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22 RESEARCH NEWS STEROID CUTS COVID-19 DEATHS BY ONE THIRD The steroid dexamethasone reduced the death rate among patients hospitalised with COVID-19 who were on oxygen or ventilators, but not among those who were not receiving these interventions to help with their breathing, according to clinical trial data. These results from the RECOVERY trial – a controlled, open-label trial comparing a range of possible treatments in patients who were hospitalised with COVID-19 – have been published in the New England Journal of Medicine after earlier being released as a preprint. Patients were assigned to receive dexamethasone (2104 patients) or usual care (4321 patients). Overall, in the dexamethasone group, the incidence of death was 29.3 per cent compared with 41.4 per cent in the usual care group among patients receiving invasive mechanical ventilation. Comparing the incidence of death of the dexamethasone group with those receiving oxygen without invasive mechanical ventilation, the incidence of death was also lower in the dexamethasone group (23.3 per cent versus 26.2 per cent). This study by British researchers has also shown that patients who are not on oxygen support have better outcomes when receiving usual care rather than the drug (17.8 per cent in the dexamethasone group versus 14 per cent in the control group). The researchers looked at more than 6400 patients who took part in the RECOVERY trial undertaken by the University of Oxford, with the objective being to identify treatment for those with COVID-19 or suspected of having COVID-19. More than 2100 patients were given 6mg of dexamethasone daily for 10 days, while more than 4300 received usual care. Deaths were reduced by one third in patients receiving invasive mechanical ventilation and by one fifth in those receiving supplemental oxygen. The research highlighted that dexamethasone had the most benefit among patients who were critically ill and that death rates were not reduced in people not receiving respiratory support. Patients given dexamethasone died at the rate of 17 per cent, compared with patients who didn’t receive it at 13.2 per cent. To read the study, visit: nejm.org/ doi/10.1056/NEJMoa2021436 SPIKE IN STRESS AND SLEEPLESSNESS FOUND As the world struggles with a mass-killer virus among many other troubles, and with the unanticipated changes and lockdown measures that have been brought on by the COVID-19 pandemic, it’s not surprising that a national survey of more than 100 pharmacists from across Australia has found a spike in people seeking professional advice on managing stress and overcoming sleeping disorders. The survey, conducted by Priceline Pharmacy revealed that 64 per cent of the surveyed pharmacists have seen an increase in demand for help with sleep management, with 54 per cent reporting an increase in requests to boost mood or manage anxiety. Additionally, the survey found that 40 per cent of the pharmacists who have dealt with those seeking help report that up to half of the cases were a direct result of COVID-19 related social and economic pressures. These findings align with recent research from The Lab ‘Mental Wellbeing During the COVID-19 Crisis’ report, which says the combination of not being able to see friends, economic and job uncertainty and fewer social interactions as a result of the COVID-19 measures have had a negative impact on 46 per cent of Australians surveyed. Given these results and the unique position of retail pharmacy – pharmacists and pharmacy assistants – within this pandemic, it’s important for pharmacy staff to understand ways to help manage stress and sleeplessness. “We have many customers seeking professional advice on managing stress and sleeplessness,” Priceline Pharmacist Nancy El-miski said. “They’re seeking information and recommendations on natural medicines and over-the-counter products. “This has certainly increased since the COVID-19 pandemic, with one in three of our pharmacists reporting an increase in demand during this time.” Ways to manage stress and sleeplessness Ms El-miski suggests the following strategies to manage stress and sleeplessness: • Avoid \\\\\\\\\\\\\\\[excessive\\\\\\\\\\\\\\\] caffeine and alcohol consumption, and nicotine. • Regular physical activity. • A healthy diet. • Relaxation techniques. • Managing time – to-do lists and a stress diary may help. • Talking to someone – opening up about your concerns may be helpful. “We know there is heightened stress in the community,” Ms El-miski said. “We work very closely with GPs and other health professionals to encourage our customers to seek professional advice on all aspects of their health, particularly mental health. “There are great services available that can really help.” Mental health services that are available in Australia include: • Beyond Blue: beyondblue.org.au • Headspace: headspace.org.au • Lifeline: lifeline.org.au • Kids Helpline: kidshelpline.com.au • ReachOut Australia: au.reachout.com • SANE Australia: sane.org • Black Dog Institute: blackdoginstitute.org.au • Open Minds: openminds.org.au RETAIL PHARMACY • AUG 2020