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Jan 21 โ€ข 6 tweets โ€ข 8 min read
THREAD: #ExercisePrescriptions

1/5 The TIโ€™s Dr. Josh Levin asks:

Clinicians, can you help your patients be more active? ๐Ÿƒ๐Ÿพโ€โ™€๏ธ๐ŸŠ๐Ÿพโ€โ™‚๏ธ ๐Ÿšถ๐Ÿพโ€โ™‚๏ธ

๐Ÿ‘‰๐ŸพWatch Dr. Levinโ€™s recent presentation: bit.ly/3nLCEje ๐Ÿ‘จ๐Ÿพโ€๐Ÿ’ป

#Exercise #prescribing #twitterRx
2/5 #ExercisePrescriptions: How much activity should people get? It depends on their age.

๐Ÿ‘‰๐ŸพSee the Canadian Society for Exercise Physiology activity guidelines for different age groups: csepguidelines.ca ๐ŸŠ๐Ÿพโ€โ™‚๏ธ๐Ÿƒ๐Ÿพโ€โ™€๏ธ๐Ÿšถ๐Ÿพ

#Exercise #prescribing #twitterRx #BetterHealth
3/5 Below is an example of an #ExercisePrescription ๐ŸŠ๐Ÿพโ€โ™‚๏ธ๐Ÿƒ๐Ÿพโ€โ™€๏ธ๐Ÿšถ๐Ÿพโ€โ™‚๏ธ

#Exercise #prescribing #twitterRx #BetterPrescribing
4/5 Joshโ€™s Top 10 list of #exercise resources

#ExercisePrescriptions #prescribing #twitterRx #BetterHealth
5/5 Tips and tricks for patients starting new #exercise habits ๐Ÿ•บ๐Ÿพ๐Ÿ“๐Ÿง˜๐Ÿพโ€โ™‚๏ธ

3 Step changing behaviour model from @bjfogg, other healthy activity tips from Dr. Josh Levin:

#ExercisePrescriptions #prescribing #twitterRx #BetterPrescribing
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More from @Drug_Evidence

Nov 27, 2021
THREAD: SGLT2 inhibitors for #diabetes

1/5 Dr. Jamie Falk @jamisonfalk presented "A Deep Dive into #SGLT2i: What Comes to the Surface for Individuals with Diabetes"

๐Ÿ‘‰๐ŸฝWatch the presentation here: bit.ly/3FRCEoM ๐Ÿง‘๐Ÿพโ€๐Ÿ’ป

#T2DM #medsafety #FOAMed #MedEd
2/5 #AdverseEffects for #SGLT2i to be aware of: genital infections, hypovolemia, DKA, amputations

โœ…Check out the image โฌ‡๏ธ for the risk estimates
โœ…Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM๐Ÿง‘๐Ÿพโ€๐Ÿ’ป

#T2DM #medsafety #FOAMed #MedEd #diabetes #ptsafety
3/5 Evidence to date for #SGLT2i:

The first of the two new classes of medications for type II diabetes to reduce โ†˜๏ธ risk of CV #AdverseEvents and mortality

โœ…Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM๐Ÿง‘๐Ÿพโ€๐Ÿ’ป

#T2DM #medsafety #FOAMed #MedEd #diabetes
Read 6 tweets
Nov 10, 2021
THREAD: Evidence for oseltamivir for #influenza prevention

1/6 Not much #flu last year, yet almost 14,000 BC residents were prescribed #oseltamivir (Tamiflu) for prevention

โœ…Flu guidelines bit.ly/3wwGJei

โœ…Systematic review of Tamiflu safety pubmed.ncbi.nlm.nih.gov/27246259
2/6 #Oseltamivir for prevention reduces โ†˜๏ธ symptomatic influenza by 3%, (NNT=33) with an uncertain effect on asymptomatic #influenza

It likely has a central symptom reducing effect but may not reduce viral transmission
pubmed.ncbi.nlm.nih.gov/27246259

#Tamiflu #prescribing
3/6 #Oseltamivir wonโ€™t reduce the risk of developing influenza-like illness though it can make people feel better (i.e. fewer symptoms) and reduces โ†˜๏ธ fever

There is not enough evidence to say it prevents death, hospitalizations, or flu complications
pubmed.ncbi.nlm.nih.gov/27246259
Read 7 tweets
Sep 19, 2021
THREAD: Medication adherence and shared decision-making

1/6 Our TI Letter 132 suggests a more democratic & ethical approach to shared decision-making: ti.ubc.ca/letter132

Here are 5โƒฃ highlightsโ€ฆ

#MedEd #FOAMed #MedicationAdherence #PatientPreferences
2/6 Patients always retain right to say โ€œno, thank youโ€๐Ÿ›‘

Some pts may not want to accept their doctor's recommendations for a prescribed ๐Ÿ’Š & have their own reasons to feel that it's not worth it for them.

This "intentional non-adherence" is a choice that should be respected
3/6 Studies have tested adherence aids

While these aids can improve adherence we donโ€™t know if they lead to improved health outcomes ๐Ÿ˜•

See our TI Letter 132 on medication adherence: ti.ubc.ca/letter132 ๐Ÿ’ป

#MedEd #FOAMed #MedicationAdherence #PatientPreferences
Read 7 tweets
Jul 12, 2021
THREAD: Shedding light on the risks of anticholinergic drugs

1/8 NEW information on risk of dementia and harm in the frail elderly. Free #BestEvidence webinar w/ Dr. Aaron Tejani @amtejani on July 14th

โœ…Registration: ti.ubc.ca/Anticholinergiโ€ฆ

#MedEd #deprescribing #medsafety
2/8 One of every 14 of the top 200 ๐Ÿ’Š prescribed in BC has anticholinergic properties

They include: amitriptyline, cyclobenzaprine, fluoxetine, quetiapine, sertraline, trazadone, venlafaxine, zopiclone, citalopram...

๐Ÿ‘‰๐ŸฝMore here ti.ubc.ca/2018/09/10/113โ€ฆ

#MedEd #deprescribing
3/8 What kinds of harms can #anticholingergics cause?
๐Ÿ‘‰๐ŸฝDry mouth ๐Ÿ˜ฆ

โ“Could your patient on an anticholinergic be experiencing bad breath/gum problems/tooth decay/trouble swallowing? ๐Ÿค”

More here: ti.ubc.ca/2018/09/10/113โ€ฆ

#MedEd #deprescribing
Read 9 tweets
Jun 30, 2021
THREAD:5โƒฃthings to know from 5 recent TI Therapeutics Letters๐Ÿ‘ฉ๐Ÿฝโ€๐Ÿ”ฌ

1/5: How to choose a good #mirtazapine dose? ๐Ÿค”

Mirtazapine has a dose response ๐Ÿ’Šfor harm but NOT for efficacy: harm โ†—๏ธ after 30mg/day but efficacy doesn't: bit.ly/361LU9E

#MedEd #deprescribing #ptsafety
2/5: Want to learn about recent @GovCanHealth #medsafety or international warnings for medications?

Read our Therapeutics Letter on international drug safety advisories: bit.ly/3wc0ar8 โš ๏ธ ๐Ÿ’Š

#drugsafety #SegPac #ptsafety
3/5: Do you like receiving feedback on your #prescribing?๐Ÿ‘ฉ๐Ÿฝโ€โš•๏ธ๐Ÿ’Š

Read about Personal Prescribing Portraits: bit.ly/3hkf8WO

#MedEd #deprescribing
Read 6 tweets
May 11, 2021
THREAD - What if we could track and record repeat Adverse Drug Events? ๐Ÿค” ๐Ÿ’Š

1/6: Register for our May 12 #BestEvidence webinar, as @corinne_hohl talks about Assessing the Impact of Information Continuity on Health Outcomes: bit.ly/3ap4FGO #MedEd
2/6: Why do Adverse Drug Events (ADEs) matter?

Each year in British Columbia, ADEs account for:
๐Ÿ‘‰240,000 emergency dept (ED) visits
๐Ÿ‘‰480,000 days in hospital
๐Ÿ‘‰approx. 1 in 9 adult ED visits

More here: bit.ly/2Q7UGi8
#drugsafety #ptsafety #MedEd
3/6: In Canada, adverse drug events ๐Ÿ’Š cause or contribute to almost 2โƒฃmillion emergency department visits annually ๐Ÿ˜ฏ ๐Ÿ†˜

See publication list here: actionade.org/referenced-artโ€ฆ

#MedEd #ptsafety #prescribing
Read 7 tweets

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