132 - The benefits and pitfalls of evidence based medicine with Jonathan Underhill

Pharmacist, Jonathan Underhill is a consultant clinical advisor for the Medicines Optimisations team at the National Institute for Health and Care Excellence (NICE). His work is focussed on evidence-based medicine but, as he explains, this is more than simply telling people what to do. One of the particular focuses of Jonathan’s work is the process known as ‘shared decision making’ between the clinician and the patient and he’s interested in how you involve a person in choices and decisions about their own healthcare.

Jonathan outlines some of the reasons NICE was originally set up – to reduce uncertainty and variation in prescribing – and with Louise, he evaluates whether this has been the outcome 6 years down the line, after the release of the NICE guidelines on menopause diagnosis and management.

Jonathan’s tips for shared decision making as a patient:

1. It’s OK to ask questions.
2. If you need it, take someone with you that you trust who can listen and advocate for you

And for healthcare professionals:

1. David Haslam’s (former Chair of NICE) consultation skills advice for doctors were basically ‘shut up and listen, show empathy, and know something’. If you can do these 4 things well it will make a big difference
2. Practice your conversation skills as a clinician. You can learn to communicate better with your patients.

The NICE guidelines on menopause can be read in full here and more about shared decision making can be found here.

If you are a healthcare professional, the following link offers 4 hours of free online learning in shared decision making from NICE and Keele University:

https://www.nice.org.uk/guidance/ng197/resources/shared-decision-making-learning-package-9142488109