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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...
What is the best diagnostic approach to postmenopausal vaginal bleeding in women taking hormone replacement therapy?
(Family Physicians Inquiries Network, 2001)
continues. (Grade of recommendation: C, based on case series.) Evaluation of this bleeding should begin with a pelvic examination and Papanicolaou (Pap) test (if not done in the previous 12 months), then transvaginal ultrasound (TVUS), followed...
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). ...
Is pneumococcal vaccine effective in nursing home patients?
(Family Physicians Inquiries Network, 2003)
Evidence from clinical trials supports the use of pneumococcal polysaccharide vaccine for prevention of pneumonia in nursing home patients (strength of recommendation: B, based on randomized, nonblinded clinical trials). Case-control studies have...
Initiating antidepressant therapy? Try these 2 drugs first
(Family Physicians Inquiries Network, 2009)
When you initiate antidepressant therapy for patients who have not been treated for depression previously, select either sertraline or escitalopram. A large meta- analysis found these medications to be superior to other ...
Patient safety outcomes with bedside reporting
(2023)
"This EBP project was started in response to patient safety events reported that could have been prevented had nursing staff completed change of shift hand off at the patient's bedside. A few commonly found events included ...
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 old is too old for statins?
(Family Physicians Inquiries Network, 2020)
How old is too old for statins? When to start, continue, or stop statins in those ages [greater than or equal to] 75 years has been a quandary. Here 's why 2 studies have to say. PRACTICE CHANGER: Do you start a statin in patients ages [greater than...
How often does long-term PPI therapy cause clinically significant hypomagnesemia?
(Family Physicians Inquiries Network, 2018)
Q: How often does long-term PPI therapy cause clinically significant hypomagnesemia? EVIDENCE-BASED ANSWER: Rarely. Proton pump inhibitors (PPIs) may be associated with decreases in serum magnesium laboratory values to below 1.6 to 1.8 mg...
Give vitamin C to avert lingering pain after fracture
(Family Physicians Inquiries Network, 2008)
Vitamin C 500 mg daily for 50 days reduced the risk of complex regional pain syndrome for patients with a wrist fracture. We think vitamin C 500 mg a day for 7 weeks is well worth recommending. Stength of recommendation: A: Based on 2 consistent...
Does breastfeeding affect the risk of childhood obesity?
(Family Physicians Inquiries Network, 2016)
Q: Does breastfeeding affect the risk of childhood obesity? Evidence-based answer: Yes. Even having breastfed during the first year of life is associated with a 15% lower risk of overweight or obesity over the next 2 to 14 years compared with never...
No pain, if you've got game
(Family Physicians Inquiries Network, 2021)
No pain, if you've got game. Allowing children to engage in active distraction techniques--such as playing a video game--during venipuncture can lead to reduced pain and anxiety. PRACTICE CHANGER: Employ active distraction, such as playing a video...
An alternative regimen to reduce risk of asthma exacerbations
(Family Physicians Inquiries Network, 2021)
An alternative regimen to reduce risk of asthma exacerbations This study supports the use of an ICS/LABA as needed for adults with intermittent, mild persistent, and moderate persistent asthma. Practice changer: PRACTICE CHANGER Use an inhaled...
At what age do patients no longer need colorectal cancer screening?
(Family Physicians Inquiries Network, 2001)
Good evidence supports fecal occult blood testing (FOBT) for patients up to age 75 (grade of recommendation: A, based on systematic review of randomized controlled trials). There is insufficient evidence to recommend for or against colorectal cancer...
Does vitamin D without calcium reduce fracture risk?
(Family Physicians Inquiries Network, 2016)
Q: Does vitamin D without calcium reduce fracture risk? Evidence-based answer: No. Supplemental vitamin D without calcium -- in doses averaging as much as 800 IU per day -- doesn't reduce the risk of hip, vertebral, or nonvertebral fractures...
Efficacy of a low-carbohydrate or ketogenic diet in preventing patient morbidity and mortality
(Family Physicians Inquiries Network, 2020)
-analysis of RCTs). Treatment of type 2 diabetes mellitus with low-carbohydrate diets demonstrated a decrease in hemoglobin A1c (HbA1c) levels (SOR C: disease-oriented evidence based on meta-analysis or RCTs). Low-carbohydrate diets paired with animal-based proteins...
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.)...
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....
A therapist survey of evidence-based practices in publicly funded youth mental health
(University of Missouri--Columbia, 2018)
sizes in controlled clinical trials for evidence-based treatments (EBTs) for youth MH problems (Weisz, Jensen-Doss & Hawley, 2006). One potential reason for this discrepancy may be that therapists within TAU contexts are not implementing EBTs. To date...
When should we treat isolated high triglycerides?
(Family Physicians Inquiries Network, 2004)
No evidence exists that treating isolated high triglyceride levels in the absence of other risk factors prevents coronary events. Although elevated triglycerides in some studies correlates with coronary events, the association weakens when...