| Our coverage of the British Pharmaceutical Conference concludes
this week. Harriet Adcock covers sessions on pharmaceutical public health
(p615).
Clare Bellingham reports on progress in Scotland (p616). Olivia
Timbs describes
Welsh developments in clinical governance (p617).
Dawn Connelly reports on natural products (p619) and Rachel
Graham covers
sessions on skill mix (p618) and the product life cycle (p620)
How medicines are sold and promoted raises important public health
issues, Roger Walker, consultant in pharmaceutical public health at the
National
Public Health Service for Wales, told conference delegates. He warned
that the profession had to be careful that it was not promoting the use
of medicines
at the cost of the public’s health. “Increased availability
of medicines does create health issues. And we need to be aware of them,” Professor
Walker said.
He illustrated his point with several examples: resistance to head lice
preparations; the contribution of over-the-counter medicines to road
traffic accidents and falls; use of sympathomimetic preparations and
risk of stroke;
and the general misuse of medicines.
In particular, Professor Walker believed that the way industry uses brand
names needs to be addressed. “I understand that companies need to
use names that are well recognised but this can lead to confusion and it
is getting out of control.” There are many instances where a single
brand name is used for medicines containing different ingredients — for
example, Anadin (aspirin, paracetamol), Sudafed (pseudoephedrine and paracetamol,
pseudoephedrine and ibuprofen), Senokot (senna, ispaghula husk), Benadryl
(acrivastine, cetirizine) and Canesten (clotrimazole, fluconazole).
Professor Walker was also critical of the way industry encourages pharmacy
staff to display branded products together. “We are giving the public
a whole range of similar boxed products. Is this causing them difficulties,” he
asked.
The problem is not just restricted to brand names. The prefixes and suffixes
used with product names can also be confusing. He pointed out that 21
products use the term “ultra”, 32 products use the term “plus”,
38 products use the term “extra”. “What do these words
mean,” he asked. That there is more of the active ingredient, that
the product is stronger or that it is suitable for older patients? “These
are real public health issues that need to be addressed.”
Professor Walker acknowledged that the examples he gave were anecdotal. “But
do we have to wait for a disaster before we bring about change,” he
demanded.
Professor Walker also believes that by focusing on medicines, pharmacists
are neglecting some of the important issues in public health. He suggested
that young people are bombarded with images of smoking but are also aware
of the options for smoking cessation. “People are hearing that medicines
resolve problems. But medicines are only part of the solution,” he
said.
In the discussion that followed Professor Walker’s presentation,
Alison Blenkinsopp, Keele University, pointed out that pharmacists are
least comfortable dealing with things that are not medicines-related. There
had been a high uptake of pharmacy-led initiatives involving emergency
hormonal contraception and smoking cessation. But when it came to giving
lifestyle advice pharmacists felt uncomfortable offering advice on physical
activity. |
The
Pharmaceutical Journal