Purple Pen Podcast – Détails, épisodes et analyse

Join us as we talk with Prof Prash Sanders about the role of anticoagulation for patients with atrial fibrillation (AF), learn when patients should be screened for AF, how to perform a stroke risk assessment and strategies to reduce the risk of bleeding. 

This podcast is in collaboration with Medcast and the Quality Use of Medicines Alliance, a provider of health professional education in Australia focused on the quality use of medicines. Check out their resources here.

Clinical guide: Anticoagulant management for AF

Anticoagulant patient care plan

Prof Prash Sanders is a cardiologist and electrophysiologist with a focus on heart rhythm disorders, particularly atrial fibrillation. He graduated with Honours from the University of Adelaide and completed advanced training in Melbourne and Bordeaux, France, earning national and international recognition for his research and clinical expertise.

He is the Clinical Director of Cardiac Electrophysiology at the Royal Adelaide Hospital and holds the Knapman – National Heart Foundation Chair of Cardiology Research at the University of Adelaide. Dr Sanders has published over 600 papers and is a leader in advanced ablation techniques. He consults and performs procedures across multiple hospitals and regional clinics in South Australia.

Jarrah is a clinical pharmacist with a passion for education and quality use of data. He has led national health programs, including GP audit and feedback initiatives and Indigenous health nKPIs. He is currently clinical lead at MedCast, supporting best practice care through the Quality Use of Medicines Alliance.

Naloxone has been available in Australia without prescription since 2022 (after pilot programs through 2019-2021, analysis showed this trial saved 3 lives per day). Join us as Kristin and Nat talk naloxone with Pharmacist Emily Turkovic. Emily shares her personal story and why she is passionate about ensuring that naloxone is widely available in our community. Listen in for tips and tricks on how to broach the subject with patients and ways to de-stigmatise naloxone.

Resources:

Opioid Safety Toolkit

Free Take Home Naloxone training program

Find out more about the Take Home Naloxone program here.

Take Home Naloxone Program Resources

Join Kristin for a deep dive into meningococcal disease with Dr Anita Campbell.  Learn more about the various strains of meningococcal and their prevalence patterns in Australia and how that might impact the way we think about vaccination for meningococcal, using Men B as an example.

Dr Anita Campbell is a clinician researcher working as a paediatric infectious disease specialist and medical lead of the Stan Perron Immunisation service at Perth Children’s Hospital.

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: Cardiovascular version 7

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 Guidelines

Visit the Therapeutic Guidelines at http://www.tg.org.au

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.