As all pharmacists will know, some GPs introduce blood pressure medicines that according to guidelines are not recommended for particular patient groups, or in the wrong order, or with careless dose titration.
The kind of thing I'm talking bout:
- A 35 year old slightly overweight Indian lady, who has a strong family history of diabetes, started on bendroflumethiazide rather than other drugs.
- A 75 year old lady given Doxazosin 8mg daily without any initial dose titration
- Minoxidil intriduced by GP as second drug.
The second two I intervened in and managed to get changed. I feel I should also attempt to tackle the first patient.
But it's a tiring job to get past the receptionists, deal with the patients who get very worried when I started discussing this with them etc, deal with the doctor who initially tried to be dismissive etc.
I'm sure all of you will have LOADS more examples.
My question is: should we intervene in every single case (milder ones in which there may not necessarily be a large risk of a bad outcome) or only the worst and most harmful cases?
The kind of thing I'm talking bout:
- A 35 year old slightly overweight Indian lady, who has a strong family history of diabetes, started on bendroflumethiazide rather than other drugs.
- A 75 year old lady given Doxazosin 8mg daily without any initial dose titration
- Minoxidil intriduced by GP as second drug.
The second two I intervened in and managed to get changed. I feel I should also attempt to tackle the first patient.
But it's a tiring job to get past the receptionists, deal with the patients who get very worried when I started discussing this with them etc, deal with the doctor who initially tried to be dismissive etc.
I'm sure all of you will have LOADS more examples.
My question is: should we intervene in every single case (milder ones in which there may not necessarily be a large risk of a bad outcome) or only the worst and most harmful cases?
Comment