Episode 136: PREMIUM - A head-to-head comparison of ezetimibe and prunes
In episode 136, James and Mike once again raise the content bar level with the premium of all PREMIUM podcasts. We talk about a study that looked at the effect of ezetimibe plus simvastatin and we get a very clear answer but unfortunately the question that was asked was completely wrong.
Comments
constipation
As an NP working in a long term care facility, I always appreciate the chance to learn more about bowel management! I do think you missed the boat a bit by focusing on number of BMs per week. I find myself continually dealing with staff who believe a person can't be constipated if they are having a BM daily, which is not the case. The Rome Criteria are really helpful here: http://ww3.peerviewpress.com/gpimgs/fastcast/n165/pdf/table2.pdf
I think there are a lot of people who meet the criteria for IBS-C that are totally missed in practice. Just knowing what the diagnosis is helps people cope since they are so often dismissed as "not constipated because you had a BM today," We've created a decision support tool to help nursing staff think through what kind of bowel problem the resident has so that they don't indiscriminately request treatments that are unlikely to work. DOSS does not appear anyone on the tool.
Thanks for all you do to keep practicing clinicians updated.
Late comment, but like Mike,
Late comment, but like Mike, I have conspiracy theory on the brain. It was asked why the third arm wasn't considered. Who sponsored the study.... Merck.And who makes Zetia? Oh wow... Merck!
constipation
not that it counts a lot, but 12 prunes is about 240-250 calories and the psyllium (branded flavored and tolerable) is about 40 calories and sugar free, no calories. Big selling point if you consider 3500 calories = 1 pound, then this a a half pound a week potential weight gain...balanced perhaps by the weight loss from the colon?
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