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Published on 1 March 2007

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Illuminating the therapeutic path

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Ray Fitzpatrick
Consultant Editor

In the columns of this new-look journal we carry a variety of articles describing the role of pharmacists in various clinical settings, how we can harness technology to improve our services and patient care, as well as therapeutic reviews. In this edition the emphasis is on the latter, with a number of articles reviewing various aspects of therapy. Some of these cover treatment of the primary disease, whereas others cover supportive therapy.

The article by Andrea Nicolini and colleagues reviews the evidence for the use of third-generation aromatase inhibitors as adjuvant therapy in breast cancer. This issue is very topical, as treatment of breast cancer is one of oncology’s success stories, and recently, in the UK, the National Institute for Health and Clinical �Excellence (NICE) has issued guidance supporting the use of aromatase inhibitors in breast cancer. The article by Iain Macdougall and colleagues covers a different therapeutic area and describes current recommended practices for the management of anaemia in chronic kidney disease patients. The treatment of complications associated with renal disease is also the subject of the article by Rob Bradley, which discusses phosphate-binding agents for the prevention of hyperphosphataemia in patients with endstage renal disease. Just as importantly, the article also discusses the pharmacist’s role in educating patients about their treatment with these medicines to improve compliance. The article by Catherine Laillier also covers treatment of problems secondary to a disease, except in this case it is postoperative nausea and vomiting. We as pharmacists must not overlook this area of therapeutic intervention. Although it does not impact directly on patient survival, postoperative nausea and vomiting is nevertheless a very important area, increasing morbidity and length of stay following surgery. Finally, the article by Andreas Groll reviews a novel second-generation antifungal agent for the treatment of invasive fungal infections.

As I stated at the beginning of this editorial, having a large number of therapeutic reviews in one edition is slightly unusual. However, it is also refreshing, as it reminds us of an important skill we as pharmacists �possess: the ability to review primary evidence critically. As pharmacists, particularly in hospitals, we are called upon daily to provide advice on the most appropriate use of medicines for individual patients. However, a well-researched critical review of the literature for a particular treatment or therapeutic area can benefit many patients, and represents time well spent. Our contributors in this edition have demonstrated not only the skills of undertaking a well-researched review, but also the report writing skills to communicate the message effectively.

As we strive to build pharmacists’ knowledge and understanding of the underpinning science and therapeutics in our practice, we must not overlook the report writing skills, which are important if we are to communicate effectively our therapeutic messages to other healthcare professionals.

Healthcare is advancing at a rapid pace, and so too are therapeutic developments, which are contributing to greater life expectancy in the developed world. As a result, there is a plethora of information available on the use of ever-more complex and powerful medicines.

It has been said that, “Doctors use evidence as a drunk uses a lamp post, more for support than illumination.” Pharmacists have a role to play in providing timely critical reviews on medicines use, through which we can help illuminate the correct therapeutic path.



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