Immunosuppression prescription: Progress!

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“The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man.” — George Bernard Shaw

I’ve never considered myself an unreasonable man. In fact, at times, I feel cursed that I invariably see both sides of an argument and succeed only in reaching a state of reasonable indecisiveness! Occasionally, however, an issue will arise, such as Brexit or the election of Donald Trump, and all sense of reasonableness disappears (I’m against both, by the way). Three years ago, my reasonableness was replaced by anger, and I wrote about the proposed changes to the prescription of immunosuppression medication and the largely negative impact it would have on me; a 50-mile round trip to my renal centre, long waits in the outpatient pharmacy and the mini-tax on patients with long term conditions, hospital car parking fees. When you’re so dependent on medication, any change in the prescription or delivery service invariably arouses suspicion and a reluctance to change.

One of the few upsides to living with a long-term condition and spending so much time in hospital clinics is that you get to witness process changes and improvements; so how has the prescription of immunosuppression medication changed, and has the process made my life as a patient better in the past few years?

Following a sticky start to the new process, typified by a 1hr 40-minute wait at the outpatient pharmacy to collect my first immunosuppression prescription, I have to say that I’ve been impressed by the changes to the prescription process and other aspects of my regular clinic appointments.

I invariably have early morning clinic appointments, partly to allow my blood pressure to stabilise after the rush hour journey and hopefully help minimise the white coat effect, but it also gives me the opportunity to collect my immunosuppression medication, the prescription of which is now synchronised with my clinic appointments.  No more lengthy waits in outpatient pharmacy and no more medication supply issues!

 

One other change to my renal clinic has also resulted in a marked improvement in recent years; because the unit has a dedicated PKD clinic, I see the same consultant, Dr Grahame Wood, at every appointment. This change was brought about as a result of a patient workshop at an ADPKD Information Day so if you’ve not attended events like this, get yourself along and make a difference!

In a complex setting such as a major renal centre like Salford Royal, the success of patient-centred change relies heavily on a Multi-Disciplinary Approach, and Elizabeth Lamerton has been instrumental in the new immunosuppression prescription process and the introduction of Tolvaptan as a treatment for Polycystic Kidney Disease.

While I’m under the care of people like Elizabeth and Grahame, it is unlikely that my unreasonableness will see the light of day for some time!

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