Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Review the different methods of glucose monitoring glucose currently available in Canada
2. Discuss the latest updated guidelines on glucose monitoring by Diabetes Canada
3. Explore practical tools/online resources to aid in-office diabetes management in Primary Care

Description:
Technology in diabetes is evolving at a very fast pace and primary care may sometimes find it overwhelming on deciding how to incorporate it in routine in-office diabetes management. In 2021, Diabetes Canada Guidelines updated its Glucose monitoring chapter. We will be discussing the recommendations including: deciding which glucose monitoring device to use for your patients, differences in the various continuous glucose monitoring sensors and targets for most people living with diabetes as well as special populations. We will also be discussing various factors that can cause lab A1c to falsely high or low and how to proceed if there is a seeming discrepancy between lab-measured A1c and home glucose readings. As part of Primary Care Interest Group within Diabetes Canada, this session will be used to explore some of the practical tools and online resources which can aid the office visits in patients with diabetes.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Describe how to make a diagnosis of bipolar disorder in a time efficient manner
2. Describe how to use psychopharmacology to treat bipolar disorder, using current guidelines
3. Describe issues concerning psychopharmacology and pregnancy in bipolar disorder

Description:
Bipolar disorder affects millions of people in North America. It can now be diagnosed and treated in the primary care setting. In this presentation, we will discuss how to make the diagnosis of bipolar disorder in a time efficient manner. We will define the different types of Bipolar Spectrum Disorders, including Bipolar Type 1, Bipolar Type 2, and Cyclothymic Disorder. We go on to describe current psychopharmacological treatment of bipolar disorder. We will look at what medications are useful for bipolar manic state, bipolar depressed state, and the prevention of future episodes. We will use current guidelines, based on The Canadian Network for Mood and Anxiety Treatments (CANMAT) 2018 guidelines for bipolar disorder. We will also comment on the National Institute for Health and Care Excellence (NICE) guidelines for bipolar disorder. We will focus on Lithium, Valproic Acid, Lamotrigine and Quetiapine in our discussion of medications. We discuss the workup for each of these medications, along with the pertinent side effects, and dosing. We discuss issues with pregnancy and the use of these bipolar medications. We discuss issues of disability, as related to bipolar disorder.

Learning objectives: At the conclusion of this activity, participants will be able to:

1. Define female sexual interest and arousal disorder (FSIAD) within the spectrum of sexual function/dysfunction
2. Review the incidence, pathogenesis, diagnosis and current treatment options of FSIAD
3. Provide a practical clinical approach to FSIAD in a busy family practice

Description:
More than 40% of your female patients have sexual problems. Sexual health is important. This sometimes “not so sexy” area of medicine, however, can be very challenging for practitioners and patients. Having a practical approach to the most common sexual dysfunctions can be very helpful in day-to-day primary care. This session will be a review of low libido and arousal (Female sexual interest and arousal disorder or FIASD) which is the commonest female sexual health complaint. Expect a fast paced, interactive session which will give you a pragmatic clinical frame-work to approach this challenging area of primary care. Dr Ted Jablonski (he,him) is a family physician in Calgary with longstanding expertise in sexual medicine and transgender and gender diverse (TGD) health. His sessions are always highest rated for their practical clinical pearls.

Learning objectives: At the conclusion of this activity, participants will be able to:

1. Identify the 2022 C-CHANGE Guideline Update recommendations for the prevention and management of cardiovascular disease
2. Implement recommendations for multimorbidity in a single patient
3. Reflect how the C-CHANGE recommendations can help older adults live at home longer and healthier

Description:
This interactive workshop will provide participants the opportunity to learn about the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) 2022 Guideline Update related to the prevention and management of cardiovascular disease. The goal of the C-CHANGE process is for all Canadian healthcare providers to have easy access to a comprehensive and practical set of harmonized guidelines. This workshop will be a case-based review of a patient with multiple cardiovascular comorbidities presenting to a primary care clinic and illustrate (through audience polling) how the harmonized C-CHANGE Guidelines can be used to effectively manage this patient to reduce residual cardiovascular risk

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Identify unnecessary investigations in certain pediatric sport and exercise medicine conditions
2. Determine appropriate investigations and management of certain pediatric sport and exercise medicine conditions
3. Critically appraise the evidence for the choosing wisely recommendations

Description:
A small working group created by the Canadian Academy of Sport and Exercise Medicine (CASEM) developed a list of pediatric-specific sport and exercise medicine (SEM) recommendations based on existing research, experience and common practice patterns. A national electronic survey was conducted with CASEM’s membership to solicit feedback for each recommendation. There was greater than 80% agreement with all of the proposed items. The final 8 items included: imaging recommendations for Osgood Schlatter’s disease, shoulder and knee injuries, back pain, scoliosis, spondylolysis, distal radial buckle fractures, minor head injury/concussion, and management of chronic pain syndromes. Following CASEM Board final approval, the list was accepted by Choosing Wisely Canada (CWC). Using a case-based interactive format, participants will become familiar with several opportunities for quality improvement in the care of children presenting with SEM concerns.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Recognize FASD as a full-body diagnosis, not just a brain disorder
2. Formally diagnose FASD in your practice on your own
3. Improve communication/adherence, and screening & management of chronic health conditions for FASD patients

Description:
Fetal Alcohol Spectrum Disorder (FASD) affects up to 1.4 million patients in Canada despite significant underdiagnosis and under-recognition. While traditionally thought of as a diagnosis affecting brain function, it is now known that FASD can affect the development and functioning of every organ in the body. There are screening and monitoring considerations given earlier and more frequent development of chronic diseases, including dementia. Communication and adherence are areas requiring modified strategies. Therefore, FASD is relevant to every family doctor in any practice setting. This presentation will also guide you in making formal FASD diagnoses on your own, for patients of all ages, which can potentially avoid years-long waiting lists for “specialized assessments” (if available in your area) or the need for privately-funded assessments. Having a diagnosis of FASD will dramatically impact all aspects of medical care, and has been shown to improve patients’ understanding of themselves, as well as improve access to appropriate supports and role models.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Define and recognize the importance of intra-professional care – the way in which we work together as family doctors – within the discipline of family medicine
2. Consider our relationships to one another as family physicians as we move into an uncertain future together
3. Propose a 5th principle of family medicine

Description:
Dr. Sarah Newbery, now in practice for almost 30 years, holds deep admiration for the work of family physicians all across the health care system. She will share three lessons learned from her career in rural family practice that may help to shape the way forward together as we address the challenges that we face in the current health care system. Using those same lessons, she will invite consideration of a fifth principle for family medicine as a discipline through which we can find meaning and joy.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Describe the pharmacotherapeutic approach to heart failure (HF) & how to apply in primary care
2. Summarize the evidence for HF medications, including benefits and harms
3. Identify resources to facilitate shared decision-making regarding HF medications

Description:
Heart failure (HF) affects about 750,000 Canadians, impairs quality of life, and has a lower survival than most common cancers. The management of HF is complex and rapidly evolving, with current guidelines recommending standard therapy with at least 4 core medications, followed by dose titration and subsequent consideration of ≥6 additional medications based on patient-specific clinical factors. This presentation will summarize recent evidence for HF medications, and describe an approach to optimize HF pharmacotherapy in primary care. The session will provide strategies to manage common issues related to HF medications and scenarios seen in primary care, as well as tools to engage patients in shared decision-making regarding their HF medications.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Understand the common causes of insomnia and how it may present in primary care
2. Learn a framework for the assessment of a sleep problem in primary care
3. Be familiar with the major approaches to managing sleep disorders in primary care

Description:
It has been estimated that up to 60% of Canadian adults do not get sufficient sleep and insomnia is one of the commonest problems encountered in primary care. Many factors can contribute to poor sleep including lifestyle, mental health problems, other general medical problems, medications, or primary sleep disorders. This workshop discusses the importance of sleep and the consequences of insufficient sleep and presents a framework for understanding, assessing and treating commonly encountered sleep problems. It summarizes the five stage sleep cycle, the circadian cycle and the sleep wake cycle and outlines the different ways in which changes in these can contribute to sleep problems. It differentiates between a primary sleep disorder (eg sleep apnoea, narcolepsy, restless leg syndrome, delayed sleep onset disorder) and primary or secondary insomnia, and the potential consequences of each of these. It then reviews the major causes of insomnia and presents simple questions that can be introduced into any health assessment. It outlines a comprehensive but relatively succinct assessment of a sleep problem in primary care, and presents some simple screening tools including a sleep log, to assist with this. It then reviews the 4 major approaches to managing a sleep problem – sleep hygiene strategies, CBT for insomnia, the use of medications and the use of OTCs. Finally it outlines an approach to managing the four primary sleep disorders listed above in any primary care setting, and the criteria for referral to a sleep clinic.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Apply an efficient approach to assessment of neck pain/conditions
2. Detect serious pathology (degenerative cervical myelopathy) related to cervical conditions
3. Implement appropriate rehab approaches to neck conditions

Description:
Neck pain is very common and family physicians are a typical point of initial contact for patients who have neck pain. While many cases of neck pain will be due to benign cervical conditions and resolve quickly, others can be complex and chronic and there can be serious pathologies to be aware of. It can be challenging to assess the cervical spine in a typical office encounter, this case-based session will provide a practical approach to efficient office assessment of the neck. The session will provide an overview of Degenerative Cervical Myelopathy (DCM), a serious etiology not to be missed and lastly an overview of rehabilitative care will be presented. The session will be a collaborative perspective by presenters from Family Medicine, Neurosurgery and Physical Medicine and Rehabilitation faculties

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Know how to approach red and itchy skin
2. Be aware of common red and itchy skin conditions
3. Diagnosis, management and avoiding pitfalls

Description:
Dermatological conditions comprise up to 1/7 of all consultations in family medicine. When confronted with skin lesions that are red and itchy, practising family physicians can be lost in the deep blue sea as to how and where to start, let alone making a diagnosis and prescribing treatment. This may lead to either unnecessary dermatological referral or inappropriate prescription of steroids cream in a reflex-arc manner. This presentation will give a bird’s eye view to common red and itchy skin conditions as encountered in family medicine, coupled with ample visual material and interactive Q&As, will equip attendees with a logical flow-chart approach for diagnosing and managing these conditions. Barriers to change will be addressed when appropriate.

This is an Ancillary Session, sponsored and paid for by a CPD provider that may have also received external funding for program development. All conflicts of interests will be fully disclosed on slides and shared verbally at the start of the presentation.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Describe how to identify and investigate IDA
2. Compare and contrast between iron replacement options
3. Select appropriate iron repletion options for different patient populations

Description:
This goal of this program is to support clinicians in identifying patients with iron deficiency anemia (IDA) and recommending appropriate treatment options based on current guideline recommendations.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Identify priority areas for reducing unnecessary antibiotic prescribing in the community setting
2. Examine drivers of antibiotic overuse in their own practices and opportunities for improvement
3. Apply tools to encourage conversations about appropriate antibiotic use

Description:
There are estimates that up to 30-50% of antibiotics prescribed for respiratory tract infections in primary care are unnecessary. Common illnesses in primary care that result in antibiotic overuse when prescribing for both adults and children include uncomplicated otitis media, pharyngitis, sinusitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), influenza-like illness, bronchitis/asthma and COVID-19. This workshop will explore common drivers of antibiotic overuse in the outpatient primary care setting including diagnostic uncertainty, time pressures and perceptions of patient expectations. Choosing Wisely Canada, in collaboration with the College of Family Physicians of Canada, has developed a number of tools and resources to address these barriers, support decision-making, and help clinicians engage in conversations with patients to improve antibiotic stewardship practices. The workshop will demonstrate how to integrate these, like the viral prescription and delayed prescription pad into primary care practices, and incorporate them into electronic medical records. Patient-tested language and behavioral science optimized tools to support shared decision making with patients will also be shared.

This is an Ancillary Session, sponsored and paid for by a CPD provider that may have also received external funding for program development. All conflicts of interests will be fully disclosed on slides and shared verbally at the start of the presentation.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Assess a patient presenting with excessive daytime sleepiness (EDS)
2. Review sleep disorders that can cause EDS
3. Discuss appropriate management strategies, including referral practices, for patients presenting with EDS

Description:
Excessive daytime sleepiness (EDS) is common with an estimated prevalence of 10-25% in the general population. Despite being a common symptom, it can be difficult for primary care physicians to recognise, diagnose and treat as most physicians receive very little training in sleep medicine and there are no Canadian guidelines specific for EDS to which they can refer. The goal of this learning activity is to help primary care providers better identify and screen patients presenting with EDS and to review the sleep disorders that can cause EDS. In this case-based activity, participants will learn how to assess and conduct a differential diagnosis of sleep disorders that can cause EDS to identify those patients who can be managed in primary care and those who require expert assessment and management (i.e. referral to a sleep specialist). This session concludes with a review of basic EDS management principles.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Validate the pain that patients with endometriosis experience and recognize its impact
2. Identify patients with endometriosis and choose appropriate tests when endometriosis is suspected
3. Recognize when to refer to gynaecology and understand evidence-based management strategies

Description:
This session will provide an up-to-date, practical summary of the patient experience, diagnosis and management of endometriosis for the primary care provider. This important condition affects about 10% of women and an unknown number of trans and gender diverse individuals. Endometriosis can cause significant pain and infertility, negatively impacting quality of life and productivity. The average time to diagnosis is unfortunately about 9 to 10 years, and some patients wait upwards of 20 years. This session will provide the primary care practitioner with a patient perspective about what it is like to live with endometriosis and the positive qualities and impact of patient-centered care for endometriosis. The session will outline the key components of history, physical exam, bloodwork and imaging when endometriosis is suspected. Tips on when and why a patient should be referred to a specialist will be explored, and overview of surgical treatment approaches will be provided so that you can advocate for your patients when they are seeking surgical management. Evidence-based management strategies that can be initiated by the primary care provider will be discussed.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. List the key features required to diagnose myalgic encephalomyelitis
2. Implement a basic approach to management of myalgic encephalomyelitis and its co-morbidities
3. Debunk common misconceptions associated with myalgic encephalomyelitis

Description:
Myalgic Encephalomyelitis (ME), formerly known as chronic fatigue syndrome (CFS), is a devastating, chronic, complex, multi-system disease that afflicts approximately 600,000 Canadians. These patients have some of the lowest quality of life, and they are often misdiagnosed. Management of ME does not fit under any single specialist and there are limited places to refer patients in Canada. This means that diagnosis and management falls to family physicians. This session introduces interactive case examples to help family physicians to feel more confident in ME diagnosis and management. We use the latest biomedical research evidence to challenge some of the common misconceptions in this fascinating disease.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Describe the spectrum of sexuality within the TGD community
2. Explore the effects of hormones (HRT) and gender affirming surgeries on sexual function
3. Outline the special considerations of fertility, contraception and STI within this population

Description:
We are long past the trans health basic 101 sessions now. An ever growing list of transgender folks in your practice are asking questions and seeking answers about their sexual health and function whether this be fertility, contraception, safe sex practices and STI and beyond. Topics ranging from asexual to pansexual, monogamous to polyamorous, and solo to sex-trade will be discussed. This session will provide a safe and practical clinical approach to the sexual health needs of your trans/TGD patients. Expect a fast paced, interactive and novel session that may have you supporting the sexual health of your trans patients in a safe, non-judgemental and trans-competent manner. Dr Ted Jablonski (he,him) is a family physician in Calgary with longstanding expertise in sexual medicine and transgender and gender diverse (TGD) health. His sessions are always highest rated for their practical clinical pearls.

Learning objectives:
At the conclusion of this activity, participants will be able to:

1. Review the common causes of dyspnea and how to investigate for them
2. Review some less common causes of dyspnea that you do not want to miss
3. Understand the pathophysiology and associations so we can institute newer therapies for refractory cough

Description:
It would be nice if patients present with a label on their forehead in our offices telling us what their diagnosis is. They don’t. Patients present with symptoms as well as their fears and expectations that we have to wade through and investigate to lead to the first step in helping them, making the diagnosis. Only with the proper diagnosis, can we institute therapy and join our patient down a pathway to be the best they can be. This session will review patients who present with dyspnea. Dyspnea has many causes including biochemical, cardiologic, respiratory, psychologic and thrombotic. We will go through the diagnostic tests needed and deal with management strategies to optimize both current symptoms and long term health for many common (and some uncommon) conditions causing dyspnea. At the end, we will leave you with an algorithm for how to approach your patients with this often disabling (and possibly life threatening) symptom complex