Frankly Speaking About Family Medicine

Selecting Medication for Depression: Do Genomics Matter? - Frankly Speaking Ep 304

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-304
Overview: Pharmacogenomic testing has been suggested as a way to personalize medicine, particularly where the metabolism of medications can vary significantly. Unfortunately, despite increasing use of this testing, there has been little evidence showing a benefit in clinical outcomes. Listen to this podcast to explore the data on clinical outcomes for pharmacogenetic testing and how to best select medication for patients with depression.
Episode resource links:
Oslin DW, Lynch KG, Shih MC, et al. Effect of Pharmacogenomic Testing for Drug-Gene Interactions on Medication Selection and Remission of Symptoms in Major Depressive Disorder: The PRIME Care Randomized Clinical Trial. JAMA. 2022;328(2):151-161.
Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato

Time to Stop Recommending Vitamin D? - Frankly Speaking Ep 303

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-303
Overview: Millions of Americans take Vitamin D supplementation to prevent a variety of illnesses, from COVID-19 and osteoporosis to heart disease and cancer. While most studies have failed to show a benefit in preventing COVID-19, heart disease, and cancer, the evidence has been mixed, at best, in showing benefits for preventing bone fractures. Despite this, vitamin D supplementation remains popular for fracture prevention. Join us to review a study published in the New England Journal of Medicine that failed to find any benefits for preventing fractures.
Episode resource links:
N Engl J Med 2022;387:299-309. DOI: 10.1056/NEJMoa2202106
Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato

New AACE Guidelines for Non-Alcoholic Fatty Liver Disease - Frankly Speaking Ep 302

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-302
 
Overview: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, with a prevalence rate of more than 30% of US adults. Most have not been diagnosed or treated. Join us to discuss the new AACE guidance on the diagnosis and treatment of NAFLD to reduce the burden of this common disease.
 
Episode resource links:
AACE Guideline:  Endocrine Pract: May 2022, 28(5): 528-562
Coffee: Front Pharmacol. 2021 Dec 13;12:786596. doi: 10.3389/fphar.2021.786596
 
Guest: Robert A. Baldor, MD
 
Music Credit: Richard Onorato 

Walking and Osteoarthritis of the Knee: A Simple Strategy to Slow Cartilage Loss - Frankly Speaking Ep 301

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-301
 
Overview: In this episode, we will discuss a simple and inexpensive yet effective strategy for slowing the loss of knee joint cartilage in a patient with osteoarthritis: walking. Hear how recent evidence suggests that including a walking regimen into treatment plans may confer numerous benefits in this patient population.
 
Episode resource links:
Busse, JW, Sadeghirad, B., Oparin, Y. et al; Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med.2020;173:730-738. [Epub 18 August 2020]. doi:10.7326/M19-3601
Kolasinski, S.L., Neogi, T., Hochberg, M.C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W.F., Hawker, G., Herzig, E., Kwoh, C.K., Nelson, A.E., Samuels, J., Scanzello, C., White, D., Wise, B., Altman, R.D., DiRenzo, D., Fontanarosa, J., Giradi, G., Ishimori, M., Misra, D., Shah, A.A., Shmagel, A.K., Thoma, L.M., Turgunbaev, M., Turner, A.S. and Reston, J. (2020), 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res, 72: 149-162. https://doi.org/10.1002/acr.24131
Lo GH, Vinod S, Richard MJ, et al. Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals with Knee Osteoarthritis: Data from the Osteoarthritis Initiative Cohort [published online ahead of print, 2022 Jun 8]. Arthritis Rheumatol. 2022;10.1002/art.42241. doi:10.1002/art.42241
Thudium C. Markers of synovial inflammation matrix turnover and symptoms. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting).
Ooman JMH. Babs on a mission: An experimental study on the effects of message framing and exemplification on treatment intentions of osteoarthritis patients. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting).
Zeng C, Doherty M, Persson MSM, et al. Comparative efficacy and safety of acetaminophen, topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis: evidence from a network meta-analysis of randomized controlled trials and real-world data. Osteoarthritis Cartilage. 2021;29(9):1242-1251. doi:10.1016/j.joca.2021.06.004
 
Guest: Susan Feeney, DNP, FNP-BC, NP-C
 
Music Credit: Richard Onorato 

Cats Causing Psychosis! - Frankly Speaking Ep 300

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-300
 
Overview: Most primary care clinicians are unaware of a possible association between childhood cat ownership and adult psychosis. Join us to hear the results of a recent retrospective study that suggests this link. Hear practical tips to share with patients who own an outdoor cat to help them avoid the toxoplasmosis that may be a potential etiologic agent for psychiatric illness.
 
Episode resource links:
Journal of Psychiatric Research. Volume 148, April 2022, Pages 197-203
doi.org/10.1016/j.jpsychires.2022.01.058
 
Guest: Robert A. Baldor, MD
 
Music Credit: Richard Onorato 

Deprescribing in Patients with Dementia: Less Is More - Frankly Speaking Ep 299

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-299
Overview: Polypharmacy is a burden on patients with dementia. Adverse drug reactions, side effects, the cost, and inappropriate medications that may lead to falls and morbidity/mortality may be conferring more harm than benefit. Unfortunately, 44% of men and 57% of women >65 years take five or more nonprescription and/or prescription medications per day. Join us as we discuss methods for deprescribing polypharmacy in this patient population. 
Episode resource links:
Growdon, M. E., Gan, S., Yaffe, K., & Steinman, M. A. (2021). Polypharmacy among older adults with dementia compared with those without dementia in the United States. Journal of the American Geriatrics Society, 69(9), 2464–2475. PMID: 34101822 https://doi.org/10.1111/jgs.17291
Narayan, S. W., & Nishtala, P. S. (2017). Discontinuation of Preventive Medicines in Older People with Limited Life Expectancy: A Systematic Review. Drugs & aging, 34(10), 767–776. PMID: 28853000  https://doi.org/10.1007/s40266-017-0487-1
Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Richard Onorato 

Leave the Antibiotics on the Shelf for Kids with Lower Respiratory Tract Infections - Frankly Speaking Ep 298

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-298
Overview: :  Lower respiratory tract infections are a common presentation in children, and many of those children receive antibiotic prescriptions. Join us for this episode to review evidence that supports avoiding such treatment unless pneumonia or other bacterial infections are suspected.
Episode resource links:
Little P, Francis NA, Stuart B, et al. Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial. Lancet. 2021;398(10309):1417-1426
Guest: Jillian Joseph, MSPAS, PA-C Music Credit: Richard Onorato

Probiotics to Prevent Diarrhea During Antibiotic Course in Children - Frankly Speaking EP 297

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-297
 
Overview: The efficacy of probiotic formulations in the prevention of antibiotic-associated diarrhea remains unclear. Join us to review a recent study in JAMA Pediatrics that attempts to answer this question.
 
Episode resource links:
Multispecies Probiotic for the Prevention of Antibiotic-Associated Diarrhea in Children A Randomized Clinical Trial
 
Guest: Robert A. Baldor, MD
 
Music Credit: Richard Onorato

Preventing Overdose Deaths with Naloxone: Harm Reduction vs Encouraging Use - Frankly Speaking EP 296

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-296
 
Overview: The number of drug overdoses in the United States continues to rise in tandem with the growing opioid epidemic. In 2020, nearly 92,000 people died from drug overdoses in the United States, which was an approximate 31% increase in just one year. This episode will highlight perceived barriers to harm reduction and show primary care providers how they can play a key role in overdose prevention. 
 
Episode resource links:
https://www.cdc.gov/opioids/overdoseprevention/reverse-od.html
https://www.cdc.gov/drugoverdose/deaths/index.html#:~:text=Drug%20Overdose%20Deaths%20Remain%20High&text=Opioids%E2%80%94mainly%20synthetic%20opioids%20(other,of%20all%20drug%20overdose%20deaths).
Bonner, L. (2022). As the opioid epidemic takes a turn for the worse, do we need more potent forms of naloxone?. Pharmacy Today, 28(3), 26.
Messmer, S., & Jarrett, J. (2022). When Naloxone Isn’t Enough. New England Journal of Medicine.
Tse, W. C., Djordjevic, F., Borja, V., Picco, L., Lam, T., Olsen, A., ... & Nielsen, S. (2022). Does naloxone provision lead to increased substance use? A systematic review to assess if there is evidence of a ‘moral hazard’associated with naloxone supply. International Journal of Drug Policy, 100, 103513.
 
Guest: Mariyan L. Montaque, DNP, FNP-BC
 
Music Credit: Richard Onorato

Suspecting COPD: What If the Spirometry Result Is Normal? - Frankly Speaking EP 295

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-295
 
Overview: Chronic obstructive pulmonary disease (COPD) is typically diagnosed based on spirometry findings, but what if that finding isn’t what you expect? Spirometry measurements are compared to standard values for age, sex, and race. The use of race-based equations has been questioned in several clinical situations, and researchers are now raising similar concerns about the use of race-based equations in spirometry, which may lead to health inequities. Join us for an important discussion on how to overcome these potential disparities in diagnosing COPD.
 
Episode resource links:
Liu GY, Khan SS, Colangelo LA, et al. Comparing Racial Differences in Emphysema Prevalence Among Adults With Normal Spirometry: A Secondary Data Analysis of the CARDIA Lung Study [published online ahead of print, 2022 Jul 19]. Ann Intern Med. 2022;10.7326/M22-0205.
 
Guest: Alan Ehrlich MD, FAAFP
 
Music Credit: Richard Onorato