Frankly Speaking About Family Medicine

Latest Episodes:

Cats Causing Psychosis! - Frankly Speaking Ep 300 Oct 31, 2022

Show notes

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 Oct 24, 2022

Show notes

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 Oct 17, 2022

Show notes

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 Oct 10, 2022

Show notes

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 Oct 03, 2022

Show notes

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 Sep 26, 2022

Show notes

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

The Best Evidence for Treating Fibromyalgia - Frankly Speaking EP 294 Sep 19, 2022

Show notes

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-294

Overview: Fibromyalgia is a common and difficult to diagnose disease, with highly subjective symptoms. Another challenge is that treatment is dependent on a patient’s implementation lifestyle changes. This brief podcast walks you through the diagnosis of fibromyalgia and offers best evidence on effective treatments.

Episode resource links:

Mediations: JAMA Netw Open. 2022;5(5):e2212939
Acupuncture: J Pain Res. 2022; 15: 315–329

Guest: Susan Feeney, DNP, FNP-BC, NP-C

Music Credit: Richard Onorato

Wait Before Writing That Antibiotic Prescription! Is it appropriate? - Frankly Speaking EP 293 Sep 12, 2022

Show notes

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-293

Overview: Evidence informs us that almost one-third of antibiotic prescriptions written for children in the United States are inappropriate, meaning they are not in line with evidence-based guidelines. Antibiotics are tremendous tools and beneficial when used appropriately; however, as with all pharmacological therapy, there are risks of adverse effects and healthcare cost. When prescribed inappropriately, they unnecessarily put children at risk and cause financial burden on individuals and the system. Please join the podcast team as we discuss recent evidence on these risks and burden and consider how this evidence can help improve practice.

Episode resource links:

Butler AM, Brown DS, Durkin MJ, et al. Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures. JAMA Netw Open.2022;5(5):e2214153. doi:10.1001/jamanetworkopen.2022.14153

Guest: Susan Feeney, DNP, FNP-BC, NP-C

Music Credit: Richard Onorato

Reducing the Risk of Alcohol-Associated Liver Disease - Frankly Speaking EP 292 Sep 05, 2022

Show notes

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-292

Overview: Alcohol use disorder is common, but effective medications to treat this disorder are not widely prescribed in the outpatient primary care setting, despite being available and having relatively good formulary coverage. Join us to hear how the use of medical treatment can decrease the incidence and progression of alcohol-associated liver disease.

Episode resource links:

Augustin G. L. Vannier et al, Incidence and Progression of Alcohol-Associated Liver Disease After Medical Therapy for Alcohol Use Disorder, JAMA Network Open (2022). DOI: 10.1001/jamanetworkopen.2022.13014
Tetreault JM, O'Connor PG. Risky drinking and alcohol use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis. UpToDate. Published April 28, 2022. Accessed June 11, 2022.
Holt SR, Tetrault, JM. Ambulatory Management of alcohol withdrawal. UpToDate. Published May 19, 2022. Accessed June 11, 2022.
Holt SR. Approach to treating alcohol use disorder. UpToDate. Published March 22, 2022. Accessed June 11, 2022.

Guest: Jillian Joseph, MSPAS, PA-C

Music Credit: Richard Onorato

Is Less More When Treating BP in Older Adults? - Frankly Speaking EP 291 Aug 29, 2022

Show notes

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-291

Overview: Concerns have been raised over guideline recommendations for lowering systolic blood pressure (BP) to 60 years. To achieve such targets often requires intensive BP treatments, which can result in harms from syncope or falls. Join us to review the results of a recently published meta-analysis done to estimate the time needed to potentially derive clinical benefit from such BP treatments in patients 60 years and older.

Episode resource links:

JAMA Intern Med. 2022;182(6):660-667. doi:10.1001/jamainternmed.2022.1657

Guest: Robert A. Baldor, MD

Music Credit: Richard Onorato

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