Frankly Speaking About Family Medicine

Latest Episodes:

Boosting Weight Loss with Medications: New support for GLP-1 RAs - Frankly Speaking Ep 270 Apr 04, 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-270

Overview: You know GLP-1 RAs are an important class of agents for weight loss, but do you know which drug within this class is right for your patient? This brief podcast walks you through the recent evidence from the STEP 8 randomized clinical trial, comparing the efficacy and adverse reaction profiles for 2 GLP-1 RAs: semaglutide (Wegovy) and liraglutide (Saxenda). This is a must-listen for anyone looking to optimally individualize care for patients with obesity.

Episode resource links:

Rubino DM, Greenway FL, Khalid U, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. doi:10.1001/jama.2021.23619

Guest: Jillian Joseph, MSPAS, PA-C
Music Credit: Richard Onorato

Screen Patients Early and Routinely for Prescription Drug Misuse - Frankly Speaking Ep 269 Mar 28, 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-269

Overview: Join us as we discuss the trajectories of prescription drug misuse from adolescence through adulthood. This session explores the findings from a longitudinal cohort study demonstrating the need for screening patients from adolescence through adulthood for substance use disorder. You’ll walk away with the tools and resources you need to accurately screen patients and determine next best steps for each individual.

Episode resource links:

McCabe, S. E., Schulenberg, J. E., Schepis, T. S., Evans-Polce, R. J., Wilens, T. E., McCabe, V. V., & Veliz, P. T. (2022). Trajectories of Prescription Drug Misuse Among US Adults From Ages 18 to 50 Years. JAMA network open, 5(1), e2141995. https://doi.org/10.1001/jamanetworkopen.2021.41995 PMID: 34982159
National Institute on Drug Abuse (NIDA) Drug Screening Tool for use in general medical settings: https://archives.drugabuse.gov/nmassist/
National Institute on Drug Abuse (NIDA) Evidence Based Screening and Assessment Tools and Resources (Includes adults and adolescents) https://www.drugabuse.gov/nidamed-medical-health-professionals/screening-tools-resources/chart-screening-tools

Guest: Jill M. Terrien PhD, ANP-BC
Music Credit: Richard Onorato

PrEP: Are We Educating Patients Effectively? - Frankly Speaking Ep 268 Mar 21, 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-268

Overview: This episode will help bring awareness to the importance of educating patients about post-exposure prophylaxis (PrEP) in the primary care setting. This talk will also discuss how to reduce the stigma surrounding this prevention method. Finally, you will hear about the newly FDA approved PrEP treatment option that could potentially improve outcomes for patients.
Episode resource links:

https://www.healio.com/news/infectious-disease/20211220/fda-approves-first-longacting-injectable-for-hiv-prevention
Philbin, M. M., Parish, C., Kinnard, E. N., Reed, S. E., Kerrigan, D., Alcaide, M. L., ... & Metsch, L. R. (2021). Interest in long-acting injectable pre-exposure prophylaxis (LAI PrEP) among women in the women’s interagency HIV study (WIHS): a qualitative study across six cities in the United States. AIDS and Behavior, 25(3), 667-678.
Kim Y. S. (2021). Long-Acting Injectable Antiretroviral Agents for HIV Treatment and Prevention. Infection & chemotherapy, 53(4), 686–695. https://doi.org/10.3947/ic.2021.0136
CDC Practice guidelines https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf

Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Richard Onorato

Bad News for E-Cigarette Users—Possible Link Between E-Cigarettes And ED - Frankly Speaking Ep 267 Mar 14, 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-267

Overview: The clinical literature is filled with new and evolving evidence on the use of e-cigarettes and potential harms. The question of their use as a harm reduction strategy is a hotly debated topic—pitting traditional combustible tobacco with its well-known effect on morbidity and mortality against electronic nicotine delivery systems (ENDS), which although not harmless, are considered less harmful than smoked cigarettes. Recent evidence is emerging on the potential cardiovascular risks posed by newer generations of ENDS with far greater delivery of nicotine. Join us while we discuss the findings from a recent study that examines ENDS use and associated increase rates of erectile dysfunction (ED) and how this information may impact your practice.

Episode resource links:

El-Shahawy O, Shah T, Obisesan OH, Durr M, Stokes AC, Uddin I, Pinjani R, Benjamin EJ, Mirbolouk M, Osei AD, Loney T, Sherman SE, Blaha MJ. Association of E-Cigarettes With Erectile Dysfunction: The Population Assessment of Tobacco and Health Study. Am J Prev Med. 2022 Jan;62(1):26-38. doi: 10.1016/j.amepre.2021.08.004. Epub 2021 Nov 30. PMID: 34922653.
Caponnetto P. Well-being and harm reduction, the consolidated reality of electronic cigarettes ten years later from this emerging phenomenon: A narrative review. Health Psychol Res. Dec 30 2020;8(3):9463. doi:10.4081/hpr.2020.9463
Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5

Guest: Susan Feeney, DNP, FNP-BC, NP-
Music Credit: Richard Onorato

Fever Free: Acetaminophen or Ibuprofen? - Frankly Speaking Ep 266 Mar 07, 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-266

Overview: ‘Tis the season for pediatric fevers! Join us to review a recent meta-analysis looking at 18 studies with patients younger than 2 years old who received acetaminophen or ibuprofen for fever or pain to determine if one medication should be recommended first, before the other. After this session, you’ll be able to confidently advise parents of young children on how best to manage fever and/or pain at home with over-the-counter medications.
Episode resource links:

Long B, Gottlieb M. Ibuprofen vs. Acetaminophen for Fever or Pain in Children Younger Than Two Years. Am Fam Physician. 2022 Jan ;105(1):19.
Wong T, Stang AS, Ganshorn H, Hartling L, Maconochie IK, Thomsen AM, Johnson DW. Combined and alternating paracetamol and ibuprofen therapy for febrile children. Evid Based Child Health. 2014 Sep;9(3):675-729. doi: 10.1002/ebch.1978. PMID: 25236309.
Sullivan JE, Farrar HC. Fever and Antipyretic Use in Children. Pediatrics (2011) 127 (3): 580-587. (Reaffirmed 2016)

Guest: Jillian Joseph, MSPAS, PA-C
Music Credit: Richard Onorato

“Could It Be My Thyroid?” The Quandary of Subclinical Hypothyroidism - Frankly Speaking Ep 241 Mar 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-241

Overview: Seven percent of the US population has an active levothyroxine prescription, which is significantly greater than the number of people diagnosed with overt hypothyroidism. Many of these prescriptions appear to be for the treatment of subclinical hypothyroidism and other conditions in euthyroid individuals. Join us to uncover the latest findings on the use of levothyroxine and what the evidence tells us about appropriate use and misuse of this drug.

Episode resource links:

Brito, J., Ross, J., El Kawkgi, O., Maraka, S., Deng, Y., Shah, N., Lipska, K. & (9000). Levothyroxine Use in the United States, 2008-2018. JAMA Internal Medicine, Publish Ahead of Print, doi: 10.1001/jamainternmed.2021.2686.
Johansen, M., Marcinek, J., Yun, J. & (2020). Thyroid Hormone Use in the United States, 1997–2016. Journal of the American Board of Family Medicine, 33 (2), 284-288. doi: 10.3122/jabfm.2020.02.190159.
Jeffrey R. Garber, Rhoda H. Cobin,Hossein Gharib,James V. Hennessey, Irwin Klein, Jeffrey I. Mechanick, Rachel Pessah-Pollack, Peter A. Singer,Kenneth A. Woeber. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association; November–December 2012.
https://www.endocrinepractice.org/article/S1530-891X(20)43030-7/fulltext; https://www.endocrinepractice.org/action/showPdf?pii=S1530-891X%2820%2943030-7

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

Music Credit: Richard Onorato

Fluvoxamine as a Treatment for COVID-19 - Frankly Speaking Ep 265 Feb 28, 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-265

Overview: Most cases of COVID-19 will resolve without interventions, but some patients are at high risk for complications. Several treatment options for high-risk patients are now available to help prevent the need for hospitalization. Join us to review a recent large, randomized trial evaluating fluvoxamine as a treatment for high-risk patients who were diagnosed with COVID-19.
Episode resource links:

Reis G, et al. TOGETHER investigators. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health. 2022 Jan;10(1):e42-e51
Berwanger O. Fluvoxamine for outpatients with COVID-19: where do we stand? Lancet Glob Health. 2022 Jan;10(1):e2-e3. doi: 10.1016/S2214-109X(21)00501-5
https://activ6study.org/

Guest: Alan M. Ehrlich, MD, FAAFP
Music Credit: Richard Onorato

COVID-19 and Children - Frankly Speaking Ep 264 Feb 22, 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-264

Overview: Get answers to your questions on COVID-19 infection in children. Listen to this podcast to review outcomes and potential risk factors associated with acute COVID-19 infection in this population. Finally, learn the status of immunizations for children younger than 5 years of age.
Episode resource links:

JAMA Netw Open. 2022;5(1):e2142322. doi:10.1001/jamanetworkopen.2021.42322

Guest: Jillian Joseph, MSPAS, PA-C
Music Credit: Richard Onorato

Oral Anti−COVID-19 Medications—a Game Changer? - Frankly Speaking Ep 263 Feb 14, 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-263

Overview: The FDA’s recent emergency use authorization (EUA) for oral agents to treat COVID-19 means that primary care providers (PCPs) will be on the frontline of treating patients with COVID-19. Therefore, PCPs must understand who is eligible for such treatments and how to prescribe them. We will discuss the results of the recent FDA EUA for Pfizer’s Paxlovid and Merck’s molnupiravir antiviral agents and give you the information you need to confidently prescribe them.

Episode resource links:

Guest: Robert A. Baldor MD, FAAFP

Music Credit: Richard Onorato

Menopausal Transition: Bothersome Symptoms Sooner Than You Expect! - Frankly Speaking Ep 262 Feb 07, 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-262

Overview: Join us as we discuss menopausal transition and the unique qualities and symptoms that are bothersome to women at an early age.

Episode resource links:

Coslov, N., Richardson, M. K., & Woods, N. F. (2021). Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey. Menopause (New York, N.Y.), 28(9), 1012–1025. https://doi.org/10.1097/GME.0000000000001805 https://pubmed.ncbi.nlm.nih.gov/34313615/
ACOG Practice Guidelines: Clinical Guidelines on the Management of Menopausal Symptoms: https://www.aafp.org/afp/2014/0901/p338.html
Women Living Better Website: https://womenlivingbetter.org/
Maki, P. M., Kornstein, S. G., Joffe, H., Bromberger, J. T., Freeman, E. W., Athappilly, G., Bobo, W. V., Rubin, L. H., Koleva, H. K., Cohen, L. S., Soares, C. N., & Board of Trustees for The North American Menopause Society (NAMS) and the Women and Mood Disorders Task Force of the National Network of Depression Centers (2018). Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Menopause (New York, N.Y.), 25(10), 1069–1085. https://doi.org/10.1097/GME.0000000000001174 https://pubmed.ncbi.nlm.nih.gov/30179986/
Johnson, A., Roberts, L., & Elkins, G. (2019). Complementary and Alternative Medicine for Menopause. Journal of evidence-based integrative medicine, 24, 2515690X19829380. https://doi.org/10.1177/2515690X19829380 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/
Barnard, N; Kahleova, H; Holtz, D; del Aguila, F; Neola, M; Crosby, Lelia M.& Holubkov, R (2021). The Women's Study for the Alleviation of Vasomotor Symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women, Menopause 28 (10), 1150-1156 doi: 10.1097/GME.0000000000001812

Guest: Jill M. Terrien PhD, ANP-BC

Music Credit: Richard Onorato

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