Aseem Malhotra. Are prescription drugs a waste of time?

A Radio 5Live discussion (50 minutes) on the overprecription of drugs and patient expectations.
The salient points for those of us with Diabetes starts at roughly the 35.00 mark.
Covers: the costs to the NHS, the importance of risk to benefit ratios, R&D and trusting the published data among other things.

This programme reinforces something that we here on DCUK forum learn very early on, to do the research to the best of our ability and to try to work with our HCPs rather than abrogating resposibility to them.

Phoenix55 said:

Interesting that the onus is being put back on the individual to 'do the research'. I appreciate that many people go to their GP expecting that there is a 'pill for everything' and that somehow they have failed if they do not come out with a prescription, but GPs also need to keep themselves up to date and to sometimes spend a little time advising on life-style. Instead of rebuking me for not taking the prescription of metformin both of the GPs in my practice would have done better to check on how I intended to lower and manage my diabetes without medication. They would then have found out my objections to the suggested medication, that I was monitoring my bloods and reducing carbs, losing weight and keeping it off. I would have felt that I was being treated as a partner in my health not as another statistic, an 'awkward'. All professionals have to attend additional training and are expected to look at others in the profession who are trying something 'new' that is working and decide what they can apply to their own situation. Not everyone has access or knows how to use the internet to do the necessary research. They were brought up in a generation who were told to trust the doctor to know what was best, that is a heavy responsibility for a GP.

Click to expand...

I agree with you, it is what came across in the programme. There has to be a change of mindset on both sides of the consulting desk. As was pointed out by Aseem, Ionnides has been quoted as saying that less than 10% of published data currently can be deemed unbiased and based on properly conducted research. This is backed up by former editors of medical journals. So our doctors are at a disadvantage.
As patients we are not always in a position to do research to any meaningful depth (depends on i ternet access and savviness) so some of us are at a disadvantage. That is why I made a point of saying '...to the best of our ability'.

I get where you're coming from with the point about Metformin, I am in the same position wrt statin medication and I feel that the HCPs are just not listening. For me, I am not yet in partnership with my HCPs, I am being dictated to by them. But, let's say I had done absolutely no research on statins, I took them for one week and got side effects so stopped them and that should be a perfectly valid reason but we hear of people being told 'Take the statin or you will die!' regardless of side effects. I do not know why you decided not to take Metformin but your GPs should have had the conversation with you instead of just following 'the pathway'. This is one thing I do not understand, recently I read an OP where the member said they had taken Met for 2 years with ongoing gastric trouble, my immediate response was to ask myself 'Why on earth would anyone suffer that long with Met tummy side effects and not just make the decision to change treatment or discontinue it?' We're all different but saying nowt gets us nowhere.

helensaramay said:

Very interesting but ...

The emphasis on diabetes is Type 2.

Please be aware when you post on generic topics that there are people on this forum with different types of diabetes.
I appreciate 90% of people with diabetes have type 2 but there are another 10% of us who don't bite but have a different condition which, whilst it may have very similar symptoms, is treated differently.

I am very happy for this material to be shared in the generic topics (I genuinely find them interesting and as someone with diabetes, friends and colleagues assume I know about all diabetes). I just ask for the text (or tags) to mention the type of diabetes.

Thank you for reading my gripe. I hope it does not come across as harsh: it is not meant that way.

Click to expand...

I thought carefully before choosing this part of the forum. As the programme is about over prescription of drugs in general (and does touch on statin prescription which is common to both T1 and T2) and advocates lifestyle changes as a possible adjunct or alternative to said then I think I made the right choice. I highlighted the point in the programme which touches on T2 but the programme is not about T2 specifically.

Phoenix55 said:

Sometimes it is a question of confidence. Some people spend a lifetime in work which not only does not challenge them to think but actively discourages thinking. For them to challenge a professional in a position of power takes courage.
In my position I was diagnosed on an HBA1c of 6.6, just tipping into diabetes when a few years earlier I would have been advised to watch my diet. I was beginning to wonder about my inability to shift weight that was starting to creep upwards. A finger prick test at the surgery gave a result of 11+ after I had eaten breakfast. The Dn prescribed but said not to pick up the prescription until after Christmas. That made me suspicious, and for the first time in my life I went online to find out about possible side effects and was shocked at the figures I found. I have an hour journey each way to work and there is no-where to stop except for an emergency, a field gateway if the car breaks down. I bought a bg meter and almost immediately found that the large bowl of porridge with mincemeat was probably the cause of the high finger prick test. Add that to a sedentary lifestyle and it was not surprising that I had raised levels. I started exercising more, changed my intake of carbs and found that not only did the weight drop off but also within three months the HbA1c was down to prediabetic levels. GP agreed that I did not need the Metformin. Finding this website was an added bonus, members on here reassured me that I was doing the right thing and I am trying to pass that on.

Click to expand...

Again, I agree with you. Atorvastatin has challenged my faith in HCPs. Type 2 dietary advice given by my DN has seriously dented my confidence in her ability to treat my Diabetes. This has led me to question my treatment wrt my other conditions and the drugs I take for them.

I have been asking myself if I could be one of those who are overmedicated and already managed to give up one of those medications without consulting a HCP. As was said at the beginning of the programme, it is advisable to have the conversation with your GP before stopping any medication but if my experience with Atorvastatin is anything to go by then for me the decision is mine and mine alone and I am responsible for any untoward consequences.