

Complete a case study to help refine your clinical decision-making skills. You can download the latest case study or visit the NPS health professionals home page for more information.

Practice nurses

Remember, you can participate in educational visits and facilitated small group case discussions. Just contact the NPS facilitator at your local division of general practice.

Nurse practitioners

Charles Darwin University and NPS have collaborated to produce a series of online case-based modules for nurse practitioners.

The Quality Use of Medicines for Nurse Practitioners website has been designed for the ongoing professional development of nurse practitioners. For access to case studies and resources register via the website.

Residential aged care nurses

Visit the medication management website for useful resources and tools.

NPS publications

NPS News

NPS News is a bi-monthly publication, keeping you informed of quality use of medicines issues in relation to different therapeutic areas.

Read the latest NPS News: A planned approach to prescribing opioids.  

Prescribing Practice Review

Prescribing Practice Review (PPR) provides key messages for quality prescribing on selected therapeutic topics and evidence-based prescribing information.

Download the latest Prescribing Practice Review from the NPS website.

NPS RADAR

NPS RADAR offers evidence-based information about new medicines, new Pharmaceutical Benefits Scheme (PBS) listings and research.

Visit the NPS RADAR home page to download the latest issue.

Australian Prescriber

Australian Prescriber is a bi-monthly, independent publication that provides readily accessible information about drugs and therapeutics.

Visit the Australian Prescriber website to download the April 2010 issue.

Medicines Talk

Medicines Talk is written by consumers for consumers. We invite you to print copies for use in doctors’ rooms, hospital waiting rooms and visitors’ areas.

Download the latest Medicines Talk from the NPS website.

Medicine Update

Medicine Update lets you know about new medicines and new PBS listings. Each issue provides an independent assessment of current information and research about a different medicine.

Visit the NPS Consumer home page to download the latest Medicine Update.

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NPS – Better choices, better health. Independent, not-for-profit and evidence based, NPS enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing.