Podcasts about Polypharmacy

In this podcast episode, Sara A. Hurvitz, MD, FACP, La-Urshalar B. Brock, FNP-BC, CNM, and Jordan Hill, PharmD, BCOP, discuss the important role of the multidisciplinary team in achieving comprehensive and individualized care of patients with HR-positive/HER2-negative metastatic breast cancer and preexisting comorbidities, including:Key Comorbidities in Patients with HR+/HER2- MBCImpact of PolypharmacyRole of APPs in Comprehensive CareRole of CDK4/6 Inhibitors and Other Treatments for HR+/HER2- MBCUtility of RWE dataCommunicating Treatment Options With Patients and CaregiversUnderstanding Patient Goals and Coordinating With the Multidisciplinary Team to Individualize Treatment and Maximize Quality of LifeLink to full program:https://bit.ly/4jCQe38

www.YourHealth.orgwww.SCHomeRx.comwww.thedisruptedpodcast.comwww.experiencinghealthcare.com www.YourHealth.Org

We explore the expanding field of Geriatric Emergency Medicine. Hosts: Ula Hwang, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Geriatric_Emergency_Medicine.mp3 Download Leave a Comment Tags: Geriatric Show Notes Key Topics Discussed Importance and impact of geriatric emergency departments. Optimizing care strategies for geriatric patients in ED settings. Practical approaches for non-geriatric-specific EDs. Challenges in Geriatric Emergency Care Geriatric patients often present with: Multiple chronic conditions Polypharmacy Functional decline (mobility issues, cognitive impairments, social isolation) Adapting Clinical Approach Core objective remains acute issue diagnosis and treatment. Additional considerations for geriatric patients: Review and caution with medications to prevent adverse reactions. Address functional limitations and cognitive impairments. Emphasize safe discharge and care transitions to prevent unnecessary hospitalization. Identifying High-Risk Geriatric Patients Screening tools: Identification of Seniors at Risk (ISAR) Frailty screens Alignment with the “Age-Friendly Health Systems” initiative focusing on: Mentation Mobility Medications Patient preferences (what matters most) Mistreatment (elder abuse awareness)

Dr. Dean St Mark, a pharmacologist and product formulator for UK-based brand called Supplement Needs, brings his expertise on testosterone, PEDs, and their health implications to the podcast.• TRT usage has shifted from older men to being prescribed for men in their mid-20s with hypogonadism• Many users push beyond replacement therapy (800 ng/dL) into enhancement territory (1200+ ng/dL) • Androgens impact brain chemistry, creating psychological dependency through altered dopamine thresholds• Female athletes face unique risks including potentially irreversible virilization effects like voice deepening• Polypharmacy and arbitrary dosing based on gym advice rather than science increases health risks• "FemTest" protocols inappropriately extrapolate safety data from PCOS patients to healthy female athletes• Excessive size and muscle mass may contribute to early mortality in bodybuilders (40-60 years old)• EPO can benefit endurance athletes but requires careful monitoring due to blood viscosity concernsFind Dr. Dean St Mark on Instagram @DeanSTM.

Send BFTA a commentDr. H breaks down the complex task of deprescribing into six clear steps, starting with the most important and challenging question of all:   Who is the patient and why are they suffering?"Bringing Therapy into Med Management"-- a psychotherapy training intensive with Dr. H for psych NPs and PAs this October in Ft Collins https://www.craigheacockmd.com/training/BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/BFTA/ Dr. Hhttps://www.craigheacockmd.com/podcast-page/

In this episode of "Next Steps 4 Seniors: Conversations on Aging," host Wendy Jones discusses the critical topic of medication management for aging adults. Wendy, along with an unnamed speaker, highlights the complexities and risks of managing multiple medications, including memory issues and pharmacy. They share real-life stories to illustrate the dangers of improper medication use and emphasize the importance of collaboration with healthcare providers. Wendy advises consulting pharmacists for potential drug interactions and maintaining updated medication records. The episode aims to provide practical tips to help families ensure the safety and well-being of their aging loved ones. Have questions or suggestions? Call 248-651-5010 or email hello@nextsteps4seniors.com. For podcast topics or sponsorship opportunities, contact marketing@nextsteps4seniors.com. Don’t forget to subscribe, follow, and share on your favorite podcast platform. Visit NextSteps4Seniors.com to learn more and explore additional resources. Let’s take the next steps together! This episode is proudly sponsored by Aeroflow Urology, a leader in incontinence care solutions. You may be eligible to receive your incontinence supplies at no cost through your insurance, delivered discreetly and directly to your door. *Some exclusions apply Visit aeroflowurology.com/ns4s to learn more and see if you're eligible.Learn more : https://nextsteps4seniors.com/See omnystudio.com/listener for privacy information.

In this episode, we explore the unique challenges and considerations in treating older adults, focusing on the need for a different approach to care due to polypharmacy and multimorbidity. We delve into the complexities of managing these patients, emphasizing the importance of understanding frailty—how to assess, prevent, and address it. The discussion also covers late-onset rheumatoid arthritis, its distinction from rheumatoid arthritis, and why it often goes underdiagnosed and undertreated. We introduce the 5 M's framework; a geriatric care model that helps clinicians focus on what truly matters to older adults. Additionally, we address the role of palliative care in rheumatology, highlighting its importance beyond end-of-life care, and provide guidance on shared decision-making with older adults and their families to ensure patient-centered outcomes.   

What is Deprescribing? Why is it so important? And the big question... who invented it?! We present a masterclass in deprescribing from pharmacist Dr Emily Reeve from Monash University in Australia who is also Chair of the Australian Deprescribing Network.The need to review, reduce or stop medicines has been a regular topic of conversation here on the Aural Apothecary. But how do we do it? Deprescribing should be an integral component of appropriate prescribing and is defined as the systematic process of dose reduction or discontinuing a medicine under the supervision of a healthcare professional. We chat to Emily about the difficulties faced, advancements in practice and her research into the topic. What help is available for prescribers? Do patients actually want their medicines stopped? And who is the world leader in Deprescribing...?There is no one better with whom to discuss this topic. Dr Emily Reeve, as well as being Chair of the Australian Deprescribing Network, is a Senior Research Fellow and Deputy Theme Lead for the Centre for Medicines Use and Safety, in the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University in Australia.Should information on how to stop a drug feature in guidance on how to start it? In our micro-discussion we delve deeper into the guidance available for prescribers when we look at one of Emily's papers 'What do clinical practice guidelines say about deprescribing' https://qualitysafety.bmj.com/content/34/1/28 As with all of our guests, Emily shares with us her Memory Evoking Medicine, a career anthem and book that has influenced her career or life. We learn that it is hard to dance with the devil on your back.Want to get your papers published? Jamie mentioned the site https://gettingpaperspublished.com/.You can listen to the Aural Apothecary playlist here;https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQw Pyz1KBgYou can view the Aural Apothecary Library here;https://litalist.com/shelf/view-bookcase?publicId=KN6E3OOur website is https://www.theauralapothecary.com/       To get in touch follow us on Twitter and Instagram @auralapothecary or email us at auralapothecarypod@gmail.com . Don't forget to rate us and comment wherever you have got this podcast from.

In this Complex Care Journal Club podcast episode, Dr. Kathleen C. Thomas discusses a cross-sectional study of associations between neighborhood context with psychotropic polypharmacy and psychotherapy among children with high-needs for medical or psychiatric care. She describes the inclusion of parent advisors on the study team, the inclusion of children with medical complexity in the study population, key insights including the importance of non-medical supports, and the next steps from this work. SPEAKER Kathleen C. Thomas, PhD, MPH Professor and Vice Chair of Research and Graduate Education Division of Pharmaceutical Outcomes and Policy Eshelman School of Pharmacy University of North Carolina at Chapel Hill HOST Kristina Malik, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine Medical Director, KidStreet Pediatrician, Special Care Clinic, Children's Hospital Colorado DATE Initial publication date: January 13, 2025. ARTICLE REFERENCED Thomas KC, Annis IE, deJong NA, Christian RB, Davis SA, Hughes PM, Prichard BA, Prichard JR, Allen PS, Gettinger JS, Morris DN, Eaker KB. Association Between Neighborhood Context and Psychotropic Polypharmacy Use Among High-Need Children. Psychiatr Serv. 2024 Sep 11:appips20230639. doi: 10.1176/appi.ps.20230639. Epub ahead of print. PMID: 39257315. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/3rffshwp3q2km53w7xckq38/011025_CCJCP__Where_You_Live_Matters Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: forms.gle/Bdxb86Sw5qq1uFhW6 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Thomas KC, Malik KE. Where You Live Matters: Psychotropic Polypharmacy and Psychotherapy in Children with High-Needs‌. 01/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/where-you-live-matters-psychotropic-polypharmacy-and-psychotherapy-in-children-with-high-needs.

Women's health can feel like a never-ending mystery, right? One symptom leads to another question, and the cycle keeps going. In this special New Year's Q&A, I'm sitting down with my daughter Amira again to answer the questions so many of you have been asking. From the effects of medications and hormone disruptors to lessons I learned from my mom's health journey, we're unpacking stories and strategies to help you feel more in control of your body and your choices.   Let's talk about the stuff that's been keeping you up at night—like hair loss and those annoying heart flutters that seem to come out of nowhere. We're getting into why these things happen, especially during menopause, and what you can actually do about them.   Oh, and if you're tired of hitting that midday slump or fighting off cravings, I've got a little secret for you: my Keto Green Shake. It's not just tasty—it's a game changer for energy, focus, and feeling good in your skin. Head over to dranna.com/tryketoshake and give it a try—I promise you'll love it!   Key Timestamps: [00:00] Introduction. [00:05:35] Polypharmacy and its consequences. [00:10:13] Empowering patients in healthcare decisions. [00:15:10] Hormone disruptors and health risks. [00:19:22] Hair loss in postmenopausal women. [00:22:23] Hormone replenishment versus replacement. [00:25:42] Hair loss solutions and tips. [00:36:18] Women's heart health and hormones.   Memorable Quotes:   "You really have to ask questions. If you're not feeling that you have the ability, the hospitality to ask questions and get answers from your medical providers, facilities, insurance, whatever. You keep looking, you are the best advocate for your health." [00:09:59] – Dr. Anna Cabeca   "Test, don't guess." [00:33:15] – Dr. Anna Cabeca   Links Mentioned: Keto Green Shake: https://dranna.com/tryketoshake   Connect with Dr. Anna Cabeca: Website: https://drannacabeca.com/pages/show Instagram: https://www.instagram.com/thegirlfrienddoctor/ YouTube: https://www.youtube.com/@thegirlfrienddoctor TikTok: https://www.tiktok.com/@drannacabeca   Produced by Evolved Podcasting: www.evolvedpodcasting.com

Women's health can feel like a never-ending mystery, right? One symptom leads to another question, and the cycle keeps going. In this special New Year's Q&A, I'm sitting down with my daughter Amira again to answer the questions so many of you have been asking. From the effects of medications and hormone disruptors to lessons I learned from my mom's health journey, we're unpacking stories and strategies to help you feel more in control of your body and your choices.   Let's talk about the stuff that's been keeping you up at night—like hair loss and those annoying heart flutters that seem to come out of nowhere. We're getting into why these things happen, especially during menopause, and what you can actually do about them.   Oh, and if you're tired of hitting that midday slump or fighting off cravings, I've got a little secret for you: my Keto Green Shake. It's not just tasty—it's a game changer for energy, focus, and feeling good in your skin. Head over to dranna.com/tryketoshake and give it a try—I promise you'll love it!   Key Timestamps: [00:00] Introduction. [00:05:35] Polypharmacy and its consequences. [00:10:13] Empowering patients in healthcare decisions. [00:15:10] Hormone disruptors and health risks. [00:19:22] Hair loss in postmenopausal women. [00:22:23] Hormone replenishment versus replacement. [00:25:42] Hair loss solutions and tips. [00:36:18] Women's heart health and hormones.   Memorable Quotes:   "You really have to ask questions. If you're not feeling that you have the ability, the hospitality to ask questions and get answers from your medical providers, facilities, insurance, whatever. You keep looking, you are the best advocate for your health." [00:09:59] – Dr. Anna Cabeca   "Test, don't guess." [00:33:15] – Dr. Anna Cabeca   Links Mentioned: Keto Green Shake: https://dranna.com/tryketoshake   Connect with Dr. Anna Cabeca: Website: https://drannacabeca.com/pages/show Instagram: https://www.instagram.com/thegirlfrienddoctor/ YouTube: https://www.youtube.com/@thegirlfrienddoctor TikTok: https://www.tiktok.com/@drannacabeca   Produced by Evolved Podcasting: www.evolvedpodcasting.com

Zana Carver, PhD, is an associate professor with expertise in physiology, toxicology, and pharmacokinetics. In this episode, using thyroid issues as an example, Dr. Carver explains that the medical industry intentionally develops tests that lead to a failure to diagnose root medical problems, allowing multiple symptoms to develop, leading to perpetual polypharmacy.Reference Linkshttps://informedchoicewa.substack.com/ Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Zana Carver, PhD, is an associate professor with expertise in physiology, toxicology, and pharmacokinetics. In this episode, using thyroid issues as an example, Dr. Carver explains that the medical industry intentionally develops tests that lead to a failure to diagnose root medical problems, allowing multiple symptoms to develop, leading to perpetual polypharmacy. Reference Links https://informedchoicewa.substack.com/ Learn more about your ad choices. Visit podcastchoices.com/adchoices

Zana Carver, PhD, is an associate professor with expertise in physiology, toxicology, and pharmacokinetics. In this episode, using thyroid issues as an example, Dr. Carver explains that the medical industry intentionally develops tests that lead to a failure to diagnose root medical problems, allowing multiple symptoms to develop, leading to perpetual polypharmacy. Reference Links https://informedchoicewa.substack.com/

2024–a year in review (America's worsening health picture); Obesity and cancer incidence rise in U.S. while healthspan declines; First-of-its-kind lawsuit takes aim at ultra-processed food makers; Nutritional support for childhood developmental disorders; Dr. Mark Hyman, integrative pioneer, gets the New York Times treatment; Can a blood pressure medication cause canker sores? Curbing Omega-6s, boosting Omega-3s, improves prostate cancer outcomes. 

Medication reviews are vital for optimising treatments, preventing adverse drug events and improving quality of life Differences between Home Medicines Review and Residential Aged Care Medication Review Which situations and what frequency are best for initiating medication reviews Clear communication with the pharmacist, starting from a detailed referral and reviewing pharmacist recommendations are crucial for a successful medication review Clinical, economical and patient-centred benefits Medicare funded, therefore benefits the health system overall Host: Dr Marita Long | Total Time: 19 mins Expert: Dr Peter Tenni, Clinical Pharmacist Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEDT Click here to register for the next oneSee omnystudio.com/listener for privacy information.

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Association of semaglutide with first-time diagnosis of Alzheimer's disease in patients with type 2 diabetes 2.     Increasing Medication Use and Polypharmacy in Type 2 Diabetes 3.     Association of Energy Intake and Dietary Glycemic Load in Different Time Periods With Cardiovascular Disease Mortality Among U.S. Adults With Type 2 Diabetes 4.     Comparative effectiveness of sodium-glucose cotransporter-2 inhibitors for recurrent nephrolithiasis among patients with pre-existing nephrolithiasis or gout 5.     GLP-1 Receptor Agonists and the Path to Sustainable Obesity Care   For more information about each of ADA's science and medical journals, please visit.www.diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

Taking multiple medications, called polypharmacy, is often a cause and contributor to health problems as we age. Seventy percent of people over 40 take at least one drug, twelve percent of people over 65 take ten or more prescription or nonprescription medications. And a whopping 95% of people older than 65 are taking a medication that increases their risk for falls. Dr. Fleming helps patients and providers understand what to watch for and provides simple tools for avoiding complications.   Key Takeaways To Tune In For: (01:08) - Understanding Polypharmacy (07:09) - The Risks of Blood Pressure Medications (11:11) - The Dangers of Drug Interactions (17:07) - Tips for Patients to Navigate Medication Reviews (21:14) - The Role of Advocates in Healthcare (25:05) - Recommended Resources for Healthy Aging     Resources talked about in this episode Guest website - Vital Aging Clinic

In this solo episode Dr. H shares his current thoughts on working in the here and now; polypharmacy; the root causes of suicidality; diagnostic parsimony ; ketamine microdosing; and online psych NP training programs.BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/BFTA/ Dr. Hhttps://www.craigheacockmd.com/podcast-page/

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to another episode of "Ditch the Lab Coat," the podcast where we critically explore the latest in medical science and healthcare with engaging discussions and a dose of skepticism. I'm your host, Dr. Mark Bonta, and today we have an insightful conversation lined up with our distinguished guest, Dr. Allan Detsky. Dr. Detsky, a professor at the University of Toronto and former Chief Physician at Sinai Health Systems, brings his extensive knowledge in evidence-based medicine, health policy, and clinical experience into our discussion.In this episode, we'll delve into the complex landscape of pain management and the opioid crisis, explore the future health challenges posed by climate change and societal shifts in civility, and critique the growing influence of unregulated health advice on social media. Dr. Detsky shares his candid views on the pharmaceutical industry's role in drug development, conflicts of interest, and the intricate relationship between lifestyle changes and medical advancements.We'll also discuss the limitations of evidence-based medicine, especially when it comes to treating patients with multiple conditions, and the challenges of applying clinical guidelines to real-world settings. Plus, stay tuned for an announcement about a website overhaul, launching in December, featuring expanded blog content for our curious listeners.Join us as we unravel these pressing issues and more, always questioning, always learning. "Ditch the Lab Coat" continues right now.00:00 - Podcast begins with healthcare insights from Dr. Alan Detsky.05:31 - Highlighting the role of randomized trials in improving evidence-based medicine.08:52 - Questioning the efficacy of zinc supplements for healthy young adults.10:27 - Clinical study results often fail to align with real patient demographics.16:57 - Lack of shared decision-making opportunities for hospitalized patients.19:22 - Discussing right-wing skepticism toward pharmaceutical companies, balanced with acknowledgment of their contributions.21:21 - Exploration of how pharmaceutical companies prioritize profits over public-interest-driven drug development.25:00 - Reflecting on personal and professional relationships with drug industry figures.30:43 - Increasing dependency on lifelong medications in healthcare.35:14 - Potential for AI to address systemic issues despite its resource demands.36:35 - Emphasizing the importance of verifying credentials to avoid unqualified healthcare professionals.

In this episode of Southern Medicine, Dr. Ankur Patel highlights the potential consequences of polypharmacy, such as drug interactions, decreased adherence, and increased likelihood of adverse events. He also emphasize the rising prevalence of ADEs, underscoring their impact on patient outcomes, healthcare costs, and the burden on healthcare providers. 

Joining us on Well Said is Dr. Philip Solomon, Geriatrics Fellowship Program Director at Northwell Health, Director of Geriatric Education and Clinical Integration, and Assistant Professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell to discuss the difficulties faced by those needing to be on many different medications at once.

This episode of “Good Health, Better World” is all about polypharmacy, or more than one medication at the same time. Tune in to understand some of the considerations for chronic medications as we age, and hear about how insurance plans and pharmacies work together to help members and patients manage their medications as prescribed.  Find show notes and additional information at upmchp.us/ghbw-s4ep5

An alarming number of individuals find themselves dependent on antidepressants and psychiatric medications, desperately seeking guidance on how to safely discontinue their use. The general medical community has failed to assist people in safely getting off these drugs. The dependency can create severe withdrawal symptoms. Most doctors have no clue how to get their patients off safely keeping them in a cycle of drug dependency. The worst of prescribers will frame the withdrawal symptoms as worsening "depression" and justification for staying on drugs. On Episode 154 of the Radically Genuine Podcast Dr. Roger McFillin dives into the topic of deprescribing and tapering off psychiatric drugs with a pharmacist. Dr. Shawn Gill, PharmD, is a pharmacist, writer, podcaster, and entrepreneur dedicated to sparking change in healthcare through deprescribing. He is the founder of Deprescribe Solutions, an independent consulting practice focused on reversing early-stage chronic conditions in mental health, hypertension, and type 2 diabetes. He hosts the "Deprescribe" podcast and writes the Substack newsletter "B.U.D.S," where he explores topics in health, deprescribing, parenting, and personal growth. Chapters00:00 The Silent Epidemic of Over-Prescription03:06 The Role of Pharmacists in Mental Health06:11 Understanding Compounding Pharmacy09:01 Polypharmacy: A Growing Concern11:58 The Dangers of SSRIs and SNRIs15:12 The Ethics of Prescribing Practices18:01 Navigating Withdrawal and Tapering20:57 Hyperbolic vs. Linear Tapering24:14 Protracted Withdrawal: Understanding the Risks26:49 Preventing Dependency: Education and Awareness29:58 The Future of Mental Health TreatmentResources: Systematic review detailing the relationship between SERT occupancy and SSRI dosing.- This is a great systematic review that breaks down the hyperbolic nature of SSRIs. It also elucidates on the potential pharmacology and mechanism behind protracted withdrawal, which we touched upon. RELEASE Clinical Trial - RCT which will be investigating hyperbolic tapering vs. linear tapering. The trial will begin in 2025.Outro Health - Fantastic organization trying to scale and make hyperbolic tapering accessible to the US. Dr. Sean Gill SubstackDeprescribe Podcast w/ Dr. Sean Gill RADICALLY GENUINE PODCASTDr. Roger McFillin / Radically Genuine WebsiteYouTube @RadicallyGenuineDr. Roger McFillin (@DrMcFillin) / XSubstack | Radically Genuine | Dr. Roger McFillinInstagram @radicallygenuineContact Radically GenuineConscious Clinician CollectivePLEASE SUPPORT OUR PARTNERS15% Off Pure Spectrum CBD (Code: RadicallyGenuine)10% off Lovetuner click here—-----------FREE DOWNLOAD! DISTRESS TOLERANCE SKILLS

Join us this week as we unpick Polypharmacy and Anticholinergic Burden with Dr Anirudh Kumar, including how to monitor for side effects and make considered deprescribing decisions.

When and how to deprescribe Some medications impact on cognition, health-related quality of life and mortality - polypharmacy can cause underprescribing of high priority medications Health assessments for those over 75 can initiate the process of deprescribing   Host: Dr Marita Long | Total Time: 22 mins Experts: Dr Peter Tenni, Clinical Pharmacist Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEDT Click here to register for the next oneSee omnystudio.com/listener for privacy information.

Both Democrats and Republicans agree that we have a health care crisis, with high costs and poor outcomes.  This week, a fired-up Dr. Prather talks about a proven solution to this crisis.  In this episode, you'll discover:—How America spends the most on health care, but has the worst outcomes when compared to all other industrialized nations.—The drug problem in America, both in terms of illicit drugs and an over-reliance on pharmaceuticals.  And the problem of Polypharmacy, which impacts 40% of those over the age of 65 who are taking more than 4 prescription drugs. —Why Dr. Prather says that, if drugs and pharmaceuticals were the answer to our health care, then Americans should be the healthiest people on the planet.—The reason the news media aren't interested in reporting negative stories on pharmaceuticals.  And the astonishing percentage of news media revenues that come directly from Big Pharma.—Why Dr. Prather says he is actually "proud" of America's Disease Care, but that we're missing the necessary Structure-Function Care which should be our source of primary care for best patient results.—How Blue Cross/Blue Shield of Illinois did a 10-year study that proved the health care model used in Dr. Prather's office lowers health care costs by 60%, while improving patient outcomes by 85%.  And why the pharmaceutical companies oppose this health care model because it resulted in an 80% reduction in pharmaceutical costs.—The importance of Health Savings Accounts (HSA's) in health care reform to put the power in the hands of the patients, not government or insurance company bureaucrats. —How we can have better pharmaceutical drugs and a more innovative pharmaceutical industry through smart regulatory reform. —Why pharmaceutical industry "capture" of the very government agencies regulating them is such a problem. —Plus, how you can attend Dr. Prather's speech on this subject at the Trinity Health Expo on Saturday, September 28th at 1 p.m.http://www.TheVoiceOfHealthRadio.com

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on polypharmacy and guideline-directed medical therapy initiation among adults hospitalized with heart failure.

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to another enlightening episode of "Ditch the Lab Coat," the podcast where we critically examine health issues through a lens of scientific skepticism and practical wisdom. I'm your host, Dr. Mark Bonta, and today, we have a special guest, Dr. Shawn Gill, a clinical pharmacist and founder of Deprescribed Solutions. Dr. Gill collaborates closely with physicians and patients to create detailed taper plans for safely coming off medications like SSRIs. In this episode, we dive deep into the challenges of convincing physicians to adopt evidence-based tapering approaches, the importance of individualized patient care, and the hazards of over-relying on medication for minor ailments. Dr. Gill shares his practical, sustainable mental health-boosting practices and underscores the need to consider lifestyle interventions over long-term pharmaceutical treatments.Listen in as we explore the complexities of medication therapy in both acute and community settings, debate the appropriateness of prescribing SSRIs, and discuss the collaborative interprofessional model in healthcare. We also touch on the systemic challenges within a fee-for-service infrastructure and the significance of managing patient expectations during the transition off medications.Join us for an insightful discussion on how we can evolve as healthcare providers and implement holistic, non-pharmacological approaches to improve patient care. And remember, this podcast is aimed at fostering thoughtful discussion and is not a substitute for professional medical advice or treatment. Enjoy the episode, and stay tuned for more in-depth conversations on "Ditch the Lab Coat"!06:43 Limited access to specialists leads to disjointed care.10:31 Concern about medication adherence and deprescribing motivation.14:21 Navigating healthcare challenges and career self-reflection.16:53 Intervening with young patients to prevent complications.18:58 Emphasizing patient goals and identifying severity of symptoms.23:43 Antidepressant numbness, fear of stopping medication.26:22 Mental health treatment lacking options due to time.31:36 Pharmacist navigates patient dynamics without prescribing authority.32:59 Experienced doctor focuses on patient's mental health.37:31 Coordinate deep prescribing with physicians, share updates.39:19 Building trust, giving feedback, and fragile egos.42:33 Consider stopping antidepressants, it's possible and rewarding.47:07 Discontinuing medication requires careful adjustment and support.51:46 Reflection on medical practice, calls for diverse guests.53:48 Mother's nursing work inspired son's medical career.

Laura Beaton talks to pharmacist Aili Langford and geriatrician Sarah Hilmer about their article on deprescribing antihypertensive drugs in frail older adults. They discuss how the potential benefits and harms of lowering blood pressure may change with increasing age and frailty, the evidence for deprescribing, and how to deprescribe antihypertensive drugs. Read the full article by Aili, Sarah, and their co-authors, in Australian Prescriber.

***SUMMER REWIND  - INITIALLY RELEASED ON 31ST JAN 2024*** To get in touch: primarycarepodcasts@gmail.com Doctors Lisa and Sara talk to Senior Pharmacist Sarah Hafeez about Polypharmacy. She explains the difference between inappropriate and appropriate polypharmacy before talking through some typical cases that illustrate several examples of common scenarios.  This leads to discussions on prioritising concerns, weaning/stopping medications, counselling patients on the effects of Opioids and Gabapentinoids and involving community teams aiming for successful reductions of addiction forming medications. Other gems include a discussion of the potential long term risks of Proton Pump Inhibitors and advice on weaning, remembering to consider anticholinergic burdens as well as handy resources for tackling Polypharmacy, Structured Medications Reviews and medication reductions. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Useful resources:  Greater Manchester Medicines Management Group: Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack (from Dec 2022, accessed Dec 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/02/GMMMG-Polypharmacy-resource-pack-v3.0.pdf Scotland Polypharmacy Resources for Professionals and for Patients: https://www.polypharmacy.scot.nhs.uk/for-patients-and-carers/ Scottish Polypharmacy Guidance 2018: https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf Lewis T. Using the NO TEARS tool for medication review. BMJ. 2004 Aug 21;329(7463):434. doi: 10.1136/bmj.329.7463.434. PMID: 15321901; PMCID: PMC514207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514207/ Toolkit for General Practice in Supporting Older People Living with Frailty (includes a great Appendix of the STOPP/START criteria (2017): https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf An example of an Anticholinergic Burdon Resource from West Essex CCG 2020: https://westessexccg.nhs.uk/your-health/medicines-optimisation-and-pharmacy/clinical-guidelines-and-prescribing-formularies/04-central-nervous-system/61-anticholinergic-side-effects-and-prescribing-guidance/file Canadian Resource for Deprescribing including reducing medications and some patient information leaflets: https://deprescribing.org/ Resource for help reducing and stopping medications: https://medstopper.com/ Me and My Medicines Resource for Patients to look through their medications before reviews or for information: https://meandmymedicines.org.uk/ Anticholinergic Medications and Risks of Dementia Cochrane Editorial with Reports in Link (Sept 2021): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000154/full Anticholinergic drugs and risk of dementia: Time for action? British Pharmacological Society. Bell B et al Jun 2021 (9:3). Accessed 15/1/2024:  https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1002/prp2.793 Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder. Clin Interv Aging. 2020; 15: 1493–1503: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457731/ Greater Manchester Medicines Management Group: Management of Overactive Bladder Including a simple Bladder Diary before and after stopping Medications (Jun 2019): https://gmmmg.nhs.uk/wp-content/uploads/2021/08/Management-of-OAB-in-adults-v3-0-approved-Aug-2019.pdf ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Michelle Keller is an assistant professor of gerontology and the Leonard and Sophie Davis Early Career Chair in Minority Aging at the USC Leonard Davis School. She spoke to us about her research focused on improving patient-clinician communication, medication management, and the identification of dementia in minority older adults. Here are highlights from our conversation. On polypharmacy “When it comes to older adults and medications, it's important to understand that while medications can be incredibly beneficial for treating various conditions, they can also present really unique risks in this population. Older adults often take multiple medications at the same time. This is what we call polypharmacy.” “Older adults can be more sensitive to certain medications, they might experience side effects more intensely or even at lower doses than younger individuals. … This is particularly true for medications that affect our central nervous system, our brain, right? So, thinking about medications that are sedating or that have some sort of psychoactive effect. These medications, especially when they're combined together, can lead to things like confusion, dizziness and an increased risk of falls.” On her study of interventions to address polypharmacy “What we found in this study was that interventions to address polypharmacy can do a great job of reducing medications which are potentially harmful, identifying which medications people should be taking, improving the appropriateness of the medications people are taking, and reducing the total number of medications. So thinking about outcomes related to medications, what we have found is that it is really hard to change more downstream clinical outcomes, things like mortality, falls, hospitalizations, and emergency department visits. We did find that interventions that had multiple components; in other words, where a clinician is meeting face to face with a patient, reviewing their medications, reviewing all the chronic diseases that they have, along with their full patient history of what has happened to them in the past, those interventions tend to have a greater effect on mortality. So in other words, those types of interventions are reducing the risk of that someone actually dies.” “We also found that falls decrease when patients fully stop potentially harmful medications. These may be medications where somebody is feeling very dizzy or that make people feel very dizzy or drowsy, medications that may control somebody's blood sugar a little bit too much… So, their blood pressure's a little too low and they may actually fall as a result of these medications. But what we found was that stopping medications such as benzodiazepines, which are often taken for sleep or anxiety, can take months. These types of medications can have withdrawal effects. And so it's really, really important for somebody to work very closely with a healthcare provider to slowly taper these medications down to try to reduce those withdrawal effects.” “What we have found in working with other researchers and clinicians is that when patients team up with a healthcare provider, such as their primary care physician or clinical pharmacist who's embedded in the healthcare system, they really are able to stop taking some of these medications, and they feel a lot better. They feel much more energy, they're able to do the things that they really enjoy. They have a greater quality of life. But it's something that just takes time.” On the Empower Intervention for benzodiazepines “The typical recommendation for benzodiazepines is that they really should be taken short-term. These are medications that physicians typically recommend somebody take for a maximum of four weeks. What we have found in some of our research is that people are actually taking these for years, if not decades. And so stopping these medications can be quite challenging, and sometimes patients aren't fully convinced about why they should be stopping these medications. So, we took an intervention that started in Canada. It was developed by researchers in Quebec, and this is called the Empower Intervention. And what we did is we tailored it to a health system here in the US. The Empower Intervention is a really great brochure that contains some pretty striking facts about benzodiazepines.” “To give you some examples of benzodiazepine, these are like your Xanax, your Ativan, your Klonopin; these are the medications that we're talking about here. These brochures highlighted some really interesting facts, such as the fact that they can be harmful or linked to hip fractures and car accidents, and they can make people feel very tired and weak. What we did for this intervention is we sent these brochures to about 300 people along with a letter from their primary care physician, emphasizing that these medications can be harmful if taken for too long and especially among older adults. So what we did for this study is we compared patients who had received these brochures to patients who did not receive them. So they're going on usual care. Their physicians may have mentioned something to them, this was our control group, right? We didn't send anything to this particular group.” “We reviewed the medical records for both groups, and we looked at what kinds of medications they had been prescribed. And what we found is that patients who received the brochures were really activated. You know, when they received this messaging they would send messages in the patient portal to their physicians saying, ‘I didn't know that there were these risks of these medications. I would really like to come in and talk to you about them.' They made appointments to start tapering down these medications. What we found was for every 10 brochures that we sent, one person completely stopped taking these medications, which is a really good return on investment. This is a simple intervention. It has now been done in some other health systems in the US, particularly the Veterans Affairs health system.” On challenges in de-prescribing “I think some of the challenges that physicians face in de-prescribing is that de-prescribing takes a lot of time. As we all know, our primary care visits are very short; physicians, particularly in the primary care setting, are really rushed through their visits. And so I think having some of these conversations can just be something that's challenging. I also think they're quite complex conversations to have. They may not have received the training, for example, on how to taper a medication in a safe way so that a patient does not feel withdrawal effects. And I do think that there is something about getting physician buy-in … they are concerned [that] if they bring it up, the patient may be angry with them; they may be upset. And so I think really showing physicians ways in which this can be brought up that are really framed around ‘how do we center the patient's health and quality of life' – I think those are still questions that we as researchers are working on.” On the role of caregivers “It's really important for caregivers to be aware of the medications their loved ones are taking for many reasons. I think they can be amazing advocates in helping bring up potential side effects during doctor's visits. So, for example, if a caregiver is noticing that someone is feeling drowsy or doesn't have that much energy or is feeling dizzy, any sort of cognitive impairments such as those that may be seen in dementia, [they] may actually be a result of medication side effects. So, I think really becoming an advocate for somebody when seeing the doctor is one really important thing that caregivers can do.”  “Another area where caregivers can play a really important role is among people with dementia. People with dementia can have really some challenges in managing their medications. They may miss doses, they may take several medications twice, so they may have an overdose, or they may take the wrong medication altogether. So, caregivers can play really pivotal roles in helping somebody manage medication changes. There have been some early interventions looking at how to engage caregivers and persons with dementia. And some of the challenges that those researchers have seen is that there [is] often more than one person actually caring for somebody with dementia. And so, engaging that whole group of people who may be working with that person has been a real challenge.” On challenges facing patients with language barriers  “There is research showing that patients with language barriers have a greater risk of being hospitalized or re-hospitalized because of some of the communication challenges that come with medication management. So, you can imagine that, for example, older adults and their caregivers with language barriers may have a difficult time understanding medication instructions, which can lead to improper use. So when and how to take medications, recognizing potential side effects, understanding the purpose of each medication. And on top of that, you can layer on things, like if somebody doesn't have a great understanding of the condition. We call that disease literacy, or they may have health literacy issues.” “Right now, a mentee and I are working on this review of interventions that have been done specifically for patients with language barriers focused on improving medication management. And what we found was that interventions that really engaged people from communities with language barriers have been some of the most effective ways to really help people learn about which medications are working really well for them, how to improve medication adherence and other important outcomes. So, for example, an intervention that we found was researchers engaged folks in the community, co-created videos about medications in the community and why it was important to take them. And then when they actually distributed these interventions, they made sure that both in terms of the videos and some of the other educational materials that were handed out to folks that these really were very tailored both language-wise, literacy-wise, and culturally tailored to the communities that they were serving.” On new dementia medications and disparities in the diagnosis of dementia  “We are learning that older Black and Latino adults tend to get diagnosed with dementia once the disease has progressed more. And what that means is that they may not have received some of the kind of services that may help them or their families. So, for example, they may not have received enough support to be able to plan for the rest of their lives, or their families may not necessarily have received caregiving support early on in disease progress.” “I think in regard to these particular dementia medications, for example, if older adults are diagnosed with dementia at a place where they're no longer eligible to receive these medications, I think that'll be a really pretty serious health equity issue. So, I am really interested in how we make sure that people are getting diagnosed in time to make them eligible for really potentially beneficial treatments that may help them down the road.” On effective strategies for de-prescribing  “The most effective strategies that we see de-prescribing these medications is offering something else. So, for example, some of the most evidence for insomnia really exists around the use of using cognitive behavioral therapy. There's also been well-done systematic reviews that have found evidence that music or acupuncture may help people with insomnia. … I think one thing that's very important to think about when we de-prescribe medications is what else can we offer people? We're not just leaving people in the lurch and saying, ‘We're taking this away and we're leaving you with nothing.' We're actually able to offer them some non-pharmacological options as well.” Transcript Speaker 1 (00:02): One thing that's very important to think about when we de-prescribe medications is: what else can we offer people? We're not just leaving people in the lurch and saying, we're taking this away and we're leaving you with nothing. We're actually able to offer them some non-pharmacological options as well Speaker 2 (00:17): From the USC Leonard Davis School of Gerontology, this is Lessons in Lifespan Health, a podcast about the science and scientists improving how we live and age. I'm Orli Belman, Chief Communications Officer. On today's episode: how Professor Michelle Keller is working with older adults, caregivers and clinicians to manage the use and potential overuse of high risk medications. Michelle Keller is an Assistant Professor of Gerontology and the Leonard and Sophie Davis Early Career Chair in Minority Aging at the USC Leonard Davis School. Her research is focused on improving patient-clinician communication, medication management, and the identification of dementia in minority older adults. Hi, Michelle. Welcome and thank you for joining us today. Speaker 1 (01:06): Thank you so much for having me. Speaker 2 (01:08): I wanna start by asking you to talk about older adults and medications. We can all understand why medications are beneficial, but when it comes to older adults, what are some of the ways they can be problematic? Speaker 1 (01:19): Absolutely. So when it comes to older adults and medications, it's important to understand that while medications can be incredibly beneficial for treating various conditions, they can also present really unique risks in this population. So older adults often take multiple medications at the same time. This is what we call polypharmacy. Polypharmacy can increase the risk of drug interactions, right? So I like to think of the example of a suitcase, right? So imagine that you are packing up, getting ready to go to a trip. You start putting one thing into the suitcase, gets a little heavy, but you can manage it, right? You're suddenly adding more and more things and the suitcase is getting heavier and heavier to the point where you actually throw out your back at the airport, right? This is really what I think of when our bodies are kind of processing multiple medications at once with the additional challenge that some of these drugs may actually interact with one another. Speaker 1 (02:15): This is why it's so important for patients to talk to their doctors about the medications they're taking and the potential risks of each medication as people get older. I think one thing that people don't often think about is that when clinical trials are being done, often many clinical trials have excluded older adults. So we don't always have a great sense of how these medications work in older adult populations. And on top of that, they may exclude people with chronic conditions who are already taking a variety of other medications. And so as a result, what is happening now is that we have many people who are taking these medications, and it hasn't been well tested in these populations. It hasn't really been, you know, we don't have a clear sense of what is happening when all of these medications are being taken together. So polypharmacy can really increase the risk of drug interactions. Speaker 1 (03:09): As I was saying, when one medication affects another, and this can lead to a variety of adverse effects. So for example, if someone is taking multiple medications that make you feel drowsy or sleepy when you stack them on top of each other–thinking again about that suitcase, that can lead someone to have an increased risk of falls, potentially a fracture resulting from those falls, car accidents if they're feeling very drowsy or dizzy and other medications can increase our risk of internal bleeding. Another thing that's really important to think about for older adults is that as we get older, our bodies undergo various changes that can alter how our medications are absorbed, distributed, and actually excreted from the body. So for example, kidney and liver function can really decline with age. And so that can actually affect how well we process the drugs through our body. Speaker 1 (04:05): What that means is that drugs may stay in our bodies for longer periods of time leading to more side effects or adverse effects. The last thing I really wanted to bring up is this idea of how things change as we get older. So we maybe have been taking a medication for many years, but as we get older because of the changes that are happening within our body, some medications, which were fine for us when we were younger, are now gonna lead to more serious adverse effects now that we're older. So older adults can be more sensitive to certain medications, so they might experience side effects more intensely or even at lower doses than younger individuals. They might feel the effects. So this is particularly true for medications that affect our central nervous system, our brain, right? So thinking about medications that are sedating or that have some sort of psychoactive effect. Speaker 1 (05:04): These medications, especially when they're combined together, can lead to things like confusion, dizziness, and an increased risk of falls. One medication which people often take to help them sleep is Benadryl or Tylenol PM. This medication is actually a drug that's really recommended to avoid in older adults because it can be very sedating, making people feel very drowsy throughout the day. And it actually also has the effects on the brain and has been associated with a higher increased risk of dementia. So these are medications that again, we don't think of as generally harmful, but again, in an older person might really be an issue. Speaker 2 (05:46): That's a really helpful example 'cause that's just an over the counter medication that anyone can get, even without a doctor. You recently published two papers looking at interventions for addressing polypharmacy. The first one was a review of several studies. What did you learn in that review about the effectiveness or not of programs that are designed to reduce harmful polypharmacy? Speaker 1 (06:08): So we reviewed several systematic reviews. These are collections, as you mentioned, of numerous studies to understand how well interventions to address polypharmacy are working. Many of these interventions include a process called de-prescribing, which is the process of systematically reducing or stopping medications that may no longer be beneficial or might be causing harm, particularly in older adults. The goal of deprescribing is to optimize an individual's medication regimen to improve their overall health and quality of life. What we found in this study was that interventions to address polypharmacy can do a great job of reducing medications which are potentially harmful, identifying which medications people should be taking, improving the appropriateness of the medications people are taking, and reducing the total number of medications. So thinking about outcomes related to medications, what we have found is that it is really hard to change more downstream clinical outcomes. Speaker 1 (07:11): Things like mortality falls, hospitalizations, and emergency department visits. We did find that interventions that had multiple components, in other words where a clinician is meeting face-to-face with a patient, reviewing their medications, reviewing all the chronic diseases that they have along with their full patient history of what has happened to them in the past, those interventions tend to have a greater effect on mortality. So in other words, those types of interventions are reducing the risk that someone actually dies. We also found that falls decrease when patients fully stop potentially harmful medications. So these may be medications that make people feel very dizzy or drowsy medications that may control somebody's blood sugar a little bit too much and so they're actually feeling very low blood sugar or medications where their blood pressure is overly controlled. So their blood pressure's a little too low, and they may actually fall as a result of these medications. Speaker 1 (08:12): But what we found was that stopping medications such as benzodiazepines, which are often taken for sleep or anxiety, can take months. These types of medications can have withdrawal effects. And so it's really, really important for somebody to work very closely with a healthcare provider to slowly taper these medications down, to try to reduce those withdrawal effects. And because it takes so long to fully stop these medications, it's hard for studies to really find an effect unless they're following that person for a long period of time, which studies often don't. And so that's one of the challenges that we've seen in the research is that studies haven't followed people for enough time. Or at the time that they're measuring some of these clinical outcomes, not enough time has gone by to really see the full effects. So what we have found in working with other researchers and clinicians is that when patients team up with a healthcare provider such as their primary care physician or clinical pharmacist who's embedded in the healthcare system, they really are able to stop taking some of these medications and they feel a lot better. They feel much more energy, they're able to do the things that they really enjoy. They have a greater quality of life, but it's something that just takes time. Speaker 2 (09:28): And I imagine it's something you have to balance when someone really might need a medication to treat something and then managing the side effects. That's really interesting. I know the second study looked at a particular intervention and this was the use of educational materials for benzodiazepines. What led you to explore this area and what did you find? Speaker 1 (09:49): Great question. So benzodiazepines are, as I mentioned earlier, medications that are often used for sleep or anxiety. The typical recommendation for benzodiazepines is that they really should be taken short term. These are medications that, you know, physicians typically recommend somebody take for a maximum of four weeks. What we have found in some of our research is that people are actually taking these for years, if not decades. And so stopping these medications can be quite challenging and sometimes patients aren't fully convinced about why they should be stopping these medications. So we took an intervention that started in Canada. It was developed by researchers in Canada, in Quebec, and this is called the Empower Intervention. And what we did is we tailored it to a health system here in the US. The Empower Intervention is a really great brochure that contains some pretty striking facts about benzodiazepines. Speaker 1 (10:45): To give you some examples of benzodiazepine, these are like your Xanax, your Ativan, your Klonopin. These are the medications that we're talking about here. These brochures highlighted some really interesting facts such as the fact that they can be harmful or linked to hip fractures and car accidents and they can make people feel very tired and weak. What we did for this intervention is we sent these brochures to about 300 people along with a letter from their primary care physician, emphasizing that these medications can be harmful if taken for too long and especially among older adults. So what we did for this study is we compared patients who had received these brochures to patients who did not receive them. So kind of they're going on their usual care, their physicians may have mentioned something to them. This was our control group, right? We didn't send anything to this particular group. Speaker 1 (11:40): We reviewed the medical records for both groups and we looked at what kinds of medications they had been prescribed. And what we found is that patients who received the brochures were really activated. You know, when they received this messaging, they would send messages in the patient portal to their physicians saying, I didn't know that there were these risks of these medications. I would really like to come in and talk to you about them. They made appointments to start tapering down these medications. What we found was for every 10 brochures that we sent, one person completely stopped taking these medications, which is a really good return on investment. This is a simple intervention. It has now been done in some other health systems in the US, particularly the Veterans Affairs health system. And you know, groups have found similar effects. We also found that the probability that someone in the intervention group completely stopped their medications was about 10% greater compared to the group that did not get the brochure. Speaker 1 (12:41): So again, you know, for a cheap simple intervention, we were pretty excited about these results. What's been really interesting is I just came back from two conferences, the US De-Prescribing Research Network and the Society for General Internal Medicine Annual Meeting. And we find that other researchers are also finding that engaging patients in reducing these potentially harmful medications is actually one of the most effective forms of deprescribing. There have been plenty of studies where researchers have actually engaged physicians and those have not been as successful. So what I'm really excited about in terms of thinking about future interventions is, how do we really engage patients in learning about what are the best options for them to manage their health? Speaker 2 (13:28): So you just said that physicians, it's been a little harder to see change in their prescribing behaviors. What do we know about ways they can introduce the idea of reducing or stopping a medication? Speaker 1 (13:39): Yeah, I think it's a great question. I think communicating when, how and why a medication should be reduced or stopped can be really challenging. What researchers have found is that when physicians focus on improving a patient's quality of life, that is what is most effective. So for example, thinking about stopping or reducing certain medications can give somebody more energy, help them move around better, they're not feeling as unsteady on their feet or dizzy. They can think more clearly because they're no longer feeling feelings of brain fog or sleepiness or drowsiness. I think these can be some really effective messages. I think some of the challenges that physicians face in de-prescribing is that de-prescribing takes a lot of time. As we all know, our primary care visits are very short. Physicians, particularly in the primary care setting, are really rushed through their visits. And so I think having some of these conversations can just be something that's challenging. Speaker 1 (14:41): I also think they're quite complex conversations to have. They may not have received the training, for example, on how to taper a medication in a safe way so that a patient does not feel withdrawal effects. And I do think that there is something about getting physician buy-in, in terms of, they are concerned about, you know, if they bring it up, the patient may be angry with them, they may be upset. And so I think really showing physicians ways in which this can be brought up that's really framed around, how do we center the patient's health and quality of life? I think those are are still questions that we as researchers are working on. Speaker 2 (15:17): We've talked about physicians and obviously patients themselves. How about caregivers? What role can they play in helping address some of these issues? And are there interventions that especially aim to include them? Speaker 1 (15:28): Yeah, great question. I think it's really important for caregivers to be aware of the medications their loved ones are taking. For many reasons. I think they can be amazing advocates in helping bring up potential side effects during doctor's visits. So for example, if a caregiver is noticing that someone is feeling drowsy or doesn't have that much energy or is feeling dizzy, any sort of cognitive impairments, right? So, such as those that may be seen in dementia, may actually be a result of medication side effects. So I think really becoming an advocate for somebody when seeing the doctor is one really important thing that caregivers can do. Another area where caregivers can play a really important role is among people with dementia. People with dementia can have some challenges in managing their medications. They may miss doses, they may take several medications twice, so they may have an overdose or they may take the wrong medication altogether. So caregivers can play really pivotal roles in helping somebody manage medication changes. There have been some early interventions looking at how to engage caregivers and persons with dementia. And some of the challenges that those researchers have seen is that there are often more than one person actually caring for somebody with dementia. And so engaging that whole group of people who may be working with that person has been a real challenge. Speaker 2 (16:54): Are there particular challenges faciing under-resourced communities or populations with language barriers? I imagine some of this communication is even harder in these cases. What do you think needs to be done in these areas? Speaker 1 (17:09): Absolutely. There is research showing that patients with language barriers have a greater risk of being hospitalized or rehospitalized because of some of the communication challenges that come with medication management. So you can imagine that for example, you know, older adults and their caregivers with language barriers may have a difficult time understanding medication instructions, which can lead to improper use. So when and how to take medications, recognizing potential side effects, understanding the purpose of each medication. And on top of that, you can layer on things like, you know, if somebody doesn't have a great understanding of the condition, right? So we call that disease literacy. Or they may have health literacy issues, or on top of that, we may even have literacy concerns where the person does not know how to read or has a limited ability to read. So layering on all these challenges can really make it difficult to both manage your medications and communicate with physicians about their concerns or side effects regarding medications. Speaker 1 (18:14): Right now, mentee and I are working on this review of interventions that have been done specifically for patients with language barriers focused on improving medication management. And what we found was that interventions that really engaged people from communities with language barriers have been some of the most effective ways to really help people learn about which medications are working really well for them, how to improve medication adherence and other important outcomes. So for example, an intervention that we found was researchers engaged folks in the community. They co-created videos about medications in the community and why it was important to take them. And then when they actually distributed these interventions, they made sure that both in terms of the videos and some of the other educational materials that were handed out to folks, that these really were very tailored both language wise, literacy wise, and culturally tailored to the communities that they were serving. Speaker 2 (19:16): Another area I wanna touch on is your work improving doctor patient communication. And I'm curious if your background as a newspaper reporter has informed your research in this area, and what are some of the ways that patients lose out when communication is not clear? Speaker 1 (19:32): So I think a lot about how we can help clinicians communicate complex information about medications and other treatments in simple, accessible ways. Which is really something that I aimed to do as a reporter, right? When I worked as a reporter, oftentimes I would take studies from medical journals and I would break them down in a way that was really easy and accessible for the public to read. And so that is really something that I'm very interested in. How do we help clinicians do the same thing? Or if we're designing interventions for patients, how do we do something similar? How do we make the risks and benefits of medications very clear to people so that they're able to make the best decisions about those for their health? So one area that I'm really interested in is these new medications for dementia that have come out, which are the anti amyloid medications. These medications have some pretty potentially serious side effects such as brain bleeding and swelling. And I'm working on a research proposal thinking about, how do we best present these medications to patients in a way that they feel like they're able to make the best decisions for themselves and their loved ones? I think it'd be really critical, particularly in terms of health equity for people to have a very good sense of how these medications can potentially help but also understand the serious risks associated with the new dementia medications. Speaker 2 (21:02): And speaking of dementia, I think you've also looked at the diagnosis of dementia and whether or not there's differences in minority populations. Is that something you can tell us a little bit about? Speaker 1 (21:14): Absolutely. So that is an area of research that I'm actually just starting to get into because what we are learning is that older black and Latino adults tend to get diagnosed with dementia once the disease has progressed more. And what that means is that they may not have received some of the services that may help them or their families. So for example, they may not have received enough support to be able to plan for the rest of their lives, or their families may not necessarily have received caregiving support early on in disease progress. I think in regards to these particular dementia medications, for example, if older adults are diagnosed with dementia at a place where they're no longer eligible to receive these medications, I think that'll be a really pretty serious health equity issue. So I am really interested in, how do we make sure that people are getting diagnosed in time to make them eligible for really potentially beneficial treatments that may help them down the road? So I'm thinking about how do we train physicians who are working in under-resourced settings, which may serve large proportions of black and Latino older adults, how to diagnose dementia in a primary care setting, and working with some colleagues in the Los Angeles Department of Health Services on how we can think about making physicians feel more confident, their diagnosis of dementia among older adults. Speaker 2 (22:40): And I wanna go back to sleep and anxiety because I know that's something that affects so many people at all ages. If these interventions are successful and people are able to stop taking some of these medications, are there strategies or interventions that we know might work for helping them with the initial conditions they were struggling with to begin with? Speaker 1 (23:01): Yeah, absolutely. I think that's a really good question because sleep and anxiety are things that can really affect somebody's quality of life and functioning, right? The most effective strategies that we see de-prescribing these medications is offering something else. So for example, some of the most evidence for insomnia really exists around using cognitive behavioral therapy. There's also been really well done systematic reviews that have found evidence that music or acupuncture may help people with insomnia. So I think one thing that's very important to think about when we de-prescribe medications is what else can we offer people? We're not just leaving people in the lurch and saying, we're taking this away and we're leaving you with nothing. We're actually able to offer them some non-pharmacological options as well. Speaker 2 (23:48): That's a really helpful note to end on. Thank you for joining us, and I know that people are really gonna benefit from learning about all you've been working on and all your work that's gonna continue in the future. Speaker 1 (23:59): Thank you so much for having me today. It's been a real pleasure. Speaker 2 (24:02): That wraps up this lesson in Lifespan Health. Thanks to Professor Michelle Keller for her time and expertise and to all of you for choosing to listen. Join us next time for another Lesson in Lifespan Health, and please subscribe to our podcast@lifespanhealth.usc.edu. Lessons in Lifespan Health is supported by the Ney Center for Healthspan Science.

In this engaging episode, Dr. Fred interviews Dr. Romi Fung, a naturopathic physician from British Columbia, Canada, who specializes in cognitive decline, dementia, and optimizing cognitive well-being through natural means. Dr. Fung shares his inspiring journey from overcoming mental health challenges and a sensitive gag reflex in his youth to discovering naturopathic medicine. The conversation delves into fascinating topics surrounding cognitive decline, including the role of lifestyle factors, diet, inflammation, sleep, and detoxification. Dr. Fung highlights the importance of addressing the root causes and looking at the body as a whole system, rather than just treating the diagnosis. Drawing from the remarkable longevity and cognitive health observed in "Blue Zones" like Okinawa, Japan, Dr. Fung emphasizes that up to half of cognitive decline cases may be preventable through lifestyle modifications. He also discusses the potential for mitigating and even reversing cognitive decline in some cases through a holistic approach. Throughout the episode, Dr. Fung offers insightful perspectives on the role of medications, the challenges of polypharmacy, and the need for collaboration among healthcare practitioners. His parting advice? "The earlier, the better" when seeking help for cognitive decline, as early intervention can significantly impact the prognosis.     Links: FB: https://www.facebook.com/DrRomiFungND Linkedin: https://www.linkedin.com/in/drromifungnd/ Website: https://www.drromifungnd.com/about-dr-romi-fung-nd IG: @DrRomiFungND YouTube: https://www.youtube.com/@DrRomiFungND Email: Contact@DrRomiFungND.com     Show Notes: Cognitive decline prevention and blue zones for optimal brain health. 0:05 Preventing cognitive decline through lifestyle changes, including diet, exercise, sleep, and stress management. 4:49 Medications' roles in dementia prevention, including antidepressants, anti-anxiety agents, and thyroid medication. 9:25 Medications for dementia, including Aricept, Exelon, and Namenda, with a focus on their effectiveness and potential ris 12:51 Challenges in conventional medicine, including polypharmacy and lack of collaboration among clinicians. 16:48 Mental health, cognitive decline, and naturopathic medicine. 20:36  

About this episode: One in five U.S. adults is taking five or more prescription drugs at a time, often for years without reassessment of need, dosage, or possible interactions. Today, a look at polypharmacy and why it's important for physicians to periodically check in with patients about all the prescription—and nonprescription—drugs they're taking. The guests also discuss the importance of considering non-pharmaceutical treatments like physical or talk therapy, and empowering patients and their care partners to ask questions about what they're being prescribed. Guests: Dr. Cynthia Boyd is a geriatrician and faculty at Johns Hopkins Medicine. She is also a senior associate with the Johns Hopkins Center on Aging and Health. Dr. Ariel Green is a geriatrician and faculty at Johns Hopkins Medicine. She is also a core faculty member of the Johns Hopkins Bloomberg School of Public Health Center for Drug Safety and Effectiveness. Host: Stephanie Desmon, MA, is a former journalist, author, and the director of public relations and communications for the Johns Hopkins Center for Communication Programs, the largest center at the Johns Hopkins Bloomberg School of Public Health. Show links and related content: Taking Multiple Medications? You May Need to Scale Back.—The New York Times Taking more than 5 pills in a day? ‘Deprescribing' can prevent harm—especially for older people—The Conversation Contact us: Have a question about something you heard? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on X @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed

In this episode of Managed Care Cast, Nihar Desai, MD, MPH, cardiologist and vice chief of Cardiology at the Yale School of Medicine, discusses therapies for cardiovascular conditions as they relate to patient adherence, polypharmacy, and health access.

Patrick Alonso is a catalyst for change in healthcare, driven by an unyielding commitment to progress. As the force behind Your Tampa Healthcare Advocate, he fearlessly advocates for his client's health and well-being, leveraging his expertise as a licensed Florida Pharmacist for health and wellness. During Pharmacy school, Patrick transformed his lifestyle after realizing his family history of heart disease and the impact of healthy choices. Previously, his roles as a pathology-genetics laboratory liaison and owner of Chupacabras Baseball Academy exposed him to the toll of stress and unhealthy habits. This realization inspired him to prioritize whole foods, exercise, sleep, and self-care. Patrick's journey also led to the inception of Men's Health Unscripted, a platform dedicated to advocating for men's mental, physical, and emotional health. As Founder and Consultant Pharmacist at Your Tampa Healthcare Advocates, he excels in healthcare advocacy, notably improving health outcomes for his clients enduring chronic diseases like diabetes, high blood pressure, heart disease, stroke, and mild to moderate dementia. Patrick helps his clients by handling the stressful aspects of the healthcare system, managing medications, and working with their physicians to create tailored treatment plans that best suit theirlifestyle. Recognized for leadership by the USF College of Pharmacy, Patrick Alonso's diverse background underscores his commitment to innovation and community health. www.georgebatista.com

Today's sponsor of the 10 Commandments of Polypharmacy podcast is FreedAI. Freed listens, transcribes, and writes medical documentation for you. FreedAI is offering a discount exclusive to RLP listeners! Users will get $50 off their first month with Freed! Use the discount code: RLPPOD Here is part 2 of 2 on the final 5 of the 10 commandments of polypharmacy. 6. Thou shalt identify limits for medications not intended for chronic use as well as not continue a medication indefinitely for symptoms that have an expected short duration 7. Thou shalt not start a medication from a similar medication class without appropriate rationale 8. Thou shalt not initiate a medication without considering medications that may treat duplicate conditions – Kill two birds with one stone 9. Thou shalt consider eliminating or reducing medications at every medication review 10. Thou shalt be willing to accept risk in discontinuing a medication if they were willing to accept the risk of initiating a medication

What is Polypharmacy? (WBH with Dr. Saleeby Ep. 18) Learn more about Whole Body Health: https://covid19criticalcare.com/courses/whole-body-health-with-dr-saleeby/ Are you taking multiple supplements and multiple medications? You wouldn't be alone if so. Discover the complexities of "polypharmacy" in this latest episode of Whole Body Health. Dr. JP Saleeby explains that polypharmacy means taking many medications or supplements, which can sometimes cause problems, like bad reactions between drugs or taking more than you need. Not to worry! In this video, Dr. Saleeby shows you how to figure out what medications and supplements are really necessary and how to avoid these issues. Join us to learn simple steps to handle taking multiple medications or supplements safely. Dr. JP Saleeby | Carolina Holistic Medicine
 https://carolinaholisticmedicine.com/ Dr. JP Saleeby's Substack | Yusuf's Substack
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This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only. Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.

In this episode of Health 411, host Dr. Jonathan Karp and student producer Marina JB are joined by Patrick Alonso, pharmacist and health advocate. Join us as Patrick gives talks about his personal experience with Polypharmacy and how he shaped a career around filling the gaps made by medicine.

On this special episode, I provide some real-life examples and layout 5 of my 10 commandments of polypharmacy. Today's sponsor of the Top 10 Anticoagulant Drug Interactions podcast is FreedAI. Freed listens, transcribes, and writes medical documentation for you. FreedAI is offering a discount exclusive to RLP listeners! Users will get $50 off their first month with Freed! Use the discount code: RLPPOD Here are the first 5 commandments that are addressed in the podcast. 1. Thou shalt not start, ask for, dispense, or administer medication without reviewing a medication list that is accurate, up to date, and complete with over-the-counter medications and supplements 2. Thou shalt consider utilizing non-drug approaches and interventions to solve patient problems before initiating medication 3. Thou shalt assess if a medication is effective before adding a new medication for the same condition 4. Thou shalt consider any new symptom is an adverse effect of another medication until proved otherwise 5. Thou shalt not start a medication without an appropriate indication and assessing appropriate lab work

Join us for a discussion on medication awareness and prescribing cascades with Paula Rochon, a geriatrician. As we embark on a new year, many focus on diet and exercise resolutions, but overlooking medication management can have profound implications for health. With nearly 4 in 10 adults over 65 taking five or more medications, polypharmacy is a pressing concern. In this episode, Paula shares insights into the risks of polypharmacy, particularly for older adults, and illuminates the phenomenon of prescribing cascades. Learn how recognizing and addressing prescribing cascades can mitigate unnecessary medication use and improve patient outcomes. Paula Rochon is a geriatrician. She discusses the KevinMD article, "Now is a good time to reassess your medications with your clinician." Our presenting sponsor is Nuance, a Microsoft company. Together, Microsoft and Nuance are leveraging their rich digital technology and advanced AI capabilities to tackle some of health care's biggest challenges. AI-driven technology promises to revolutionize patient and provider experiences with clinical documentation that writes itself. The Nuance Dragon Ambient eXperience, or DAX for short, is a voice-enabled solution that automatically captures patient encounters securely and accurately at the point of care. DAX Copilot combines proven conversational and ambient AI with the most advanced generative AI in a mobile application that integrates directly with your existing workflows. Physicians who use DAX have reported a 50 percent decrease in documentation time and a 70 percent reduction in feelings of burnout, and 85 percent of patients say their physician is more personable and conversational. Discover AI-powered clinical documentation that writes itself. Visit https://nuance.com/daxinaction to see a 12-minute DAX Copilot demo. VISIT SPONSOR → https://nuance.com/daxinaction SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://earnc.me/IkYiYX Powered by CMEfy.

This episode of Vitality Radio features a return of the Vital Rant! Jared discusses a PubMed article titled the War Against Polypharmacy. Data suggests that among those who take prescription medications, the average number of medications taken is four! Many are taking far more than that. You'll learn about the mortality risk increase with multiple pharmaceutical drugs and how you can reduce that risk by finding natural alternatives to many of those drugs.Jared also interviews Shane and Liz Watt about the Be Healthy Utah Natural Health and Wellness Conference taking place this month in Sandy, Utah. If you aren't local to Sandy, you will have the opportunity to hear the recorded presentations after the event as well so you won't want to miss hearing about the lineup of speakers for the event!Finally, Jared shares another Homeopathic Minute from his series of quick, easy to digest information on single homeopathic remedies. Today's remedy is Belladonna.Products:Belladonna HomeopathicAdditional Information:The War Against Polypharmacy - PubMed article#260: Prescribing Poisons. Commonly Prescribed Drugs; Are the Risks Worth the Benefits? Part 1#414: A Natural Approach to Healthy Blood Pressure#266: Prescribing Poisons Part 2. Ibuprofen, PPI's, and Flouroquinalone Antibiotics#264: Jen's Story: How One Woman Fought Through Addiction, Mental and Physical Illness to Find Vitality.#227: VR Vintage: There is an Herbal Supplement that Works for Diabetes, Blood Pressure and Cholesterol Better than Drugs! Berberine is that Powerful!#347: Thyroid Health: Why Your Doctor Might Be Looking at the Wrong Numbers With Dr. Todd Cameron#407: Deep Dive on Nattokinase: A Special Enzyme with Cardiovascular Benefits and More with Julia Craven#259: Osteoporosis: Answering all of Your Big Questions of how to Prevent and Reverse it Naturally!#260: Prescribing Poisons. Commonly Prescribed Drugs; Are the Risks Worth the Benefits? Part 1Be Healthy Utah discount code: vitality40BeHealtyUtah.com***Be sure to listen to Wednesday podcasts this year for Jared's Homeopathic Minute to learn more about specific remedies.#393: What Is Homeopathy and How Does It Work? With Guillaume LoisVisit the podcast website here: VitalityRadio.comYou can follow @vitalityradio and @vitalitynutritionbountiful on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Please also join us on the Dearly Discarded Podcast with Jared St. Clair.Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

This is a special edition, TSC Talks Revival episode with Justin Leslie! Justin is an ex-Pfizer scientist and whistleblower. Justin was also one of my first guests on my podcast "TSC Talks" in 2018, (https://bit.ly/3Iz0FUU) where he shared his story about his experience with diagnosis and living with TSC. This clip is a short glimpse from our full conversation, dropping soon. In "Project Whistleblower" Justin shares his personal journey, including living with Tuberous Sclerosis Complex (TSC), a condition that not only shaped his childhood but also inspired him to pursue a career in pharmacology, aiming to find a cure for his condition.During his time as a vaccine scientist at Pfizer, Justin began to collaborate undercover with Project Veritas. This partnership led to the revealing of mind blowing revelations about the COVID-19 ‘scamdemic' and other alleged misconduct within Pfizer. However, he soon started to observe concerning behaviors within Project Veritas, such as the suppression of timely truths and vaccine concerns. These observations led him to question the integrity of the organization and its founder, James O'Keefe.In collaboration with Marty Leeds, Justin has produced the compelling documentary “Project Whistleblower.” This film delves into his experiences and his growing awareness of the covert tactics and manipulations at Pfizer, Project Veritas, and OMG Media Group. In an era rife with lies and deception, the documentary underscores the revolutionary act of truth-telling." (credit to Amanda Vollmer: https://yummy.doctor/video-list/advocates-for-truth-amandha-vollmer-adv-with-justin-leslie/)Contact info for Justin!Justin Leslie: https://justintegrity.net/Justin's Linktree: https://linktr.ee/justinleslieContact: justinleslie3@protonmail.comDonate to Justin's work: https://www.givesendgo.com/ProjectWhistleblowerWATCH THE DOCUMENTARY HERE:  https://justintegrity.net/project-whistleblower/Produced by: https://linktr.ee.com/jillwoodworth https://jillwoodworth.comShort clip produced by @jillwoodworth https://jillwoodworth.comBecome a supporter of this podcast: https://www.spreaker.com/podcast/tsc-talks--1666046/support.

Listen to Roger Bedimo, MD, MS, FACP, discuss considerations for older people living with HIV, including:Polypharmacy and deprescribingThe risk of cardiovascular events with various ART regimensApproaches for managing weight gainPresenter:Roger Bedimo, MD, MS, FACPProfessor of MedicineInterim Director, Office of Global HealthUT Southwestern Medical CenterChief, Infectious Diseases SectionVA North Texas Health Care SystemDallas, TexasGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.To download the slides:  https://bit.ly/49zrnZsTo view the full online program:https://bit.ly/49x0W6D

This episode of the Flow Radio podcast features Dr. Peter H. Diamandis, the entrepreneur behind 20 companies in the areas of longevity, space, venture capital, and education. Diamandis joins FRC executive director and bestselling author, Steven Kotler, for a deep dive on flow, entrepreneurship, and the cutting-edge science of human life-extension. This episode is a must-listen for anyone who wants to implement science-backed strategies to support a longer and more effective lifespan. In This Episode: 0:00 Introduction 05:25 Uncertainty and the Desire to Go Big 09:53 The Biggest Longevity Levers 26:14 Cutting-Edge Developments in Longevity 31:48 Supplements and Polypharmacy 41:50 Diagnostics and Mindset 1:01:42 Epigenetic Reprogramming About The Guest: Named by Fortune as one of the “World's 50 Greatest Leaders,” Peter H. Diamandis is the founder and executive chairman of the XPRIZE Foundation, which leads the world in designing and operating large-scale incentive competitions. He is also the executive founder of Singularity University, a graduate-level Silicon Valley institution that counsels the world's leaders on exponentially growing technologies. Episode Resources: Website: ⁠https://www.diamandis.com/ ⁠ LinkedIn: ⁠https://www.linkedin.com/in/peterdiamandis/ ⁠ X: ⁠https://twitter.com/PeterDiamandis/ ⁠ Instagram: ⁠https://www.instagram.com/peterdiamandis/ ⁠ Facebook: ⁠https://www.facebook.com/PeterDiamandis/ ⁠ Flow Radio Is Presented By Flow Research Collective Are you an entrepreneur, a leader, or a knowledge worker, who wants to harness the power of flow so you can get more done in less time with greater ease and accomplish your boldest professional goals faster? If the answer is yes, then our peak-performance training Zero To Dangerous may be a good fit for you. Flow Research Collective is a leading neuroscience research and training company. If you're interested in learning the science-backed techniques we used to train top executives at Facebook, Audi and even the Navy SEALs, click the link here: ⁠⁠https://www.flowresearchcollective.com/zero-to-dangerous/overview⁠⁠ Follow Flow Research Collective: YouTube: ⁠⁠https://www.youtube.com/@flowresearchcollective⁠⁠ Instagram: ⁠⁠https://www.instagram.com/flowresearchcollective⁠⁠ LinkedIn: ⁠⁠https://www.linkedin.com/company/flowresearchcollective⁠⁠ X: ⁠⁠https://twitter.com/thefrc_official⁠⁠ Facebook: ⁠⁠https://www.facebook.com/flowresearchcollective⁠⁠ Spotify: ⁠⁠https://open.spotify.com/show/6RQY0d5rdlEiinHEtfWy6A⁠⁠ Website: ⁠https://www.flowresearchcollective.com/⁠ Flow Research Collective was founded by Steven Kotler, one of the world's leading experts on human peak performance. He is an award-winning journalist and author with over ten bestselling books.

In this episode, Tamara and Scott delve into the dynamic realm of pharmacogenomics within the long-term care. Covering its advantageous impacts and supported by research demonstrating its value, we offer an insightful overview of the presence and significance of pharmacogenomics in long-term care. Dr. Scott Stewart:  linkedin.com/in/scott-stewart-34973870 Dr. Tamara Ruggles:  linkedin.com/in/tamara-ruggles-491882251 References:  - Jokanovic N, Jamsen KM, Tan ECK, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and Variability in Medications Contributing to Polypharmacy in Long-Term Care Facilities. Drugs Real World Outcomes. 2017;4(4):235-245. doi:10.1007/s40801-017-0121-x - Saldivar JS, Taylor D, Sugarman EA, et al. Initial assessment of the benefits of implementing pharmacogenetics into the medical management of patients in a long-term care facility. Pharmgenomics Pers Med. 2016;9:1-6. Published 2016 Jan 19. doi:10.2147/PGPM.S93480 - Kistler CE, Austin CA, Liu JJ, et al. The feasibility and potential of pharmacogenetics to reduce adverse drug events in nursing home residents. J Am Geriatr Soc. 2022;70(5):1573-1578. doi:10.1111/jgs.17679 - Hayashi M, Hamdy DA, Mahmoud SH. Applications for Pharmacogenomics in Pharmacy Practice: A Scoping Review. Res Social Adm Pharm. 2021. Epublication ahead of print. - Rodriguez-Escudero I, Cedeno JA, Rodriguez-Nazario I, et al. Assessment of the Clinical Utility of Pharmacogenetic Guidance in a Comprehensive Medication Management Service. J Am Coll Clin Pharm. 2020;3(6):1028–1037. - PGx in the Long-Term Care Environment. RxGenomix. Accessed January 30, 2024. https://rxgenomix.com/insight/pgx-in-the-long-term-care-environment/ Scott Stewart PharmD  Tamara Ruggles PharmD BCGP

Doctors Lisa and Sara talk to Senior Pharmacist Sarah Hafeez about Polypharmacy. She explains the difference between inappropriate and appropriate polypharmacy before talking through some typical cases that illustrate several examples of common scenarios.  This leads to discussions on prioritising concerns, weaning/stopping medications, counselling patients on the effects of Opioids and Gabapentinoids and involving community teams aiming for successful reductions of addiction forming medications. Other gems include a discussion of the potential long term risks of Proton Pump Inhibitors and advice on weaning, remembering to consider anticholinergic burdens as well as handy resources for tackling Polypharmacy, Structured Medications Reviews and medication reductions. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Useful resources:  Greater Manchester Medicines Management Group: Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack (from Dec 2022, accessed Dec 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/02/GMMMG-Polypharmacy-resource-pack-v3.0.pdf Scotland Polypharmacy Resources for Professionals and for Patients: https://www.polypharmacy.scot.nhs.uk/for-patients-and-carers/ Scottish Polypharmacy Guidance 2018: https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf Lewis T. Using the NO TEARS tool for medication review. BMJ. 2004 Aug 21;329(7463):434. doi: 10.1136/bmj.329.7463.434. PMID: 15321901; PMCID: PMC514207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514207/ Toolkit for General Practice in Supporting Older People Living with Frailty (includes a great Appendix of the STOPP/START criteria (2017): https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf An example of an Anticholinergic Burdon Resource from West Essex CCG 2020: https://westessexccg.nhs.uk/your-health/medicines-optimisation-and-pharmacy/clinical-guidelines-and-prescribing-formularies/04-central-nervous-system/61-anticholinergic-side-effects-and-prescribing-guidance/file Canadian Resource for Deprescribing including reducing medications and some patient information leaflets: https://deprescribing.org/ Resource for help reducing and stopping medications: https://medstopper.com/ Me and My Medicines Resource for Patients to look through their medications before reviews or for information: https://meandmymedicines.org.uk/ Anticholinergic Medications and Risks of Dementia Cochrane Editorial with Reports in Link (Sept 2021): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000154/full Anticholinergic drugs and risk of dementia: Time for action? British Pharmacological Society. Bell B et al Jun 2021 (9:3). Accessed 15/1/2024:  https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1002/prp2.793 Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder. Clin Interv Aging. 2020; 15: 1493–1503: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457731/ Greater Manchester Medicines Management Group: Management of Overactive Bladder Including a simple Bladder Diary before and after stopping Medications (Jun 2019): https://gmmmg.nhs.uk/wp-content/uploads/2021/08/Management-of-OAB-in-adults-v3-0-approved-Aug-2019.pdf ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Welcome back to the Stronger Bones Lifestyle Podcast. Today Debi welcomes back spinal surgeon Nick Birch to discuss the importance of orthopedic surgeons when it comes to the diagnosis of Osteoporosis. In 2018 Nick founded OsteoscanUK with the intention of offering high quality bone health assessments locally, rather than in a hospital setting, using the Echolight REMS system and has carried out over 2200 REMS scans. Listen today as he discusses using melatonin to reverse osteoporosis, why a standard diagnosis of osteoporosis can lead to more bone loss and how orthopedic surgeons can use new technology like the REMS scan to make proper diagnoses.Join Nick and Debi as they talk about polypharmacy, internal balance versus external balance, the body's ultimate goal and the importance of what we are doing to our bodies.Key  Takeaways:[2:32] Melatonin[4:21] Shape of brain and jet lag[6:12] The issues with the treatments for osteoporosis[7:21] What are we missing[10:16] Intelligence of our body[11:09] Fair test[12:57] Stress can lead to all disease[15:06] Anxiety in rats[16:51] Bone toughness[17:42] Orthopedic surgeons[19:19] Diagnosis leads to more bone loss[20:36] Nick's training[21:18] The importance of what we are doing to our bodies[21:55] Polypharmacy[23:04] Internal imbalance[24:48] Preventative costs[26:05] You're never at zero risk of fracturing[26:51] Debi's mission[29:12] The body's ultimate goal[31:27] The best way to test your bonesWhere to Find Guest:WebsiteEp 39: Bone Nutrients, Bone Density and a Better Bone Scan with Nick BirchEp 44: Diagnosing Osteoporosis- REMS, A Better Bone Scan with Nick BirchMemorable Quotes:"What are we missing in our lives and how do we fix that?" [7:21] – Nick"It cant just be about the amount of bone, it has to be the quantity." [18:34] -Nick"We are so focused on external balance with osteoporosis, we work on that, standing on one leg, strengthening our balance, yet its that internal balance of bone metabolism that we haven't focused on." [23:08] - Debi"We need to give our body what it needs to find that balance." [29:30] – Debi To learn more about me and to stay connected, click on the links below:Instagram: @debirobinsonwellnessWebsite: DebiRobinson.comHealthy Gut Healthy Bones Program

So, let's talk about polypharmacy in relation to geriatrics and how it's detrimental to our way of care... Do you have a family member, a loved one, a coworker, and/or a friend who is 60 years old and above and has a lot of medication in their dresser right now? According to statistics, the use of one or more prescription drugs is more common among adults aged 60-79 compared with those aged 40-59. This, in and of itself, usually leads to a growing concern called polypharmacy. In layman's terms, polypharmacy is when an individual is given lots of medications (five and above) that are to be taken all at the same time. And although commonly believed to be normal, the truth is, it's detrimental, especially to our elderly. If not managed correctly, these people will have increased chances of dying. But we don't want that to happen, so sit back and relax as I present to you a discussion about this concern. Together, let us discover how we can help prevent further complications for those involved. Why you need to check this episode: Find out what polypharmacy is and how it affects people's overall health and well-being, especially the elderly Discover the reasons for polypharmacy, as well as the strategies for prevention and management; and Understand how important it is to work with those involved in order to provide the best care for the patients “In the medication that they are, they are at an increased risk to have drug-drug interaction; they are at an increased risk to have medication non-compliance. So, you need to, as the doctor, try to figure out a way. 'Is there a way I can help this person?”– Dr. Berry Pierre Notable Quotes: "We are getting older. And if we are getting older, you best believe problems can arise." - Dr. Berry Pierre "Let's pump the breaks here—we are not only getting older; we are getting older faster over the last 100 years." - Dr. Berry Pierre "Because we're getting older, our diseases are getting older with us. So, we're having to deal with high blood pressure longer; we're having to deal with high cholesterol longer. We're having to deal with all of these things much longer than expected." - Dr. Berry Pierre "You need to have one central person who, even if they're not the one person who prescribes all these medications, they're the one person who knows about these medications." - Dr. Berry Pierre "An engaged patient is a compliant patient." - Dr. Berry Pierre Sign up at www.listentodrberry.com  to join the mailing list. Remember to subscribe to the podcast and share the episode with a friend or family member. Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, and Spotify