RADIO INTERVIEW: FiveAA Afternoons: Parliamentary Inquiry into UTI Treatment with National Pharmacies Chief Pharmacist Bec Rogers

HOST: Angie McBride: Jayne Stinson … You are the Member of Badcoe … remind the listeners what area that covers.

Stinson: Yeah sure, well I’m lucky enough to be the Member of Parliament in the South Australian Parliament for the Badcoe area, which is essentially the inner southern and western suburbs. So, everywhere from Keswick and Millswood right down to all the Plymptons … and down to Ascot Park as well. So, there’s 16 suburbs that I represent and it’s a ripper area. I think it's the best place in the State.

McBride: That’s a lot of suburbs.

Stinson: It is, and it’s quite a diverse community, so, I love it. It really puts my skills and interests to good use. I love hearing what’s going on in our local community where I live and try and fix problems for local people.

McBride: So, you were a journalist.?

Stinson: Which is how we know each other!

McBride: Yes, are you glad you made the change?

Stinson: I suppose I feel like it’s an extension of what I was doing as a journalist. I feel that as a journalist your job is to highlight issues, things that are going wrong in the community, unfairness, and try and get people like politicians to pay attention and fix them. So, I suppose now I’m the politician that those journalists and members of my community are calling on to fix things. And I really love that, it’s a hard slog sometimes, but when you do manage to make a difference for people, even on a personal level, or with legislation and big change, like we’re going to talk about today, that’s really rewarding, and it’s a feeling that I really haven’t experienced anywhere else, being able to change the world. It’s an amazing opportunity and something I relish every day.

McBride: So, Jayne, tell us … you’ve got a Parliamentary inquiry you’re going to put forward about UTI treatment? Tell us about that.

Stinson: Yeah, it’s underway now. So, we launched it just before Christmas and we’ve called for community feedback, so people can still give us their feedback, especially if they’re sufferers of Urinary Tract Infections. We’re very keen to hear from South Australians in the city and country about their experiences with Urinary Tract Infections and in particular access to treatment and medication in particular.

McBride: So, what is the access to it now and what are you wanting to see?

Stinson: I’ve unfortunately got firsthand experience as a sufferer of it myself, and my mother and grandmother as well. 50% of South Australian women will get a UTI at some point, and 5% of men as well. It’s incredibly painful, it’s quite debilitating. I have found that when it’s really bad I can’t even walk. It’s horrible. And basically, what happens is that you have an urge to go to the loo and then you can’t and if you do urinate it’s incredibly painful, like a razor. So, it’s a horrible condition, there’s really only one effective treatment for it, at least in my experience, and that’s a course of antibiotics as quickly as you can possibly get it. So, what happens at the moment is people have to book in to get a GPs appointment, and we know how difficult that is and how long people are waiting now, sometimes weeks before they can get in and see a GP, and all that time their condition is painful, it means they maybe can’t care for their kids, they can’t go to work, and in the worst case scenario it can develop into a kidney infection which will leave you in hospital.

McBride: It’s quite easy to self-diagnose. I’ve never had it, but my mum has had many over the years. It’s quite easy to self-diagnose a UTI isn’t it? Or … should we ask Pharmacist Bec Rogers? She’s the Chief Pharmacist, National Pharmacies, who is here as well … how are you Bec? … So … could you accidentally misdiagnose a UTI or is it pretty straightforward?

Rogers: Definitely for somebody who’s had a UTI before, they will acknowledge those symptoms and recognise them from before, so I think in most cases, someone who’s had a UTI before and been diagnosed by a GP knows what those symptoms are, recognises them pretty quickly, and if there was the opportunity for them to get treatment right away from the likes of a pharmacist for instance, that would be really beneficial for them.

McBride: So, what are one of the reasons why you have to go to a doctor and they’re not allowing you to just pick up medication from the pharmacist?

Rogers: Well, I guess it’s that all antibiotics are Schedule 4, so we can’t actually provide them legally without a prescription at this time.

McBride: Right, ok, and how do you see this working? If it did work, so if they think they have a UTI, so you’d have a checklist of what to check, would you test their urine at all? Would that be a possibility?

Stinson: In Queensland that’s exactly what they’ve done. So, they’ve had a trial for about 18 months, and now in Queensland, it’s business as usual, and people can actually walk into their pharmacist, speak with a pharmacist, and go through a process. Bec might want to enlighten us on what that’s like and the model that we’re looking at.  Essentially the inquiry’s looking at the Queensland model and whether that would work here in South Australia.

Rogers: Yeah, I absolutely think that the Queensland trial would work in South Australia ... really the process is a lot of pharmacies are offering this service, so they’ve got specially trained pharmacists, they’re upskilled in this particular area, so you can either book in online to make an appointment for a UTI situation or you know just walk in and if a pharmacist is available you know they’ll be able to service you at that time, but certainly you know all National Pharmacies stores, most National Pharmacies stores have got a private consultation area where they would take a patient in this situation because you don’t want to be chatting about your UTI symptoms over the counter where everybody can hear ... we take them into a consult room and go through a checklist ... pharmacists are really good at following processes and procedures, definitely a strength of ours ... there are really you know strict guidelines that have come out of the Queensland pilot that I think are really robust ... that definitely identify any red flags that would mean that it’s not suitable or appropriate for a pharmacist to supply an antibiotic in that instance and that would mean referral to the GP.

McBride: So, what is the medication like?  So, let’s say on the off chance they didn’t have a UTI, but you thought yeah all the symptoms ... is the UTI medication is that dangerous for other people or?

Rogers: ... that speaks to why a pharmacist is appropriate to supply these medications because we’re medicines experts ... we take into consideration the patient themselves, any other medications that they might be on, any potential drug interactions, any medical conditions because ... there are three different antibiotics that Queensland have used in their trial and some of them might have considerations for someone if they’ve got renal impairment or kidney issues for instance ... we are really well equipped to be able to ask those questions and assess those things and if there were any red flags that it might not be an appropriate decision to make, to supply the antibiotic it would just be a referral.

McBride ... I know there are silent sufferers so Bec Rogers is here so if you’ve got any questions ... for Bec please call us ... this is interesting ... about 6,000 presentations to emergency departments ... we’ve got an issue with ramping now so that would definitely help that.

Stinson: Yeah, absolutely ... our government, the new Labor Malinauskas made a real point of the health system, that we want to fix the health system ... in particular ramping and people having to wait in our emergency departments for a long time, so those statistics are the most recent Australian Institute of Health and Welfare statistics that show there are about 6,000 presentations to our emergency department wards each year related to urinary tract infections. So that can be people who have got the symptoms of a UTI out of hours and there’s nowhere for them to go, they can’t get into a GP, they can’t get medication at the moment from the pharmacy, and so they’re rocking up at our emergency departments. But it can also be people who haven’t managed to get medication and are now suffering complications like kidney infections. So we don’t want those people to be in our emergency departments if we can possibly treat them earlier and provide access for them much earlier so they can treat themselves. Because we want other people with much more serious conditions being seen in our emergency departments. (McBride: And Bec, what if it does go untreated?

Rogers: I guess as Jayne has alluded to, there can be consequences of an untreated urinary tract infection. It can lead to kidney infections which can be quite serious and very rarely but worst case, in sepsis … definitely don’t want that, especially when there’s an easy fix. (McBride: What of the old wives’ tale … yoghurt?

Stinson: For thrush?

Rogers: Yeah, maybe for thrush.

McBride: Oh, that’s something different. [all laughing]

Rogers: But we probably have more appropriate treatments for thrush as well and your friendly National Pharmacist can help you with thrush treatments over the counter.

Stinson: Cranberry juice is the thing for UTIs … and some people say that that works. Some people say it’s more of a preventative thing. But I think the astringent nature of cranberry juice is a wives’ tale that’s effective but personally I haven’t found it effective but some other people I know … say it is something they find effective.

McBride: How did that come around? Is that because it’s acidic?

Rogers: I think the idea with the cranberry is that it’s supposed to prevent the bacteria from adhering or sticking to the bladder and the urethra … there’s not a lot of scientific evidence behind cranberry juice.

McBride: … Can we just repeat the symptoms ?

Rogers: The most common symptoms are pain on urination and definitely that feeling of needing to go more frequently.

McBride: Jayne you said it is still open for feedback how long is it open and how do we out our feedback in if we want.

Stinson: Yes well we have already received quite a lot of submissions I think we are getting close to 100 submissions now but we are particularly keen to hear from sufferers themselves so a lot of our peak medical organisations have put in really comprehensive and fantastic submissions and we are now hearing their evidence in person so the AMA, the RACGP, the Urologist Association, the Pharmacy Guild, the Pharmacy Society so we will hear from all of them but it’s really important to us as a Parliament, we want to hear from people who are actually suffering this.  We have heard, we have got quite a few submissions from sufferers which have gone through difficulties people are facing like the long waits to get a GP appointment, the inconvenience if they are shift workers, we have got some submissions from people in regional areas who don't have great access to GPs and are waiting even longer times so that’s really important for us to hear how this is actually affecting ordinary South Australians because that’s our job is to represent ordinary South Australians and make sure that we are providing adequate healthcare access for them.  So if you want to submit your views you still can, we have got a really easy online submission form so you don't need to write any essay you can just go online at bit.ly/utiinquiry so I know you have got that there if anyone wants to ring in you can provide that to them but at that site they can just put in a few details, you can stay anonymous as well and you can just give us your feedback about whether you think this is a good idea or not and if you have had any personal experience yourself or your loved one. 

McBride:  Bec thank you so much for coming in … Jayne we will come back with some more topics after the break. [AD BREAK]

McBride: … Sarah sent an email … regarding UTIs … ‘my mum is very susceptible to getting them, it’s a combination of being older and also being on certain medications that may have made her immunocompromised. If she doesn’t get onto antibiotics in a timely manner she’ll end up in hospital … get to the point off being mentally unwell …’ I think they make you hallucinate if you don’t get treatment pretty quickly.)

Stinson: Yeah, in older people delirium can be a symptom.

McBride: …Sarah is all for having quick access to medication through pharmacists … good look with it … when does feedback close again?

Stinson: We’re going to keep it open so that people can let us know, but hopefully in the next few weeks and months we’ll wrap up the inquiry and have some recommendations.

McBride: … thanks for coming in …)

Stinson: I brought you some choccies so enjoy those

McBride: … Yes thanks so much! I love Bracegirdle’s chocolates! if people want to get in touch …

Stinson: They can always give me a call 8371 5600 or I’m hot on Facebook, so just look me up Jayne Stinson MP.

McBride: Thank you Jayne. Great to see you.