"A lot of renal patients, whether they are on dialysis or have been transplanted, like to try to lead as normal a life as possible and that includes going abroad, holidays, foreign travel, whatever," she said.

"But that does obviously have implications because if they want to go somewhere exotic, then they've got to have travel vaccines, malaria tablets etc.

"So, they either come and visit us personally or they ring up the renal unit and say: 'I'm just going to Borneo or somewhere strange and my GP has said I need X, Y, and Z vaccines and malaria tablets.' Or 'I'm going abroad, what do I need to take?' And, 'Is it all right to take X?'"

To answer the patient or their medical carer, the pharmacist has to take various considerations into account, she explained.

"You have to think, are they on dialysis? Can their body excrete the various anti-malarial tablets? Or, if they are a transplant patient, do the anti-malarial tablets interact with their immunosuppression? Or, because most renal patients, whether they are transplanted or on dialysis, are immunocompromised they are not supposed to have live vaccines, only dead or attenuated ones."

To cut down the number of telephone calls about this, Caroline Ashley and her colleague Helen Atkinson designed a booklet which doctors and other renal-patient healthcare professionals can carry around with them. Alternatively, it can be pinned up on the wall of the registrars' room, for example. The leaflet is also available to patients and it is planned to make it available to GPs.

According to the duo's poster presentation at Nephrology in Practice 2001, the leaflet has been well received all round.

"So, basically it's dissemination of information, at least for starters, and then they can come back to my colleague or myself if they need anymore detailed information," Caroline Ashley said.

"But the telephone calls are not going down because word has gone out that we've done it so we get telephone calls about that now!"

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