Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
@drotte.medsky.social
Palliative care/family doc in Nanaimo, BC. Clinical Associate Prof, UBC Medicine
Focus: the intersection of Palliative Care + sustainability. Was @lessismoremedicine.❤️quaternary prevention, preventing overdiagnosis, goal-concordant EBM, choosing wisely.
Focus: the intersection of Palliative Care + sustainability. Was @lessismoremedicine.❤️quaternary prevention, preventing overdiagnosis, goal-concordant EBM, choosing wisely.
Yes everything should be open access. unfortunately publishing is such a profit-based endeavor, and charges of $3k to put something in a legitimate and well circulated journal are not sustainable for researchers. Thankfully they circulate the same ideas in public talks, press releases, websites
November 18, 2025 at 5:11 PM
Yes everything should be open access. unfortunately publishing is such a profit-based endeavor, and charges of $3k to put something in a legitimate and well circulated journal are not sustainable for researchers. Thankfully they circulate the same ideas in public talks, press releases, websites
you read our minds... @amtejani.bsky.social and some other crackerjack pharmacist brains are looking at other racemic/enantiomers ... and it doesn't look good for pharma :P
November 18, 2025 at 5:18 AM
you read our minds... @amtejani.bsky.social and some other crackerjack pharmacist brains are looking at other racemic/enantiomers ... and it doesn't look good for pharma :P
“While you are on chemotherapy …” Myths:
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
“While you are on chemotherapy …”: common recommendations that lack evidence and may cause harm
Abstract. Patients on chemotherapy often use multiple resources to obtain information on wide-ranging issues, including prognosis, treatments, diet, exerci
academic.oup.com
November 18, 2025 at 5:17 AM
“While you are on chemotherapy …” Myths:
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
This is a huge challenge for patients. Proprietary parts for their means of mobility and very few vendors, lots of rules about who can fix them, etc and it means many simply can’t be mobile. That is not ok!
Imagine the driver's seat in your car needs to be fixed, and you're waiting for the dealer to get a new one.
It's going to be months.
Now imagine you have to stay in bed 24/7 until the new seat arrives.
This is life for many #wheelchair users in BC.
✅ READ: b.link/wheelchair
It's going to be months.
Now imagine you have to stay in bed 24/7 until the new seat arrives.
This is life for many #wheelchair users in BC.
✅ READ: b.link/wheelchair
November 13, 2025 at 11:03 PM
This is a huge challenge for patients. Proprietary parts for their means of mobility and very few vendors, lots of rules about who can fix them, etc and it means many simply can’t be mobile. That is not ok!
As it turns out, escitalopram is just a marketing parachute for citalopram.
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
November 13, 2025 at 10:59 PM
As it turns out, escitalopram is just a marketing parachute for citalopram.
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
🧵 TI Annual Course - REGISTER NOW!
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
October 28, 2025 at 5:11 PM
🧵 TI Annual Course - REGISTER NOW!
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
this makes no sense. Clearly investing in exercise and social programs for vulnerable elders would be a much better use of resources.
“It does not stop people from getting worse, but the disease is slowed.”
(Lesions seem better without clinically significant effects)
Lencanemab aka Leqembi gets approved in Canada
www.ctvnews.ca/health/artic...
(Lesions seem better without clinically significant effects)
Lencanemab aka Leqembi gets approved in Canada
www.ctvnews.ca/health/artic...
‘An important milestone:’ Canada approves expensive new drug that can slow Alzheimer’s disease
Health Canada has approved an expensive new drug that can slow the progression of Alzheimer’s disease.
www.ctvnews.ca
October 27, 2025 at 11:30 PM
this makes no sense. Clearly investing in exercise and social programs for vulnerable elders would be a much better use of resources.
Check it:
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
October 20, 2025 at 4:06 PM
Check it:
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
RTVS programs = incredible. Saw that at the JCC talk today. As one who stopped remote practice, one reason was not feeling able to manage occasional critical cases with the skills/confidence required. That’s a big barrier to sustaining rural work.
RTVS could (does) make all the difference!!!
RTVS could (does) make all the difference!!!
October 7, 2025 at 9:00 PM
RTVS programs = incredible. Saw that at the JCC talk today. As one who stopped remote practice, one reason was not feeling able to manage occasional critical cases with the skills/confidence required. That’s a big barrier to sustaining rural work.
RTVS could (does) make all the difference!!!
RTVS could (does) make all the difference!!!
Yes. Some are better than others. Many suggest things that conflict with others.
October 7, 2025 at 8:53 PM
Yes. Some are better than others. Many suggest things that conflict with others.
another TI @drug-evidence.bsky.social + collaborators publication:
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
October 7, 2025 at 12:07 AM
another TI @drug-evidence.bsky.social + collaborators publication:
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
One + of covid-era delays: learned Rx like rituximab for MS in lower/less frequent doses are still effective = lower cost & easier for patient!
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
October 3, 2025 at 10:57 PM
One + of covid-era delays: learned Rx like rituximab for MS in lower/less frequent doses are still effective = lower cost & easier for patient!
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
good question...probably not. The mechanism is likely related to neurotransmitters and their post-synaptic receptors being down-regulated.
Our group has done a fair bit of work on this: www.ti.ubc.ca/2025/06/18/1... and www.ti.ubc.ca/2025/07/17/1... are our recent efforts.
Our group has done a fair bit of work on this: www.ti.ubc.ca/2025/06/18/1... and www.ti.ubc.ca/2025/07/17/1... are our recent efforts.
Therapeutics Initiative | [156] Antidepressant withdrawal syndrome – Update
www.ti.ubc.ca
September 17, 2025 at 1:28 AM
good question...probably not. The mechanism is likely related to neurotransmitters and their post-synaptic receptors being down-regulated.
Our group has done a fair bit of work on this: www.ti.ubc.ca/2025/06/18/1... and www.ti.ubc.ca/2025/07/17/1... are our recent efforts.
Our group has done a fair bit of work on this: www.ti.ubc.ca/2025/06/18/1... and www.ti.ubc.ca/2025/07/17/1... are our recent efforts.
@cfpjournal.bsky.social ah! you do have a Bluesky account! Couldn't find it the other day, sorry about that, would have @'d you otherwise :)
September 16, 2025 at 6:18 PM
@cfpjournal.bsky.social ah! you do have a Bluesky account! Couldn't find it the other day, sorry about that, would have @'d you otherwise :)
Our @drug-evidence.bsky.social team has worked so hard on Portraits www.ti.ubc.ca/portrait/ and we have RCT evidence that it improves prescribing patterns.
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
September 15, 2025 at 7:11 PM
Our @drug-evidence.bsky.social team has worked so hard on Portraits www.ti.ubc.ca/portrait/ and we have RCT evidence that it improves prescribing patterns.
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
. . . particularly in youth. I think tramadol carries a warning (in the USA anyway) of increased risk of suicide. We did not assess that in our paper - but none of the studies reported on it anyway. One has to look at population-level data and there are certainly a number of case reports that fit.
September 15, 2025 at 4:23 AM
. . . particularly in youth. I think tramadol carries a warning (in the USA anyway) of increased risk of suicide. We did not assess that in our paper - but none of the studies reported on it anyway. One has to look at population-level data and there are certainly a number of case reports that fit.
I'm sorry you went through that, it must have been very frightening! Pharmacologically: the molecular structure and mechanism of action of tramadol, besides opioid-effect, is that of an SNRI (similar to venlafaxine). Increased suicidality can be a side effect of SSRI or SNRI antidepressants. . .
September 15, 2025 at 4:23 AM
I'm sorry you went through that, it must have been very frightening! Pharmacologically: the molecular structure and mechanism of action of tramadol, besides opioid-effect, is that of an SNRI (similar to venlafaxine). Increased suicidality can be a side effect of SSRI or SNRI antidepressants. . .
tough! In Canada we don’t have “direct to consumer” marketing thankfully. People do see American TV ads but it is more the physicians who follow the myth that tramadol is “safer than opioids” who I suspect drive the prescribing trend. hopefully our article helps a bit
September 13, 2025 at 3:39 PM
tough! In Canada we don’t have “direct to consumer” marketing thankfully. People do see American TV ads but it is more the physicians who follow the myth that tramadol is “safer than opioids” who I suspect drive the prescribing trend. hopefully our article helps a bit
that is a perfect summary! haha that is exactly what we found. Our inclusion of types/durations of pain and the durations of studies etc was perhaps overly broad, but there is so little out there that we decided it would be best to include it all.
September 13, 2025 at 5:58 AM
that is a perfect summary! haha that is exactly what we found. Our inclusion of types/durations of pain and the durations of studies etc was perhaps overly broad, but there is so little out there that we decided it would be best to include it all.
Took a few years... but we got it done and in print thanks to @cfpc-cmfc.bsky.social's CFP.
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
Tramadol (with or without acetaminophen) efficacy and harm
Objective To evaluate the efficacy and safety of tramadol (with or without acetaminophen) in adult pain management compared with nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminoph...
www.cfp.ca
September 13, 2025 at 4:54 AM
Took a few years... but we got it done and in print thanks to @cfpc-cmfc.bsky.social's CFP.
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
I also have questions!
Mid-Island MLAs were questioned regarding when the Nanaimo hospital will get a new patient tower and cardiac catheterization lab, promises made by Premier David Eby during last year's election campaign.
#Nanaimo
nanaimonewsnow.com/2025/08/22/p...
#Nanaimo
nanaimonewsnow.com/2025/08/22/p...
Promised new patient tower & cardiac care addressed by Nanaimo MLA’s
NANAIMO - Nearly a year after B.C.'s premier made significant healthcare promises for Nanaimo on the campaign ...
nanaimonewsnow.com
August 23, 2025 at 3:11 AM
I also have questions!
oh #academictwitter where you at?!
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
a man and two women are standing next to each other in a room .
ALT: a man and two women are standing next to each other in a room .
media.tenor.com
August 19, 2025 at 10:26 PM
oh #academictwitter where you at?!
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
Toronto-area MDs and pharmacists: Join us for Therapeutics Day 2025
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
August 13, 2025 at 12:05 AM
Toronto-area MDs and pharmacists: Join us for Therapeutics Day 2025
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
🎆It's here!!!!! 🎆
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
July 31, 2025 at 2:13 AM
🎆It's here!!!!! 🎆
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
Just wait. The comments after the post will confirm this post's truth.
July 22, 2025 at 12:03 PM
Just wait. The comments after the post will confirm this post's truth.