Talking Meds - A PrescQIPP podcast
Engaging conversations about medicines-related dilemmas.
Talking Meds is hosted by Jonathan Underhill who, every two weeks, will chat to a fantastic guest about current medical issues and clinical dilemmas.
Jonathan has a background as a hospital clinical pharmacist but worked for many years at the National Prescribing Centre (NPC) developing innovative ways of teaching therapeutics, evidence-based medicine and clinical decision making to prescribers and their support teams. Until recently, he worked at NICE as a consultant clinical adviser in their Medicines Optimisation Team. He is now Medicines Clinical Adviser at PrescQIPP.
Jonathan and his guests will discuss topics such as new guidance from NICE on menopause, asthma, depression deprescribing and insomnia; how to tackle penicillin allergy de-labelling.
There will also be a series on ’Sensible prescribing in Older people with Jonathan and Lucy’, with consultant geriatrician and author Lucy Pollock.
PrescQIPP is a Community Interest Company. We operate on a not-for-profit basis for the benefit of NHS patients and organisations and help NHS organisations to improve medicines-related care to patients. Find out more here: https://www.prescqipp.info/
Talking Meds - A PrescQIPP podcast
12. Sensible prescribing in older people with Jonathan and Lucy; Statins
In this episode of Talking Meds we continue the series ‘Sensible prescribing in Older people with Jonathan and Lucy' with a discussion between Jonathan Underhill and Dr Lucy Pollock about the prescribing of statins.
So we meet Mrs Evans, an 87 year old lady who lives with her daughter in a ‘granny flat’ annex of her house. She has several co-morbidites including type 2 diabetes, hypertension, heart failure with preserved ejection fraction and has recently had a stroke. Her daughter is concerned about her mum who she says ‘the sparkle has gone from her eyes’. Mrs Evans often looks at her daily handful of medicines and asks ‘what’s the point?
Mrs Evans has recently been prescribed atorvastatin 80mg a day - in line with the guideline from NICE. Mrs Evan’s daughter asks Lucy - ‘are these new tablets worth my mum’s time?’ To try and help answer this, Jonathan and Lucy look at the icon arrays on the statins tab of GP Evidence where it shows how, out of 100 people like Mrs Evans who don't take a statin, around 29 will have a heart attack or stroke in the next 10 years. If all 100 take a statin, then 7 will be prevented from having a cardiovascular event but 22 will still have one. So the majority, 78, will not have a heart attack or stroke, but 71 wouldn’t have had one anyway without taking a statin!
Explaining risks and benefits using numbers can often help some people - but not everyone. The important thing is to ask and find out 'what is it that really matters to you?'
PrescQIPP resources mentioned in this episode:
PrescQIPP Lipid modification e-learning course (pay per use)
PrescQIPP Prescribing Mastery webinar 'Cholesterol management'
Other resources mentioned in this episode:
BBC Podcast with Rory Stewart - the long history of ignorance
Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238)
Risk communication: NICE Shared Decision making guideline recommendations 1.4
Drug and Therapeutics Bulletin - How to communicate evidence to patients by Baroness Alex Freeman
A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info
PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.
The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.
Find out more about PrescQIPP here