Purple Pen Podcast

Recorded live at MM2019, Dan, Kristin and special guest host Viv Banks chat to some more poster presenters about their work. Visit purplepenpodcast.com for links to the poster abstracts.

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 September - not long to go! Register now and save up to $500!

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: 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.

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

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

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.

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. We talk about: 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