In episode 422, James and Mike, go MEGA-PREMIUM and discuss the most recent meta-analysis (yes, yet another one) around the use of statins in older people. We then quickly review an article that looks at whether or not the guidelines for monitoring chronic conditions in primary care are evidence based. We are “shocked” when we find out “There is no evidence to support frequency of testing of any test in any of the guidelines”.  

Show notes

1) Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials

Lancet. 2019 Feb 2;393(10170):407-415. doi: 10.1016/S0140-6736(18)31942-1

2) Are guidelines for monitoring chronic disease in primary care evidence based?

BMJ. 2019 Jun 13;365:l2319. doi: 10.1136/bmj.l2319

In episode 421, Mike and James discuss the best available evidence around the newer and typically more expensive iron formulations used for iron deficiency anemia. We find the newer iron formulations are inferior to older ferrous salts when it comes to treating anemia and the evidence that newer formulations have less adverse effects is at best inconsistent.

Show notes

Tools for Practice

Iron-ing Out the Wrinkles in Anemia Management

In episode 420, James and Mike welcome back Bruce Arroll to talk about approaches to how we should talk about, discuss, chart and treat mental health issues. We discuss avoiding psychiatric labels, consider giving transdiagnostic labels, and doing functional assessments around work, love, and play.

Show notes

1) Transdiagnostic Symptom Clusters and Associations With Brain, Behavior, and Daily Function in Mood, Anxiety, and Trauma Disorders

JAMA Psychiatry. 2018 Feb 1;75(2):201-9

2) The psychopathology of James Bond and its implications for the revision of the DSM-(00)7

Med J Aust. 2015 Dec 14;203(11):452-6.

3) Saving Normal: An Insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, Big Pharma and the medicalization of ordinary life

Psychotherapy in Australia, Vol. 19, No. 3, May 2013: 14-18

4) brucearroll.com

5) Reforming disease definitions: a new primary care led, people-centred approach

BMJ Evidence Based medicine doi:10.1136/ bmjebm-2018-111148 

FACT- work/love/play

Limit the problem focus

1) work – 1 to 10

2) love (friends) – 1 to 10

3) love (intimates) – 1 to 10 

4) love (family) – 1 to 10 

5) play  – 1-10