Pharmacist prescribes relationships and resources to patients

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Kate Mudge thinks kidneys are “fantastic little things”. She also knows there is much more to pharmacy than just putting “pills in bottles and labels on packets”.

The Mackay Hospital and Health Service (HHS) senior renal pharmacist said the prevalence of kidney disease was rising in the community.

“There are a lot of factors for this including that people are living longer today and there’s more chronic disease which can potentially result in renal complications,” Kate said.

“Kidneys can get down to only 10% function before you get any symptoms and even notice a decline in function.

“Most people think high blood pressure is associated with heart attack and strokes, but kidney disease is often a consequence too as it seriously affects the kidney’s ability to function. Other reasons for kidney decline include auto immune disease and the fact that Polycystic kidney disease can be hereditary, often showing up generationally, so many people are now getting monitored for it.”

In the last 10 to 15 years, renal function had become a routine part of blood work in adults, Kate said, with the estimated Glomerular Filtration Rate (eGFR) test able to measure the level of kidney function and determine the stage of kidney disease.

Medications prescribed for chronic kidney disease were vital to manage symptoms, slow down progress of the disease and help prevent other related health problems.

“Every doctor in an outpatient clinic will ask what medications you are on,” she said.

“If you don’t know what you are already taking, they can’t then make appropriate and effective treatment decisions.

“I’ve learnt quite a few tips and tricks from patients including keeping physical lists of medications on the fridge and even taking photos of the pill bottles for when they go to the doctor.

“People with kidney disease have complex health needs and there are a lot of medications involved in looking after them, many of which also target issues like blood pressure, diabetes and cholesterol,” she said.

Pharmacists’ interventions had a positive impact on outcomes for people with kidney disease, including improving the management of anaemia and blood pressure and significantly reducing risk of hospitalisation and incidence of end-stage renal disease.

Renal pharmacy was focused on supporting doctors and staff in delivering healthcare plans as much as it was about supporting patients, Kate said. It was part of a multi-disciplinary approach to chronic kidney disease (including dialysis and transplant patients) which involved dieticians, social workers and psychologists as well as medical and nursing staff. It was vital patients realised they are an integral part of the team too.

“We try to encourage and empower people to take an active role in their healthcare and help patients understand their medications and the role they play. We also try to make it easier where we can as well,” she said.

“Sometimes that means helping them understand specifically what the medication does or even find suitable times to take their medication as it can be quite overwhelming for people the number of tablets they have to take. Dialysis patients can sometimes be on up to 20  tablets in one day.

“Pharmacy is more than just pills, it’s also about building relationships and providing resources to our patients – not every drug agrees with everybody.”

Born in Sarina, Kate is very invested in regional healthcare and has spent more than 25 years offering clinical pharmacy and outpatient renal pharmacy services across the state including at public and private hospitals in the south-east. She returned to Mackay Base Hospital in early January having worked here previously in 1999 and in 2006.

There was enormous opportunity to close the gap between healthcare in regional and metropolitan centres with regional hospital pharmacies now performing all the same essential services as their southern counterparts.

“I love what I do. I love helping people make sense of their medications so they can get the best health outcomes,” Kate said.

“I also like supporting the patients, as well as the doctors and nursing staff in their contributions towards better healthcare outcomes for all.

“We all have lots to offer but ultimately we are all here for the same reason and that’s the patient.”

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