Frankly Speaking About Family Medicine

New Benefits Give SGLT2 Inhibitors Their Turn to Shine - Frankly Speaking Ep 376

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-376
Overview: While GLP-1 agents are center stage in the medical and lay press, drugs in the class of sodium-glucose cotransporter 2 inhibitors (SGLT2is) are also quite remarkable at improving a variety of health endpoints. This episode provides an overview of studies supporting the use of SGLT2is to improve patient outcomes.
Episode resource links:
DM/HF:  Age Ageing 2024 Jan 2;53(1):afad254. doi: 10.1093/ageing/afad254
Kidney stones: JAMA Intern Med. 2024 Jan 29:e237660. doi: 10.1001/jamainternmed.2023.7660
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato

Breast Cancer: Increased Incidence Doesn’t Mean Increased Mortality - Frankly Speaking Ep 375

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-375
Overview: Listen in as we discuss trends seen in breast cancer incidence over recent decades. Despite a notable rise in its prevalence, we’ve witnessed a decline in mortality rates. This positive shift owes itself to improvements in medication and screening efforts. Explore with us the multifaceted factors shaping this evolving landscape of breast cancer diagnosis and treatment.
Episode resource links:
https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html
https://www.uspreventiveservicestaskforce.org/uspstf/
Caswell-Jin, J. L., Sun, L. P., Munoz, D., Lu, Y., Li, Y., Huang, H., ... & Plevritis, S. K. (2024). Analysis of Breast Cancer Mortality in the US—1975 to 2019. JAMA, 331(3), 233-241.
Xu, S., Murtagh, S., Han, Y., Wan, F., & Toriola, A. T. (2024). Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status. JAMA Network Open, 7(1), e2353331-e2353331.
Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Richard Onorato

Sleep Lab in Your Pocket: Smartphone Diagnostics for Sleep Apnea - Frankly Speaking Ep 374

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-374
Overview: This episode explores the use of data from smartphone recordings as a diagnostic tool for obstructive sleep apnea (OSA), highlighting at-home testing as a more accessible, convenient, and appropriate option for some patients. Hear how the evidence can inform your practice and improve the diagnosis and treatment of patients with OSA.
Episode resource links:
Han SC, Kim D, Rhee CS, Cho SW, Le VL, Cho ES, Kim H, Yoon IY, Jang H, Hong J, Lee D, Kim JW. In-Home Smartphone-Based Prediction of Obstructive Sleep Apnea in Conjunction With Level 2 Home Polysomnography. JAMA Otolaryngol Head Neck Surg. 2024 Jan 1;150(1):22-29. doi: 10.1001/jamaoto.2023.3490. PMID: 37971771; PMCID: PMC10654929.
OSA and CV disease in adults, UpToDate
Home sleep apnea testing for adults, UpToDate
Guest: Jillian Joseph, MPAS, PA-C Music Credit: Richard Onorato

Type 2 Diabetes Mellitus: Can Lifestyle Reverse It? - Frankly Speaking Ep 373

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-373
Overview: In this episode, we review the effectiveness of intensive lifestyle intervention for type 2 diabetes mellitus (T2DM) remission. We unpack study findings on total diet replacement and consider its potential for improving weight loss and maintenance in patients. Tune in to enrich your clinical toolkit, empowering you to optimize patient outcomes and enhance quality of life.
Episode resource links:
Hocking, S. L., Markovic, T. P., Lee, C. M. Y., Picone, T. J., Gudorf, K. E., & Colagiuri, S. (2024). Intensive Lifestyle Intervention for Remission of Early Type 2 Diabetes in Primary Care in Australia: DiRECT-Aus. Diabetes care, 47(1), 66–70. https://doi.org/10.2337/dc23-0781
 
Centers for Disease Control:  Diabetes Care for Providers: https://www.cdc.gov/diabetes/professional-info/index.html
 
Optifast USA: https://www.optifast.com/
 
Pattinson, A. L., Seimon, R. V., Harper, C., Nassar, N., Grech, A., Santoso, E. A., Franklin, J., Inan-Eroglu, E., Gibson, A. A., & Sainsbury, A. (2021). Diet Quality following Total Meal Replacement Compared with Food-Based Weight-Loss Diets in Postmenopausal Women with Obesity: A Secondary Analysis of the TEMPO Diet Trial. The Journal of nutrition, 151(11), 3299–3312. https://doi.org/10.1093/jn/nxab311
Guest: Jill M. Terrien, PhD, ANP-BC  Music Credit: Richard Onorato

Chocolate—Get the Lead Out! - Frankly Speaking Ep 372

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-372
Overview: Listen in as we unwrap Consumer Reports’ findings on heavy metals found in commonly consumed chocolate products. Our discussion looks into concerns about high levels of metals like lead and cadmium in these treats and offers advice on how to counsel your patients for worry-free chocolate enjoyment. 
Episode resource links:
A Third of Chocolate Products Are High in Heavy Metals, CR T - Consumer Reports
Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato

Beta-Blockers Post-Myocardial Infarction: Are They Still Needed? - Frankly Speaking Ep 371

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-371
Overview: Beta-blockers have traditionally been used indefinitely after a myocardial infarction (MI), but this is now only recommended for a subset of patients. Listen in as faculty review new recommendations for managing patients with chronic cardiac disease, including how to determine which patients are good candidates for beta-blocker therapy and for how long.
Episode resource links:
Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines [published correction appears in Circulation. 2023 Sep 26;148(13):e148] [published correction appears in Circulation. 2023 Dec 5;148(23):e186]. Circulation. 2023;148(9):e9-e119. 
Joo SJ. Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it. Acute Crit Care. 2023;38(3):251-260. 
Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Richard Onorato

Low Back Pain—More Evidence for the Effectiveness of Nonnarcotic Modalities - Frankly Speaking Ep 370

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-370
Overview: Low back pain is one of the most common symptoms presenting in primary care. Listen in as we analyze the results of a recent systematic review supporting the use of a variety of effective nonnarcotic treatments for this condition. Gain evidence-based insights to help you choose the most informed option for managing low back pain.
Episode resource links:
Gianola S, Bargeri S, Del Castillo G, et al. Br J Sports Med 2022;56:41–50. doi.org/ 10. 1136/ bjsports- 2020- 103596).
Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato

Be a Flamingo: 1-Legged Stance Test Predicts Risks - Frankly Speaking Ep 369

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-369
Overview: Uncover a simple, 10-second intervention—the 1-legged stance test—for predicting the risk of falling in adults. Join us as we discuss how this swift assessment can help identify patients who are prone to falls, fractures, and increased mortality. This episode brings you a practical tool to enhance patient assessments and tailor interventions, contributing to a more proactive and personalized approach to care.
Episode resource links:
JAMA. 2023;329(18):1605-1607. doi:10.1001/jama.2023.3054
Br J Sports Med. 2022;56:975–980.
Pharmacoepidemiol Drug Saf. 2021 Aug;30(8):1049-1056. doi: 10.1002/pds.5201
PLoS Med 18(11): e1003821. https://doi.org/10.1371/journal.pmed.1003821
Guest: Jillian Joseph, MPAS, PA-C Music Credit: Richard Onorato

Data-Driven Perspectives on Prescriptive Authority and the Quality Quandary - Frankly Speaking Ep 368

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-368
Overview: In this insightful episode, we explore compelling data comparing inappropriate prescribing practices among physicians and nonphysician prescribers. This discussion covers the nuances and restrictive scope of prescribing authority and aims to take an evidence-based approach to encouraging collaboration between clinicians and expanding patients’ access to care.
Episode resource links:
Huynh, J., Alim, S. A., Chan, D. C., & Studdert, D. M. (2023). Inappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians. Annals of internal medicine, 176(11), 1448–1455. https://doi.org/10.7326/M23-0827
American Association of Nurse Practitioners https://www.aanp.org/
American Academy of Physician Associates https://www.aapa.org/
Jiao, S., Murimi, I. B., Stafford, R. S., Mojtabai, R., & Alexander, G. C. (2018). Quality of Prescribing by Physicians, Nurse Practitioners, and Physician Assistants in the United States. Pharmacotherapy, 38(4), 417–427. https://doi.org/10.1002/phar.2095
2023 Beers Criteria American Geriatrics Society: Free to read https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18372
Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Richard Onorato

The Portfolio Diet—Another Approach to Eating Healthy? - Frankly Speaking Ep 367

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-367
Overview: Join us for a look at the Portfolio Diet, a plant-based approach with potential to improve cardiovascular outcomes. We’ll take you through the details of this regimen and what the evidence says about its effect on the risks of cardiovascular diseases. Stay informed on the latest research and feel prepared to answer your patients’ questions about the Portfolio Diet.
Episode resource links:
Circulation. 2023;148:00–00. DOI: 10.1161/CIRCULATIONAHA.123.065551
Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato