iiinova — where your digital self keeps evolving

Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 19/02/2026

More is not always better. This patient clearly explains why and how patients can/should say “hey, could I take fewer medications?” Sometimes a prescriber just needs a nudge to reconsider how adding more and more pills is not the only answer to help people feel well again.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 18/11/2025

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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 18/11/2025

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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 18/11/2025

“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

academic.oup.com

“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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 13/11/2025

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!

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 13/11/2025

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… 😬👀

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Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱

Therapeutics Initiative (TI) @drug-evidence.bsky.social · 28/10/2025

🧵 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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 27/10/2025

this makes no sense. Clearly investing in exercise and social programs for vulnerable elders would be a much better use of resources.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 20/10/2025

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

ti.ubc.ca

Therapeutics Initiative | Bringing Best Evidence to Clinicians Annual Course 2025

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 07/10/2025

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!!!

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 07/10/2025

Yes. Some are better than others. Many suggest things that conflict with others.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 07/10/2025

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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 17/09/2025

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.

ti.ubc.ca

Therapeutics Initiative | [156] Antidepressant withdrawal syndrome – Update

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 16/09/2025

@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 :)

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 15/09/2025

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...

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 15/09/2025

. . . 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.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 15/09/2025

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. . .

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 13/09/2025

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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 13/09/2025

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.

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Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱

David Juurlink @davidjuurlink.bsky.social · 13/08/2025

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

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 31/07/2025

🎆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

announcement form HQBC about Appropriate Care / Choosing Wisely hub in British Columbia

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Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱

Raywat Deonandan 🍁🇨🇦 @deonandan.bsky.social · 22/07/2025

Just wait. The comments after the post will confirm this post's truth.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 19/07/2025

a reasonably accessible explanation of overdiagnosis and why it matters in cancer screening: iai.tv/articles/50-...

iai.tv

We are overcounting cancer cases by vast amounts | H. Gilbert Welch

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 15/07/2025

If it’s on purpose, that’s just good legacy planning 😉

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 14/07/2025

Critical thinking skills 101. How do you know something is “true”? Kids need to be able to reason.

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Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱

Nature @nature.com · 02/07/2025

This is how to have difficult conversations with vaccine sceptics

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Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱

Timothy Caulfield @caulfieldtim.bsky.social · 30/06/2025

The sheer volume of harmful & exploitive BS? Study finds 81% of cancer cures touted by TikTok videos are fake medicalxpress.com/news/2024-11... From study: "...draw on a conspiratorial worldview to present various miracle cures..." "...the app provides accessible avenues for monetization..."

medicalxpress.com

Study finds 81% of cancer cures touted by TikTok videos are fake

As many as 81% of cancer cures touted by content creators on TikTok are fake, according to new research from City St George's, University of London.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 28/06/2025

Don't eat THIS. Opened up the mozzarella and it was the same shade of violet as PUBS (purple urine bag syndrome). Had to wonder: "What in the fresh !$%#^* got in there?!" No it isn't a UTI. It's pseudomonas fluorescens! www.pagepressjournals.org/ijfs/article... #medsky #purpleurine #purplecheese

a container of fresh mozzarella that turned purple!

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 26/06/2025

Well, it happened folks: I received a “mild update.” ‼️ And they also request that I submit my manuscript, even if it’s by accident. How should I proceed?! PS is this low rent AI or a maltreated ESL laborer generating these emails?! #scamjournals #academia #medacademia #predatorypublishing

A threatening nonsensical email from a scam or predatory journal

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 26/06/2025

This was interesting; her description of time as a trainee was evocative! Even as a not-really-writer, I found her ruminations on ‘how a doctor ought to approach writing’ relatable.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 24/06/2025

Also, in your defense, it saves zero time. You still have to enter your password anyway, and tapping takes about the same amount of time it takes to type your username.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 24/06/2025

Whenever I see MAHA it’s always “make America hate again”. This movement has been successful. Oh the H is for Healthy?! Nahhhhhhhhh!! 😂 you’re kiddin’!!

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 24/06/2025

Autism remains both under and over diagnosed RFKJ remains one of a handful of current leaders who will no doubt make the health status worse for all autistic people and probably all Americans.

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 17/06/2025

Palliative care seeks neither to shorten or lengthen life but in a study of lung cancer patients on chemo, those randomized to palliative care lived 2.7 months longer on average, had better quality of life, and had fewer invasive/costly treatments near end of life pubmed.ncbi.nlm.nih.gov/20818875/

pubmed.ncbi.nlm.nih.gov

Early palliative care for patients with metastatic non-small-cell lung cancer - PubMed

Among patients with metastatic non-small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving standard care, pa...

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Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱

Alt National Park Service @altnps.bsky.social · 05/06/2025

🍿

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 06/06/2025

I ❤️ pall! Your talk was the most engaging of the day- than you for presenting !

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 05/06/2025

[open to feedback if I got these details wrong! trying to learn, in a mostly caucasian/culturally Christian community]

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 05/06/2025

cont'd - patients may wish to fast (eg during Ramadan) even though they are permitted medical exemption Other pearls: - death is a transition, not an end - alertness often prioritized as it allows prayer

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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 05/06/2025

- emotional reserve is a cultural norm but pts likely vocal about symptoms (= an ask for support) - pts may seek 'aggressive' measures but also accept stopping futile care - what happens is in Allah's hands but pts may want life-prolonging measures from clinicians, through which Allah can work

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