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Episodes

Where is the COMPASS Taking Us? Rivaroxaban, Aspirin, or Both for Stable CVD ?

12/8/2017
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Since the introduction of direct oral anticoagulants (DOACs) less than a decade ago, use of this class has expanded beyond the prevention and treatment of venous thromboembolism and stroke prevention in the setting of atrial fibrillation. The potential role of DOACs in the secondary prevention of coronary artery disease (CAD) has been of considerable interest. In the setting of CAD, warfarin has resulted in significant more major bleeding when given either alone or in combination with...

Duration: 00:18:48


Azithromycin to Prevent Asthma Exacerbations: What AMAZES Us and What Doesn’t

11/26/2017
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Despite good adherence to high-dose inhaled corticosteroids (ICS) and concomitant long-acting beta agonists (LABA), millions of people with asthma continue to experience exacerbations. What more can patients and clinicians do to reduce the risk of exacerbations? Does the routine use of antibiotics reduce the frequency of exacerbations? This is the question the recently published AMAZES study attempted to answer.

Duration: 00:12:21


Painstaking Efforts to Improve Opioid Stewardship

11/10/2017
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Drug overdose is now the leading cause of death among Americans under the age of 50. In 2016, the United States (U.S.) Centers for Disease Control and Prevention (CDC) released a seminal guideline for primary care clinicians regarding opioid prescribing. These guidelines are now being implemented by clinicians, insurers, and healthcare institutions. The Transforming Opioid Prescribing in Primary Care (TOPCARE) study sought to assess the impact of a multicomponent care management...

Duration: 00:16:25


Painting a New CANVAS for SGLT-2 Inhibitors?

10/13/2017
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While good glycemic control has been shown to prevent microvascular complications (e.g. retinopathy, nephropathy, neuropathy), only a few anti-diabetic agents have been shown to reduce macrovascular complications (e.g. cardiovascular events. Empagliflozin, a sodium glucose transporter-2 (SGLT2) inhibitor, not only reduced the risk of CV events but also all-cause mortality in the EMPA-REG OUTCOME study. Based on this data, the SGLT2 inhibitors were given favorable second-line treatment...

Duration: 00:10:43


Validating HERDOO2 - When is it Safe to Stop Therapy After an Unprovoked VTE?

9/22/2017
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According to the 2016 CHEST VTE Guidelines, at least 3 months of therapy is recommended for an unprovoked DVT or PE (Grade 1B).Thereafter, the clinician is expected to weigh the risks and benefits to determine if extended therapy is appropriate. Balancing the risk of mortality from recurrent VTE versus major bleeding has been challenging. A validated clinical decision tool is sorely needed! Until recently, no risk assessment tool has been validated and therefore none have been widely...

Duration: 00:14:47


Testing the Limits on Blood Glucose Monitoring: Can We Safely Cut Back?

9/8/2017
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Is self-monitoring of blood glucose (SMBG) cost-effective? SMBG is often recommended to help guide treatment decisions. Consumer-oriented advertising often promotes frequent SMBG as means to achieve better glycemic control but current clinical practice guidelines do not provide specific recommendations regarding the frequency of blood glucose monitoring. The lack of conclusive evidence supporting the clinical benefits of routine SMBG combined with the rising costs of healthcare has led...

Duration: 00:13:50


Are Statins ALL THAT for Primary Prevention in Older Adults? A Second Look at ALLHAT-LLT

8/25/2017
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Statins reduce atherosclerotic cardiovascular disease (ASCVD) risk. However, the utility of statin therapy in older adults — particularly in those age 75 years and older — remains controversial. The need for additional evidence to guide clinical practice is underscored by the fact that one-in-three older Americans report taking a statin. Given the paucity of prospective data, a post-hoc analysis of the ALLHAT-LLT (Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial...

Duration: 00:14:26


Wrapping up Knee Pain: Cabbage Leaf Wraps for Osteoarthritis of the Knee

8/11/2017
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Cabbage leaf wraps (CLWs) … the newest health craze trending on social media? A culinary masterpiece? Or an effective complementary treatment for osteoarthritis (OA) relief? A recently published study attempted to answer the latter question. Guest Author: Emily Prohaska, PharmD, BCACP, BCGP Music by Good Talk

Duration: 00:10:30


All for One and FOURIER for All!

7/27/2017
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Although statins have a proven benefit and are widely used, ASCVD continues to be the leading cause of death in the US. In 2015, two proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, alirocumab (Praluent®) and evolocumab (Repatha®), were approved to treat elevated cholesterol when added to maximally-tolerated statin therapy in patients with familial hypercholesterolemia or history of ASCVD. However, the lack of long-term CV outcomes data, high cost, and uncertainty...

Duration: 00:18:21


Vitamin D to Prevent Respiratory Tract Infections: Is the Evidence Dazzling or Disappointing?

6/26/2017
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Observational studies and systematic reviews have shown an association between low vitamin D concentrations and acute respiratory tract infections (ARTIs). An association is one thing, but can vitamin D supplementation reduce the risk of ARTIs? That’s what a recent systematic review and meta-analysis attempted to determine. Guest Author: Amanda Schartel, Pharm.D., BCACP Theme music by Good Talk

Duration: 00:11:50


It’s All Relative: EINSTEIN CHOICE - Rivaroxaban for Extended Secondary Prevention of VTE

6/10/2017
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For the acute treatment of venous thromboembolism, the direct oral anticoagulants (DOACs) have increasingly replaced injectable anticoagulant therapy followed by warfarin. For patients with an unprovoked deep vein thrombosis or pulmonary embolism who may benefit from long-term extended prophylaxis for the secondary prevention of VTE, the choice is less clear. Should a DOAC be used? If so, which one and what’s the best dose? What about low-dose aspirin? Is extended therapy needed at all?...

Duration: 00:15:01


Peeling Back the Layers on Coated Aspirin

4/14/2017
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More than 15 million Americans have coronary heart disease and most should be taking aspirin daily. Given aspirin’s ubiquity in cardiovascular medicine and patients’ pill boxes, it is shocking that there are still so many unanswered questions about aspirin use. Which dose and dosage forms should be prescribed? How common is aspirin resistance? What is the relationship between platelet inhibition and clinical outcomes? Guest Author: Daniela Valencia, Pharm.D. Theme Music by Good Talk

Duration: 00:13:17


Antithrombotic Therapy Following Stent Placement in Patients with A-Fib: Should DOACs Be Preferred?

3/24/2017
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Many patients with atrial fibrillation (AF) received triple antithrombotic therapy after undergoing a percutaneous coronary intervention (PCI) and receiving cardiac stent. Triple therapy consists of warfarin plus dual antiplatelet therapy (DAPT) with a P2Y inhibitor and low-dose aspirin. But is triple therapy the best approach? This practice, while widely employed, is not entirely evidence-based. Moreover, the effectiveness and safety of the direct oral anticoagulants (DOACs) in this patient...

Duration: 00:11:53


Getting Some SHUTi: Using the Internet to Treat Patients with Insomnia

3/13/2017
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Could automated, web-based cognitive behavioral therapy (CBT) replace flesh-and-blood healthcare practitioners? Can computers deliver healthcare at lower cost and similar quality to face-to-face interactions with humans? Several web-based CBT programs have been developed and are now being marketed directly to consumers. But do they actually work? Theme Music by Good Talk

Duration: 00:12:22


Think Before You Make a RAS Decision: Evaluating the Use of RAS Blockers in Patients with Diabetes

2/24/2017
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Hypertension affects more than 70% of patients with type 2 diabetes mellitus and further increases the risk of cardiovascular disease in this high-risk population. While renin angiotensin system (RAS) blockers are clearly indicated in patients with heart failure, chronic kidney disease with proteinuria, and coronary artery disease (CAD), experts have come to different conclusions regarding their role as initial antihypertensive therapy for patients with diabetes. Theme Music by Good Talk

Duration: 00:10:30


Helpful, Harmful, or Futile — Antidepressant Use in Patients with Heart Failure

2/9/2017
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About 5 million Americans are currently living with heart failure (HF) and an astounding 24-42% also suffer from depression. One meta-analysis found a greater than 2-fold risk of death in patients with HF and comorbid depression. Depressed patients with HF are more likely to be hospitalized, seek care from emergency rooms, and rack up big bills. Not surprisingly, patients with HF and depression have a much lower quality of life when compared to HF patients without depression. Clearly, this...

Duration: 00:14:51


Ten Pitfalls to Avoid When Evaluating the Primary Literature

1/25/2017
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Critically evaluating the primary literature and applying the information to patient care is vital to ensuring optimal patient outcomes. Unfortunately, the foundational knowledge and skills that most of us acquire during our formal education and post-graduate training programs are unlikely to fully prepare us for the challenges and intricacies of interpreting the evolving methods used in clinical drug studies today. Like the development of any skill, it requires practice and refinement...

Duration: 00:50:47


Is there a Role for Fixed-Ratio Injectable Combinations in Type 2 Diabetes?

1/13/2017
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Pharmacotherapy for diabetes management has expanded in recent years with several new drug classes. Current guidelines recommend several options for patients who have not reached their goal A1c on metformin monotherapy including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) or basal insulin. However, if basal insulin is chosen as the first add-on treatment with metformin, the post-prandial blood glucose (PPG) often will remain elevated. A combination product that includes both a...

Duration: 00:15:28


Bowel Cleansing Regimens – Pick Your Poison (Wisely)!

12/29/2016
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Colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States. Screening is imperative because the early stages of CRC are often asymptomatic.Colonoscopy is an effective and widely employed screening option for CRC. Suboptimal bowel preparation is a problem in more than 20% of colonoscopy procedures, which reduces adenoma detection rates (ADR). Day-before, split-dose, and same-day regimens are options for colon cleansing prior to a colonoscopy. Is...

Duration: 00:15:01


Preventing Pediatric Dosing Errors – Is It Time to Dump the Medicine Cup?

12/7/2016
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Children are often given liquid dosage forms for both prescription and over-the-counter medicines. Several studies have shown that caregivers unintentionally put children at risk by inaccurately measuring the dose of liquid medications. In 2015, the American Academy of Pediatrics (AAP) adopted a policy statement which recommends exclusively using milliliters for dosing instructions to prevent dosing errors. Our guest today critically examines a recent study that examined labeling and...

Duration: 00:12:12

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