Frankly Speaking About Family Medicine – Details, episodes & analysis

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-399

Overview: In this episode, we look at a new study showing increased probability of survival for patients with Alzheimer disease (AD) who take donepezil and memantine together. We review current treatments for AD and address common hesitations in prescribing dual pharmacotherapy, providing vital insights for primary care clinicians.

Episode resource links:

• Yaghmaei, E., Lu, H., Ehwerhemuepha, L. et al. Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer’s disease patients.Commun Med 4, 99 (2024). https://doi.org/10.1038/s43856-024-00527-6
• Guo J, Wang Z, Liu R, Huang Y, Zhang N, Zhang R. Memantine, Donepezil, or Combination Therapy-What is the best therapy for Alzheimer's Disease? A Network Meta-Analysis. Brain Behav. 2020 Nov;10(11):e01831. doi: 10.1002/brb3.1831. Epub 2020 Sep 10. PMID: 32914577; PMCID: PMC7667299.

Guest: Jillian Joseph, MPAS, PA-C

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 

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-398

Overview: Low back pain is the leading cause of years lived with disability, with approximately 70% of individuals experiencing a recurrence within 12 months following recovery from an episode. Clinicians are poised to play a crucial role in encouraging patients to incorporate walking to prevent recurrences of low back pain.

Episode resource links:

• Pocovi NC, Lin CC, French SD, Graham PL, van Dongen JM, Latimer J, Merom D, Tiedemann A, Maher CG, Clavisi O, Tong SYK, Hancock MJ. Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomised controlled trial. Lancet. 2024 Jun 19:S0140-6736(24)00755-4. PMID: 38908392.

Guest: Alan M. Ehrlich, MD, FAAFP 

Music Credit: Richard Onorato

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 

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-389

Overview: Let’s talk lipid panels and their potential to assess more than cardiovascular disease risk. Through a case scenario, we highlight a study on the potential link between metabolic markers and mood disorders such as depression and anxiety. Join us to learn how lipid panels could aid in early detection and intervention for these conditions.

Episode resource links:

• Chourpiliadis C, Zeng Y, Lovik A, Wei D, Valdimarsdóttir U, Song H, Hammar N, Fang F. Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders. JAMA Netw Open. 2024 Apr 1;7(4):e244525. doi: 10.1001/jamanetworkopen.2024.4525. PMID: 38564219; PMCID: PMC10988352.

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

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  

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

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

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

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

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

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