How do we avoid harming the elderly with prescription drugs?
Is the best medicine no medicine at all? Sometimes. My past posts have emphasized that the appropriateness of any drug depends on an evaluation of benefits and risks. There are no completely safe interventions, and no drug is free of any side effects. Our choice is ideally informed by high-quality data like randomized controlled trials, with lots of real-world experience so we...
Choosing Wisely: Five things Pharmacists and Patients Should Question
Is the health care spending tide turning? Unnecessary medical investigations and overtreatment seems to have entered the public consciousness to an extent I can’t recall in the past. More and more, the merits of medical investigations such as mammograms and just this week, PSA tests are being being widely questioned. It’s about time. Previous attempts to critically appraise overall benefits and consequences...
The drug expiry date: A necessary safety measure, or yet another Big Pharma conspiracy?
Consider this scenario: You’re in good health and take no prescription drugs. You use the following remedies occasionally: Excedrin for the rare migraine Arnica 30CH for bumps and bruises Echinacea capsules, when you feel a cold coming on Today you look in your cupboard, and notice all three products expired last year. Would you still consider taking any of them? Why or...
Gold mine or dumpster dive? A closer look at adverse event reports
All informed health decisions are based on an evaluation of expected risks and known benefits. Nothing is without risk. Drugs can provide an enormous benefit, but they all have the potential to harm. Whether it’s to guide therapy choices or to ensure patients are aware of the risks of their prescription drugs, I spend a lot of time discussing the potential negative consequences of...
Systemic Enzyme Therapy
One of the recurrent themes in alternative medicine is the practice of simplifying complex medical conditions, and then offering up equally simple solutions which are positioned as still being within the realm of science. This approach allows the practitioner to ignore all of the complexity and difficulty of practicing real medicine, yet offer nostrums that, on first glance, can sound legitimate. Science-y,...
Anti-anti-vax: Getting to the gist
I’m currently putting the finishing touches on a presentation for the The Ontario Public Health Convention next week, where I’ll be speaking, with occupational therapist Kim Hébert, about the anti-vaccine movement and social media (SM): how antivaccine advocates use it, and the challenges and opportunities for public health advocates. I’m pleased to see Seth Mnookin, author of The Panic Virus and someone...
Adherence: The difference between what is, and what ought to be
One of the most interesting aspects of working as a community-based pharmacist is the insight you gain into the actual effectiveness of the different health interventions. You can see the most elaborate medication regimens developed, and then see what happens when the “rubber really hits the road”: when patients are expected to manage their own treatment plan. Not only do we get...
Is gluten the new Candida?
Celiac disease and non-celiac gluten sensitivity are very different things. The former has a large, visible, well-understood scientific foundation that is lacking in the latter.
Drug Interactions, Polypharmacy, and Science-Based Medicine
As I write this, the American news cycle is firmly focused on the issue of drug harms. It’s in the headlines not because of the thousands of cases of drug toxicity, hospitalizations, and even deaths that are documented each year, but because of the untimely death of singer Whitney Houston. While the cause of Houston’s death has not yet been identified,prescription drugs...
IgG Food Intolerance Tests: What does the science say?
I spend a lot of time as a pharmacist discussing side effects and allergies to drugs. For your own safety, I won’t recommend or dispense a drug until I know your allergy status. I don’t limit the history to drugs—I want to know anything you’re allergic to, be it environmental, food, insects, or anything else. Allergies can create true therapeutic challenges: We...