Another interesting article

Thank you for posting that. Certainly food for thought.

Jo_the_boat said:

I found it very interesting. And slightly alarming.

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Genius piece thanks for linking. Really like his writing.

At a PPG I went to they introduced a new Pharmacist working for the practise rather than the pharmacy..
I asked about deprescribing medication.. they looked at me like I was from Mars..

Very interesting article. Thanks for posting.

Dr Unwin is also referenced. Very good article and the examples given are ones that I have also noted when reading study reports. The use of Relative Risk and Hazard Ratio to describe results is very deceptive, and NNT and NNH would be far more representative and understandable. Now when I see RR or HR quoted, I divide the figure by at least 10 (and by 100 if the study was performed or funded by a manufacturer).

The other problem not mentioned by the author is that most medical studies performed prior to 2012 used a statistical method that has since been banned (the PETO method) because it could be used to exaggerate small differences by giving weightings to various results based on nothing more substantial than gut feeling. The report of the result was not required to declare what these weightings were or why they applied, but typically and looking at the ACTOS and AVANDIA trials where I gained access to the submission report for FDA licencing, the prmary outcome of death by CVE was ignored because the test cohort were cardiovalscular and elderly patioents in a VA nursing facility, and CVE was ignored because it was a natural event and was not a proven effect of the drug during the trial period.

The Pareto method which replaced PETO does the same thing, but the weightings and reasons have to be declared in the report.

bulkbiker said:

Genius piece thanks for linking. Really like his writing.

At a PPG I went to they introduced a new Pharmacist working for the practise rather than the pharmacy..
I asked about deprescribing medication.. they looked at me like I was from Mars..

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It is crazy but as a business they get zero direct financial benefit from deprescribing other than kudos from reversing diabetes, hypertension etc. etc....

NicoleC1971 said:

It is crazy but as a business they get zero direct financial benefit from deprescribing other than kudos from reversing diabetes, hypertension etc. etc....

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Good point. No incentive. Only a possible mention in a CQC report. Their bonus is generally based on number of petients seen, how many added to the GP practice targets for certain treatments (BP. CVD, Statin takeup, consultant referrals). Mine seems very keen to get all T2D on Dapagliflozin for some reason, and he is upset that I am dropping it. I suspect Novartis is pushing that med for CVE and other uses for all.
https://www.nice.org.uk/news/articl...flozin-for-people-with-chronic-kidney-disease

Soon all we will need is a fistfull of statins and -glifozins and all our pains will go away.
Edit: And to think when I was a child all we needed was an apple a day.

Thanks for that article which I have read. As someone who was told to take metformin recently when I knew I could do it by diet I totally agree with everything said in the article. I refused the drug and have put my T2 in to remission in less than a month just by diet. I haven't taken pain killers very much in my life, the last time I had a paracetamol was in 2012 with a tooth abscess. I don't like taking meds because in my opinion alternative treatments are much better with no side effects.

I have always thought that GP's are financially rewarded by the drug companies one way or another, and who doesn't like a perk of the job, but when it affects people's lives I think something needs to change. Whether my assumptions about financial gain is correct or not I don't know, it's just my opinion. But I've always thought GP's are controlled by the drug companies. Whether they realise it or not who knows.

I do think GP's should have a wider knowledge of 'natural medicine' such as diet. My doctor hadn't heard of the low carb diet neither had my diabetic nurse. They prefer to hand out drugs instead. They need educating I think because there's an awful lot of patients on a lot of drugs they don't need when all that should be done is to treat the cause and not the symptoms in whichever condition they are suffering from. How can it be so hard for GP's to do that?

Oldvatr said:

Good point. No incentive. Only a possible mention in a CQC report. Their bonus is generally based on number of petients seen, how many added to the GP practice targets for certain treatments (BP. CVD, Statin takeup, consultant referrals). Mine seems very keen to get all T2D on Dapagliflozin for some reason, and he is upset that I am dropping it. I suspect Novartis is pushing that med for CVE and other uses for all.
https://www.nice.org.uk/news/articl...flozin-for-people-with-chronic-kidney-disease

Soon all we will need is a fistfull of statins and -glifozins and all our pains will go away.
Edit: And to think when I was a child all we needed was an apple a day.

Click to expand...

Its fascinating to me. They no longer tend to accept lunches bought by pharma reps but there are many hungry reps out there using all possible tricks to get them alone for 10 minutes to push the often marginal benefits of drugs for chronic illnesses based on sponsored rcts or the co writing of articles in publications who depend on advertising revenue. In surveys GPs don't believe themselves to be influenced of course but if the med school curriculum has no food based prevention and therapeutic discussion and the GP is merely a gateway to consultants in silos then you are not going to get root cause diagnosis!
The flozin class (sglt2 inhibitors) encourage the body to flush out excess glucose via the kidneys, and have side effects of course, so I can see they may help reduce microvascular damage in kidneys but seems similar to widening the plughole to prevent a flood rather than turning off the tap!
see also this on MSM
https://www.foxnews.com/opinion/insulin-shortage-next-supply-chain-crisis
The possibility of an insulin shortage in the US prompts talk of a new wonder drug for type 2s tirzereptide. Works to make you less hungry and use less insulin apparently. Mmmm can also think of diets that help with that!!

For those here who do not know how the NTT and NNH figures are calculated
https://patient.info/doctor/numbers-needed-to-treat