TI Blog Update: July 2024

TI Blog Update: July 2024

In British Columbia, people at risk of unwanted pregnancy now have easy access to “morning after” pills. There is controversy and scientific uncertainty as to whether the generic levonorgestrel pill available without prescription and free of charge is equally effective as ulipristal – a newer and more expensive brand name alternative that also requires a prescription.

This month we released Therapeutics Letter 150 that reviews evidence available from randomized controlled trials. Prominent guidelines prefer ulipristal, and the results of 2 RCTs are tantalizing, but our TI systematic review did not allow us to conclude that ulipristal is superior. Our simple conclusion accords with others:

  • To avoid unwanted pregnancy after unprotected sexual intercourse, take either available emergency contraceptive pill (ECP) as soon as possible.

It leads to another practical message for women at risk of unwanted pregnancy and their primary health care providers:

  • If you’re liable to be at risk of unprotected sex, carry an ECP with you.

Therapeutics Letter 150 received careful and helpful reviews from a number of internationally regarded experts in reproductive medicine. Not all will agree with our conclusions, but we encourage sceptics to look at the detailed TI Drug Assessment Working Group report posted on our website that discusses in detail the subtleties of understanding available evidence. As we discussed RCT results within our group, we wondered why, if ulipristal is indeed more effective than levonorgestrel (whether overall, or for use during a later interval after unprotected sex), the French manufacturer has never run a definitive trial that prove superiority.

We publish interesting scientifically oriented comments, when the submitters also provide a standard International Committee of Medical Journal Editors (ICMJE) disclosure of real or potential conflicts of interest. So if anyone knows the answer, we are open to posting replies.


The TI Methods Speaker Series Webinar continues this  Wednesday, July 31st at 12:00pm PDT [convert to your local time] when Dr. Caspar J. Van Lissa, Associate Professor at Tilburg University (Netherlands), will discuss pioneering work on Text Mining Systematic Reviews (TMSR) by presenting two studies that used different TMSR pipelines to extract a latent nomological network from the literature in a particular subfield, and will reflect on general considerations regarding the use of text mining in research synthesis, based on his experience as Associate Editor of Research Synthesis Methods.

Read more about this webinar or REGISTER.

The TI Methods Speaker Series are offered monthly free of charge and everyone is welcome. The event is usually held at noon on the last Wednesday of each month via Zoom. The presentations are recorded and the video recordings are posted online. Click here to view the list of talks offered in 2024.


REGISTRATION for our popular annual course is now open. Evaluations by past attendees often say they appreciate “the other side of the story” about prescription drugs – presented and discussed by an unconflicted faculty. Please consider joining us for Best Evidence 2024, and let your colleagues or students know about this opportunity:

2024 Annual Course: Bringing Best Evidence to Clinicians

To mark the 30th anniversary of the Therapeutics Initiative, we’re excited to introduce a unique format for this year’s event, with an in-person gathering on Friday, October 18, followed by hybrid (virtual and in-person) sessions on Saturday, October 19. Those who attended in the past know that the audience is as lively and fun to interact with as the speakers. And the conference hotel rate of $169/night (plus taxes, parking) is now a very attractive rate for a visit to Vancouver. But you can also attend online by Zoom.

This year’s course features two internationally renowned guest faculty with rave reviews from past audiences in Vancouver and online:

  • Dr. Derelie (Dee) Mangin is a leading research professor in Family Practice, originally from New Zealand and now at McMaster University. She is one of the rare physicians who has run trials of deprescribing. Dee can be as funny as she is friendly, and this is a great opportunity for anyone to meet her during our Friday evening pre-course reception or on Saturday, October 19th.
  • Dr. John Mandrola is an experienced cardiac electrophysiologist who has won international appreciation for his communication skills in dissecting and logically analyzing what we know and do not know from clinical trials. He’s as friendly and approachable as Dr. Mangin.

Of course our own TI faculty are not easily outdone. We guarantee that this course will make you think – and hopefully re-think some of what you do. But whether you’re a NP, pharmacist, physician, or student/resident,  we’ll also provide you with practical trips to improve patient care.

On Friday afternoon, October 18th, we also offer a specialized small-group Practical Deprescribing Workshop. If you face challenges in dealing with polypharmacy, or wonder if you could gain professional satisfaction by sometimes going “where others fear to tread,” this workshop is for you. It’s designed to interest and assist any health professional involved with medications – from student or resident to even a very experienced practitioner.

By working with UBC CPD, we keep fees to the minimum possible – to promote affordable access. In person registration fees cover lunch and refreshments on Saturday, and a refreshment break on Friday. If you can’t afford the fee, let us know – so we can consider a subsidy.

This year’s course is hosted at UBC Robson Square in downtown Vancouver, a central location that offers convenient access to nearby popular attractions, making it an ideal location for attendees and family members to explore the city’s offerings outside of conference hours. Furthermore,  this year’s event offers a variety of social activities, including a Friday evening reception at the Glowbal at Telus Garden (a chance to meet faculty and colleagues in a congenial environment with good food) and a guided gallery tour for family members at the Vancouver Art Gallery, both conveniently located just minutes away from the conference venue. ‘Early bird‘ registration runs until September 4 and we are also running a Portrait Online promotion that offers a 30% discount from the course registration fee to BC family physicians and nurse practitioners who sign up for Portrait Online between June 26 and September 4.

Read more about this year’s course or REGISTER.


If you are a BC family physician or nurse practitioner, we invite you to join over 1,000 of your BC colleagues who have signed up for the TI Portrait program at our secure online portal: https://secure.ti.ubc.ca/ Log in to view your Portraits and/or related materials, or sign up if you haven’t already. New Portrait Online users who sign up for this service between June 26 and September 4 will receive a 30% discount on registration for the 2024 Annual Course: Bringing Best Evidence to Clinicians.

Questions? Email the TI Portrait team at portrait@ti.ubc.ca We welcome your feedback.


We wish everyone in the northern hemisphere a great summer and hope to “see you” soon by Zoom, or in person this fall.

Thomas L. Perry MD, FRCPC
Editor, Therapeutics Letter
Therapeutics Initiative
University of British Columbia, Vancouver

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