Talking Meds - A PrescQIPP podcast (PrescQIPP C.I.C. )

We are excited to share a clip of our new podcast, 'Talking Meds' with our host Jonathan Underhill and guests, which launces on 20 September.

Talking Meds will be available to listen to via your usual podcast system and a new episode will come out every fortnight, on the first and third Friday of each month.

Jonathan Underhill has a background as a hospital clinical pharmacist but worked for many, many years at the National Prescribing Centre (NPC) developing innovative ways of teaching therapeutics, evidence-based medicine and clinical decision making to prescribers and their support teams. Until recently, he worked at NICE as a consultant clinical adviser in their Medicines Optimisation Team.

Episode 1 launches on Friday 20th September and features guest Magnus Hird to discuss his role, how he prioritises people for medication review as well as two current safety issues that have recently been in the news.

Magnus is a pioneer of clinical pharmacists working in General Practice and one of the first ever pharmacist independent prescribers. He was one of the first cohort of NPC Trainers, running educational events in the North West. He now works two days per week in a busy general practice in Blackpool, with the rest of his week occupied as clinical lead for ambulance commissioning, covering the 999 paramedic emergency service, NHS111 and patient transport services across the northwest, and as a clinical advisor for urgent care to the NHS England regional team. He also runs a smallholding farm in the North West of England (follow his antics on various social media outlets via https://sites.google.com/view/monkhallfarm/home)

Future episodes

• A series on ’Sensible prescribing in Older people with Jonathan and Lucy’, with consultant geriatrician and author Lucy Pollock
• Penicillin allergy de-labelling with Phil Howard OBE
• New NICE Menopause guideline with NICE committee member Hayley Berry
• As well as topics such as the NICE/SIGN Asthma guideline, depression deprescribing and insomnia 

So subscribe now to make sure you don't miss an episode.

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the first episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Magnus Hird about his role, how he prioritises people for medication review as well as two current safety issues that have recently been in the news.

Magnus is a pioneer of clinical pharmacists working in General Practice and one of the first ever pharmacist independent prescribers. He was one of the first cohort of NPC Trainers, running educational events in the North West. He now works 2 days per week in a busy general practice in Blackpool, with the rest of his week occupied as clinical lead for ambulance commissioning, covering the 999 paramedic emergency service, NHS111 and patient transport services across the northwest, and as a clinical advisor for urgent care to the NHS England regional team. He also runs a smallholding farm in the North West of England (follow his antics on various social media outlets via https://sites.google.com/view/monkhallfarm/home

Jonathan and Magnus discuss what a typical day in general practice could look like for Magnus, how he prioritises his workload, deals with complexity and what particular skills a clinical pharmacist brings to the primary care team. 

Useful sources discussed include:

 PINCER - Pharmacist-led Information technology iNtervention for the reduction of Clinically important ERrors in medicines management

https://healthinnovationwessex.org.uk/projects/56/pincer

 Estimating the economic effect of harm associated with high risk prescribing of oral non-steroidal anti-inflammatory drugs in England: population based cohort and economic modelling study. BMJ 2024;386:e077880

https://www.bmj.com/content/386/bmj-2023-077880

 Asthma: effect of excess short-acting β2-agonist (SABA) inhaler prescriptions on healthcare resource utilisation

Mark L Levy, Toby GD Capstick and Thomas Antalffy

British Journal of General Practice 2024;  74 (745): 374-376.

https://doi.org/10.3399/bjgp24X739089

 NICE Guideline - Asthma: diagnosis, monitoring and chronic asthma management (Expected publication date: 27 November 2024)

https://www.nice.org.uk/guidance/gid-ng10186/documents/450

Useful PrescQIPP resources (need to be registered and logged into the website to access):

Asthma bulletin 251
https://www.prescqipp.info/our-resources/bulletins/bulletin-251-asthma/

PrescQIPP Asthma e-learning course (pay per use)

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the 2nd episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. 

Today your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, introduces a new series within the Talking Meds podcast called ‘Sensible prescribing in Older people with Jonathan and Lucy’. Jonathan and Dr Lucy Pollock outline their plan to share some real patient stories that may help us think about how to ensure we consider what really matters to patients when we are reviewing their medicines.  

Lucy grew up in Northern Ireland, read medicine at Cambridge University and St Bartholomew’s Hospital and is eternally grateful for the advice of an early boss who hoped she would not be offended if he suggested she should become a geriatrician. She trained in general and geriatric medicine in London before taking up a consultant post in Somerset in 2001. She lives with her husband and dog Rose near Langport. They have three grown-up children.  

Lucy writes about her patients, their families and the complicated, funny, sad problems that arise as we age. The Book About Getting Older (2021) and The Golden Rule (2024) are both published by Penguin Random House.  @lucypollock | Linktree

In this episode, Jonathan and Lucy talk how about we need to be really careful when starting some medicines, making sure we are considering some of the potential, perhaps unintended consequences. Lucy tells about her experiences where sometimes the very best of intentions to try and help treat symptoms may lead to ‘prescribing cascades’ and how tricky that can be for our patients.

Useful sources referred to in this episode include:

Introduction to ‘prescribing cascades’ from Canadian Medication Appropriateness and Desprescribing Network: https://www.deprescribingnetwork.ca/blog/prescribing-cascade

BMJ Open Adverse drug reactions, multimorbidity and polypharmacy: a prospective analysis of 1 month of medical admissions

https://bmjopen.bmj.com/content/bmjopen/12/7/e055551.full.pdf

Useful PrescQIPP resources (need to be registered and logged into the website to access):

Polypharmacy and deprescribing webkit
https://www.prescqipp.info/our-resources/webkits/polypharmacy-and-deprescribing/

IMPACT Bulletin 268
https://www.prescqipp.info/our-resources/bulletins/bulletin-268-impact/

Clinical Masterclasses on Multimorbidity, Frailty and Polypharmacy in Older People
https://www.prescqipp.info/our-resources/clinical-webinars/clinical-masterclass-dec-2021/

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. 
Today Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Dr Mark Horowitz about how to safely stop antidepressants and the importance of tapering dose reduction slowly to reduce the risk of withdrawal symptoms.

Dr Mark Horowitz  is a training psychiatrist and Visiting Lecturer in London, and  the lead author of the Maudsley Deprescribing Guidelines (see below). Mark co-authored the recent Royal College of Psychiatrists’ guidance on ‘Stopping Antidepressants’, and has been commissioned by Health Education England to prepare a teaching module on how to safely stop antidepressants for the NHS (coming soon!). 

Mark has experienced the difficulty of coming off psychiatric medications first hand which has informed much of his work.

Useful sources referred to in this episode include:

Dose response curves/Law of Mass action illustrated here (see figure 1)

https://pharmaceutical-journal.com/article/ld/case-based-learning-safe-withdrawal-and-tapering-of-antidepressants

The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs

https://www.wiley.com/en-gb/The+Maudsley+Deprescribing+Guidelines%3A+Antidepressants%2C+Benzodiazepines%2C+Gabapentinoids+and+Z-drugs-p-9781119823025

RPS members can get free access to the Maudsley Deprescribing Guidelines here:
https://www.vlebooks.com/Account/Logon/RPS

Maudsley Prescribing Guidelines

The Maudsley Prescribing Guidelines in Psychiatry eBook
Register for an NHS England OpenAthens account.

NICE guidelines

NICE guideline on depression in adults – see section 1.4.12 to 1.4.21 for information on stopping antidepressants.

NICE guideline on medicines associated with dependence or withdrawal symptoms - further recommendations on withdrawing antidepressants.

Clinical Knowledge Summary (CKS)

NICE clinical knowledge summa

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. 

Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, continues the series within the Talking Meds podcast called ‘Sensible prescribing in Older people with Jonathan and Lucy’.

Jonathan and Lucy discuss Brenda, an older lady who has become frail and has significant dementia that is affecting her ability to cope with everyday life and living. She has been taking aspirin, originally intended to reduce her risk of a further heart attack, but which hasn’t been thought about for a while. They discuss how clinicians are prone to overestimate benefits of medicines, but underestimate harms. The importance of finding out a patient’s (and their carer’s) expectations are key to sensible prescribing. Sometimes the tablets aren’t worth our precious older people taking them, as the harms may well outweigh the potentially small benefits.

Resources mentioned in this episode include:

GPs’ understanding of the benefits and harms of treatments for long-term conditions: an online survey. Julian Treadwell in British Journal of General Practice. https://bjgpopen.org/content/4/1/bjgpopen20X101016

A brilliant resource to help illustrate likely benefits and harms for some commonly used medicines - GP Evidence https://gpevidence.org/

PrescQIPP webinar recording. How well do GPs understand the benefits and harms of treatments for long term conditions?
Dr Julian Treadwell.
https://www.prescqipp.info/our-resources/clinical-webinars/how-well-do-gps-understand-the-benefits-and-harms-of-treatments-for-long-term-conditions/

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds on the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. 

Today, your host Jonathan Underhill talks to Clare Howard, Clinical Lead for Medicines Optimisation at Health Innovation Wessex, about the development of the Repeat Prescribing Toolkit she led on behalf of the Royal Pharmaceutical Society and Royal College of General Practitioners. 

The toolkit was commissioned by NHS England in answer to recommendation 7 of  the National Overprescribing Review, to help practices improve the consistency of their repeat prescribing processes. There are 1.18 billion medicines prescribed and dispensed in Primary Care in England each year. While most people get their medicines without any issues, there are around 20-30,000 ‘probable avoidable’ harm incidents each year, of which around a quarter are related to medicines. Clare and Jonathan discuss the multiple ways this toolkit can help reduce the risk of these errors.

The NHS is a complex system, and repeat prescribing is a ‘WICKED’ problem (difficult or impossible to fix) as it involves human to human interactions. Clare and Jonathan acknowledge that while you can’t ‘fix’ it and completely prevent any errors, having a structured approach can help reduce the risk of those errors and make for a more efficient process (and happier patients and healthcare staff!)

Resources mentioned in this episode include:

Repeat Prescribing Toolkit:

https://www.rpharms.com/resources/repeat-prescribing-toolkit

National Polypharmacy Programme from Wessex Health Innovation Network

https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy

Get details of upcoming ALS cohorts and book your place here. 

Useful related resources from PrescQIPP:

The PrescQIPP 'Practice Medicines Coordinators' e-learning course is recommended as a training resource for prescription clerks in the RPS/RCGP Repeat Prescribing Toolkit.
PrescQIPP Practice Medicines Coordinators e-learning course (Pay per use)

PrescQIPP Bulletin 325: Empowering patients to manage their repeat prescriptions

PrescQIPP Bulletin 292: Repeat prescriptions

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds on the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, continues the series within the Talking Meds podcast called ‘Sensible prescribing in Older people with Jonathan and Lucy’. 

Today, Jonathan and Lucy talk about the identification AND sensible management of heart failure with preserved ejection fraction. They discuss how we need to have a different approach than that for heart failure where the ejection fraction is reduced by a significant amount. But that the key is to consider what matters most to people and tailor our approach accordingly. Its guidelines not tramlines!

The importance of ‘sick day rules’ are also discussed – stopping medicines for a short period where volume depletion or a urinary tract infection (UTI) is present.

We also meet Marjory, who has recently been started on dapagliflozin but is admitted to hospital with a raging UTI and delirium. The EMPORER study found that for every 100 people on a flozin, one of them would get a UTI due to the flozin. But this risk may be higher in older people as they are at higher risk of this happening in the first place than those included in the EMPORER study. Medicine is tricky eh?

See the tab for HFPrEF in GP Evidence https://gpevidence.org/ to illustrate this with icon arrays.

Resources mentioned in this episode include:

P Moorhouse, K Rockwood. Frailty and its quantitative clinical evaluation

National Institute for Health and Care Excellence. Urinary tract infection (lower): antimicrobial prescribing

NICE guideline [NG109]Published: 31 October 2018

PrescQIPP bulletin 347. Chronic Heart Failure

PrescQIPP e-learning. Chronic Heart Failure in Adults (pay per use)

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Hayley Berry about the update to the NICE Guideline on the identification and management of the menopause, published in November 2024. 

Hayley has a background in community pharmacy and general practice and now works for CPPE at the University of Manchester as a Lead learning development pharmacist. As a pharmacist independent prescriber, she works at a private menopause clinic and was a member of the NICE Menopause guideline development committee.

Jonathan and Hayley discuss the important aspects of the update and touch on some of the somewhat controversial issues that surround this subject. The choice about whether to take HRT or not is a highly preference sensitive decision, where the values and preference of each woman needs to be taken into account. They discuss the various tools available to help facilitate those conversations, particularly the discussion tool published by NICE to accompany the guideline update, as well as the excellent GP Evidence website and the upcoming patient decision aid being developed by the Winton Centre.

They also discuss the research recommendations within the guideline, highlighting how relatively poor the existing evidence base is for the management of the menopause.

Resources mentioned in this episode include:

NICE Guideline on Menopause: identification and management. NG 23 – updated November 2024

Tools from NICE to communicate the benefits and risks of HRT

GP Evidence has summarised the evidence on the benefits and risks of HRT for menopause.

Winton Centre for Risk and Evidence Communication – watch this space for the upcoming menopause patient decision aid

NICE CKS Menopause topic (excellent for a quick summary of the guidance)

Useful related resources from PrescQIPP:

PrescQIPP Bulletin 299. Menopause

PrescQIPP Clinical Masterclass on 29th January 2025 on the NICE Menopause Guideline

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to this special festive edition of Talking Meds and the Presqipp podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at Presqipp, and Dr Lucy Pollock, consultant geriatrician and author, talk about drug holidays, often known as treatment breaks. 

Sometimes it can be helpful to consider temporarily stopping a person’s medicines in order to take into account what really matters to them at a particular point of their lives. Jonathan and Lucy discuss when this might be appropriate, particularly around the festive period where everyday life might be slightly different for some people.

This includes situations where, for example, symptoms that were previously troublesome are controlled and the person wishes to see if they can manage without the medicine for a short time. They discuss the types of medicines or conditions this may apply to, in particular those where there is limited prognostic value (that is, where stopping taking them is unlikely to affect their chances of having a relapse of their condition or having an event that will affect their longer term health). This can help reduce the overall burden of the medicines someone takes, reduce the risk of them having an adverse event, and probably improve their overall quality of life.

They also discuss the age-old question of whether its ok to have an alcoholic beverage of your preference at Christmas, always in moderation of course!

PrescQIPP have recently published a bulletin with accompanying resource pack on treatment breaks, available to subscribers here:

Bulletin 358. Medicine treatment breaks 

The Aural Apothecary podcast is available on all the usual podcast media channels. You can find the website here with an archive of episodes. The episode with John Seddon which is discussed by Jonathan and Lucy can be found here.

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the Presqipp podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at Presqipp, talks to Professor Neal Maskrey about his new book, Rebalancing Medicine.

Neal was a GP in Yorkshire for 20 years and continues to work extensively supporting postgraduate training with GP Trainers and their registrars. He then worked for North Yorkshire Health Authority developing primary care, was an early editor of Clinical Evidence (BMJ Publications), and then spent 14 years as a director of the National Prescribing Centre and Programme Director of the Medicines and Prescribing Centre at NICE. He still has a chair as Visiting Professor of Evidence-informed decision making at Keele University where Jonathan and Neal still collaborate on innovative stuff on shared decision making such as us using avatars to allow people to hone their consultation skills with feedback in a safe space (as its a computer it doesn’t have any feelings – not yet they don’t anyway!)

Jonathan and Neal discuss what influenced him to write his book, what the key themes are as well as the sources, experiences and stories that influenced the writing. They then provide some food for thought as to the future of healthcare, what this means for NICE and other organisations, and how individual healthcare professionals can make sure they are prepared for the future.

Resources mentioned in this episode include:

• Review of Rebalancing Medicine from Dr Richard Lehman
• How Doctors Think by Jerome Groopman
• Era 3 for Medicine and Health Care by Don Berwick
• Youtube video of Keynote presentation of this
• Applying the time needed to treat to NICE guidelines on lifestyle interventions - Minna Johansson and colleagues  
• Population-health impact of new drugs recommended by the National Institute for Health and Care Excellence in England during 2000–20: a retrospective analysis – Huseyin Naci et al.

Useful related resources from PrescQIPP:
Information Mastery face to face Workshops in March and April 2025

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the Presqipp podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, continues the series within the Talking Meds podcast called ‘Sensible prescribing in Older people with Jonathan and Lucy. 

Today Jonathan and Lucy talk about the sensible management of heart failure with reduced ejection fraction. They discuss the so-called ‘Four Pillars’ of heart failure, remembering that the key is to consider what matters most to people and tailor our approach accordingly. The important words in the NICE Quality Standard on Heart Failure being ‘appropriate’ and ‘optimal’ – not simply following the protocol by rote!

The people in the big heart failure trials tend to be people aged in their 60s and men. So how do we apply this to older people or those who are women. Carefully, sensibly and by agreement is the answer...

So we meet Janet, an 86 year old lady who Lucy has seen. She lost her husband recently and misses him terribly. She is lonely and is just starting to show signs of cognitive impairment. We discuss the importance of getting to know your patients. And perhaps their beloved pet cat or dog.

See the tab for HFReEF in GP Evidence https://gpevidence.org/ to illustrate this with icon arrays.

Resources mentioned in this episode include:

Show me your meds, please - Deb Gompertz

NICE Quality Standard (QS9) Chronic heart failure in adults 

NICE CKS Topic Scenario: Confirmed heart failure with reduced ejection fraction

The Cinnamon Trust

The Name of the Dog

Useful related resources from PrescQIPP:

PrescQIPP bulletin 347. Chronic Heart Failure

PrescQIPP e-learning. Chronic Heart Failure in Adults (pay per use)

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Prof Anna Murphy and Rajijyot Saggu – two talented and eminent pharmacists who work in the field of respiratory disease. We discuss the latest update the asthma guideline from NICE - a milestone as for the first time, this integrates NICE, BTS and SIGN guideline as a collaboration between the three organisations.

Anna, is Professor of Pharmacy Practice at DeMontfort University, and a Consultant Respiratory Pharmacist for University Hospitals of Leicester. She has over 25 years experience working in the field of Respiratory Medicine and sits on several national committees, most notably on the BTS council, as co-chair of the medicine optimisation working group of the Taskforce for Lung Health and a member of the NHSE Inhaler working group.

Anna has published widely in peer reviewed journals, is author of Asthma-in-Focus and produced the “7-Steps to Success” inhaler education materials. 

Ravijyot has a background as a hospital pharmacist is an honorary clinical lecturer for the London School of Pharmacy at UCL. She was the Chief Pharmaceutical Officer’s clinical fellow in 2021/22. She is chair of the UK Clinical Pharmacy Association respiratory committee and has been part of NICE/British Thoracic Society (BTS) & European Respiratory Society guideline development committees.  She is a coach as well as a NICE Associate, and is passionate about sustainable, personalised and holistic care for patients, population health/integrated care to reduce health inequalities

We discuss the main highlights of the update and some of the challenges that may arise when implementing these recommendations, particularly around the person-centred approach needed and the sustainability implications.

Resources mentioned in this episode include:

Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN)

Patient decision aid on asthma inhalers and climate change

AAC uncontrolled asthma pathway

Greener practice asthma QI toolkit

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

In this episode of Talking Meds we continue the series ‘Sensible prescribing in Older people with Jonathan and Lucy' with a discussion between Jonathan Underhill and Dr Lucy Pollock about the prescribing of statins.

So we meet Mrs Evans, an 87 year old lady who lives with her daughter in a ‘granny flat’ annex of her house. She has several co-morbidites including type 2 diabetes, hypertension, heart failure with preserved ejection fraction and has recently had a stroke. Her daughter is concerned about her mum who she says ‘the sparkle has gone from her eyes’. Mrs Evans often looks at her daily handful of medicines and asks ‘what’s the point?

Mrs Evans has recently been prescribed atorvastatin 80mg a day - in line with the guideline from NICE. Mrs Evan’s daughter asks Lucy - ‘are these new tablets worth my mum’s time?’ To try and help answer this, Jonathan and Lucy look at the icon arrays on the statins tab of GP Evidence where it shows how, out of 100 people like Mrs Evans who don't take a statin, around 29 will have a heart attack or stroke in the next 10 years. If all 100 take a statin, then 7 will be prevented from having a cardiovascular event but 22 will still have one. So the majority, 78, will not have a heart attack or stroke, but 71 wouldn’t have had one anyway without taking a statin!

Explaining risks and benefits using numbers can often help some people - but not everyone. The important thing is to ask and find out 'what is it that really matters to you?'

PrescQIPP resources mentioned in this episode:

PrescQIPP Lipid modification e-learning course (pay per use)

PrescQIPP Prescribing Mastery webinar 'Cholesterol management' 

Other resources mentioned in this episode:

BBC Podcast with Rory Stewart - the long history of ignorance

Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238)

Risk communication: NICE Shared Decision making guideline recommendations 1.4

Drug and Therapeutics Bulletin - How to communicate evidence to patients by Baroness Alex Freeman

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Dr Julian Treadwell, an academic GP who has developed the absolutely fabulous resource GP Evidence.

Julian has worked for many years in UK General Practice and is keenly interested in polypharmacy, multiple long-term conditions and evidence-based practice. He developed the website GP Evidence which provides easily accessible and understandable information on the benefits and harms of treatments for long-term conditions. He has additional roles with NICE as a moderator of their GP Reference Panel, was a founding member of the Royal College of General Practitioners standing group on Overdiagnosis (see below if you want to join) and is an associate editor of the Drug and Therapeutics Bulletin.

PrescQIPP resources mentioned in this episode:

• PrescQIPP webinar March 2023: Making evidence understandable - why you need to use GP Evidence.
• PrescQIPP Clinical Masterclass 25th February 2025:  The GP Evidence website: user-friendly clinical evidence to support shared decision making about treatments for long-term conditions.

Other resources mentioned in this episode:

• GP Evidence website
• Do clinicians overestimate benefits and underestimate the risks of treatments? BJGP Open - GPs’ understanding of the benefits and harms of treatments for long-term conditions: an online survey
• NICE Shared decision making guideline and eLearning:
  Shared decision making NICE guideline [NG197]
  Shared decision making eLearning package
• Seminal paper by Gabbay and Le May (and their updated book as reviewed by Trish Greenhalgh)
  Original BMJ paper from 2004 - Evidence based guidelines or collectively constructed “mindlines?” Ethnographic study of knowledge management in primary care
  Mindlines: making sense of evidence in practice, John Gabbay and Andrée le May, BJGP 2016
  Knowledge Transformation in Healthcare: Putting Mindlines to Work edited by John Gabbay and Andrée le May

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Hadeel Mohamed about a fantastic programme she co-leads to provide mentorship for female pharmacists from an ethnically diverse background – ENIGMA.

Hadeel is a senior pharmacist prescriber with a background in hospital and general practice. She is currently Deputy Head of Clinical Pharmacy and Education Lead for a GP Federation in Leeds and Polypharmacy Clinical Lead for Health Innovation Yorkshire & Humber. Hadeel is also in her final year of a PhD at The University of Bradford, which is exploring medication self-management behaviours in older people using multiple medicines at the hospital-to-home transition.

Jonathan and Hadeel first met via the Royal Pharmaceutical Society Mentorship scheme - https://www.rpharms.com/development/mentoring. Mentoring is important to both of them and they talk about Hadeel's inspiration to set up and lead (with fellow pharmacist Emily Turner) the ENIGMA programme. ENIGMA stands for ‘ENhancing leadershIp amonGst ethnically diverse feMale phArmacists’. 

In particular they discuss why such programmes are important to overcome some of the rather stark workforce figures (32% of the UK pharmacy workforce are women from an ethnically diverse background, yet only 6% of NHS Band 9 posts are made up of people) from this group). They discuss the initial success stories from this and how it is important that this work continues on a firm footing.

PrescQIPP resources mentioned in this episode:

• PrescQIPP Skills training: Mentoring
• PrescQIPP Leadership at Lunch webinars

Other resources mentioned in this episode:

• Royal Pharmaceutical Society Mentorship scheme
• ENIGMA programme
• Find out more and contact Hadeel or Emily on LinkedIn

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, introduces the first episode of a new series called 'Caring about medicines in Care Homes with Jonathan and Sundus'. 

We meet Sundus Jawad, who works for NHS Frimley, and has over 25 years' experience working closely with GP practices, care homes and other providers. 

In this episode, our hosts discuss some of issues she comes across commonly in her everyday work in care settings, which will be covered in more detail in future episodes. These include specific medicines safety challenges, common medication errors, the importance of nutrition and hydration as well as dealing with some of the behavioural aspects of dementia. The role of pharmacy professionals within the wider multidisciplinary team is at the heart of all of this and Sundus shares some memorable stories of people living in care settings she has met along the way.

PrescQIPP resources mentioned in this episode:

• PrescQIPP Care Homes webkit
• PrescQIPP Clinical Masterclass - September 2024 - Antipsychotic prescribing in people with dementia
• PrescQIPP Bulletin 268: IMPACT
• PrescQIPP Bulletin 356: Stopping over-medication of psychotropic drugs
• PrescQIPP Bulletin 331: Medication reviews in patients with multi-morbidity

Other resources mentioned in this episode:

• NICE Guideline on Managing medicines in care homes
• Care Quality Commission Medicines information for adult social care services
• Repeat Prescribing Toolkit
• National Polypharmacy Programme from Wessex Health Innovation Network
• Get details of upcoming ALS cohorts and book your place here.

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here

Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. Today, your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Philip Newland-Jones about new treatments for obesity and the updated NICE guideline from January 2025.

Philip is a Consultant Pharmacist in Diabetes and Endocrinology and leads a large dynamic team at University Hospital Southampton. He works at a National level on various committees including being the lead pharmacist for the NHS England Diabetes and Endocrinology Clinical Reference Group.

Jonathan and Philip discuss various challenging and sometimes controversial issues around the management of obesity. The evidence for the effectiveness of some of the medicines options is impressive, but they are not without side effects - careful and appropriate use is key. Many new medicines are in development and Philip gives us an insight into what we can expect on the horizon.

PrescQIPP resources mentioned in this episode:

• Bulletin 323: Bariatric surgery July 2023
• PrescQIPP Prescribing Mastery; Prescribing Hot topics 26th March 2025

Useful NICE obesity resources:

• Tirzepatide: local formulary information
• A practical guide to using medicines to manage overweight and obesity

Other resources mentioned in this episode:

• NHS England Interim commissioning guidance for
  tirzepatide (Mounjaro®)

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here