Can anyone offer advice about the 19 different meds Im taking including bericitnib.
I have Diabetes,COPD, RA, Aneamia and Hypertension. At the moment nothing is working.
Who really knows how all these meds interact. My pharmacist is unwilling to offer an opinion on so many.
The responsibility for a patient taking this huge amount of meds is with the doctor. You should insist that your doctor gives you a picture of how these meds interact with one another. You are very right in wondering.
I'm sorry but we're unable to as we're not medically qualified. You really need to ask the prescribers of the meds you take. If you list each under which Specialist & then either ask those to whom they apply or maybe request a full medication review with either the Practice's Resident Pharmacist or your GP. You should be having annual medication reviews. Both my GP & my Pharmacist do mine, whoever gets to me first.
If you feel they're not working then again you really need to speak to the prescriber who initiated each of them, again making a list under each prescriber is helpful. I don't think it's unusual being prescribed so many meds given you have 5 different conditions, as long as they're necessary & aren't contraindicated.
Is this how it really goes, that there is really no one that is responsible for the pas medical situation as a whole? That it's up to the patient to look up all perscribers and hope they will give some clairity? It is a well known fact that this workes very poorly. In the US as well as in my home country it has been a big worry that different specialist prescribe different meds without really taking responsibility for the other meds the pa is taking. This has all too often resulted in a situation where patients are using too many meds and meds that have not been suitable in these enormous cocktails.
No, as I said there should be a med review annually by the GP Practice's Resident Pharmacist but if one isn't arranged then she can request her/his GP or Pharmacist at the Chemist where scripts are fulfilled review them. What is also being said is that at the mo nothing is working so she/he really needs to speak to each prescriber to discuss why the meds prescribed by each aren't working. For example, I take 9 meds & 2 prescribed supplements & each year they're passed as necessary. All except once last year, the reduction of 40mg of one reduced to 20mg. That has recently been reviewed again & been increased to 40mg again because it's deemed necessary & it's proving to be the correct advice.
Unfortunately in the present climate ...with the shortage of staff in all areas of the NHS, we all have to keep alert.
Anyone prescribed multiple drugs should always tactfully remind the physician prescribing a new drug, what drugs you are already taking.
You probably won't be Miss Popularity but it's your body the drugs are going into ...so it's in your interest to speak up.
It is not an ideal situation , but until staff shortages improve we must look out for ourselves.
I recently made a visit to one of the 8 GP's in my practice... He was looking very professionally at his computer-I explained my problem he said oh I will prescribe X-I then had to reply I already take X-he just doubled X ! Go figure!
Very unsafe practice for the patient. The doctors cannot in any way assume that the responsibility for checking interactions of meds falls on the patient. There are patients that always check but then again there are patients that trust the doctor with whatever he does. It's serious business handing out meds often with risky side effects.😳
You're preaching to the choir Simba. This is why I said we need to ask the prescribers, we have to be proactive nowadays, those that aren't, most often the elderly, do risk side effects or worse as our family is more than aware. It's proving it though. You've not been treated by the NHS so you're not aware of how things have changed in the past 10 years or so.
I'm not saying it's the patient's RESPONSIBILITY, but as we all know the NHS is really overstretched,& if you are prescribed different drugs for different conditions, it seems to me only common sense to check for ourselves....especially if we feel a new drug is causing a problem.
As nmh mentioned we do have annual prescription reviews, but things can be missed & if we can just make a little effort to keep an eye on things it might be to our own advantage.
Sadly these days ....the benign GP who looked after us from cradle to adulthood rarely exists.....so we have to help ourselves a little bit more. Not ideal...but a fact of life I'm afraid.
So the elderly without a safety net as well as those anxious vulnerable chronicly ill pas that do not have the strength or courage to speak up for themselves must just be seen as acceptable casualtes of a system that works as well as it can. Quite cynical in my view. Big Pharma is spending a lot of money on doctors to promote their meds they could infact also put some money on checking up meds and giving perks to doctors for doing this as well. As it is now the only thing that interest Pharma is that as much as possible meds are prescribed to patients.
It's easy to knock a system when you have no personal experience of how it works I'm afraid. Medications checks are carried out & it's not difficult to ask for one if it's overdue or you've never had one. Neither you nor I or 10,000 patients could change the way the NHS is presently & to be honest it's concerning enough without being reminded it's not fit for purpose. I know this to be true having experienced an alternate Healthcare system & returning to the NHS. Please, no need to bring "Big Pharma" into the discussion either, it's not relative. Unless you have personal experience of it spending a lot of money on GP's to promote their meds then please don't assume. Generalising isn't helpful nor is it factual.
No secret how Pharma is catering to doctors. This happens everywhere, I doubt UK is an exception. Have a lot of personal experience and knowledge since I come from a family of MDs and have many international contacts.
In UK there are extremely strict rules on the interaction between Big Pharma & GP's.Gone are the days of one man practices with autonomy over their drug usage....it is all ..thank goodness......strictly controlled & unless the patient misunderstands or ignores how drugs should be taken checks & balances work well.
These rules are bypassed by arranging different fancy seminars for doctors to exotic places, where meds are introduced. All included.When my brother was doing his military service, he was already a MD and others like him were infact invited to fancy dinners while other ordinary blokes just had their potatoes and gravy. So it starts very early.
Not these days Simba...I have lots of friends from my days working in hospitals, whose children are now physicians &'surgeons in UK & they see the difference. In fact only one daughter of friends is a GP, the others all prefer hospital medicine.....apart from one who moonlights as a Medical Officer on Cruise liners.....that must be some great job!
Are you talking about recent "catering" your personal knowledge is from?
Discussion still going on.
theconversation.com/whos-pa...
This article is from 2017, relating to Australia specifically 2013 & 2015 & to Specialists or Pharmacists/Pharmacy Technicians.
I don't think it's being cynical Simba, just realistic. I have lived in the US & my friends over there would kill for a medical service like our NHS, even though we have seen it go slowly down hill.......for emergency medicine it is still amongst the best in the world.
In the US ...if you are prescribed three meds, you can often only afford one as your Insurance doesn't cover it. ...& that is not people on Welfare, but those with good incomes, so believe you me they really investigate which drug they should choose.
We have the choice of getting as many drugs as we are prescribed for the price of a decent bottle of wine a month. with the pre payment certificate,& when we retire at 60 in England we get all our meds FREE.
I don't think it's asking too much for patients to summon up the effort to questions if they have doubts about the drugs they are taking, do you?
If someone is obviously old & frail, I'm sure the average GP would have his practice nurse ensure their drugs were well monitored.
These days there are very strict rules about GP,s accepting sample drugs & hospitality from Pharmaceutical companies. Gone are the days of oodles of free samples & individual GP,s choosing which drugs to choose.
So please everybody..if you doubt your drugs are working....just ask. No need for a major rant....just say X makes you feel ???! Any GP worth his salt will investigate....don't just "put up with it"!
Have any of your doctors said anything to you about research into the possibility, and I emphasise possibility, of treating COPD with baricitinib? My chest consultant told me about it some time ago.
Hi there, I have RA and Graves (overactive thyroid) and my consultants cross reference each other, via email etc, but it took some time for them to do so (and for some years I copied letters I was sent/ blood results for both of the consultants and let them know the major info.) When there are more consultants involved then that's going to be rather more difficult 😑 I mentioned recently on NRAS some software at my docs' practice which alerts the docs to med interactions and comes up on the screen when they type in the med they want to prescribe. Whether it is only certain meds like antibiotics I don't know as this is what I could see on my screen at the top. It seems to be like a MIMS software package. I know my docs also look up in their paper version of MIMS if they want to prescribe anything else for me. As long as your GP is receiving all the info/results back from each of your consultants and that always should be happening, then yes as said above, it is up to you to try get them communicating, especially if some conditions and side effects are interrelated. I was taking quite a few more meds than I am now about ten years ago (not 19 but 6-8) and I made a table/simple grid using a MSWord box document. Just five headings .. I typed the med name and dosage, date started, what condition the meds are taken for and a note of any side effects. I took it to both consultants at my review clinics each time as often dosage was changing and my conditions fluctuating. I used to give my GP a copy too. (Dentist also.) Yes it was a bit of effort and will be more for you too but just a thought if it can help them see everything in one place on one side of A4 paper? It helped me. I separated each condition's meds too so the meds were grouped together and easier to read. Good luck and hope you can find a way to get your consultants more in sync. x
Good for you! 👍🏻Unfortunately this is too much to ask of many pas
My failed medication (baricitinib) has now given me shingles on top of everything else. Mainstream medicine has only given me pain and problems so I must search for natural alternatives that will work and wont destroy my immune system. Extensive research will be the key. My RA team are all nice helpful people but limited in what they can do within the NHS.
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