March In A Nutshell

Online prescriptions

The public has been advised to be careful when buying medications on the Internet after an investigation by the Care Quality Commission (CQC) found that some online providers have “little clinical oversight” over how they prescribed pills.

The CQC has published a clear set of standards for online pharmacies which include:

  1. Verifying photo ID with patients
  2. Getting a thorough, up-to-date medical history
  3. Giving patient information about the medication they are getting (how and when to take them, what to avoid etc)
  4. Getting patient’s consent to contact his/her GP

Both and were inspected by the CQC as these companies were found to be not providing safe care to patients and therefore, putting them at risk.

The CQC has also offered some tips for the public who choose to buy prescription online:

  1. Check if an online doctor service is registered with the CQC
  2. Check if an online pharmacy service is registered with the General Pharmaceutical Council using the EU common logo
  3. Check who are they – are they based in the UK or overseas and are they registered?
  4. Check their contact details
  5. Check if you have clear information about the prescribed medicine

As Gerald Heddell, director of inspection, enforcement and standards at the Medicines and Healthcare products Regulatory Agency (MHRA) said: “Prescription-only medicines are prescription only for a reason and should only be taken under the supervision of a healthcare professional”.

Read more at the BBC.


Exempt NHS from overseas doctors charge, urge unions

In an effort by the government to promote home-grown skills, the Immigration Skills Charge which will be imposed on NHS in April means it has to pay 1000 pounds each year for any non-EU worker coming to the UK.

This applies to those who are recruited under the Tier 2 visa. For example, if a hospital wanted to hire a doctor for three years, the trust has to pay 3000 pounds upfront when applying to the UK Visas and Immigration department for a certificate of sponsorship.

The charge is imposed for two reasons. Firstly, it attempts to reduce the number of businesses taking on migrant workers. Secondly, it encourages locals to take up these positions. Nevertheless, the British Medical Association and the Royal College of Nursing, which are both unions that represent doctors and nurses respectively, believe this solution will not address the current shortage of health staffs quickly. This is because it takes a lengthy time to train a senior doctor. Also, there are limited places to both medical and nursing degrees in the UK.

Currently, nurses remain one of the occupations that are still experiencing shortage in the UK. This ruling however, does not affect international students in the UK who are switching their visas from Tier 4 to Tier 2.

Read the full report at the BBC website.


The 5-minute workouts


If the lack of time has always been an excuse for you to not exercise, you might need to rethink that.

The Star reports a study published by the Journal of the American College of Cardiology which concluded that 5-minute exercises can actually bring many health benefits to you. They include

  1. Enhanced memory and thinking – exercise promotes the growth of new brain cells
  2. Higher self-esteem – makes you feel better about yourself
  3. Healthier sleep
  4. Higher resilience – exercise improves your immunity

If you are afraid of being bored doing the same routine every day, you can alternate different forms of workout. Some of them are

  1. Burpees – it trains your endurance, stamina and strength if carried out properly
  2. Reverse planks – ideal for core body workouts
  3. Sun salutations – makes your heart pumps faster and stretches the muscles in your body
  4. Jumping rope – a good cardio workout which is often overlooked by many
  5. Walking - as simple as that

Keep yourself motivated by doing something that you enjoy. Slowly and steadily, you can increase the time spent in exercising as you get use to the regime.

In conclusion, sparing 5 minutes a day to exercise makes you healthier, even if it doesn't make you a marathon runner.


Moderate alcohol intake may reduce risk of heart disease

A group of researchers from University of Cambridge and University College London conducted a four year cohort study to find the link between alcohol intake and the risk of heart disease. Nearly 2 million patient records were taken from a GP database and they include their alcohol consumption, incidence of first cardiovascular disease in the last six years and confounding variables like age, gender, smoking status, blood pressure and socioeconomic status. Patients were categorised into five groups: non-drinkers, former drinkers, occasional drinkers, moderate drinkers (who adhered to the then guidelines of 21 units per week for men and 14 units for women; now 14 units per week for both genders) and heavy drinkers (those who exceeded the guidelines).

The results showed non-drinkers had a higher risk of first cardiovascular attack compared to moderate drinkers. Some of them are:

  • Myocardial infarction (32% higher risk)
  • Heart failure (24% higher risk)
  • Stable angina (15% higher risk)
  • Stroke (12% higher risk)

However, there was no significant difference for transient ischaemic attacks and sudden cardiac death between the groups.

It can be concluded that moderate alcohol consumption is associated with a lower risk of initial presentation of some, but not all, heart diseases. This is strictly applied to moderate drinkers. Although the probability of heavy drinkers with first myocardial infarction onset was relatively low, the researches warned this could be due to the development of other alcohol-related disease before heart disease sets in.

As this is a cohort study, it can only show an association but it cannot prove a direct relation between alcohol intake and heart disease due to other confounding factors.


Ibuprofen increases risk of cardiac arrests 

A Danish study looked at the relation between NSAID use and the risk of cardiac arrest in 29,000 people.

This was a case-time-control study. It included people aged 10 and above who had an out-of-hospital cardiac arrest from 2001 to 2010. They were put in a case period of 30 days before their cardiac arrests and a control period for another 30 days (no arrest here). In between these two periods, there was a 30-day “wash out”. In the case period, researches identified 3376 patients who were on NSAIDs. They included diclofenac (21.8%), naproxen, ibuprofen (51%) and COX-2 selective inhibitors such as rofecoxib and celecoxib.

This type of study uses the same individual as both the subject and control in two different periods of time. This means confounding variables will remain the same when making comparisons.

The results:

  1. Use of any NSAID increased risk of cardiac arrest by 31%
  2. Use of ibuprofen increased risk of cardiac arrest by 31%
  3. Use of diclofenac increased risk of cardiac arrest by 50%
  4. Use of naproxen was not associated with cardiac arrect, nor was the use of COX-2 inhibitors

The results showed the risk of an out-of-hospital cardiac arrest increase by nearly a third for those who took ibuprofen within 30 days of its onset.  This risk doubled for those who took diclofenac, another type of NSAID which is only available via prescription in the UK.


In a nutshell, our heart is one of the most important organs in our body - keeping us alive by pumping blood every minute of our lives. Thus, we must take care of our heart by exercising regularly, avoiding risk factors such as ibuprofen and drinking in moderation. And if a cardiac problem does arise, please see a local GP for a prescription instead of ordering drugs online, to reduce the risk of adverse events.

Visit the MMI UK Facebook page for more exciting articles.



Go back