iForumRx.org
Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care

Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care

July 17, 2020

Imagine you have recommended statin therapy to a patient with diabetes. A few weeks later, the patient experiences leg pain and stops it. Was this patient’s leg pain caused by the statin? Or was it a nocebo effect? Muscle symptoms in placebo-controlled trials of statin therapy range from 3-5%, while rates in real-world observational studies are between 15-20%. Ambulatory care pharmacists have an important role in recognizing and managing placebo and nocebo effects. Understanding the placebo effect allows clinicians to harness the power of placebos. Reframing risks during patient education may decrease nocebo effects.

Guest Authors:  Sara Wettergreen, PharmD, BCACP and Joseph Nardolillo, PharmD

Music by Good Talk

Does Long-Term Proton Pump Inhibitor Use Pump Up Your Risk of Adverse Effects?

Does Long-Term Proton Pump Inhibitor Use Pump Up Your Risk of Adverse Effects?

May 22, 2020

Many studies have linked proton pump inhibitor (PPI) use to several adverse effects including Clostridium difficile-associated diarrhea, community-acquired pneumonia, bone fractures, and nutritional deficiencies. Other reports have linked PPI use with chronic kidney disease, cognitive decline, myocardial infarction (MI), stroke, and even death. Many patients take PPIs chronically and may be concerned about the risk of these side effects. This poses a challenge for healthcare providers as safety data has been primarily based on retrospective and observational studies. A recently pre-planned analysis using data from the prospective COMPASS study sheds some reassuring light.

Guest Authors:  Hindu Rao, PharmD and Jelena Lewis, PharmD, BCACP, APh

Music by Good Talk

Fall Risk and Benzos – Is Trazodone Really the Knight in Shining Armor?

Fall Risk and Benzos – Is Trazodone Really the Knight in Shining Armor?

January 18, 2019

Older adults are often tormented by insomnia, pain, and other comorbidities that impact their quality of life.  Medication therapy is often sought to treat and manage these diseases, but healthcare providers often overlook the risks of prescribing medications to patients who are older, frail, and at high risk for falls.  Trazodone is increasingly prescribed for insomnia instead of benzodiazepines presumably because it is considered to be safer and it does not appear on either the Beers or STOP/START lists.  But is trazodone really safer for patients than benzodiazepines?

Guest Authors:  Anthony M. Todd, PharmD and Nicole A Slater, PharmD, BCACP

Music by Good Talk

Play this podcast on Podbean App