Frankly Speaking About Family Medicine

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-114-older-sexuality-2 Overview: This episode focuses on older adults and caregivers/partners in relation to their intimacy and sexuality for patients experiencing changes in cognition. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-113-deprescribing-2 Overview: Join us as we discuss deprescribing; the provider-supervised process of discontinuing inappropriate medication(s). We will review minimizing risk, improving quality of life and maximizing patient-centered care. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-112-teen-sexting Overview: Sexting is increasing among U.S. youth. As cellular technology evolves, so does the behavior. There is some evidence that can help inform teens and their parents of risk, which includes increased risk of high-risk sexual behavior and non-consensual sharing of personal digital data. This episode provides clinicians important evidence on teens and sexting to inform their care of teens and their families. Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-111-allergies Overview: Many adults report having food allergies. However, many of those who have a food allergy have not been diagnosed by a physician and many who report having a food allergy may not have one at all. Join us for a discussion and recent review of data about the prevalence of food allergies in adults, and how to assess and manage food allergies. Guest: Alan Ehrlich MD Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-110-prep-2 Overview: The USPSTF recently issued a Draft Grade A recommendation that all at-risk patients be offered pre-exposure prophylaxis to prevent the transmission of HIV. This multi drug, single pill regimen can lower risk of HIV and potentially prevent lifelong burden of disease. While only a draft recommendation, the USPSTF expects, after stakeholder comment, to continue to support an A recommendation to offer for all patients who are increased risk. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-109-alcohol-hf Overview: In a recent study, data from the Cardiovascular Health Study examined the association between alcohol consumption and incident HF. It was found that moderate alcohol consumption was associated with a survival benefit, implying that individuals 65 years and older with newly diagnosed HF may not need to stop their alcohol use. Join the discussion about these findings and learn how they may impact the care of your patients with HF. Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-108-tai-chi-2 Overview: Falls in the older population are associated with significant morbidity and mortality yet little evidence exists to determine best practices for prevention. Join us while we discuss a recent RCT that examined Tai Chi versus more traditional exercising in older individuals and its impact on reduction in falls for those at greatest risk. Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-107-postmenopausal Overview: Postmenopausal women experience vulvovaginal symptoms that in 50% of the population go untreated. Join us as we discuss a randomized trial that compares common treatments available to this population and help you determine best practice options. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-106-lipids Overview: Managing cholesterol is one of the most common clinical problems. Recently, the American College of Cardiology and the American Heart Association issued new guidance on the management of blood cholesterol. Ten other societies participated in the development of the guidelines. Listen to find out who should be treated with statins, what the treatment targets are, and when other cholesterol-lowering medications should be added. Guest: Alan Ehrlich MD Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-105-leg-cramps Overview: This episode will discuss a Case Control study of seniors to determine if there is a relationship between regular alcohol consumption and nocturnal leg cramps. Guest: Alan Ehrlich MD Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-104-aspirin Overview: For patients with established cardiovascular disease,aspirin is clearly beneficial as part of secondary prevention. However, when used as primary prevention in patients without documented cardiovascular disease, its benefit is much less certain. This podcast will explore 3 recent trials that evaluated aspirin in different populations and found nobenefit for its use as primary prevention. Guest: Alan Ehrlich MD Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-103-bp-screening Overview: The AAP released new guidelines for the screening and management of high BP in children and teens in 2017. The last recommendations were published in 2004. Join us as we discuss these updated recommendations and their impact on your practice. Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-102-flow Overview: This podcast will explore the results of 3 recent studies that evaluate how the “state of flow” or mental absorption (also called being “in the zone”) alters a person’s ability to handle stress and how intentional use of distractions affect emotions. Guest: Alan Ehrlich MD Music Credit: Richard Onorato

Health benefits and the potential lowering of healthcare costs by billions of dollars seem like enough reasons to increase physical activity. Why can’t we do it? Why is it so hard? We’ll discuss the new guidelines (11/2018) and strategies that may get your patients moving. Guest: Jill Terrien PhD, ANP-BC Associate Professor, Director NP Programs UMMS-GSN Landing Page: https://www.pri-med.com/online-education/Podcast/101-physical-activity-frankly-speaking

This episode is a discussion of the recent summary and recommendations of an expert panel that conducted a systemic review on the published perimenopausal literature to identify, characterize and treat women in this population. Guest: Jill Terrien PhD, ANP-BC Associate Professor, Director NP Programs UMMS-GSN Landing Page: https://www.pri-med.com/online-education/Podcast/100-perminopausal-depression-frankly-speaking

Recently, there has been a deluge of research and news surrounding e-cigarettes and vaping – particularly regarding adolescent usage. Join us as we discuss a recent study describing the prevalence of cannabis use in e-Cigarettes and some strategies for addressing this in your practice. Guest: Susan Feeney, DNP, FNP-BC Landing Page: https://www.pri-med.com/online-education/Podcast/99-eCigarettes-frankly%20speaking

This episode reviews a study that looked at imaging that was performed over a one year period for women with a complaint of breast pain. Guest: Jill Terrien PhD, ANP-BC Landing Page: https://www.pri-med.com/online-education/Podcast/98-breast-imaging-frankly-speaking

Cannabinoids include tetrahydrocannabinol (THC) and cannabidiol, which are found in marijuana, as well as synthetic compounds such as nabilone. The agents have been studied for the treatment of various chronic pain conditions. A meta-analysis was performed that analyzed any cannabinoid, for any chronic pain condition. Guest: Alan Ehrlich MD Landing Page: https://www.pri-med.com/online-education/Podcast/97-cannabis-frankly-speaking

Evidence of the efficacy of statins to reduce ASCVD morbidity and mortality in individuals > 75 years who have known clinical ASCVD (secondary prevention) is well established. Primary prevention in this population has not been as clear. Join us while we discuss a recent study in the BMJ which assessed the benefits of statins for primary prevention of ASCVD morbidity and mortality in individuals > 75 years with and without DM. Guest: Susan Feeney, DNP, FNP-BC Landing Page: https://www.pri-med.com/online-education/Podcast/96-statin-therapy-frankly-speaking.aspx#sm.0000akbf5ldmtfh2s4u14ah34rz3b

This episode will review a randomized controlled trial of adding 10.5 grams of a soluble fiber, psyllium, to a Type 2 Diabetes diet and its influence on weight loss, BMI and other parameters of diabetes. Guest: Jill Terrien PhD, ANP-BC Landing Page: https://www.pri-med.com/online-education/Podcast/95-psyllium-frankly-speaking.aspx

As fall arrives, many patients question the need for an influenza vaccine while clinicians urge patients to get it. 2017-18 flu season data shows high influenza mortality. Learn how to help motivate patients to accept the vaccine. Guest: Susan Feeney, DNP, FNP-BC Landing Page: https://www.pri-med.com/online-education/Podcast/94-influenza-frankly-speaking

8% of patients believe they have a penicillin allergy, yet the actual number is far less. Listen to this episode to learn about the incidence of penicillin allergy, the risks associated with reporting a believed allergy, and how you can better manage these patients. Guest: Susan Feeney, DNP, FNP-BC Landing Page: http://www.pri-med.com/online-education/Podcast/93-penicillin-frankly-speaking

Listen to this episode to learn about the update to the 2012 United States Preventive Services Task Force (USPSTF) recommendation on screening for cervical cancer.

Listen to this episode to learn about a small study which found that adding 35 grams of fiber and 0.8 grams of protein/kg/day to the diets of obese patients—without making any other diet changes—led to weight loss at 12 weeks. Guest: Susan Feeney, DNP, FNP-BC

Both the WHO and AAP recommend exclusive breastfeeding until 6 months of age then solids and breast milk until 12 months of age. The well-established benefits of breastfeeding include support of infant growth and development of immunity. Recently, a clinical trial from the UK found an association between the early introduction of foods and infant sleep. Join us while we discuss the findings of this study and possible implications to your care of moms and their infants.

Best practices in treating acute and chronic pain have been clouded by years of misinformation. Listen to this podcast episode to learn an evidence-based recommendations that dispels these myths and encourages a new and better approach to pain management.

The number of adults in the US on prescription medications is rising, with approximately 15% taking five or more daily medications. A recent study found that depression is a common side effect—37.2% prevalence among American adults taking prescription medications—and is associated with an increased risk of concurrent depression. Guest: Susan Feeney, DNP, FNP-BC

Chronic non-cancer pain in adults over 60 years old is common. The consequences are a decreased quality of life, disability and increased healthcare costs which can be due to the cost of therapies or from adverse pharmacologic effects to name a few. This episode discusses the results of a systematic review and meta-analysis by Niknejad et al (2018) that looked at pain outcomes in this population using psychological modalities. Guest: Jill Terrien PhD, ANP-BC

Adults often present with atraumatic shoulder pain around age 50 and are diagnosed with impingement syndrome (rotator cuff tendonitis). However, as this recent study demonstrates, the standard of care for treatment should not be surgery. Guest: Susan Feeney, DNP, FNP-BC

A recent longitudinal study of high school students in the LA area found a modest but significant association between high-frequency digital media use (phones, tablets) and subsequent ADHD symptoms. Join us as we discuss these findings and the possible impact on adolescent primary care. Guest: Susan Feeney, DNP, FNP-BC

This episode is an introductory discussion of the very real problem of physician burnout. It affects you and those around you. What do we know about burnout and how can we move beyond it? Guest: Jill Terrien PhD, ANP-BC

In this episode, we will discuss using an inhaled steroid twice a day to control mild asthma symptoms, versus using the combination budesonide and formoterol. Guest: Jill Terrien PhD, ANP-BC

It has been fairly established that short duration of sleep is associated with obesity in teens and adults; however, the impact of quantity and quality of sleep has not been as well established. A cross-sectional study by Feliciano et al. found that longer and better sleep was associated with better cardiometabolic profiles in early adolescence – independent of other factors. Guest: Susan Feeney, DNP, FNP-BC

Discussing goals of care with patients that have a serious, life-limiting illness does not affect the patient’s anxiety or depression—but can increase the quality of the communication. Listen to this podcast episode for tips that are easily adaptable to any outpatient or specialty practice. Guest: Jill Terrien PhD, ANP-BC

Breastfeeding exclusively in the first six months of life is widely recommended. However, in this study of newborns who were losing weight because their mother’s milk had not yet come in, post-breastfeeding supplementation improved weight and did not alter breastfeeding rates at one month. Guest: Susan Feeney, DNP, FNP-BC

In 2013, a groundbreaking clinical trial from Spain touted the benefits of the Mediterranean Diet to reduce CVD risk. A recent review of the study found some irregularities in the randomization procedure that cast concern on the validity of the findings. After reanalysis of the data, however, the results were essentially the same. Guest: Susan Feeney, DNP, FNP-BC

For adolescents who binge drink, when they begin and how often they do it affects academic performance. This episode discusses the findings of a longitudinal analysis of secondary school students in Canada: The COMPASS study. Guest: Jill Terrien PhD, ANP-BC

This study looked at how pain was treated following spine and joint surgery and found the majority of patients were not encouraged to use non-opioid analgesia and that most had a supply of unused opioids at home. Guest: Jill Terrien PhD, ANP-BC

Hypertension affects an estimated 80 million Americans. We diagnose, determine the need for medication therapy, and monitor treatment efficacy based on a simple office blood pressure measurement – but how accurate is that measurement, and what is the most valid method to obtain it? Guest: Susan Feeney, DNP, FNP-BC

Fibromyalgia can be difficult to treat and often requires a multifaceted approach combining exercise, medications, cognitive behavioral therapy, and health education. For many patients, pain hinders participation in a vigorous exercise regimen. Listen to this review of a randomized trial comparing aerobic exercise to tai chi in a patient population with fibromyalgia. Guest: Alan Ehrlich, MD

For women experiencing an uncomplicated UTI, nitrofurantoin and fosfomycin are two first-line options for treatment. Is one more effective than the other? Listen to this episode to learn about the results from a multinational, open-label, randomized clinical trial. Guest: Jill Terrien PhD, ANP-BC

Listen to this week’s podcast episode to learn about a meta-analysis showing no benefit to rectal examinations in men. Guest: Susan Feeney, DNP, FNP-BC

A recent AHA presentation offered data that showed an overwhelming amount of patients would prefer to take a pill or drink tea rather than exercise to lower their BP. This begs the questions: How much does drinking tea lower BP? Does exercise help those with primary HTN or resistant HTN who are already on medication? Finally, how do we get our patients to exercise? Guest: Robert A. Baldor, MD, FAAFP

Listen to this week's episode to learn about a randomized trial of children in music vs. visual arts instruction. Music instruction led to improvements in verbal intelligence, executive functions, and academic performance. Guest: Susan Feeney, DNP, FNP-BC

This episode will review The Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) series of 4 randomized controlled trials, pooling individual data that will provide guidance for discussing pharmacologic and non-pharmacologic options for your peri- and postmenopausal patients. Guest: Jill Terrien PhD, ANP-BC

The National Institute on Aging-Alzheimer’s Association (NIA-AA) just released an updated Framework of the 2011 Guidelines for Alzheimer’s Disease Research, focusing on the use of biomarkers rather than clinical criteria to make the diagnosis. Listen to this week’s episode to learn more. Guest: Robert A. Baldor, MD, FAAFP

Chronic pain is a difficult but common problem in primary care. Patients are often desperate for any form of relief, and as a result, many are eventually started on opioid analgesics. This can be associated with many adverse effects. But is it worth it? A recent randomized trial compared opioid to non-opioid management of patients with chronic low back pain or chronic hip pain or knee pain due to osteoarthritis. Guest: Alan Ehrlich, MD

A recent research study published in JAMA Internal Medicine examined the use of antibiotics to treat acute sinusitis based upon the Infectious Diseases Society of America (IDSA) guideline recommending 5-7 days when antibiotics are indicated and found that most courses of antibiotics are too long. Listen to this week’s episode to learn more. Guest: Robert A. Baldor, MD, FAAFP

The American College of Physicians supported an evidence-based review of the topic guidelines for type 2 diabetes and concluded clinicians should aim for an A1c goal between 7.0-8.0 and recommended even less aggressive care for those over the age 80 years. Listen to this podcast episode to learn more about these new guidelines. Guest: Alan Ehrlich MD

Listen to this podcast episode for a brief summary of the literature on electronic media and its relation to sleep—specifically delayed bedtimes and decreased sleep duration. Screen-based media consumption is eating up our sleep health! Guest: Jill Terrien PhD, ANP-BC