Primary Care Update

Primary Care Update

Four healthily skeptical primary care physicians discuss the latest in primary care medicine. Join Essential Evidence Editor Mark Ebell MD, Rush University's Kate Rowland MD, MSU Professor of Medicine Gary Ferenchick MD, and POEMs co-founder Henry Barry MD, MS for this fast-paced weekly update on evidence-based primary care.

Episodes

July 16, 2025 32 mins

This week our intrepid primary care docs discuss 4 new POEMs: spironolactone vs amiloride for resistant hypertension, mirtazapine for insomnia in older adults, baloxivir for influenza post exposure prophylaxis, and platelet-rich plasma injections for knee osteoarthritis. We've got opinions!

Show notes:

Spironolactone vs amiloride for resistant hypertension: pubmed.ncbi.nlm.nih.gov/40366680/

Mirtazapine for chronic insomnia...

Mark as Played

Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs: a new and very hard to pronounce antibiotic for uncomplicated UTI, the best drugs for relieving pain in adults with fibromyalgia, a clinical trial of a multicancer detection test in asymptomatic persons, and bedtime vs morning administration of antihypertensives.

Gepotidacin for uncomplicated UTI: https://pubmed.ncbi.nlm.nih.gov/38342126/

Drugs for fibromyalgia: ...

Mark as Played

This week, join Kate, Mark and Henry as they discuss all in one triple inhalers for COPD, the best medication for pain management in children and suzetrigine, a new medicine for acute pain in adults. Gary is off this week, working on his French lessons. And we add intro music! Yay!

Mark as Played

Join Mark, Henry, and Gary (we are Kate-less unfortunately this week) for discussion of epidural steroid injections for adults with radicular back pain, post a fib ablation management, and oral semaglutide for high-risk patients with Type 2 DM


Mark as Played

This week, Kate, Mark, Gary and Henry discuss 4 great new POEMs: foot care wipes for patients at risk of diabetic foot infection, resuming DOACS following intracerebral hemorrhage in adults with a fib, treating prediabetes with tirzepatide, and more on intermittent fasting.

Show links

BMJ Magic Evidence interactive review of diabetes medications. A great practice and teaching tool: https://matchit.magicevidence.org/230125dist-diab...

Mark as Played

This week, Kate, Gary, Mark and Henry chat about the health effects of dance for older adults, POCUS for diagnosing clavicular fractures, treating male partners of women with BV, and prehabilitation  before elective surgery .

Links:

Dance for older adults: https://pubmed.ncbi.nlm.nih.gov/39480190/

POCUS for clavicle fractures: https://pubmed.ncbi.nlm.nih.gov/39626455/

Oral + topical treatment of male partners for BV: ...

Mark as Played

This week join our intrepid primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new studies: an experimental treatment for chronic migraines, safety of albuterol in wheezy kids under 2, oral gepotidacin for uncomplicated UTI, and vitamin K2 and Leg Cramps.

Here are the links:

Lukas' Fund supporting the Piedmont Athens and Grady Atlanta NICUs: https://www.lukasfund.org

Essential Evidence Plus: http://www.essentia...

Mark as Played

This week Kate, Gary, Mark and Henry discuss discontinuation of benzodiazepines and treatment of insomnia, the value of baseline cognitive testing of college athletes, vonoprazan vs PPI for preventing and treating ulcers, and whether herpes zoster vaccine reduces dementia risk.

Show links:

Essential Evidence Plus: www.essentialevidenceplus.com

Tapering benzos: https://pubmed.ncbi.nlm.nih.gov/39374004/

Baseline neuro eval...

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This week Gary, Mark, Kate and Henry discuss: adverse effects from inhaled steroids in asthma, Italian dementia guideline, fezolinetant for treatment of vasomotor symptoms, and updated USPSTF recommendations for osteoporosis screening.

Show notes and links:

Asthma and risk of CV events: https://pubmed.ncbi.nlm.nih.gov/39088770/

GINA 2024 guidelines: https://ginasthma.org/2024-report/

Italian dementia guidelines: https://www...

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Join Kate, Gary, Mark and Henry as they discuss 4 new POEMs relevant to primary care: bright light therapy for non-seasonal depression, fever control in children, abelacimab for atrial fibrillation, antibiotics vs surgery in children with nonperforated appendicitis. Get all of the POEMs (a new one every day) by going to Essential Evidence Plus and subscribing.

Links from today's podcast:

Bright lights for non-seasonal depression:...

Mark as Played

This week, Gary, Kate, Henry and Mark discuss 4 new studies relevant to primary care practice: the effectiveness of RSV monoclonals in infants, acupuncture for sciatica associated with disk herniation, zoledronate every 5 years for low risk women, and the effect of arm position on blood pressure readings. Plus a quiz! Please see below for show notes and links:

Learn more about Essential Evidence Plus: www.essentialevidenceplus.co...

Mark as Played

Join Kate, Mark, Gary and Henry as they discuss 4 new POEMs on treatment of sexual dysfunction, the benefits and harms of GLP-1 agonists, active surveillance vs usual care for ductal carcinoma in situ, and medications to prevent episodic migraine headache.

Henry mentioned AAFP's uncensored resources:

www.aafp.org/family-physician/patient-care/clinical-recommendations.html 

www.aafp.org/family-physician/patient-care/care-resources....

Mark as Played

This week, join Kate, Mark, Gary and Henry as they discuss 4 new studies: prenatal cannabis exposure, fluid resuscitation during acute sickle crises, edoxaban or edoxaban + ASA for afib with CAD, and the impact of aerobic exercise on weight loss in adults


Mark as Played

Join Henry, Kate, Mark and Gary as they discuss 4 new POEMs: an RCT of mindfulness for chronic pain, use of methotrexate (huh?) for pain relief in adults with knee DJD, a new way to eradicate H., and oral resveratrol for adults with painful DJD of the knee  (you know, the stuff from red wine). And a quiz: what actually are the benefits of lower BP targets?


Links

Mindfulness for chronic pain:  https://pubmed.ncbi.nlm.nih.gov/391588...

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This week join our intrepid team of skeptical primary care doctors as Kate, Mark, Henry and Gary discuss a web- and text-based intervention to prevent obesity in babies, the best timing of DOAC initiation after ischemic stroke in adults with atrial fibrillation, using semaglutide for knee osteoarthritis, and the differential diagnosis of thunderclap headaches. Plus the BEST quiz ever.

Links:

Preventing obesity in babies: https://pu...

Mark as Played

This month Kate, Mark, Gary and Henry discuss yoga for treating urinary incontinence in older women, benefits and harms of muscle relaxants for adults with chronic pain, maternal prenatal cannabis use and developmental delays, and bariatric surgery vs. glucagon-like peptide 1 receptor agonists in obese adults with T2DM.

Links:

Yoga for incontinence: https://pubmed.ncbi.nlm.nih.gov/39186785/

Muscle relaxants for painful conditions:...

Mark as Played

This week Mark, Kate, Gary and Henry talk about the comparative effectiveness of migraine medications, strategies for adults with plantar fascia pain, whether to continue beta-blocker use after acute MI, and the outcomes of 5-alpha reductase inhibitor use prior to prostate cancer diagnosis.

Links

Migraine: https://www.bmj.com/content/386/bmj-2024-080107

Plantar fasciitis: https://pubmed.ncbi.nlm.nih.gov/38904119/  and https://pubme...

Mark as Played

This week listen in as Kate, Mark, Gary and Henry discuss antiviral treatment for infant RSV, colonoscopy competence by specialty, oral minoxidil for hair loss in men, and artificial intelligence performance on interpreting electrocardiograms .

RSV medication:

https://www.nejm.org/doi/full/10.1056/NEJMoa2313551#ap2  and https://pubmed.ncbi.nlm.nih.gov/39321361/ 

Colonoscopy by specialty

https://pubmed.ncbi.nlm.nih.gov/38588561/ 


...

Mark as Played

Join Kate, Gary, Henry and Mark as they discuss a new therapy for dry eye syndrome, antibiotics for suspected UTI in adults with delirium, a new ACG guideline for treating H pylori, and the prevalence of knee pathology in asymptomatic adults. See below for links to the articles and other stuff:

Dry eye treatment

BMJ: https://www.bmj.com/content/386/bmj-2024-080474

Patient instructions: https://www.bmj.com/content/bmj/suppl/2024/09...

Mark as Played

Join Gary, Kate, Mark and Henry as they discuss text messages for adolescent vaping cessation, stopping BP meds in nursing home residents with dementia, the benefits of SGLT-2 inhibitors, and mobile phone app–based artificial intelligence for diagnosing melanoma.

Click here for transcript, notes and links for this episode.


Mark as Played

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