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The Snoring & Sleep Apnoea Forums

leng's dripple

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Re: leng's dripple

Post by leng » Fri Nov 27, 2009 4:14 pm

In a recent BMJ journal a professor admitted much prescribed medicine is not taken, knowing few patients adhere to "prescription" guidance. Stating “It is also clear that patient’s beliefs and attitudes influence how they take drugs.” This is particularly true for preventive medicine (thus largely for conditions without symptoms) and for drugs that have more side effects or other drawbacks, than we all may want to know. As interest in the concept of patient autonomy increases, we are becoming more aware, and more respectful, of intentional dissent—where better informed patients decline certain methods of treatments, describing the process whereby the patient and doctor rarely reach an agreement on how a therapy will be used, if at all.

Most people take their health for granted until they have a health problem, and then expect their doctor to fix it. Unfortunately this way of thinking about health doesn't work and probably more than many we with OSA are only all too well aware, society and its many expectations produces unhealthy people despite the increasing sums of money being spent on health care.

Big pharmaceutical companies have changed the way medicine is practiced. This began with the discovery and development of standardised synthetic medicines, which was an improvement over unstandardized and variable herbal products. Progress developed hand in hand with developments in the understanding of diseases themselves. We are now in a state where the financial power of pharmaceutical companies influences or dictates health care systems and policies,.as we have witnessed with swine flu, and the political lobbying to make a vaccine available for all, yet still unclear if it is totally reliable, or if the flu will change it’s identity once again. We think nothing of going down to the GP, or local high street pharmacy/health food shop, wanting a pill to do away with many of our health problems. Is that just another way of resolving ourselves of our own past irresponsibilities?

The National Health Service (NHS) began in 1948 Unfortunately the NHS has totally changed the concept of health in the UK. Most people totally rely on it for all their health needs, and don't take responsibility for their own health. Why should they? They have paid their taxes, and it's their right. Such a concept is thought not economically sustainable, also politically unfixable. We are often led to believe the private insurance based systems are better like USA where each individual is responsible for their own health cover. In the extreme form this means that if you can't afford health insurance, you don't get treated if you become ill. I infact have also witnessed the missfortunes of people being asked what level of insurance do you have, and applying a care package to suit your insurance plan.

Health inequalities are a big concern worldwide. People on low income often have worse health than those with more money. Efforts to improve the health of people on low income often have low success rates. Such people either use a greater amount of resource in an NHS type system, or risk being excluded from a US type system. Even when never given the truth between both systems.

Evidence based medicine is being promoted as the way to spend money wisely on health care. This is absolutely correct. However, there have been many investigations into how published medical research has been less than honest in the way that it is done and presented. Even the pharmaceutical research body themselves have admitted the financial power of pharmaceutical companies, with political lobbying and the lack of money for research on non-patentable therapies have all contributed to an over rigid evidence based health care system.

How do we talk to our GP’s ask outright for help? Give up to what they want to offer? Or try and have an informed discussion of ten from a person that tends to do his or her up most not to want to build a relationship with the patient. In an area of low prescribing and high expectations the decision to prescribe is often closely related to actual and perceived expectations, as discussed in the BMJ

Evidence that patients' expectations influence general practitioners' prescribing is equivocal; in this study patients' hopes of receiving a prescription exceeded both doctors' perceptions and the level of prescribing
Over a quarter of patients who hoped for a prescription did not receive one
In a fifth of consultations in which a prescription was written, the prescription was not strictly indicated on purely medical grounds
Doctors' perceptions were the strongest determinant of the decision to prescribe
Doctors who felt pressurised were less likely to write a prescription if they perceived that the patient wanted one, and if they did write a prescription, it was less likely to be indicated than when the doctor did not feel pressurised

Sergeant Snorer
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Re: leng's dripple

Post by DeenJai » Wed Feb 05, 2014 1:31 pm

I agree that people need to be more involved about our own health especially if you have a long term condition as you need to take control. When I go to see my GP I take a list of questions that I want to ask him. I have many long term health conditions so I have come an expert in each condition so that I can educate my GP as s/he cant be an expert in everything.

Until everyone that control of their own health then the NHS will struggle. I have made a health book which would go to hospital with me so they know all the details of problems, allergies and a few other problems.

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