Extra care is necessary when taking several different medicines. This is particularly true for patients with visual or cognitive impairment. Blister packs make it simple and easy to take the right medicines at the right time by dividing your tablets into separately sectioned blisters, each marked with the time of day when the tablets should be taken. This can improve your medication adherence and reduce errors. Caregivers can also easily check that the right medicines have been taken in a timely manner. Blister packs can help if you are

• Struggling to organise medicines.
• Finding it difficult to remember when to take your medicines.
• Helping to look after someone else.
• Recently home from hospital and suddenly have a lot more tablets to take.
• Looking after someone who is visually impaired.
• On a complex medication regime.

Hypertension is the foremost risk factor for cardiovascular events globally and affects around a third of adults. High blood pressure can affect people of all ages but does not always have symptoms. Untreated, high blood pressure may lead to conditions like heart disease or a stroke. Monitoring your blood pressure for 24 hours can help work out if its consistently high. This would be particularly useful if you:

• Have family members with a history of high blood pressure.
• Suspect you have high or borderline high blood pressure.
• Experience variable blood pressure.
• Have conditions such as diabetes or high cholesterol.
• Already take medicines to reduce your blood pressure.
• Experience blood pressure that is hard to control.
• Want to check for Atrial Fibrillation (irregular heartbeat).

For convenience and proximity reasons, community pharmacies play an increasingly important role in hypertension screening and monitoring. Our service involves fitting you with a device to wear, which includes a cuff around your arm that will measure your blood pressure for 24 hours.

Blood Pressure Category	Systolic mm Hg (upper number)		Diastolic mm Hg (lower number)
Normal	Less than 120	and	Less than 80
Elevated	120-129	and	Less than 80
High Blood Pressure – Hypertension Stage 1	130-139	or	80-89
High Blood Pressure – Hypertension Stage 2	Higher than 140	or	Higher than 90
Hypertensive Crisis	Higher than 180	and/or	Higher than 120

Cholesterol is a soft, waxy fat that body needs to function appropriately. However, too much cholesterol can lead to heart disease, atherosclerosis, or stroke. A cholesterol test can be used to measure the amount of “good” and “bad” cholesterol and triglycerides, a type of fat, in the blood. A cholesterol test can help determine your risk of the accumulation of plaques in your arteries that can lead to narrowed or blocked arteries throughout your body. High cholesterol levels often are a significant risk factor for coronary heart disease. Because, high cholesterol usually causes no signs or symptoms, a cholesterol test. is done to determine whether your cholesterol is high and estimate your risk of developing heart attacks and other forms of heart disease and diseases of the blood vessels. Adults at average risk of developing coronary artery disease should have their cholesterol checked every five years. More-frequent testing might be needed if your initial test results were abnormal or if you already have coronary artery disease, you are taking cholesterol-lowering medications, or you're at higher risk of coronary artery disease because you:

• Have a family history of high cholesterol or heart attacks.
• Are overweight.
• Are physically inactive.
• Have diabetes.
• Eat an unhealthy diet.
• Smoke cigarettes.
• Are a man older than 45.
• Or a woman older than 55.

Cholesterol control often requires lifestyle changes. Not only can we check your cholesterol, we can also give you advice on making lifestyle changes to get cholesterol to healthy levels and keeping them normal. Apart from monitoring diet, an active lifestyle can help to lower cholesterol levels and research suggests about 150 minutes of moderate-intensity aerobic activity every week can help to improve cholesterol levels.

Seasonal flu or influenza is an acute respiratory infection caused by flu viruses which circulate in all parts of the world. Seasonal flu symptoms include a high temperature, a severe (usually dry) cough, headache, muscle pain, joint pain, sore throat, and a runny nose. A person with the flu will also feel extremely unwell. Most people recover from the symptoms within a week or two without requiring medical attention. But flu can cause severe illness or death especially in people at high risk (see below). Illnesses range from mild to severe and even death. Hospitalisation and death occur mainly among high risk groups. The most effective way to prevent the flu is get vaccinated. An annual vaccination is recommended as immunity decreases over time. The flu vaccine can be administered as an injection or using an intra-nasal spray. While everyone should consider getting a flu vaccine, it is especially important that the following groups get vaccinated:

• Persons aged 65 years and older.
• Persons with a chronic illness requiring regular follow up, e.g. chronic respiratory disease (including chronic obstructive pulmonary disease, cystic fibrosis, moderate or severe asthma and bronchopulmonary dysplasia), chronic heart disease (including acute coronary syndrome), chronic renal disease, diabetes mellitus, haemoglobinopathies, chronic liver disease, chronic neurological disease (including multiple sclerosis, hereditary and degenerative disorders of the central nervous system).
• Those who are immunosuppressed due to disease or treatment including those with missing or non-functioning spleens.
• All cancer patients.
• Patients with any condition that can compromise respiratory function, e.g. spinal cord injury, seizure disorder or other neuromuscular disorder.
• Persons with Down syndrome.
• Those with morbid obesity, i.e. body mass index over 40.
• All pregnant women (vaccine can be given at any stage of pregnancy).
• Healthcare workers.
• Household contacts of at-risk persons.
• Out-of-home care givers to at-risk persons.
• Residents of nursing homes and other long stay institutions.
• Carers.
• People with regular contact with pigs, poultry, or waterfowl.

The delivery of patient care and pharmacy services to patients residing in residential care and nursing homes is a primary patient safety and professional practice issue. As pharmacists, we play an ongoing role in the healthcare team caring for nursing home and residential care patients, particularly in ensuring safe and appropriate supply and management of medicines. Our SOPs set out the requirements involved in the sale and supply of medicines to patients who are living in residential care settings/nursing homes. Our SOPs adhere to the PSI guidelines which outline several interactions between pharmacies and nursing home / care facilities relating to the importance of prescriptions, mandatory review of prescribed medicines, patient counselling the appropriate delivery of medicines. Our pharmacists are also available to participate in an interdisciplinary review of each patient on long-term medication. HIQA recommends this is complete at least every three months.

According to the HSE, obesity levels in Ireland have reached “epidemic proportions” and affect up to a fifth of all adults and result in 2,000 premature deaths annually. Weight management means maintaining a healthy body weight. Body weight can affect health in many ways. Being overweight can increase your chances of developing high blood pressure, high cholesterol, diabetes, and other cardiovascular problems. If people maintain a healthy weight, this will decrease the risk of developing these problems. In addition to improve general health, losing weight can help to increase levels of confidence and make people feel better. If people are serious about losing weight, we could help reach the goal, with the support of a highly trained healthcare professional on hand for information, advice, and encouragement. We are here to help you figure out what direction is best for you as there is no such thing as a ‘one-size-fits-all’ weight management product or programme.