Frankly Speaking About Family Medicine

Preventing Opioid Dependence While Effectively Treating Pain - Frankly Speaking EP 89

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