WEBVTT 00:00.000 --> 00:03.220 You know what I found in my mum's handbag yesterday? 00:04.040 --> 00:04.660 Irina's? 00:05.900 --> 00:08.140 Seven boxes of medicine. 00:08.960 --> 00:09.420 Seven. 00:10.420 --> 00:13.440 She tipped the whole lot out onto the kitchen table 00:13.440 --> 00:17.620 because she wasn't sure she'd actually taken what she was meant to that morning. 00:18.520 --> 00:20.860 Seven? And all of them on repeat? 00:21.540 --> 00:22.360 I think so. 00:23.320 --> 00:24.780 One from the cardiologist, 00:25.360 --> 00:26.320 two from the GP, 00:27.280 --> 00:29.460 two for her joints from the rheumatologist, 00:30.100 --> 00:32.020 and two she couldn't even name. 00:32.740 --> 00:36.320 The pink one and the little white one. 00:37.620 --> 00:41.880 Hello, I'm Thomas Schuster and I built the Moya Pteczka app. 00:42.340 --> 00:44.540 And what Isar's just described has a name. 00:44.980 --> 00:46.720 It's called Polypharmacy. 00:47.160 --> 00:50.060 And it isn't the exception, it's the norm. 00:50.820 --> 00:51.560 The norm? 00:52.100 --> 00:55.740 Because my mum's convinced she's the only one like this. 00:56.340 --> 00:58.540 That she's the one who's lost track. 00:58.540 --> 01:02.840 If she's lost track, then so have an awful lot of people her age. 01:03.500 --> 01:04.140 Look at the numbers. 01:04.820 --> 01:07.900 There's a big Polish study, Professor Kardas, 2021. 01:08.800 --> 01:12.620 They went through the prescription records of nearly 38 million people. 01:12.620 --> 01:13.840 And what came out? 01:13.840 --> 01:19.720 Among polls over 65, 43% are on five medicines or more. 01:20.600 --> 01:21.960 43%! 01:22.640 --> 01:26.220 That's nearly one in two, at that age. 01:26.780 --> 01:29.220 And over 80, more than half. 01:29.780 --> 01:30.620 56%. 01:30.620 --> 01:32.820 All right. 01:32.820 --> 01:36.880 But that doesn't mean somebody's made a mistake, does it? 01:36.880 --> 01:42.220 If the doctors prescribed it all, then presumably that's what's needed. 01:42.220 --> 01:45.760 And here's the hardest thing in the whole story. 01:45.760 --> 01:50.900 Because each of those medicines on its own usually has a good reason behind it. 01:51.540 --> 01:53.400 The cardiologist was looking at her heart. 01:54.000 --> 01:55.900 The rheumatologist at her joints. 01:56.580 --> 01:58.600 Each of them saw their own slice. 01:59.600 --> 02:00.360 Well, quite. 02:00.360 --> 02:02.680 So, where's the problem? 02:03.700 --> 02:06.040 That none of them ever saw the whole thing. 02:06.800 --> 02:09.700 Your typical 70-year-old has three or four specialists. 02:10.220 --> 02:11.860 And they don't talk to one another. 02:12.540 --> 02:15.520 There's no single place where somebody sits down and says, 02:15.920 --> 02:16.340 Hang on. 02:16.860 --> 02:19.140 She's taking all of this at once? 02:19.340 --> 02:21.460 So everyone sees their bit. 02:22.160 --> 02:23.860 Nobody sees the whole picture. 02:24.460 --> 02:24.860 Exactly. 02:24.860 --> 02:28.500 And that's when you get something called a prescribing cascade. 02:29.640 --> 02:31.520 One medicine causes a side effect. 02:31.880 --> 02:33.760 The patient takes that to another doctor. 02:34.180 --> 02:36.940 Who, not knowing it's a side effect of the first medicine, 02:37.380 --> 02:38.420 prescribes another. 02:39.080 --> 02:42.720 For a symptom that wouldn't be there if it weren't for that first one. 02:43.380 --> 02:44.880 Give me an example. 02:45.560 --> 02:47.720 Because that sounds a bit abstract. 02:48.520 --> 02:48.880 Happily. 02:49.400 --> 02:50.360 A blood pressure tablet. 02:50.880 --> 02:53.060 In some people, it makes their ankles swell. 02:53.060 --> 02:55.400 So off the pensioner goes to the doctor. 02:55.920 --> 02:57.160 My legs are swelling up. 02:57.640 --> 02:58.940 She's given a water tablet. 02:59.580 --> 03:01.560 The water tablet flushes out potassium. 03:02.100 --> 03:03.040 Potassium drops. 03:03.580 --> 03:04.620 And now there's weakness. 03:05.080 --> 03:05.440 Cramp. 03:05.980 --> 03:06.680 Another appointment. 03:07.200 --> 03:07.880 Another medicine. 03:08.300 --> 03:11.640 And nobody along the way went back to that first one. 03:11.960 --> 03:13.180 The blood pressure tablet. 03:13.800 --> 03:14.160 Nobody. 03:14.840 --> 03:17.600 Because nobody saw the whole road from the start. 03:17.960 --> 03:20.480 And it isn't anyone's spite or stupidity. 03:20.480 --> 03:25.440 There's simply no one whose job it is to look at the whole list at once and go through 03:25.440 --> 03:26.340 it with the doctor. 03:26.780 --> 03:30.860 Because what to actually do about it, only a doctor can judge that. 03:31.400 --> 03:31.780 Right. 03:32.360 --> 03:34.320 Now tell me something practical. 03:35.060 --> 03:40.520 Because when mum tipped those boxes out on the table, what was I meant to do? 03:41.140 --> 03:42.020 I'm not a doctor. 03:42.520 --> 03:44.740 I can't tell whether any of it clashes. 03:44.740 --> 03:46.300 And you don't have to. 03:46.820 --> 03:47.920 That's not your job. 03:48.340 --> 03:49.920 Your job is one thing. 03:50.560 --> 03:53.960 Making sure the doctor she goes to gets the full list. 03:54.460 --> 03:56.340 Not seven boxes in a carrier bag. 03:56.860 --> 03:57.500 A list. 03:57.940 --> 04:00.800 But where am I supposed to get a list like that from? 04:01.180 --> 04:05.480 That's exactly why I built a report for the GP into the Moya Pteczka app. 04:06.040 --> 04:09.120 You type in, or scan, all of your mum's medicines. 04:09.700 --> 04:10.580 Once at the start. 04:10.940 --> 04:13.000 Then you update it whenever something changes. 04:13.000 --> 04:16.520 And then, with one tap, you turn it into a document. 04:17.240 --> 04:19.020 And it's not just the brand names on there. 04:19.400 --> 04:21.480 It's the active ingredient of each medicine. 04:21.860 --> 04:22.400 The schedule. 04:22.860 --> 04:23.520 What she takes. 04:23.840 --> 04:24.260 And when. 04:24.800 --> 04:26.640 All grouped under one person. 04:26.800 --> 04:27.740 The active ingredient? 04:28.540 --> 04:29.900 What do I want that for? 04:30.160 --> 04:31.860 When I've got the name off the box? 04:32.460 --> 04:36.240 Because that's the exact moment the duplicates show up. 04:36.980 --> 04:37.220 Listen. 04:37.700 --> 04:40.620 Two boxes can have completely different names on them. 04:40.620 --> 04:42.840 And the same substance inside. 04:43.860 --> 04:46.980 Somebody's taking one because the cardiologist prescribed it. 04:47.420 --> 04:49.240 And another because the GP did. 04:49.780 --> 04:51.580 Under two different names. 04:52.060 --> 04:52.920 The same thing. 04:53.480 --> 04:53.900 Twice. 04:54.600 --> 04:55.120 Hang on. 04:56.020 --> 04:58.180 You know what I did with mum's list? 04:58.180 --> 05:01.360 I printed it off and took it to her GP. 05:02.100 --> 05:02.520 And? 05:02.600 --> 05:05.620 He looked at it for ten seconds and said, 05:06.620 --> 05:10.400 So, why's she taking two lots of the same thing for her stomach? 05:10.400 --> 05:14.540 And I didn't even know it was the same thing twice. 05:14.820 --> 05:17.460 To me, they were two different names. 05:17.960 --> 05:19.920 Because they were two different names. 05:20.460 --> 05:21.420 Same substance. 05:21.900 --> 05:22.520 Two boxes. 05:23.180 --> 05:24.420 And that's it exactly. 05:25.160 --> 05:29.320 The GP saw in ten seconds something you had no way of knowing. 05:29.760 --> 05:33.760 And that he'd have had no way of getting out of your mum in a ten-minute appointment. 05:33.760 --> 05:36.060 And interactions. 05:36.940 --> 05:39.920 Because that scares me more than a duplicate does. 05:40.480 --> 05:41.600 There's a second thing. 05:42.360 --> 05:46.980 Before you even add a new medicine to your mum's list, the one the GP's just prescribed, 05:46.980 --> 05:51.380 you can check in the app whether it clashes with what she's already on. 05:52.260 --> 05:53.120 You pick the medicines. 05:53.640 --> 05:56.280 The app compares them in an interactions database. 05:57.020 --> 05:59.960 And shows you whether there's anything and how serious. 06:00.840 --> 06:01.160 Wait. 06:01.700 --> 06:06.600 But if the app tells me two medicines clash, am I meant to stop them? 06:07.300 --> 06:07.620 No. 06:08.200 --> 06:12.200 And this is the most important sentence in the whole episode for me. 06:12.760 --> 06:14.720 The app doesn't stop anything. 06:14.720 --> 06:16.880 And it doesn't tell you to take anything. 06:17.800 --> 06:18.420 It signals. 06:19.480 --> 06:22.300 It shows you, careful, there's an interaction here. 06:22.740 --> 06:23.840 And here's how serious. 06:24.800 --> 06:30.040 And the decision, what to do about it, belongs to the GP or the pharmacist. 06:30.600 --> 06:31.000 Always. 06:32.000 --> 06:32.400 Right. 06:33.220 --> 06:35.620 That at least sounds honest. 06:36.240 --> 06:39.480 Because most apps carry on as though they know everything. 06:39.480 --> 06:44.960 Because if the app said, stop this medicine, and someone did, without a doctor, 06:44.960 --> 06:48.940 that would be more dangerous than the polypharmacy itself. 06:48.940 --> 06:52.340 I put the facts in your hands. 06:52.960 --> 06:54.960 The judgement stays with the doctor. 06:54.960 --> 06:59.300 You know what got to me most in all this? 06:59.300 --> 07:02.480 That I live in a different town from Mum. 07:03.060 --> 07:04.660 And that's the third thing. 07:05.060 --> 07:07.080 You can be set up as her carer. 07:07.920 --> 07:09.500 Mum has her own medicine cabinet. 07:09.860 --> 07:10.660 Her own medicines. 07:11.300 --> 07:15.400 And you, from your own phone, can see what's planned for today. 07:15.400 --> 07:17.600 And what she's ticked off as taken. 07:18.500 --> 07:18.960 A bar. 07:19.540 --> 07:21.420 How many of today's doses are ticked? 07:21.880 --> 07:22.760 How many are left? 07:23.640 --> 07:26.080 Without ringing up at seven in the evening. 07:26.480 --> 07:28.500 Mum, did you take the pink one? 07:29.180 --> 07:30.440 Not once. 07:31.000 --> 07:33.400 Because that question gets you nowhere anyway. 07:33.900 --> 07:35.440 It gets you nowhere. 07:36.220 --> 07:40.160 She always says, yes, yes, and then she's not sure. 07:40.160 --> 07:43.520 And I'm miles away and still none the wiser. 07:44.580 --> 07:46.520 And this way, you don't have to ask. 07:47.100 --> 07:47.900 You just see. 07:48.860 --> 07:51.840 And by the way, everything we're talking about here, 07:52.380 --> 07:55.620 these really are features in the Moya Potechka app. 07:56.120 --> 07:57.140 It's not an advert. 07:57.720 --> 07:58.900 Just so we're clear. 07:59.680 --> 07:59.920 Hmm. 08:00.400 --> 08:01.880 Just so we're clear. 08:02.860 --> 08:04.360 And you know what's interesting? 08:04.860 --> 08:07.400 That elsewhere, they've already got a handle on this. 08:07.400 --> 08:12.580 In Germany, a patient who's regularly on at least three prescribed medicines 08:12.580 --> 08:15.980 has a right to a single medication plan. 08:16.820 --> 08:17.900 On paper, yes. 08:18.360 --> 08:21.340 But one plan shared across all their doctors. 08:22.340 --> 08:25.300 And here in the UK, you can get a medication review. 08:25.940 --> 08:29.280 Your GP or a pharmacist going through the whole lot 08:29.280 --> 08:32.220 with checklists that help them catch the medicines 08:32.220 --> 08:34.720 that might be unnecessary or risky. 08:35.380 --> 08:36.960 And the ones someone's missing. 08:37.980 --> 08:40.280 So we're actually not badly off here? 08:41.220 --> 08:42.380 Not badly off at all. 08:42.980 --> 08:45.120 But a review happens now and again 08:45.120 --> 08:47.860 and someone still has to walk into that room 08:47.860 --> 08:50.120 with the complete up-to-date picture. 08:51.260 --> 08:53.900 Seven boxes in a carrier bag won't do it. 08:55.080 --> 08:57.900 And between reviews, keeping that picture current, 08:58.440 --> 09:01.400 more often than not, that falls to the family. 09:01.400 --> 09:03.780 So it's us again. 09:04.220 --> 09:04.800 Us again. 09:05.220 --> 09:07.380 But at least now there's a tool for it. 09:07.840 --> 09:10.120 So it isn't a heap of boxes in a carrier bag, 09:10.620 --> 09:13.520 but one page the GP reads in ten seconds. 09:13.520 --> 09:16.260 If you'd like to give it a go, 09:16.700 --> 09:19.140 that'd be the Moya Poteczka app. 09:19.500 --> 09:21.860 The app is free and works offline. 09:22.360 --> 09:24.520 You'll find the link in the episode description. 09:24.520 --> 09:27.940 And if this episode was any use to you, 09:28.500 --> 09:31.360 pass it on to someone who's just been handed a carrier bag 09:31.360 --> 09:32.880 of their parents' medicines. 09:32.880 --> 09:36.000 One more thing before we go. 09:36.820 --> 09:39.760 This podcast is made with the help of artificial intelligence. 09:40.760 --> 09:42.140 I wrote the dialogue myself, 09:42.560 --> 09:44.900 but the voices you're hearing aren't ours. 09:45.400 --> 09:47.840 They're AI-generated, synthetic voices. 09:48.800 --> 09:50.500 We're telling you this straight out 09:50.500 --> 09:52.440 because we think it should be the standard 09:52.440 --> 09:54.420 for any podcast made this way. 09:55.440 --> 09:56.940 Full details are in the show notes 09:56.940 --> 09:59.080 and in every episode description. 09:59.720 --> 10:00.780 Until next time. 10:01.660 --> 10:02.720 Until next time.