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-340 Overview: Depression and anxiety rates are escalating, with a 36% increase in suicide cases between 2018 and 2021, as reported by the CDC. This distressing trend can be attributed to various significant stressors that have arisen in recent times, such as pandemic-related illness and isolation. Medications alone are not as effective as when other modalities are incorporated into the treatment regime. Recent meta-analysis has revealed a strong correlation between engaging in physical activity and reducing suicidal ideation across all levels. Listen in as we discuss these findings and explore practical strategies for their implementation in your clinical practice. Episode resource links: Vancampfort, D., Hallgren, M., Firth, J., Rosenbaum, S., Schuch, F. B., Mugisha, J., Probst, M., Van Damme, T., Carvalho, A. F., & Stubbs, B. (2017). Physical activity and suicidal ideation: a systematic review and meta-analysis. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.08.070 https://www.healio.com/news/primary-care/20230403/metaanalysis-exe 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-339 Overview: In this episode, we dive into a recent systematic review and meta-analysis confirming the association between cannabidiol (CBD) use and hepatotoxicity. Gain a deeper understanding of clinical applications and the delicate balance of risks and benefits when discussing CBD use with your patients. Episode resource links: Lo LA, Christiansen A, Eadie L, Strickland JC, Kim DD, Boivin M, Barr AM, MacCallum CA. Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis. J Intern Med. 2023 Mar 13. doi: 10.1111/joim.13627. Epub ahead of print. PMID: 36912195. https://store.samhsa.gov/sites/default/files/pep22-06-04-003.pdf 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-338 Overview: Listen in as we explore the connection between asthma and cancer. We examine new Global Initiative for Asthma (GINA) guidelines and recent observational data correlating an asthma diagnosis with an increased cancer risk. Don't miss out on this essential discussion that will empower you with valuable knowledge for enhanced patient care. Episode resource links: Guo, Y, Bian, J, Chen, Z, et al. Cancer incidence after asthma diagnosis: Evidence from a large clinical research network in the United States. Cancer Med. 2023; 00: 1- 7. doi:10.1002/cam4.5875 GINA guidelines 2022: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf 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-337 Overview: There has been uncertainty as to the best time for patients to take blood pressure medications. Tune in as we review the Treatment in Morning versus Evening (TIME) study, which assessed whether morning or evening dosing improves cardiovascular outcomes. Episode resource links: Mackenzie IS, Rogers A, Poulter NR, et al. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. Lancet. 2022;400(10361):1417-1425. 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-336 Overview: In 2020, the National Asthma Education and Prevention Program (NAEPP) updated its guidelines for asthma management, incorporating significant changes. This marked the first update since 2007. A recent study revealed that >280 providers of the new asthma guidelines had an average knowledge score of <45%, indicating that these guidelines have likely not been fully incorporated into their practice. We invite you to join us as we discuss the new guidelines and explore strategies for integrating them into your practice. Episode resource links: Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update from the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301–2317. doi:10.1001/jama.2020.2197 https://jamanetwork.com/journals/jama/article-abstract/2773482 https://www.jacionline.org/programs_abstracts https://www.healio.com/news/primary-care/20230225/physicians-show-lack-of-knowledge-on-latest-updates-to-asthma-management-guidelines Cloutier MM, Teach, SJ., Lemanske RF, Blake KV. The 2020 Focused Updates to the NIH Asthma Management Guidelines: Key Points for Pediatricians. PEDIATRICS Volume 147, number 6, June 2021:e2021050286; https://publications.aap.org/pediatrics/article/147/6/e2021050286/180305/The-2020-Focused-Updates-to-the-NIH-Asthma?autologincheck=redirected GINA Guidelines: https://ginasthma.org/pocket-guide-for-asthma-management-and-prevention/ Pocket Guide: https://ginasthma.org/wp-content/uploads/2022/07/GINA-2022-Pocket-Guide-WMS.pdf 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-335 Overview: In this episode, we review recent updates from the Diabetes Prevention Program (DPP) trial and Diabetes Prevention Program Outcomes Study (DPPOS). Join us as we discuss the impact of the updates on diabetes prevention strategies for cardiovascular outcomes. Episode resource links: Goldberg RB, Orchard TJ, Crandall JP, Boyko EJ, Budoff M, Dabelea D, Gadde KM, Knowler WC, Lee CG, Nathan DM, Watson K, Temprosa M; Diabetes Prevention Program Research Group*. Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. Circulation. 2022 May 31;145(22):1632-1641. doi: 10.1161/CIRCULATIONAHA.121.056756. Epub 2022 May 23. PMID: 35603600; PMCID: PMC9179081. Galaviz KI, Weber MB, Suvada K BS, Gujral UP, Wei J, Merchant R, Dharanendra S, Haw JS, Narayan KMV, Ali MK. Interventions for Reversing Prediabetes: A Systematic Review and Meta-Analysis. Am J Prev Med. 2022 Apr;62(4):614-625. doi: 10.1016/j.amepre.2021.10.020. Epub 2022 Feb 10. PMID: 35151523. 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-334 Overview: It can be tricky to navigate conflicting data when discussing alcohol intake with patients, so we’re here to discuss the topic’s most recent evidence. In this episode, we take a look at the findings to help you and your patients make informed decisions about daily alcohol consumption and their health. Episode resource links: JAMA Network Open. 2023;6(3):e236185. doi:10.1001/jamanetworkopen.2023.6185 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-333 Overview: Tune in as we discuss the potential consequences of perceived stress on the cognition and well-being of older adults. We explore screening and intervention opportunities to better help you recognize and manage stress in your patients aged ≥45 years. Episode resource links: Kulshreshtha, A., Alonso, A., McClure, L. A., Hajjar, I., Manly, J. J., & Judd, S. (2023). Association of Stress With Cognitive Function Among Older Black and White US Adults. JAMA network open, 6(3), e231860. https://doi.org/10.1001/jamanetworkopen.2023.1860 Top 12 Apps for Mindfulness https://positivepsychology.com/mindfulness-apps/ 15 Simple Ways to Relieve Stress 15 Simple Ways to Relieve Stress and Anxiety (healthline.com) 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-332 Overview: In this episode, we take a look at the dynamic landscape of hyperlipidemia management, discussing current guidelines for hyperlipidemia treatment and the interplay between evidence-based recommendations and expert opinions. Tune in to gain a broader understanding of hyperlipidemia management and unlock fresh perspectives to enhance patient care. Episode resource links: JAMA Intern Med. March 14, 2022. doi:10.1001/jamainternmed.2022.0134 JAMA. Published online March 6, 2023. doi:10.1001/jama.2023.2487 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-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

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, 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-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

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.2022.6117 Nutrients 2021 Jul 9;13(7):2342. doi: 10.3390/nu13072342. 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-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-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-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

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

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

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

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

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-321 Overview: Most perimenopausal and menopausal individuals will experience some symptoms. Up to 80% of women report some symptoms, with vasomotor symptoms being the most commonly reported; however, other symptoms such as sleep disturbance, sexual dysfunction, and mood can be present. These symptoms can have a tremendous negative impact on quality of life and well-being, yet many women remain untreated for their symptoms even though evidence-based treatments exist. Join us to discuss effective treatments and ways you can overcome barriers to providing evidence-based menopausal therapy. Episode resource links: DePree, Barbara MD, NCMP, MMM1; Houghton, Katherine MSc2; Shiozawa, Aki DrPH, MBA3; Esterberg, Elizabeth MS4; King, Deanna D. MS, PhD3; Kim, Janet PhD3; Mancuso, Shayna DO, FACOG3. Treatment and resource utilization for menopausal symptoms in the United States: a retrospective review of real-world evidence from US electronic health records. Menopause 30(1):p 70-79, January 2023. | DOI: 10.1097/GME.0000000000002095 https://journals.lww.com/menopausejournal/Fulltext/2023/01000/Treatment_and_resource_utilization_for_menopausal.11.aspx The North Amrican Menopause Society. (NAMS) The 2022 Hormone Therapy Position Statement of the North American Menopause Society. Menopause: The Journal of the North American Menopause Society. 29 (7) pp 767-794. DOI: 10.1097/GME.0000000000002028 The North American Menopause Society (NAMS). Menopause Practice: A Clinician's Guide. 6th Pepper Pike, Ohio. September 2019. 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-320 Overview: New evidence points to the efficacy of a simple approach to managing and potentially curing generalized anxiety disorder. Join us to discuss this simple intervention and to review the diagnosis and treatment options for this prevalent disorder. Episode resource links: JAMA Psychiatry. 2023;80(1):13-21. doi:10.1001/jamapsychiatry.2022.3679 https://positivepsychology.com/mindfulness-based-stress-reduction-mbsr/ 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-319 Overview: In children, bacterial infections are a common cause of infectious conjunctivitis. But, like many clinicians, you may be uncertain about the efficacy of using antibiotic drops in these pediatric patients. Join us to get an evidence-based answer to the important question, “Are antibiotic drops needed in children with acute infectious conjunctivitis?” Episode resource links: Honkila M, Koskela U, Kontiokari T, et al. Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(10):e2234459. Published 2022 Oct 3. 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-318 Overview: Have you ever experienced impostor syndrome? Or do you mentor someone struggling with this sense of inadequacy? If so, you won’t want to miss this podcast episode. You will formulate a clear definition of impostor syndrome, understand its components, and walk away with practical tips to help overcome it... Episode resource links: J Am Coll Surg 2021 Nov;233(5):633-638. Curr Pharm Teach Learn 2022 Feb;14(2):130-132. doi: 10.1016/j.cptl.2021.11.019. Epub 2021 Dec 27 Guest: Mariyan L. Montaque, DNP, FNP-BC & Susan Feeney, DNP, FNP-BC, NP-C & Jill M. Terrien, PhD, ANP-BC Music Credit: Richard Onorato To learn more about Primary Care Bootcamp for NPs and PAs: https://bootcamp.pri-med.com/app

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-317 Overview: Exercise has been shown to be an effective way of decreasing migraine frequency, but the best type of exercise for this has not been established. A systematic review compared strength training to both high-intensity aerobic exercise and low-intensity aerobic exercise. Episode resource links: Woldeamanuel YW, Oliveira ABD. What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials. J Headache Pain. 2022;23(1):134. Published 2022 Oct 13. 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-316 Overview: While the benefits of proton pump inhibitors (PPIs) are widely known, the same cannot be said of the risks. These common medications are generally considered “safe,” but new data suggest the potential for long-term risks. Join us to discuss these long-term risks of PPI use and whether some of your patients should step down from PPIs to H2RAs. Episode resource links: Gut : 28 September 2020. doi: 10.1136/gutjnl-2020-322557 Gut 2022 Jan; 71:16. (https://doi.org/10.1136/gutjnl-2021-325097) Front Pharmacol. 2022 Sep 14;13:979215. doi: 10.3389/fphar.2022.979215. eCollection 2022 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-315 Overview: A recent publication shows that being a “weekend warrior” exerciser provides the same benefit to mortality risk as spreading the physical activity out across the week. Listen to this podcast to hear the data from this study and to optimally counsel your patients on how to lower their mortality risk through physical activity. Episode resource links: Physical Activity Guidelines for Americans, 2nd Edition.; 2018. https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf. dos Santos M, Ferrari G, Lee DH, et al. Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns With All-Cause and Cause-Specific Mortality: A Nationwide Cohort Study. JAMA Intern Med.2022;182(8):840–848. doi:10.1001/jamainternmed.2022.2488 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-314 Overview: The herpes zoster virus, or shingles, is more than just a rash. Oftentimes we don’t consider the long-term risk of viruses, but we should. This episode focuses on the association between the herpes zoster virus and an increased risk of stroke. Join us to discuss data that show a reduction in stroke risk in individuals who receive the herpes zoster vaccine. Episode resource links: Andrew N Bubak, Christina Coughlan, Janelle Posey, Anthony J Saviola, Christy S Niemeyer, Serena W R Lewis, Sara Bustos Lopez, Adriana Solano, Stephen K Tyring, Cassidy Delaney, Keith B Neeves, Ravi Mahalingam, Kirk C Hansen, Maria A Nagel, Zoster-Associated Prothrombotic Plasma Exosomes and Increased Stroke Risk, The Journal of Infectious Diseases, 2022;, jiac405, https://doi.org/10.1093/infdis/jiac405 https://www.idse.net/Review-Articles/Article/10-22/Immunization-Vaccine-Updates-Beyond-COVID-19/68244 https://www.cdc.gov/shingles/index.html https://familydoctor.org/condition/shingles/ Yang, Q., Chang, A., Tong, X., & Merritt, R. (2021). Herpes zoster vaccine live and risk of stroke among medicare beneficiaries: a population-based cohort study. Stroke, 52(5), 1712-1721. https://news.cuanschutz.edu/news-stories/researchers-reveal-why-shingles-can-cause-strokes 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-313 Overview: The prevalence of anxiety and depression has been increasing in US youth over the past decade with noted increases during the pandemic. The USPSTF recently released its recommendations supporting general screening for depression in 12- to 18-year-olds. Join us while we discuss the recommendations, the basis for these recommendations, how to integrate them into practice, and some strategies on how to support adolescents and families with a positive screen. Episode resource links: CDC Children’s Mental Health: https://www.cdc.gov/childrensmentalhealth/depression.html i. Data and Statistics on Children’s Mental Health https://www.cdc.gov/childrensmentalhealth/data.html Screening for Depression and Suicide Risk in Children and Adolescents - US Preventive Services Task Force Recommendations Statement; JAMA. doi:10.1001/jama.2022.16946. Published online October 11, 2022. US Preventive Services Task Force Recommendation Statement on Depression and Suicide Risk in Children and Adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-children-adolescents 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-312 Overview: Brain training activities have been advocated to slow or prevent cognitive decline. Crossword puzzles can be cognitively demanding and have recently been shown to be superior to some of the brain training activities that have been promoted on apps and websites. Join us for discussion on how to counsel patients looking to improve their cognitive function. Episode resource links: Pillai JA, Hall CB, Dickson DW, Buschke H, Lipton RB, Verghese J. Association of crossword puzzle participation with memory decline in persons who develop dementia. J Int Neuropsychol Soc. 2011;17(6):1006-1013. Devanand DP et al. Computerized Games versus Crosswords Training in Mild Cognitive Impairment. NEJM Evidence October 27,2022 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-311 Overview: Join us to discuss the results of a randomized controlled trial that evaluated the influence of increased dairy intake on fractures in older adults. Learn how this simple intervention can significantly mitigate the risk of falls and fractures in this vulnerable population. Episode resource links: BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2364 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-310 Overview: Join us as we discuss the importance of assessing for sexual dysfunction in young women with a cancer diagnosis. Episode resource links: Lena Wettergren, Lars E. Eriksson, Charlotta Bergström, Christel Hedman, Johan Ahlgren, Karin E. Smedby, Kristina Hellman, Roger Henriksson & Claudia Lampic (2022): Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis – a population-based study, Acta Oncologica, DOI: 10.1080/0284186X.2022.2112283 https://doi.org/10.1080/0284186X.2022.2112283 Guest: Jill 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-309 Overview: Listen to this podcast to get answers to important questions about vitamin D supplementation in the first year of life. We will review a recent systematic review and meta-analysis on the relationship between vitamin D supplementation in the first year of life and outcomes, and we will discuss how these findings can be applied to your practice. Episode resource links: Nutrients; 2021 Feb 5;13(2):524. doi: 10.3390/nu13020524 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-308 Overview: In this episode, each podcaster will discuss the most impactful paper and podcast of the year. Episode resource links: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-302 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-299 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-289 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-281 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-275 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-268 Guest: Alan Ehrlich MD, FAAFP, Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C, Mariyan L. Montaque, DNP, FNP-BC, 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-307 Overview: The COVID-19 epidemic resulted in overflowing ICUs and significant numbers of deaths among older adults. A recent study looked at the differences in outcomes between patients admitted with “No-code” vs “CPR” status and found no difference for high-risk individuals. Listen to this brief podcast to explore the data from this study and, in turn, give patients the information they need to make informed decisions regarding their desired code status on their advanced directives. 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-306 Overview: In 2015, a landmark study, LEAP (Learning Early About Peanut Allergy), found that early introduction to peanuts, at 4 to 6 months, significantly reduced the incidence of peanut allergies in all children but especially in those at high risk for allergies. A recent survey of pediatric residents and attendings in a large academic center regarding knowledge and implementation of the guidelines uncovered a significant knowledge gap impacting the health of children. Join us as we discuss this gap and review the guidelines for preventing peanut allergies in infants and children. Episode resource links: Sandhu S, Hanono M, Nagarajan S, Vastardi MA. Knowledge assessment of early peanut introduction in a New York City population [published online ahead of print, 2022 Jun 18]. Ann Allergy Asthma Immunol. 2022;S1081-1206(22)00534-8. doi:10.1016/j.anai.2022.06.013 Greer FR, Sicherer SH, Burks AW, AAP COMMITTEE ON NUTRITION, AAP SECTION ON ALLERGY AND IMMUNOLOGY. The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Pediatrics. 2019;143(4): e20190281 Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Ann Allergy Asthma Immunol. 2017;118(2):166-173.e7. doi:10.1016/j.anai.2016.10.004 Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus Communication on Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants. Pediatr Dermatol. 2016;33(1):103-106. doi:10.1111/pde.12685 Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., Brough, H. A., Phippard, D., Basting, M., Feeney, M., Turcanu, V., Sever, M. L., Gomez Lorenzo, M., Plaut, M., Lack, G., & LEAP Study Team (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England journal of medicine, 372(9), 803–813. https://doi.org/10.1056/NEJMoa1414850 Koplin JJ, Soriano VX, Peters RL. Real-World LEAP Implementation. Curr Allergy Asthma Rep. 2021;22(6):61-66. doi:10.1007/s11882-022-01032-3 https://www.fda.gov/food/cfsan-constituent-updates/fda-completes-review-notification-regarding-health-claim-related-peanut-allergies Guest: Susan Feeney, DNP, FNP 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-305 Overview: We will review the general treatment approach to gastroesophageal reflux disease (GERD) and the risks of using proton pump inhibitors (PPI) for long durations. In particular, we will examine a new study that links PPI use, in comparison with H2 receptor antagonist (H2RA) use, with a significant increase in the risk of gastric cancer. This episode will highlight the importance of looking at PPIs on a medication review and evaluating whether patients are taking them for longer than needed. Episode resource links: Abrahami D, McDonald EG, Schnitzer ME, et al. Proton pump inhibitors and risk of gastric cancer: population-based cohort study. Gut. 2022;71(1):16-24. 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-304 Overview: Pharmacogenomic testing has been suggested as a way to personalize medicine, particularly where the metabolism of medications can vary significantly. Unfortunately, despite increasing use of this testing, there has been little evidence showing a benefit in clinical outcomes. Listen to this podcast to explore the data on clinical outcomes for pharmacogenetic testing and how to best select medication for patients with depression. Episode resource links: Oslin DW, Lynch KG, Shih MC, et al. Effect of Pharmacogenomic Testing for Drug-Gene Interactions on Medication Selection and Remission of Symptoms in Major Depressive Disorder: The PRIME Care Randomized Clinical Trial. JAMA. 2022;328(2):151-161. 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-303 Overview: Millions of Americans take Vitamin D supplementation to prevent a variety of illnesses, from COVID-19 and osteoporosis to heart disease and cancer. While most studies have failed to show a benefit in preventing COVID-19, heart disease, and cancer, the evidence has been mixed, at best, in showing benefits for preventing bone fractures. Despite this, vitamin D supplementation remains popular for fracture prevention. Join us to review a study published in the New England Journal of Medicine that failed to find any benefits for preventing fractures. Episode resource links: N Engl J Med 2022;387:299-309. DOI: 10.1056/NEJMoa2202106 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-302 Overview: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, with a prevalence rate of more than 30% of US adults. Most have not been diagnosed or treated. Join us to discuss the new AACE guidance on the diagnosis and treatment of NAFLD to reduce the burden of this common disease. Episode resource links: AACE Guideline: Endocrine Pract: May 2022, 28(5): 528-562 Coffee: Front Pharmacol. 2021 Dec 13;12:786596. doi: 10.3389/fphar.2021.786596 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-301 Overview: In this episode, we will discuss a simple and inexpensive yet effective strategy for slowing the loss of knee joint cartilage in a patient with osteoarthritis: walking. Hear how recent evidence suggests that including a walking regimen into treatment plans may confer numerous benefits in this patient population. Episode resource links: Busse, JW, Sadeghirad, B., Oparin, Y. et al; Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med.2020;173:730-738. [Epub 18 August 2020]. doi:10.7326/M19-3601 Kolasinski, S.L., Neogi, T., Hochberg, M.C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W.F., Hawker, G., Herzig, E., Kwoh, C.K., Nelson, A.E., Samuels, J., Scanzello, C., White, D., Wise, B., Altman, R.D., DiRenzo, D., Fontanarosa, J., Giradi, G., Ishimori, M., Misra, D., Shah, A.A., Shmagel, A.K., Thoma, L.M., Turgunbaev, M., Turner, A.S. and Reston, J. (2020), 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res, 72: 149-162. https://doi.org/10.1002/acr.24131 Lo GH, Vinod S, Richard MJ, et al. Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals with Knee Osteoarthritis: Data from the Osteoarthritis Initiative Cohort [published online ahead of print, 2022 Jun 8]. Arthritis Rheumatol. 2022;10.1002/art.42241. doi:10.1002/art.42241 Thudium C. Markers of synovial inflammation matrix turnover and symptoms. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Ooman JMH. Babs on a mission: An experimental study on the effects of message framing and exemplification on treatment intentions of osteoarthritis patients. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Zeng C, Doherty M, Persson MSM, et al. Comparative efficacy and safety of acetaminophen, topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis: evidence from a network meta-analysis of randomized controlled trials and real-world data. Osteoarthritis Cartilage. 2021;29(9):1242-1251. doi:10.1016/j.joca.2021.06.004 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-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

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

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

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