Practical Talks for Family Docs: Recent Episodes
Multiple Authors
The College of Family Physicians of Canada is pleased to bring you Practical Talks for Family Docs, the podcast edition. These recordings originate from the College’s clinical webinar series. Each webinar focusses on key topics that are relevant to family practice in Canada and are brought to you by speakers hand-picked by our team at CFPC. If you are interested in joining our live-stream webinars, visit cfpc.ca/clinicalwebinars to learn about our upcoming features.
This podcast series is part of a larger collection of online learning opportunities hosted on our GoMainpro website. In addition to the practical podcasts, on this site you will find:
The collection of Tools for Practice articles which are short articles that address clinical questions using the best available evidence. They have great bottom line summaries and take away messages for clinicians in primary care.
You will also find videos recordings from CFPC webinars and conferences from the Alberta College of Family Physicians, including PEIP and FMS.
Brand new to this collection is a game called “Choose your briefs: Covering the Essentioals”, based on the very popular Jeopardy game format that Dr. Mike Allan and the PEER team provide at medical conferences across Canada. The College, in partnership with the PEER team, is pleased to be able to bring the online version for you to play at your convenience.
To claim Mainpro+ credits for any of these opportunities, you will need to have a subscription to GMP and you can get this for a low annual fee. Find out more at https://gomainpro.ca.
Thanks for tuning in to Practical Talks for Family Docs – The Podcast Edition.
In this module of In the Clinic, the team discusses Diana Neer, a 64-year-old woman complaining of shoulder pain.
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https://cfpclearn.ca/podcast/itc61/
In this module of In the Clinic, the team discusses Diana Neer, a 64-year-old woman complaining of shoulder pain.
To claim your CPD credits, click the link below and then select "Complete Activity."
In episode 625, Mike K and James invite Danielle Perry and Tony Nickonchuk to the podcast to talk about the evidence around blood pressure measurement techniques. You might be surprised by what does and does not influence blood pressure measurements. Check out the podcast.
Show Notes Tools For Practice Blood Pressure Measurement Technique: Meaningful mistakes or minor details?
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https://cfpclearn.ca/podcast/bs625/
In episode 624, James and Mike K invite Tony Nickonchuk to go over all the new evidence we have for the PCSK9 inhibitors. First, we discuss whether or not the evidence addresses the issue of primary versus secondary prevention. We then give you all the numbers and the context you need to allow you to discuss these with your patients.
Show Notes Tools For Practice PCSK9 Inhibitors: Cardiovascular prevention panacea or pricey pokes?
PEIP Conference Oct 16-17, 2026
To claim your CPD credits, click the link below and then select "Claim Credits Now".
https://cfpclearn.ca/podcast/bs624/
Le groupe d'intérêt des membres sur la santé des patients 2SLGBTQ+ a collaboré avec projet NUANCES, centre de soins en diversité sexuelle et de genre. Dre Judith Lajeunesse et Caroline Paquette de projet NUANCES présentent un cas clinique qui permettra aux médecins de famille de mieux comprendre leur rôle en appuyant les patients qui veulent discuter une transition de genre.
This podcast discusses two of the most common gender-affirming surgeries - vaginoplasty in a transfeminine patient and top surgery or mastectomy in a trans masculine patient. These are emotionally high stakes surgeries for our transgender and gender diverse patients. Family doctors have the knowledge and skills to provide routine postoperative care, and equally important, provide reassurance and a safe place for our patients to be heard.
In episode 623, Jamie and James invite Samantha Moe back again to talk about the never-ending debate as to what is the target for systolic blood pressure. We look at the evidence and then try to put it into a reasonable context because at best the evidence is always nuanced. But at least you will now know the numbers.
To claim your CPD credits, click the link below and then select "Claim Credits Now".
https://cfpclearn.ca/podcast/bs-medicine-epis…-pressure-target/
In episode 622, Jamie and James invite Émélie Braschi back again to talk about if we should be using inhalers that combine corticosteroids and beta-agonists as rescue inhalers. We go over the best available evidence and then try to put the findings into context.
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https://cfpclearn.ca/podcast/bs-medicine-epis…haler-for-asthma/
In this episode of In the Clinic, the team discusses Tina Mojsov, a 30-year-old woman who wants to lose weight.
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In the Clinic Episode 59: Weight Loss - CFPCLearn
In episode 621, Tina, James and Mike K talk about the evidence around whole-body MRIs. We discuss how many abnormalities are found, how many cancers are actually found, and finally the lost opportunity costs. You need to know these numbers to talk to your patients about the value or lack thereof of doing this test.
To claim your CPD credits, click the link below and then select "Claim Credits Now".
https://cfpclearn.ca/podcast/bs-medicine-episode-621-whole-body-mri-for-cancer-screening-many-findings-little-benefit/
In episode 620, Mike K and James bring back Danielle Perry, this time to talk about the evidence around the use of colchicine for secondary cardiovascular prevention. There are some large RCTs so we talk about all the numbers and as always put them into the proper context.
To claim your CPD credits, click the link below and then select "Claim Credits Now".
BS Medicine Episode #620: Back on the stand: Colchicine for secondary cardiovascular prevention update - CFPCLearn
In episode 619, Mike K and James chat yet again with Émélie Braschi. The topic this time is the use of point-of-care ultrasound (POCUS) to help diagnose patients coming into emerg with dyspnea. The results certainly suggest this may be a useful tool. Tune in and find out if it is useful enough for you.
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BS Medicine Episode #619: Scan, See, Decide: POCUS in the Evaluation of Dyspnea - CFPCLearn
In this episode of In the Clinic, the team discusses John Painica, a 52-year-old man presenting with neck pain.
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https://cfpclearn.ca/podcast/in-the-clinic-episode-58-neck-pain/
In this episode of In the Clinic, the team discusses Nadia Hench, a 49-year-old woman following up regarding achiness, fatigue, and poor sleep.
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In the Clinic Episode 57: Fibromyalgia - CFPCLearn
In this episode of In the Clinic, the team discusses Leah Sandwich, 64-year-old woman presenting with fatigue.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
In the Clinic Episode 56: Fatigue, Part II - CFPCLearn
In episode 618, Mike K and James chat with Émélie Braschi who helps us go over, yet again, the evidence for the use of gabapentinoids. This time it is for the treatment of osteoarthritis. We then put the best available evidence into the context of the other treatments we have for osteoarthritis. Have a listen and find out if and/or where it might fit in.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
BS Medicine Episode #618: From Nerve Pain to Knee Pain: Gabapentinoids for osteoarthritis - CFPCLearn
In episode 617, Tina and James bring in Caitlin Finley to review the latest trial that attempts to answer the question of does treating male sexual partners of females undergoing treatment for bacterial vaginosis infection decrease recurrence? We'll find out that despite this trial getting lots of press it doesn't provide definitive evidence about who/how to treat. Have a listen as you need to see what the results really show.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
BS Medicine Episode #617: A Whiff of Prevention: Treating Male Partners to Reduce Bacterial Vaginosis Recurrence - CFPCLearn
In episode 616, Tina and James discuss the issue around the evidence for using topical anesthetics to reduce the pain associated with IUD insertion. To help with this discussion, we bring in Jessica Kirkwood and Caitlin Finley to provide practical information and insight. The evidence is really interesting and worth knowing. So have a listen – it might change your practice.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
BS Medicine Episode #616: Taking the "ouch" out of IUD insertion: Can topical lidocaine help? - CFPCLearn
In this episode of In the Clinic, the team discusses Leah Sandwich, 64-year-old woman presenting with fatigue.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
In the Clinic Episode 55: Fatigue, Part I - CFPCLearn
In this episode of In the Clinic, the team discusses Adrian Cage, a 42-year-old father of two presenting with anxiety.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
In the Clinic Episode 54: Anxiety - CFPCLearn
In this episode of In the Clinic, the team discusses Val Sternbach, a 65-year-old presenting with racing heart and trouble breathing.
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In the Clinic Episode 53: Palpitations - CFPCLearn
In episode 615, Mike and James revisit the evidence around using electronic cigarettes for smoking cessation. We look at smoking cessation rates between the use of e-cigarettes, nicotine-free e-cigarettes, nicotine replacement therapy or varenicline. Tune in to hear about the numbers from the trials – it may inform you as to what you could recommend to smokers in your practice.
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BS Medicine Episode #615: Vape Expectations: Are electronic cigarettes the real deal for smoking cessation? - CFPCLearn
In episode 614, Mike and James discuss with Caitlin Finley the evidence around a very common primary care question. Does restricting early use of pacifiers result in higher rates of breastfeeding up to 6 months of age in term infants? We discuss the findings and do our best to put the evidence into context.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
BS Medicine Episode #614: Nipple Confusion or Nonsense? Pacifiers and Breastfeeding Duration - CFPCLearn
In episode 613, Mike and James discuss with Jessica Kirkwood the evidence for post-exposure prophylaxis of sexually transmitted infections. We go over the 4 RCTs that have looked at the value of a single dose of doxycycline. It does reduce the risk for some specific infections – but as always you need to know the numbers. We give you all of them and much, much more.
To claim your CPD credits, click the link below and then select "Claim Credits Now."
BS Medicine Episode #613: Doxycycline for post-exposure prophylaxis of sexually transmitted infections - CFPCLearn
In episode 611, Tina and James talk with Samantha Moe about the use of betablockers and other medications for essential tremor. There is some evidence – much of it from the 1970s, but also some more recent publications. We do our best to tease out all the numbers you need to help you with your recommendations.
Show Notes
Tools For Practice Meds for Essential Tremor: Steady solution or shaky science?
In episode 610, Jamie and James chat with Jennifer Young about yet another Vitamin D Tools for Practice. We look at what happens to mortality, CVD and cancer when Vitamin D supplements are compared to placebo. The results may surprise you – or maybe not if you have listened to previous BS Medicine Podcasts on this seemingly never-ending topic.
Show Notes
Tools For Practice Vitamin D and Mortality – Don't bet your life on it!
Vitamin D and Respiratory Tract Infections: Does the sun's vitamin chase the cold?
Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 115ème épisode, Sébastien, Nicolas et Isabelle terminent leur série d'épisodes sur l'ostéoporose. Dans cette troisième et dernière partie, on aborde la prise en charge suite à une fracture, les marqueurs du remodelage osseux, l'ostéoporose induite par les corticostéroïdes et la prise concomitante de suppléments de calcium et de vitamine D lors de l'utilisation d'un traitement pharmacologique.
Les objectifs pour cet épisode sont les suivants:
- Discuter de la prise en charge des patients qui ont subi une fracture de fragilisation
- Discuter de l'utilité des marqueurs biochimiques du remodelage osseux
- Résumer la prise en charge de l'ostéoporose induite par les corticostéroïdes
- Conseiller adéquatement la prise d'un supplément de calcium et de vitamine D aux patients prenant un traitement pharmacologique contre l'ostéoporose
Ressources pertinentes en lien avec l'épisode
Qaseem A et coll; Clinical Guidelines Committee of the American College of Physicians. Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians. Ann Intern Med. 2023;176:224-38.
National Osteoporosis Guideline Group – UK. Clinical Guideline for the Prevention and Treatment of Osteoporosis 2021. Septembre 2021.
Moe S, Paige A, Allan GM. Osteoporosis in postmenopausal women. Can Fam Physician. 2021;67:346.
Nayak S, Greenspan SL. Osteoporosis Treatment Efficacy for Men: A Systematic Review and Meta-Analysis. J Am Geriatr Soc. 2017;65:490-95.
National Institute for Health and Care Excellence (NICE). Osteoporosis: assessing the risk of fragility fracture. London; 2017.
Papaioannou A et coll. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182:1864-73.
Management of Osteoporosis in Postmenopausal Women: The 2021 Position Statement of The North American Menopause Society'' Editorial Panel. Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021;28:973-97.
Bessette L et coll. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int. 2008;19:79-86.
Deng J et coll. Pharmacological prevention of fractures in patients undergoing glucocorticoid therapies: a systematic review and network meta-analysis. Rheumatology. 2021;60:649-57.
Calculateur FRAX Centre for Metabolic Bone Diseases. FRAX: Fracture Risk Assessment Tool. University of Sheffield, UK.
Outil d'aide à la décision Mayo Foundation for Medical Education and Research. Bone Health Choice Decision Aid. Mayo Clinic, USA.
Holala! Un premier épisode du Pharmascope enregistré devant public est maintenant disponible! En direct de Jonquière, Sébastien, Nicolas et Isabelle continuent leur série d'épisodes sur l'ostéoporose. Dans cette deuxième partie, on aborde le calcium, la vitamine D ainsi que les différentes options pharmacologiques dans le traitement de l'ostéoporose.
Les objectifs pour cet épisode sont les suivants:
- Discuter des avantages et des inconvénients à la prise de calcium et de vitamine D
- Expliquer les avantages et les inconvénients des traitements pharmacologiques de l'ostéoporose
Ressources pertinentes en lien avec l'épisode
Qaseem A et coll; Clinical Guidelines Committee of the American College of Physicians. Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians. Ann Intern Med. 2023;176:224-38.
Bolland MJ et coll. Calcium intake and risk of fracture: systematic review. BMJ. 2015;351:h4580.
Avenell A, Mak JC, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014;2014:CD000227.
Moe S, Paige A, Allan GM. Osteoporosis in postmenopausal women. Can Fam Physician. 2021;67:346.
Nayak S, Greenspan SL. Osteoporosis Treatment Efficacy for Men: A Systematic Review and Meta-Analysis. J Am Geriatr Soc. 2017;65:490-95.
National Institute for Health and Care Excellence (NICE). Osteoporosis: assessing the risk of fragility fracture. London; 2017.
Papaioannou A et coll. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182:1864-73.
Management of Osteoporosis in Postmenopausal Women: The 2021 Position Statement of The North American Menopause Society'' Editorial Panel. Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021;28:973-97.
Calculateur FRAX Centre for Metabolic Bone Diseases. FRAX: Fracture Risk Assessment Tool. University of Sheffield, UK.
Outil d'aide à la décision Mayo Foundation for Medical Education and Research. Bone Health Choice Decision Aid. Mayo Clinic, USA.
Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 113ème épisode, Sébastien, Nicolas et Isabelle débutent une série d'épisodes sur l'ostéoporose. Dans ce premier épisode, on aborde le dépistage, l'évaluation et le diagnostic de l'ostéoporose, une maladie qui n'en est peut-être pas vraiment une…
Les objectifs pour cet épisode sont les suivants:
- Définir l'ostéoporose
- Identifier les patients nécessitant un dépistage de l'ostéoporose
- Expliquer les avantages et les limites d'une ostéodensitométrie
- Évaluer le risque de fracture d'un patient
Ressources pertinentes en lien avec l'épisode
National Institute for Health and Care Excellence (NICE). Osteoporosis: assessing the risk of fragility fracture. London; 2017.
US Preventive Services Task Force. Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319:2521-31.
Viswanathan M et coll. Screening to Prevent Osteoporotic Fractures: An Evidence Review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018. (Evidence Synthesis, No. 162.
Papaioannou A et coll. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182:1864-73.
Korownyk C, McCormack J, Allan GM. Who should receive bone mineral density testing? Can Fam Physician. 2015;61:612.
Choisir avec soin. L'ostéodensitométrie. Canada.
Management of Osteoporosis in Postmenopausal Women: The 2021 Position Statement of The North American Menopause Society'' Editorial Panel. Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021;28:973-97.
Calculateur FRAX Centre for Metabolic Bone Diseases. FRAX: Fracture Risk Assessment Tool. University of Sheffield, UK.
Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 111ème épisode, Sébastien, Nicolas et Isabelle terminent leur série sur le processus de décision partagée, cette fois en discutant des avantages, des obstacles et des moyens de l'appliquer au quotidien à l'aide d'outils.
Les objectifs pour les épisodes 110 et 111 sont les suivants:
- Définir le processus de prise de décision partagée
- Identifier les bénéfices et les inconvénients du processus de décision partagée
- Appliquer un processus de décision partagée
Ressources pertinentes en lien avec l'épisode
Stacey D et coll. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4:CD001431.
Coronado-Vázquez V et coll. Interventions to facilitate shared decision-making using decision aids with patients in Primary Health Care: A systematic review. Medicine (Baltimore). 2020;99:e21389.
Outils d'aide à la décision partagée McCormack J, Pfiffner P. The absolute CVD Risk / Benefit Calculator. 2017.
PEER. Comparing Treatment Options for Pain: The C-TOP Tool.
Mayo Foundation for Medical Education and Research. Bone Health Choice Decision Aid. 2023.
BMJ Publishing Group. BMJ Rapid Recommendations. 2023.
The Ottawa Hospital Research Institute. Patient Decision Aids. 2022.
Primary Health Tasmania. Medication Management – deprescribing. 2023.
Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 110ème épisode, Sébastien, Nicolas et Isabelle discutent d'un concept souvent mentionné mais pas toujours appliqué: le processus de décision partagée.
Les objectifs pour les épisodes 110 et 111 sont les suivants:
- Définir le processus de prise de décision partagée
- Identifier les bénéfices et les inconvénients du processus de décision partagée
- Appliquer un processus de décision partagée
Ressources pertinentes en lien avec l'épisode
The SHARE Approach—Essential Steps of Shared Decisionmaking: Expanded Reference Guide with Sample Conversation Starters. Septembre 2020. Agency for Healthcare Research and Quality, Rockville, MD.
Institut national d'excellence en santé et en services sociaux. La prise de décision partagée: une approche gagnante. Octobre 2019.
Hoffmann TC, Del Mar C. Clinicians' Expectations of the Benefits and Harms of Treatments, Screening, and Tests: A Systematic Review. JAMA Intern Med. 2017;177:407-19.
Trewby PN et coll. Are preventive drugs preventive enough? A study of patients' expectation of benefit from preventive drugs. Clin Med (Lond). 2002;2:527-33.
Douglas F et coll. Differing perceptions of intervention thresholds for fracture risk: a survey of patients and doctors. Osteoporos Int. 2012;23:2135-40.
Zipkin DA et coll. Evidence-based risk communication: a systematic review. Ann Intern Med. 2014;161:270-80.
Stacey D et coll. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4:CD001431.
Coronado-Vázquez V et coll. Interventions to facilitate shared decision-making using decision aids with patients in Primary Health Care: A systematic review. Medicine (Baltimore). 2020;99:e21389.
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 103ème épisode, Nicolas, Sébastien et Isabelle discutent encore une fois de vitamine B12. Cette fois, on jase de plein de choses: les médicaments pouvant causer une déficience en B12, la supplémentation en B12 et même de l'effet de la B12 sur les performances au karaoké!
Les objectifs pour cet épisode sont les suivants:
- Identifier les médicaments ou substances susceptibles de causer une déficience en vitamine B12
- Comparer les avantages et les inconvénients des différentes voies d'administration disponibles pour l'administration de vitamine B12
- Discuter du suivi à effectuer suite à l'amorce de la vitamine B12
Ressources pertinentes en lien avec l'épisode
Boughrassa F, Framarin A. Usage judicieux de 14 analyses biomédicales: Outil pratique. Institut national d'excellence en santé et services sociaux. Avril 2014.
Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226.
Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368:149-60.
de Jager J et coll. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ. 2010;340:c2181.
Sanz-Cuesta et coll; OB12 Group. Oral versus intramuscular administration of vitamin B12 for vitamin B12 deficiency in primary care: a pragmatic, randomised, non-inferiority clinical trial (OB12). BMJ Open. 2020;10:e033687.
Wang H et coll. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev. 2018;3:CD004655.
Volkov I et coll. Effectiveness of vitamin B12 in treating recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled trial. J Am Board Fam Med. 2009;22:9-16.
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 102ème épisode, Nicolas, Sébastien et Isabelle discuteront de vitamine B12. Dans ce premier épisode d'une série de deux, on discute de manifestations cliniques, d'évaluation biochimique, d'approche diagnostique et de bénéfices (ou pas) du traitement d'un déficit en vitamine B12.
Les objectifs pour cet épisode sont les suivants:
- Identifier les patients avec une indication de doser la vitamine B12
- Discuter de la fiabilité du dosage de la vitamine B12
- Discuter de l'approche diagnostique du déficit en vitamine B12
- Expliquer les bénéfices d'un supplément de vitamine B12 dans le traitement et la prévention de diverses conditions
Ressources pertinentes en lien avec l'épisode
Boughrassa F, Framarin A. Usage judicieux de 14 analyses biomédicales: Outil pratique. Institut national d'excellence en santé et services sociaux. Avril 2014.
Solomon LR. Cobalamin-responsive disorders in the ambulatory care setting: unreliability of cobalamin, methylmalonic acid, and homocysteine testing. Blood. 2005;105:978-85.
Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226.
Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368:149-60.
Didangelos T et coll. Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021;13:395.
Dangour AD et coll. Effects of vitamin B-12 supplementation on neurologic and cognitive function in older people: a randomized controlled trial. Am J Clin Nutr. 2015;102:639-47.
McCleery J et coll. Vitamin and mineral supplementation for preventing dementia or delaying cognitive decline in people with mild cognitive impairment. Cochrane Database Syst Rev. 2018;11:CD011905.
Rutjes AW et coll. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database Syst Rev. 2018;12:CD011906.
Kwok T et coll. A randomized placebo-controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. Clin Nutr. 2020;39:2399-2405.
Kwok T et coll. A randomized placebo controlled trial of vitamin B12 supplementation to prevent cognitive decline in older diabetic people with borderline low serum vitamin B12. Clin Nutr. 2017;36:1509-1515.
Van der Zwaluw NL et coll. Results of 2-year vitamin B treatment on cognitive performance: secondary data from an RCT. Neurology. 2014;83:2158-66.
Almeida OP et coll. B vitamins to enhance treatment response to antidepressants in middle-aged and older adults: results from the B-VITAGE randomised, double-blind, placebo-controlled trial. Br J Psychiatry. 2014;205:450-7.
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 98ème épisode, Nicolas, Sébastien et Isabelle discuteront encore une fois du traitement de la douleur chronique en s'inspirant du guide de pratique publié plus tôt cette année par Nicolas et le groupe PEER. Dans ce deuxième épisode de la série, on discutera des bienfaits et des inconvénients de divers traitements en arthrose et en douleur neuropathique.
Les objectifs pour cet épisode sont les suivants:
- Expliquer à un patient les attentes envers le traitement de la douleur chronique
- Conseiller à un patient les mesures non pharmacologiques adéquates en douleur chronique
- Discuter des bienfaits et des risques des traitements pharmacologiques en arthrose et en douleur neuropathique
Korownyk CS et coll. PEER simplified chronic pain guideline: Management of chronic low back, osteoarthritic, and neuropathic pain in primary care. Can Fam Physician. 2022 Mar;68:179-190.
Ton J et coll. PEER umbrella systematic review of systematic reviews: Management of osteoarthritis in primary care. Can Fam Physician. 2020 Mar;66:e89-e98.
Kolber MR et coll. PEER systematic review of randomized controlled trials: Management of chronic low back pain in primary care. Can Fam Physician. 2021 Jan;67:e20-e30.
Falk J et coll. PEER systematic review of randomized controlled trials: Management of chronic neuropathic pain in primary care. Can Fam Physician. 2021 May;67:e130-e140.
PEER. Comparing treatment options for pain: the C-TOP tool. Edmonton, AB: Alberta College of Family Physicians; 2022.
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 97ème épisode, Nicolas, Sébastien et Isabelle discuteront du traitement de la douleur chronique en s'inspirant du guide de pratique publié plus tôt cette année par Nicolas et le groupe PEER. Dans ce premier épisode d'une série de deux, on abordera brièvement la méthode derrière le guide de pratique, on discutera des issues cliniques pertinentes en douleur chronique puis on comparera les bienfaits et les inconvénients de divers traitements en lombalgie chronique.
Les objectifs pour cet épisode sont les suivants:
- Discuter sommairement de la méthodologie utilisée pour développer le guide de pratique
- Expliquer à un patient les attentes envers le traitement de la douleur chronique
- Conseiller à un patient les mesures non pharmacologiques adéquates en lombalgie chronique
- Discuter des bienfaits et des risques des traitements pharmacologiques en lombalgie chronique
Ressources pertinentes en lien avec l'épisode
Korownyk CS et coll. PEER simplified chronic pain guideline: Management of chronic low back, osteoarthritic, and neuropathic pain in primary care. Can Fam Physician. 2022 Mar;68:179-190.
Ton J et coll. PEER umbrella systematic review of systematic reviews: Management of osteoarthritis in primary care. Can Fam Physician. 2020 Mar;66:e89-e98.
Kolber MR et coll. PEER systematic review of randomized controlled trials: Management of chronic low back pain in primary care. Can Fam Physician. 2021 Jan;67:e20-e30.
Falk J et coll. PEER systematic review of randomized controlled trials: Management of chronic neuropathic pain in primary care. Can Fam Physician. 2021 May;67:e130-e140.
PEER. Comparing treatment options for pain: the C-TOP tool. Edmonton, AB: Alberta College of Family Physicians; 2022.
Un nouvel épisode du Pharmascope est disponible! Dans ce 90ème épisode et la deuxième et dernière partie de notre série concernant l'usage du fer, Nicolas, Sébastien et Isabelle décortiquent les subtilités de la posologie optimale de fer.
Les objectifs pour cet épisode sont les suivants:
- Comparer les avantages et les inconvénients des différentes posologies de fer possibles (prise intermittente, uniquotidienne, biquotidienne)
- Conseiller un patient lors de l'initiation d'un traitement de fer
- Expliquer dans quel contexte l'administration de fer intraveineux est indiqué
Ressources pertinentes en lien avec l'épisode
Lignes directrices Snook J et coll. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021;70:2030-51.
British Columbia Ministry of Health. Iron Deficiency – Diagnosis and Management. BCGuidelines.ca. Avril 2019.
Article de revue Pasricha S-R et coll. Iron deficiency. Lancet. 2021;397:233-48.
Articles portant sur la posologie du fer oral Lee H et coll. Iron dosing frequency. Can Fam Physician. 2021;67:436.
Rimon E et coll. Are we giving too much iron? Low-dose iron therapy is effective in octogenarians. Am J Med. 2005;118:1142-7.
Fernandez-Gaxiola AC, De-Regil LM. Intermittent iron supplementation for reducing anaemia and its associated impairments in adolescent and adult menstruating women. Cochrane Database Syst Rev. 2019;1:CD009218.
Düzen Oflas N et coll. Comparison of the effects of oral iron treatment every day and every other day in female patients with iron deficiency anaemia. Intern Med J. 2020;50:854-8.
Kaundal R et coll. Randomized controlled trial of twice-daily versus alternate-day oral iron therapy in the treatment of iron-deficiency anemia. Ann Hematol. 2020;99:57-63.
Utilisation du fer intraveineux Litton E et coll. Safety and efficacy of intravenous iron therapy in reducing requirement for allogeneic blood transfusion: systematic review and meta-analysis of randomised clinical trials. BMJ. 2013;347:f4822.
Ponikowski P et coll. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial. Lancet. 2020;396:1895-1904.
Un nouvel épisode du Pharmascope est disponible! Dans ce 89ème épisode, premier d'une série de deux concernant l'usage du fer, Nicolas, Sébastien et Isabelle animeront vos globules rouges en vous parlant de l'évaluation d'une carence en fer, des indications de traitement ainsi que des différences cliniques entre les différentes formulations de fer.
Les objectifs pour cet épisode sont les suivants:
- Interpréter un résultat de ferritine
- Identifier les patients pouvant bénéficier d'un traitement de fer
- Comparer les avantages et inconvénients cliniques des différentes formulations de fer
Ressources pertinentes en lien avec l'épisode
Lignes directrices Snook J et coll. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021;70:2030-51.
British Columbia Ministry of Health. Iron Deficiency – Diagnosis and Management. BCGuidelines.ca. Avril 2019.
Article de revue Pasricha S-R et coll. Iron deficiency. Lancet. 2021;397:233-48.
Document de l'INESSS sur l'utilisation du bilan martial Boughrassa F, Framarin A. Usage judicieux de 14 analyses biomédicales. Institut national d'excellence en santé et en services sociaux. Avril 2014.
Revues du traitement de la carence en fer sans anémie Miles LF et coll. Intravenous iron therapy for non anaemic, iron deficient adults. Cochrane Database Syst Rev. 2019;12:CD013084.
Houston BL et coll. Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open. 2018;8:e019240.
McKennitt D, Allan GM. Iron Supplementation in Non-Anemic Women with Unexplainable Fatigue: Another Tired Theory? Tools for Practice 79. Août 2016.
Revue de la comparaison de l'efficacité et l'innocuité de types de fer Moe S, Allan GM. New iron supplements for anemia. Can Fam Phys. 2019;65(8):556.
Étude portant sur la prise concomitante de vitamine C Li N et coll. The Efficacy and Safety of Vitamin C for Iron Supplementation in Adult Patients With Iron Deficiency Anemia: A Randomized Clinical Trial. JAMA Network Open. 2020;3:e2023644.
In episode 609, Jamie and James chat with Jennifer Young about what the evidence says around exercise for fibromyalgia. Unfortunately, the evidence and the way it is presented is somewhat limited but nonetheless we do put it into context to help you and your patients make decisions.
Show Notes 1) Tools For Practice Use the soft touch for buckle fractures? https://cfpclearn.ca/tfp396/
Un nouvel épisode du Pharmascope est disponible! Dans ce 87ème épisode, deuxième de la série sur l'insomnie, Nicolas, Sébastien et Isabelle tentent de vous maintenir éveillés en discutant du traitement pharmacologique de l'insomnie.
Les objectifs pour cet épisode sont les suivants:
- Comparer les traitements pharmacologiques de l'insomnie
- Expliquer les bénéfices et les risques des traitements pharmacologiques de l'insomnie
- Discuter des avantages et des inconvénients de chacun des traitements pharmacologiques de l'insomnie
Ressources pertinentes en lien avec l'épisode
Publications de l'American Academy of Sleep Medicine Edinger JD et coll. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17:255-62.
Edinger JD et coll. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17:263-98.
Sateia MJ et coll. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13:307-49.
Lignes directrices du U.S. Department of Veterans Affairs and U.S Department of Defense Mysliwiec V et coll. The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. Ann Intern Med. 2020;172:325-36.
Publications de l'American College of Physicians Qaseem A et coll. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;165:125-33.
Wilt TJ et coll. Pharmacologic Treatment of Insomnia Disorder: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians. Ann Intern Med. 2016;165:103-12.
Outil: Index de Sévérité de l'Insomnie Morin, C. Index de Sévérité de l'Insomnie. Centre d'étude des troubles du sommeil. Université Laval.
Le 85ème épisode du Pharmascope est maintenant disponible! Cette fois, Nicolas, Sébastien et Isabelle tentent de ne pas trop vous endormir en discutant de la prise en charge non-pharmacologique de l'insomnie.
Les objectifs pour cet épisode sont les suivants:
- Questionner adéquatement un patient souffrant d'insomnie
- Identifier les comorbidités et les médicaments pouvant contribuer à l'insomnie
- Suggérer des méthodes non pharmacologiques appropriées pour la prise en charge de l'insomnie chronique
Ressources pertinentes en lien avec l'épisode
Lignes directrices de l'American Academy of Sleep Medicine Edinger JD et coll. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17:255-62.
Edinger JD et coll. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17:263-98.
Lignes directrices du U.S. Department of Veterans Affairs and U.S Department of Defense Mysliwiec V et coll. The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. Ann Intern Med. 2020;172:325-36.
Lignes directrices de l'American College of Physicians Qaseem A et coll. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;165:125-33.
Outil: Index de Sévérité de l'Insomnie Morin, C. Index de Sévérité de l'Insomnie. Centre d'étude des troubles du sommeil. Université Laval.
Un nouvel épisode du Pharmascope est disponible! Dans ce 80ème épisode, Nicolas, Sébastien et Isabelle, inspirés par une populaire série documentaire, abordent cette fois-ci l'utilisation des thérapies non-hormonales en ménopause.
Les objectifs pour cet épisode sont les suivants:
- Discuter des mesures non pharmacologiques utiles dans la prise en charge des symptômes de la ménopause
- Discuter des bénéfices et des risques associés aux thérapies non-hormonales en ménopause
- Conseiller adéquatement une patiente sur les thérapies non-hormonales offertes dans le traitement de la ménopause
Pharmascope Medecine: (Protected Content)
Ressources pertinentes en lien avec l'épisode
Série documentaire Loto-Méno Produit par KOTV, 2021. Disponible sur l'EXTRA d'ICI TOU.TV
Articles de revue des traitements non-hormonaux Drewe J et coll. A systematic review of non-hormonal treatments of vasomotor symptoms in climacteric and cancer patients. Springerplus. 2015;4:65.
Hickey M et coll. Non-hormonal treatments for menopausal symptoms. BMJ. 2017;359:j5101.
Dugré N, Bustamante H. Combattre les chaleurs sans hormone? Le Médecin du Québec. 2020;55:47-51.
Études portant sur les produits naturels Franco OH et coll. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016;315:2554-63.
Mohammady M et coll. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2018;228:295-302.
Études portant sur les mesures non pharmacologiques Tran S et coll. Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors. Support Care Cancer. 2021;29:1183-93.
Cramer H et coll. Yoga for menopausal symptoms-A systematic review and meta-analysis. Maturitas. 2018;109:13-25.
Stefanopoulo E, Grunfled EA. Mind-body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review. J Psychosom Obstet Gynaecol. 2017;38:210-25.
Befus D et coll. Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. J Altern Complement Med. 2018;4:314-23.
Ayers B et coll. Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial. Menopause. 2012;19:759-69.
Un nouvel épisode du Pharmascope est disponible! Dans ce 79ème épisode, Nicolas, Sébastien et Isabelle, inspirés par une populaire série documentaire, abordent l’utilisation des thérapies hormonales en ménopause.
Les objectifs pour cet épisode sont:
- Expliquer le concept d’hormones bio-identiques
- Discuter des bénéfices et des risques associés à l’hormonothérapie en ménopause
- Conseiller adéquatement une patiente sur la prise d’hormones dans le traitement de la ménopause
Pharmascope Medecine: (Protected Content)
Ressources pertinentes en lien avec l’épisode
Série documentaire Loto-Méno Produit par KOTV, 2021. Disponible sur l’EXTRA d’ICI TOU.TV
Revues systématiques portant sur l’efficacité et l’innocuité de l’hormonothérapie Maclennan AH et coll. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database Syst Rev. 2004;2004:CD002978.
Gaudard AMIS et coll. Bioidentical hormones for women with vasomotor symptoms. Cochrane Database Syst Rev. 2016;(8):CD010407.
Rubinow DR et coll. Efficacy of estradiol in perimenopausal depression: so much promise and so few answers. Depress Anxiety. 2015;32:539-49.
Lethaby A et coll. Hormone replacement therapy for cognitive function in postmenopausal women. Cochrane Database Syst Rev. 2008;2008:CD003122.
Boardman HMP et coll. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev. 2015;(3):CD002229.
Marjoribanks J et coll. Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2017;1:CD004143.
Études WHI Rossouw JE et coll. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321-33.
Anderson GL et coll. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA. 2004;291:1701-12.
Manson JE et coll. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women’s Health Initiative Randomized Trials. JAMA. 2017;318:927-38.
Étude WISDOM Vickers MR et coll. Main morbidities recorded in the women’s international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women. BMJ. 2007;335:239.
Autres références Hoibraaten E et coll. Increased risk of recurrent venous thromboembolism during hormone replacement therapy–results of the randomized, double-blind, placebo-controlled estrogen in venous thromboembolism trial (EVTET). Thromb Haemost. 2000;84:961-7.
Rowe T. A Word About Bioidenticals. J Obstet Gynaecol Can. 2016;38:697-9.
Plourde R, Tan R. L’hormonothérapie de remplacement. Quand, pour qui et comment? Le Médecin du Québec. 2020;55:41-6.
Un nouvel épisode du Pharmascope est maintenant disponible et on termine notre série d’épisodes sur les troubles neurocognitifs majeurs. Dans ce 76ème épisode, Nicolas, Sébastien, Isabelle et leur invité discutent du traitement pharmacologique de la démence.
Les objectifs pour cet épisode sont:
- Expliquer les bénéfices et les risques associés aux traitements pharmacologiques des troubles neurocognitifs
- Discuter du suivi de l’efficacité et de l’innocuité des traitements utilisés dans les troubles neurocognitifs
- Comparer les avantages et inconvénients des différents agents utilisés dans le traitement des troubles neurocognitifs
Ressources pertinentes en lien avec l’épisode
Revues systématiques Birks JS, Harvey RJ. Donepezil for dementia due to Alzheimer’s disease. Cochrane Database Syst Rev. 2018;6:CD001190.
Birks JS, Evans JG. Rivastigmine for Alzheimer’s disease. Cochrane Database Syst Rev. 2015;4:CD001191.
McShane R et coll. Memantine for dementia. Cochrane Database Syst Rev. 2019;3:CD003154.
Consensus canadien sur la démence Ismail Z et coll. Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia. Alzheimers Dement. 2020;16:1182-95.
Commission du Lancet Livingston G et coll. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396:413-46.
Documents de l’INESSS Institut national d’excellence en santé et en services sociaux. Outils de repérage mesurant les fonctions cognitives, l’autonomie fonctionnelle et les symptômes comportementaux et psychologiques de la démence. 2015.
Institut national d’excellence en santé et en services sociaux. Alzheimer – outils / activités. 2015.
Un nouvel épisode du Pharmascope est maintenant disponible et on poursuit notre série d’épisodes sur les troubles neurocognitifs majeurs. Dans ce 75ème épisode, Nicolas, Sébastien, Isabelle et leur invité discutent de la prise en charge non pharmacologique de la démence.
Les objectifs pour cet épisode sont les suivants:
- Identifier des facteurs de risque d’exacerbation des troubles neurocognitifs
- Conseiller des mesures non-pharmacologiques bénéfiques pour aider les individus atteints d’un trouble neurocognitif
- Connaître les preuves scientifiques concernant le risque de certains médicaments en trouble cognitif
Ressources pertinentes en lien avec l’épisode
Étude FINGER Ngandu T et coll. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385:2255-63.
Consensus canadien sur la démence Ismail Z et coll. Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia. Alzheimers Dement. 2020;16:1182-95.
Commission du Lancet Livingston G et coll. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396:413-46.
Documents de l’INESSS Institut national d’excellence en santé et en services sociaux. Outils de repérage mesurant les fonctions cognitives, l’autonomie fonctionnelle et les symptômes comportementaux et psychologiques de la démence. 2015.
Institut national d’excellence en santé et en services sociaux. Alzheimer – outils / activités. 2015.
Après les vaccins contenant des puces 5G, voici le tout nouveau produit au potentiel de surveillance sous-estimé: l’implant contraceptif NexplanonMD Dans ce 70ème épisode disponible exclusivement aux membres Premium du Pharmascope, Nicolas, Sébastien et Isabelle discutent de tout ce qu’il y a à savoir sur cette nouvelle méthode contraceptive.
Les objectifs pour cet épisode sont les suivants:
- Identifier les patients pour qui l’implant d’étonogestrel NexplanonMD est indiqué
- Comparer l’efficacité et l’innocuité de l’implant d’étonogestrel NexplanonMD aux autres contraceptifs disponibles sur le marché
- Expliquer les avantages et les inconvénients de l’implant d’étonogestrel NexplanonMD
Ressources pertinentes en lien avec l’épisode
Monographie de produit: NexplanonMD. Merck Canada. Mai 2020.
Darney P et coll. Safety and efficacy of a single-rod etonogestrel implant (Implanon): results from 11 international clinical trials. Fertil Steril. 2009;91:1646-53.
Secura GM et coll. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010;203:115.e1-7.
Xu H et coll. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet Gynecol. 2012;120:21-6.
On va essayer de ne pas compliquer le traitement des cystites non compliquées en parlant de fosfomycine. Dans ce 63ème épisode disponible exclusivement aux membres Premium du Pharmascope, Nicolas, Sébastien et Isabelle discuteront de la fosfomycine sous tous ses angles: traitement de la cystite non compliquée et compliquée, germes multirésistants et prophylaxie des infections récurrentes.
Les objectifs pour cet épisode sont:
- Identifier les patients pour qui la fosfomycine est indiquée
- Comparer l’efficacité et l’innocuité de la fosfomycine à d’autres antibiotiques dans le traitement de la cystite
- Expliquer les avantages et les inconvénients de la fosfomycine dans le traitement des infections urinaires
Ressources pertinentes en lien avec l’épisode
Guide d’usage optimal de l’INESSS Institut national d’excellence en santé et en services sociaux. Infection urinaire chez l’adulte. Octobre 2017.
Lignes directrices de l’IDSA Gupta K et coll. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103-20.
Revues systématiques comparant la fosfomycine à d’autres antibiotiques Falagas ME et coll. Fosfomycin versus other antibiotics for the treatment of cystitis: a meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2010;65:1862-77.
Cai T et coll. Fosfomycin Trometamol versus Comparator Antibiotics for the Treatment of Acute Uncomplicated Urinary Tract Infections in Women: A Systematic Review and Meta-Analysis. J Urol. 2020;203:570-8.
Étude randomisée contrôlée comparant la fosfomycine à la nitrofurantoïne Huttner A et coll. Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women: A Randomized Clinical Trial. JAMA. 2018;319:1781-9.
Étude comparative en traitement de cystite à germe multirésistant Senol S et coll. Carbapenem versus fosfomycin tromethanol in the treatment of extended-spectrum beta-lactamase-producing Escherichia coli-related complicated lower urinary tract infection. J Chemother. 2010;22:355-7.
Revue systématique portant sur la prophylaxie d’infections urinaires récurrentes Nalliah S et coll. The use of chemotherapeutic agents as prophylaxis for recurrent urinary tract infection in healthy nonpregnant women: A network meta-analysis. Indian J Urol. 2019;35:147-55.
Revue systématique portant sur la prophylaxie antibiotique lors de biopsie de la prostate Pilatz A et coll. Antibiotic Prophylaxis for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol. 2020;204:224-30.
Dernier épisode et certainement le plus controversé de notre série sur la goutte! Dans ce 62ème épisode du Pharmascope, Nicolas, Sébastien et Isabelle tentent de répondre à plusieurs questions croquantes: Quand initier un traitement prophylactique contre la goutte? Comment ajuster les doses? Suivre les niveaux d’acide urique, est-ce pertinent? Et la prophylaxie de la prophylaxie,c’est utile?
Les objectifs pour cet épisode sont:
- Discuter du moment idéal pour débuter un traitement prophylactique de la goutte
- Expliquer les avantages et les inconvénients d’une approche d’ajustement de dose d’hypouricémiant selon l’atteinte de niveaux cibles d’acide urique
- Expliquer les bénéfices et les risques d’une prophylaxie anti-inflammatoire concomitante à l’initiation d’un traitement hypouricémiant
Ressources pertinentes en lien avec l’épisode
Lignes directrices portant sur la prise en charge de la goutte FitzGerald JD et coll. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Rheumatol. 2020;72:879-95.
Richette P et coll. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Ann Rheum Dis. 2020;79:31-8.
Qaseem A et coll. Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166:58-68.
Articles de revue portant sur la prise en charge de la goutte Drug and Therapeutics Bulletin. Latest guidance on the management of gout. BMJ. 2018;362:k2893.
Sidari A, Hill E. Diagnosis and Treatment of Gout and Pseudogout for Everyday Practice. Prim Care. 2018;45:213-36.
Dugré N. L’hyperuricémie et la goutte. Québec Pharmacie. Juin/juillet 2015. 25p.
Initiation d’un traitement hypouricémiant pendant une crise de goutte Taylor TH et coll. Initiation of allopurinol at first medical contact for acute attacks of gout: a randomized clinical trial. Am J Med. 2012;125:1126-34.e7.
Hill EM et coll. Does starting allopurinol prolong acute treated gout? A randomized clinical trial. J Clin Rheumatol. 2015;21:120-5.
Ajustement des doses d’hypouricémiants selon des niveaux cibles Stamp LK et coll. A randomised controlled trial of the efficacy and safety of allopurinol dose escalation to achieve target serum urate in people with gout. Ann Rheum Dis. 2017;76:1522-8.
Stamp L et coll. Serum urate as surrogate endpoint for flares in people with gout: A systematic review and meta-regression analysis. Semin Arthritis Rheum. 2018;48:293-301.
Prophylaxie anti-inflammatoire concomitante avec la colchicine Paulus HE et coll. Prophylactic colchicine therapy of intercritical gout. A placebo-controlled study of probenecid-treated patients. Arthritis Rheum. 1974;17:609-14.
Borstad GC et coll. Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis. J Rheumatol. 2004;31:2429-32.
On continue notre série goutteuse! Dans ce 61ème épisode du Pharmascope, Nicolas, Sébastien et Isabelle discutent des mesures non pharmacologiques et du traitement prophylactique de la goutte.
Les objectifs pour cet épisode sont les suivants:
- Expliquer les mesures non pharmacologiques utilisées dans le traitement chronique de la goutte
- Identifier les indications pour débuter un traitement prophylactique en goutte
- Expliquer les bénéfices et les risques associés aux traitements prophylactiques en goutte
Ressources pertinentes en lien avec l’épisode
Lignes directrices portant sur la prise en charge de la goutte FitzGerald JD et coll. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Rheumatol. 2020;72:879-95.
Richette P et coll. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Ann Rheum Dis. 2020;79:31-8.
Qaseem A et coll. Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166:58-68.
Articles de revue portant sur la prise en charge de la goutte Drug and Therapeutics Bulletin. Latest guidance on the management of gout. BMJ. 2018;362:k2893.
Sidari A, Hill E. Diagnosis and Treatment of Gout and Pseudogout for Everyday Practice. Prim Care. 2018;45:213-36.
Dugré N. L’hyperuricémie et la goutte. Québec Pharmacie. Juin/juillet 2015. 25p.
Études portant sur les traitements chroniques de la goutte Badve SV et coll. Effects of Allopurinol on the Progression of Chronic Kidney Disease. N Engl J Med. 2020;382:2504-13.
Doria A et coll. Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 Diabetes. N Engl J Med. 2020;382:2493-2503.
Kimura K et coll. Febuxostat Therapy for Patients With Stage 3 CKD and Asymptomatic Hyperuricemia: A Randomized Trial. Am J Kidney Dis. 2018;72:798-810.
Schumacher Jr HR et coll. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthritis Rheum. 2008;59:1540-8.
Seth R et coll. Allopurinol for chronic gout. Cochrane Database Syst Rev. 2014;10:CD006077.
Ramasamy SN et coll. Allopurinol Hypersensitivity: A Systematic Review of All Published Cases, 1950–2012. Drug Saf. 2013;36:953-80.
White WB et coll. Cardiovascular safety of febuxostat or allopurinol in patients with gout. N Engl J Med 2018;378:1200-10.
otre patience est maintenant récompensée, voici notre tant attendue série goutteuse! Dans ce 60ème épisode du Pharmascope, Nicolas, Sébastien et Isabelle discutent épidémiologie, facteurs de risque, manifestations cliniques et prise en charge des crises de goutte.
Les objectifs pour cet épisode sont:
- Identifier les facteurs de risque de goutte
- Expliquer les manifestations aiguës et chroniques de la goutte
- Expliquer les bénéfices et les risques associés aux traitements utilisés en crise de goutte
Ressources pertinentes en lien avec l’épisode
Lignes directrices portant sur la prise en charge de la goutte FitzGerald JD et coll. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Rheumatol. 2020;72:879-95.
Richette P et coll. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Ann Rheum Dis. 2020;79:31-8.
Qaseem A et coll. Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166:58-68.
Articles de revue portant sur la prise en charge de la goutte Drug and Therapeutics Bulletin. Latest guidance on the management of gout. BMJ. 2018;362:k2893.
Sidari A, Hill E. Diagnosis and Treatment of Gout and Pseudogout for Everyday Practice. Prim Care. 2018;45:213-36.
Dugré N. L’hyperuricémie et la goutte. Québec Pharmacie. Juin/juillet 2015. 25p.
Études portant sur le traitement aigu de la goutte van Durme CMPG et coll. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev. 2014;9:CD010120.
Terkeltaub RA et coll. High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum. 201062:1060-8.
Roddy E et coll. Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care. Ann Rheum Dis. 2020;79:276-84.
In episode 608, Tina and James invite Jennifer Young back again to the podcast to go over the evidence we have for a simple but important question around buckle fractures – does treating with a soft bandage versus a rigid splint/cast produce different clinical outcomes? The answer is quite clear around what we should do. Check out what we found.
Show Notes 1) Tools For Practice Use the soft touch for buckle fractures?
2) PEIP Conference Edmonton October 17-18, 2025
In episode 607, Tina and James invite Caitlin Finley to go over what the group found with regard to the best available evidence around surgical frenotomy. We look at the effect the surgery has on breast pain, self-reported breastfeeding improvement, and infant weight gain. Tune in as you might be impressed with the absolute benefits.
Show Notes 1) Tools For Practice Trying Tongue-Tie Treatment: Does Frenotomy Fix Feeding Frustrations?
2) PEIP Conference Edmonton October 17-18, 2025
Per Colate, Part II, a 72 year old man presenting with ongoing symptoms of nocturia and urinary frequency
In episode 606, Jamie and James go over the best available evidence we have for the medications used in overactive bladder, with a focus on a newer agent mirabegron. We end up having to discuss the exciting topics of number of voids and dry mouth and at the end we give you all the numbers you need to have an evidence-based conversation with your patients.
Show Notes 1) Tools For Practice Avoiding the void? Mirabegron for overactive bladder
2) PEIP Conference Edmonton October 17-18, 2025
In episode 605, James and Jamie get Emelie Braschi to answer a simple and common clinical question. ASA versus direct oral anticoagulants – which one is safer with regard to bleeding? As always it comes down to the numbers and we go over all those numbers and put them into the overall benefit and harm ratio for Afib.
Show Notes 1) Tools For Practice An ASA a day keeps the Afib at bay?
2) SparcTool – Stroke Prevention in Atrial Fibrillation Risk Tool
3) PEIP Conference Edmonton October 17-18, 2025
In episode 604, James and Mike K get Jennifer Young to tackle the topic of nose bleeds and what the evidence shows around the use of topical tranexamic acid and how it compares to other treatments. We go over all the endpoints and give you all the numbers.
Show Notes 1) Tools For Practice Stop the Drip: Tranexamic Acid Solution for Nosebleeds
2) PEIP Conference Edmonton October 17-18, 2025
In episode 603, James and Mike K invite Jennifer Young back to the podcast to talk about the best available evidence for topical minoxidil and hair growth. We discuss outcomes such as the numbers of hairs per squared centimeter – the main outcome reported – but when available, we also other report on other outcomes and also the side effects. So, if you want to know about numbers of hair per squared centimeter and all the other numbers, tune in.
Show Notes 1) Tools For Practice Topical minoxidil for androgenetic alopecia: When blood pressure agents make you hairy 2) PEIP Conference Edmonton October 17-18, 2025
Vous êtes toujours parmi nous? La fin approche! Dans ce 47ème épisode du Pharmascope et dernier de la série sur le TDAH, Nicolas, Isabelle et leur invitée discutent entre autres des options de traitement pharmacologiques autres que les psychostimulants.
Les objectifs pour cet épisode sont :
- Comprendre les risques et les bénéfices associés à la prise de l’atomoxetine et de la guanfacine
- Évaluer la place de l’atomoxetine et la guanfacine dans l’algorithme de traitement du TDAH
- Adapter le traitement pharmacologique du TDAH en fonction du patient
Ressources pertinentes en lien avec l’épisode
Lignes directrices canadiennes CADDRA – Canadian ADHD Ressource Alliance : Lignes directrices canadiennes pour le TDAH, quatrième édition, Toronto (Ontario); CADDRA 2018.
Lignes directrices américaines Wolraich ML et coll. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Subcommittee on children and adolescents with attention-deficit / hyperactive disorder. Pediatrics 2019. 144(4). pii:e20192528.
Revues du TDAH Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet. 2016;387(10024):1240-50.
Auclair M, Elalami M. Traitement du TDAH chez l’enfant. Québec Pharmacie. Septembre 2018. 28p.
Revue systématique globale Stuhec M, Lukic P, Locatelli I. Efficacy, Acceptability, and Tolerability of Lisdexamfetamine, Mixed Amphetamine Salts, Methylphenidate, and Modafinil in the Treatment of Attention-Deficit Hyperactivity Disorder in Adults: A Systematic Review and Meta-analysis. Ann Pharmacother. 2019; 2:121-133.
Liens utiles pour ressources Canadian ADHD Ressource Alliance (CADDRA). 2020.
Centre for ADHD awareness, Canada (CADDAC). 2017.
Clinique FOCUS. 2020.
Annick Vincent. TDAH, informations, trucs et astuces. 2020.
Méta-analyse comparant l’atomoxétine aux psychostimulants en TDAH Liu Q, Zhang H, Fang Q, et coll. Comparative Efficacy and Safety of Methylphenidate and Atomoxetine for Attention-Deficit Hyperactivity Disorder in Children and Adolescents: Meta-analysis Based on Head-To-Head Trials. J Clin Exp Neuropsychol. 2017; 39(9): 854-65.
Évaluation de la guanfacine en TDAH par l’INESSS Institut national d’excellence en santé et services sociaux. INTUNIV XRMC – Trouble du déficit de l’attention avec ou sans hyperactivité. Février 2014.
Étude portant sur des doses de 1 à 7mg de guanfacine en TDAH chez l’adolescent Wilens TE, Robertson B, Sikirica V, et coll. A Randomized, Placebo-Controlled Trial of Guanfacine Extended Release in Adolescents With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2015;54(11):916–925.
Restez concentrés parce que ce n’est pas terminé! Après un premier épisode sur le diagnostic et la prise en charge non-pharmacologique du TDAH, on porte cette fois toute notre attention sur les pilules. Dans ce 46ème épisode du Pharmascope, Nicolas, Isabelle et leur invitée discutent donc du traitement pharmacologique du TDAH, plus spécifiquement des psychostimulants.
Les objectifs pour cet épisode sont :
- Identifier les différentes formulations de psychostimulants disponibles dans le traitement du TDAH
- Comprendre les risques et les bénéfices associés à la prise de psychostimulants dans le traitement du TDAH
- Comparer l’efficacité et l’innocuité des différents psychostimulants entre eux en TDAH
Ressources pertinentes en lien avec l’épisode
Lignes directrices canadiennes CADDRA – Canadian ADHD Ressource Alliance : Lignes directrices canadiennes pour le TDAH, quatrième édition, Toronto (Ontario); CADDRA 2018.
Lignes directrices américaines Wolraich ML et coll. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Subcommittee on children and adolescents with attention-deficit / hyperactive disorder. Pediatrics 2019. 144(4). pii:e20192528.
Revues du TDAH Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet. 2016;387(10024):1240-50.
Auclair M, Elalami M. Traitement du TDAH chez l’enfant. Québec Pharmacie. Septembre 2018. 28p.
Revues systématiques portant sur les mesures non-pharmacologiques Good AP et coll. Nonpharmacologic Treatments for Attention-Deficit / Hyperactivity Disorder: A Systematic Review. Pediatrics. 2018;141(6). Pii:e20180094.
Lopez PL et coll. Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev.2018,23(3):CD010840.
Études portant sur l’effet des amphétamines Punja S et coll. Amphetamines for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev.2016;2:CD009996.
Castells X et coll. Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev.2018;8:CD007813.
Études portant sur l’effet du méthylphénidate Storebo OJ et coll. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database Syst Rev. 2015;11:CD009885.
Epstein T et coll. Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev. 2014;9:CD005041.
MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999;56:1073-86.
Revue systématique globale Stuhec M, Lukic P, Locatelli I. Efficacy, Acceptability, and Tolerability of Lisdexamfetamine, Mixed Amphetamine Salts, Methylphenidate, and Modafinil in the Treatment of Attention-Deficit Hyperactivity Disorder in Adults: A Systematic Review and Meta-analysis. Ann Pharmacother. 2019; 2:121-133.
Liens utiles pour ressources Canadian ADHD Ressource Alliance (CADDRA). 2020.
Centre for ADHD awareness, Canada (CADDAC). 2017.
Clinique FOCUS. 2020.
Annick Vincent. TDAH, informations, trucs et astuces. 2020.
Attention, attention! Un nouvel épisode du Pharmascope est maintenant disponible! Et, cette fois, il va falloir rester concentré parce qu’on a fait trois épisodes sur le TDAH . Dans ce 45ème épisode du Pharmascope et premier de cette série, Nicolas, Isabelle et leur invitée de marque discutent des manifestations cliniques, de l’approche diagnostique et de la prise en charge initiale du TDAH.
Les objectifs pour cet épisode sont:
- Comprendre l’approche diagnostique du TDAH
- Discuter des comorbidités fréquemment associées au TDAH
- Identifier les objectifs de traitement du TDAH
- Suggérer des mesures non pharmacologiques pour le TDAH
Ressources pertinentes en lien avec l’épisode
Lignes directrices canadiennes CADDRA – Canadian ADHD Ressource Alliance : Lignes directrices canadiennes pour le TDAH, quatrième édition, Toronto (Ontario); CADDRA 2018.
Lignes directrices américaines Wolraich ML et coll. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Subcommittee on children and adolescents with attention-deficit / hyperactive disorder. Pediatrics 2019. 144(4). pii:e20192528.
Revues du TDAH Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet. 2016;387(10024):1240-50.
Auclair M, Elalami M. Traitement du TDAH chez l’enfant. Québec Pharmacie. Septembre 2018. 28p.
Revues systématiques portant sur les mesures non-pharmacologiques Good AP et coll. Nonpharmacologic Treatments for Attention-Deficit / Hyperactivity Disorder: A Systematic Review. Pediatrics. 2018;141(6). Pii:e20180094.
Lopez PL et coll. Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev.2018,23(3):CD010840.
Gillies D et coll. Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev. 2012.(7):CD007986.
Liens utiles pour ressources Canadian ADHD Ressource Alliance (CADDRA). 2020.
Centre for ADHD awareness, Canada (CADDAC). 2017.
Clinique FOCUS. 2020.
Annick Vincent. TDAH, informations, trucs et astuces. 2020.
In episode 602, James and Mike Kolber go over the best available evidence for the benefits and the harms for one of the most commonly used classes of medications – proton pump inhibitors. We find out the benefit numbers are much larger than the harm numbers. Check out the podcast to get all the numbers you need to help people make decisions.
Show Notes 1) Tools For Practice Side effects of long-term PPI use: Leaving a bad taste in your mouth? Proton Pump Inhibitors (PPIs): Is Perpetual Prescribing Inevitable?
2) PEIP Conference Edmonton October 17-18, 2025
3) SPARCTool
4) RX files PPI Stopping your Proton Pump Inhibitor or “PPI”
In episode 601, James and Mike invite Jennifer Young back to the podcast to go over all the evidence we have for pregabalin and gabapentin in patients with fibromyalgia. During the discussion we find out how many people actually get a ≥30% reduction in pain compared to placebo. We even look at some information about different doses. All the numbers are revealed by the end of the podcast – and we give tips and suggestions throughout. Check it out.
Show Notes 1) Tools For Practice Pharm for Fibro, Round 2: Can gabapentinoids ease the pain?
2) MEME Conference 2025 in Vancouver – May 9/10, 2025
In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Benazir Pervez, a 17-year-old female coming in for acne.
In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Micti Colate, a 70-year-old female coming in for urinary incontinence.
In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Annie Ploidy, a 36-year-old female coming in for prenatal screening.
Over 60% of Canadian trans adults rate their mental health as fair-to-poor and are twice as likely to avoid seeking primary care. Avoidance isn’t random – it’s the predictable outcome of everyday micro-aggressions, systemic barriers, and what psychologists call minority stress. This podcast will name those forces of avoidance and offer trauma-informed counter-moves family physicians can use on the front line to support their 2SLGBTQ+ patients.
Learning objectives:
By the end of this episode, listeners will be able to: 1. Explain the minority‑stress model and its relevance to everyday family practice. 2. Recognise three common clinic‑level micro‑aggressions that fuel avoidance behaviour. 3. Apply trauma‑informed communication skills that transform micro‑aggressions into micro‑affirmations.
Un nouvel épisode du Pharmascope est disponible… Et on s’attaque encore au trouble d’usage d’alcool! Dans cette deuxième partie, Nicolas, Isabelle et une invitée discutent des traitements de maintien du trouble d’usage d’alcool.
Les objectifs pour cet épisode sont:
- Discuter des interventions comportementales dans le traitement de maintien du trouble d’usage d’alcool
- Discuter de la prise en charge pharmacologique du trouble d’usage d’alcool
- Comparer les avantages et les inconvénients de chaque classe médicamenteuse en trouble d’usage d’alcool
Ressources pertinentes en lien avec l’épisode
Wood E, Bright J, Hsu K, et coll. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ. 2023 Oct 16;195(40):E1364-E1379.
Repères canadiens sur l’alcool et la santé : rapport final. Centre canadien sur les dépendances et l’usage de substances. 2023
Répertoire des ressources en dépendances du MSSS
INESSS. Sevrage d’alcool et prévention des rechutes. 2021.
Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database Syst Rev. 2020 Mar 11;3(3):CD012880.
McPheeters M, O’Connor EA, Riley S, et coll. Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis. JAMA. 2023 Nov 7;330(17):1653-1665.
Rösner S, Hackl-Herrwerth A, Leucht S, et coll. Opioid antagonists for alcohol dependence. Cochrane Database Syst Rev. 2010 Dec 8;(12):CD001867
Rösner S, Hackl-Herrwerth A, Leucht S, et coll. Acamprosate for alcohol dependence. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD004332.
Cheng YC, Huang YC, Huang WL. Gabapentinoids for treatment of alcohol use disorder: A systematic review and meta-analysis. Hum Psychopharmacol. 2020 Nov;35(6):1-11.
Anton RF, Latham P, Voronin K, et coll. Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial. JAMA Intern Med. 2020 May 1;180(5):728-736.
Blodgett JC, Del Re AC, Maisel NC, Finney JW. A meta-analysis of topiramate’s effects for individuals with alcohol use disorders. Alcohol Clin Exp Res. 2014 Jun;38(6):1481-8.
Agabio R, Saulle R, Rösner S, Minozzi S. Baclofen for alcohol use disorder. Cochrane Database Syst Rev. 2023 Jan 13;1(1):CD012557.
Un nouvel épisode du Pharmascope est disponible et on s’attaque cette fois au trouble d’usage d’alcool. Dans cette première partie, Nicolas, Isabelle et une nouvelle invitée discutent du dépistage et de l’évaluation de cette maladie sous diagnostiquée, en plus de réviser la prise en charge du sevrage alcoolique.
Les objectifs pour cet épisode sont:
- Procéder au dépistage du trouble d’usage d’alcool
- Diagnostiquer un trouble d’usage d’alcool
- Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques du sevrage alcoolique
Ressources pertinentes en lien avec l’épisode
Lignes directrices canadiennes récentes en trouble d’usage d’alcool Wood E, Bright J, Hsu K, et coll. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ. 2023 Oct 16;195(40):E1364-E1379.
Repères canadiens sur l’alcool et la santé : rapport final. Centre canadien sur les dépendances et l’usage de substances. 2023
Guide canadien sur les risques associés à l’usage d’alcool Coalition canadienne pour la santé mentale des personnes pagées. Lignes directrices sur le trouble lié à l’utilisation de l’alcool chez les personnes âgées. 2023.
Guide de l’INESSS sur la prise en charge du trouble d’utilisation d’alcool INESSS. Sevrage d’alcool et prévention des rechutes. 2021.
US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et coll. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018 Nov 13;320(18):1899-1909.
Mitchell AJ, Bird V, Rizzo M, et coll. Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis. Br J Gen Pract. 2014 Jul;64(624):e408-18.
Bush K, Kivlahan DR, McDonell MB, et coll. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998 Sep 14;158(16):1789-95.
Maldonado JR, Sher Y, Das S, et coll. Prospective Validation Study of the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) in Medically Ill Inpatients: A New Scale for the Prediction of Complicated Alcohol Withdrawal Syndrome. Alcohol Alcohol. 2015 Sep;50(5):509-18.
Kaner EF, Beyer FR, Muirhead C, et coll. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018 Feb 24;2(2):CD004148.
Amato L, Minozzi S, Vecchi S, Davoli M. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD005063.
Daeppen JB, Gache P, Landry U, et coll. Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial. Arch Intern Med. 2002 May 27;162(10):1117-21.
Elholm B, Larsen K, Hornnes N, Zierau F, Becker U. Alcohol withdrawal syndrome: symptom-triggered versus fixed-schedule treatment in an outpatient setting. Alcohol Alcohol. 2011 May-Jun;46(3):318-23.
Minozzi S, Amato L, Vecchi S, Davoli M. Anticonvulsants for alcohol withdrawal. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD005064.
Airagnes G, Valter R, Ducoutumany G, Vansteene C, Trabut JB, Gorwood P, Dubertret C, Matta J, Charles-Nelson A, Limosin F. Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial. Alcohol Alcohol. 2023 May 9;58(3):329-335.
Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 138ème épisode, Nicolas, Isabelle et Olivier discutent d’un problème pas reposant : le syndrome des jambes sans repos.
Les objectifs pour cet épisode sont :
- Expliquer la présentation clinique, les critères diagnostics et les facteurs de risque du syndrome des jambes sans repos
- Conseiller des mesures non-pharmacologiques pour aider les personnes avec un syndrome des jambes sans repos
- Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques du syndrome des jambes sans repos
Ressources pertinentes en lien avec l’épisode
Manconi M, Garcia-Borreguero D, Schormair B, Videnovic A, Berger K, Ferri R, Dauvilliers Y. Restless legs syndrome. Nat Rev Dis Primers. 2021 Nov 3;7(1):80.
Trotti LM, Becker LA. Iron for the treatment of restless legs syndrome. Cochrane Database Syst Rev. 2019 Jan 4;1(1):CD007834.
Earley CJ, García-Borreguero D, Falone M, Winkelman JW. Clinical Efficacy and Safety of Intravenous Ferric Carboxymaltose for Treatment of Restless Legs Syndrome: A Multicenter, Randomized, Placebo-controlled Clinical Trial. Sleep. 2024 Apr 16:zsae095.
Short V, Allen R, Earley CJ, Bahrain H, Rineer S, Kashi K, Gerb J, Auerbach M. A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia. Am J Hematol. 2024 Jun;99(6):1077-1083.
Wilt TJ, MacDonald R, Ouellette J, Khawaja IS, Rutks I, Butler M, Fink HA. Pharmacologic therapy for primary restless legs syndrome: a systematic review and meta-analysis. JAMA Intern Med. 2013 Apr 8;173(7):496-505.
Allen RP, Chen C, Garcia-Borreguero D, Polo O, DuBrava S, Miceli J, Knapp L, Winkelman JW. Comparison of pregabalin with pramipexole for restless legs syndrome. N Engl J Med. 2014 Feb 13;370(7):621-31.
Trenkwalder C, Benes H, Grote L, Happe S, Högl B, Mathis J, Saletu-Zyhlarz GM, Kohnen R; CALDIR Study Group. Cabergoline compared to levodopa in the treatment of patients with severe restless legs syndrome: results from a multi-center, randomized, active controlled trial. Mov Disord. 2007 Apr 15;22(5):696-703.
Trenkwalder C, Beneš H, Grote L, García-Borreguero D, Högl B, Hopp M, Bosse B, Oksche A, Reimer K, Winkelmann J, Allen RP, Kohnen R; RELOXYN Study Group. Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol. 2013 Dec;12(12):1141-50.
Carlos K, Prado GF, Teixeira CD, Conti C, de Oliveira MM, Prado LB, Carvalho LB. Benzodiazepines for restless legs syndrome. Cochrane Database Syst Rev. 2017 Mar 20;3(3):CD006939.
Jadidi A, Rezaei Ashtiani A, Khanmohamadi Hezaveh A, Aghaepour SM. Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial. BMC Complement Med Ther. 2022 Dec 31;23(1):1.
Wali SO, Abaalkhail B, Alhejaili F, Pandi-Perumal SR. Efficacy of vitamin D replacement therapy in restless legs syndrome: a randomized control trial. Sleep Breath. 2019 Jun;23(2):595-601.
Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 136ème épisode, Nicolas, Isabelle et un invité discutent de la prophylaxie pré-exposition au VIH dans diverses situations à risque.
Les objectifs pour cet épisode sont :
- Résumer et comparer les modalités de prise en charge de la PrEP
- Identifier les patients pouvant bénéficier de la PrEP
- Discuter des avantages et des risques associés à la prise de la PrEP
Ressources pertinentes en lien avec l’épisode
Baril JG et coll. La prophylaxie préexposition au virus de l’immunodéficience humaine : Guide pour les professionnels de la santé du Québec. Ministère de la santé et des services sociaux. Janvier 2019. Disponible, en ligne.
US Public Health Services.Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update. A Clinical Practice Guideline. 2021. Disponible, en ligne.
Grant RM et coll; iPrEx Study Team. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587-99.
Grant RM et coll; iPrEx study team. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14:820-9.
McCormack S et coll. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387:53-60.
Molina JM et coll; ANRS IPERGAY Study Group. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med. 2015;373:2237-46.
Baeten JM et coll; Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399-410.
Choopanya K et coll; Bangkok Tenofovir Study Group. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381:2083-90.
In episode 600, James and Mike invite Jamie Falk back to the podcast again and we talk about if exercise helps movement in Parkinson’s disease. You might be surprised by the size of the effect so have a listen and get all the evidence and numbers you need.
Show Notes Tools For Practice Exercise for Parkinson’s Disease: More movement = Better movement?
MEME Conference 2025 In Vancouver – May 9/10, 1025
In episode 599, James and Mike invite Roni Kraut to the podcast for the first time to talk about a common problem that has a simple answer. What route and/or duration of antifungals is needed when treating uncomplicated vulvovaginal candidiasis in non-pregnant women. Tune in to find out all the simple details.
Show Notes Tools For Practice A single dose for treating yeast infections: Is it really this simple?
MEME Conference 2025 Vancouver – May 9/10, 1025
In episode 598, James and Mike continue to talk with David Gardner about the issue of insomnia. We discuss his latest, very cool, Your Answers When Needing Sleep (YAWNS NB) randomized clinical trial. YAWNS was a pragmatic, open-label, minimum-contact, RCT where people with long-term use of benzodiazepines and current or past insomnia were randomly allocated to different mailed behavior change interventions or no intervention. They found that in people who got the intervention more of them stopped or reduced the dose of their benzodiazepines and more improved their sleep. Tune in for the numbers for this simple intervention.
Show Notes
The YAWNS NB trial
Booklets: order booklets via the Resource Centre
Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals.
Some features and resources to explore are: Sleepwell stories (patient and health care professional video and written accounts) Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills)
Zopiclone’s residual effects on actual driving performance in a standardized test: a pooled analysis of age and sex effects in 4 placebo-controlled studies Clin Ther 2014 Jan 1;36(1):141-50. doi: 10.1016/j.clinthera.2013.11.00
Audio Player
In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Mr. Ramakanta, a 75-year-old man who is having trouble sleeping at night and difficulty breathing in the day time.
In episode 597, James and Mike invite David Gardner to talk in depth about the issue of insomnia. We talk about triggers, precipitating factors, acute and chronic insomnia, and chronic use of sleeping pills. We discuss Cognitive Behavioral Therapy for Insomnia (CBT-I) and how his team has developed a comprehensive website, Sleepwell, that provides patients and clinicians with great tools and recommendations for the self-care of chronic insomnia. Mike stays awake for the whole podcast and James only has a brief nap.
Show Notes
Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals.
Visit https://mysleepwell.ca/
Some features and resources to explore are: Sleepwell stories (patient and health care professional video and written accounts) Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills)
In episode 596, Mike and James talk in a PREMIUM way about three trials that used methotrexate for osteoarthritis and walking for back pain. Nothing miraculous but there seems to be an effect – so have a listen.
In episode 595, Mike and James invite Jennifer Young back to talk about the use of combined oral contraceptives for heavy menstrual bleeding (benign etiology) and see if they improve patient outcomes. They do! Have a listen to get all the numbers and see how they compare to using levonorgestrel-containing intrauterine devices or NSAIDs.
Show notes
Tools for Practice 1) How to Slow the Flow: Combined oral contraceptives 2) How to Slow the Flow: Tranexamic acid for heavy menstrual bleeding 3) How to Slow the Flow: Levonorgestrel intrauterine systems for heavy menstrual bleeding 4) How to Slow the Flow: NSAIDs for Heavy Menstrual Bleeding
In episode 594, Mike and James invite Samantha Moe back to talk about the use of the RSV vaccine in pregnancy. The only way to have an informed conversation around this vaccine is to know the numbers. If you listen to the whole podcast, you’ll get all the numbers available to date.
Show notes Tools for Practice 1)Bumpin’ Up the Protection? RSV Vaccine in Pregnancy
2) Preventing RSV Infections in Infants
3) Preventing RSV in the elderly
In episode 593, Mike and James invite Samantha Moe back to talk about a newer agent for osteoporosis. So, if you want to know all the evidence for romosozumab, tune in and all will be revealed about the benefits and harms.
Show notes 1) Tools for Practice Tony Romo-sozumab: Winning touchdown in osteoporosis or interception for the loss?
2) FRAX site for Canada
In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Jay Mal, a 9 year old boy presenting with fatigue and fever.
In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Brea Salter, a 4-year old girl presenting with wheezing.
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 this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Sissy Hayes, a 38 year old patient who thinks she has a urinary tract infection.
In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Dixie Brittle, an elderly patient who is worried about fractures.
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?
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 this episode of In the Clinic, Mike and Jess are joined by Mike Kolber, family physician from Peace River, Alberta. The team discusses Michelle Reblok - a 25 year old patient who presents with stomach problems - and works through the differential diagnosis.
To claim Mainpro+ credits, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-29-stomach-problems/
Mike, Jess and Jennifer follow up with Farrah Lo, a 27 year old patient, who was diagnosed with iron deficiency anemia in an earlier podcast. Today, the team discusses the management of heavy menstrual bleeding.
Did you miss Farrah's original visit? Tune into episode #13: https://open.spotify.com/episode/366me3xA7wkZYEWS9ANynE?si=5a2b105167214a29
To claim your Mainpro+ credit, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-28-heavy-menstrual-bleeding/
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 585, 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?
Mike, Jess and Émélie follow up with Charlotte McLeod, a 50 year old patient, who originally presented to the clinic with diabetes. Today, the team discusses the management of Charlotte's blood pressure in the context of diabetes.
Did you miss Charlotte's original visit? Tune into episode #12: https://open.spotify.com/episode/1F1eZobKKIKTswqYGy9C2c?si=22fa6e6f8a9041e1.
To claim your Mainpro+ credit, please click on this link: https://cfpclearn.ca/podcast/in-the-clinic-episode-27-managing-hypertension-in-diabetes/
Mike, Jess and Émélie discuss Ms. Ottie Stone, a 35 year old patient who presents with dizziness. Today's podcast will discuss the diagnosis and management of benign paroxysmal positional vertigo.
To claim your Mainpro+ credit on CFPCLearn, click here: https://cfpclearn.ca/?post_type=podcast&p=13750&preview=true
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
In episode 582, Mike and James go over the issues associated with using CVD risk calculators. We talk about where the numbers come from, what they mean, what their limitations are, how to think about them and how to use them. So have a listen as it may decrease your risk but it will definitely increase your understanding.
Show notes 1) PEER Simplified Cardiovascular Decision Aid https://decisionaid.ca/cvd/
2) Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022 JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793
3) 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
4) Agreement among cardiovascular disease risk calculators Circulation. 2013;127:1948–1956
In episode 581, Mike and James invite Mike Kolber back to the podcast for the umpteenth time – this time we talk about a topic we haven’t discussed before – acute diverticulitis. Historically, if a person has diverticulitis they were given antibiotics BUT do they really do anything? We look at all the evidence and the results may surprise you.
Show notes Tools for Practice Antibiotics or no antibiotics for acute diverticulitis, that is the question!
In episode 580, Mike and James invite Jennifer Young to talk about the treatment of pityriasis rosea. Believe it or not there are 2 simple treatments that seem to work really quite well. Tune in to hear what works and how well they work.
Show notes Tools for Practice (A)dressing the Christmas Tree? Therapies for pityriasis rosea
In episode 579, Mike and James invite Nicholas Dugré back to the podcast to talk about the evidence around the benefits and harms of a new class of medications for the acute treatment of episodic migraines. Ubrogepant is an oral calcitonin gene-related peptide antagonist. In this case, amazing as it may sound, there are triple the number of systematic reviews than there are RCTs. Nonetheless, we go over all the evidence and at the end of the podcast you’ll know what the world knows about these agents.
Show notes
Tools for Practice
Oral Calcitonin Gene-related Peptide Antagonists: A painfully long name for the acute treatment of migraines
In episode 578, Mike, James and Jennifer Potter try to answer the question, in patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy? We look at the evidence for methylphenidate, antipsychotics, and antidepressants so tune in to find out if any of these treatments have any sort of effect in this very difficult to treat condition.
Show notes Tools for Practice Making a difference in indifference? Medications for apathy in dementia
In episode 577, Mike and James invite Jennifer Young to join us to go over all the evidence around how best to close punch biopsies, lacerations and incisions. We go over all the evidence for sutures (absorbable/nonabsorbable), skin glue, and tape. We look at cosmesis, patient satisfaction, and infection rates so have a listen and find out what we found.
Show notes Tools for Practice Looking for Closure: Managing simple excisions or wounds efficiently
n episode 576, James, Mike, and Jamie continue to review the evidence for acne treatments. In this podcast, we examine if antibiotics work and we find they do have an effect. Check out the podcast for all the numbers.
Show notes
Tools for Practice Facing the Evidence in Acne, Part II: Oral Antibiotics
Tools for Practice Is less more with isotretinoin and acne?
Alberta Medication Costs
Mike, Jess and Jennifer follow up with Norma Munroe, a 78 year old patient, who originally presented with insomnia. Today's podcast discusses the management of insomnia including sleep restriction and medications.
Did you miss Norma's original visit? Tune into episode #24: https://open.spotify.com/episode/4kwHSsa8Yq3Qs8y4JBGvka?si=d858551f82bf4a1f
To claim your Mainpro+ credit, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-25-insomnia-part-ii/.
In today's clinic, Mike, Jess and Jennifer introduce Norma Munroe, a 78 year old with complaints of insomnia. This podcast discusses the assessment of insomnia. Be sure to listen to episode #25 also which continues with insomnia managment!
To claim a credit for this podcast, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-24-insomnia-part-i/.
Mike, Jess and Émélie follow up with Jennifer Aweiree, a 47 year old patient who presented with fatigue in episode #7. Today's follow up involves screening for depression.
Did you miss episode #7? Listen now: https://open.spotify.com/episode/5NWcvn4OO2TeJnVs6Zsj4V?si=fcc8f7d80cd64a8a
To claim a credit for episode #23, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-23-depression/.
Mike, Jess and Émélie discuss a new patient, Remi Alfred. Remi is a 40 year female patient presenting with joint pain. Join the team as they focus on the differential diagnosis of joint pain and investigations required.
To claim your Mainpro+ credit, complete the survey at this link: https://cfpclearn.ca/podcast/in-the-clinic-episode-22-rheumatoid-arthritis/.
Mike, Jessica and Jennifer present the case of Guy Lumbago, a 40 year old man with low back pain. Tune in as the team discusses the diagnosis and management of Guy's symptoms while offering up some great clinical tools that family docs can use in their office.
Mike, Jess and Jennifer discuss the case of Aira Salter, a 16 month old who is brought to the office with coughing and wheezing.
In this episode, Mike, Jess and Émélie discuss Mr. Dion Silenus, a 60 year old man whose concern is that his heart is acting up. Tune in to find out how these symptoms are tied into Dion's alcohol use.
In this episode, Mike, Jess and Émélie discuss Richard Solare, a 70 year old man who presents with red patches on his face.
Discussing Decision-Making Capacity Assessment is vital because as our population ages, the demand for physicians to be proficient in this area is increasing. Family physicians, being at the forefront of patient care, play a pivotal role not only in diagnosing and managing dementia but also in evaluating decision-making capacity.
Learning objectives:
-
Discuss the circumstances in which a capacity assessment is necessary.
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Identify the appropriate tools and methods to conduct a standardized capacity assessment.
In episode 575, James and Mike invite Jamie Falk back to the podcast to help us sift through all the evidence for using oral contraceptives and spironolactone to treat acne. We find that they actually do work. We go over all the numbers for the benefits and harms. Have a listen.
Show notes Tools for Practice Facing the Evidence in Acne, Part I: Oral contraceptives and spironolactone in females
In episode 574, James and Mike invite Jennifer Young back to the podcast to help us yet again look at the evidence for cranberries and the prevention of UTI’s. Unfortunately, there is a problem with the evidence as there is a high risk-of-bias from potential publication bias, small studies, and unblinding. However, if we look past some of these biases, cranberry products might be worth a try. But have a listen and see what the evidence says.
Show notes 1) Tools for Practice Any berry good solutions to preventing UTIs: Cranberries? 2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE Vancouver May 24/25, 2024
In this episode, Mike, Jess and Jennifer discuss the case of Myles Tension who was originally presented in Episode #1. Myles is back for a follow up appointment to discuss the management of his blood pressure.
If you haven't already listened to Episode #1, check it out: https://open.spotify.com/episode/4uO4L7AgmVYDiBLJYFlXeB?si=e8c234c3a22a48db).
In this episode, Mike and Jess are joined by family physician Jennifer Young. The team discusses Hans Goteborg, a 58 year old patient whose appointment today is focussed on cancer screening.
In this episode, Mike and Jess are joined by family physician Émélie Braschi. Together, they discuss the patient Liz Hall who presents with diarrhea. They discuss various potential causes for the diarrhea, including a workup for C. difficile diarrhea.
In this episode, Mike and Dess discuss Ana Flax who presents with seasonal allergies. She also has a history of penicilin allergy and the team discusses the likelihood that Ana has a true penicillin allergy.
This episode will review the ways that 2SLGBTQ+ patients can experience homelessness differently than the general population, and how to best support them in your practice.
Learning objectives:
- Understanding the factors affecting 2SLGBTQ individuals experiencing homelessness on a population level
- Recognizing the importance of screening for poverty and housing insecurity, especially in the 2SLGBTQ population
- Developing strategies to support and stabilize 2SLGBTQ patients experiencing homelessness.
In episode 573, James and Mike invite Jamie Falk back to the podcast to help us simplify all the evidence around using antipsychotics for difficult to treat depression. They do seem to “work”, but you really need to know the numbers around what “work” means. At the end of the podcast, you will!
Show notes 1) Tools for Practice Overcoming Resistance: Antipsychotics for difficult to treat depression
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE Vancouver May 24/25, 2024
In episode 572, James and Mike invite Samantha Moe back to the podcast to go over the evidence around the safety and effectiveness of the monoclonal antibodies used to reduce the risk of respiratory syncytial virus (RSV) infections in infants. We go over all the numbers for hospitalizations and death so you can make evidence-informed decisions.
Show Notes 1) Tools for Practice Preventing RSV Infections in Infants
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE Vancouver May 24/25, 2024 https://hectalks.com
In this episode, Mike and Jess discuss Farrah Lo who has been feeling tired. She is coming in to follow up on bloodwork.
To claim your Mainpro+ credit, click here:
https://cfpclearn.ca/podcast/in-the-clinic-episode-13-anemia/
The ‘In the Clinic’ podcast series discusses a new patient case in each episode. Join family physicians Dr. Mike Allan, Dr. Jess Kirkwood and the gang to resolve the patient’s chief complaint. With practical tips and best available evidence, each podcast highlights the challenges that arise from diagnosis to management. Don’t miss this engaging podcast series brought to you by the College of Family Physicians of Canada!
In this episode, Mike and Jess discuss Charlotte McLeod who has high sugars but is reluctant to take medication.
To claim your Mainpro+ credit, click on this link:
https://cfpclearn.ca/podcast/in-the-clinic-episode-12-sugars/
The ‘In the Clinic’ podcast series discusses a new patient case in each episode. Join family physicians Dr. Mike Allan, Dr. Jess Kirkwood and the gang to resolve the patient’s chief complaint. With practical tips and best available evidence, each podcast highlights the challenges that arise from diagnosis to management. Don’t miss this engaging podcast series brought to you by the College of Family Physicians of Canada!
In episode 571, James and Mike talk about 2 new papers – we learn what antibiotics we can use for community-acquired pneumonia and we also talk about the prevalence and management of dyslipidemia in Canadian primary care practices and find out who has this problem and who gets treated.
Show Notes
Identifying the Best Initial Oral Antibiotics for Adults with Community‐Acquired Pneumonia: A Network Meta‐Analysis J Gen Intern Med. 2024 Feb 15.doi: 10.1007/s11606-024-08674-1.
Prevalence and management of dyslipidemia in primary care practices in Canada Can Fam Physician. 2024 Mar;70(3):187-196.doi: 10.46747/cfp.7003187
In episode 570, James and Mike finish their trilogy on statistics. We take what we discussed in the previous podcasts and go through a couple of examples that will hopefully solidify what all the terms and numbers really mean.
Show Notes
1) Sensible Medicine Doing statistics can be difficult but understanding them can be fairly simple
2) Analysis of 567,758 randomized controlled trials published over 30 years reveals trends in phrases used to discuss results that do not reach statistical significance PLoS Biol 2022: e3001562. https:// doi.org/10.1371/journal.pbio.3001562
In episode 569, James and Mike continue to go over what statistics really show – we focus on what inferential statistics can and cannot do, what a p value means and more importantly what it doesn’t mean. And yes we try to keep all this stat stuff on a realistic and practical level – easier said than done.
Show Notes Sensible Medicine Doing statistics can be difficult but understanding them can be fairly simple
In episode 568, James and Mike go over what statistics really show – and importantly what they don’t show. We go over the terms and nuances and hopefully put them all into a simple context. Statistics are not just in medicine – they are in much of what you do every day – so you really do need to understand them.
Show Notes Sensible Medicine Doing statistics can be difficult but understanding them can be fairly simple
In episode 567, Mike and James revisit the old topic of industry influence on health care providers. We go over the issues, the nuances and some of the latest evidence around the interactions, the influence, and patient perceptions.
Show Notes
1) Industry Evidence Handout
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE
Vancouver May 24/25, 2024
In episode 566, Mike and James invite Émélie back yet again to the podcast and the topic is the balance of benefits to harms of using corticosteroids in adults or children for atopic dermatitis. We come to the realization, as always, that how to use topical corticosteroids is based on knowing the best available evidence and then using lots of common sense – we give you all of that in just 30 minutes.
Show notes
Tools for Practice Topical corticosteroids for atopic dermatitis – More than skin deep
MAKING EVIDENCE MATTER for EVERYONE CONFERENCE Vancouver May 24/25, 2024
In episode 565, Mike and James invite Émélie Braschi back to the podcast to talk about do-it-yourself hearing aids. We find some very interesting information about how direct-to-consumer self-fitted hearing aids compare to conventional hearing aids fitted via audiogram. You really need to listen to this podcast – your patients will thank you.
Show notes
Tools For practice
Do-It-Yourself Hearing Aids
MAKING EVIDENCE MATTER for EVERYONE CONFERENCE Vancouver May 24/25, 2024
Episode 564: Can non-hormonal drugs improve vasomotor symptoms in menopause?
In episode 564, Mike and James invite Samantha Moe back to the podcast to talk about the benefits and harms of non-hormonal medications for vasomotor symptoms in menopause. We find they do have an effect over placebo but also people in the placebo group improve, so you need to know all the numbers. We give you those and so much more so please spend 28 minutes with us when you get a chance.
Show notes
Tools For Practice Turn Down the Heat! Can non-hormonal drugs improve vasomotor symptoms in menopause? MAKING EVIDENCE MATTER for EVERYONE CONFERENCE Vancouver May 24/25, 2024
In this episode, Mike and Jess discuss James Pauls who complains that he has difficulty doing his job.
To claim your Mainpro+ credit, click on this link:
https://cfpclearn.ca/podcast/in-the-clinic-episode-11-trouble-doing-job/
The ‘In the Clinic’ podcast series discusses a new patient case in each episode. Join family physicians Dr. Mike Allan, Dr. Jess Kirkwood and the gang to resolve the patient’s chief complaint. With practical tips and best available evidence, each podcast highlights the challenges that arise from diagnosis to management. Don’t miss this engaging podcast series brought to you by the College of Family Physicians of Canada!
In this episode, Mike and Jess discuss Tilly Bloc who is in for refills for atrial fibrillation medication.
To claim your Mainpro+ credit, click on the link: https://cfpclearn.ca/podcast/in-the-clinic-episode-10-atrial-fibrillation/
The ‘In the Clinic’ podcast series discusses a new patient case in each episode. Join family physicians Dr. Mike Allan, Dr. Jess Kirkwood and the gang to resolve the patient’s chief complaint. With practical tips and best available evidence, each podcast highlights the challenges that arise from diagnosis to management. Don’t miss this engaging podcast series brought to you by the College of Family Physicians of Canada!
In episode 563, Mike and James go over all the RCT evidence for the Respiratory Syncytial Virus (RSV) vaccine in older adults. You need to know the vaccine works, but you really need to know the baseline risk of RSV before anyone can really make an informed decision about this vaccine. We’ll do our best to give you all the numbers.
Show notes Preventing RSV in the elderly
MAKING EVIDENCE MATTER for EVERYONE CONFERENCE
In episode 562, Mike and James continue to discuss our recently revised 2023 simplified lipid guidelines with Adrienne and Mike. We talk about all the medications used for cardiovascular risk reduction. We go over all the evidence and all the numbers for the benefits (and sometimes lack of benefit) and the harms. We also specifically talk about how to deal with statin intolerance.
Show notes
1) PEER simplified lipid guideline 2023 update 2) Lipid-lowering therapies for cardiovascular disease prevention and management in primary care – PEER umbrella systematic review of systematic reviews 3) Simplified Cardiovascular Decision Aid
In episode 561, Mike and James invite Adrienne Lindblad and Mike Kolber to discuss our recently revised 2023 simplified lipid guidelines. We talk about the guideline process, the best available evidence, and discuss some of the rationale we used to recommend the simpler approaches outlined in our guideline. As always, the focus was on shared decision-making and the time needed to treat. Have a listen and see what you think.
Show notes
1) PEER simplified lipid guideline 2023 update 2) Lipid-lowering therapies for cardiovascular disease prevention and management in primary care – PEER umbrella systematic review of systematic reviews 3) Simplified Cardiovascular Decision Aid
In this episode, Dr. Michael Allan and Dr. Jess Kirkwood discuss Maxwell, a one-year old with an ear infection.
To claim your Mainpro+ credit, click on the link below:
https://cfpclearn.ca/podcast/in-the-clinic-episode-9-ear-infection/
The ‘In the Clinic’ podcast series discusses a new patient case in each episode. Join family physicians Dr. Mike Allan, Dr. Jess Kirkwood and the gang to resolve the patient’s chief complaint. With practical tips and best available evidence, each podcast highlights the challenges that arise from diagnosis to management. Don’t miss this engaging podcast series brought to you by the College of Family Physicians of Canada!
In this episode, Dr. Mike Allan and Dr. Jessica Kirkwood discuss a case of a pregnant patient presenting with nausea.
To claim your Mainpro+ credits, click on the link below:
https://cfpclearn.ca/podcast/in-the-clinic-episode-8-nausea/
The ‘In the Clinic’ podcast series discusses a new patient case in each episode. Join family physicians Dr. Mike Allan, Dr. Jess Kirkwood and the gang to resolve the patient’s chief complaint. With practical tips and best available evidence, each podcast highlights the challenges that arise from diagnosis to management. Don’t miss this engaging podcast series brought to you by the College of Family Physicians of Canada!
Older adults can often present with moderate-severe intensity general symptoms and a broad workup may need to be supplemented with a detailed history. In this case, we explore one such case of an older adult with cryptic abdominal pain.
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Understand the importance of a detailed and organized history in accurately diagnosing acute medical issues.
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Acknowledging age-related biases and their role in medical care.
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Highlight the central role of family discussions with geriatric patients.
In episode 560, Mike and James finish their discussion around the use of hallucinogens/psychedelics by going over the psilocybin evidence. As with ketamine we cover the many limitations of the evidence around psilocybin and also talk about the side effects, costs and inconvenience. So now you know all we know for what that is worth.
Show notes
HANDOUT From Hallucinations to Healing: The Rise of Novel Mental Health Therapies
In episode 559, Mike and James continue to discuss the best available evidence around ketamine and severe depression. We go over the many limitations of the evidence and at the end we wrap it all up by going over the side effects, costs and inconvenience.
Show notes
HANDOUT Psychodelics Podcast From Hallucinations to Healing?
In episode 558, Mike and James decide to start to tackle the ketamine for depression story. Mike talks about what the media says about ketamine and then he delves into what the guidelines say. Then as always, we discuss the best available evidence. Have a listen so that you can be in the know about ketamine.
Show notes
HANDOUT Psychodelics Podcast From Hallucinations to Healing?
Episode 557: Fancy Creams for Scaly Skin: Topical calcineurin inhibitors for atopic dermatitis
In episode 557, Mike and James invite Emelie Braschi back to the podcast to talk about how effective topical calcineurin inhibitors are for atopic dermatitis. We’ll give you all the numbers so have a listen and learn what they are.
Show notes
Tools for Practice Fancy Creams for Scaly Skin: Topical calcineurin inhibitors for atopic dermatitis
In episode 556, Mike and James have Betsy Thomas back to podcast to talk about how effective are artificial tears for people with dry eyes. Both of us cry halfway through the podcast because of the craziness and inconsistency of the evidence. Have a listen and see what we found.
Show notes
Tools for Practice Not a Dry Eye in the House – Looking into Artificial Tears
In episode 555, James and Mike invite Jamie Falk back to the podcast to talk about the best available evidence for acetylsalicylic acid and its potential impact on reducing the risk of complications in women at risk of preeclampsia. The evidence is pretty clear and we are able to give decent estimates of the benefits and harms. Have a listen – it may change your practice.
Show notes
Tools for Practice An ASA a day when a baby’s on the way?
In episode 554, James and Mike go over a topic we have never covered in 553 previous podcasts. We invited Samantha Moe back to the podcast to talk about how effective are pelvic floor exercises or pessaries for stress urinary incontinence. We find that the magnitude of the benefits from pelvic floor exercises is fairly impressive. Tune in to find out what numbers we thought justified the phrase “fairly impressive” and see if you agree.
Show notes
Tools for Practice Stress Urinary Incontinence: Pelvic floor exercises or pessary?
In episode 553, James and Mike get Jen Potter back to talk about the last option we have for heavy menstrual bleeding – tranexamic acid. We talk about how it compares to placebo, NSAIDs, progestins and levonorgestrel intrauterine devices and go over all the numbers for benefits and harms. And then as always, we put everything into clinical context.
Show notes
1) How to Slow the Flow III: Tranexamic acid for heavy menstrual bleeding
Tools for Practice
2) Updated Simplified Lipid Guideline 2023
Canadian Family Physician October 2023, 69 (10) 675-686; DOI: https://doi.org/10.46747/cfp.6910675
3) CFPC Learn
In episode 552, James and Mike go over a couple of new trials. We talk about a blood pressure trial that examined taking the pills in the morning vs the evening and a heart failure trial that looked at getting patients on “high intensity” treatment. Find out the results here.
Show notes
Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial Lancet 2022 Oct 22;400(10361):1417-1425
Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial
Lancet 2022 Dec 3;400(10367):1938-1952
In episode 551, James and Mike invite Danielle Perry back to the podcast to talk about the best available evidence for the use of statins in people 65 and over. As you’ll hear, we have lots of evidence so all you need to know is what it says. Then, you can have an evidence-based discussion with all your people in this age category. After that discussion, your patient can make a decision one way or another and that means both of you win and you don’t have to care what guidelines say about this topic. Check it out.
Show notes
Tools for Practice Statins in Older Adults
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 550, James and Mike talk in a PREMIUM way about a new cholesterol lowering agent. Bempedoic acid is nothing tremendously exciting but what was very interesting was a subsequent publication that looked at a primary subset analysis, yet completely left out the secondary subset data. Have a listen and find out why.
Show Notes
Sensible Medicine Lipid lowering – a Bempedoic Acid Subset Analysis – To be right, you have to also look at what is left
MyStudies
CFPC Learn
PEIP conference Oct 20-21, 2023
In episode 549, James and Mike invite Blair MacDonald to the podcast for the first time and we talk about a topic that we haven’t really covered to-date. We discuss the evidence around what happens to the risk of pancreatitis when we use triglyceride-lowering medications (fibrates, statins, niacin, omega-3s) in patients with hypertriglyceridemia. Have a listen as the results may surprise you somewhat.
Show Notes
Tools for Practice
Triglyce-Ride that High?
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 548, James and Mike invite Betsy Thomas back to the podcast to talk about whether or not measuring lipoprotein(a) or apolipoprotein B improves cardiovascular risk prediction in a meaningful way over and above using standard risk factors. Many guidelines are now recommending we should do these measurements but is this an evidence-based recommendation? Give us 30 minutes of your time and you’ll know the answer.
Show Notes
Less is More Unless it’s Sleep or Toilet Paper: Non-traditional lipoproteins for cardiovascular risk
Tools for Practice
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 547, James and Mike invite Jessica and Scott back again to talk about whether or not COPD patients seen in primary care are like the people studied in the large COPD trials. We talk about how to focus care on the people who are most likely to benefit from therapy. There are lots of important primary care tips in this one. Have a listen.
Show Notes
Risk and distribution of chronic obstructive pulmonary disease–related hospitalizations among primary care patients
Canadian Family Physician June 2023, 69 (6) 409-414
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 546, James and Mike invite Jessica Kirkwood and Scott Garrison to talk about a new study they published looking at what proportion of common chronic medical conditions such as hypertension, diabetes and COPD are handled by family physicians, specialists, and nurse practitioners manage. We find that family physicians provide the majority of care for these conditions. Tune in to find out the actual numbers and possibly how these findings should be used.
Show Notes
Who provides chronic disease management?
Canadian Family Physician June 2023, 69 (6) e127-e133
CFPC Learn
PEIP conference Oct 20-21 2023
Environmental exposures have a significant impact on health and well-being, and family physicians play a crucial role in identifying and managing these exposures. Unfortunately, environmental exposures are often overlooked in clinical practice. Taking an environmental exposure history can help uncover potential causes for a patient's symptoms or health conditions.
In episode 545, James and Mike invite Samantha Moe back again to the podcast to talk about whether or not statins increase the risk of dementia or worsening of cognitive scores. I forgot the answer so you will have to listen to the podcast.
Show Notes
Tools for Practice
Forget about it? Statins and the risk of dementia
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 544, James and Mike invite Samantha Moe to the podcast to talk about whether or not PPIs improve crying, fussiness, irritability, or regurgitation attributed to feeds. If you’ve ever used PPIs for this condition, you may be surprised by the results.
Show Notes
1) Tools for Practice
Crying babies: Can proton pump inhibitors help?
2) CFPC Learn
3) PEIP conference Oct 20-21 2023
To claim your Mainpro credits please click on the link below:
https://cfpclearn.ca/podcast/bs-medicine-episode-544-crying-babies-can-proton-pump-inhibitors-help/
Tune into our latest episode as MIGs family physician, Dr. Val Ginzburg discusses the topic of watery diarrhea as a common gastrointestinal and digestive health issue in family medicine practice.
In episode 543, James and Mike invite Tina Korowynk and Jennifer Young to discuss their recent paper where they talk about the evidence around comprehensive primary care that is led by a family physician. We find out family physician care improves patient outcomes such as mortality, decreased emergency department visits, hospitalizations, readmissions, and health care costs. At the end we discuss a few ideas for how to start to solve some of the issues that have created the present primary care crisis.
Dr. Ian Casson joins us to provide his expert insight into IDD Health Check, a primary care tool for comprehensive health assessments of adults with intellectual and developmental disabilities. Listen to episode 2 now.
In episode 542, James and Mike finish their discussion around placebo. We then talk about tips and tricks for how to best use the knowledge about the placebo group effect when it comes to day-to-day decisions of choosing, stopping and starting medications/treatments.
Show Notes
Placebo handout
In episode 541, James and Mike get into a powerful discussion of placebo. We talk about the evidence around placebo, the placebo effect, the placebo group effect/response and we try to put it all into the context of clinical practice. The bottom line is the placebo effect is likely not what you think it is, however, it is very important you know what it is and what it is not.
Show Notes
Placebo handout
Join MIGs family physician, Gordon Arbess, as he shares his expertise on 2SLGBTQ+ health through an examination of the diagnosis of HIV among the elderly and other STIs common within the community. Listen now on CFPC Learn.
In episode 540, James and Mike invite Jennifer Young to go over all the evidence we have for what antibiotics to choose for bladder infections. The evidence clearly shows that the antibiotics we have been using for decades are still the drugs of choice. Tune in and find out which one you should choose and also what dose and duration.
1) Tools For Practice
Clear, not cloudy: Antibiotic options for uncomplicated urinary tract infections
In episode 539, James and Mike focus in a PREMIUM way on the latest prostate cancer intervention trial. Patients with prostate cancer were randomized to active monitoring, surgery, or radiotherapy and followed for 15 years to see which was the best option. Have a listen and hear what was found.
Show Notes
1) Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer N Engl J Med. 2023:10.1056/NEJMoa2214122
2) Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment NEJM Evid 2023;2 DOI: 10.1056/EVIDoa2300018
In episode 538, James and Mike discuss the great (but pretty much silly) egg controversy. We go over the best available evidence for eggs which is at best not great. We talk about the cohorts, the effect of eggs on cholesterol and much more. At the end we conclude definitively that, and you heard it here first, eggs are not as bad for you as smoking. Tune in to find out why.
Show Notes
The Nutrition Proposition
In episode 537, Mike and James invite Ricky Turgeon back to the podcast to talk about the impact of the influenza vaccination on cardiovascular events in both primary and secondary prevention. The best evidence is in secondary prevention. Tune-in to hear the numbers.
To claim your mainpro+ credit please click here: https://cfpclearn.ca/podcast/bs-medicine-episode-536-asymptomatic-bacteriuria-in-the-elderly-dont-drug-the-bugs/
In episode 536, Mike and James talk about 4 questions – Is any bacteriuria associated with altered mental state? – Does treating ASB improve/prevent clinical outcomes? – Does treating ASB improve altered mental state? – Do antibiotic reduction interventions for ASB affect patient outcomes? Tune in to find out the answers.
Show Notes 1) Tools for Practice Asymptomatic bacteriuria in the elderly: Don’t drug the bugs?
In episode 535, Mike and James work through all the evidence and come up with the definitive (in our minds) answer as to whether or not statins cause muscle symptoms. They likely do in 1% of people, but if you have muscle symptoms when you are on a statin it is very unlikely it is because of the statin.
Tools for Practice Wouldn’t Bet On it: What is the risk of muscle symptoms on statins?
To clam your Mainpro credit please use the link below: https://cfpclearn.ca/podcast/bs-medicine-episode-534-come-spy-with-me-continuous-glucose-monitoring-in-diabetes/
In episode 534, Mike and James bring Jamie Falk to go through all the evidence for continuous glucose monitors that use subcutaneous sensors. There certainly seems to be evidence of benefit for T1DM but when it comes to T2DM the evidence for a benefit is not clear at all. Have a listen to get all the details.
Show Notes Tools for Practice Come Spy with Me: Continuous glucose monitoring in diabetes
To claim your Mainpro+ credit please click on the below:
https://cfpclearn.ca/podcast/bs-medicine-episode-528-proving-you-dont-need-to-repeat-cholesterol-measurements/
In episode 528, James and Mike go through the logic and math around CVD risk estimates with regard to repeat cholesterol measurements. We discuss the impact remeasuring cholesterol has on CVD risk estimates and show that re-measuring every 5-10 years provides minimal if any value when it comes to making treatment decisions. All you need to do is look at a person’s drivers license.
To claim your Mainpro+ credit please use the link below:
https://cfpclearn.ca/podcast/in-the-clinic-episode-6-rashes/
The In the Clinic Podcast is a case centered review with clinical guidance based on the best available evidence guideline and practical tips. It is meant to mirror a family practice, particularly practice in an office setting. Each episode our hosts will go through a case and talk about the clinical questions and challenges arising from that case, from prognosis to diagnosis to management including investigation, medications, follow up, and referral.
In this episode Dr. Michael Allan and Dr. Jessica Kirkwood look at a case that discusses rashes with a 13-year-old male.
In episode 522, James and Mike quickly go over 3 new COVID trials that give useful PREMIUM information. BUT then we quickly go SUPER PREMIUM with evidence around the shelf life of medications and we discuss why the expiry dates on medications in almost no circumstances represent the date when medications should no longer be used.
Click on the link below to claim your Mainpro+ credit: https://cfpclearn.ca/podcast/bs-medicine-episode-520-ultra-processed-food-is-it-really-all-bad-for-you/
In episode 520, James and Mike delve into the delicious area of ultra-processed food. We review all the best available evidence and try to put it into a digestible format. At the end we put a cherry on top to make it even more appetizing/interesting.
To claim your Mainpro+ credit click on link below: https://cfpclearn.ca/podcast/bs-medicine-episode-519-oh-baby-combined-oral-contraceptives-during-breastfeeding/
In episode 519, Mike and James ask Jen Potter back to the podcast to talk about a common primary care question around oral contraceptives and breast feeding. We review the best available evidence which unfortunately we find out is not the highest quality. Nonetheless, we go over the numbers and then come up with useful, hopefully, suggestions for what to do around this issue.
To claim your Mainpro+ credit please click on the link below: https://cfpclearn.ca/podcast/in-the-clinic-episode-4-copd/
The In the Clinic Podcast is a case centered review with clinical guidance based on the best available evidence guideline and practical tips. It is meant to mirror a family practice, particularly practice in an office setting. Each episode our hosts will go through a case and talk about the clinical questions and challenges arising from that case, from prognosis to diagnosis to management including investigation, medications, follow up, and referral.
In this episode Dr. Michael Allan and Dr. Jessica Kirkwood look at a case that discusses COPD with a 64-year-old Male.
To claim your mainpro+ credit please click on the link below:
https://cfpclearn.ca/podcast/bs-medicine-episode-518-avoiding-lactose-containing-products-during-acute-pediatric-diarrhea/
In episode 518, Mike and James get Samantha to go through all the evidence we have for restricting lactose-containing foods in children with acute diarrhea. While we find out that looking at this evidence is at best tricky, it seems like reducing or diluting formula may provide a reasonable benefit. Listen to the podcast for the numbers.
To claim your Mainpro+ credit please click on the link below:
https://cfpclearn.ca/podcast/in-the-clinic-episode-3-annual-check-up/
The In the Clinic Podcast is a case centered review with clinical guidance based on the best available evidence guideline and practical tips. It is meant to mirror a family practice, particularly practice in an office setting. Each episode our hosts will go through a case and talk about the clinical questions and challenges arising from that case, from prognosis to diagnosis to management including investigation, medications, follow up, and referral.
In this episode Dr. Michael Allan and Dr. Jessica K look at a case that discusses an annual check-up with a 28-year-old female.
In episode 516, James and Mike invite Nicolas Dugré to the podcast yet again, and this time we talk about the evidence around the latest long-acting implantable reversible contraception. As always, we talk about the efficacy, the harm and all the rest of the issues around the use of these forms of contraception.
In episode 516, James and Mike invite Nicolas Dugré to the podcast yet again, and this time we talk about the evidence around the latest long-acting implantable reversible contraception. As always, we talk about the efficacy, the harm and all the rest of the issues around the use of these forms of contraception.
Click here to Claim your Mainpro Credit:
https://cfpclearn.ca/podcast/fm-rounds-10-asymptomatic-bacteriuria/
“Confusion in seniors isn’t always a urinary tract infection (UTI)!” In this episode of Family Medicine Rounds, Dr. Cassandra Hoggard discusses the prevalence of Asymptomatic Bacteriuria in the elderly and explains why UTIs in the elderly is a clinical diagnosis, not a laboratory diagnosis.
Click here to Claim your Mainpro Credit:
https://cfpclearn.ca/podcast/fm-rounds-10-asymptomatic-bacteriuria/
“Confusion in seniors isn’t always a urinary tract infection (UTI)!” In this episode of Family Medicine Rounds, Dr. Cassandra Hoggard discusses the prevalence of Asymptomatic Bacteriuria in the elderly and explains why UTIs in the elderly is a clinical diagnosis, not a laboratory diagnosis.
In episode 465, Mike and James invite Jamie Falk to go over all the data we have for the plethora of inhalers and COPD. We start with what we know about single puffers, how we decide whom to treat, and then when to try dual inhalers.
In episode 464, Mike and James and talk about 4 recent publications that should likely impact you practice if not today, then tomorrow. We talk about how long to give narcotics for acute MSK injuries, how to treat dyslipidemias, a non-steroid cream for psoriasis and a single dose of antibiotics for operative vaginal delivery.
In episode 463, James and Mike talk about the latest reports of the results of the 2 COVID-19 vaccine trials. We give you all the numbers you need to know and maybe more importantly we discuss the nuances around industry bias, the approval process and general thoughts around vaccines in these crazy times.
In episode 462, James and Mike invite Scott Garrison to talk about some important nuances around guideline recommendations and how low we should lower systolic blood pressure. We look in detail at the SPRINT trial and then come up with a reasonable (in our minds) approach to what thresholds we should use.
In episode 461, James and Mike invite Tina Korownyk to talk about the important question of whether or not virtual visits are as good as face-to-face when it comes to diagnosing undifferentiated presentations.
In episode 460, James and Mike invite Mike Kolber back again to answer the question does advising patients to abstain from alcohol reduce atrial fibrillation recurrence. The results may surprise you!
In episode 436, Mike and James invite Samantha Moe to help us work through the recent evidence suggesting that hydrocholorothiazide is associated with squamous cell skin cancer. We go over all the numbers and talk about how we use cohort data to figure out if an association needs to influence our clinical practice. As always it is tricky.
Dr. Jared Bullard (medical microbiologist, Manitoba) and Dr. Naheed Dosani (palliative care physician, Ontario), along with Dr. Mike Allan of the CFPC, talk about the signs and symptoms of infection, the course of illness and testing considerations.
Protecting Patients and Physicians during the Pandemic
Dr Allan Grill and two panelists - Dr Allison McGeer (Microbi and Epi) and Dr Jennifer Young (Rural Family Doctor with ER time and president of OCFP).
The COVID-19 is uppermost on all our minds and our lives are changing. Many of us are adapting to some form of virtual care. For many, that may mean telephone visits but for others, it could include email, video chats, and electronic access to reports. Our host, Dr Jeff Sisler, Executive Director of Professional Development and Practice Support, will discuss with two of Canada's leaders in virtual care Dr. Mark Dermer and Dr. John Pawlovich. They will be addressing general tech issues and options, as well as specific aspects of family physician care in a virtual setting. Whether it is phone visits or more, this session should have something for everyone adapting to virtual care provision.
An Office-Based Induction of Buprenorphine/Naloxone using PEER Guideline
Dr. Jessica Kirkwood
Boyle McCauley Health Centre in Edmonton
This talk focuses on a practical approach to the simplified guidelines for opioid use disorder (OUD) that PEER is developing. By the end of this webinar, participants will be able to:
Understand the best available evidence on OUD management in primary care
Describe methods used to identify patients with OUD
Compare and contrast available treatments for OUD
Initiate opioid agonist treatment in a primary care setting
Provide ongoing treatment in a primary care setting for patients prescribed opioid agonists
Dr. Tina Korownyk is a family physician, an associate professor in the Department of Family Medicine at the University of Alberta, and leads PEER. Dr. Jessica Kirkwood is a family physician at the Boyle McCauley Health Centre in Edmonton and focuses her efforts on marginalized patients who struggle with addictions, mental illness, and homelessness.
CFPC’s Webinar Series will bring you up-to-date on best practices in Antenatal Care.
Providing comprehensive care in the first 20 weeks of pregnancy is a standard for many family doctors but small volumes may limit our comfort with this important area.
Dr Bill Ehman will highlight topics of aneuploidy screening, estimating due date, and the role of ASA and vaginal progesterone in pregnancy.
MAID and Palliative Care: Questions and answers for family physicians.
By the end of this Podcast, participants will be able to:
- Demonstrate importance of access to palliative care.
- Define Medical Assistance in Dying (MAID) and recognize clinical scenarios where MAID fits within the current Canadian legislation.
- Integrate an approach to End-of-Life Care conversations that can be initiated in multiple family practice clinical settings.
Depression is one of the most common conditions managed in primary care. Dr. Mike Allan will cover the 10 evidence-based issues highly relevant to management of depression including a discussion about available medications and how long they take to work, severity of depression and how it could impact patient outcomes, length of treatment, use of non-medication treatment methods, and much more.
This webinar will be in English only.
Wondering how best to initiate advance care planning (ACP) discussions with your patients? In this one-hour webinar Dr. Allan Grill—Physician Advisor for the College of Family Physicians of Canada’s Programs and Practice Support Department—will provide helpful advice on this important issue.
Those who watch the video after the live event may complete a Linking Learning exercise to earn CPD credits.
Join Dr. Michael Allan, Director of the CFPC’s Programs and Practice Support Department for a one-hour webinar while he highlights some of the top research studies from 2018.
Examples of topics we’ll cover include ASA trials, the ketogenic diet, a new Omega-3-derived drug and the new shingles vaccine. It will be a rapid-fire presentation with a focus on bottom-line clinical application.
Dr. Alleyne is a family physician with a focused practice in sport and exercise medicine, an educator, and a clinical lead on the development of the OA tool.
The episode will:
• Describe the need for the OA Tool in clinical practice • Walk participants through the tool using cases to diagnose, stage, and treat OA • Help family physicians learn how to educate patients about OA • Help family physicians learn how to apply criteria for investigations and referrals
“Dr. Julia Alleyne is a sport medicine physician and physiotherapist and is currently the MSK Lead for Outpatients at Toronto Rehab. She holds academic appointments with the University of Toronto, Department of Family and Community Medicine. She was Chief Medical Officer for the Canadian Olympic team in London 2012, the 2015 PanAm Games, and the 2017 Invictus Games in Toronto.”