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Do oral decongestants have a clinically significant effect on BP in patients with hypertension?
(Family Physicians Inquiries Network, 2017)
Q: Do oral decongestants have a clinically significant effect on BP in patients with hypertension? Evidence-based answer: It is unclear. Pseudoephedrine causes an average increase of 1.2 mm Hg in systolic blood pressure (BP) in patients...
Need an add-on to metformin? Consider this
(Family Physicians Inquiries Network, 2017)
Need an add-on to metformin? Consider this. Sulfonylureas have been the preferred add-on therapy to metformin for T2DM, but a study finds that DPP-4s have lower risks of death, CV events, and hypoglycemia. Practice changer: Consider a dipeptidyl...
When to "CAP" off treatment for pneumonia
(Family Physicians Inquiries Network, 2017)
clinical success rates as longer treatment regimens, but is associated with fewer negative patient outcomes....
SSRIs for depression/heart failure patients? Not so fast
(Family Physicians Inquiries Network, 2017)
This study should put to rest the practice of starting SSRIs in depressed patients with heart failure in an attempt to affect CVD outcomes. PRACTICE CHANGER: Do not prescribe selective serotonin reuptake inhibitors to ...
When can exercise supplant surgery for degenerative meniscal tears?
(Family Physicians Inquiries Network, 2017)
When can exercise supplant surgery for degenerative meniscal tears? PRACTICE CHANGER: Recommend supervised exercise therapy to your patients with a medial, degenerative meniscal tear and a minimal history of osteoarthritis ...
Steroids during late preterm labor: better later than never
(Family Physicians Inquiries Network, 2017)
Steroids during late preterm labor: Better later than never. Steroids--even when administered in the last leg of the late preterm period--still reduce the likelihood of respiratory complications in newborns. Practice ...
Does azithromycin have a role in cesarean sections?
(Family Physicians Inquiries Network, 2017)
Does azithromycin have a role in cesarean sections? Yes, adding azithromycin to the usual antibiotic protocol in nonelective c-sections reduces infections. But not everyone can take advantage of it. PRACTICE CHANGER: Prescribe a one-time dose...
Do ACE inhibitors or ARBs help prevent kidney disease in patients with diabetes and normal BP?
(Family Physicians Inquiries Network, 2017)
with type 1 and type 2 diabetes, ACE inhibitor therapy reduces the risk of developing diabetic kidney disease, defined as new-onset microalbuminuria or macroalbuminuria, by 18% (strength of recommendation [SOR]: C, meta-analysis of randomized controlled...
The benefits--and limits-- of PPIs with warfarin regimens
(Family Physicians Inquiries Network, 2017)
Patients on warfarin + antiplatelet/NSAID regimens are likely to benefit from the gastroprotective effect of PPIs. For patients taking warfarin alone, it's a different story. PRACTICE CHANGER: Prescribe a proton pump ...
Which interventions are effective in managing parental vaccine refusal?
(Family Physicians Inquiries Network, 2017)
about the vaccine, but may decrease intention to vaccinate in parents who already have strong concerns about safety (SOR: C, low-quality RCT). Discussions about vaccines that are more paternalistic (presumptive rather than participatory) are associated...
What is the optimal frequency for dental checkups for children and adults?
(Family Physicians Inquiries Network, 2017)
for preventive dental visits (strength of recommendation [SOR]: C, expert opinion), but a 24-month interval does not result in an increased incidence of dental caries in healthy children and young adults or increased incidence of gingivitis in healthy adults (SOR...
Potential harms of long-term acne treatment with oral antibiotics
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What are the potential harms of long-term acne treatment with oral antibiotics? Evidence-based answer: Specific evidence attributing adverse effects to long-term acne treatment with oral antibiotics is lacking. However...
Do pedometers increase activity and improve health outcomes?
(Family Physicians Inquiries Network, 2017)
Q: Do pedometers increase activity and improve health outcomes? Evidence-based answer: yes. In overweight and obese patients, exercise interventions using a pedometer increase steps by about a mile per day over the same ...
How do hyaluronic acid and corticosteroid injections compare for knee OA relief?
(Family Physicians Inquiries Network, 2017)
Q How do hyaluronic acid and corticosteroid injections compare for knee OA relief? A: Inconsistent evidence shows a small amount of pain relief early (one week to 3 months) with corticosteroid (CS) injections and an equally ...
Do probiotics reduce C diff risk in hospitalized patients?
(Family Physicians Inquiries Network, 2019)
Do probiotics reduce C diff risk in hospitalized patients? A systematic review and meta-analysis says, "Yes," but that doesn't necessarily mean they will start appearing on hospital formularies. Practice changer: Start probiotics within 1 to 2 days...
Acupuncture for low back pain
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: Is acupuncture effective in improving pain relief for low back pain? Evidence-based answer: Acupuncture is an effective treatment for relief from low back pain, even when compared with other interventions (sham...
Do group visits improve HbA1c more than individual visits in patients with T2DM?
(Family Physicians Inquiries Network, 2005)
Do group visits improve HbA1c more than individual visits in patients with T2DM? Evidence-based answer: Yes. In patients with type 2 diabetes mellitus (T2DM), group visits led by health professionals or teams improved glycosylated hemoglobin (HbA1c...
Can sleep apnea be accurately diagnosed at home?
(Family Physicians Inquiries Network, 2019)
Can sleep apnea be accurately diagnosed at home? A recent study says Yes, and that it offers advantages: it can be scheduled faster, is less expensive, and is more acceptable to many patients than lab testing. PRACTICE ...
A better approach to the diagnosis of PE
(Family Physicians Inquiries Network, 2019)
angiography when evaluating patients for suspected pulmonary embolism unless: (1) the patient has a d-dimer concentration ≥ 1000 ng/mL; or (2) the patient has a d-dimer concentration ≥ 500 ng/mL, PLUS: (A) clinical signs of deep vein thrombosis, (B) hemoptysis...
Efficacy of a low-carbohydrate or ketogenic diet in preventing patient morbidity and mortality
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What is the efficacy of a low-carbohydrate or ketogenic diet in the prevention of patient morbidity and mortality? Evidence-based answer: Ketogenic diets can reduce seizure incidence in refractory epilepsy (strength...