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September 25th, 2013

Podcast 168: The Camden Coalition’s work on alleviating the discontinuity of medical care

(3 votes, average: 3.67 out of 5)

Running time: 10 minutes

The Camden Coalition of Healthcare Providers formed about 10 years ago as a quarterly breakfast club of primary-care providers who were frustrated in their attempts to bring care to comprehensive care to their patients in Camden, N.J.

The Coalition’s found and executive director, Dr. Jeffrey Brenner (himself a family physician) has just been awarded a MacArthur Foundation fellowship, and so we caught up with him for a quick chat.

Link:

The coalition’s website

September 14th, 2013

Podcast 167 — The polypill: adherence at last?

(4 votes, average: 3.00 out of 5)

Running time: 7 min

The recent JAMA article examining the effects of the “polypill” on adherence and clinical benefits in patients with (or at high risk for) cardiovascular disease, is our topic. The polypill in this trial contained fixed doses of four separate drugs: aspirin, a statin, lisinopril and one other blood-pressure-lowering drug — either atenolol or hydrochlorothiazide.

Adherence among patients on the polypill was 20 percentage points higher than among those following regular multi-pill regimens. It was even higher — by some 40 percentage points — among those least adherent to their regimens at the start of the 15-month trial.

Dr. Anthony Rodgers of the University of Sydney — the paper’s senior author — talks with us about the trial.

Links:

Physician’s First Watch coverage of the trial (free)

JAMA article (free)

August 21st, 2013

Podcast 166: Delirium and intensive care

(5 votes, average: 3.80 out of 5)

Running time: 19:45

This week’s guest is Yoanna Skrobik, a Montreal intensivist and author of an intriguing commentary on a Lancet Respiratory Medicine paper on the (non)effect of haloperidol in influencing the incidence or length of delirium/coma in critically ill patients.

Physician’s First Watch coverage of the Lancet articles

Nurse-facilitated family participation

Early physical/occupational therapy in mechanically ventilated patients

August 15th, 2013

Podcast 165: The Mediterranean diet’s salutary interaction with risk-conferring genes

(2 votes, average: 4.50 out of 5)

Running time: 14 minutes.

A study in Diabetes Care shows that people at higher genetic risk for diabetes and cardiovascular complications had a relatively lower stroke risk when they adhered to a Mediterranean diet. Dr. Jose Ordovas, the study’s senior author, is our guest for this discussion about the interaction between genes and diet — and its implications even for those without risky genetics.

Diabetes Care abstract (free)

Physician’s First Watch summary (free)

August 1st, 2013

Podcast 164: Talking about death

(3 votes, average: 2.67 out of 5)

Running time: 11 minutes

Last month John You and his colleagues published a guide to discussing advance care planning with patients at high risk of dying in the Canadian Medical Association Journal.

It’s full of practical advice, and I thought it would be interesting to get a sense of You’s approach to this difficult issue that all clinicians confront sooner or later.

Links:

Physician’s First Watch coverage of the CMAJ paper.

Link to the prognosis estimators.

June 14th, 2013

Podcast 163: Boston bombings – 4

(2 votes, average: 4.00 out of 5)

Dr. Brien Barnewolt of Tufts Medical Center shares his thoughts on the aftermath of the April 15 bombings at the Boston Marathon. Simple things matter in these circumstances, like wearing your ID badge.

Length: 9 minutes

Clinical Conversations

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