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

  • Less is more when it comes to ketorolac for pain 

    Lyon, Corey; Claus, Liza W. (Family Physicians Inquiries Network, 2019-01)
    Less is more when it comes to ketorolac for pain. It’s time to review our dosing with ketorolac for acute pain management. PRACTICE CHANGER: Using a low dose (10 mg) of intravenous ketorolac for moderate to severe acute ...
  • What’s the best treatment setting for stable PE patients? 

    Schaffer, Monica; Castelli, Gregory (Family Physicians Inquiries Network, 2018-12)
    What’s the best treatment setting for stable PE patients? The answer seems to be the outpatient setting. Here’s why. PRACTICE CHANGER: Manage patients with acute pulmonary embolism (PE) who are hemodynamically stable in ...
  • Should you reassess your patient’s asthma diagnosis? 

    Stevermer, James J.; Hayes, Alisa (Family Physicians Inquiries Network, 2018-11)
    Should you reassess your patient's asthma diagnosis? Asthma may not be a permanent diagnosis in adults. A study finds that up to one-third of adults with physician-diagnosed asthma no longer had it after 5 years. ...
  • Time to stop glucosamine and chondroitin for knee OA? 

    Lyon, Corey; Mullen, Rebecca; Ashby, Drew (Family Physicians Inquiries Network, 2018-09)
    Time to stop glucosamine and chondroitin for knee OA? Prior studies provided conflicting results regarding the efficacy of these medications. This study offers evidence for discontinuing them. Practice changer: Tell patients ...
  • Time to switch to nonsterile gloves for these procedures? 

    Castelli, Gregory; Friedlander, Mary Pat (Family Physicians Inquiries Network, 2018-08)
    Time to switch to nonsterile gloves for these procedures? Are sterile gloves worth the extra cost for common cutaneous surgeries? This systematic review and meta-analysis provides answers. Practice changer: Using nonsterile ...
  • First-time, mild diverticulitis: Antibiotics or watchful waiting? 

    Marshall, Bob; Prasad, Shailendra; Noel, Mary Alice; Burket, Jeffrey; Arnold, Michael; Arthur, Benjamin; Bennett, Nick; Smith, Ashley (Family Physicians Inquiries Network, 2018-07)
    First-time, mild diverticulitis: antibiotics or watchful waiting? Dn't jump to antibiotic Tx for mild, uncomplicated diverticulitis, a recent RCT says. Observation may be just as effective. Practice changer: For mild, ...
  • Let low-risk moms eat during labor? 

    Phelps, Karen; Davers, Justin; Seehusen, Dean A.; Stevermer, James J. (Family Physicians Inquiries Network, 2018-06)
    Let low-risk moms eat during labor? Allowing low-risk pregnant women to eat less restrictive diets during labor may not only make them happier, but may shorten labor, too. Practice changer: Allowing low-risk patients ...
  • 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, 2017-07)
    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, 2017-06)
    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, 2017-05)
    An effective migraine prevention alternative with minimal adverse effects Melatonin is an accessible and affordable option for preventing migraine headaches in chronic sufferers.

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