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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 improve depression and reduce...
Which combined OC to prescribe with CV safety in mind?
(Family Physicians Inquiries Network, 2017)
When prescribing combined oral contraceptives, choose one containing levonorgestrel and low-dose estrogen (20 mcg) to minimize the risks of pulmonary embolism, ischemic stroke, and myocardial infarction.
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 changer: Use steroids in women...
"Cold turkey" works best for smoking cessation
(Family Physicians Inquiries Network, 2017)
"Cold turkey" works best for smoking cessation. PRACTICE CHANGER: Counsel patients who want to quit smoking that abrupt smoking cessation is more effective for long-term abstinence than taking a gradual approach. STRENGTH OF RECOMMENDATION: B: Based...
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...
Direct oral anticoagulants or warfarin for A fib?
(Family Physicians Inquiries Network, 2017)
A recent study evaluated the effectiveness of 3 direct oral anticoagulants and warfarin in patients with atrial fibrillation. So which agents came out on top? PRACTICE CHANGER: Use direct oral anticoagulants instead of warfarin in patients...
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 because it is as effective...
Consider melatonin for migraine prevention
(Family Physicians Inquiries Network, 2017)
An effective migraine prevention alternative with minimal adverse effects Melatonin is an accessible and affordable option for preventing migraine headaches in chronic sufferers.
Oral agent offers relief from generalized hyperhidrosis
(Family Physicians Inquiries Network, 2017)
Hyperhidrosis is a common, self-limiting problem affecting 2% to 3% of the population in the United States. Patients may complain of localized sweating of the hands, feet, face, or underarms or more systemic, generalized ...
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...
When to "CAP" off treatment for pneumonia
(Family Physicians Inquiries Network, 2017)
Is 5 days of antibiotic therapy really sufficient for adults hospitalized with community-acquired pneumonia? PRACTICE CHANGER: Prescribe 5 days of antibiotic treatment for inpatients with community-acquired pneumonia because it produces the same...
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 inhibitor for patients taking...
Are oral emergency contraceptives a safe & effective form of long-term birth control?
(Family Physicians Inquiries Network, 2017)
Q: Are oral emergency contraceptives a safe & effective form of long-term birth control? A: Yes, but not as effective as some other methods. Annual pregnancy rates in women using pericoital levonor- gestrel 150 mcg to 1 ...
What effects -- if any -- does marijuana use during pregnancy have on the fetus or child?
(Family Physicians Inquiries Network, 2017)
Q: What effects -- if any -- does marijuana use during pregnancy have on the fetus or child? Evidence-based answer: The effects are unclear. Marijuana use during pregnancy is associated with clinically unimportant lower ...
Can mobile technology improve weight loss in overweight and obese patients?
(Family Physicians Inquiries Network, 2017)
Q: Can mobile technology improve weight loss in overweight and obese patients? Evidence-based answer: Yes, this technology can help in the short term. Mobile technology compared with minimal or no intervention increases ...
Which interventions are effective in managing parental vaccine refusal?
(Family Physicians Inquiries Network, 2017)
Q: Which interventions are effective in managing parental vaccine refusal? A: it's unclear whether educational initiatives alone alter vaccine refusal. Although about a third of parents cite herd immunity as motivation for ...
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 ...
Do ACE inhibitors or ARBs help prevent kidney disease in patients with diabetes and normal BP?
(Family Physicians Inquiries Network, 2017)
Q: Do ACE inhibitors or ARBs help prevent kidney disease in patients with diabetes and normal BP? Evidence-based answer: Yes for angiotensin-converting enzyme (ACE) inhibitors, no for angiotensin receptor blockers (ARBs). ...
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 ...
What is the most effective treatment for scabies?
(Family Physicians Inquiries Network, 2017)
Q: What is the most effective treatment for scabies? Evidence-based answer: Topical permethrin is the most effective treatment for classic scabies (strength of recommendation [SOR]: A, meta-analyses with consistent results). ...