THE PATIENT VOICE: AN ANALYSIS OF PERSONAL ACCOUNTS OF PRESCRIBED DRUG DEPENDENCE AND WITHDRAWAL (

                                                                       

http://prescribeddrug.org/wp-content/uploads/2018/10/Voice-of-the-Patient-Petition-Analysis-Report.pdf


The Pa'ent Voice: an analysis of personal accounts of prescribed drug dependence and withdrawal submi;ed to pe''ons in Scotland and Wales. (MARION BROWN el AL)


This report collates and analyses 158 personal accounts of people impacted by prescribed drug dependence and withdrawal (specifically for antidepressants and benzodiazepines) that were submitted in response to two petitions lodged with parliamentary Petitions CommiIees in Scotland and Wales in 2017. The report blends qualitative data in the form of verbatim quotes with quantitative data derived from a formal thematic analysis structured using a ‘lean thinking’ approach to process improvement. The analysis identifies eight systemic ‘failure points’ 






https://bjgp.org/content/69/681/163/tab-e-letters?fbclid=IwAR3EVrkWveSDWMb5l5w_f57YZW2-bUz9ZBmmDD99HyytMNSdNYzT3cnlEps

Published on: (4 April 2019) in British Journal of General Practice:

The right stuff - or the wrong stuff?

• Marion Brown, Psychotherapist and mediator (retired), none

As last month, Roger Jones's April 2019 Editor’s briefing has given cause to revisit, again, my response1 to his ‘Do no harm’ Editor’s briefing two years ago.  The challenge of learning from ‘medically unexplained symptoms’ is surely urgent.  I and others have been flagging this up2 and have repeatedly been patronised and ignored.

There is a ‘medical’ explanation for many ‘unexplained’ symptoms: medicine.  However, doctors are being actively trained to disbelieve patients’ experiences3 and to assume ‘unknown aetiology’ and/or ‘psychosomatic’ causes.

'The Patient Voice: an analysis of personal accounts of prescribed drug dependence and withdrawal submitted to petitions in Scotland and Wales"4 was published October 2018.  The aetiology of burgeoning 'medically unexplained’ symptoms can be clearly seen in the published patient testimony collated in this report.  The systems analysis 'Lean thinking' framework identifies clear ‘failure points'. These common failures are resulting in consequences where patients' health is being (presumably unintentionally) worsened by prescribed medicines, and over the longer term. "For some of theresponders all consultations, no matter what the problem, are now being seen through the root cause in anxiety/depression because of their history with these medications, sometimes when that wasn't even the reason for being prescribed the drug in the first place". 

Clearly this is ‘unwanted’, difficult and uncomfortable territory for prescribers.  Patients are courageously trying to raise the alarm and are being silenced.

Together with patients themselves, I and others are researching and sharing what people have learned from their/our own experiences.  My own professional psychotherapy body, Human Givens Institute, has been publishing our findings.5  My ‘Patient Journey’ infographic, linked within article,5 summarises the pattern of what we are seeing. Repeatedly.

The challenge of self-harm and suicidality in young people may also be exacerbated by medication – another medical ‘no-go’ area, despite ample evidence that there are significant links.  Instead, attention is being diverted to ‘social media’ factors.

The medical profession apparently obscuring and denying these very serious prescribed harm issues is not OK – and the newly released antidepressant prescribing figures for England are deeply alarming.6 

Courageous leadership is sorely needed. 

References
1. Brown M.  Br J Gen Pract 2017 67(656) 99 E-letter response February 2017.  https://bjgp.org/content/67/656/99/tab-e-letters#do-no-harm---a-serious-concern  (accessed 04 Apr 2019).
2. Brown M.  Update: Managing patients with medically unexplained symptoms.  GP View Sept 2017.  https://gpview.co.uk/update-managing-patients-with-medically-unexplained-symptoms/ (accessed 04 Apr 2019).
3. National Collaborating Centre for Mental Health. The Improving Access to Psychological Therapies (IAPT) Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms. Helpful resources. London: National Collaborating Centre for Mental Health. 2018.  www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/nccmh-iapt-ltc-helpful-resources.pdf?sfvrsn=1fd8e50f_2 (accessed 04 Apr 2019).
4. Guy A., Brown M., Lewis S.  The Patient Voice: an analysis of personal accounts of prescribed dependence and withdrawal submitted for petitions in Scotland and Wales.  All Party Parliamentary Group for Prescribed Drug Dependence, 2018.   http://prescribeddrug.org/wp-content/uploads/2018/10/Voice-of-the-Patient-Petition-Analysis-Report.pdf (accessed 04 Apr 2019).
5.  Human Givens Institute.  Case History (James): My experience with antidepressants 2018. www.hgi.org.uk/resources/delve-our-extensive-library/case-histories/case-study-antidepressant-experience  (accessed 04 Apr 2019).
6. Read J., Lewis S., Moncrieff J., Kinderman P., Davies J.  How many antidepressants is too many? BMJ 2019; 364: l1508/rr-0   Rapid Response 2019. www.bmj.com/content/364/bmj.l1508/rr-0 (accessed 04 Apr 2019).