I don't know about anyone else, but I'm fed up with being prescribed pills and then just left on them for ever. I'm not just talking about heart pills here, but pills in general. No medical person ever contacts me to ask how I am on them or whether they're working. If we all gave feedback on whether medication was working for us or not, then surely those who prescribe them would have an idea of which ones are the most efficient.
I feel really sorry for elderly people who just carry on taking prescription drugs, no matter how they make them feel because the big god GP has said they'll do them good. I was talking to a neighbour a while back about what pills he took and what they were for, he didn't know why he was taking one of them. Well ask your GP I said, to which his response was that he'd been taking them for ages so he must need them!!!!
Does anyone actually get to have a medication review with their GP?
Jean
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Interesting question. It says on my repeat on-line script renewal that I need a review - but all that happens is a doctor has to look at the screen & tick a box. They don’t need to see or talk to you,
I know our surgery happen to be one of the best - they are up for an award so in the top 1%in U.K. according to the QCC. So if that is what the BEST practice is - who knows what the worst is like?
Even more reason to need to be your own expert but I agree elderly and confused and vulnerable people need advocates and they may not always be informed or conscientious.
I am afraid the very elderly are increasingly more vulnerable re. med. checks and home visits as well as hospital consultations even when someone is looking out for them as I did for an elderly for many years until he reached 97. He was pretty 'get up and go' for most of that time but had lost a lot of hearing and sight.It was a constant battle to get his medical life organised and somewhat up to scratch with hospital visits a no no without him having a companion.Doctors spoke quietly ,directed him to other departments and med. checks were pretty rare .
It's a sad world regarding the care of elderly people now. I think some doctors are caring, but they are few and far between. Of most importance to us as we grow older is nutritious food and exercise, certainly not more pills. Think I'll start an OAP revolution!!!
My doctor's surgery is rated Outstanding too. I've never had a review of my pills there. I think I'm going to bring the tablet checks to their attention. We are always being asked for our input as patients, so they'll get it.
Two years ago, mainly because of my Afib medication, I booked an appointment for the very purpose of an ‘annual review’. Two weeks prior to the appointment i booked the practice nurse for a general blood test - have to fib a little.
I have since then been taken off one drug and had another reduced by half, have also found a vitamin deficiency that is now being addressed.
The Gp has said he has no problem with this and added that it is ‘your right’ so my actions are endorsed and i feel a lot happier.
That's interesting to hear Jonjub and what a good job you asked for the check. I must admit I did ask for a full blood test myself and was given one, but that was with regards to support for my underactive thyroid.
I also have an annual review and monthly bloods and fairly regurlary monitored but the majority of the monitoring occurs on line from numbers and results. I only see a GP if I am called in or I take the initiative myself.
The GPs in our surgery now spend one third of their time NOT seeing patients but looking at computer screens. Do they like it? NO!
Are they able to do anything about it? NO - because a lot of the time they have to spend ticking boxes that they have had the ‘statin’ conversation or fulfilled their quota of vaccinations etc etc. And all of that to be paid by government.
Happy you're back. From the posts I've seen plus my own thoughts you may have started a healthy revolution about recharging our batteries on a regular basis. Even our jobs gave us off 2 days a week. Made me take a look at how I allow my energy to be drained and how to set better boundaries. My plan is to take a day off a week and limit forum hours. L've been told I'm a sponge for people's problems.
I agree, jean. I have never had my repeat medication queried or reviewed by my GP - and if I didn’t proactively question some of my meds I’d still be taking ones I really don’t need and shouldn’t be having.
A few months back when I changed pharmacy to Boots, a wonderful pharmacist asked me if I’d like a medication review and gave me a really thorough review. She was shocked to hear I hadn’t been having one with my old pharmacy. I do think a good pharmacist is worth their weight in gold! But of course that doesn’t close the link between the GP and the meds, unless the patient goes back to discuss and query it.
I do worry about people who have no one to look out for them over their meds, especially when they’re just getting them delivered with no one checking they’re all necessary 😕
Hi Jane, Interesting that I'm not alone in not having my medication reviewed. We really have to push ourselves forward to get attention and yes some older people are just not up to it: probably too drugged up with all the pills pushed on them!
I agree. I think it's up to us to every so often ask our doctors if certain meds are still necessary and why. It shouldn't be this way but once again another facet required by the patient to get good health care. I trust my pharmacist a lot and often get his input before filling new prescriptions. And if we disagree with the doctor's explanation for continuing, let him know and perhaps suggest a vacation from the med to see how we might do better without it. My pharmacist is my best source about side effects and what to expect with a medication. My experience is doctors are often economical about side effect information. Maybe from time constraints or maybe they believe we can'r decide for ourselves if we really have a side effect or are just susceptible to provided information. Pharmacists see the results of meds, hear patient anecdotes, and fill prescriptions needed to lessen the side effects. They also know which doctors have the most problems. They know where the bodies are buried, in my opinion. Pharmacists have to be careful how they present info but they want to help and sometimes we have to read between the lines of their words. But there is good info available from them. And just because we have a refill available doesn't mean we have to fill it. We can call and ask if we need to continue a med before we spend the money. Often I've had doctors say "No. I just gave you a refill for convenience. Call me if you feel you want to start taking this med again." Be a partner in your care not an obedient middle school student.
Our Medical Centre has annual reviews. My repeat prescriptions have a review date on them my next being January 19. Each year I have a BP and bloods check where I can discuss any medication and of course I can still make any other appointments to see my lovely GP should I feel the need.
I do agree about too many pills by the way and am currently considering reducing my BP medication to see what happens as my recent weight loss does seem to have brought it down enough for me to occasionally get postural hypotension. Haven't fainted yet but do grab things to steady myself sometimes. Numbers for me are lower than ever so maybe time to experiment. I wont ever stop the Warfarin of course.
Do these checks just happen when you reach 70 Bob? If so I've a few more years to go. My prescriptions have a review date too, but nothing happens. Saying that in the last 15 years they have been reviewed twice at my pharmacy, but they were bit of a none event.
I'm 55 and have the same checks as Bob. There is a date on my prescription under each medication as to what date the next yearly review is done. If you fail to make an appointment to review any medication then they refuse to issue another prescription for that item until you have had your review. The nurse also asks about medication at the yearly MOT.
No Jean I didn't have a heart condition (or not one that I was aware of) until the end of April this year. As far as I am aware the MOT is something all patients from the age of 50 get offered at our surgery.
Our surgery annual check is for anyone with a chronic disease, Started with just cardiac &COPD patients but now all chronic diseases. They’ve just moved the date so now it is on your birthday.
Hi Jeannie, I wrote a long post to you just now on he open forum , but it does not seem to be showing. That is annoying, a pink strip came up saying " undefined" . Hope you can read it.
No, not received it Luludean. That's happened to me before and it's so annoying because you're enthusiastic and pour out how you feel. I can never be bothered to write it again - the moment is lost!
Can't really remember when.....seems to have been a long time. May have something to do with the amount of meds I have. Surgery is very efficient. Even have me down as 'moderate frailty ' (yikes!)......now that is being a bit too efficient.......
I have a meds review every 6 months, and have to make an appointment to see the nurse and have bloods taken. My GPs are really good, and I feel I can talk to any of them re meds. All my meds are actually prescribed by the Brompton, and I have said to my GPs that they cannot change them without referral to the Brompton, and they are fine with that, and have discussed meds with my various consultants. I can understand that some people are nervous of questioning their GP, which is difficult so not sure what the answer is to that.
I'm not a person who's nervous of anyone and now that I know you're all having checks I'll be wanting to know why I'm not. Grateful for all your responses.
My pharmacist has reviewed my medication twice in the last 15 years. Doctor has never checked. Hmm need to give this some thought. I feel sure that if we had to report back on any medication and how successful it was, like antibiotics etc., they'd have a better understanding of what works well
Artificial Intelligence will solve the problem. Be able to talk to a virtual doctor about the price of fish and free up your GP to specialise in something more interesting than dealing with the general public.
Yes, I've seen something like that mentioned. Feel sure it will happen one day. My surgery have a website that's on the way there, you can type in if you have a cough or cold and get internet advice. Haven't used it myself, may well give it a try one day just to see how good it is.
Fortunately, I’ve not been on my cardiac meds that long (less than a year still), I understand what each is for and I don’t have any appreciable side effects, so I am presently comfortable with continuing to take them.
However, I have been on one drug for an enlarged prostate for 13 years now. A couple of years ago I asked my GP whether this should be reviewed, as my prostate function is poor but I felt that I was dismissed out of hand. When my cardiac issues are sorted I will probably ask again.
Hi Bob - Yes I do have regular PSA tests but I think better diagnostic tools are available these days although I’ve never been offered anything else. 13 years ago I had three separate biopsies which were quite traumatic so don’t know if the poor function is attributable to those or the extended use of the medicine (or my age, of course 😏).
The fourth biopsy which discovered my cancer was trans-perinial . Oh yes they said we found it hiding round the front. Gee thanks fellas. When do you cut it out? 7 years now and still clear
Hi Bob - My husband has prostrate problems this started about 5 years ago. He has had an enlarged prostate for many years and had been having the PSA test done regularly. 5 years ago they found a lump so he had a bipopsy the outcome was that it was cancer but they were not 100 percent sure so did another one within a few weeks which came back negative. Over the past 5 years his psa has varied been over been normal once had two more biopsies and a CT scan. I think it worries him a lot, I know he gets worried when it is time for his PSA blood test, he is tested every six months now. Life goes on though.
Hi Cassie. Yes I have six monthly PSA tests which so far have all come back undetectable. Next one 6th August and yes it can be a tense time. 7 years now since mine was removed along with a few other bits and bobs.
Ask for one, I was asked by my chemist not so long ago if I wanted to discuss repeat pescription pills with him. I was given to understand that the local health board had asked them to do this, to see if patients felt that the pills were doing good, and if they still used them!
I have been on heart meds for well over 4 years now and never had an annual review, all my meds on my prescription have a review date but when this date comes nothing happens and new date appears on the prescription. I have never had an annual health check, husband had one about 2 years ago (he is 75, I am 71) I do get a annual blood test but I have to push for this myself. Our surgery has a good reputation, and my GP is okay, she will see me fairly quickly if needed. I sort of get the impression that she knows I will query things and in general know more about than AF than she does, so I am left to it.
I was talking to a lady I know from walking the dog, she is my age has AF, is at a different surgery, on similar medications but is on aspirin, she has no valve problems, when I explained she should query this and go on an anticoagulant she said I will stay on the aspirin, I have been with my GP for years he must know what is best!
I too have concerns about some of the elderly patients that are on drugs that give them poor quality of life but who have no one to act on their behalf and query thier medications. We had problems with dad's GP, he prescribed him Bisoprolol, he was told this would help his blood pressure. He never had a problem with his blood pressure, all his life he had perfect blood pressure, sometimes a little on the low side, when we eventually found out we asked why and he more or less said because of his age. Dad later had a pace maker fitted to keep his HR above 60 and at the hospital they noticed that he was still being prescribed Biso, so wrote to the GP and told him he was not to take it. Was left off his prescription for 3 months then put back on again. Had a repeat performance a year later when he went into hospital. Dad only took the biso for a short time as it made him feel dizzy, he told the GP but he carried on prescribing it.
Must be off now have to phone the eye clinic and breast cancer clinic to chase overdue yearly check ups. Had to chase both of these last year, before that always got a letter on time.
Cassie, that's dreadful to hear the way your dad was prescribed Bisoprolol when he didn't need it. Thank goodness he has you keep a watch on him. I really hope he's not taking it now?
Hi Jean - Dad sadly died in August 2016 at the grand age of 94 - and no he did not carry on taking it - although they arrived each month with his other meds he just put them in a draw - something else that had to be disposed of when we cleared the house!
Unfortunately GPs in general.are extremely money driven. Although they are self employed their payments from the Health Boards are determined by the boxes ticked. Almost all services provided by GPs qualify for extra payments. Maternity, asthma, diabetes, childhood immunisation, smears, BP checks, height/weight, new patients, review of the elderly, elderly visits etc. Flu jags are a great earner, thus the reason you're chased up to attend, ask your GP if he/she have had one!!! There's a cash incentive for generic prescribing & reducing prescribing costs. If there's a target to be met to qualify for more cash then you're more likely to be asked to attend for review. Call me a cynic but I worked with GPs for most of my working life. Things will have changed greatly since I retired I am sure and the goal posts been moved but bottom line is that cash determines the service provided.
That's interesting, but also sad to hear. It's certainly a greedy, money orientated world now. All I can say is I'm glad I've lived through the period I have, rather than be just starting out in life. I dread to think what life will be like ahead for newborns. I really can't see people switching back to natural non plastic products and nutritious food.
Explains why my GP was so eager to test my cholesterol level, she congratulated me enthusiastically about its lowness but I am sure she was secretly disappointed 😀
Sounds like a page-make that chapter- from our (US) healthcare playbook. For insurance companies the more ordered the merrier. I get frequent calls from my insurance carrier pushing me to avail myself of their service where a nurse calls me to go over my meds by phone. I AM a nurse and don't need another one to discuss my meds with so my insurance carrier can bill medicare a la carte for this 'service', I would block these marketing calls but companies are cagey. They have so many numbers they call from it's impossible to identify them all. "And the money keeps rolling in." from Evita
My dispensing chemist does occasional reviews, Jean. He checks through and seems to ask all the right questions. He will then maybe make a suggestion - but i must then raise a question with my GP. I really think that a proactive approach is best and I have sat with my GP and asked the questions (Do I still need....can I reduce, etc.).
Sounds like you have a good dispensing chemist there Dadog. I'll be creating a new post of my experience with medication soon, that also touches on this subject. Good to hear from you again.
Yes, with some of our ailments I think we're well looked after. I last saw my EP in April last year when he told me there was nothing more he could do for me ablation wise. I'm now wondering if that meant that he's no longer going to see me for checks. He's really only concerned with doing ablations, but from what I read on this forum not all EP's are like that.
Yes. When you are prescribed an anticoagulant, Kaiser Insurance has an anticoagulant clinic that contacts you about the drug and continue communications on how you are doing for 3 months.
For other drugs, the Pharmacist will ask you if you have any questions about the drug. I can appreciate this. The GP has not done this as I think they know the pharmacy explains it.
OK, it's working again ... I also had a problem with it locking up as mentioned above. Anyway I wanted to thank you for bringing this up. I think meds are a real problem and it's amazing to me that doctors are pretty slack about it. I was on Xarelto and Diltiazem and getting dizzy spells in the evening. When I checked online, they interact -- so I asked my doctor and got switched to Eliquis, which also interacts with Diltiazem (a heart rate regulator) but it doesn't make me dizzy. And I'm thinking you have ALL THIS TRAINING and you still prescribed me something that was going to make me dizzy? And I'm relatively young for a heart patient (55) ... what if I were older and more at a fall risk?? Also I cannot count the number of times doctors have pushed ibuprofen on me for arthritis, which I am also lucky enough to have ... And I constantly say 'no I can't take that ... look at my chart, I'm on blood thinners' and they say 'oh gee, I guess so!' My mother in law got herself in a dangerous situation by taking ibuprofen while on Xarelto for joint pain because "her doctor said it was OK." At the time, I was annoyed at her but now I feel bad because she is an older and more trusting generation -- why would a doctor tell her to do something wrong? So we just have to be vigilant for ourselves and yes, that annoys doctors, but if they don't want to be annoyed they should be paying attention in the first place. I think British doctors ARE somewhat overwhelmed due to cuts, etc., so I have more sympathy for them. Here in the US at least you can shop around more ... but it seems we share a lot of the same issues with being heard as patients (and God forbid you should be even 10 pounds overweight because then it's pretty much your 'fault' no matter what is wrong with you).
That's not good a doctor trying to prescribe something that interacts with other drugs being taken. I'm sure that happens a lot and elderly people are very trusting of doctors. If the doctor says it's right then they totally believe them. Thankfully over here in the UK we have a Dr Sanjay Gupta who has recorded honest opinions on what's naturally good for the heart and ways to help it. If you are interested look at Sanjay Gupta York Cardiology on YouTube.
And what you describe is all too common. Also in other areas. I have a pacemaker that is not compatable with MRI's. Last year I went to the ER for an unrelated problem and fortunately I was alert and knowledgeable about my pacer. As I heard him ordering an MRI I said I can't have MRI's because of my pacer type and showed him my wallet card. The look on his face was stunning. I'm not always the most diplomatic of patients and I said "Why don't you read your patient's charts before you come in the room to see us?" Scary. I'm a real advocate of taking someone with you to hospitals, dr's visits, if you are not able to speak for yourself. PS He cancelled the MRI and did a CT scan. irina (US)
OMG that's just terrifying. You're absolutely right -- taking someone with you is important. I think I'm definitely taking a questioning and alert attitude! And since I've become so weary with tests, I've now several times asked 'why do you want to run that test' and a lot of times we mutually agree that there's not much point. I got pancreatitis from taking some steroids for arthritis (it's a common side effect unfortunately -- never had it before or since) and talked my GP out of any further tests/scans because we could all pinpoint a cause ... You could take this too far and I'm always willing to listen but your story reminds me you can't be too careful!
You're smart to ask why a test or procedure is necessary. We should all do that. We don't have to be rude or aggresive but if we took our car in for repairs and were told we needed (whatever) I would bet most of us would ask why the repair was necessary before agreeing to it. Why do we allow more to be done to our bodies without understanding the reason and asking if something less invasive might work just as well? Hospitals have what I refer to as a 'money-making pecking order.' The order might have changed but years ago I was a Head Nurse in a US operating room and part of my job was involved with budget. At that time the top 3 revenue-producing departments in a hospital were the Operating room, Radiology, and the Laboratory. All areas were looked at quarterly by the powers that be and if a department had slipped from its expected position one could expect to see more tests, etc ordered to regain their standing. This might possibly still be an evaluation tool though I doubt many people are aware of this and even fewer would admit it is true. A friend of mine frequently reminds me that before I make any decision in any area of my life always consider the other party's agendas. So it's good to question many things in this money driven world, in my opinion.
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I re-read your post and was reminded of something else. Nowadays MRI's, CT scans, etc are common tests and are commonly done with and without contrast. (The IV medicine given during the test for better viewing.). It has been documented that too much contrast dye over time) can have deliterious effects that are not easily reversed as the med used remains in the body too long. Medical care, even when absolutely necessary, helpful, and possibly life-saving is not without its insult to our bodies. It often comes down to the decision if the care offered to help us is better or worse than possible side effects. Often it is better and I for one have benefitted and am probably still here because of some pretty fancy, invasive care. But it is still our responsibility lo learn as much as we can so we can make informed decisions about what care we will or will not accept to help us get better, save our lives, or even keep the Quality of Life we currently are comfortable with. Just my opinion and what I try to do for myself.
I always want to tell my medical folks that I'll come to see them when they stop "practicing" medicine and are experts. YOU are in charge of your health, but medical people can help, but I feel we need to take our health in our own hands. I've weaned myself off of all my meds but cardiziem and feel waaayyy better, almost great. Once I lose 60lbs, I feel most of the AFIB issues will melt away. Not easy but... Gotta do it.
It must be a common problem and one that the medical establishment recognizes even if they don't address it. Here (US) there is a name for so many meds a patient is taking and the term is used in patients' charts. It's called a "MEDICATION CASCADE."
FYI all. I just looked up medication cascade and found this: Thought it was worth passing on. How many of us fall into this category? "A prescribing 'cascade' occurs when a new medication is prescribed to 'treat' an adverse reaction to another drug in the mistaken belief that a new medical condition requiring treatment has developed." When I googled the question "What is a medication cascade?" quite a few explanations popped up. I just chose the shortest one. Hope this helps. irina
I think every GP surgery should have a nutritionist that you see automatically at 60 to read the riot act about your past diet (gluten, sugar, processed) and explain the party's over now and you need to build your physicality for old age - that would save a few bob for the NHS! Incidentally, sorry to miss your Exeter meet, I'm down there Aug11/12 but normally in Hampshire.
Every Dr I've seen regarding meds whether it be a review or just discussing treatment has given me conflicting advice on what I should be taking or not taking.
"Should be on them long term or not long term".
"You should be taking this or shouldn't be taking that".
"See how it goes or how you feel".
"It's up to you"
is advice I've been given in the past. Which doctor do have confidence in or believe they know they're subject matter?
It doesn't fill you with great hope that you're doing the right thing taking all this medication, does it?
Hi there, yes I myself take so many pills that I often voice that the side effects are more debilitating than whatever they were prescribed for! However, yes at my surgery we do get an annual medication review and I also spoke at length to my pharmacist and to be honest I got more information from there than at the gp's!
I once asked for medication review as date on scrip was past." Oh it'll be done next time you're in. " I have no plans to come in". I was then given appt with locum who was " doing the reviews" I mentioned a couple of things that I thought might be meds related; he thought it was possible. Only concern was that I was ordering my meds in time and taking them! Pharmacist offered a review last year. Very thorough.
There are 2 services offered by pharmacists which are free to us but the pharmacy gets paid for by the NHS. The first is Medicine Use Review (MUR) where the pharmacists go over your medication with you, making sure you know what you are taking for what, possible drug interactions, the way you take your drugs ( time of day, relationship to food and other meds etc.). Listens to any concerns you have and advises you to consult your doctor if they think a Med could be discontinued or changed. They can also make recommendations to doctors. Go into your pharmacy when it’s not busy and ask.
The other service is the New medicine Service (NMS) where if you are start one from a list of particular drugs. the pharmacist will discuss it with you, advise on how to take it and will follow up over a period of time to make sure there are no concerns. This can be done over the phone.
If you google NMS or MUR and pharmacy it will explain it a lot better than me. Some pharmacies, staff or pharmacists are more proactive than others. Counter and dispensary staff are the ones who normally identify potention candidates for MURs and if they are busy, they just don’t have time. Ask to speak to your pharmacist and ask if they have time to do an MUR. Most will be keen providing they can fit it in as the pharmacy gets paid for each one and some give the pharmacist a small amount per MUR as an incentive. MURs can take a while, so to make it more effective take your recent repeat prescription with you as the consultation room may not have a computer and also your patient record only shows what they have had dispensed within the last year so items such as GTN sprays may not appear in their records. Don’t side track the pharmacist with your life story and make sure you mention any concerns you have.
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