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As a practicing GP and GP Tutor I strive to keep abreast of landmark
epidemiological surveys and their acronyms. One thing always worries me
however. At what point does adding cardiovascular medicine to the
patient's inner environment become counter productive? Taking the example
of an housebound person with moderate Parkinson's disease, angina,
diabetes, osteoarthritis and COPD we may find that two or three drugs
tacked on to lower blood pressure brings the tally of prescribed items to
ten or more. Can we model the risks of interaction? I think not. We
probably cannot model those risks with a grand total of four drugs. If the
patient smokes heavily and insists on a co-opioid at night "for me knees"
while concealing a hefty alcohol habit we can clearly wreak havoc! When
trying to sell hypotensive medication to our chairbound population what
can we say about the ABSOLUTE risk reduction of a 10pc drop in BP? These
arguments ae closely balanced.Is our patient really competent and enabled
to opt in?
Who decides what is "worthwhile?"
Sir
As a practicing GP and GP Tutor I strive to keep abreast of landmark
epidemiological surveys and their acronyms. One thing always worries me
however. At what point does adding cardiovascular medicine to the
patient's inner environment become counter productive? Taking the example
of an housebound person with moderate Parkinson's disease, angina,
diabetes, osteoarthritis and COPD we may find that two or three drugs
tacked on to lower blood pressure brings the tally of prescribed items to
ten or more. Can we model the risks of interaction? I think not. We
probably cannot model those risks with a grand total of four drugs. If the
patient smokes heavily and insists on a co-opioid at night "for me knees"
while concealing a hefty alcohol habit we can clearly wreak havoc! When
trying to sell hypotensive medication to our chairbound population what
can we say about the ABSOLUTE risk reduction of a 10pc drop in BP? These
arguments ae closely balanced.Is our patient really competent and enabled
to opt in?
Competing interests: No competing interests