Frankly Speaking About Family Medicine

Peaceful, Easy Feeling: Can Mindfulness Exercise Improve Asthma-Related Quality of Life? - Frankly Speaking Ep 255

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-255
 
Overview: Asthma is one of the most prevalent conditions, affecting almost 340 million individuals across the globe and approximately 25 million Americans, or 7.8% of the US population. Treatment is complex and goals of therapy are elusive for many. Anxiety and other concerns are common in those diagnosed with asthma and can worsen outcomes. A recent study from the UK found the use of a mindfulness app was associated with improved asthma-related quality-of-life indicators. Join us while we discuss this study’s implications for helping patients with asthma in primary care.
 
Episode resource links:
Ainsworth, B., Stanescu, S., Stuart, B., Russell, D., Liddiard, M., Djukanovic, R., & Thomas, M. (2021). A feasibility trial of a digital mindfulness-based intervention to improve asthma-related quality of life for primary care patients with asthma. Journal of Behavioral Medicine. Advance online publication. https://doi.org/10.1007/s10865-021-00249-3
CDC Most Recent National Asthma Data: https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm
Guest: Susan Feeney, DNP, FNP-BC, NP-C
 
Music Credit: Richard Onorato
 

Older Adults and Loneliness—Avoid High-Risk Medications - Frankly Speaking Ep 254

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-254-2
 
Overview: Older adults who suffer from loneliness may be at risk of overusing medications prescribed for pain, insomnia, depression, or anxiety. Replacing these medications with social interventions may improve outcomes and help patients avoid adverse consequences. Join us as we discuss the importance of reviewing medications and assessing for loneliness in older adults to prevent adverse events and outcomes.
 
Episode resource links:
Kotwal, A. A., Steinman, M. A., Cenzer, I., & Smith, A. K. (2021). Use of High-risk Medications Among Lonely Older Adults: Results From a Nationally Representative Sample. JAMA internal medicine, e213775. Advance online publication. https://doi.org/10.1001/jamainternmed.2021.3775 https://pubmed.ncbi.nlm.nih.gov/34309620/
Education for Patients: Tips on Staying Connected—National Institutes on Aging https://www.nia.nih.gov/health/loneliness-and-social-isolation-tips-staying-connected
Guest: Jill M. Terrien PhD, ANP-BC
 
Music Credit: Richard Onorato

The End of ACE Inhibitors? - Frankly Speaking Ep 253

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-253
 
Overview: ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are both recommended as first-line treatments for hypertension. ACE inhibitors have known side effects, such as cough, that are frustrating for many patients, while ARBs appear to have less annoying side effects. This podcast will review a recently published retrospective, comparative cohort study comparing the effectiveness and safety of ACE inhibitors vs ARBs in the first-line treatment of hypertension.
 
Episode resource links:
Hypertension. 2021;78:591–603. DOI: 10.1161/HYPERTENSIONAHA.120.16667
 
ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/ NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127–e248. doi: 10.1016/j.jacc.2017.11.006
Guest: Robert A. Baldor MD, FAAFP
 
Music Credit: Richard Onorato

Contraception: When Do We Start Them? - Frankly Speaking Ep 252

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-252
 
Overview: For patients who would like to prevent pregnancy, many options—both hormonal and nonhormonal—exist. Despite the availability of multiple options, many patients do not use them because of either a lack of knowledge or a lack of access, the latter being especially true in uninsured and non−English-speaking communities. Research has shown over the years that while unintended pregnancies have decreased in the United States, more can be done, and primary care providers can play an important role in helping to further decrease and eliminate barriers to contraception.
 
Episode resource links:
Lesnewski, R. (2021). Initiating Hormonal Contraception. American Family Physician, 103(5), 291-300.
Guest: Mariyan L. Montaque, DNP, FNP-BC
 
Music Credit: Richard Onorato

Primary HPV Testing Alone for Cervical Cancer Screening: a Review of Recent Guideline Updates - Frankly Speaking Ep 251

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-251
 
Overview: Primary care providers should be up to date on the changes to the guidelines for cervical cancer screening to be able to guide patients in shared decision-making about health maintenance. Join us to review the recent changes to cervical cancer screening guidelines as recommended by the American Cancer Society.
 
Episode resource links:
Cervical Cancer Screening: Updated Guidelines from the American Cancer Society. Am Fam Physician. 2021 Sep; 104(2):314-315.
American College of Obstetricians and Gynecologists. Updated cervical cancer screening guidelines. Practice advisory. April 2021. Accessed September 30, 2021. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines
Fontham, ETH, Wolf, AMD, Church, TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin. 2020. https://doi.org/10.3322/caac.21628.
Guest: Jillian Joseph, MPAS, PA-C
 
Music Credit: Richard Onorato

Time to Recommend the Use of Salt Substitutes for CVD Prevention? - Frankly Speaking Ep 250

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-250
 
Overview: While the data conflict on how much sodium intake is optimal for preventing cardiovascular disease, it is clear that daily salt intake for most Americans exceeds what is recommended. However, restricting salt intake on an individual or on a public health level has been controversial. An interesting alternative is the use of salt substitutes, which can help to decrease sodium intake while increasing potassium intake, and both have been associated with lowering blood pressure. Join us to hear a discussion on the results of the recently published studies on salt and cardiovascular disease, along with an overview of the Salt Substitute and Stroke Study (SSaSS).
 
Episode resource links:
Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med. DOI: 10.1056/NEJMoa2105675
O’Donnell M, Mente A, Alderman MH, et al. Salt and cardiovascular disease: insufficient evidence to recommend low sodium intake, European Heart Journal, Volume 41, Issue 35, 14 September 2020, Pages 3363–3373, https://doi.org/10.1093/eurheartj/ehaa586
Circulation. 2021;143:1542–1567. DOI: 10.1161/CIRCULATIONAHA.120.050371
Guest: Robert A. Baldor MD, FAAFP
 
Music Credit: Richard Onorato

Using DOACs for Valvular Atrial Fibrillation - Frankly Speaking Ep 249

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-249
 
Overview: For non-valvular atrial fibrillation, physicians, patients, and guideline organizations all prefer direct oral anticoagulants (DOACs) over vitamin K antagonists, such as warfarin, for thromboembolic prophylaxis. For those with valvular atrial fibrillation, the data for safety and efficacy have been limited because randomized trials comparing DOACs to warfarin often exclude patients with valvular atrial fibrillation. Join us to explore new data that shed light on the use of DOACs in valvular atrial fibrillation.
 
Episode resource links:
Dawwas GK, Dietrich E, Cuker A, Barnes GD, Leonard CE, Lewis JD. Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation : A Population-Based Cohort Study. Ann Intern Med. 2021;174(7):910-919.
Guest: Alan Ehrlich MD, FAAFP
 
Music Credit: Richard Onorato

Aspirin—Not Really for Primary Prevention - Frankly Speaking Ep 248

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-248
 
Overview: Join us to hear a discussion on the important changes the AHA/ACC and USPSTF have made to their positions on the use of aspirin for primary prevention of cardiovascular disease. The organizations note that while aspirin for primary prevention lowers the risk of a myocardial infarction, its harmful effects may outweigh its benefits. Learn the aspirin recommendations for your patients in their 40s, 50s, and 60s who are at higher risk for a cardiovascular event.
 
Episode resource links:
New: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication
Old: https://www.aafp.org/afp/2016/1015/od1.html
https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer
Guest: Jill M. Terrien PhD, ANP-BC
 
Music Credit: Richard Onorato

A Fishy Method to Prevent Migraines - Frankly Speaking Ep 247

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-247
 
Overview: When it comes to chronic migraines, your first-line prevention is probably medication, but according to a new study, it may not have to be. Certain foods may play a role in increasing and decreasing migraine recurrence. Join us to review a recent randomized controlled trial aimed at preventing migraines in those with chronic migraines.
 
Episode resource links:
BMJ 2021; 374 :n1448 doi:10.1136/bmj.n1448; doi: https://doi.org/10.1136/bmj.n1448
The association of dietary patterns with migraine attack frequency in migrainous women. Nutritional Neuroscience 23:9, pages 724-730
Guest: Alan Ehrlich MD, FAAFP
 
Music Credit: Richard Onorato

Muscle Relaxants for Low Back Pain: Are They Worth the Risk? - Frankly Speaking Ep 246

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-246
 
Overview: Low back pain often leads to disability and loss of income and is a significant burden on patients and the healthcare system. While muscle relaxants are the third most common prescribed drugs in the treatment of low back pain, recent data demonstrating its use and efficacy are limited. This session discusses a recent systematic review of the safety, efficacy, and accepted use of muscle relaxants in the treatment of low back pain. Don’t miss this opportunity to learn how to provide low back pain treatments that have clear benefits for your patients.
 
Episode resource links:
Cashin A G, Folly T, Bagg M K, Wewege M A, Jones M D, Ferraro M C et al. Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis BMJ 2021; 374 :n1446 doi:10.1136/bmj.n1446 https://pubmed.ncbi.nlm.nih.gov/34233900/
Guest: Jill M. Terrien PhD, ANP-BC
 
Music Credit: Richard Onorato