Objective To report the frequency of 27 enhanced pharmacy services (EPS) provided in Australia's community pharmacies and to analyse barriers and facilitators for providing priority services. Setting A large representative sample of community pharmacies in Australia in 2002. Method Questionnaires were mailed to owners or managers of a stratified, representative sample of Australia's community pharmacies; 1131of 1391 consenting pharmacies responded (81.3%). Specifically trained staff, fees charged, structural and other components and plan to introduce EPS were analysed. The barriers and facilitators for all EPS were rated by a Likert scale. Logistic regression models tested for predictors for providing one or more EPS and those related to Australia's National Health Priorities. Key findings Eighty‐eight per cent of Australia's community pharmacies offered ≥1 EPS. More than 40% offered EPS for asthma, diabetes, methadone, herbal medicines, hypertension and wound care. Pharmacies with higher turnover (odds ratio (OR), 1.90; 99% confidence interval (CI) = 1.05–3.42) and younger owners (OR for age, 0.69; 99% CI = 0.48–0.99) were predictors for providing ≥1 EPS. Higher turnover was a predictor for diabetes care. Enclosed counselling area was a predictor for hypertension care. Owners and managers committed to continuing education was a predictor for diabetes and hyperlipidaemia services. Significant barriers perceived were lack of confidence for diabetes care and not being regarded as ‘part of the job’ for asthma, diabetes, hypertension and weight‐management services. Conclusion The percentages of pharmacies in Australia that provided equivalent EPS were similar or higher than the UK, New Zealand and USA. The frequency of existing and planned EPS appeared disproportionately low to satisfy national health priorities. Significant barriers and facilitators and pharmacy characteristics for providing EPS were identified. The results assist national bodies to increase the uptake of EPS by pharmacies.

Many have commented on the potential of community pharmacy as a health promotion setting, due to accessibility, high level of use, and the respect afforded to pharmacists. Community pharmacy could be a setting through which to address risk and protective health behaviours relevant to Australia's National Health Priority Areas. However, apart from some studies on smoking cessation, there is scant evidence on its involvement in other healthy behaviours. This paper discusses how to increase research and interventions on healthy behaviours in community pharmacy. This includes placing community pharmacy's role within a broader health promotion context, expanding community expectations of pharmacists, and addressing barriers to performing a health promotion role. J Pharm Pract Res 2007; 37: 42-4.

Objectives: To examine trends in the licit consumption of the psychostimulants dexamphetamine and methylphenidate in Australia and nine other countries from 1994 to 2000 and in each State and Territory of Australia from 1984 to 2000. Design: Annual rates of consumption of psychostimulants were compared using Poisson regression models. All drug consumption was standardised to defined daily doses per 1000 population per day. Main outcome measures: Rates of consumption of each psychostimulant in each country and in each Australian State and Territory. Results: For the 10 countries from 1994 to 2000, total psychostimulant consumption increased by an average 12% per year, with the highest increase from 1998 to 2000. Australia and New Zealand ranked third in total psychostimulant use after the United States and Canada. Australia consumed significantly more than the United Kingdom, Sweden, Spain, the Netherlands, France or Denmark. In Australia, from 1984 to 2000, the rate of consumption of licit psychostimulants increased by 26% per year, with an 8.46‐fold increase from 1994 to 2000. Western Australia ranked first, with nearly twice the consumption rate of total psychostimulants as New South Wales, which ranked second. Methylphenidate is the main psychostimulant consumed in the US and Canada, and dexamphetamine in Australia. Conclusions: The consumption of psychostimulants in Australia is high internationally and varies significantly between States and Territories. The results imply varied jurisdictional prescribing determinants and supply processes throughout Australia, which may require new national prescribing standards and access to online patient data for prescribers and dispensers.

Objective To report the characteristics of community pharmacies in Australia and analyse them for their association with pharmacists' consultation time.Setting A large representative sample of community pharmacies in Australia in 2002. Method Questionnaires were mailed by an independent survey group to managers and owners in a national sample of pharmacies stratified into six zones. Questionnaires were returned by 1131 of 1532 pharmacies contacted (73.8%). The data were analysed using the general linear model (GLM) for univariate analysis. Key findings: Male pharmacists comprised 76.3% of pharmacy owners and 39.5% were aged ≥ 51 years. Most pharmacies (81.1%) had one or two pharmacist owners, and 51.3% of pharmacies were members of marketing groups. Medicines accounted for approximately 75% of annual sales and occupied a minority of the average total area of 187.2 m 2 . Pharmacies opened for an average of 55.5 h per week. Pharmacists spent 18.8% of their time on patient consultation. This was significantly related to pharmacies with forward pharmacy dispensing areas (P < 0.001), which were owner or partner operated (P < 0.002) and had high numbers of customers (P < 0.004). Holding national accreditation status and belonging to a banner group may be additional factors. Conclusions Ownership of community pharmacies in Australia is dominated by pharmacists in contrast to the minority pharmacist ownership in the USA and England. Owners and managers of pharmacies were mainly male and older than other staff. Pharmacists working in pharmacies with a forward dispensing area, designed to facilitate patient consultation, were significantly more likely to provide increased consultation time for patients. Owner-or partner-operated pharmacies, and pharmacies with high numbers of customers were also significantly associated with patient consultation time. The strength of association between membership of marketing groups and national accreditation with consultation time requires more evidence.Community pharmacy practice, including the pharmacists and the environment where they work, have changed in many countries from a mainly dispensing function to include a wide range of other services involving medicines and health.

Objective: To investigate the pharmacokinetics of intranasal fentanyl in adult post-operative female patients. Method: Patients received both intravenous and intranasal fentanyl (approximately 50 pg) in a randomised cross-over study. Results: Pharmacokinetic data sets from 19 patients showed intranasal fentanyl produced plasma levels within the therapeutic range within two minutes, with median bioavailability values of 55% (pH 6 formulation) and 71% (pH 8 formulation). Mean peak serum concentrations were 0.33 ng/mL (pH 6) and 0.37 ng/mL (pH 8) respectively, compared with 2.33 ng/mL after intravenous fentanyl. Conclusion: We conclude that the absorption of intranasal fentanyl is rapid, the bioavailability more than half that of intravenous administration and that the formulations studied are suitable for more extensive clinical evaluation.

Using the Simpler tool facilitated the delivery of comprehensive evidence-based diabetes management and significantly improved clinical outcomes. The Simpler tool supported pharmacists in providing enhanced structured diabetes care.

Pharmacies are being underutilised with respect to their capacity to deliver heath prevention advice and ways to capitalise on this potential need to be investigated.

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