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Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
, based on randomized controlled trials (RCTs) and systematic reviews] There is limited evidence that antidepressant medications and cognitive behavioral therapy are similarly effective for patients with severe depression [Strength of recommendation: B...
Angiotensin blockade for diabetes: Monitor microalbuminuria?
(Family Physicians Inquiries Network, 2007)
No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and expert opinion suggest...
Are major bleeding events from falls more likely in patients on warfarin?
(Family Physicians Inquiries Network, 2006)
There is no evidence of increased risk for major bleeding as a result of falls in hospitalized patients taking warfarin (strength of recommendation [SOR]: B, based on retrospective cohort studies). In the average patient taking warfarin for atrial...
What's the best secondary treatment for patients who fail initial triple therapy for H pylori?
(Family Physicians Inquiries Network, 2018)
Q: What's the best secondary treatment for patients who fail initial triple therapy for H pylori? Evidence-based answer: treating patients with Helicobacter pylori infection who have failed clarithromycin-based triple therapy with either...
Is lower BP worth it in higher-risk patients with diabetes or coronary disease?
(Family Physicians Inquiries Network, 2016)
Q: Is lower BP worth it in higher-risk patients with diabetes or coronary disease? Evidence-based answer: There is no simple answer; the risk/benefit picture is complicated. Controlling blood pressure to a target of 130/80 mm Hg or lower produces...
Does tranexamic acid reduce mortality in women with postpartum hemorrhage?
(Family Physicians Inquiries Network, 2019)
Q: Does tranexamic acid reduce mortality in women with postpartum hemorrhage? EVIDENCE-BASED ANSWER: Yes. When used in conjunction with the standard of care, 1 g intravenous (IV) tranexamic acid given 1 to 3 hours after delivery is associated with a...
Are oral agents effective for the treatment of verruca vulgaris?
(Family Physicians Inquiries Network, 2006)
Of the available oral therapies for common warts, none has sufficient evidence to recommend it as an effective therapy (strength of recommendation [SOR]: B). To date, no oral agent has been shown to be effective in a randomized, placebo...
What is the best strategy for monitoring the lipid-lowering effects of medical therapy used for the primary prevention of coronary artery disease (CAD)?
(Family Physicians Inquiries Network, 2001)
There is good evidence that treatment for primary prevention of CAD decreases risk of major first coronary events and cardiovascular mortality, though all-cause mortality has not been shown to be reduced. There is no evidence identifying the best...
Do corticosteroid injections improve carpal tunnel syndrome symptoms?
(Family Physicians Inquiries Network, 2016)
Q: Do corticosteroid injections improve carpal tunnel syndrome symptoms? Evidence-based answer: Yes. injected corticosteroids reduce symptoms of carpal tunnel syndrome (CTS) more effectively than placebo or systemic steroids, but no better than anti...
Nurse resident job satisfaction with a formal mentorship program
(2023)
"This quality improvement (QI) project aims to evaluate the impact of a new mentoring program on the job satisfaction of nurse residents as part of their participation in the nurse residency program between January 2023 ...
What's the best way to screen for anxiety and panic disorders?
(Family Physicians Inquiries Network, 2007)
The GAD-7 has the best evidence and utility in the primary care setting for generalized anxiety disorder (strength of recommendation [SOR]: A), while the proprietary Quick PsychoDiagnostics Panel (QPD) has the best operating characteristics...
Do glucosamine and chondroitin worsen blood sugar control in diabetes?
(Family Physicians Inquiries Network, 2006)
Despite theoretical risks based on animal models given high intravenous doses, glucosamine/chondroitin (1500 mg/1200 mg daily) does not adversely affect short-term glycemic control for patients whose diabetes is well-controlled, or for those without...
Should you consider antibiotics for exacerbations of mild COPD?
(Family Physicians Inquiries Network, 2014)
Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).
Is screening for lead poisoning justified?
(Family Physicians Inquiries Network, 2003)
Evidence is insufficient to recommend for or against universal screening of young children for lead poisoning in high- prevalence communities (strength of recommendation [SOR]: C). In low-prevalence communities, evidence is insufficient to recommend...
Do insulin-sensitizing drugs increase ovulation rates for women with PCOS?
(Family Physicians Inquiries Network, 2005)
Short-term use of metformin (Glucophage) improves ovulation rates for women with polycystic ovary syndrome (PCOS) (strength of recommendation [SOR]: A, based on systematic reviews of randomized controlled trials [RCT]). Metformin also decreases...
Is intra-articular platelet-rich plasma injection an effective treatment for knee OA?
(Family Physicians Inquiries Network, 2019)
Q: Is intra-articular platelet-rich plasma injection an effective treatment for knee OA? EVIDENCE-BASED ANSWER: PROBABLY NOT, based on the balance of evidence. While low-quality evidence may suggest potential benefit, the balance of evidence...
How safe is vaginal birth after cesarean section for the mother and fetus?
(Family Physicians Inquiries Network, 2006)
Compared with planned repeat low-transverse cesarean section, vaginal birth after cesarean section (VBAC) is not associated with increased risk of maternal or neonatal mortality (strength of recommendation [SOR]: B). ...
Do inhaled steroids increase the risk of osteoporosis?
(Family Physicians Inquiries Network, 2007)
, systematic reviews and randomized controlled trials [RCTs]). However, higher doses of inhaled corticosteroids may be associated with negative bone density changes at up to 4 years of follow-up (SOR: C, RCTs without change in fracture rates). No evidence...
What medical therapies work for gastroparesis?
(Family Physicians Inquiries Network, 2018)
Q: What medical therapies work for gastroparesis? Evidence-based answer: It's unclear if there are any highly effective medications for gastroparesis (TABLE1-10). Metoclopramide improves the sense of fullness by about 40% for as long as 3 weeks, may...
How should you manage a depressed patient unresponsive to an SSRI?
(Family Physicians Inquiries Network, 2006)
The best approach among studied alternatives to manage a patient with treatment-resistant depression is not clear from the evidence. All of the options reviewed seem to have about a 25% to 30% success rate. Switching to other antidepressants...