Quote:
Originally Posted by Unregistered
It depends on the case my friend. Note evrything you read in the book is applicable in real life. We cannot force patients, we can discuss , offer explain pros and cons. If that patients BP was 120/80 for example, well, asymptomatic , on those meds for many years and the 80 year old auntie die die dont wanna change the meds, u cant do anything right?
Fam med is a discussion with the patient. It depends on what the discussion was. If patient understands, doesnt want to streamline the meds but optimising sub-optimal doses and cutting out the rest of the meds cause these are the doses she is familiar with and taking for 20 plus years what can u do by giving 1 month TCU??
OFC if auntie want to change meds or wasnt even offered, then that is a lapse
Dont anyhow slam people la... doesnt mean whats correct on paper happens in real life. Hello, cant force patients u know, ultimately their choice
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hello my friend. why are u so defensive?
when I saw this patient, I immediately asked her on her opinion of taking so many med and she straight away say ya lor, dunno why need so many.
I cut some for u? ur Bp not bad lei,no need so many. she immediately smile. even say dunno why need so many, eat medicine also eat till full liao. that small conversation basically tells me all I need to know including the fact my rp didn't offer any changes to the med.
you sound like a novice practioner tbh. discuss pros and cons? explore ice? priest la.
paper knowledge? dude, no paper knowledge how to guide ur decisions? let me give u a pro tip, we don't innudate patient with unecssary information , u think the 80 year old ah mah can understand? u must first know ur science, then u seek their preference , if its the same line , easy task , if not , test resistance for change, low resistance enforce maternastically, high resistance move on, aka discuss pros and cons with patient and she declined.
it's like noac Vs warfarin. pls la u still go and wax lyrical about warfarin ? if patient can pay, straight away offer noac liao. mention warfarin like it's some dirty med.
fyi, trials have show poor outcome of BP control below 120 for geriatric population.
it's acceptable at 150/90
polypharmacy also contributes to falls, over dose etc
even if u want to control BP at 110, u can increase the dose of some meds and take away some.
this was a m.med station a few years ago fyi.
pls la, I know my rp pattern more than anything. u think they spend time talking so much? esp when they need a translator since they don't speak hokkien or even mandarin for that matter.