Priority Updates from the Research Literature (PURLs) distill the literature to those few articles that are relevant, practice-changing, and able to be implemented immediately. They generate new evidence-based recommendations for practice for family physicians and other primary care clinicians. PURLs are published exclusively in the Journal of Family Practice.

Recent Submissions

  • Noncardiac inpatient has acute hypertension: Treat or not? 

    Marshall, Robert C.; Thiel, Derrick J.; Samar, Haroon (Family Physicians Inquiries Network, 2022-09)
    A retrospective study found more harm than benefit from treating elevated blood pressure in hospitalized noncardiac patients.
  • A "no-biopsy" approach to diagnosing celiac disease 

    Mott, Timothy; Gray, Carrie; Storey, Jon (Family Physicians Inquiries Network, 2022-10)
    This noninvasive alternative to the diagnostic gold standard may cut risk and expense for adult patients.
  • Time to consider topical capsaicin for acute trauma pain? 

    Cleary, Dillon; Burton, Samuel; Cardon, Brock (Family Physicians Inquiries Network, 2022)
    Topical capsaicin is more effective than topical piroxicam at reducing pain in acute upper extremity injuries.
  • Migraine relief in 20 minutes using eyedrops? 

    Ge, Yufei; Castelli, Gregory (Family Physicians Inquiries Network, 2022)
    One randomized crossover trial demonstrated the effectiveness of this simple, affordable treatment for patients with acute migraine pain.
  • Is it time to approach spontaneous pneumothorax more conservatively? 

    Jones, Gregory; Georgiadis, Jeremias; Staples, Valerie; Mullen, Rebecca (Family Physicians Inquiries Network, 2022)
    A recent study provides modest evidence for observational management over interventional treatment, sparing patients from invasive procedures.
  • Getting a jump on recovery from sports-related concussion 

    Stem, Leah; Castelli, Gregory (Family Physicians Inquiries Network, 2022)
    Early subthreshold aerobic exercise safely improved recovery time over a stretching regimen among adolescents in this clinical trial.
  • Colchicine may decrease cardiovascular events in patients with coronary artery disease 

    Griffin, Leslie; Groce, Julia; Conway, Sara (Family Physicians Inquiries Network, 2022)
    This oral anti-inflammatory agent may offer a low-cost option for prevention of cardiovascular events in this patient population.
  • Can extended anticoagulation prophylaxis after discharge prevent thromboembolism? 

    Anwar, Muhammad Nadeem; Khan, Usman Ahmad; Morris, Laura Elizabeth (Family Physicians Inquiries Network, 2022)
    A meta-analysis confirmed the benefit of thromboprophylaxis with a direct oral anticoagulant for high-risk nonsurgical patients after hospital discharge.
  • Can early introduction of gluten reduce risk of celiac disease? 

    Hall, Ashley U.; Meisenheimer, Erica S.; Marshall, Robert C. (Family Physicians Inquiries Network, 2022)
    This UK study revealed the benefits of introducing gluten at age 4 months.
  • Alcohol abstinence reduces A-fib burden in drinkers 

    Thiel, Derrick J.; Marshall, Robert C.; Rogers, Tyler S. (Family Physicians Inquiries Network, 2022)
    A recent Australian study demonstrated a significant reduction in A-fib recurrence and burden among regular drinkers who abstained from alcohol.
  • Monotherapy for nonvalvular A-fib with stable CAD? 

    Garigan, Thomas P.; Earwood, John S.; Poplawski, Michal (Family Physicians Inquiries Network, 2021)
    A meta-analysis found oral anticoagulant (OAC) monotherapy provided efficacy comparable to OAC plus single antiplatelet therapy--with lower bleeding risk.
  • Skip that repeat DXA scan in these postmenopausal women 

    Zweid, Alexander; Tunink, Carl; Morria, Laura (Family Physicians Inquiries Network, 2021)
    Skip that repeat DXA scan in these postmenopausal women. Repeat bone density measurement offers no advantage in predicting fracture risk in postmenopausal women who do not have osteoporosis. PRACTICE CHANGER: Do not routinely ...
  • Validated scoring system identifies low-risk syncope patients 

    Lewton, Amanda Kay; Morris, Laura Elizabeth (Family Physicians Inquiries Network, 2021)
    This study validated the Canadian Syncope Risk Score for predicting 30-day serious outcomes in patients presenting to the ED within 24 hours of syncope.
  • Updated USPSTF screening guidelines may reduce lung cancer deaths 

    Marshall, Robert C.; Tiglao, Samuel Miguel; Thiel, Derrick (Family Physicians Inquiries Network, 2022)
    By nearly doubling the number of patients eligible for screening, as many as 60,000 US lives may be saved--but concerns may limit acceptance.
  • Prescribe an SGLT2 inhibitor for heart failure in the absence of diabetes? 

    Koenigsberger, Debra; Marquez, Alexander; Hughes, Pamela R. (Family Physicians Inquiries Network, 2021)
    Prescribe an SGLT2 inhibitor for heart failure in the absence of diabetes? An RCT demonstrates that dapagliflozin produces better cardiovascular outcomes than placebo for heart failure patients with and without diabetes. ...
  • This is not the time to modify a HTN regimen 

    Grubbs, Calvin; Morris, Laura (Family Physicians Inquiries Network, 2021)
    This is not the time to modify a HTN regimen. Intensifying hypertension regimens at discharge increases risk in older patients. PRACTICE CHANGER: Avoid intensifying antihypertensive medication regimens at hospital discharge ...
  • Antibiotics and COPD : time to order a C-reactive protein test? 

    Piggott, Cleveland; Lyon, Corey (Family Physicians Inquiries Network, 2021-06)
    This RCT provided valuable insights as to whether CRP-guided prescribing could safely reduce antibiotic use during acute COPD exacerbations.
  • Confidently rule out CAP in the outpatient setting 

    Mott, Timothy; Echeverri, David; Fondren, Luke; Hunter, Ashley (Family Physicians Inquiries Network, 2021)
    Confidently rule out CAP in the outpatient setting. A focus on specific signs and symptoms -- without imaging -- may rule out community-acquired pneumonia in outpatients. PRACTICE CHANGER: You can safely rule out ...
  • Automated office BP measurement : the new standard in HTN screening 

    Tiglao, Samuel Miguel; Meisenheimer, Erica S.; Marshall, Robert C. (Family Physicians Inquiries Network, 2021)
    Automated office BP measurement: The new standard in HTN screening. Obtain greater accuracy in blood pressure measurement with an automated office device. PRACTICE CHANGER: Measure patients' blood pressure (BP) using an ...
  • An alternative regimen to reduce risk of asthma exacerbations 

    Shelesky, Gretchen; Castelli, Gregory (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 ...

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