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

  • A new protocol for RhD-negative pregnant women? 

    Lyon, Corey; English, Almee (Family Physicians Inquiries Network, 2018-05)
    Can cell-free DNA testing reduce unnecessary use of anti-D immunoglobulin in RhD-negative women and still prevent harm to their RhD-positive infants? PRACTICE CHANGER: Employ cell-free DNA testing at 27 weeks’ gestation ...
  • Treating migraines : it's different for kids 

    Hawks, Matthew; Mounsey, Anne (Family Physicians Inquiries Network, 2018-04)
    Treating migraines: It’s different for kids Certain medications used for migraine prevention in adults do not perform the same way in children and adolescents and can actually cause harm. PRACTICE CHANGER: Do not prescribe ...
  • An easy approach to obtaining clean-catch urine from infants 

    Morris, Laura (Family Physicians Inquiries Network, 2018-03)
    An easy approach to obtaining clean-catch urine from infants Current collection methods leave much to be desired. But a new method may provide a quick alternative. Apply gauze soaked in cold sterile saline to the suprapubic ...
  • Does fish oil during pregnancy help prevent asthma in kids? 

    Neutze, Dana; Evans, Kelly Lacy; Koenig, Marianne; Castelli, Gregory; Mounsey, Anne (Family Physicians Inquiries Network, 2018-02)
    Does fish oil during pregnancy help prevent asthma in kids? The evidence on fish oil has been mixed, but this study affirms its benefits—in certain women. PRACTICE CHANGER: Fish oil supplementation taken by women in the ...
  • Tamsulosin for patients with ureteral stones? 

    Hughes, Pamela; Lyon, Corey (Family Physicians Inquiries Network, 2018-01)
    Tamsulosin for patients with ureteral stones? Yes, but only for some. Find out which of your patients can benefit. PRACTICE CHANGER: Prescribe tamsulosin for stone expulsion in patients with distal ureteral stones 5 to 10 ...
  • Does azithromycin have a role in cesarean sections? 

    Castelli, Gregory; Flaherty, Allison; Jarrett, Jennie B. (Family Physicians Inquiries Network, 2017-12)
    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: ...
  • The benefits—and limits— of PPIs with warfarin regimens 

    Ludden-Schlatter, Alicia; Stevermer, James J. (Family Physicians Inquiries Network, 2017-11)
    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 ...
  • When to "CAP" off treatment for pneumonia 

    Castelli, Gregory; Jarrett, Jennie B. (Family Physicians Inquiries Network, 2017-10)
    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 ...
  • SSRIs for depression/heart failure patients? Not so fast 

    Ricco, Jason; Benson, Janice; Prasad, Shailendra (Family Physicians Inquiries Network, 2017-09)
    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 ...
  • Direct oral anticoagulants or warfarin for A fib? 

    Lyon, Corey; Reed, Alex; Prasad, Shailendra (Family Physicians Inquiries Network, 2017-08)
    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 ...
  • Which combined OC to prescribe with CV safety in mind? 

    Lam, Yee; Coe, Catherine; Mounsey, Anne; Prasad, Shailendra (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.
  • Oral agent offers relief from generalized hyperhidrosis 

    Jarrett, Jennie B.; Moss, David; Mounsey, Anne (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 ...
  • Consider melatonin for migraine prevention 

    Lyon, Corey; Langner, Shannon; Stevermer, James J. (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.
  • When can exercise supplant surgery for degenerative meniscal tears? 

    Jarrett, Jennie B.; Sauereisen, Sandra (Family Physicians Inquiries Network, 2017-04)
    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 ...
  • "Cold turkey" works best for smoking cessation 

    Smith, Dustin K.; Miller, Deborah E.; Mounsey, Anne (Family Physicians Inquiries Network, 2017-03)
    "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 ...
  • Steroids during late preterm labor: better later than never 

    Lyon, Corey; Bello, Jennifer (Family Physicians Inquiries Network, 2017-02)
    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: ...
  • Need an add-on to metformin? Consider this 

    Wyncott, David; Lyon, Corey; Mounsey, Anne (Family Physicians Inquiries Network, 2017-01)
    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: ...
  • A more palatable alternative to oral rehydration therapy for kids 

    Reust, Carin; Stevermer, James J.; Jarrett, Jennie B. (Family Physicians Inquiries Network, 2016-12)
    A more palatable alternative to oral rehydration therapy for kids. Parents no longer need to struggle to get their kids to drink electrolyte solutions during episodes of mild gastroenteritis; apple juice works just as well. ...
  • Monitoring home BP readings just got easier 

    Jarrett, Jennie B; Hogan, Linda; Lyon, Corey (Family Physicians Inquiries Network, 2016-10)
    Monitoring home BP readings just got easier. This novel method of identifying patients with uncontrolled hypertension correlates well with ambulatory BP monitoring. Practice changer: Use this easy "3 out of 10 rule" to ...
  • Deliver or wait with late preterm membrane rupture? 

    Bergeson, Keri; Prasad, Shailendra (Family Physicians Inquiries Network, 2016-11)
    Deliver or wait with late preterm membrane rupture? While ACOG recommends delivery for all women with ruptured membranes after 34 weeks' gestation, a new study finds expectant management may be the way to go. Practice ...

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