Sometimes it's hard to know what to do for the best, especially if you're already on lots of meds for multiple conditions. I read a little snippet in a newspaper 'health tips' article written by a GP recently which I thought was useful. It said if you are offered a new pill or treatment discuss and weigh up the pros and cons with your doctor before deciding, using the mnemonic BRAN -
What are the likely or promised Benefits?
Possible Risks/side effects?
What are the Alternatives?
What happens if you do Nothing?
I think this is a very useful structure. My problem is I feel many doctors are often too optimistic about the benefits, too pessimistic about the risks (eg with steroids), not interested in alternatives unless there have been full double b;ind scientific trials, and sometimes get shirty if you don't take their advice as they know best, but then I confess I'm far too cynical for one so young.
What are your thoughts?
Written by
tangocharlie
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I think that's actually a really useful & helpful mnemonic and have made a note of it for my own future use.
It covers key, important considerations when a new medication comes into the mix and certainly will help aid decision making.
Several times I've 'upset' a medical professional because I've refused to take a medication they've wanted to start me on.
Without convinving evidence that I actually needed a specific drug, I would never agree to take something just because I'm told to though.
If I'd not taken this approach, as well as my Prednisolone, Propanolol & Atorvastatin, I'd now also be taking Omeprazole, Alendronic Acid, Gabapentin, Pregabalin and Amitriptyline .......none of which I've needed so far!
Of course, if circumstances changed I would obviously re- assess & reconsider.
So important to do your research, listen to reliable, trustworthy and informative advice and not be afraid to question anything you're not comfortable with.
I feel its my body and therefore (as long as I take a sensible approach) I decide what I actually put in it!
I agree - question everything! Before I have any medical appintment I try and think, firstly What is my objective? what outcome do I want from the appointment and secondly, what questions and doubts do I have going round in my head that I need answering? I ask questions like How will we know if this is helping? Do you really think I need it? Note I try and use 'we' instead of I to show I respect their opinions and to make them think it's at least partly their decision 😀. As well as asking the questions above of course. GPs keep trying to give me PPIs even though they really upset my stomach. I get round that problem by putting my Pred in gastro resistant capsules. I also had a battle when they wanted to put me on diabetes meds and I said I wanted to control my BS through diet, which I did. My 89 year old dad is always being givne new meds and when I ask him if they are helping he says he doesn't know!
I took my dad for a medication review a few years ago, managed to get him off statins and a few others that he'd been on for no apparent benefit and got him switched to a liquid version of iron tablets which suited him much better. He just trusts what he's told without questioning, as I'm told many of his generation do
The older we get the more drugs we're put on. I overheard a conversation last time I was in A&E. A Dr asked a patient if he was on any medications, and he replied 'yes I bloody rattle'. Not very useful info for the dr but many people laughed
A few years ago one of our gps advised me that I needed to be on a couple of drugs. They were quite powerful and I really didn’t want to be on anything else unless it was absolutely necessary and I told him that. He said “Mrs ……, I can only advise you, if you choose to ignore my advice and die from a heart attack don’t come back to me complaining.” I said if I die from a heart attack I won’t be coming back to see you any time soon! 🤣
This is a very useful mnemonic. Thanks! Guess I've unconsciouly been applying this rule for a while. Now that I'm off pred (touch wood) when recently answering some medical questions for triage it was quite nice to be able to say "no prescription meds". Potentially could have been on stomach protection (to protect against a prescription painkiller), an OP med, and who knows what else by now. This is not to say that there aren't plenty of non-prescription remedies in my home.
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