Frankly Speaking About Family Medicine

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-385 Overview: Through the framework of a case-based scenario, this episode explores both pharmacological and surgical treatment options for obesity. We discuss the efficacy and cost challenges of injectable medications, insurance coverage, and alternative payment solutions. Gain valuable insights into the cost-effectiveness of treatments, including recent research on endoscopic sleeve gastroplasty, to better advise patients. Episode resource links: Haseeb M, Chhatwal J, Xiao J, Jirapinyo P, Thompson CC. Semaglutide vs Endoscopic Sleeve Gastroplasty for Weight Loss. JAMA Netw Open. 2024;7(4):e246221. doi:10.1001/jamanetworkopen.2024.6221 https://obesitymedicine.org/blog/does-insurance-cover-weight-loss-medication/ Guest: Jillian Joseph, 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-384 Overview: This episode investigates the inaccurate correlation made between acetaminophen use during pregnancy and an increased risk of developmental disorders, including autism spectrum disorder, in children. Expert faculty discuss the history of these claims, followed by a study evaluating outcomes in children, and emphasize the importance of evidence-based decision-making for patients and clinicians. Episode resource links: Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 Nat Rev Endocrinol. 2021 Dec;17(12):757-766. doi: 10.1038/s41574-021-00553-7 Guest: Aylin Madore, MD, MEd   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-383 Overview: This episode highlights a growing concern—the prevalence of food allergies is on the rise. We underscore the importance for clinicians to help keep vulnerable populations safe through risk reduction strategies as well as the use of medication therapy. Feel empowered to prepare and safeguard patients from adverse reactions to food allergies. Episode resource links: Abrams, E. M., & Becker, A. B. (2015). Food introduction and allergy prevention in infants. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 187(17), 1297–1301. https://doi.org/10.1503/cmaj.150364 Elghoudi, A., & Narchi, H. (2022). Food allergy in children-the current status and the way forward. World journal of clinical pediatrics, 11(3), 253–269. https://doi.org/10.5409/wjcp.v11.i3.253 Wood, R. A., Togias, A., Sicherer, S. H., Shreffler, W. G., Kim, E. H., Jones, S. M., ... & Chinthrajah, R. S. (2024). Omalizumab for the Treatment of Multiple Food Allergies. New England Journal of Medicine. https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan CDC.gov https://acaai.org/ 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-382 Overview: Tune in as we discuss the AHA’s newly validated risk calculator designed to assess the risk of developing cardiovascular disease and heart failure in certain patients. We review which risk factor variables were included in the development of this new tool and whether to consider incorporating it in your practice. Episode resource links: https://doi.org/10.1161/CIRCULATIONAHA.123.067626 The calculator: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator Guest: Robert A. Baldor 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-381 Overview: While the aerosol in e-cigarettes does contain toxicants and carcinogens, since it is not burned like combustible tobacco cigarettes, vaping exposes the user to fewer toxicants and chemicals. Many consider using e-cigarettes for smoking cessation, but evidence has been conflicting. Tune in as we discuss a recent review examining the efficacy of e-cigarettes in aiding smoking cessation and explore potential adverse effects associated with their usage. Episode resource links: Lin, H. X., Liu, Z., Hajek, P., Zhang, W. T., Wu, Y., Zhu, B. C., Liu, H. H., Xiang, Q., Zhang, Y., Li, S. B., Pesola, F., & Wang, Y. Y. (2024). Efficacy of Electronic Cigarettes vs Varenicline and Nicotine Chewing Gum as an Aid to Stop Smoking: A Randomized Clinical Trial. JAMA internal medicine, 10.1001/jamainternmed.2023.7846. Advance online publication. https://doi.org/10.1001/jamainternmed.2023.7846 Lindson, N., Butler, A. R., McRobbie, H., Bullen, C., Hajek, P., Begh, R., Theodoulou, A., Notley, C., Rigotti, N. A., Turner, T., Livingstone-Banks, J., Morris, T., & Hartmann-Boyce, J. (2024). Electronic cigarettes for smoking cessation. The Cochrane database of systematic reviews, 1(1), CD010216. https://doi.org/10.1002/14651858.CD010216.pub8 Sanford BT, Brownstein NC, Baker NL, et al. Shift From Smoking Cigarettes to Vaping Nicotine in Young Adults. JAMA Intern Med. Published online November 13, 2023. doi:10.1001/jamainternmed.2023.5239 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-380 Overview: This episode brings you a comparison of thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers on cardiovascular outcomes, stroke, and all-cause mortality. Gain evidence-based insights to help you make informed choices for your patients’ care. Episode resource links: https://pubmed.ncbi.nlm.nih.gov/38048133/#:~:text=JAMA%20Netw%20Open,10.1001/jamanetworkopen.2023.44998 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-379 Overview: Recent data has shown that colchicine can improve outcomes in patients with known coronary artery disease (CAD), with consideration of colchicine now recommended by the American Heart Association (AHA). Hear valuable insights into the potential benefits and limitations to refine your clinical approach to managing CAD. Episode resource links: Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020;383(19):1838-1847.  Mohammadnia N, Los J, Opstal TSJ, et al. Colchicine and diabetes in patients with chronic coronary artery disease: insights from the LoDoCo2 randomized controlled trial. Front Cardiovasc Med. 2023;10:1244529. Published 2023 Oct 6.  Roubille F, Bouabdallaoui N, Kouz S, et al. Low-Dose Colchicine in Patients With Type 2 Diabetes and Recent Myocardial Infarction in the COLchicine Cardiovascular Outcomes Trial (COLCOT). Diabetes Care. Published online January 5, 2024.  Guest: Alan M. 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-378 Overview: Effective treatments for dementia remain elusive. In this episode, we’re discussing dementia treatment developments gathered from recent publications, covering topics of drugs, exercise, and liver disease. Stay informed and equipped to offer the latest guidance to patients with dementia and their families. Episode resource links: Ann Fam Med 2024;22:50-58. https://doi.org/10.1370/afm.3050 JAMA Netw Open. 2024;7(1):e2353965. doi:10.1001/jamanetworkopen.2023.53965 Guest: Robert A. Baldor, 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-377 Overview: Fluid in the middle ear, or otitis media with effusion (OME), is common in children with upper respiratory infections and typically resolves without treatment. Most guidelines do not recommend antibiotics for treatment; however, they are often prescribed, and the persistence of effusion can cause a significant impact on quality of life. Join us as we discuss recent review findings on antibiotics in OME treatment and the potential impact on your practice. Episode resource links: Mulvaney CA, Galbraith K, Webster KE, et al. Antibiotics for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2023;10(10):CD015254. Published 2023 Oct 23. doi:10.1002/14651858.CD015254.pub2 Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., Hoelting, D., Hunter, L. L., Kummer, A. W., Payne, S. C., Poe, D. S., Veling, M., Vila, P. M., Walsh, S. A., & Corrigan, M. D. (2016). Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 154(1 Suppl), S1–S41. https://doi.org/10.1177/0194599815623467 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-376 Overview: While GLP-1 agents are center stage in the medical and lay press, drugs in the class of sodium-glucose cotransporter 2 inhibitors (SGLT2is) are also quite remarkable at improving a variety of health endpoints. This episode provides an overview of studies supporting the use of SGLT2is to improve patient outcomes. Episode resource links: DM/HF:  Age Ageing 2024 Jan 2;53(1):afad254. doi: 10.1093/ageing/afad254 Kidney stones: JAMA Intern Med. 2024 Jan 29:e237660. doi: 10.1001/jamainternmed.2023.7660 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-375 Overview: Listen in as we discuss trends seen in breast cancer incidence over recent decades. Despite a notable rise in its prevalence, we’ve witnessed a decline in mortality rates. This positive shift owes itself to improvements in medication and screening efforts. Explore with us the multifaceted factors shaping this evolving landscape of breast cancer diagnosis and treatment. Episode resource links: https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html https://www.uspreventiveservicestaskforce.org/uspstf/ Caswell-Jin, J. L., Sun, L. P., Munoz, D., Lu, Y., Li, Y., Huang, H., ... & Plevritis, S. K. (2024). Analysis of Breast Cancer Mortality in the US—1975 to 2019. JAMA, 331(3), 233-241. Xu, S., Murtagh, S., Han, Y., Wan, F., & Toriola, A. T. (2024). Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status. JAMA Network Open, 7(1), e2353331-e2353331. 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-374 Overview: This episode explores the use of data from smartphone recordings as a diagnostic tool for obstructive sleep apnea (OSA), highlighting at-home testing as a more accessible, convenient, and appropriate option for some patients. Hear how the evidence can inform your practice and improve the diagnosis and treatment of patients with OSA. Episode resource links: Han SC, Kim D, Rhee CS, Cho SW, Le VL, Cho ES, Kim H, Yoon IY, Jang H, Hong J, Lee D, Kim JW. In-Home Smartphone-Based Prediction of Obstructive Sleep Apnea in Conjunction With Level 2 Home Polysomnography. JAMA Otolaryngol Head Neck Surg. 2024 Jan 1;150(1):22-29. doi: 10.1001/jamaoto.2023.3490. PMID: 37971771; PMCID: PMC10654929. OSA and CV disease in adults, UpToDate Home sleep apnea testing for adults, UpToDate 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-373 Overview: In this episode, we review the effectiveness of intensive lifestyle intervention for type 2 diabetes mellitus (T2DM) remission. We unpack study findings on total diet replacement and consider its potential for improving weight loss and maintenance in patients. Tune in to enrich your clinical toolkit, empowering you to optimize patient outcomes and enhance quality of life. Episode resource links: Hocking, S. L., Markovic, T. P., Lee, C. M. Y., Picone, T. J., Gudorf, K. E., & Colagiuri, S. (2024). Intensive Lifestyle Intervention for Remission of Early Type 2 Diabetes in Primary Care in Australia: DiRECT-Aus. Diabetes care, 47(1), 66–70. https://doi.org/10.2337/dc23-0781   Centers for Disease Control:  Diabetes Care for Providers: https://www.cdc.gov/diabetes/professional-info/index.html   Optifast USA: https://www.optifast.com/   Pattinson, A. L., Seimon, R. V., Harper, C., Nassar, N., Grech, A., Santoso, E. A., Franklin, J., Inan-Eroglu, E., Gibson, A. A., & Sainsbury, A. (2021). Diet Quality following Total Meal Replacement Compared with Food-Based Weight-Loss Diets in Postmenopausal Women with Obesity: A Secondary Analysis of the TEMPO Diet Trial. The Journal of nutrition, 151(11), 3299–3312. https://doi.org/10.1093/jn/nxab311 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-372 Overview: Listen in as we unwrap Consumer Reports’ findings on heavy metals found in commonly consumed chocolate products. Our discussion looks into concerns about high levels of metals like lead and cadmium in these treats and offers advice on how to counsel your patients for worry-free chocolate enjoyment.  Episode resource links: A Third of Chocolate Products Are High in Heavy Metals, CR T - Consumer Reports Guest: Robert A. Baldor, 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-371 Overview: Beta-blockers have traditionally been used indefinitely after a myocardial infarction (MI), but this is now only recommended for a subset of patients. Listen in as faculty review new recommendations for managing patients with chronic cardiac disease, including how to determine which patients are good candidates for beta-blocker therapy and for how long. Episode resource links: Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines [published correction appears in Circulation. 2023 Sep 26;148(13):e148] [published correction appears in Circulation. 2023 Dec 5;148(23):e186]. Circulation. 2023;148(9):e9-e119.  Joo SJ. Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it. Acute Crit Care. 2023;38(3):251-260.  Guest: Alan M. 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-370 Overview: Low back pain is one of the most common symptoms presenting in primary care. Listen in as we analyze the results of a recent systematic review supporting the use of a variety of effective nonnarcotic treatments for this condition. Gain evidence-based insights to help you choose the most informed option for managing low back pain. Episode resource links: Gianola S, Bargeri S, Del Castillo G, et al. Br J Sports Med 2022;56:41–50. doi.org/ 10. 1136/ bjsports- 2020- 103596). Guest: Robert A. Baldor, 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-369 Overview: Uncover a simple, 10-second intervention—the 1-legged stance test—for predicting the risk of falling in adults. Join us as we discuss how this swift assessment can help identify patients who are prone to falls, fractures, and increased mortality. This episode brings you a practical tool to enhance patient assessments and tailor interventions, contributing to a more proactive and personalized approach to care. Episode resource links: JAMA. 2023;329(18):1605-1607. doi:10.1001/jama.2023.3054 Br J Sports Med. 2022;56:975–980. Pharmacoepidemiol Drug Saf. 2021 Aug;30(8):1049-1056. doi: 10.1002/pds.5201 PLoS Med 18(11): e1003821. https://doi.org/10.1371/journal.pmed.1003821 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-368 Overview: In this insightful episode, we explore compelling data comparing inappropriate prescribing practices among physicians and nonphysician prescribers. This discussion covers the nuances and restrictive scope of prescribing authority and aims to take an evidence-based approach to encouraging collaboration between clinicians and expanding patients’ access to care. Episode resource links: Huynh, J., Alim, S. A., Chan, D. C., & Studdert, D. M. (2023). Inappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians. Annals of internal medicine, 176(11), 1448–1455. https://doi.org/10.7326/M23-0827 American Association of Nurse Practitioners https://www.aanp.org/ American Academy of Physician Associates https://www.aapa.org/ Jiao, S., Murimi, I. B., Stafford, R. S., Mojtabai, R., & Alexander, G. C. (2018). Quality of Prescribing by Physicians, Nurse Practitioners, and Physician Assistants in the United States. Pharmacotherapy, 38(4), 417–427. https://doi.org/10.1002/phar.2095 2023 Beers Criteria American Geriatrics Society: Free to read https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18372 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-367 Overview: Join us for a look at the Portfolio Diet, a plant-based approach with potential to improve cardiovascular outcomes. We’ll take you through the details of this regimen and what the evidence says about its effect on the risks of cardiovascular diseases. Stay informed on the latest research and feel prepared to answer your patients’ questions about the Portfolio Diet. Episode resource links: Circulation. 2023;148:00–00. DOI: 10.1161/CIRCULATIONAHA.123.065551 Guest: Robert A. Baldor, 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-366 Overview: Join us as we explore the nuances of healthy eating patterns, distinguishing between time-restricted and calorie-restricted approaches. We also review a randomized controlled trial that found time-restricted eating for people with type 2 diabetes mellitus (T2DM) can benefit HbA1c levels and weight reduction. Gain insights to elevate patient care in understanding and implementing these impactful dietary strategies. Episode resource links: Pavlou V, Cienfuegos S, Lin S, et al. Effect of Time-Restricted Eating on Weight Loss in Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2339337. doi:10.1001/jamanetworkopen.2023.39337 Jefcoate PW, Robertson MD, Ogden J, Johnston JD. Exploring Rates of Adherence and Barriers to Time-Restricted Eating. Nutrients. 2023 May 16;15(10):2336. doi: 10.3390/nu15102336. PMID: 37242218; PMCID: PMC10223820. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato