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.

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

Dan and Kristin spoke to Dr Juanita Westbury, Senior Lecturer with the Wicking Dementia Research & Education Centre at the University of Tasmania about the best practice use of antipsychotics in aged care.

We spoke to Juanita about:

• The roles for pharmacists in aged care facilities

• Common issues with medicines use in aged care facilities

• Complexities around the term “chemical restraint”

• Best practice for the management of behavioural symptoms of dementia

We caught up with Dr Simone Taylor from Austin Health and Amy McRae from Alfred Health about their work. Both Simone and Amy had projects featured in the “Time To Shine” session at last year’s SHPA Medicines Management Conference.

Amy’s paper is titled “Collaboration Between Healthcare and Industry to Improve the Safety of Neuromuscular Blocking Agents in Australia”. It describes an initiative to improve the packaging and labelling of these high-risk medicines.

Simone’s paper is titled “Emergency Department Screening Tools to Assist Pharmacists Targeting Patients at Risk For Medication Related Problems”. It describes the development of a tool to help pharmacists to identify patients who are at highest risk and would benefit most from pharmacist intervention.

Join us for a very special World Pharmacist Day edition of the Purple Pen Podcast.  Recorded live during pharmacy wellbeing week at Monash Health, Nat & Kristin reconnect with Jane Booth and Karlee Johnston to talk about Pharmacist Wellbeing.  We explore the concepts of empathy, vulnerability, burnout and restorative supervision.

Our guest, Dr Karlee Johnston, is a clinical pharmacist with extensive experience in critical care and winner of the SHPA - Australian Clinical Pharmacy award in 2023. Karlee’s PhD focused on the experiences of Australian pharmacists during the COVID-19 pandemic, with a specific interest in burnout in this cohort. Following from this research Karlee has continued to research burnout and possible interventions to better support healthcare professionals in their work.

Recorded live at MM2018 in Brisbane, Dan and Kristin sat down with Erica Tong, Deputy Director of Pharmacy and Chief Pharmacy Information Officer for Alfred Health about partnered pharmacist medication charting.

We spoke to Erica about her team’s work developing a model for partnered pharmacist medication charting on admission to hospital and the safety outcomes that have been achieved.

Happy holidays! The team is taking an episode off over Christmas, and in honour of Rohan’s Clinical Pharmacy award at 2018, we are re-broadcasting this “classic hit”. We will see you all in the new year with some great new episodes

Jane and Dan spoke to Dr Rohan Elliott, senior pharmacist in aged care at Austin Health, adjunct senior lecturer at Monash University, and a research consultant with the Royal District Nursing Service Institute.

 We talk to Rohan about:

·      The definition of geriatric medicine, and what it means to be frail

·      How the geriatric medicine approach differs from other specialties

·      Decision making in geriatric medicine

In this very special holiday episode, Dan and Kristin are joined by Dr Lindsey Fitzharris. Lindsey has a PhD in History from Oxford University and authored the wonderful book “The Butchering Art” which details the efforts of Joseph Lister to make surgery safer.

We discuss:

• What surgery was like before anaesthetics and antiseptics
• How these agents were introduced to Britain
• Why you didn’t want surgery in a hospital in the 1800s
• Two key surgeons in Victorian Britain: Liston and Lister
• Joseph Lister’s relentless drive to introduce antiseptics to surgical practice
• Lots of gory details about surgery 150 years ago!

Recorded live at MM2018, the 44th SHPA National Conference, Jane, Dan and Kristin caught up with keynote speaker Prof Brian Dolan. Brian is Director of Health Service 360 (UK) and Director of Service Improvement, Canterbury District Health Board, NZ where his role includes whole system culture engagement and change.

• why boredom could be worse than smoking for our patients

• the language that we use in healthcare that can be problematic for our patients

• what is meant by the term “PJ Paralysis” and how this became a movement

This is Part 2 of our episode recorded live at the Antibiotic Allergy in Practice Workshop at Austin Health. We spoke to Prof Elizabeth Phillips, Professor of Medicine at Vanderbilt University (USA); Prof Connie Katelaris, Allergist and Immunologist at the University of Western Sydney and Campbelltown Hospital; and Dr James Yun, Allergist and Immunologist and the University of Sydney.

We were really lucky to get to speak to this panel of experts. We asked them about:

• practical aspects of delabelling antibiotic allergies

• the emerging role of genetic testing

• why not all SCARs are created equal

• emerging treatment options for severe cutaneous adverse reactions (SCARs)

• the long-term sequelae of a severe adverse reaction

Jane and Dan attended the Antibiotic Allergy in Practice Workshop, held at Austin Health.

In this bumper episode we speak with a number of distinguished guests around the management of antibiotic allergy:

• Dr Ar Kar Aung, ID Physician from The Alfred discusses the classification and detection of antibiotic adverse reactions

• Dr MIchelle Goh, Dermatologist at Alfred Health, Austin Health and Peter MacCallum regarding characterising allergy phenotypes

• Dr Natasha Holmes, ID and Antibiotic Allergy Physician, on drug induced acute interstitial nephritis

• Karen Urbancic, ID Pharmacist at Austin Health and the National Centre for Antimicrobial Stewardship, on the practicalities of desensitisation protocols.

Back by popular demand, Prof Jason Roberts joins Dan to discuss ceftriaxone. They discuss situations where ceftriaxone is useful (spoiler: it's not "being an inpatient") and some pharmacokinetic quirks.

Jane caught up with A/Prof Ernie Butler, neurologist and head of the Monash MS Clinic at the SHPA Vic Branch symposium. We discuss:

• Why neurology is the most interesting specialty

• Background to MS - the link to the sun and its symptoms and progression

• Management of MS with traditional drugs, and how the monoclonal antibodies fit into practice

• Monitoring for side effects, including screening for JC virus

• Managing these side effects

Jane chats with Dr Jenny Stephens, pain specialist and anaesthetist at St Vincent’s Hospital, Sydney.

Jane and Jenny discuss:

• The significance of Australia’s problem with prescription opioids

• How the risks of post-operative opioids may start before admission

• The problems, beyond dependance, caused by long term opioid use

• Risk factors for opioid dependance post-discharge

• How Australia compares to the rest of the world with regard to problems with prescription opioids

• The impact of a pharmacy-led intervention at St Vincent’s Sydney

• Empowering junior doctors to stand up for good opioid prescribing

• Simple interventions pharmacists can make to help

• Empowering patients and managing their expectations around analgesia

Jane and Dan caught up with Chris Braithwaite, a pharmacist with the Galambila Aboriginal Health Service in Northern NSW.

Chris spoke to us about:

• his journey to working with indigenous communities
• what an average day looks like
• the challenges posed by existing funding models for home medicines reviews
• cultural competence and institutional racism

Join Kristin as she chats with Rebekah Moles about fever. Rebekah is an Associate Professor in Pharmacy Practice at the University of Sydney and she is passionate about quality use of medicines in paediatric patients. She has conducted research on the management of common ailments such as fever and cough/cold in young patients.

Dr Kimberley Haines, Vice Chair of ANZICS Victorian Branch and ICU Physio at Western Health joins Dan and Jane to discuss survival following ICU admissions.

Dr Kimberley discusses her journey to research, what happens to patients following ICU discharge and how we can improve the ICU journey for patients, staff and family.

Jane and Dan caught up with Professor Jason Roberts, NHMRC Practitioner Fellow at The University of Queensland and Consultant Clinical Pharmacist at the Royal Brisbane and Women’s Hospital. Jason is a senior member of the Burns Trauma and Critical Care Research Centre within the University of Queensland Centre for Clinical Research and is Director of the Centre for Translational Anti-infective Pharmacodynamics in School of Pharmacy where he is also Chair of the research Strategies Committee. 

We could have talked to Jason all day. In part two of our two-part discussion on pharmacokinetic modelling of antimicrobials we talk about:

• different pharmacodynamic models for antimicrobials: concentration, time and AUC dependant 
• the clinical evidence for using pharmacokinetic and pharmacodynamic modelling
• future directions for clinical pharmacokinetics

Jane and Dan caught up with Professor Jason Roberts, NHMRC Practitioner Fellow at The University of Queensland and Consultant Clinical Pharmacist at the Royal Brisbane and Women’s Hospital. Jason is a senior member of the Burns Trauma and Critical Care Research Centre within the University of Queensland Centre for Clinical Research and is Director of the Centre for Translational Anti-infective Pharmacodynamics in School of Pharmacy where he is also Chair of the research Strategies Committee. 

We could have talked to Jason all day. In part one of our two-part discussion on pharmacokinetic modelling of antimicrobials we talk about:

• Jason's pathway to a research career and the projects that his team are currently working on
• The patients and pathogens that benefit from individualised dosing of antimicrobials
• The narrowing therapeutic indices of some antimicrobials
• Some under-recognised adverse effects of beta-lactam antibiotics
• how to apply pharmacokinetics and individualised dosing in everyday practice

Dan caught up with NAPSA President Sandra Minas at the inaugural SHPA-NAPSA symposium in Melbourne on Friday. We discussed issues facing students, the results of the latest NAPSA survey and key programs being rolled out by NAPSA.

We learn that despite concerns about graduate numbers, the rise of discounters and low pay, almost all pharmacy students are dedicated to their profession, and are looking forward to their careers.

Jane and Dan spoke to Horst Thiele from the Primary Care and Transitions of Care specialty practice leadership group.

We asked Horst about the barriers and opportunities for pharmacists to assist patients at transitions of care and the evidence base for these services.

Dan and Jane are joined by Clarissa Rentsch to discuss updates on Inflammatory Bowel Disease with Clarissa Rentsch.

Clarissa is the Senior Pharmacist - Gastroenterology at Alfred Health, and discusses new therapy for IBD, the developing role for TDM in the management of this disease and her innovative clinic based role at The Alfred.

We discuss:

• Commencing therapy with and monitoring purine analogues
• Infliximab - its expanding role in therapy, and the emerging field of TDM for biologicals
• Clarissa's innovative role in the clinics, including dose adjustment and monitoring.

Jane and Dan spoke to Dr Manuel Serrano Santos, Lecturer of Pharmacy at QUT and member of the editorial committee for the third edition of Don't Rush to Crush.

We spoke to Manuel about:

• his role as a specialist dysphagia pharmacist
• what goes wrong when medicines are modified inappropriately
• common reasons for making mistakes when modifying medicines

This is a reboot of our first ever episode: Antibiotic Allergies with Dr Jason Trubiano

For our special 50th Episode we first discuss some things we've learned from making the podcast. Then Jane caught up with Dr Jason Trubiano, an Infectious Diseases Physician from Austin Health. Jason appeared on our first episode, and in Episode 50 we get an update on the world of antibiotic allergies and bust some more myths.

We're also re-releasing Episode One as a special 50th Episode treat.

Jane caught up with two members of the writing group for the recently updated Therapeutic Guidelines: Cardiovascular. Confusingly, they are also called Jane and Dan! Jane O'Connor is an Editor at Therapeutic Guidelines and Dr Daniel Scherer is a Cardiologist and PhD Candidate at the South Australian Health and Medical Research Institute.

Join us as we talk with Dr David Liew about the underappreciated condition of gout, dispel some myths and talk about what's changed in recommendations. 

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. 

Arthritis Australia have further information on gout here.

The 2015 study by Philip C Robinson is here An Observational Study of Gout Prevalence and Quality of Care in a National Australian General Practice Population 

Dan discusses PREPx with three experts: A/Prof Edwina Wright from The Alfred, Monash Uni and The Burnet Institute, Alison Duncan, Lead Pharmacist for HIV at The Alfred and Luxi Lal, Pharmacist and Scientist from the Burnet Institute.

We were so fortunate to have Edwina - who ran the pivotal Australian trials and was so kind in sharing her knowledge with us.

We learn about:

• How the key Australian studies were set up and run
• Novel dosing modalities
• Information for pharmacists and key counselling points for dispensing PREP
• Side effects and monitoring with PREP
• How PREP is changing the paradigm of HIV prevention

Jane and Dan talk Specialty Practice with Courtney Munro and Suzanne Newman from SHPA and Susie Welch from St Vincent’s Hospital in Sydney.

• Development of standards of practice
• How involvement in specialty practice can form part of your CPD plan
• What can be gained from involvement in a Specialty Practice Stream
• Hot topics in Emergency Medicine

Jane and Dan spoke to Bronwyn Clark, CEO of the Australian Pharmacy Council and Catriona Bradley, Executive Director of the Irish Institute of Pharmacy. Bronwyn is the Host Committee Convenor and Catriona is a keynote speaker at the upcoming Life Long Learning in Pharmacy Conference.

We discuss different models for assessing pharmacist competence, how to measure and develop competency in soft skills and what patients want pharmacists to be doing.

Dan is joined by eminent physician, pharmacologist and former pharmacist Prof  Dave Juurlink from the Faculty of Medicine at the University of Toronto.

We talk about:

• Why Tramadol is a bad choice of analgesia
• Why Codeine upscheduling is a good idea for Canada and Australia
• How scheduling impacts medication choice
• How a 100-word "paper" in NEJM contributed to the opioid epidemic

In the lead up to International Women’s Day 2018, Jane sat down with three Pharmacy Leaders: Sue Kirsa (Director of Pharmacy, Monash Health), Nicole Dirnbauer (Assistant Deputy Director of Pharmacy, Monash Children’s Hospital) and Marisa Hodgkinson (SHPA Victorian Branch Committee Chair).

We talk about:

• Challenges and things that have helped build a career
• Whether a mentor is necessary for success
• Whether we still need to be talking about women in healthcare leadership

At the Society of Hospital Pharmacists of Australia (SHPA)’s International Women’s Day Breakfast Debate, members can make up their own minds as thought leaders from Australian clinical pharmacy debate: Priority or luxury? Flexible hours in clinical pharmacy practice.

Jane and Dan spoke to Janelle Penno, Perioperative Medicine Pharmacist at Peter MacCallum Cancer Centre in Melbourne. Janelle's paper "Improving Medication Labelling - Patients Driving Their Information" was awarded best paper at the MM2017 conference in November.

We spoke to Janelle about:
Patients' preferences for medicine instructions
Principles of Plain English communication
Useful resources to help improve the way that health professionals communicate with their patients

ane talks to Benita Suckling, a clinical pharmacist with the Opioid Stewardship Service at Redcliffe Hospital in Queensland.

We spoke about:

A model for an opioid stewardship service, and why it is beneficial
Risk factors for inappropriate opioid use post discharge
Strategies to optimise pain management on discharge
SHPA members can join the Pain Management Specialty Practice stream to connect with other pharmacists working in this area

Jane and Dan spoke to Garth Birdsey, Senior clinician pharmacist at Barwon Health.

We asked Garth about:

Real world experience with DOACs in special patient groups 
Concerns about under-dosing patients with DOACs
Optimal use of beta-blockers and why metoprolol 12.5 mg bd is often inappropriate in IHD

In our final MM2017 episode, we speak to Rahul Singal Associate Chief Pharmacist - Operational Productivity at Kings College Hospital in London. Rahul was a keynote speaker at SHPA MM2017.

We talk to Rahul about:

The future for pharmacists in the UK and Australia
How pharmacists can improve patient safety at transitions of care
Models for pharmacist prescribing
Professional responsibilities and expanded roles

Jane and Dan spoke to Dr James Edwards at MM2017. James is a Senior Staff Specialist in Emergency Medicine at Royal Prince Alfred Hospital in Sydney, he is also the founder of www.onthewards.org which is designed to assist medical practitioners in their earliest days of postgraduate practice.

• FOAM (Free Open Access Medical Education)

• Different models of education for health professionals

• Dissemination of research and digital scholarship

• Quality control issues for open access information

Kristin is joined by Professor Sanjay Swaminathan to talk all things MABs or monoclonal antibodies.

Dr Sanjay Swaminathan is a Clinical Immunologist and Allergist, he is a Senior Staff Specialist and Head of the Department of Immunology and Allergy at Westmead and Blacktown Hospitals.

Jane and Dan caught up with Professor Zubin Austin at the recent MM2017 SHPA Conference where he was a keynote speaker. Professor Austin is the Murray Koffler Chair in Management at the University of Toronto. His research focuses on the professional and personal development of the health human resources workforce. '

• Culture shock

• Defining a professional culture

• How understanding the culture of different health craft groups can improve the relationships between them

Jane and Dan caught up with Natalie Tasker and Kristin Xenos, two members of the MM2017 Conference Scientific Program committee for a recap of the conference.

Live from Day 2 of the SHPA MM2017 conference, Jane and Dan caught up with some notable attendees:

• Amanda Horiniak, Resident Pharmacist at Alfred Health and newly awarded Resident of the Year
• Andrew Matthews, General Manager, Workforce Transformation at SHPA
• Stephen Bazire, author of the Psychotropic Drug Directory.