@WynesSeth Please direct message me about Climate Action and Awareness Fund proposal
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Malcolm Maclure
30 posts
Malcolm Maclure
@MalcolmMaclure
I'm the BC Academic Chair in Patient Safety and Professor in the Dept of Anesthesiology, Pharmacology and Therapeutics at UBC. All views expressed are my own.
Victoria Katılım Aralık 2011
106 Takip Edilen165 Takipçiler
@Deprescribing A3: In med & nursing school, create a non-shame supportive culture of small-group performance review, not secrecy #derxchat
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@Deprescribing A2 "Prescribing" educational websites and tools for patients and families. Write a URL on a Rx pad. #derxchat
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@Deprescribing A1 Ministries of Health who sit (too passively) on dispensing data needed for QI feedback on deprescribing #derxchat
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@Deprescribing Health prof associations have responsibility to embrace deprescribing as a key to QI in residential care #derxchat
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@Pharma_Emma @rojasfec @Deprescribing To teach UBC med students deRx, we use Barb's 1st CMAJ case as reading; but too few students read it
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@Deprescribing #DeRxchat Most deRx is in seniors; do family members want to hear anecdotes of success, testimony of others, from Internet?
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@Deprescribing #DeRxchat As a patient/spouse stopping a med: I notice change of symptoms: n-of-1 trial but low power (too few crossovers)
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@MalcolmMaclure Chair Patient Safety UBC. Good morning/afternoon!
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@Deprescribing #deRxchat A4: a) Descriptive Epi = small area variations; b) 'Analytic' Epi = compare diff cohorts' outcomes; c) Trials
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@Deprescribing #deRxchat A2: Organizations like Cochrane and NIHCE are needed to judge evidence quality. Beyond ability of clinicians.
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@Deprescribing #derxchat A1: Ministry data routinely collected on massive numbers of patients. Ministries' drug plans should pay for trials.
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@Deprescribing #deRxchat A1 To demonstrate statistically fewer falls, sample size > 2500. Significantly fewer fractures, sample > 10,000.
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@Deprescribing #deRxchat A1: Deprescribing often involves a 'non-inferiority' hypothesis (you are no worse). Requires bigger samples.
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#deRxchat A1 Generalizability is puzzling when the patients are so mixed in their other meds and co-morbidities. @Deprescribing
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@Deprescribing A1: If solid evidence is needed to add meds (default is don't add), maybe deprescribe is default if evid to continue is low
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@DAGoldmann #ph556x What’s a paper on SPC v RCT/epidem analysis? why longer “before period” boosts signif diff of means, but not in SPC?
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I DIG THE SHAPE OF YOUR FORMULARY! #PharmacareValentines @CadaretteSM
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