Melatonin: Is a “Natural” Sleep Aid as Harmless as We Think? - Frankly Speaking Ep 476

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-476 Overview: Melatonin is widely used and often perceived as a safe, natural solution for insomnia. However, a new preliminary study raises concerns about long-term melatonin use and increased risk of heart failure, hospitalization, and all-cause mortality in patients with chronic insomnia. In this episode, we review the findings, discuss how they fit with existing evidence, explore limitations, and offer practical guidance for clinicians counseling patients about sleep supplements. Episode resource links: American Heart Association Scientific Sessions 2025 – Abstract 4371606 AHA Scientific Statement: Multidimensional Sleep Health and Cardiometabolic Risk (Circulation, 2025) Li et al. Lancet Diabetes & Endocrinology, 2024 American Academy of Sleep Medicine Clinical Practice Guidelines AHA Life’s Essential 8 & Sleep Health Resources Guest: Mariyan Montaque, DNP, FNP-BC   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-475 Overview: A prescribing cascade occurs when adverse effects of a medication are mistaken for a new condition and treated with additional drugs. Older adults experiencing polypharmacy are most at risk. The impact of prescribing cascades can be substantial, leading to falls, organ injury, unnecessary imaging and tests, and more. Join us as we explore how to recognize and prevent these harmful cascades in your patients. Episode resource links: Adrien  O, Mohammad  AK, Hugtenburg  JG,  et al.  Prescribing cascades with recommendations to prevent or reverse them: a systematic review.   Drugs Aging. 2023;40(12):1085-1100. doi:10.1007/s40266-023-01072-yPubMedGoogle ScholarCrossref   Brath  H, Mehta  N, Savage  RD,  et al.  What is known about preventing, detecting, and reversing prescribing cascades: a scoping review.   J Am Geriatr Soc. 2018;66(11):2079-2085. doi:10.1111/jgs.15543PubMedGoogle ScholarCrossref   Daunt R, McGettigan S, Kelly L, Curtin D, O'Mahony D. Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study. Drugs Aging. 2025;42(6):535-546. doi:10.1007/s40266-025-01201-9   Growdon ME, Tjota N, Campbell R, et al. Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade. JAMA Netw Open. 2025;8(12):e2545274. doi:10.1001/jamanetworkopen.2025.45274   McCarthy  LM, Savage  R, Dalton  K,  et al.  ThinkCascades: a tool for identifying clinically important prescribing cascades affecting older people.   Drugs Aging. 2022;39(10):829-840. doi:10.1007/s40266-022-00964-9PubMedGoogle ScholarCrossref   O’Mahony, D., Cherubini, A., Guiteras, A.R. et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 14, 625–632 (2023). https://doi.org/10.1007/s41999-023-00777-y   Rochon, P.A., O’Mahony, D., Cherubini, A. et al. International expert panel’s potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16, 1573–1584 (2025). https://doi.org/10.1007/s41999-025-01215-x   Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS One. 2021;16(8):e0255642. Published 2021 Aug 3. doi:10.1371/journal.pone.0255642 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-474 Overview: Depression affects many people with dementia, but some evidence suggests certain antidepressants may accelerate cognitive decline. This episode explores the potential risks of antidepressants in people with dementia, which medications require careful consideration, and how to make informed prescribing decisions that optimize patient outcomes while minimizing potential cognitive harm. Episode resource links: Mo M, Abzhandadze T, Hoang MT, et al. Antidepressant use and cognitive decline in patients with dementia: a national cohort study. BMC Med. 2025;23(1):82.  Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-473 Overview: Join us as we review long-term outcomes from a recently published trial on prostate-specific antigen (PSA) testing and prostate cancer mortality. Learn how updated evidence informs shared decision-making and balances early detection with potential harms. Equip yourself to guide patients through nuanced discussions on PSA testing’s limitations, mortality data, and meaningful clinical impact. Episode resource links: N Engl J Med 2025;393:1669-80. DOI: 10.1056/NEJMoa2503223 Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472 Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes. Episode resource links: Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association. Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.   Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272. Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-471 Overview: Discover how flexible physical activity patterns can reduce mortality and cardiovascular risk in patients with diabetes. This episode translates evidence on “weekend warrior” vs regular exercise into practical counseling strategies, empowering you to help time-constrained patients achieve the mortality benefits of weekly moderate-to-vigorous physical activity—regardless of scheduling pattern. Episode resource links: Wu, Z., Sheng, C., Guo, Z., Zheng, Y., Zheng, D., Li, X., Guo, X., & Li, H. (2025). Association of Weekend Warrior and Other Physical Activity Patterns With Mortality Among Adults With Diabetes : A Cohort Study. Annals of internal medicine, 178(9), 1279–1286. https://doi.org/10.7326/ANNALS-25-00640 Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-470 Overview: Social media use is nearly ubiquitous among adolescents, raising concern about its role in rising rates of depression, anxiety, insomnia, and suicidality. Although prior evidence has been mixed, emerging studies offer new insights on the relationship between social media use and adolescent mental health. Join us as we review current literature and discuss potential strategies to mitigate negative impacts and improve outcomes. Episode resource links: Calvert E, Cipriani M, Dwyer B, et al. Social Media Detox and Youth Mental Health. JAMA Netw Open. 2025;8(11):e2545245. doi:10.1001/jamanetworkopen.2025.45245 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840489   Clayborne ZM, Capaldi CA, Mehra VM. Associations between digital media use behaviours, screen time and positive mental health in youth: results from the 2019 Canadian Health Survey on Children and Youth. BMC Public Health. 2025;25(1):2303. Published 2025 Jul 3. doi:10.1186/s12889-025-22874-2 Grøntved A, Singhammer J, Froberg K, et al. A prospective study of screen time in adolescence and depression symptoms in young adulthood. Prev Med. 2015;81:108-113. doi:10.1016/j.ypmed.2015.08.009 Nagata JM, Memon Z, Talebloo J, et al. Prevalence and Patterns of Social Media Use in Early Adolescents. Acad Pediatr. 2025;25(4):102784. doi:10.1016/j.acap.2025.102784 Oberle E, Ji XR, Kerai S, Guhn M, Schonert-Reichl KA, Gadermann AM. Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: A population-level study. Prev Med. 2020;141:106291. doi:10.1016/j.ypmed.2020.106291 Pieh C, Humer E, Hoenigl A, et al. Smartphone screen time reduction improves mental health: a randomized controlled trial. BMC Med. 2025;23(1):107. Published 2025 Feb 21. doi:10.1186/s12916-025-03944-z Riehm KE, Feder KA, Tormohlen KN, et al. Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth. JAMA Psychiatry. 2019;76(12):1266–1273. doi:10.1001/jamapsychiatry.2019.2325 Varona MN, Muela A, Machimbarrena JM. Problematic use or addiction? A scoping review on conceptual and operational definitions of negative social networking sites use in adolescents. Addict Behav. 2022;134:107400. doi:10.1016/j.addbeh.2022.107400 Woolf SH. The Youth Mental Health Crisis in the United States: Epidemiology, Contributors, and Potential Solutions. Pediatrics. 2025;156(5):e2025070849. doi:10.1542/peds.2025-070849 Xiang AH, Martinez MP, Chow T, et al. Depression and Anxiety Among US Children and Young Adults. JAMA Netw Open. 2024;7(10):e2436906. doi:10.1001/jamanetworkopen.2024.36906 BBC: Australia has banned social media for kids under 16. How will it work? https://www.bbc.com/news/articles/cwyp9d3ddqyo Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-469 Overview: Tune in to hear how self-collected vaginal human papillomavirus (HPV) testing has potential to expand access to cervical cancer screening and reduce barriers for your patients. This episode reviews cervical cancer screening guidelines, follow-up recommendations, and how to consider offering self-collection as an option to increase screening rates and improve preventive care in your practice. Episode resource links: CA CancerJClin.2026;e70041. DOI:10.3322/caac.70041 US Food and Drug Administration (FDA). Device Classification Under Section 513(f)(2)(De Novo). Device for home collection and transport of vaginal specimens by lay users for use in an approved HPV molecular assay. FDA; 2025. [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-nutrition-update Overview: In this episode, we explore the latest changes to the USDA’s nutrition guidelines, trace the history of the food pyramid, and examine the evidence behind current guidance. Come away with tips to counsel patients on nutrition that supports long-term health and reduces chronic disease risk. Episode resource links: Review the history of nutrition recommendations from the United States Department of Agriculture (USDA) Analyze the USDA’s 2026 food guidelines Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected]  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-468 Overview: We first discussed aspirin use for primary prevention of cardiovascular disease in 2022 when the USPSTF recommended against it. In this follow-up episode, we review new trial data reinforcing that guidance and help you translate the evidence into safer prevention strategies. Build confidence in supporting patients with evidence-based approaches to reduce cardiovascular risk. Episode resource links: Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 2025 Aug 12:ehaf514. doi: 10.1093/eurheartj/ehaf514. Epub ahead of print. PMID: 40796244. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at [email protected] The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.