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Australian Journal of Pharmacy : July 2005
fessional annual influenza vaccination for all peo- ple aged 65 years and over. It is also rec- ommended for other groups such as chil- dren and adults with chronic conditions. In 2004, survey estimates indicated 79 per cent of Australians aged 65 years or older were vaccinated. However, only 42 per cent of people younger than 65 years at risk were vaccinated. By increasing vaccination rates for those younger than 65 there would be a significant reduction in hospitalisations and deaths. Pharmacists should make patients who are under 65 aware of the risk of influenza if they have chronic con- ditions, and pharmacists are ideally placed to do this. Optimal management of blood pressure A national survey in 2000 found the prevalence of hypertension in an adult population was 29 per cent. Slightly more than half of these people were tak- ing antihypertensives and, of those who were taking antihypertensives, more than 60 per cent had results above the normal range. There is a large scope for pharmacists to be involved in the detection of hyper- tension and also to assist general practi- tioners in the ongoing management of hypertension with the aim of helping patients reach target blood pressures. Prevention of osteoporosis in at-risk individuals One of the most important risk factors for osteoporotic fractures is a past history of a fracture. A number of studies have found that the majority of patients with osteoporosis-related fractures do not receive evaluation and/or treatments that are recommended by clinical guide- lines. Effective and well-tolerated treatments are available such as the bisphosphonates, raloxifene, calcium and vitamin D. A number of Australian surveys have found that there is a significant under-utilisation of anti-osteoporotic therapy, with only about 20 per cent of post menopausal women who have had previous fractures receiving specific osteoporosis treatment. Pharmacists need to be aware of the risks of further fractures with osteoporotic patients and they need to actively pro- mote the prescribing of osteoporosis pre- ventive therapy. Other gaps Other gaps identified in the publication were: • promoting and supporting breast feed- ing; • placing infants to sleep on their back to reduce the risk of SIDS; • managing acute mild asthma in the emergency department; • recognising and managing panic dis- roder and agoraphobia; • commencing haemodialysis with appropriate vascular access • optimising care for stroke victims; and • applying compression therapy to treat chronic venous leg ulcers. In 2003, NICS published their first Evi- dence-Practice Gaps report which, impor- tantly for pharmacists, identified 11 gaps of which seven were centred on medica- tion use and relevant to pharmacists. These included: • advice on smoking cessation; • under-use of antithrombotics for stroke prevention in atrial fibrillation; • under-use of ACE inhibitors and ß- blockers in heart failure; • overuse of antibiotics for the common cold; and • prevention of venous thromboem- bolism in hospitalised medical patients. For copies of both reports on evidence- practice gaps, go to the NICS website (www.nicsl.com.au). ¦ THE AUSTRALIAN JOURNAL OF PHARMACY VOL 86 JULY 2005 ? 517