Welcome back to The Aural Apothecary! For our first episode we bring you an exciting new format, where we’ll be diving deeper into some of the recurring themes from our first six series. The Aural Apothecary Analyses!

In this episode, we focus on statins and the importance of shared decision making in healthcare. Inspired by a recent paper in the BMJ by Sam and Brian et al, we explore their argument that guidelines should move away from population-level risk thresholds and focus more on individualised risk and patient preferences.

But how does this work in practice? We’ll explore the challenges faced by busy healthcare professionals when trying to balance shared decision making with the realities of daily practice. And, perhaps most importantly, we’ll ask: do patients actually want shared decision making?

Dr Sam Finnikin is an academic GP with an interest in shared decision making. Brian Finney is an active patient representative.

Links to some of the articles discussed:
Statins, Risk and Personalised Care BMJ article https://www.bmj.com/content/384/bmj-2023-076774
Lipid Lowering to Prevent Cardiovascular Disease Clinician Decision Aid https://gpevidence.org/conditions/lipids/
PEER Simplified Cardiovascular Decision Aid from Canada https://decisionaid.ca/cvd/
Disutility of Statins: Patient-Accessible Tool for Shared Decision Making in Cardiovascular Primary Prevention https://www.ahajournals.org/doi/10.1161/circulationaha.113.007595  

As with all of our guests, Sam and Brian share with us their Memory Evoking Medicine, a career anthem and book that has influenced their careers or life. 

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?
publicId=KN6E3O

Our website is https://www.theauralapothecary.com/ 

To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from. 

Join us for the last episode of series six and a joyful exploration of the importance and reality of person centred care. 

For five years Tommy Whitelaw was a full-time carer for his late mother Joan who had Vascular Dementia. In 2011 he undertook a walk around Scotland’s towns and cities to collect hundreds of life stories and letters detailing the experiences of individuals who care for a loved one living with dementia. It was a journey that taught him the importance of gentle honesty, that Civility really does Saves Lives and that listening really is the best drug available. 

We find out how an intervention by his local community pharmacist ‘gave him his Mum back’.  We discuss the concept of ‘intelligent kindness’ and how the impact of being busy affects our ability to care. ‘When we are busy we do less of the beautiful stuff first…’

We delve deeper into the topic of Intelligent Kindness when we discus Effecting Change - Evidencing Culture Change in Compassionate Care https://www.alliance-scotland.org.uk/blog/news/effecting-change-evidencing-culture-change-on-person-centred-care/

Tommy highlights the importance of music for people with dementia (and those caring for them). Check out Playlist for Life, a music and dementia charity. The charity was founded in 2013 by writer and broadcaster Sally Magnusson after the death of her mother, Mamie, who had dementia. Their vision is simple: For everyone with dementia to have a unique, personalised playlist, and everyone who loves or cares for them to know how to use it. https://www.playlistforlife.org.uk/

As with all of our guests, Tommy shares with us a Memory Evoking Medicine, a career anthem and book that has influenced his career or life.

Tommy works for Person Centred Voices, an ALLIANCE project that works to promote person centred practices in public sector organisations in Scotland; that is, to advocate for personalisation, empowerment and shared decision making across all areas of care and support. He has also had a fantastic career on the road as a tour manager for many of the Worlds best known bands. This has inspired him to hold a bi-annual ‘Concert for Carer’s’. Find out more here; https://linktr.ee/personcentred

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! 

To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from. 

Pain in the eye? It is a red-flag all healthcare professionals are trained to be aware of. But when spotted, who deals with it? We are joined by Specialist Head and Neck Pharmacist Ann Marie Goacher. Ann Marie describes her journey from a local community pharmacist in Ireland to being the lead pharmacist for the head and neck directorate at University Hospitals Sussex. What does an ophthalmic and specialist uveitis pharmacist do?

We talk to Ann Marie about her passion for eye care, and the importance of getting back to basics with the simple act of administration. Glaucoma can be better managed simply by ‘knowing your drops’ yet it is a neglected area of care. We discuss how off-licence use of drugs for a common eye condition has saved the NHS millions and the controversies that surround this.

For our micro-discussion we look at The burden of acute eye conditions on different healthcare providers: a retrospective population-based study,  a paper that looks at the public awareness of community eyecare services in a world where the demand for acute eyecare exponentially outstrips capacity. https://bjgp.org/content/74/741/e264

Further information on the ‘Know your Drops’ campaign can be found on the website of Moorfields Eye Hospital https://www.moorfields.nhs.uk/for-patients/information-hub. 

Ann Marie was spotted as a guest for the podcast after having the misfortune to sit next to Jamie on a plane. The topic of the conversation was the book she was reading - which happened to be written by her Father. “Once there was a boy who survived” by Maurice Heffernan which tells the story his early days in an orphanage in Ireland to his tumultuous journey through foster care, institutionalisation, and forced labour https://www.amazon.co.uk/Once-There-was-Boy-Survived/dp/1915502667. 

The “statistics made simple and relevant” podcasts with James McCormack mentioned in the episode can be found here https://therapeuticseducation.org/podcast-episode-list/

As with all of our guests, Ann Marie shares with us a Memory Evoking Medicine, a career anthem and book that has influenced her career or life. 

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! 

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/. 

To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from. 

Do Doctors know best? How do you explain the risks and benefits of a medicine when you yourself don’t really know? We chat to Maricarmen Climént, Research and Editorial Officer at Sense about Science about risk communication and how we best help patients to make better choices in the face of uncertainty?

Maricarmen has a diverse background in science journalism and risk communication and holds a degree in Veterinary Medicine and an MSc in Science Communication. She also worked for four years at the Winton Centre for Risk and Evidence Communication at the University of Cambridge, which we discuss. Do clinicians, deep down, think they know best? How can you teach risk to those whose career is predicated on supposedly knowing everything? How do you explain complexity in a simple way when the reality is rarely simple?

Things are never certain and we discuss how clinicians can best navigate this difficult terrain and the importance of training in understanding and explaining risk. Dr Julian Treadwell’s research we mention - " GPs’ knowledge of the absolute benefits and harms of treatments is poor, with inaccuracies of a magnitude likely to meaningfully affect clinical decision-making and impede conversations with patients regarding treatment choices" https://bjgpopen.org/content/4/1/bjgpopen20X101016

In our micro-discussion we delve into the paper “Bad news: how the media reported on an observational study about cardiovascular outcomes of COVID-19”. Are the media deliberately biased - or just incompetent - in how they report on scientific research? And how much are the papers’ authors themselves to blame? https://ebm.bmj.com/content/early/2024/04/17/bmjebm-2023-112814. 

As with all of our guests, Maricarmen shares with us a Memory Evoking Medicine, a career anthem and book that has influenced her career or life.

Sense about Science: https://senseaboutscience.org/. 

Spurious Correlations: http://www.tylervigen.com/spurious-correlations. 

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! 

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/. 

To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from. 

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

We chat to Physiotherapist and Consultant Practitioner, Esther Clift about her pioneering role in the management of frailty. A varied career, where a passion for working with older people was ignited in Southampton, where she undertook an MSc in Gerontology. She currently leads an Acute Frailty Service on the Isle of Wight. 

What is frailty and how can the multi-disciplinary team support it? We chat to Esther about helping older people to live better lives, the risks of decompensation and the importance of goal-setting with patients. We hear how the Isle of Wight, as a ‘petri-dish’ of frailty is the ideal place to pioneer this new role.

We continue the theme of frailty in our micro-discussion when we review the document ‘Joining the Dots: A Blueprint for Preventing and Managing Frailty in Older People’ from the British Geriatrics Society Joining the Dots: A blueprint for preventing and managing frailty in older people | British Geriatrics Society (bgs.org.uk). Is what we need a national frailty service - or indeed, a National Care Service…?

Bonus Content! We chat to Esther about the challenges, benefits and controversies over advanced practitioner roles. https://www.theauralapothecary.com/p/bonus-material/.

Also, check out STC chat about his career and more medicines stories on the recent Pharmacist Diaries podcast.  https://www.pharmacistdiaries.com/podcast/140

As with all of our guests, Esther shares with us a Memory Evoking Medicine, a career anthem and book that has influenced her career or life.

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! 

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/. To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from. 

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

Did you know that according to the OECD, a fifth of healthcare costs adds no value to patient care? This, along with the drive for shared decision making is the drive behind Scotland’s ‘Realistic Medicine’ campaign. We chat to Dr Catherine Labinjoh, Consultant Cardiologist and National Clinical Advisor to the Realistic Medicine programme about the campaign.

One of the main aims of Realistic Medicine is for people using healthcare services and their families to feel empowered to discuss their treatment fully with healthcare professionals, including the possibility that a suggested treatment might come with side effects – or even negative outcomes. Everyone should feel able to ask their healthcare professional why they’ve suggested a test, treatment or procedure, and all decisions about a person’s care should be made jointly between the individual and their healthcare team. This is a theme we have covered often on the podcast and so we explore with Catherine what this means for how healthcare is being delivered in Scotland.

In our micro-discussion, we talk about a recent article in the New Statesman “I can’t find a diagnosis for Ted – but he can diagnose modern medicine”. Ted explains how ““Everything’s decided on thousands of people…. that can’t possibly tell you what to do for any individual.” https://www.newstatesman.com/politics/health/2024/03/i-cant-find-a-diagnosis-for-ted-but-he-can-diagnose-modern-medicine In tandem we discuss a recent BMJ Quality & Safety about the coordination of care for patients with heart failure.  https://qualitysafety.bmj.com/content/33/4/232?ijkey=d1d5807c3fd3a9dff0a2cb225570adea3a3bc139&keytype2=tf_ipsecsha In a truly memorable conversation, we also pick up on the role of a ‘single-organologist’ versus a generalist – “the patient is more than the organ of your choice…” We seek out that “elusive unicorn, the time rich specialist generalist!” 

As with all of our guests, Catherine shares with us a Memory Evoking Medicine, a career anthem and book that has influenced her life.

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! 

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/. 

To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from. 

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

It takes a special sort of person to work in paediatric care. We chat to Alison Tennant, Chief Pharmacist at Birmingham Women’s and Children’s NHS Trust about the risks and rewards of working with children and their medicines. Parents going home with bags of bottles, the difficulties of shared decision making and instead of DNA we have DNB - Did not Bring. A joyous and fascinating episode where we delve into the art and practice of prescribing in children.

In our micro discussion we discuss the excellent paper “Why learning how to swallow pills is good for patients, parents, and the planet” in which we learn about the importance of teaching children how to swallow tablets. Both as a lifeskill and as a measure to support sustainability. “If you can swallow Lego you can swallow a tablet!” https://www.bmj.com/content/384/bmj-2023-076257

Video: Kidzmedz Project: Teaching Children to Swallow Tablets: https://youtu.be/XwiuU-k2FIM?si=pXmEULvikHBA4Ftt
As with all of our guests, Alison shares with us a Memory Evoking Medicine, a career anthem and book that has influenced his life. Alison’s choice is as unique as you might expect!

Bonus Content! Pharmacogenomics in Children- Listen to Alison talk about her favourite subject regarding pharmacogenomics in mental health youngsters,  and how it helps the shared decision making process in deciding which medicines to use https://www.theauralapothecary.com/p/bonus-material/

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! 

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/. 

To get in touch follow us on Twitter and Instagram @auralapothecary or email us at [email protected] .

Don’t forget to rate us and comment wherever you have got this podcast from. 

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg 

You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

How do you influence the prescribing habits of an entire country? This is the task of NHS England’s National Clinical Director of Prescribing Professor Tony Avery. We chat to Tony about this new, groundbreaking leadership role and techniques used to influence and improve prescribing practice across a whole nation. In addition to this role Tony is a practising GP, a professor of primary health care at the University of Nottingham and an NIHR Senior Investigator.

In 2012, Tony and his team developed ‘Pharmacist-led Information Technology Intervention for Medication Errors’ — or PINCER — project, which was rolled out nationally to general practices in England to tackle hazardous prescribing from 2018.

In our micro-discussion, we talk about the recent Chief Medical Officer’s annual report 2023: health in an ageing society https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2023-health-in-an-ageing-society Professor Chris Whitty's report recommends actions to improve quality of life for older adults and prioritise areas with the fastest growth in older people. We discuss the concept of ‘Lifespan vs Healthspan’ and what that means for prescribing in an increasingly specialist medical model .

As with all of our guests, Tony shares with us a Memory Evoking Medicine, a career anthem and book that has influenced his life. Be prepared for an Aural Apothecary first as Tony surprises us with his choice of song…

Join us for our next live show in Bordeaux for the European Association of Hospital Pharmacists Congress! https://www.eahp.eu/congresses/programme

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think!

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/.

To get in touch follow us on Twitter @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from.

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg

You can view the Aural Apothecary Library here; https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

A lively chat as we are joined by sexual health pharmacist Sally Kneath. Sally busts the myths that often surround people living with HIV and details how it is managed today - perhaps not how you would imagine. We reflect on the impact of the stigma caused by the 80’s ‘Don’t die of ignorance’ campaigns that still exists today and how we need to move toward seeing HIV alongside any other chronic condition.

Sally has also been instrumental in developing and promoting the use of naloxone and its role in saving hundreds, if not thousands, of people at risk of overdose from opiates. Watch her talk about it here; https://www.youtube.com/watch?v=BaOUCo1M2mk

In our micro-discussion we discuss HIV Care among Elderly Patients https://link.springer.com/article/10.1007/s40266-022-01003-3

BONUS CONTENT: HIV Testing, PeP and PreP - Listen to Sally talk about the importance of HIV testing and reducing the stigma attached. Find out about HIV preventative drugs and prophylaxis.

As with all of our guests, Sally shares with us a Memory Evoking Medicine, a career anthem and book that has influenced her life. The drug may literally save your life!

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think!

Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/.

To get in touch follow us on Twitter @auralapothecary or email us at [email protected]. Don’t forget to rate us and comment wherever you have got this podcast from.

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg
You can view the Aural Apothecary Library here; https://litalist.com/shelf/view-bookcase?publicId=KN6E3O

We are joined by Professor Bapu Jena. Physician, economist, author of ‘Random Acts of Medicine’ and host of the superb ‘Freakonomics MD’ podcast, we explore with Bapu the concept of ‘natural experimentation’. How might a marathon be bad for your health? Why might you be safer not seeing a cardiologist after a heart attack? What is the impact of striking doctors on health outcomes?

Bapu is Professor of Health Care Policy at Harvard Medical School and a physician in the Department of Medicine at Massachusetts General Hospital and so we discuss health economics, and the differences between US and UK healthcare. We also see a new interview style from Jamie as he poses some of his most challenging questions yet…

As with all of our guests, Bapu shares with us a Memory Evoking Medicine, a career anthem and book that has influenced his life. Bapu’s book choice proves challenging!

Read about Bapu here https://hcp.hms.harvard.edu/people/anupam-b-jena. Also check out the superb Freakonomics MD podcast https://freakonomics.com/series/bapu/ - it is one of Steve’s favourites.

Our new website is now live https://www.theauralapothecary.com/ and as well as being a searchable database of all episodes, we will be uploading transcripts and extra content for your enjoyment and education. Have a look and let us know what you think! Our latest blog posts talks about our first live public show - ‘Music, Memories and Medicines’ - have a read here; https://www.theauralapothecary.com/blog/the-three-apothecaries-music-medicines-and-memories/

To get in touch follow us on Twitter @auralapothecary or email us at [email protected] . Don’t forget to rate us and comment wherever you have got this podcast from.

You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg

You can view the Aural Apothecary Library here; https://litalist.com/shelf/view-bookcase?publicId=KN6E3O