Frankly Speaking About Family Medicine

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-476

Overview: Melatonin is widely used and often perceived as a safe, natural solution for insomnia. However, a new preliminary study raises concerns about long-term melatonin use and increased risk of heart failure, hospitalization, and all-cause mortality in patients with chronic insomnia. In this episode, we review the findings, discuss how they fit with existing evidence, explore limitations, and offer practical guidance for clinicians counseling patients about sleep supplements.

Episode resource links:

American Heart Association Scientific Sessions 2025 – Abstract 4371606
AHA Scientific Statement: Multidimensional Sleep Health and Cardiometabolic Risk (Circulation, 2025)

Li et al. Lancet Diabetes & Endocrinology, 2024

American Academy of Sleep Medicine Clinical Practice Guidelines

AHA Life’s Essential 8 & Sleep Health Resources

Guest: Mariyan Montaque, DNP, FNP-BC
 
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at [email protected] 

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-475

Overview: A prescribing cascade occurs when adverse effects of a medication are mistaken for a new condition and treated with additional drugs. Older adults experiencing polypharmacy are most at risk. The impact of prescribing cascades can be substantial, leading to falls, organ injury, unnecessary imaging and tests, and more. Join us as we explore how to recognize and prevent these harmful cascades in your patients.

Episode resource links:

Adrien  O, Mohammad  AK, Hugtenburg  JG,  et al.  Prescribing cascades with recommendations to prevent or reverse them: a systematic review.   Drugs Aging. 2023;40(12):1085-1100. doi:10.1007/s40266-023-01072-yPubMedGoogle ScholarCrossref

 

Brath  H, Mehta  N, Savage  RD,  et al.  What is known about preventing, detecting, and reversing prescribing cascades: a scoping review.   J Am Geriatr Soc. 2018;66(11):2079-2085. doi:10.1111/jgs.15543PubMedGoogle ScholarCrossref

 

Daunt R, McGettigan S, Kelly L, Curtin D, O'Mahony D. Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study. Drugs Aging. 2025;42(6):535-546. doi:10.1007/s40266-025-01201-9

 

Growdon ME, Tjota N, Campbell R, et al. Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade. JAMA Netw Open. 2025;8(12):e2545274. doi:10.1001/jamanetworkopen.2025.45274

 

McCarthy  LM, Savage  R, Dalton  K,  et al.  ThinkCascades: a tool for identifying clinically important prescribing cascades affecting older people.   Drugs Aging. 2022;39(10):829-840. doi:10.1007/s40266-022-00964-9PubMedGoogle ScholarCrossref

 

O’Mahony, D., Cherubini, A., Guiteras, A.R. et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 14, 625–632 (2023). https://doi.org/10.1007/s41999-023-00777-y

 

Rochon, P.A., O’Mahony, D., Cherubini, A. et al. International expert panel’s potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16, 1573–1584 (2025). https://doi.org/10.1007/s41999-025-01215-x

 

Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS One. 2021;16(8):e0255642. Published 2021 Aug 3. doi:10.1371/journal.pone.0255642

Guest: Susan Feeney, DNP, FNP-BC, NP-C
 
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at [email protected] 

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-474

Overview: Depression affects many people with dementia, but some evidence suggests certain antidepressants may accelerate cognitive decline. This episode explores the potential risks of antidepressants in people with dementia, which medications require careful consideration, and how to make informed prescribing decisions that optimize patient outcomes while minimizing potential cognitive harm.

Episode resource links:

Mo M, Abzhandadze T, Hoang MT, et al. Antidepressant use and cognitive decline in patients with dementia: a national cohort study. BMC Med. 2025;23(1):82. 

Guest: Alan M. Ehrlich, MD, FAAFP

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at [email protected] 

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-473

Overview: Join us as we review long-term outcomes from a recently published trial on prostate-specific antigen (PSA) testing and prostate cancer mortality. Learn how updated evidence informs shared decision-making and balances early detection with potential harms. Equip yourself to guide patients through nuanced discussions on PSA testing’s limitations, mortality data, and meaningful clinical impact.

Episode resource links:

N Engl J Med 2025;393:1669-80. DOI: 10.1056/NEJMoa2503223

Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce

Guest: Robert A. Baldor MD, FAAFP

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at [email protected] 

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472

Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes.

Episode resource links:

Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association.

Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.

 

Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272.

Guest: Mariyan L. Montaque, DNP, FNP-BC

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at [email protected] 

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.