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.
Show notes
Tools for Practice
Does this patient taking prescription opioids have opioid use disorder?
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
CFPC National Webinar – Learn about the top 2018 research studies – Jan 9, 2019 – 12:00 EST Web link
In episode 402, Mike and James continue to try to demonstrate beyond a shadow of a doubt that they aren’t therapeutic nihilists. We talk about treatments that really work for symptoms – antibiotics, corticosteroids, antidepressants, proton pump inhibitors, and ED medications.
Show notes
1) Handout
2) Effectiveness of Antidepressants
In episode 401, Mike and James continue to try to show they aren’t therapeutic nihilists. We talk about the ballpark benefits of treating conditions like diabetes, with a focus on nutrition and activity to reduce cardiovascular risk.
Show notes
In episode 400, Mike and James talk about why they think they aren’t therapeutic nihilists and what it means to be a healthy skeptic. We then have a much longer discussion (which will go into the next few episodes) about many of the treatments that really do work. In this podcast we talk about treatments for BP, A fib and heart failure.
Show notes
In episode 399, Mike and James discuss a new paper researched and written by the Alberta gang. There are many reasons why patients are seen in primary care. This systematic review gives all the data on what are globally, the most common presenting conditions in primary care.
Show notes
What are the most common conditions in primary care?
In episode 398, James and Mike continue their discussion of the evidence around the class of agents called monoclonal antibodies. In this podcast we focus on medications that have an effect on symptoms and at the end we put the entire class into perspective – at least as much as we can.
Show notes
In episode 397, James and Mike discuss the evidence around the class of medications called monoclonal antibodies. We talk a little bit about them as a whole and then talk specifically about 6 different agents and the trials that have looked at the effectiveness of these interesting new medications. We come to the conclusion that you need to treat these agents, just like any new medication, by looking at the best available evidence.
Show notes
In episode 396, Mike and James present PREMIUM information from a premium province (BC). We discuss new studies that looked at measurements of blood pressure and bone density. At the end we put all of this information into a premium perspective.
Show notes
Tools for Practice
1) Association of Repeated Measurements With Blood Pressure Control in Primary Care
JAMA Internal Medicine 2018;178:858-60
2) Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial
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.
This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)
