Purple Pen Podcast

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