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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...
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...
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...
What laboratory monitoring is appropriate to detect adverse drug reactions in patients on cholesterol-lowering agents?
(Family Physicians Inquiries Network, 2001)
Recommendations for measuring serum aminotransferase levels before initiating pharmacologic treatment for hypercholesterolemia, after 12 weeks of therapy, and periodically afterward are based on expert opinion. It is not recommended that serum...
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 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...
What is the best beta-blocker for systolic heart failure?
(Family Physicians Inquiries Network, 2015)
Q: What is the best beta-blocker for systolic heart failure? Evidence-based answer: Three beta-blockers--carvedilol, metoprolol succinate, and bisoprolol--reduce mortality equally (by about 30% over one year) in patients with Class III or IV...
What is a reasonable initial approach to the patient with fatigue?
(Family Physicians Inquiries Network, 2001)
with sedimentation rate, blood count, and glycohemoglobin and thyroid stimulating hormone (TSH) levels, particularly in older patients. Grade of Recommendation: C, based on case series and expert opinion...
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 ...
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...
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 effectively do ACE inhibitors and ARBs prevent migraines?
(Family Physicians Inquiries Network, 2018)
Q: How effectively do ACE inhibitors and ARBs prevent migraines? Evidence-based answer: The angiotensin-converting enzyme (ACE) inhibitor lisinopril reduces the number of migraines by about 1.5 per month in patients experiencing 2 to 6 migraines...
What are the indications for treatment with angiotensin-converting enzyme (ACE) inhibitors in patients with diabetes?
(Family Physicians Inquiries Network, 2001)
of recommendation: A, based on randomized controlled trials.)...
Should patients receive 23-valent pneumococcal vaccination more than once?
(Family Physicians Inquiries Network, 2006)
. Revaccination is recommended by the Advisory Committee on Immunization Practices (ACIP) in certain circumstances. (strength of recommendation [SOR]: C, expert opinion based on physiology/bench research). Revaccination once appears to be safe, especially...
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...
What is the best test to diagnose urinary tract stones?
(Family Physicians Inquiries Network, 2001)
. (Grade of recommendation: A, based on independent blind comparison of an appropriate spectrum of patients.)...
Focus on Leadership, Climate, Culture, and Instructional Practices: Practical Strategies for School Improvement.
(2007-02)
This presentation discusses leadership, climate, culture and instructional practices. It raises questions and links topics together for a big-picture view....
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...
Have pedometer, will travel
(Family Physicians Inquiries Network, 2008)
blood pressure. Stength of recommendation: A: Based on a meta-analysis of randomized controlled trials (RCTs) and observational studies....
When should we stop mammography screening for breast cancer in elderly women?
(Family Physicians Inquiries Network, 2001)
There is insufficient evidence to recommend for or against routine screening mammography beyond the age of 69 years. The best candidates to stop screening are elderly women who have significant comorbidities, poor functional status, low bone mineral...