Professor Professor Professor Professor

Lilian M. AzzopardiLilian M. AzzopardiLilian M. AzzopardiLilian M. Azzopardi

Point of Interest:

The publication of the book Validation Instruments for Community Pharmacy: pharmaceutical care for the third millennium by Professor Azzopardi was recognised internationally in the same year that the World Health Report had classified Malta’s Health System in the fifth place out of 191 countries

I N S I D E T H I S

I S S U E :

37th European Sympo-sium on Clinical Pharmacy Dubrovnik, Croatia 21-24 October 2008

2

Research Spot 3

Reference:Reference:Reference:Reference:

N e w H e a d o f D e p a r t m e n t -

P r o f e s s o r L i l i a n . M . A z z o p a r d i

The Department of Pharmacy

which is part of the Faculty of

Medicine and Surgery is over

400 years old. Throughout these

years there have been different

leaderships, the most recent of

which is that of Professor An-

thony Serracino Inglott who has

been leading the department for

20 years. Prof. Serracino Inglott

graduated in 1968 and since

then, he never ceased to con-

tribute to the pharmacy profes-

sion. His successor Professor

Lilian M. Azzopardi will certainly

accomplish this task success-

fully.

Achievements:

Prof. Azzopardi studied phar-

macy at the Faculty of Medicine

and Surgery of the University of

Malta. Graduating in the year

1994 she took up a position of a

teaching and research assistant

at the University of Malta. She

obtained an MPhil with a disser-

tation on the development of

formulary systems for commu-

nity pharmacy. In 1997, she

received the FIP Foundation for

Education and Research award.

The University of Malta awarded

a Ph.D. in Pharmacy Practice to

Prof. Azzopardi in 1999. In the

same year she was awarded the

ESCP German Research and

Education Foundation grant. The

money grant was exploited to

pursue additional research on

validation of community phar-

macy. Her research findings

were cited in the documentation

for the “Pharmacy in a New

Age” campaign of the Royal

Pharmaceutical Society of Great

Britain. Furthermore, her Ph.D.

work led to the publication of the

book Validation Instruments for

Community Pharmacy: pharma-

ceutical care for the third millen-

nium in the year 2000. She also

published various other books

including MCQs in Pharmacy

Practice in 2003, Further MCQs

in Pharmacy Practice in 2006

and MCQs in Clinical Pharmacy

which was published in 2007.

Prof. Azzopardi published a num-

ber of papers on clinical phar-

macy and pharmaceutical care.

She is frequently invited to give

lectures and short courses in

this area in a number of foreign

universities.

Professor Lilian M. Azzopardi during the presentation of the book MCQs in Clinical Pharmacy to Prime Minister Dr. Law-rence Gonzi

ternational Pharmaceutical Fed-

eration), ESCP (European Soci-

ety of Clinical Pharmacy), the

Royal Pharmaceutical Society of

Great Britain, the American

Pharmaceutical Association and

the American Society of Health

System Pharmacists. She was

the ad-interim director of the

ESCP. Currently, she is the coor-

dinator of the ESCP newsletter

and active in FIP Working

Groups on Quality Care Stan-

dards within the Community

Pharmacy Section of the FIP. In

addition, she also has pharma-

ceutical experience in clinical

settings, community pharmacy

and the pharmaceutical indus-

try.

Major roles:

The most recent and prominent

responsibility assigned to her is

the headship of the pharmacy

department of the University of

Malta. She is highly active in

pharmacy practice teaching and

in supervising a variety of phar-

macy projects and dissertations.

Prof. Azzopardi is an examiner in

clinical pharmacy and pharmacy

practice at the University of

Malta. Congratulations to Prof.

Azzopardi on her well-deserved

promotion.

The Pharmacy Department Review

U N I V E R S I T Y O F M A LTA

November 2008 Volume1, Issue 3

This newsletter is This newsletter is This newsletter is This newsletter is published as part of an published as part of an published as part of an published as part of an undergraduate project undergraduate project undergraduate project undergraduate project carried out by Antine Vella carried out by Antine Vella carried out by Antine Vella carried out by Antine Vella under the supervision of under the supervision of under the supervision of under the supervision of P r o f e s s o r A n t h o n y P r o f e s s o r A n t h o n y P r o f e s s o r A n t h o n y P r o f e s s o r A n t h o n y Serracino Inglott. Serracino Inglott. Serracino Inglott. Serracino Inglott.

Her past and current contribu-

tions to the profession:

She was a member of the Phar-

macy Board, the licensing au-

thority for pharmacy in Malta

for several years. Moreover,

she was the registrar of the

Malta College of Pharmacy

Practice which offers continu-

ing education. Prof. Azzopardi

has actively participated in

congresses held by the FIP (In-

Azzopardi LM, Hudson S, Salek S, Serracino Inglott A, Zarb Adami M. MCQs in clinical phar-macy. 1st ed. London; Pharmaceutical Press; 2007. p. 17,18.

Deguara L. Speech delivered by the Hon. Louis Deguara, Minister of Health, during the launch of the book “Validation instruments for community pharmacy” [Online]. 2000 Oct 6 [cited 2008 Oct 1]; Available from: URL:http://www.doi.gov.mt/EN/press_releases/2000/10/pr1310.asp

Introduction

The European Society of Clinical

Pharmacy (ESCP) was founded in

October 1979. The society aims to

develop and promote the rational

and proper use of drugs and medi-

cal equipment for the welfare of

society. The main event is the

Annual European Symposium

which takes place each year in

autumn and revolves around the

major European cities. This year’s

symposium was held between the

21st and the 24th October in Du-

brovnik, Croatia. The theme of this

symposium was Pharmaceutical

Care Models and Therapeutic

Innovations. The chair person of

this year’s scientific committee

was Professor Anthony Serracino

Inglott. The Maltese delegation

was formed by Prof. Lilian M. Az-

zopardi, Dr. Maurice Zarb Adami,

Francesca Wirth and Kristen Bu-

hagiar.

Plenary session & workshop

The Scientific Programme was

spread over three days, from

Wednesday 22nd till Friday the

24th October. The theme of the

first plenary session was

‘Balancing Costs and Effective-

ness’, with the Chair of the day

and Moderator being Prof Ser-

racino Inglott. During the plenary

session, Dr Maurice Zarb Adami

gave a presentation entitled ’The

Balancing Act and Therapeutic

Costs’. He stated that for specific

medical conditions one needs to

rely on specialists as these are in

a position to address the situation

in the best possible way. They are

able to weigh the risks and bene-

fits of every decision they make

and are responsible for every ac-

tion taken. Every decision un-

doubtedly carries with it a number

of consequences ranging from

Pharmaceutical Care Models & Therapeutic Innovations Pharmaceutical Care Models & Therapeutic Innovations Pharmaceutical Care Models & Therapeutic Innovations Pharmaceutical Care Models & Therapeutic Innovations

37th European Symposium on Clinical Pharmacy37th European Symposium on Clinical Pharmacy37th European Symposium on Clinical Pharmacy37th European Symposium on Clinical Pharmacy Dubrovnik, Croatia 21Dubrovnik, Croatia 21Dubrovnik, Croatia 21Dubrovnik, Croatia 21----24th October 200824th October 200824th October 200824th October 2008

P a g e 2 T h e P h a r m a c y D e p a r t m e n t R e v i e w

financial costs to the patient’s

quality of life. Dr. Zarb Adami

was also the moderator of the

first round table discussion

that followed the session.

The Maltese delegation, repre-

senting the Pharmacy Depart-

ment of the University of

Malta, together with Prof.

Philip Schneider from the Uni-

versity of Arizona, US gave a

workshop on Point-of-Care

Testing (POCT) in out-patient

settings and community phar-

macies. A brief overview of

POCT in a community phar-

macy setting, outlining the

steps necessary to organise an

anticoagulation monitoring

service were presented. Prof.

Schneider focused on POCT in

an acute care setting. Subse-

quently participants were di-

vided into small groups where

they were given a list of discus-

sion points on POCT. During

this discussion, the main fac-

tors required to provide a good

quality service were high-

lighted.

Oral communications

On the second day of the sym-

posium Francesca Wirth gave

an overview of the initial find-

ings of an ongoing study in a

presentation entitled ‘Time

motion study for pharmacists’

activities in a geriatric hospi-

tal’. The aim of the study was

to identify and quantify activi-

ties undertaken by clinical

pharmacists at Zammit Clapp

Hospital (ZCH), St. Julians,

using a time and motion study

technique. Results showed

that clinical pharmacy activi-

ties such as ward rounds, pre-

scription monitoring and pa-

tient discharge were predomi-

nant. However, administration

tasks such as checking of

ward medication stock and

medication orders occupied a

large portion of the pharma-

cists’ time. For optimal utilisa-

tion of pharmacist expertise,

administrative tasks should

take up a minimum of the

pharmacists’ time and clinical

tasks should be performed as

efficiently as possible. The

administration tasks can be

conducted by trained non-

pharmacist personnel such as

pharmacy technicians, allow-

ing more of the clinical phar-

macists’ time to be directed

towards patient care.

On the last day of the confer-

ence, Kristen Buhagiar pre-

sented her undergraduate

project entitled ’Community

pharmacists’ intervention in

the monitoring of oral anti-

coagulation therapy’. She

started by giving an overview

of the local INR monitoring

Reference:Pharmaceutical care models and therapeutic Innova-

tions. 37th European symposium on clinical pharmacy Dubrovnic,

Croatia 21-24th October, 2008 [Online]. 2008 [cited 2008 Oct 10];

Available from: URL:http://www.escpweb.org/uploadedFiles/cms/

store//gdhxcgbxc/splash_AnnSymposia_files/ATTACHMENTS/

ESCP_Dubrovnik_Final_Program.pdf

The Maltese delegates at the Dubrovnic conference (from left) Maurice Zarb Adami, Francesca Wirth, Kirsten Buhagiar, Lilian M. Azzopardi and Anthony Serracino-Inglott.

scenario. Monitoring takes place at

the only Anti-Coagulation Clinic

(ACC) at Mater Dei Hospital (MDH).

An objective of this study was to

investigate whether it would be fea-

sible to offer an INR monitoring

service in community pharmacies

using the CoaguChek® S. It was

interesting to find out that patients

on anti-coagulant treatment showed

trust and confidence in the capabili-

ties of the pharmacist to execute

this role. On the other hand manag-

ing pharmacists were not as posi-

tive. They argued that the cost of

the test is high considering that

most of these patients are on a

retirement pension. A concordance

test was carried out comparing the

reliability of the CoaguChek® S sys-

tem with the laboratory based

method used at the ACC. Results

issued with the CoaguChek® S were

found to be 98% concordant. Phar-

macists need to look at this pro-

posal more positively and take up

this challenge eagerly since there

are advantages which may be easily

overlooked. It was recommended

that the agents for CoaguChek® S

provide the kit free of charge to the

pharmacists hence reducing the

cost of the service even further.

Other papers presented as posters

during the symposium included

‘Chronopharmacology and diabetes’

co-authored with Marisabelle Bon-

nici and ‘Use of cholesterol monitor-

ing devices in community pharma-

cies’ co-authored with Kristy Young.

Prof. Azzopardi was a member of

the ESCP jury for the award of the

best poster and best oral communi-

cation presented during the confer-

ence.

V o l u m e 1 , I s s u e 3 P a g e 3

WebWebWebWeb: : : : http://home.um.edu.mt/phcy/http://home.um.edu.mt/phcy/http://home.um.edu.mt/phcy/http://home.um.edu.mt/phcy/

Mailing Address: Mailing Address: Mailing Address: Mailing Address: Department of Pharmacy, Department of Pharmacy, Department of Pharmacy, Department of Pharmacy,

University of Malta, Msida MSD 2080, Malta. University of Malta, Msida MSD 2080, Malta. University of Malta, Msida MSD 2080, Malta. University of Malta, Msida MSD 2080, Malta.

EEEE----mail address: mail address: mail address: mail address:

phcy@um.edu.mt phcy@um.edu.mt phcy@um.edu.mt phcy@um.edu.mt

Tel: Tel: Tel: Tel: +356 21343764/5 +356 21343764/5 +356 21343764/5 +356 21343764/5

Fax: Fax: Fax: Fax: +356 21340427+356 21340427+356 21340427+356 21340427

Head of Department:Head of Department:Head of Department:Head of Department:

Prof. L.M. Azzopardi Prof. L.M. Azzopardi Prof. L.M. Azzopardi Prof. L.M. Azzopardi

lilian.m.azzopardi@um.edu.mt lilian.m.azzopardi@um.edu.mt lilian.m.azzopardi@um.edu.mt lilian.m.azzopardi@um.edu.mt

Editor: Antine Vella Editor: Antine Vella Editor: Antine Vella Editor: Antine Vella

avel0019@um.edu.mtavel0019@um.edu.mtavel0019@um.edu.mtavel0019@um.edu.mt

Phase 1: Design of new processPhase 1: Design of new processPhase 1: Design of new processPhase 1: Design of new process To identify the factors that may influence the yield To identify the type of waste that result in product losses To identify safety procedures and quality standards that are required

Phase 2: Design and production of equipmentPhase 2: Design and production of equipmentPhase 2: Design and production of equipmentPhase 2: Design and production of equipment

To prepare specifications for the production equipment To accomplish mechanical changes required in the equipment To design and compile relevant standard operating procedures

Phase 3: Production of a batchPhase 3: Production of a batchPhase 3: Production of a batchPhase 3: Production of a batch

To prepare a batch manufacturing record To update relevant Standard Operating Procedures To implement the changes in the production of an industrial batch

Phase 4: Testing of dosage form following the procedure developedPhase 4: Testing of dosage form following the procedure developedPhase 4: Testing of dosage form following the procedure developedPhase 4: Testing of dosage form following the procedure developed

To establish extraction methods To establish and validate a method of analysis To test a batch of the newly developed solid oral dosage form through a bioequivalence study

Phase 5: Application for a patent for the procedure adopted and the new equipment devisedPhase 5: Application for a patent for the procedure adopted and the new equipment devisedPhase 5: Application for a patent for the procedure adopted and the new equipment devisedPhase 5: Application for a patent for the procedure adopted and the new equipment devised

Introduction to the R&I Programme Introduction to the R&I Programme Introduction to the R&I Programme Introduction to the R&I Programme

2008200820082008

The National Research and Innovation The National Research and Innovation The National Research and Innovation The National Research and Innovation

(R&I) Programme 2008 is a scheme (R&I) Programme 2008 is a scheme (R&I) Programme 2008 is a scheme (R&I) Programme 2008 is a scheme

within MCST (Malta Council for Science within MCST (Malta Council for Science within MCST (Malta Council for Science within MCST (Malta Council for Science

and Technology) whereby financial and Technology) whereby financial and Technology) whereby financial and Technology) whereby financial

support is given to local entities who support is given to local entities who support is given to local entities who support is given to local entities who

enroll in a research and innovation enroll in a research and innovation enroll in a research and innovation enroll in a research and innovation

project in the field of science and project in the field of science and project in the field of science and project in the field of science and

technology.technology.technology.technology.

A total of seven projects have been A total of seven projects have been A total of seven projects have been A total of seven projects have been

selected in this year’s R&I programme. selected in this year’s R&I programme. selected in this year’s R&I programme. selected in this year’s R&I programme.

The projects derive from different The projects derive from different The projects derive from different The projects derive from different

sectors, including the Manufacturing, sectors, including the Manufacturing, sectors, including the Manufacturing, sectors, including the Manufacturing,

Health & BioTechnology, Information and Health & BioTechnology, Information and Health & BioTechnology, Information and Health & BioTechnology, Information and

Communication Technology (ICTCommunication Technology (ICTCommunication Technology (ICTCommunication Technology (ICT),

The research spotThe research spotThe research spotThe research spot---- The R & I Programme 2008The R & I Programme 2008The R & I Programme 2008The R & I Programme 2008

Project Plan Project Plan Project Plan Project Plan

Environment & Energy areas. One of Environment & Energy areas. One of Environment & Energy areas. One of Environment & Energy areas. One of

these projects is cothese projects is cothese projects is cothese projects is co----ordinated by the ordinated by the ordinated by the ordinated by the

Pharmacy Department in collaboration Pharmacy Department in collaboration Pharmacy Department in collaboration Pharmacy Department in collaboration

with the local pharmaceutical with the local pharmaceutical with the local pharmaceutical with the local pharmaceutical

manufacturing company, Starpharma. manufacturing company, Starpharma. manufacturing company, Starpharma. manufacturing company, Starpharma.

The project is entitled The project is entitled The project is entitled The project is entitled increasing the increasing the increasing the increasing the

yield in the production of slow release yield in the production of slow release yield in the production of slow release yield in the production of slow release

pellets in the manufacture of tablets and pellets in the manufacture of tablets and pellets in the manufacture of tablets and pellets in the manufacture of tablets and

capsules. capsules. capsules. capsules. The overall project duration is The overall project duration is The overall project duration is The overall project duration is

estimated to be that of thirty six monthsestimated to be that of thirty six monthsestimated to be that of thirty six monthsestimated to be that of thirty six months.

Increasing the yield in the production of Increasing the yield in the production of Increasing the yield in the production of Increasing the yield in the production of

slow release pellets in the manufacture slow release pellets in the manufacture slow release pellets in the manufacture slow release pellets in the manufacture

of tablets and capsulesof tablets and capsulesof tablets and capsulesof tablets and capsules

In the manufacture of modified release In the manufacture of modified release In the manufacture of modified release In the manufacture of modified release

oral dosage forms, the drug dissolution oral dosage forms, the drug dissolution oral dosage forms, the drug dissolution oral dosage forms, the drug dissolution

profile is either modified by controlling profile is either modified by controlling profile is either modified by controlling profile is either modified by controlling

access of biological fluids to the drug or access of biological fluids to the drug or access of biological fluids to the drug or access of biological fluids to the drug or

by controlling the diffusion rate of the by controlling the diffusion rate of the by controlling the diffusion rate of the by controlling the diffusion rate of the

drug. These factors are taken into drug. These factors are taken into drug. These factors are taken into drug. These factors are taken into

consideration to achieve a formulation consideration to achieve a formulation consideration to achieve a formulation consideration to achieve a formulation

that is pharmaceutically and that is pharmaceutically and that is pharmaceutically and that is pharmaceutically and

economically viable. economically viable. economically viable. economically viable.

This project aims to establish means of This project aims to establish means of This project aims to establish means of This project aims to establish means of

how to increase the yield of active how to increase the yield of active how to increase the yield of active how to increase the yield of active

ingredient specifically for the production ingredient specifically for the production ingredient specifically for the production ingredient specifically for the production

of solid oral dosage forms and to identify of solid oral dosage forms and to identify of solid oral dosage forms and to identify of solid oral dosage forms and to identify

methods to enhance manufacture of methods to enhance manufacture of methods to enhance manufacture of methods to enhance manufacture of

modified release formulations. modified release formulations. modified release formulations. modified release formulations.

Reference: Reference: Reference: Reference: R&I Programme 2008 Evaluation of Shortlisted Proposals [Online]. 2008 [cited 2008 Oct 20]; Available from: URL:http://www.mcst.org.mt/page.aspx?id=93

Related under-Related under-Related under-Related under-graduate projectsgraduate projectsgraduate projectsgraduate projects:

“Methods to improve yield in the production of slow release oral dosage forms”- Nicolette Bartolo 3rd year pharmacy stu-dent “Production of modified release dosage forms” – Karl Schembri 4th year pharmacy student

The projects referred to in this newsletter are

The projects referred to in this newsletter are car-ried out under the supervision of members of the aca-demic staff of the Department of Pharmacy with the col-laboration of other academic staff from various faculties and institutes in the University including other depart-ments in the Faculty of Medicine and Surgery. The De-partment of Pharmacy is fortunate to have such an expert collaboration from so many academics and recognises such distinguished contributions.