Frankly Speaking About Family Medicine

When to Start Screening for Breast Cancer—Does Race Make a Difference? - Frankly Speaking Ep 331

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-331
Overview: Current recommendations for when to start breast cancer screening do not consider race or ethnicity, which may be a source of racial disparity in breast cancer outcomes. In this installment, we take a closer look at these recommendations and how you can incorporate them into individualized patient care.
Episode resource links:
Chen T, Kharazmi E, Fallah M. Race and Ethnicity-Adjusted Age Recommendation for Initiating Breast Cancer Screening. JAMA Netw Open. 2023;6(4):e238893. Published 2023 Apr 3.
Siu AL; U.S. Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement [published correction appears in Ann Intern Med. 2016 Mar 15;164(6):448]. Ann Intern Med. 2016;164(4):279-296
Oeffinger KC, Fontham ET, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society [published correction appears in JAMA. 2016 Apr 5;315(13):1406]. JAMA. 2015;314(15):1599-1614. 
Draft Update of USPSTF Screening for Breast Cancer: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults
Guest: Alan M. Ehrlich MD, FAAFP Music Credit: Richard Onorato

Long COVID: Strategies for Approaching Patient Care - Frankly Speaking Ep 330

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-330
Overview: The CDC’s Household Pulse Survey data indicate that more than 10% of adults who contracted COVID-19 have had symptoms that lasted at least 3 months. While patients worry about long COVID, there are no specific tests to confirm its diagnosis. In this episode, we discuss a recent JAMA article that addresses the primary care approach to long COVID.
Episode resource links:
Landhuis EW. How Primary Care Physicians Can Recognize and Treat Long COVID. JAMA. Published online May 03, 2023. doi:10.1001/jama.2023.6604
JAMA. 2022;328(16):1604. PMID: 36215063
Post-COVID Conditions: Information for Healthcare Providers (cdc.gov)
Guest: Robert A. Baldor MD, FAAFPMusic Credit: Richard Onorato

Can Cocoa or a Multivitamin Prevent Dementia? - Frankly Speaking Ep 329

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-329
Overview: Do you have older patients asking for guidance on what supplements can be used to prevent cognitive decline? Listen in to hear the findings of a recent Alzheimer’s & Dementia publication of a randomized controlled trial looking at the benefits and harms related to using cocoa and multivitamins for preventing cognitive decline.
Episode resource links:
Baker LD,Manson JE, Rapp SR, et al. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimer’s Dement.2022;1-12. https://doi.org/10.1002/alz.12767
Recommendation: Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: Preventive Medication | United States Preventive Services Taskforce https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-supplementation-to-prevent-cvd-and-cancer-preventive-medication
Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato

Live Longer by Eating Better - Frankly Speaking Ep 328

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-328
Overview: Are you tired of sifting through conflicting information about nutrition and mortality? Look no further than this podcast episode, where we dive deep into the latest dietary research. With so much conjecture and small data sets out there, it can be challenging to know what advice to give. Tune in to this discussion to gain valuable insights and to make informed recommendations about healthy eating habits for your patients.
Episode resource links:
JAMA Intern Med. doi:10.1001/jamainternmed.2022.6117Nutrients 2021 Jul 9;13(7):2342. doi: 10.3390/nu13072342.
Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato

As We Wave Goodbye to the Waiver! - Frankly Speaking Ep 327

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-327
Overview: Congress has recently made changes to help fight the opioid epidemic and allow for an increase in access to treatment for opioid use disorder (OUD). Join us as we review these changes, and learn how you can use them to promote health equity in a clinical setting.
Episode resource links:
Hawk, K., Hoppe, J., Ketcham, E., LaPietra, A., Moulin, A., Nelson, L., ... & D’Onofrio, G. (2021). Consensus recommendations on the treatment of opioid use disorder in the emergency department. Annals of emergency medicine, 78(3), 434-442.
Jones, K. F., O'Reilly-Jacob, M., & Tierney, M. (2022). Eliminating the buprenorphine DEA X waiver is critical to promote health equity. Nursing outlook, 70(1), 5-7.
Jones, K. F. , Jacob, M. O. , Spetz, J. , Hailer, L. & Tierney, M.  (9000). Eliminate the buprenorphine DEA X waiver: Justification using a policy analysis approach.  Journal of Nursing Scholarship,  , doi: 10.1111/jnu.12871.
Guest: Mariyan L. Montaque, DNP, FNP-BCMusic Credit: Richard Onorato

Screening for Alcohol Use and Abuse: Prevention with a Capital P - Frankly Speaking Ep 326

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-326
Overview: Alcohol abuse has become more prevalent in the past decade, which means that primary care providers must play a crucial role in treating this preventable disorder. Don’t miss this discussion on the current state of alcohol abuse and how to use evidence-based screening tools for prevention.
Episode resource links:
Esser,M., Leung, G., Sherk, A., Bohm, M., Liu, Y., Lu, H. & Naimi, T.  Estimated Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 64 Years, 2015 to 2019. JAMA Network Open. 2022;5(11):e2239485. doi:10.1001/jamanetworkopen.2022.39485
National Institute on Drug Abuse Screening and Assessment Tools Resource Chart: https://nida.nih.gov/nidamed-medical-health-professionals/screening-tools-resources/chart-screening-tools
Substance Abuse and Mental Health Services Administration (SAMHSA):  National Help Line:  https://www.samhsa.gov/find-help/national-helpline
Alcoholics Anonymous:  Find AA near you https://www.aa.org/find-aa
Paradis, C., Butt, P., Shield, K., Poole, N., Wells, S., Naimi, T., Sherk, A., & the Low-Risk Alcohol Drinking Guidelines Scientific Expert Panels. (2023). Canada’s Guidance on Alcohol and Health: Final Report. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction. 
Fairbanks J, Umbreit A, Kolla BP, et al. Evidence-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls. Mayo Clin Proc. 2020;95(9):1964-1977. doi:10.1016/j.mayocp.2020.01.030
Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Richard Onorato

Treating Children and Adolescents with Obesity—Understanding the New AAP Clinical Practice Guidelines - Frankly Speaking Ep 325

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-325
Overview: Obesity in children and adolescents is a complex and very often chronic condition. Besides encouraging healthy eating and increasing activity—both excellent behavioral measures—healthcare providers did not have a clear, evidence-based plan for managing this chronic condition until recently. In January, the AAP published its long-awaited new, evidence-based guidelines for the evaluation and treatment of children and adolescents with obesity. Greatly anticipated, it did, however, create some controversy. Please join us as we discuss the new guidelines, the evidence that it is based on, and how it may change practice. 
Episode resource links:
The American Academy of Pediatrics. Clinical Practice Guideline. S. E. Hampl. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. January 9, 2023.  Pediatrics e2022060640. https://doi.org/10.1542/peds.2022-060640
The American Academy of Pediatrics. S. E. Hampl. Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity, January 9, 2023. Pediatrics e2022060641.https://doi.org/10.1542/peds.2022-060641;  https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-060641/190440/Executive-Summary-Clinical-Practice-Guideline-for?autologincheck=redirected
AAP News release https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-issues-its-first-comprehensive-guideline-on-evaluating-treating-children-and-adolescents-with-obesity/ 
The American Academy of Pediatrics Technical report; January 9, 2023. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part I: Interventions. Pediatrics (2023) 151 (2): e2022060642.; https://doi.org/10.1542/peds.2022-060642
The American Academy of Pediatrics Technical report; January 9, 2023. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part II: Comorbidities. Pediatrics (2023) 151 (2): e2022060643. https://doi.org/10.1542/peds.2022-060643
 
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato

Is It OK to Let Your Infant Cry Themselves to Sleep? - Frankly Speaking Ep 324

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-324
Overview: Parents who struggle with infant sleep problems may turn to primary care providers for guidance to help their child, but what are the evidence-based options? Hear what the experts have to say about the findings of a recent Journal of Pediatrics study of parents’ use of a variety of behavioral interventions for infant sleep problems. 
Episode resource links:
Implementation of Behavioral Interventions for Infant Sleep Problems in Real-World Settings: J Pediatr. November 11, 2022. https://doi.org/10.1016/j.jpeds.2022.10.038
Blunden, S. and Dawson, D. (2020), Behavioural sleep interventions in infants: Plan B – Combining models of responsiveness to increase parental choice. J Paediatr Child Health, 56: 675-679. https://doi.org/10.1111/jpc.14818
Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato

Chalk It Up to Stress and Anxiety or Is There More to It? - Frankly Speaking Ep 323

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-323
Overview: This episode will explore a common syndrome that is often misdiagnosed and underdiagnosed. Listen in as we discuss the cardinal symptoms and diagnostic criteria for postural orthostatic tachycardia syndrome (POTS) and learn about different management options, including the benefits of salt. 
Episode resource links:
Zha K, Brook J, McLaughlin A, Blitshteyn S. Gluten-free diet in postural orthostatic tachycardia syndrome (POTS). Chronic Illness. 2022;0(0). doi:10.1177/17423953221076984
Cooperrider, J., Kriegler, J., Yunus, S., & Wilson, R. (2022). A Survey-Based Study Examining Differences in Perception of Postural Orthostatic Tachycardia Syndrome Between Patients and Primary Care Physicians. Cureus, 14(10).
Raj, S. R., Fedorowski, A., & Sheldon, R. S. (2022). Diagnosis and management of postural orthostatic tachycardia syndrome. Cmaj, 194(10), E378-E385.
Williams, E. L., Raj, S. R., Schondorf, R., Shen, W. K., Wieling, W., & Claydon, V. E. (2022). Salt supplementation in the management of orthostatic intolerance: Vasovagal syncope and postural orthostatic tachycardia syndrome. Autonomic neuroscience, 237, 102906.
Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Richard Onorato

2022 CDC Clinical Practice Guidelines: What’s the Update on Prescribing Opioids for Pain? - Frankly Speaking Ep 322

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-322
Overview: Patients deserve compassionate, safe, and effective pain management. But it’s important to remember that safe prescribing does not mean no prescribing. Join us as we discuss the 2022 CDC Clinical Practice Guidelines for prescribing opioids in the adult population. The updated and expanded guidelines can assist you in delivering patient-centered care for management of acute, subacute, and chronic pain.
Episode resource links:
Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain —United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1
Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. 2016;315(15):1624–1645. doi:10.1001/jama.2016.1464
Guest: Jill Terrien PhD, ANP-BC  Music Credit: Richard Onorato