In episode 410, Mike, James, and Adrienne discuss the evidence around antidepressants in the elderly. We find 40% to 80% of elderly patients will recover with antidepressants, but a number of studies show no difference from placebo response rates. In addition, approximately 20% will stop due to adverse effects. 

Show notes

Tools for Practice

In episode 409, Mike and James yet again welcome Adrienne from Red Deer to talk about whether or not we need to give antibiotics for drained abscesses. We find out that relatively, the benefit of increased cure is similar to the chance of side effects.

Show notes

Tools for Practice

In episode 408, Mike and James talk about a couple of recent survey publications. One, which examined patient satisfaction around patient requests and denials of those requests. The other examined how often and why patients are not always honest about disclosing medically relevant information. At the end we decide there is a little liar in all of us and we just need to accept it.

In episode 407, Mike and James go PREMIUM and talk about three potentially practice changing trials. Water for recurrent UTIs, e-cigarettes for smoking cessation, and acetaminophen for febrile seizures. It doesn’t get more PREMIUM than that.

Show notes

1) Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections

In episode 406, Mike, James, and Tina go over the evidence for treating opioid use disorder in primary care and the evidence is clear that it can be done in primary care but specialized opioid treatment programs are also obviously needed.

Show notes

1) Tools for Practice

In episode 405, Mike and James, with yet again the very smart and helpful Tina Korownyk, go over the evidence for buprenorphine-naloxone for pharmaceutical opioid use disorder. While the evidence is at moderate to high risk of bias the results are fairly impressive with NNTs of 3-5.

Show notes

Tools for Practice

In episode 404, Mike and James, with the very capable Tina Korownyk, go over the approach to what tools to use to help determine if a patient has an opioid use disorder (OUD). We talk about a simple tool called the Prescription Opioid Misuse Index (POMI), a 6-point questionnaire with strong predictive ability for OUD which seems to be a reasonable case-finding tool. 

In episode 403, Mike and James finally finish up their clear demonstration as to why they aren’t therapeutic nihilists.  We focus on system/ecological issues and specifically primary care – the bottom line is things aren’t as bad as they sometimes seem, but things could always be better – you heard it here first.

Show notes