A new report in the Lancet from the Oxford Clinical Trials Unit provides an update on potential risks from newer and traditional painkillers of the non-steroidal anti-inflammatory drug type. The report analysed results of a large number of clinical trials comparing these painkillers against placebo or against a comparator different painkiller. Studies were largely of high doses of the drugs, prescribed for relatively short duration - on average for under a year.
Below is a summary of my comments on the Lancet article provided to the Science Media Centre.
"In this pooled assessment (meta-analysis) of a large number of clinical trials against placebo or other pain-killer options, the Oxford Clinical Trials Service Unit confirm previous reports that the newer pain-killer drugs – coxibs - are associated with a clinically important increase in risk of coronary disease.
"Their major new finding is that among traditional non-steroidal anti-inflammatory painkiller drugs [tNSAIDs] – diclofenac, and possibly ibuprofen, but not naproxen appear associated with a similar increase fatal and non-fatal coronary heart events to the coxibs. However all naproxen, like all coxibs and tNSAIDs they studied, was associated with increased risk of heart failure and gastro-intestinal complications such as bleeding.
"The type of vascular risk with these painkillers appeared selective as none of these treatments were associated with an increase in stroke risk.
“Cautions include that we are not told about details of adjustments across treatment groups for degree of different cardiovascular risk factors e.g. from smoking as a source of bias. And the authors themselves acknowledge that their findings are largely for high dose tNSAIDs and for treatment on average for under a year. They note that they therefore cannot be sure whether the reported coronary and other risks would persist in patients on longer term treatment or on lower doses of these medicines.
“The paper underscores a key point for patients and prescribers: powerful drugs may have serious harmful effects. It is therefore important to be cautious when considering use of these medicines and to take into account cardiovascular risk, and risk of stomach or intestinal adverse effects, when tNSAIDs are prescribed or obtained over the counter, and when coxibs are considered.”
Many patients taking these tablets rely on them for relief of symptoms from arthritis and other long-term painful conditions. Patients who are concerned should consult their medical or pharmacist adviser.
See also articles by reporters on BBC Health, Reuters, Agence France Presse, CBS News ...
Friday, 31 May 2013
Sunday, 19 May 2013
Winners of the Open, NHS and Young Poets 2013 Hippocrates Prize for Poetry and Medicine
The winners were announced by the judges at an International Symposium on Poetry and Medicine at the Wellcome Rooms in London on Saturday 18th May.
More on the 2013 Hippocrates Awards:
Harvard poet and physician Rafael Campo wins Hippocrates Open International Prize for Poetry and Medicine
Psychotherapist Mary V Williams wins Hippocrates NHS Prize for Poetry and Medicine
English poet Rosalind Jana awarded international Hippocrates Young Poets Prize for Poetry and Medicine
Rafael Campo discusses poetry, medicine and his Hippocrates Open Award winning poem
Rosalind Jana talking about her Hippocrates Young Poets Award.
The judges also agreed 18 commendations in the NHS category - one each from Scotland and Wales, and 16 from England; and 20 in the Open International category – one each from Ireland, Scotland and Israel, seven from the USA and 10 from England, from the Isle of Wight to Yorkshire.
Open Awards
The £5000 open international Hippocrates first prize has been awarded to Harvard poet and physician
Rafael Campo. The second prize was shared by UK poet Matthew Barton, US Afghan war veteran Liam Corley from California and New Zealand poet Sue Wootton.
Rafael Campo said “I am delighted to receive this prestigious international prize. Through my poem – about a dying patient – I was able to address the power of empathy to combat the distance we almost reflexively adopt toward our patients and confront our own shortcomings”.
NHS Awards
The £5000 Hippocrates NHS first prize went to poet and novelist Mary V Williams from Shropshire,
who trained in psychotherapy.
The second prize went to former nurse Ann Elisabeth Gray who runs a care home Cornwall and the third prize was shared by family doctor Ann Lilian Jay from LLandysul in Wales, hospital chaplain Ian McDowell from London, and senior lecturer in midwifery Bella Madden from Milton Keynes.
Mary Williams said “My poem ‘Downs’ was inspired by my working in a pre-school nursery for special needs children, by their need for love and acceptance, and their ability to give back so much in return”.
The Hippocrates Prize is one of the most valuable poetry prizes in the world, with a yearly purse of £15000.
Young Poets Award
English poet Rosalind Jana has been awarded the inaugural international Hippocrates Young Poets
£500 Prize. 17 year old Rosalind Jana is from Hereford Sixth Form College in England. The award was presented at the Hippocrates Awards ceremony at the Wellcome Trust in London on Saturday 18th May.
The international Hippocrates Prize for Young Poets is for an unpublished poem in English on a medical theme. Entries were invited from young poets anywhere in the world aged 14 to 18 years. The 2013 Prize attracted entries from young poets from the UK, USA and Australia.
The winning entry was decided by judge and award-winning poet Clare Pollard who also commended US poet Talin Tahajian from Belmont in Massachusetts.
Notes to editors
For more information about Hippocrates Prize winners and extracts of their winning poems, contact hippocrates.poetry@gmail.com
Hippocrates Prize website
More on the 2013 Hippocrates Awards:
Harvard poet and physician Rafael Campo wins Hippocrates Open International Prize for Poetry and Medicine
Psychotherapist Mary V Williams wins Hippocrates NHS Prize for Poetry and Medicine
English poet Rosalind Jana awarded international Hippocrates Young Poets Prize for Poetry and Medicine
Rafael Campo discusses poetry, medicine and his Hippocrates Open Award winning poem
Rosalind Jana talking about her Hippocrates Young Poets Award.
The judges also agreed 18 commendations in the NHS category - one each from Scotland and Wales, and 16 from England; and 20 in the Open International category – one each from Ireland, Scotland and Israel, seven from the USA and 10 from England, from the Isle of Wight to Yorkshire.
Open Awards
The £5000 open international Hippocrates first prize has been awarded to Harvard poet and physician
 |
| Rafael Campo |
Rafael Campo said “I am delighted to receive this prestigious international prize. Through my poem – about a dying patient – I was able to address the power of empathy to combat the distance we almost reflexively adopt toward our patients and confront our own shortcomings”.
NHS Awards
The £5000 Hippocrates NHS first prize went to poet and novelist Mary V Williams from Shropshire,
 |
| Mary V Williams |
The second prize went to former nurse Ann Elisabeth Gray who runs a care home Cornwall and the third prize was shared by family doctor Ann Lilian Jay from LLandysul in Wales, hospital chaplain Ian McDowell from London, and senior lecturer in midwifery Bella Madden from Milton Keynes.
Mary Williams said “My poem ‘Downs’ was inspired by my working in a pre-school nursery for special needs children, by their need for love and acceptance, and their ability to give back so much in return”.
The Hippocrates Prize is one of the most valuable poetry prizes in the world, with a yearly purse of £15000.
Young Poets Award
 |
| Rosalind Jana |
£500 Prize. 17 year old Rosalind Jana is from Hereford Sixth Form College in England. The award was presented at the Hippocrates Awards ceremony at the Wellcome Trust in London on Saturday 18th May.
The international Hippocrates Prize for Young Poets is for an unpublished poem in English on a medical theme. Entries were invited from young poets anywhere in the world aged 14 to 18 years. The 2013 Prize attracted entries from young poets from the UK, USA and Australia.
The winning entry was decided by judge and award-winning poet Clare Pollard who also commended US poet Talin Tahajian from Belmont in Massachusetts.
Notes to editors
For more information about Hippocrates Prize winners and extracts of their winning poems, contact hippocrates.poetry@gmail.com
Hippocrates Prize website
Saturday, 4 May 2013
EACPT Awards to be presented at August Geneva Congress
The EACPT has announced its awards for 2013, to be presented at the 11th EACPT Congress in Geneva 28th - 31st August 2013.
The Special Award for services to the EACPT goes to Professor Michael Orme, who co-founded the EACPT 20 years ago in 1993. Professor was EACPT founding secretary then Chairman and played a major role in growing EACPT into a major international organisation representing all clinical pharmacology societies in Europe and their over 4000 clinical pharmacologist members.
The paper, for which Dr Devos was corresponding author, was published in the July 2012 issue of
the high impact international journal - Lancet Neurology. The prize includes a 2000 € award.
the high impact international journal - Lancet Neurology. The prize includes a 2000 € award.
The 2013 Lifetime Achievement Award of the European Association of Clinical Pharmacology and Therapeutics goes jointly to Professor Sir Michael Rawlins and to Professor Carlo Patrono, for their outstanding contributions to the national and international benefits of clinical pharmacology for medicine, health care and patient safety.
EACPT website.
Official EACPT journal - Clinical Therapeutics.
EACPT website.
Official EACPT journal - Clinical Therapeutics.
Saturday, 27 April 2013
Young poet to receive new Hippocrates Prize for Poetry and Medicine
The winner of the
inaugural Hippocrates Young Poets Prize of £500 is Rosalind Jana from
Hereford Sixth Form College in England, for her poem ‘Posterior Instrumented
Fusion for Adolescent Scoliosis’.
The international Hippocrates Prize for Young Poets is for an unpublished poem in English on a medical theme. Entrants were young poets from anywhere in the world aged 14 to 18 years. The 2013 Prize attracted entries from the UK, USA and Australia.
Hippocrates Prize founders clinical professor Donald Singer and poet Michael Hulse said: “We are delighted that the Hippocrates Prize for Young Poets is already having an international impact in inspiring a new generation of poets.”
The Hippocrates Initiative – winner of the 2011 Times Higher Education Award for
Innovation and Excellence
in the Arts – is an interdisciplinary venture that investigates the synergy
between medicine, the arts, and health.
To attend the Young Poets, NHS and Open Hippocrates Prize award ceremony in London on 18th May at the Wellcome Collection and the related Symposium on Poetry and Medicine see http://hippocrates-poetry.org
Notes for editors
For more information about Hippocrates Prize winners and extracts of their winning poems, contact hippocrates.poetry@gmail.com
About the winner
Rosalind Jana is a sixth form student and part-time freelance journalist. She won the Vogue Talent Contest for young writers in 2011 at age sixteen and has subsequently written for Vogue several times. She regularly contributes to Lionheart Magazine, Oxfam and fashion initiative All Walks Beyond the Catwalk. She has a conditional offer to read English Literature at Oxford. Further information can be found at clothescamerasandcoffee.blogspot.com
About her winning poem Rosalind said: 'At the age of fifteen I underwent an operation to fix my extraordinarily twisted spine. I had been diagnosed with scoliosis six months previously when my degree of curvature stood at 56 degrees. By the time I was offered surgery this had progressed to nearly 80 degrees. My backbone had compressed into the shape of a lopsided 'S', my right shoulder blade sticking out like a small wing and rib-cage barrelled to the left. I wheezed when I walked. Sharp aches and jabs of pain were expected. The surgical solution was to cut into my back, place titanium rods on either side of the vertebrae and screw them in place. This would manually straighten my spine and it would fuse solid over the next few months."
"Recovery was physically, emotionally and psychologically challenging. All that remains now is my scar. I am fascinated with its visual resonance, the way in which those complicated months full of agony and debilitation could have been reduced to a single, fading line of flesh. The poem was an attempt to express the strange disconnect between the skin I can see, and the muscle and bone lying beneath that my surgeon and his assistants worked with for five hours. I wanted to show how extraordinary a process it is and how intricate, messy and beautiful the body can be."
About judge Clare Pollard
Clare Pollard has published four collections of poetry, the most recent of which, Changeling (Bloodaxe, 2011), was a Poetry Book Society Recommendation. She published her first collection, The Heavy-Petting Zoo, with Bloodaxe in 1998 aged 19. Her play The Weather premiered at the Royal Court Theatre and her documentary for radio, ‘My Male Muse’, was a Radio 4 Pick of the year. She co-edited the anthology Voice Recognition: 21 Poets for the 21st Century and her new collection, Ovid’s Heroines, will be published by Bloodaxe this year.
 |
| Winner Rosalind Jana |
The international Hippocrates Prize for Young Poets is for an unpublished poem in English on a medical theme. Entrants were young poets from anywhere in the world aged 14 to 18 years. The 2013 Prize attracted entries from the UK, USA and Australia.
The winning entry was
decided by judge and award-winning poet Clare Pollard, who published her first
collection of poetry at the age of 19.
Rosalind Jana is a sixth form student and part-time freelance journalist. She won the Vogue Talent Contest for young writers in 2011 at age sixteen and has subsequently written for Vogue several times. She regularly contributes to Lionheart Magazine, Oxfam and fashion initiative All Walks Beyond the Catwalk. She has a conditional offer to read English Literature at Oxford.
Rosalind Jana is a sixth form student and part-time freelance journalist. She won the Vogue Talent Contest for young writers in 2011 at age sixteen and has subsequently written for Vogue several times. She regularly contributes to Lionheart Magazine, Oxfam and fashion initiative All Walks Beyond the Catwalk. She has a conditional offer to read English Literature at Oxford.
About the Hippocrates
Young Poets Prize she said: “I'm very pleased to be judging the first
Hippocrates Prize for Schools - in bringing science and art together, I
hope it will deepen students’ understanding of both, and
uncover poets of the future.” She added that the top entries were “extraordinarily
accomplished for writers of 18 or under”.
Of Rosalind Jana’s winning poem she
commented: “It is hard to believe that a
poem with
such an ugly name can be so beautiful, but it is an incredible
display of control and craft, formally brilliant and full of striking visual
imagery - the shuttered murk, the meaty spine, the cloak of skin, the ‘morphine
black blown out by light’. It is both passionate and eerily detached - a
deeply impressive piece of work.”
 |
| Judge Clare Pollard |
Hippocrates Prize founders clinical professor Donald Singer and poet Michael Hulse said: “We are delighted that the Hippocrates Prize for Young Poets is already having an international impact in inspiring a new generation of poets.”
The Hippocrates
Prize for Young Poets is supported by the Fellowship of Postgraduate
Medicine, the National Association of Writers in Education, and the Cardiovascular
Research Trust.
The Hippocrates Initiative – winner of the 2011 Times Higher Education Award for
To attend the Young Poets, NHS and Open Hippocrates Prize award ceremony in London on 18th May at the Wellcome Collection and the related Symposium on Poetry and Medicine see http://hippocrates-poetry.org
Notes for editors
For more information about Hippocrates Prize winners and extracts of their winning poems, contact hippocrates.poetry@gmail.com
About the winner
Rosalind Jana is a sixth form student and part-time freelance journalist. She won the Vogue Talent Contest for young writers in 2011 at age sixteen and has subsequently written for Vogue several times. She regularly contributes to Lionheart Magazine, Oxfam and fashion initiative All Walks Beyond the Catwalk. She has a conditional offer to read English Literature at Oxford. Further information can be found at clothescamerasandcoffee.blogspot.com
About her winning poem Rosalind said: 'At the age of fifteen I underwent an operation to fix my extraordinarily twisted spine. I had been diagnosed with scoliosis six months previously when my degree of curvature stood at 56 degrees. By the time I was offered surgery this had progressed to nearly 80 degrees. My backbone had compressed into the shape of a lopsided 'S', my right shoulder blade sticking out like a small wing and rib-cage barrelled to the left. I wheezed when I walked. Sharp aches and jabs of pain were expected. The surgical solution was to cut into my back, place titanium rods on either side of the vertebrae and screw them in place. This would manually straighten my spine and it would fuse solid over the next few months."
"Recovery was physically, emotionally and psychologically challenging. All that remains now is my scar. I am fascinated with its visual resonance, the way in which those complicated months full of agony and debilitation could have been reduced to a single, fading line of flesh. The poem was an attempt to express the strange disconnect between the skin I can see, and the muscle and bone lying beneath that my surgeon and his assistants worked with for five hours. I wanted to show how extraordinary a process it is and how intricate, messy and beautiful the body can be."
About judge Clare Pollard
Clare Pollard has published four collections of poetry, the most recent of which, Changeling (Bloodaxe, 2011), was a Poetry Book Society Recommendation. She published her first collection, The Heavy-Petting Zoo, with Bloodaxe in 1998 aged 19. Her play The Weather premiered at the Royal Court Theatre and her documentary for radio, ‘My Male Muse’, was a Radio 4 Pick of the year. She co-edited the anthology Voice Recognition: 21 Poets for the 21st Century and her new collection, Ovid’s Heroines, will be published by Bloodaxe this year.
More about the
Hippocrates Initiative
The Hippocrates initiative was established in 2009 and already offers two successful annual poetry prizes, one open to submissions from anyone anywhere in the world, the other restricted to NHS employees (present and past) and UK health students. In each category a first prize of £5,000 is awarded. The Hippocrates Prize has attracted thousands of entries from 55 countries, from the Americas to Fiji, from Finland to Australasia, and prizewinners have come from New Zealand and the US as well as the UK.
The Hippocrates initiative was established in 2009 and already offers two successful annual poetry prizes, one open to submissions from anyone anywhere in the world, the other restricted to NHS employees (present and past) and UK health students. In each category a first prize of £5,000 is awarded. The Hippocrates Prize has attracted thousands of entries from 55 countries, from the Americas to Fiji, from Finland to Australasia, and prizewinners have come from New Zealand and the US as well as the UK.
Sunday, 21 April 2013
Update from Paris on Geneva EACPT Congress 28-31 Aug 2013
The
EACPT Executive Committee met in Paris 18th-20th April with as major business planning for the 11th biennial EACPT congress to be held from 28th – 31st
August 2013 in Geneva.
EACPT biennial congresses provide excellent opportunities to showcase
issues of topical international concern to the CPT community.
 |
| EACPT Executive Committee at the Hôpital St Antoine in Paris |
Key themes at the Geneva congress
will range from bedside
pharmacology for special patient groups to pharmacology & toxicology, and
pharmacology and society.
To register for the Geneva EACPT Congress, go to the Congress website.
Sunday, 14 April 2013
2013 Hippocrates Poetry & Medicine Awards Symposium
A great opportunity to spend a day with an international speaker panel discussing the interface between poetry and medicine, at
the Wellcome Rooms in London on Saturday 18th May.
Of interest to poets, patients, health professionals, academics and members of the public.
At the end of the symposium, Open and NHS awards for the 2013 Hippocrates Prize for Poetry & Medicine will be announced by the judges at this 4th International Symposium on Poetry and Medicine.
Register for the whole day or for the afternoon Hippocrates Awards Symposium
Symposium Programme
With a £5000 first prize in each category, this is one of the highest value awards in the world for a single unpublished poem.
More on the awards
The judging panel for the 2013 Hippocrates Prize comprises: Jo Shapcott, winner of the 2011 Queen's
Gold Medal for Poetry, Theodore Dalrymple, doctor and writer, and Roger Highfield, science writer and Executive for the Science Museums Group.
The 2013 judges met in London on 25th March at the offices of the Fellowship of Postgraduate Medicine to agree short-lists for the NHS and Open categories for the 2013 Hippocrates Prize for Poetry and Medicine.
NHS awards
Five poets have been short-listed for the 2013 NHS awards. For all 5 poets, it is their first time to feature within the Hippocrates Awards.
The judges have agreed a further 18 commendations. 12 are new to the Hippocrates Prize. Three have previously won top 3 awards in the Hippocrates Prize and a further 2 have previously been commended by Hippocrates Prize judges. One of this year's featured poets has been commended for 2 of her entries.
Open awards
Four poets have been short-listed for the 2013 awards, 1 from New Zealand, 1 from the UK, and 2 from the USA - one from California and 1 from Massachusetts. For all 4 poets, this is their first time to feature within the Hippocrates Awards.
The judges have agreed a further 19 commendations in the Open category.
Judging for the Hippocrates Prize is anonymous and entries are also presented to the judges in an order that avoids clustering of names of poets.
The 2013 Hippocrates Anthology of the 47 winning and commended poems will be launched after the Awards Symposium at the Wellcome Rooms in London on Saturday 18th May.
Of interest to poets, patients, health professionals, academics and members of the public.
At the end of the symposium, Open and NHS awards for the 2013 Hippocrates Prize for Poetry & Medicine will be announced by the judges at this 4th International Symposium on Poetry and Medicine.
Register for the whole day or for the afternoon Hippocrates Awards Symposium
Symposium Programme
With a £5000 first prize in each category, this is one of the highest value awards in the world for a single unpublished poem.
More on the awards
The judging panel for the 2013 Hippocrates Prize comprises: Jo Shapcott, winner of the 2011 Queen's
The 2013 judges met in London on 25th March at the offices of the Fellowship of Postgraduate Medicine to agree short-lists for the NHS and Open categories for the 2013 Hippocrates Prize for Poetry and Medicine.
NHS awards
Five poets have been short-listed for the 2013 NHS awards. For all 5 poets, it is their first time to feature within the Hippocrates Awards.
The judges have agreed a further 18 commendations. 12 are new to the Hippocrates Prize. Three have previously won top 3 awards in the Hippocrates Prize and a further 2 have previously been commended by Hippocrates Prize judges. One of this year's featured poets has been commended for 2 of her entries.
Open awards
Four poets have been short-listed for the 2013 awards, 1 from New Zealand, 1 from the UK, and 2 from the USA - one from California and 1 from Massachusetts. For all 4 poets, this is their first time to feature within the Hippocrates Awards.
The judges have agreed a further 19 commendations in the Open category.
Judging for the Hippocrates Prize is anonymous and entries are also presented to the judges in an order that avoids clustering of names of poets.
The 2013 Hippocrates Anthology of the 47 winning and commended poems will be launched after the Awards Symposium at the Wellcome Rooms in London on Saturday 18th May.
Saturday, 13 April 2013
BMS Young Investigators' Symposium: Advances in the Microcirculation
An excellent scientific event held at the University of Warwick, with international participants from Russia, Italy, Poland and Germany.
An outstanding series of young scientists presented undergraduate projects, PhD research and post-doctoral studies, topics ranging from fundamental endothelial signalling to cancer, retinal, cardiovascular and stroke mechanisms, biomarkers and treatments.
The organisers are to be congratulated on a well-run, well-chaired and lively event, fully justifying its generous support by major UK cognate societies and organisations, including the British Pharmacological Society, the Physiology Society, the Company of Biologists, The Richard Bright VEGF Research Trust, and the British Heart Foundation, complementing core support by the British Microcirculation Society, and making the event affordable for young life scientists interested in the microcirculation, including support in the form of travel bursaries for abstract presenters.
Future BMS Young Investigators' Symposia deserve to be a priority in the meetings' diary for young UK and international scientists interested in the microcirculation and in a friendly forum for first presentations, asking a first question of colleagues and more senior presenters, and making research contacts for their future careers: next provisionally set for 2 years time.
Look out for BMS events at the International Union of Physiological Societies Congress in Birmingham 21-26 July 2013 and the joint BMS-BPS symposium on new pharmacological targets in the microcirculation at Pharmacology 2013 in December in London.
See more at BMS Young Investigators blog.
An outstanding series of young scientists presented undergraduate projects, PhD research and post-doctoral studies, topics ranging from fundamental endothelial signalling to cancer, retinal, cardiovascular and stroke mechanisms, biomarkers and treatments.The organisers are to be congratulated on a well-run, well-chaired and lively event, fully justifying its generous support by major UK cognate societies and organisations, including the British Pharmacological Society, the Physiology Society, the Company of Biologists, The Richard Bright VEGF Research Trust, and the British Heart Foundation, complementing core support by the British Microcirculation Society, and making the event affordable for young life scientists interested in the microcirculation, including support in the form of travel bursaries for abstract presenters.
Future BMS Young Investigators' Symposia deserve to be a priority in the meetings' diary for young UK and international scientists interested in the microcirculation and in a friendly forum for first presentations, asking a first question of colleagues and more senior presenters, and making research contacts for their future careers: next provisionally set for 2 years time.
Look out for BMS events at the International Union of Physiological Societies Congress in Birmingham 21-26 July 2013 and the joint BMS-BPS symposium on new pharmacological targets in the microcirculation at Pharmacology 2013 in December in London.
See more at BMS Young Investigators blog.
Monday, 25 March 2013
Another view of Side Effects - a cautionary tale from Soderbergh
@HealthMed
Below are extended comments arising from a Guardian interview by Laura Barnett in the Another View series.
Below are extended comments arising from a Guardian interview by Laura Barnett in the Another View series.
I went to see the Soderbergh film Side
Effects expecting a story about drugs and serious side-effects: a version
of the Constant
Gardner translated from Africa to New York.
Instead I was completely absorbed in a much more complex thriller set
within the overlapping worlds of big Pharma, psychiatry, US private medicine,
and financial fraud.
The title is very clever, hinting
not only at side effects of drugs, but also side effects of lax medical and
financial regulation, of a private medical system, of love of money, and of
one-to-one interactions of doctor with patient.
A key message of the film: public and
professionals should keep an open mind on cause, consequence or incidental link
between drugs and side effects.
Jude Law portrays his character Dr
Jonathan Banks as flawed but well-meaning and a very astute medical detective
when challenged and able to see beyond the US psychiatric culture he is shown
as having accepted after training in the UK. When pressed on why has moved to
work in the US, he talks about the US as taking a more positive view of health
care than the UK, commenting on a greater optimism among US physicians that
patients will return to health, rather than his view of the UK where he says
clinicians are resigned to illness as the model.
This appears simplistic as Banks
also appears drawn by the prospect of greater financial gain within the US
private system. He is likely to have moved from a UK NHS, with in the main more
severely ill patients referred to him by family doctors, within the UK
treatment for all model, in contrast to the US where many of his private
outpatients would be likely to be direct self referrals with many nearer the
healthy end of the mental health spectrum (ie without GP screening of whom to
refer). And in the US having chronic severe disease may lead to patients being
no longer able to afford to be seen privately.
This thriller uses a smokescreen of casual interactions among psychiatrists and drug researchers in Pharma, serious risk of powerful drugs, especially in vulnerable patient groups (specifically young people with depression), the judgement of patients and prescribers such as Jude Law’s Dr Jonathan Banks being clouded by financial conflicts in the dominantly private US health system, compounded by direct-to-patient advertising, and the impact of peers on preference for medicines. Both peers as friends of a patient, and advice with little supporting evidence from professional peers such as Catherine Zeta-Jones’s ‘opinion leader’ Dr Victoria Siebert during her contact with Law’s Dr Banks at an educational meeting.
This thriller uses a smokescreen of casual interactions among psychiatrists and drug researchers in Pharma, serious risk of powerful drugs, especially in vulnerable patient groups (specifically young people with depression), the judgement of patients and prescribers such as Jude Law’s Dr Jonathan Banks being clouded by financial conflicts in the dominantly private US health system, compounded by direct-to-patient advertising, and the impact of peers on preference for medicines. Both peers as friends of a patient, and advice with little supporting evidence from professional peers such as Catherine Zeta-Jones’s ‘opinion leader’ Dr Victoria Siebert during her contact with Law’s Dr Banks at an educational meeting.
Worth noting that Law’s Dr Banks
starts by using an older established treatment for depression with an SSRI
(thought to help depression by raising the level of the brain transmitter
serotonin at nerve endings). It is only when this appears to be causing
unacceptable side effects that he takes advice from Siebert and uses a very new
drug - ablixa.
There are several potential risks of private
medicine portrayed in the film:
- Rooney
Mara’s Emily threatens to move to another doctor if Jude Law’s Dr Banks does not
agree with her treatment preference, a move that would result in loss of income
for Banks.
- A
patient’s ‘informed’ consent to take part in a study being run by Law’s Dr
Banks (for a personal fee) is biased by being told by Dr Banks that she won’t
have to pay for drugs (much more expensive in US) – or tell her health
insurance company (with the risk that she would have her premium increased),
although Banks does mention his conflict of interest in telling the patient
that he is receiving money for carrying out the trial;
- doctor
colleagues ostracize Banks because of concerns about losing business ie
patients.
The film raises concerns about US pharma industry
strategy to promote selling of drugs, flawed ethics from industry and
clinicians in engaging in research ‘studies’ and questions about safeguards in
place, especially for new medicines and for people at high risk of side
effects, but also at high risks of complications if their disease is not
treated.
Side effects can be good or bad – e.g. unexpected
and surprising benefit of sildenafil (Viagra) when trialed for angina – or in
this film the apparent increase in sex drive associated with a drug prescribed
by Jude Law’s character. We see good practice with a dispensing pharmacist
listing side effects for Rooney Mara’s Emily – including some unpleasant,
others beneficial [although a list spoken too rapidly for a depressed patient
to follow].
A better term for harmful effects of drugs is adverse
drug reactions (ADRs). These are common and may be serious – estimated in the
UK to be a major cause of ~10% of hospital emergency medical admissions or
delayed discharges from hospital. The thalidomide scandal led since 1964 in the
UK to a yellow card reporting system, with everyone, including patients now
empowered to report suspected concerns.
The UK has the advantage of
stronger efforts to regulate cost-effectiveness and safety of medicines than
shown in the film – joint efforts of:
-
National Institute for Health and Clinical
Excellence (NICE) (since 1997; and other agencies
in Scotland and Wales);
-
MHRA monitoring system, its
suspected adverse drug effect reporting Yellow Card scheme in place since 1964;
-
direct marketing to the public of
prescription only medicines being illegal in UK.
-
and in prospect aims from 2015-2016
for a public database of payments from Pharma to health professionals – which would
help to reveal conflicts of interest in prescribing, research
and medical education
In UK, a new drug such as the ‘ablixa’ in the
film would at least during the 2 years after launch have had a ‘black
triangle’ warning to prescribers to report any concerns about major or
apparently minor adverse drug reactions to the government’s Medicines Agency.
Useful weblinks
Medicines and Healthcare Regulatory Agency Patients
concerned about possible drug-related unwanted side effects from psychiatric or
other drugs should talk to their doctor or pharmacist. Members of the public
can also use the online Yellow Card system to report directly to the
government Medicines Agency any serious or worrying problem suspected to be due
to a medicine, whether or not mentioned on a patient information leaflet about
a drug.
UK All
Trials initiative – recommends that all trials
should be registered, and full methods and all results reported.
Where science collides with life: short-list for the 2013 Hippocrates Prize
 |
Judges Dalrymple, Shapcott and Highfield at short-listing |
Now in its fourth year, the short-listed entries for the 2013 Hippocrates Prize for Poetry and Medicine have been selected from over 1000 entries from 32 countries by judges distinguished poet Jo Shapcott, psychiatrist and medical writer Dr Theodore Dalrymple, and Roger Highfield, science writer and Director of External Affairs at the Science Museum Group .
Short-listed poets in the Open Category are American Literature expert Liam Corley from California, Harvard Physician and poet Rafael Campo, from Massachusetts, published poet Matthew Barton from Bristol, in England, and poet, writer and former physiotherapist Sue Wootton from Dunedin in New Zealand.
And competing for the UK NHS 2013 Hippocrates £5000 first prize are family doctor Ann Lilian Jay from LLandysul in Wales, former nurse Ann Elisabeth Gray who runs a care home for dementia in Cornwall, poet and novelist Mary V Williams from Shropshire, hospital chaplain Ian McDowell, from London and midwifery senior lecturer Bella Madden from Milton Keynes.
The winners will be announced at an International Symposium on Poetry and Medicine at the Wellcome Rooms in London on Saturday May 18th.
The judges also agreed 18 commendations in the NHS category and 20 in the Open International category – 1 each from from Ireland, Scotland and Israel, 7 from the USA and 10 from the England, from the Isle of Wight to Yorkshire.
Full list of commended poets, with biographies and notes on inspiration for their poems
Judge Jo Shapcott said: 'The Hippocrates Prize, since its inception in 2009, has quickly established itself as one of the most important international prizes for poetry as well as providing a unique place for poetry and medicine to meet. Its international reach is reflected in this years prizewinners who come from countries all round the globe, including New Zealand, the USA, Ireland, and Israel.“
She added: “You might imagine that poetry on medical themes would be sad, even grim reading, but far from it. There was a lively range of subjects and perspectives in this year's batch, and the judges were lucky enough to be debating the merits of some outstanding poems which have in common their sheer brio, skill, and passion, and often an exhilarating deftness in deploying medical language so that it sings.”
Judge Roger Highfield commented 'The Hippocrates Prize for Poetry and Medicine works brilliantly because medicine is where science collides with life. Again and again I found myself transported in mind and spirit to unfamiliar situations where I encountered the memories, experiences and inner emotional worlds of others. I found it enthralling and, at times, disturbing, a powerful reminder of the mysterious way that a few words can herd our thoughts and emotions.'
Judge Theodore Dalrymple remarked “As the Hippocrates Prize once again demonstrates, health care is a fertile source of poetic inspiration. All the poems arise from the need to communicate a deep human experience, and succeed in doing so.”
The awards symposium will consider the relationship between poetry and medicine, with topics including poetry as therapy, using poetry in health professional training, the impact of health and disease on the professional poet and the history of poetry and medicine.
Speakers planned for the awards symposium are from USA, Spain and Switzerland, and the UK.
The Hippocrates Initiative – winner of the 2011 Times Higher Education Award for Innovation and Excellence in the Arts – is an interdisciplinary venture that investigates the synergy between medicine, the arts, and health.
To attend the Symposium see http://hippocrates-poetry.org
Notes to editors
Photos of all of the finalists, along with biographies extracts of their poems are available on request.
For more information, please contact hippocrates.poetry@gmail.com
Awards: In each category there will be: 1st prize £5,000, 2nd prize £1,000, 3rd prize of £500, and 20 commendations each of £50.
The 2013 Hippocrates Anthology of the 46 winning and commended poems will be launched after the Awards Symposium at the Wellcome Rooms in London on Saturday 18th May. Winning and commended poets are entitled to one free copy of that year's anthology.
The Hippocrates Prize judges
Jo Shapcott was born in London. Poems from her three award-winning collections, Electroplating the Baby (1988), Phrase Book (1992) and My Life Asleep (1998) are gathered in a selected poems, Her Book (2000). She has won a number of literary prizes including the Commonwealth Writers' Prize for Best First Collection, the Forward Prize for Best Collection and the National Poetry Competition (twice). Tender Taxes, her versions of Rilke, was published in 2001. Her most recent collection, Of Mutability, was published in 2010 and won the 2011 Costa Book Award. She was awarded the Queen’s Gold Medal for Poetry in December 2011. Jo Shapcott teaches creative writing at Royal Holloway, University of London.
Theodore Dalrymple is the pen name for Dr Anthony Daniels, who has worked as a doctor in Sub-Saharan Africa, the Gilbert Islands, London and Birmingham, most recently as a psychiatrist and prison doctor. His writing has appeared regularly in the press and in medical publications, including the British Medical Journal, the Times, Telegraph, Observer and the Spectator and he has published around 20 books, most recently The Pleasure of Thinking.
Roger Highfield is the Director of External Affairs at the Science Museum Group. He was born in Wales, raised in north London and became the first person to bounce a neutron off a soap bubble. He was the Science Editor of The Daily Telegraph for two decades and the Editor of New Scientist between 2008 and 2011. Roger has written seven books and had thousands of articles published in newspapers and magazines
Hippocrates Prize Organisers
Donald Singer is Professor of Clinical Pharmacology and Therapeutics, University of Warwick, and President of the Fellowship of Postgraduate Medicine. His interests include research on discovery of new therapies, and public understanding of drugs, health and disease.
Michael Hulse is a poet and translator of German literature, and teaches creative writing and comparative literature at the University of Warwick. He is also editor of The Warwick Review.
His latest publications are: The Secret History (poems, Arc) and The Notebooks of Malte Laurids Brigge (translation of Rilke's novel, Penguin Classics). With Donald Singer he co-founded in 2009 the International Hippocrates Prize for Poetry and Medicine.
2013 Hippocrates Prize is supported by:
The Fellowship of Postgraduate Medicine, a national medical society founded in 1918 and publisher of the Postgraduate Medical Journal and Health Policy and Technology, has supported the Hippocrates Prize since its launch in 2009.
The Cardiovascular Research Trust, a charity founded in 1996, which promotes research and education for the prevention and treatment of disorders of the heart and circulation.
The National Association of Writers in Education, which is supporting the new Young Poets category in the Hippocrates Prize.
Heads Teachers and Industry is also supporting the new Young Poets category in the Hippocrates Prize. HTI is a not-for-profit organisation with over 25 years experience of record of working across business, education and government to raise aspirations and employability of young people.
Thursday, 14 March 2013
Moving the new Personalized Medicine to the Clinic
Trusted doctor-patient relationships form a long recognized key underpinning basis for ensuring as effective as possible disease prevention and treatment. That relationship needs to be supported by a strong evidence base on clinical and cost-effectiveness and safety in use of medicines and supporting diagnostics and devices.
Thanks to economies arising from progress in gene technology (Moore's Law applied to medicine) and advances for exponential increase in active partners in this field (Metcalfe's Law applied to medicine), costs of genetic, genomic and other technologies to stratify diagnosis and treatment choice are becoming increasingly affordable in clinical practice.
The Summit is a one-day conference that will gather biotechnology and pharmaceutical experts and healthcare stakeholders as keynote speakers and panel discussants on legal, regulatory, funding and other key issues that will promote research and development, growth and effectiveness in the short to medium term horizon for emergence of personalized medicine for clinical care.
The summit is co-hosted by the Personalized Medicine Coalition and Foley & Lardner LLP and is supported by major academic, clinical and industry patrons Life Technologies, Cancer Treatment Centers of America and the California Institute of Regenerative Medicine.
See the Personalized Medicine Summit website for more on the conference and how to register.
Selected papers from the conference will be published in the international journal Health Policy and Technology.
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