E169 - Deprescribing antihypertensives in frail older adults

David Liew talks to rheumatologist Nicola Cook about the utility of common investigations for suspected inflammatory arthritis in adults. They discuss the notion of pretest probability and how this is used to determine the utility of testing, and the role of specific tests. Nicola also talks about the potential harm of overinvestigation. Read the full article by Nicola and her co-author, Rachelle Buchbinder, in Australian Prescriber.

Dhineli Perera chats with infectious diseases physician Emily Tucker about her article on controversies in the management of community-acquired pneumonia (CAP) in adults. Laura talks about severity scoring tools, organisms involved with CAP, and the antibiotics and other treatments used to manage CAP. Read the full article by Emily and her co-authors in Australian Prescriber.

Dhineli Perera talks to Jonathan Dartnell, managing director of QUM Connect, and Darlene Cox, Executive Director of Health Care Consumers’ Association, about changes to the quality use of medicines landscape. They discuss the challenges and opportunities following the closure of NPS MedicineWise and speculate on the future of QUM in Australia. Read the full article by Jonathan, Darlene, and their co-authors, in Australian Prescriber. This interview was conducted on 3 July 2024.

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.

David Liew speaks with geriatrician and dementia specialist Louise Waite about her article on new and emerging therapies for Alzheimer disease. Louise explains key biomarkers for Alzheimer disease, and the potentially disease-modifying monoclonal antibody therapies that have been approved by the FDA and are now being considered by the TGA in Australia. Read the full article by Louise in Australian Prescriber.

Justin Coleman talks to Darren Mansfield, Director of the Epworth Sleep Centre, about his article on the diagnosis and management of obstructive sleep apnoea (OSA) in adults. Darren outlines high-risk populations for OSA and the importance of screening. He also covers treatments, including CPAP therapy, positional and oral appliances, and surgical options. Read the full article by Darren and his co-author, Daniel Hynes, in Australian Prescriber.

Jo Cheah speaks to Peter Wark about his article on biologic therapies for severe asthma with persistent type 2 inflammation. Peter explains the difference between difficult and severe asthma and how to test for persistent type 2 inflammation. He also runs through the available biologics and when and how they are used. Read the full article by Peter and his co-author, Sahan Chandrasekara, in Australian Prescriber.

Justin Coleman talks to Garry Jennings, Chief Medical Advisor of the National Heart Foundation of Australia, about his article on the 2023 Australian Guideline for Assessing and Managing Cardiovascular Disease Risk. Garry discusses the updates to the guideline, including the age from which assessment should occur and new risk factors considered, and he gives some tips for communicating cardiovascular disease risk to patients. Read the full article by Garry and his co-authors in Australian Prescriber. 

David Liew talks to gastroenterologist Varan Perananthan about his article on diagnosis and management of eosinophilic oesophagitis (EoE). Varan explains the causes and symptoms of EoE, why the prevalence has been increasing, and how to differentiate EoE from gastro-oesophageal reflux disease. Also discussed are dietary approaches for identifying food triggers and pharmacological treatments for EoE. Read the full article by Varan and his co-author, Rebecca Burgell, in Australian Prescriber.

Laura Beaton talks to Leonie Callaway, Obstetric and General Physician and Director of Research at the Royal Brisbane and Women’s Hospital, about her article on the management of pre-existing diabetes in pregnancy. Leonie talks about maternal and fetal complications and the importance of high-quality preconception care, factors that can affect glucose control and the benefits of continuous glucose monitoring, and postpartum care. Read the full article by Leonie and her co-author Fiona Britten in Australia Prescriber.