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

  • 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 ...
  • Yeast infection in pregnancy? Think twice about fluconazole 

    Barzin, Amir; Mounsey, Anne (Family Physicians Inquiries Network, 2016-09)
    Yeast infection in pregnancy? Think twice about fluconazole. This study's findings regarding the risk of miscarriage may mean it's time to forego fluconazole in favor of topical azoles as first-line treatment. Practice ...
  • On-demand pill protocol protects against HIV 

    Justesen, Kathryn; Prasad, Shailendra (Family Physicians Inquiries Network, 2016-08)
    On-demand pill protocol protects against HIV: Finally, there's an effective prevention strategy -- other than condoms -- that can be used, as needed, by patients at high risk for HIV infection. Practice changer: Offer ...
  • More isn't better with acute low back pain treatment 

    Frazer, Kevin; Stevermer, James (Family Physicians Inquiries Network, 2016-06)
    More isn't better with acute low back pain treatment Adding cyclobenzaprine or oxycodone/acetaminophen to naproxen for the treatment of acute low back pain does nothing more than increase adverse effects. Practice changer: ...
  • Light therapy for nonseasonal major depressive disorder? 

    Eniola, Kehinde; Bacigalupo, Angela; Mounsey, Anne (Family Physicians Inquiries Network, 2016-07)
    Light therapy for nonseasonal major depressive disorder? While bright light therapy already has a place in the treatment of seasonal affective disorder, a recent trial spotlights its utility beyond the winter months. ...
  • Go low or say No to aggressive systolic BP goals? 

    Day, Margaret; Steverner, James J. (Family Physicians Inquiries Network, 2016-05)
    "Go low" or say "No" to aggressive systolic BP goals? The SPRINT trial demonstrated the benefits -- and risks -- of reaching a systolic target <120 mm Hg in non-diabetic patients at high risk for CV events. Here's who might ...
  • Resistant hypertension? Time to consider this fourth-line drug 

    Kaysin, Alexander; Mounsey, Anne (Family Physicians Inquiries Network, 2016-04)
    Resistant hypertension? Time to consider this fourth-line drug For most adults with resistant hypertension, spironolactone is superior to doxazosin and bisoprolol as an adjunct to triple therapy. Practice changer: When a ...
  • Kidney stones? It's time to rethink those meds 

    Slattengren, Andrew H.; Prasad, Shailendra; Jarrett, Jennie B. (Family Physicians Inquiries Network, 2016-02)
    Kidney stones? It's time to rethink those meds. Despite being recommended for ureteral stone expulsion, tamsulosin or nifedipine are no more effective than placebo. Practice changer: Do not prescribe tamsulosin or nifedipine ...
  • Aneuploidy screening: Newer noninvasive test gains traction 

    Nickolich, Sarah; Farahi, Narges; Jones, Kohar; Mounsey, Anne (Family Physicians Inquiries Network, 2016-01)
    Favorable results from the 2 studies reviewed here have prompted ACOG to recommend that cell-free DNA screening be discussed with all pregnant patients. Practice changer: Discuss cell-free DNA testing when offering fetal ...

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