Purple Pen Podcast

In the first of our episodes live from the SHPA Medicines Management 2019 conference, Jane and Kristin asked some poster presenters to talk about their work. Visit purplepenpodcast.com for links to the poster abstracts.

Dan and Kristin are joined by Dr Rose Cairns from the University of Sydney and the NSW Poison’s Information centre to discuss the latest trends in codeine usage. Dr Cairns’ research shows us that since codeine up-scheduled, less codeine overall is being used, patients do not seem to be switching to higher strength codeine products and opioid poisonings are down. We also discuss whether there has been a switch to other prescription opioids, illicit opioids and the public perceptions of over the counter codeine.

In this episode, Dan and Kristin are joined by Professor Andrew Wilson, chair of the Pharmaceutical Benefits Advisory Committee. We discuss: What the PBAC does How it makes decisions on which drugs to recommend for subsidy How decisions are made in difficult situations, for example with new drugs with very little long term information, or where prices are exceptionally high The PBAC is an independent expert body appointed by the Australian Government. Members include doctors, health professionals, health economists and consumer representatives. You can find out more about the work of the PBAC here If you are interested in learning more about QALY’s, Alwyn Smith’s 1987 article “Qualms about QALYs” is an interesting place to start.

Jane and Kristin are joined by Nat Tasker and Duncan McKenzie from the SHPA’s Medicines Management 2019 conference committee. We discuss highlights, include key plenaries, highlights, workshops and the gala dinner theme! SHPA Medicines Management 2019 will be held from 14-16 November on the Gold Coast. Visit the MM2019 website to view the program and register now! (Sorry for Duncan’s audio freaking out around 10 minutes in!)

Jane and Kristin spoke to Dr Bec Szabo, a gynaecologist at the Royal Women’s Hospital in Melbourne. Topics covered in this episode: the impact of screening and HPV vaccination on the rate of cervical cancer in Australia the complex factors that impact on willingness and comfort discussing women’s health common myths and misconceptions around women’s health what the future might hold for greater diversity in healthcare leadership whether discussion about Eurovision is a valid method of contraception

Kristin and Dan caught up with Lauren Cortis, pharmacist and PhD candidate to talk about generalism, specialisation and how these interact with patients needing better care.   We discuss: The risks of specialisation to patient care, and how patients need generalists as much as specialists Why pharmacists specialise and how we can think about the future of pharmacy Why all pharmacists should work towards being better generalists  Why specialisation can cause problems for patients with cancer or chronic disease  How generalist care isn’t just adding together different specialists  How ‘generalist’ as a word has negative connotations and how generalism is undervalued Visit Lauren’s Blog to read more of her insightful thoughts

  In today's episode, Kristin and Dan are joined by Dr Nisha Khot, obstetrician, educator and RANZCOG counsellor to discuss these common and potentially serious conditions in pregnancy. We discuss: How we define and diagnose gestational hypertension, pre-eclampsia and eclampsia, and the newer category of HELLP syndrome How pregnant womens present with these conditions - typical diagnosis, and new biomarkers Risks factors for these conditions Treatment and prevention options, including the role of aspirin and calcium supplementation Our treatment choices for controlling hypertension in pregnancy Links from this episode: Nisha’s twitter profile The Society of Obstetric Medicines of Australian and NZ’s Guideline for the Management of Hypertensive Disorders of Pregnancy Other guidelines from SOMANZ Summary and Full Text of the MAGPIE trial - demonstrating the benefit of magnesium sulphate in pre-eclampsia And! Remember that Early Bird Registration for Medicines Management 2019 closes on the 16th of S

In a special episode of the Purple Pen Podcast, Jane shares the story of her career journey. Originally presented at the 2018 SHPA Medicines Management Conference, Jane was invited to share her story again at Monash University which is where this episode was recorded. More information about the SHPA mentoring program is available here. Information about the Pharmacist Support Service is available here.

Kristin and Dan were joined by Toni Howell, Medication Safety pharmacist from St V’s in Melbourne, and Chair of the SHPA Specialty Practice Leadership Group in Med Safety. We had a really enjoyable chat, covering lots of topics, including: A day in the life of a med safety pharmacist The benefits of joining your SHPA Specialty practice group Handling of medicines The importance of managing risk Pros and Cons of Electronic medication management How medication safety is everyone’s job and crowd-sourcing patient care Bad handwriting (Doctors AND pharmacists) Nudging people to identify more med safety A reminder! If you are an SHPA member you can join a a Specialty Practice Interest Group. And practice group members are eligible to stand for election to the Leadership Committee.

Jane and Dan caught up with Dr Tanya Selak, anaesthetist, Tweeter and co-host of the MedEd StuffNNonsense podcast. We chat about silos and building good relationships in hospitals, common issues managing medicines in the peri-operative period and shortages, ah shortages… You can follow Tanya on Twitter here and check out the MedEd StuffNNonsense podcast here and here.

In a special episode of the podcast, Dan caught up with Sejla and Rustie from the Alcohol and Drug Foundation (ADF) about strategies for preventing and reducing harm from prescription medicines. Sejla and Rustie have some great practical and personal insights to share. The resources that we discussed are available here: SafeScript (Victoria) training and information ADF Drug Facts

Dan and Kristin welcomed Cia Connell back to the podcast to tell us about some recent publications to guide management of atrial fibrillation. Cia is a clinical manger with the Heart Foundation and a specialist cardiology pharmacist. We cover a lot of ground in this episode, from the basics of rate vs rhythm control to the most recent international guidelines. You can read more here: The AUGUSTUS trial The CABANA trial National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Diagnosis and Management of Atrial Fibrillation 2018 The Apple Heart Study If you’re a cardiology nerd like Cia and Dan, you should check out some of our other episodes: Episode 3: New anticoagulants with Cia Connell Episode 15: Controversies about lipid-lowering therapies with Dr Rochelle Gellatly Episode 20: Heart failure with Dr Rochelle Gellatly Episode 41: Hot topics in cardiology with Garth Birdsey Episode 49: Therapeutic Guidelines: Cardi

  This episode we celebrate the release of the new Therapeutic Guidelines - Antibiotic! Jane and Kristin are joined by Senior Editor Jess Gibney and Dr Emily Tucker, ID Physician from Flinders Medical Centre to discuss what’s new and what’s changed. Things we learnt include: How to say Happy Easter in Greek How Therapeutics Guidelines put its expert groups together The process of updating guidelines Why TG is no longer being published in hard copy Changes to surgical prophylaxis recommendations The new inclusion of intravenous Amoxicillin/Clavulanate as a treatment option, and the behind the scenes discussion around the use of this agent, including dosing controversies New advice for Ceftriaxone dosage The choice to expand advice around “watching and waiting” and when NOT to use antibiotics A new approach to the classification of community acquired pneumonia Significant changes to advice around antibiotic allergies (side chains!) Some challenges in updating the paediatric section of the

Kristin and Jane are joined by Professor Jonathan Iredell, ID and Microbiology Consultant at Westmead and Professor of Medicine and Microbiology and Sydney Medical School. We discuss: What is a bacteriophage? How can they help in a battle against antimicrobial resistance? How do we use them? What’s the dose and route of administration? Which infections can they be used for? How can they be regulated? What adverse effects can we expect from phage therapy? Further reading: The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug : A Memoir by Stephanie Strathdee and Thomas Patterson, available at the Book Depository Professor Iredell’s research page at Sydney Uni A review of phage therapy published this year by Patey and colleagues (Full text available)

Jane and Kristin spoke to David Ellis, a senior specialist pharmacist and team leader for non-sterile production at the Women's and Children's hospital in Adelaide. He's also a contributor to the Australian Don't Rush to Crush Handbook. We spoke to David about the newest edition of Don't Rush to Crush. Monographs now contain information on the best way to give a dose that is less than a whole tablet or capsule. David talks us through the development of the new information and common pitfalls in giving a partial oral dose. This episode is brought to you by two upcoming conferences: The Alcohol and Drug Foundation 2019 National Prevention in Practice Conference (Melbourne, June 24th and 25th) https://adf.org.au/conference/ The SHPA 2019 Electronic Medication Management Conference (Sydney, June 22nd and 23rd) https://shpa.eventsair.com/emm-conference/   

Jane and Kristin spoke to Dr Sam Costello, a gastroenterologist from South Australia about Faecal Microbiota Transplants - more loosely known as "poo transplants". It's a fascinating discussion about the practicalities around screening donors, administration of FMT and the emerging evidence for this treatment.

Kristin and Jane caught up with Professor Anne Duggan, a gastroenterologist, and Meredith Page, a pharmacist, who work at the Australian Commission on Safety and Quality in Health Care  We spoke about:   What is healthcare variation and why do we measure it? Is variation necessarily a bad thing? How does Australia compare internationally with what is measured in our Atlas, for example medication us or surgery? How measuring healthcare variation can be used to enact change  Find out more about the Australian Atlas of Healthcare Variation

f you found any of the topics discussed in this episode distressing, you can reach out for confidential advice to Pharmacists Support Service at supportforpharmacists.org.au or on 1300 244 910. Our medical colleagues can visit the Australasian Doctors’ Health Network - adhn.org.au Dan and Jane are joined by Dr Ash Witt, a Physician trainee to discuss the issue of wellbeing in the medical workforce. We discuss: How the current system lets down junior doctors What a typical career path for a junior doctor looks like The brave and moving blog post by Dr Yumiko - “The Ugly Side of Becoming a Surgeon” Rostering, overtime and nightshifts How to choose a coffee! We are indebted to Ash for her bravery in speaking out on these key issues. Follow her on twitter: @dr_ashwitt - please be sure to thank her if you enjoyed the episode.

Kristin and Dan get back to basics in Haematology from Dr Ian Bilmon,  a Haematologist & BMT Physician at Crown Princess Mary Cancer Centre, Westmead and Sydney Adventist Hospital  We talk about: the most common haematological malignancies and how they differ How these conditions present, what initial treatment looks like and how the prognosis differs What's on the horizon for Haematology