Horst I have attended various conferences given by top Cardiologists from Sydney & Melbourne over the last 10 years. Every single one has always challenged the NPS on that. Every single one of them has only had thei patients wellbeing at heart. At some of these conferences / Seminars I was at, there were at times other Cardiologists in the audience, and they would've objected if the material presented was wrong. NPS now however (I was at a seminar given by the NPS last Wednesday where I asked this question) publishes in their new guidelines that Thiazides / Betablockers not 1st choice anymore. I have never let a drugrep teach me Medicine.
More important. Nobody to date has shown me papers on studies with Thiazides that they work for 24 hours and provide 24 hour BP control. If you have any, I'd appreciate if you send them to me. (We all badmouth the older ACEs because they are not true once a day medication). Further the government does value the input from the NPS Cedric. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Horst Herb Sent: Monday, 19 June 2006 11:47 AM To: General Practice Computing Group Talk Subject: Re: [GPCG_TALK] NPS plans new drug interaction software for GPs On Monday 19 June 2006 10:51, Cedric Meyerowitz wrote: > For the past 5-10 years the NPS told us that 1st line treatment for > Hypertension in Australia is Diuretics / Betablockers. Evidence based > medicine moved away from that many years ago. Finally in the last 3 > months the NPS has discovered that they the NPS was wrong. Yet they > now want to develop this software. I haven't yet seen the NPS's views > on treating cholesterol in diabetics. PBS won't subsidise treatment > at the levels the DM association here & overseas advocates. If NPS > want to become more credible, they should be vocal on this topic. I am not aware that the NPS stated that it was wrong. Can you please point me to some reference? For all I know (I am not afiliated with the NPS in any way) the NPS sifts through the available evidence from an unbiased academic perspective, and makes recommendations based on that evidence. Recommendations btw which you can take or leave, nobody forces you to adhere to them. Recommendations btw which only have some limited degree of influence on PBS listsings Most doctors are taken for suckers by biased publications most if not all of the time. Pharmaceutical companies have been demonstrated to suppress unfavourable study results, to manufature results by statistical tweaking maneuvres etc., their reps are trained on how to give their sales spiel without triggering any critical thoughts and so forth. So we need some balance in this game. somebody who has the *long term* interest of the patient at heart from a neutral perspective, and you will certainly understand that keeping a public health system financially viable is definitely in any patient's vital interest. I still can't see any convincing evidence why I should not chose a low dose Thiazide as a first line drug in essential hypertension in people with no other risk factors / concomittant diseases that would make me decide in favour of for example an ACEI. Can you? If so, please point me to the references. and mind you, I am not intersted in barely statistically significant reductions of some-endpoint-or-other - what I am interested in is seeing the impact on long term overall mortality and morbidity. Anything else is interesting from a theoretical point, but meaningless to the patient I prescribe the medication for. All that said, what we *REALLY* would need is a government that pulls the finger out and does the studies we really want to see - hed-to-head studies with overall mortality and morbidity as endpoints, with long term follow up, and merciless publication of the results regardless ofwhether it suits one particular party or not. Horst _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
