..Information to Pharmacists
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Your Monthly E-Magazine
MAY, 2004

LACHLAN ROSE

Hospital Pharmacist Perspective

Hospitals are Making me Better

Having completed my pharmacy studies at university in 2003, my graduate year began in January this year at the pharmacy department of St Vincent's Hospital.
The shock of full-time work in a completely new environment ensured that I hit the ground running.
Four months on, I can honestly say that I'm still running.

In NSW, it is necessary to complete 2000 hours of working experience in a pharmacy before one can be registered with the Pharmacy Board as a pharmacist.

The work is great.
I'm in one of the top hospitals in Sydney.
I start early and often finish late but hours don't bother me.
My experience to date has been varied and extremely interesting.
I have had contact with all the specialties, including organ transplantation, geriatrics, respiratory, cardiology and emergency to name a few.
One particular area that has fascinated me is HIV and its associated therapies.
I'd like to share a few intriguing facts I have learnt.
St Vincent's Hospital is situated in the suburb of Darlinghurst.
Darlinghurst, bounded by Oxford St to the south and Kings Cross to the north, has a HIV prevalence comparable to some regions of Africa.
It not suprising then to hear that St Vincent's Hospital, situated in the heart of Darlinghurst, is renowned for the treatment of HIV.
I have been fortunate to visit the HIV ward and observe some "therapy in progress".

HIV is certainly a condition that generates negative stereotypes.
Basically, HIV is not a topic that is comfortably discussed at the dinner table.
My time here at the hospital, both on the HIV ward and in the Outpatients Pharmacy, continues to be a mind-broadening experience.

HIV certainly isn't the "kiss of death" that it once was considered.
Patients are remaining near-symptom free and often remain that way for years.
Since the introduction of HAART (Highly Active Anti-Retroviral Therapy) in 1997, the mean survival rate across all age groups have increased dramatically to result in 90% of patients still alive 10 years following diagnosis of HIV (1).

The financial cost of HIV medication is another issue.
In a single day at St Vincent's Hospital, approximately $60000 worth of drugs are dispensed for HIV patients through the pharmacy.
Extensive research into newer drug agents and more beneficial drug combinations is the focus of many pharmaceutical companies who have recognised the market for better HIV therapies.
It is lucky that Australia has such a generous health care system that includes the special access scheme (SAS) - a commonwealth funded scheme that provides costly medicines at a heavily subsidised price.
Patients would never be able to afford these medicines privately, but the improvements in quality of life they provide is priceless.

I will finish by saying that I believe it should be mandatory for all pharmacy graduates to spend a period in a hospital following graduation.
Hospital pharmacy is a must.

1. Porter, K. 2003. Determinants of survival following HIV-1 seroconversion after the introduction of HAART. The Lancet 362:1267-1274.