Thomas Downes
@tomdownes.bsky.social
GP in Midlothian and Honorary Research Fellow at the University of Dundee. Interested in multimorbidity, applicability and polypharmacy.
Reposted by Thomas Downes
🆕 In their Comment, Peter Hanlon and colleagues discuss pragmatic prescribing for people with moderate or severe frailty in primary care
Read the full Comment here ➡️ www.thelancet.com/journals/lan...
Read the full Comment here ➡️ www.thelancet.com/journals/lan...
Frailty, polypharmacy, and the case for pragmatic prescribing in primary care
Primary care clinicians are often caught between conflicting recommendations for clinical
care. On one side, specialist guidelines and trial evidence urge intensive treatment,
such as tight blood pres...
www.thelancet.com
February 13, 2026 at 1:36 PM
🆕 In their Comment, Peter Hanlon and colleagues discuss pragmatic prescribing for people with moderate or severe frailty in primary care
Read the full Comment here ➡️ www.thelancet.com/journals/lan...
Read the full Comment here ➡️ www.thelancet.com/journals/lan...
Reposted by Thomas Downes
Hidden harms in #End-Of-Life injectable symptom control #HealthCare: many patient safety incidents reported as 'no harm' contain descriptions of physical/psychological harm experienced by patients and families doi.org/10.3399/BJGP... @drbenbowers.bsky.social @carsonstevens.bsky.social #PrimaryCare
Revealing the hidden harms in end-of-life care: a mixed-methods characterisation of reported safety incidents involving injectable symptom control medication | British Journal of General Practice
doi.org
January 30, 2026 at 7:30 AM
Hidden harms in #End-Of-Life injectable symptom control #HealthCare: many patient safety incidents reported as 'no harm' contain descriptions of physical/psychological harm experienced by patients and families doi.org/10.3399/BJGP... @drbenbowers.bsky.social @carsonstevens.bsky.social #PrimaryCare
Had the opportunity last week to present my research on clinical trial applicability as an elevator pitch at the #NADEGS 2026 #primarycare conference in Edinburgh. Good to chance to consolidate thoughts and highlight main points. Looking forward to next year’s turn with Glasgow!
January 29, 2026 at 4:08 PM
Had the opportunity last week to present my research on clinical trial applicability as an elevator pitch at the #NADEGS 2026 #primarycare conference in Edinburgh. Good to chance to consolidate thoughts and highlight main points. Looking forward to next year’s turn with Glasgow!
Reposted by Thomas Downes
🆕 "The dominance of research... from mostly high-income countries means that much of the knowledge shaping primary care policy and practice reflects the priorities, populations, and health system structures of wealthier regions [limiting] the knowledge translation to the different contexts" ...
January 13, 2026 at 4:11 PM
🆕 "The dominance of research... from mostly high-income countries means that much of the knowledge shaping primary care policy and practice reflects the priorities, populations, and health system structures of wealthier regions [limiting] the knowledge translation to the different contexts" ...
Reposted by Thomas Downes
Reposted by Thomas Downes
"The more I support people with obesity and learn about the impact of stigma and the drivers of ill health, the less I talk about weight at all in short primary care consultations."
@ellenfallows.bsky.social on reframing consultations away from numbers on scales
www.bmj.com/content/392/...
@ellenfallows.bsky.social on reframing consultations away from numbers on scales
www.bmj.com/content/392/...
January 6, 2026 at 10:41 AM
"The more I support people with obesity and learn about the impact of stigma and the drivers of ill health, the less I talk about weight at all in short primary care consultations."
@ellenfallows.bsky.social on reframing consultations away from numbers on scales
www.bmj.com/content/392/...
@ellenfallows.bsky.social on reframing consultations away from numbers on scales
www.bmj.com/content/392/...
Excited to see work’s started on this new active travel link in Edinburgh:
www.edinburgh.gov.uk/news/article...
www.edinburgh.gov.uk/news/article...
Construction begins on first phase of West Edinburgh Link
Construction begins on first phase of West Edinburgh Link
www.edinburgh.gov.uk
December 6, 2025 at 7:51 PM
Excited to see work’s started on this new active travel link in Edinburgh:
www.edinburgh.gov.uk/news/article...
www.edinburgh.gov.uk/news/article...
Reposted by Thomas Downes
🆕 In a single-blind RCT, topical hydrogen peroxide was compared with topic fusidic acid and simple wound hygiene in the management of non-severe impetigo lesions in school-aged children in Auckland, Aotearoa New Zealand.
Read the findings of the TIARA trial ➡️ www.thelancet.com/journals/lan...
Read the findings of the TIARA trial ➡️ www.thelancet.com/journals/lan...
Topical hydrogen peroxide versus fusidic acid for non-severe impetigo in Auckland, Aotearoa New Zealand (the TIARA trial): a single-blind, randomised controlled trial
Topical hydrogen peroxide was not non-inferior to topical fusidic acid for treatment
of non-severe impetigo. However, as these infections are mild and the difference in
cure rate is small, when balanc...
www.thelancet.com
November 20, 2025 at 5:42 PM
🆕 In a single-blind RCT, topical hydrogen peroxide was compared with topic fusidic acid and simple wound hygiene in the management of non-severe impetigo lesions in school-aged children in Auckland, Aotearoa New Zealand.
Read the findings of the TIARA trial ➡️ www.thelancet.com/journals/lan...
Read the findings of the TIARA trial ➡️ www.thelancet.com/journals/lan...
Reposted by Thomas Downes
@bjgp.bsky.social
bjgp.org/content/bjgp...
Evidence-biased medicine? Applying a health equity lens to Sackett's methodological framework
#GeneralPractice
#DeepEndGP
#FamilyMedicine
#PrimaryCare
@nihrspcr.bsky.social @nihrarcs.bsky.social
bjgp.org/content/bjgp...
Evidence-biased medicine? Applying a health equity lens to Sackett's methodological framework
#GeneralPractice
#DeepEndGP
#FamilyMedicine
#PrimaryCare
@nihrspcr.bsky.social @nihrarcs.bsky.social
bjgp.org
December 2, 2025 at 9:20 AM
@bjgp.bsky.social
bjgp.org/content/bjgp...
Evidence-biased medicine? Applying a health equity lens to Sackett's methodological framework
#GeneralPractice
#DeepEndGP
#FamilyMedicine
#PrimaryCare
@nihrspcr.bsky.social @nihrarcs.bsky.social
bjgp.org/content/bjgp...
Evidence-biased medicine? Applying a health equity lens to Sackett's methodological framework
#GeneralPractice
#DeepEndGP
#FamilyMedicine
#PrimaryCare
@nihrspcr.bsky.social @nihrarcs.bsky.social
Are you a GP registrar about to start your out-of-hours (OOH) shifts? Or a qualified GP looking to get back into OOH? Check out our new article to help get you ready @rcgp-innovait.bsky.social
#primarycare
journals.sagepub.com/doi/10.1177/...
#primarycare
journals.sagepub.com/doi/10.1177/...
Sage Journals: Discover world-class research
Subscription and open access journals from Sage, the world's leading independent academic publisher.
journals.sagepub.com
November 3, 2025 at 7:21 PM
Are you a GP registrar about to start your out-of-hours (OOH) shifts? Or a qualified GP looking to get back into OOH? Check out our new article to help get you ready @rcgp-innovait.bsky.social
#primarycare
journals.sagepub.com/doi/10.1177/...
#primarycare
journals.sagepub.com/doi/10.1177/...
Reposted by Thomas Downes
🎉 Congrats to Sameera Toenjes and her team for an excellent publication in @plosone.org highlighting the perspectives of primary care clinicians regarding perceived barriers, facilitators, and team roles in addressing prescribing cascades:
Read the full article here!
buff.ly/yscPvts
Read the full article here!
buff.ly/yscPvts
October 24, 2025 at 4:05 PM
🎉 Congrats to Sameera Toenjes and her team for an excellent publication in @plosone.org highlighting the perspectives of primary care clinicians regarding perceived barriers, facilitators, and team roles in addressing prescribing cascades:
Read the full article here!
buff.ly/yscPvts
Read the full article here!
buff.ly/yscPvts
Proud to see our research featured on my news feed this morning:
Frailty index could improve life for younger patients www.bbc.com/news/article...
Frailty index could improve life for younger patients www.bbc.com/news/article...
October 15, 2025 at 9:04 AM
Proud to see our research featured on my news feed this morning:
Frailty index could improve life for younger patients www.bbc.com/news/article...
Frailty index could improve life for younger patients www.bbc.com/news/article...
Reposted by Thomas Downes
"Undermining confidence in one of the few safe and effective pain and fever relief drugs in pregnancy risks causing unintended harm."
Pregnant women are often excluded from clinical trials and evidence gaps enable unsubstantiated claims, @louiseckenny.bsky.social
www.bmj.com/content/391/...
Pregnant women are often excluded from clinical trials and evidence gaps enable unsubstantiated claims, @louiseckenny.bsky.social
www.bmj.com/content/391/...
October 2, 2025 at 3:47 PM
"Undermining confidence in one of the few safe and effective pain and fever relief drugs in pregnancy risks causing unintended harm."
Pregnant women are often excluded from clinical trials and evidence gaps enable unsubstantiated claims, @louiseckenny.bsky.social
www.bmj.com/content/391/...
Pregnant women are often excluded from clinical trials and evidence gaps enable unsubstantiated claims, @louiseckenny.bsky.social
www.bmj.com/content/391/...
Reposted by Thomas Downes
Reposted by Thomas Downes
As we head into autumn, in many instances, patient expectations following a community acquired pneumonia can have a profound effect on repeat appointments (“I feel better but I’m still coughing, Doc”). Here’s a timely reminder from NICENG250
September 17, 2025 at 9:02 AM
As we head into autumn, in many instances, patient expectations following a community acquired pneumonia can have a profound effect on repeat appointments (“I feel better but I’m still coughing, Doc”). Here’s a timely reminder from NICENG250
Reposted by Thomas Downes
VERY EXCITING
launch of the CENTRE FOR EVIDENCE AND VALUES IN HEALTHCARE at the Uni of St Andrews
first event 31st October with Sir David Haslam and Scotland's new patient safety commissioner Karen Titchener
find out more here medicine.st-andrews.ac.uk/centreforevi...
please sign up and come
launch of the CENTRE FOR EVIDENCE AND VALUES IN HEALTHCARE at the Uni of St Andrews
first event 31st October with Sir David Haslam and Scotland's new patient safety commissioner Karen Titchener
find out more here medicine.st-andrews.ac.uk/centreforevi...
please sign up and come
September 1, 2025 at 8:15 PM
VERY EXCITING
launch of the CENTRE FOR EVIDENCE AND VALUES IN HEALTHCARE at the Uni of St Andrews
first event 31st October with Sir David Haslam and Scotland's new patient safety commissioner Karen Titchener
find out more here medicine.st-andrews.ac.uk/centreforevi...
please sign up and come
launch of the CENTRE FOR EVIDENCE AND VALUES IN HEALTHCARE at the Uni of St Andrews
first event 31st October with Sir David Haslam and Scotland's new patient safety commissioner Karen Titchener
find out more here medicine.st-andrews.ac.uk/centreforevi...
please sign up and come
Reposted by Thomas Downes
More women in cardiovascular trials still needed (and CVD trials are pretty good compared to other medical specialties...)
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Participation of Women in Cardiovascular Trials, 2017 to 2023
This systematic review describes the representation of women across a broad range of cardiovascular trials registered from 2017 to 2023.
jamanetwork.com
September 2, 2025 at 10:37 AM
More women in cardiovascular trials still needed (and CVD trials are pretty good compared to other medical specialties...)
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
The electronic frailty index (eFI) is used to identify older adults (≥65 years) who may be living with frailty. In our new study, we found that the eFI also identifies younger adults (18-64 years) at high risk of mortality and hospital admission:
www.thelancet.com/journals/lan...
#frailty #medsky
www.thelancet.com/journals/lan...
#frailty #medsky
Applicability of the electronic frailty index in younger and older adults in England: a population-based cohort study
Similarly to older adults, the eFI identifies younger adults with frailty at high
risk of mortality and emergency hospital admission. The eFI might be a tool to identify
individuals for further assess...
www.thelancet.com
September 1, 2025 at 6:26 AM
The electronic frailty index (eFI) is used to identify older adults (≥65 years) who may be living with frailty. In our new study, we found that the eFI also identifies younger adults (18-64 years) at high risk of mortality and hospital admission:
www.thelancet.com/journals/lan...
#frailty #medsky
www.thelancet.com/journals/lan...
#frailty #medsky
Reposted by Thomas Downes
MHRA approves UK’s first new type of antibiotic for urinary tract infections in nearly 30 years
#Pharmsky #Medsky
www.gov.uk/government/n...
#Pharmsky #Medsky
www.gov.uk/government/n...
MHRA approves UK’s first new type of antibiotic for urinary tract infections in nearly 30 years
As with any medicine, the MHRA will keep the safety of gepotidacin under close review.
www.gov.uk
August 28, 2025 at 6:35 AM
MHRA approves UK’s first new type of antibiotic for urinary tract infections in nearly 30 years
#Pharmsky #Medsky
www.gov.uk/government/n...
#Pharmsky #Medsky
www.gov.uk/government/n...
Reposted by Thomas Downes
Ever wonder what percentage of hospital admissions are caused by medications? 💊
A systematic review published in the Age and Ageing Journal finds adverse drug reactions (ADRs) and adverse drug events (ADEs) are significant causes of hospitalization in older adults.
buff.ly/4Vuv4T2
A systematic review published in the Age and Ageing Journal finds adverse drug reactions (ADRs) and adverse drug events (ADEs) are significant causes of hospitalization in older adults.
buff.ly/4Vuv4T2
August 25, 2025 at 4:02 PM
Ever wonder what percentage of hospital admissions are caused by medications? 💊
A systematic review published in the Age and Ageing Journal finds adverse drug reactions (ADRs) and adverse drug events (ADEs) are significant causes of hospitalization in older adults.
buff.ly/4Vuv4T2
A systematic review published in the Age and Ageing Journal finds adverse drug reactions (ADRs) and adverse drug events (ADEs) are significant causes of hospitalization in older adults.
buff.ly/4Vuv4T2
Reposted by Thomas Downes
As we age, changes in our bodies can affect drug exposure, leading to potentially increased risks of both medication toxicity and treatment failure. 💊
Great review article highlights major age-related physiological changes that can impact drug use:
link.springer.com/article/10.1...
Great review article highlights major age-related physiological changes that can impact drug use:
link.springer.com/article/10.1...
August 2, 2025 at 4:34 PM
As we age, changes in our bodies can affect drug exposure, leading to potentially increased risks of both medication toxicity and treatment failure. 💊
Great review article highlights major age-related physiological changes that can impact drug use:
link.springer.com/article/10.1...
Great review article highlights major age-related physiological changes that can impact drug use:
link.springer.com/article/10.1...
Open letter from the heads of Scotland’s medical schools on the threat to the clinical academic workforce.
“If we do not act, we risk weakening the very system that has delivered some of the most transformative advances in modern medicine”
www.universities-scotland.ac.uk/clinicalacad...
“If we do not act, we risk weakening the very system that has delivered some of the most transformative advances in modern medicine”
www.universities-scotland.ac.uk/clinicalacad...
Scotland’s Quiet Crisis: Why Clinical Research Needs Urgent Rescue — Universities Scotland
www.universities-scotland.ac.uk
August 1, 2025 at 9:57 AM
Open letter from the heads of Scotland’s medical schools on the threat to the clinical academic workforce.
“If we do not act, we risk weakening the very system that has delivered some of the most transformative advances in modern medicine”
www.universities-scotland.ac.uk/clinicalacad...
“If we do not act, we risk weakening the very system that has delivered some of the most transformative advances in modern medicine”
www.universities-scotland.ac.uk/clinicalacad...
Reposted by Thomas Downes
Our realist review from #RESOLVE study funded by @nihr.bsky.social published today
@thementalelf.bsky.social @sapc.ac.uk @cmhpcommunity.pharmsky.app
onlinelibrary.wiley.com/doi/10.1111/...
@thementalelf.bsky.social @sapc.ac.uk @cmhpcommunity.pharmsky.app
onlinelibrary.wiley.com/doi/10.1111/...
Non‐pharmacologicaL InterVEntions for Antipsychotic‐Induced Weight Gain (RESOLVE) in People Living With Severe Mental Illness: A Realist Synthesis
Introduction
Antipsychotic medications are used to treat individuals with severe mental illness (SMI) but are associated with rapid weight gain and several physical and mental risk factors. Early, p.....
onlinelibrary.wiley.com
July 28, 2025 at 7:06 AM
Our realist review from #RESOLVE study funded by @nihr.bsky.social published today
@thementalelf.bsky.social @sapc.ac.uk @cmhpcommunity.pharmsky.app
onlinelibrary.wiley.com/doi/10.1111/...
@thementalelf.bsky.social @sapc.ac.uk @cmhpcommunity.pharmsky.app
onlinelibrary.wiley.com/doi/10.1111/...
Reposted by Thomas Downes
BMA and other national medical organisations come together as a voice for doctors in Europe to call for immediate action in Gaza
The Standing Committee of European Doctors (CPME) expresses deep concern about the catastrophic humanitarian situation in Gaza and the desperate levels of starvation experienced by the population.
Press release: www.cpme.eu/api/document...
Press release: www.cpme.eu/api/document...
July 29, 2025 at 8:09 PM
BMA and other national medical organisations come together as a voice for doctors in Europe to call for immediate action in Gaza