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Therapeutics Education Collaboration
Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 426: PREMIUM – if you take the polypill for 5 years, what happens?

In episode 426, James and Mike discuss in a PREMIUM way the first large RCT of the polypill. This single pill version contained aspirin, atorvastatin, hydrochlorothiazide, and either enalapril or valsartan. Have a listen and find out what happened.

Show notes

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial 

Lancet. 2019 Aug 24;394(10199):672-683. doi: 10.1016/S0140-6736(19)31791-X

Episode 423: 10 really useful studies for primary care

In episode 423, James and Mike welcome Samantha Moe, a pharmacist and clinical evidence expert with the College of Family Physicians, to the podcast. We discuss studies on cannabis and risk of schizophrenia, the harms of PPIs, H pylori infections and duration of treatment, and blood pressure measurements over clothes or a bare arm.

Show notes

Useful studies handout

Episode 422: PREMIUM – Statins do don’t not not work in older people – or do/don’t they?

In episode 422, James and Mike, go MEGA-PREMIUM and discuss the most recent meta-analysis (yes, yet another one) around the use of statins in older people. We then quickly review an article that looks at whether or not the guidelines for monitoring chronic conditions in primary care are evidence based. We are “shocked” when we find out “There is no evidence to support frequency of testing of any test in any of the guidelines”.  

Show notes

1) Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials

Lancet. 2019 Feb 2;393(10170):407-415. doi: 10.1016/S0140-6736(18)31942-1

2) Are guidelines for monitoring chronic disease in primary care evidence based?

BMJ. 2019 Jun 13;365:l2319. doi: 10.1136/bmj.l2319

Episode 421: Iron-ing out the wrinkles in anemia management

In episode 421, Mike and James discuss the best available evidence around the newer and typically more expensive iron formulations used for iron deficiency anemia. We find the newer iron formulations are inferior to older ferrous salts when it comes to treating anemia and the evidence that newer formulations have less adverse effects is at best inconsistent.

Show notes

Tools for Practice

Iron-ing Out the Wrinkles in Anemia Management

Episode 420: GPs should stop making mental health diagnoses

In episode 420, James and Mike welcome back Bruce Arroll to talk about approaches to how we should talk about, discuss, chart and treat mental health issues. We discuss avoiding psychiatric labels, consider giving transdiagnostic labels, and doing functional assessments around work, love, and play.

Show notes

1) Transdiagnostic Symptom Clusters and Associations With Brain, Behavior, and Daily Function in Mood, Anxiety, and Trauma Disorders

JAMA Psychiatry. 2018 Feb 1;75(2):201-9

2) The psychopathology of James Bond and its implications for the revision of the DSM-(00)7

Med J Aust. 2015 Dec 14;203(11):452-6.

3) Saving Normal: An Insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, Big Pharma and the medicalization of ordinary life

Psychotherapy in Australia, Vol. 19, No. 3, May 2013: 14-18

4) brucearroll.com

5) Reforming disease definitions: a new primary care led, people-centred approach

BMJ Evidence Based medicine doi:10.1136/ bmjebm-2018-111148 

FACT- work/love/play

Limit the problem focus

1) work – 1 to 10

2) love (friends) – 1 to 10

3) love (intimates) – 1 to 10 

4) love (family) – 1 to 10 

5) play  – 1-10

Episode 419: Opioid use disorder in primary care – PART III

In episode 419, Tina, Mike and James finish talking about managing opioid use disorder in primary care.  We find that positive reinforcement and brief counseling can be of some value but not the opposite – we realize we should treat this in a similar way to a chronic condition. We also realize that the evidence around urine drug testing and contracts is at best confusing and very limited. 

Show notes

Opioid use disorder in primary care: PEER umbrella systematic review of systematic reviews

Can Fam Physician. 2019 May;65(5):e194-e206

Managing opioid use disorder in primary care: PEER simplified guideline

Can Fam Physician. 2019 May;65(5):321-330

Episode 418: Opioid use disorder in primary care – PART II

In episode 418, Tina, Mike and James continue to talk about managing opioid use disorder in primary care. We talk about tools used for case finding and decide the POMI tool is the most useful. We also discuss whether or not tapering is useful and look at the naltrexone data.

Show notes

Opioid use disorder in primary care: PEER umbrella systematic review of systematic reviews

Can Fam Physician. 2019 May;65(5):e194-e206

Managing opioid use disorder in primary care: PEER simplified guideline

Can Fam Physician. 2019 May;65(5):321-330

Episode 417: Opioid use disorder in primary care

In episode 417, Mike and James invite Tina Korownyk to talk about all the work our PEER group did in developing a simplified guideline for managing opioid use disorder in primary care. We talk about how the guideline was put together, how the group decided on the questions that needed to be answered around opioid use disorder and what the evidence says around where can opioid use disorder be treated.

Show notes

Opioid use disorder in primary care: PEER umbrella systematic review of systematic reviews

Can Fam Physician. 2019 May;65(5):e194-e206

Managing opioid use disorder in primary care: PEER simplified guideline

Can Fam Physician. 2019 May;65(5):321-330

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The 2026 MEME Conference – May 8-9, 2026

REGISTRATION IN JANUARY 2026

Making Evidence Matter For Everyone | May 8-9, 2026
From the clinicians who brought you the Best Science Medicine Course and the Meds Conference, as well as the BS Medicine Podcast and Tools for Practice

hectalks.com

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BIG ANNOUNCEMENT

THE NUTRITION PROPOSITION BOOK

Check it out at nutritionproposition.com and think about picking up a copy on Amazon. All the evidence you ever wanted about nutrition and the only nutrition book that won’t tell you what to eat.

 

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