INTERNATIONAL BRIEFS

Australian Pharmacy and Medical Boards Issue Joint Statement on Compounded Medicines

The Pharmacy Board of Australia and Medical Board of Australia have released a joint statement describing good practice for practitioners when prescribing and dispensing compounded medicines.

The Boards issued the statement to remind medical practitioners and pharmacists of their respective responsibilities relating to compounded medicines, recognizing that issues with compounding medicines can impact patient safety. Recent concerns about dangers of compounding have been on the increase globally, including in the United States.

A compounded medicine may be a suitable treatment option for some patients if, for example, they have allergies or sensitivities to components in a ready-prepared commercial product.

Unlike medicines on the Australian Register of Therapeutic Goods, however, compounded medicines in Australia are not subject to the same rigorous assessment for product efficacy, quality and safety by Australia's Therapeutic Goods Administration (TGA) — which has drug oversight in that country.

According to the statement, compounded medicine should only be prescribed by a medical practitioner and prepared by a pharmacist where it is clinically indicated and if an appropriate commercial product is unavailable, or a commercial product is unsuitable.

When prescribing and compounding a medicine, the statement calls for medical practitioners and pharmacists to know and comply with the requirements of their state or territory's requirements for drug dispensing, and consider any relevant practice standards and guidelines.

In addition, practitioners and pharmacists should support patients in making an informed decision about their treatment by ensuring that they have been provided with information about the medicine which has been prescribed for compounding. Patients should also understand that compounded medicines in Australia have not been assessed by the TGA for efficacy, quality and safety.

Practitioners in Australia are being urged to review and understand the statement.

“Every medical practitioner who prescribes compounded medicines needs to ensure that these medicines are only prescribed if a commercial product does not meet the patient's needs and when patients have all the necessary information about the prescribed medicine,” Medical Board of Australia Chair Joanna Flynn, AM, said. “Supporting patients to make informed decisions about their treatment is a critical consideration for all practitioners.”

“Effective communication between medical practitioners and pharmacists is critical,” Pharmacy Board of Australia Chair William Kelly said. “If a pharmacist believes that it is not safe or appropriate to compound a prescribed medicine, they must let the prescriber and patient know so alternative treatment options can be considered.”

To read the full statement, please visit www.medicalboard.gov.au/News/Media-Releases.aspx.

Source: Medical Board of Australia News Release, November 24, 2017

UK Medical Profession at a ‘Crunch Point,’ GMC report finds

The United Kingdom's (UK) medical profession is at “a crunch point” and will suffer increasing pressure over the next 20 years unless action is taken, the General Medical Council's (GMC) “State of Medical Education and Practice in the UK” report has warned.

The report, published annually, analyzes data on the medical workforce across the UK. The latest report identifies a wide range of challenges facing the medical profession — driven significantly by an increasing and older population in the UK — and it highlights four priorities for the UK's governments and agencies responsible for medical training and workforce planning to focus on in years to come.

Four key warning signs are highlighted in the report, including:

• The supply of new physicians entering the UK's medical workforce has failed to keep pace with changes in demand. The number of physicians on the UK's medical register has grown by only 2% since 2012, while demand for physician services has risen sharply.

• Dependence on non-UK trained physicians has increased, reaching as many as 43% in parts of England.

• A variety of problems and a challenging work environment within the medical profession is making the UK a less attractive place for foreign-trained physicians to work.

• Recent reports indicate that pressures on newly trained physicians are on the rise, and that physicians have a greater desire for more flexibility in how they work and train.

“We have reached a crucial moment — a crunch point — in the development of the UK's medical workforce,” said GMC Chief Executive Charlie Massey. “The decisions that we make over the next five years will determine whether it can meet these extra demands.”

‘THE PRESSURE ON OUR HEALTH SERVICES SHOWS NO SIGNS OF LETTING UP. IT'S ON ALL OF US TO UNDERSTAND WHY DOCTORS ARE MAKING DIFFERENT CHOICES ABOUT THEIR LIVES AND CAREERS.’

“Each country needs to think carefully about how many doctors are needed, what expertise we need them to have so they can work as flexibly as possible, and where they should be located, given the changes and movement in population expected,” he said, adding that the GMC is “a professional regulator, not a workforce planning body, but we want to be an active partner in helping each country of the UK to address these priorities.”

Work is under way to address these issues and the increasing pressure on physicians in the UK, according to the GMC — including an increase in medical school locations in England, new scope-of-practice changes, and efforts to boost overseas physician-recruitment. But it acknowledges that their impact will not register in the near future and that more steps will need to be taken to meet the challenges on the horizon.

The report sets out four key priorities for medical workforce planning in the UK:

• Maintaining a healthy supply of new, qualified physicians into medical practice.

• Helping the UK medical profession evolve to meet the future needs of patients and the health care system.

• Reducing the pressure and burden on physicians wherever possible.

• Improving the culture of the workplace, making employment and training more supportive and flexible.

“The underlying challenge for all in health care is how we retain the good doctors we have right now,” Massey said. “Everything we hear from the profession tells us that we need to value them more; nurture cultures that are safe and supportive; and do what we can to help staff achieve the right balance between their professional and personal lives through more flexible working arrangements.”

“The pressure on our health services shows no signs of letting up. It's on all of us to understand why doctors are making different choices about their lives and careers,” he said.

To read the full state of UK medical education and practice report, please visit www.gmc-uk.org/publications.

Source: GMC news release, Dec. 19, 2017