In episode 592, Mike and James invite Jennifer Young back to the podcast to review the evidence around the use of antidepressants in the challenging pain condition of fibromyalgia. We find there is an effect but, if you are going to help people make decisions, what you really need to know are the numbers for the benefits and harms around the use of these medications. We give you those, so have a listen.

Show notes
Tools for Practice
Pharm for Fibro: Can antidepressants ease the pain?

In episode 591, Mike and James invite Samantha Moe back to the podcast to review the evidence for using testosterone in older men. We talk about the impact testosterone supplementation has on sexual function, strength, fatigue, cognition, quality of life, and harms. There are 16 systematic reviews so we do have pretty good evidence – have a listen and see what the evidence says about what testosterone supplementation might do or not do.

Show notes
1) Tools for Practice
Testosterone supplementation for cis-gender men: Let’s (andro-)pause for a moment

In episode 590, Mike and James talk in a PREMIUM way about a new trial that looked at the question, does depression screening provide any benefit in primary care? We also go over a case-finding publication on screening for asthma/COPD. At the end we look at, does implementing guideline care improve outcomes for CKD? The…

In episode 589, Mike and James invite Jennifer Young back to the podcast again to talk about a topic that Mike absolutely loves – Vitamin D for everyone. Tune in to hear about all the latest, and the older, evidence. Do you agree we should remove the question mark from the podcast title?

Show notes
1) Tools for Practice
Vitamin D and Fracture Prevention: Not what it’s cracked up to be?

In episode 588, Mike and James invite Émélie Braschi back to the podcast to discuss another tricky area – insulin in type 2 diabetes and how to use it. Do we need to give it once a day, twice a day or maybe no times a day? Tune in to hear about all the evidence.

Show notes
1) Tools for Practice
Strategies for initiating insulin in type 2 diabetes

In episode 587, Mike and James invite Adrienne Lindblad back to the podcast to go over all the evidence we have for the oral GLP-1 weight loss medications. You know you are going to get lots of questions about these medications so tune in to find out all the numbers around the benefit and potential harms – and cost.

Show notes
1) Tools for Practice
Mission Slimpossible Part 2: Oral GLP-1 agonists for weight loss

In episode 586, Mike and James invite Émélie Braschi back to the podcast to talk about the tricky issue of how to deal with a potential penicillin allergy. Believe it or not there are a couple of RCTs looking at this issue. These two trials compared oral challenge alone to skin testing followed (if negative) by oral challenge. The results may allow you to change your practice in a good way. Tune in and find out why.

Show notes
Tools for Practice
It’s time to challenge penicillin allergy labels!

In episode 585, Mike and James finally get back to being PREMIUM. We review the REDUCE-AMI trial which tried to answer the question – do you need to use a beta-blocker after an MI if there is preserved ejection fraction? We also review a COPD trial that shows integrating respiratory specialists in primary care improves guideline adherence. However, the interesting finding is what happens to the quality-of-life change and hospitalizations. The results of both of these trials may surprise you.

Show notes
1) REDUCE-AMI- Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction
N Engl J Med 2024;390:1372-1381

2) Cluster randomised controlled trial of specialist-led integrated COPD care (INTEGR COPD)
Thorax 2024;79:209–218

In episode 584, Mike and James invite Tina Korownyk back to the podcast to talk about the evidence for amyloid-targeting monoclonal antibodies in mild cognitive impairment or Alzheimer’s dementia. Unfortunately, the evidence shows these medications don’t seem to have a clinically important effect and do have some harms. Have a listen as we give you all the numbers so you will be able to properly discuss these medications with your patients.

Show notes

Tools for Practice
Remind me, do medications that target brain amyloid improve my dementia?

In episode 583, Mike and James continue to go over the issues associated with using CVD risk calculators. We talk about some of the limitations, how to think about the results and explain the risks and benefits to patients.

Show notes
PEER Simplified Cardiovascular Decision Aid

Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793

Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2

Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956