• A-fib and rate control: Don't go too low 

    Deane, Kristen; Jones, Kohar; Stevermer, James J. (Family Physicians Inquiries Network, 2010-08)
    Aim for a heart rate of <110 beats per minute (bpm) in patients with permanent atrial fibrillation. Maintaining this rate requires less medication than more stringent rate control, resulting in fewer side effects and no ...
  • ACE inhibitors and ARBs: One or the other—not both—for high-risk patients 

    Misra, Shamita; Stevermer, James J.; Ewigman, Bernard (Family Physicians Inquiries Network, 2009-01)
    Avoid prescribing an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin receptor blocker (ARB) for patients at high risk of vascular events or renal dysfunction. The combination does not reduce poor outcomes, ...
  • An alternative to warfarin for patients with PE 

    Morris, Laura; Stevermer, James J. (Family Physicians Inquiries Network, 2012-12)
    Consider treating patients with acute pulmonary embolism (PE) with rivaroxaban, a factor Xa inhibitor; it works as well as low-molecular- weight heparin (LMWH) followed by warfarin, but may cause fewer major bleeds. ...
  • Arthritis pain? These supplements provide little relief 

    Stevermer, James J.; Rogers, Nina Vergari (Family Physicians Inquiries Network, 2011-10)
    Tell patients with large joint arthritis that glucosamine and chondroitin have been found to be little better than placebo. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: ...
  • Bisphosphonate therapy: When not to monitor BMD 

    Sharma, Umang; Stevermer, James J.; Hickner, John (Family Physicians Inquiries Network, 2009-11)
    After starting patients on bisphosphonates for osteoporosis, wait at least 3 years before ordering a repeat dual-energy x-ray absorptiometry (DXA) scan. Strength of Recommendation: C: Based on a secondary analysis of a ...
  • Consider this strategy for upper GI bleeds 

    Frazer, Kevin; Kirley, Kate; Stevermer, James J. (Family Physicians Inquiries Network, 2013-09)
    Do not order transfusions of red blood cells for patients with acute upper gastrointestinal bleeding unless their hemoglobin level <7 g/dL. A: Based on a single randomized controlled trial (RCT) consistent with other RCTs ...
  • Counseling is a must with this smoking cessation aid 

    Stephens, Luke A.; Stevermer, James J. (Family Physicians Inquiries Network, 2012-03)
    Inform patients who are interested in taking varenicline (Chantix) that there is a small cardiovascular (CV) risk associated with it, as well as neuropsychiatric risks -- and consider recommending that smokers with a ...
  • Drugs help pass more ureteral stones 

    Stevermer, James J.; Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2008-04)
    Prescribe tamsulosin (typically 0.4 mg daily) or nifedipine (typically 30 mg daily) for patients with lower ureteral calculi, to speed stone passage and to avoid surgical intervention. Strength of recommendation A: ...
  • Ear wax removal: Help patients help themselves 

    Rogers, Nina Vergari; Stevermer, James J. (Family Physicians Inquiries Network, 2011-11)
    Suggest that patients use drops to soften the wax in their ears and a bulb syringe to remove it. Reassure them that the process is safe, easy, and effective. Strength of Recommendation: B: A single well-designed randomized ...
  • Fracture pain relief for kids? Ibuprofen does it better 

    Morris, Laura; Stulberg, Debra; Stevermer, James J. (Family Physicians Inquiries Network, 2010-05)
    Use ibuprofen instead of acetaminophen with codeine for pediatric arm fractures. It controls the pain at least as well and is better tolerated. Strength of recommendation A: Based on 1 longer-term and 2 short-term ...
  • Give vitamin C to avert lingering pain after fracture 

    Stevermer, James J.; Ewigman, Bernard (Family Physicians Inquiries Network, 2008-02)
    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. Strength of recommendation ...
  • Help for recurrent bacterial vaginosis 

    Jones, Kohar; Ewigman, Bernard; Stevermer, James J. (Family Physicians Inquiries Network, 2011-02)
    Recommend high-dose vaginal probiotic capsules to prevent recurrent bacterial vaginosis. Strength of recommendation B: Based on a single high-quality randomized controlled trial (RCT).
  • Help smokers quit: Tell them their “lung age” 

    Deane, Kristen; Stevermer, James J.; Hickner, John (Family Physicians Inquiries Network, 2008-09)
    Perform spirometry on patients who smoke -- even if they're asymptomatic -- and show them their lung age that is, the average age of a nonsmoker with a forced expiratory volume at 1 second (FEV1) equal to theirs. Doing ...
  • Is your patient still using rosiglitazone? 

    Gov-Ari, Hanna K.; Stevermer, James J. (Family Physicians Inquiries Network, 2011-05)
    Do not initiate rosiglitazone therapy for patients with diabetes, and consider switching those who are already taking it to pioglitazone. Strength of recommendation A: Based on a meta-analysis of 56 randomized trials.
  • It’s time to use an age-based approach to D-dimer 

    Urban, Karli; Kirley, Kate; Stevermer, James J. (Family Physicians Inquiries Network, 2014-03)
    Use an age-adjusted D-dimer cutoff (patient's age in years × 10 mcg/L) for patients over age 50 years when evaluating for venous thromboembolism (VTE); it reduces false positives without substantially increasing false negatives.
  • Migraine treatment “tweak” could reduce office visits 

    Wells, Jack; Stevermer, James J.; Ewigman, Bernard (Family Physicians Inquiries Network, 2009-07)
    Add dexamethasone to the standard treatment of moderate to severe migraine headache; a single dose (8-24 mg) may prevent short-term recurrence, resulting in less need for medication and fewer repeat visits to the office ...
  • A new adjunctive Tx option for venous stasis ulcers 

    Crenshaw, Benjamin H.; Roberson, Kortnee Y.; Stevermer, James J. (Family Physicians Inquiries Network, 2015-03)
    A new adjunctive Tx option for venous stasis ulcers. Practice changer: Consider adding simvastatin 40 mg/d to standard wound care and compression for patients with venous stasis ulcers.
  • Offer this contraceptive to breastfeeding new moms 

    Jones, Kohar; Egan, Mari E.; Stevermer, James J. (Family Physicians Inquiries Network, 2011-12)
    Recommend the etonogestrel implant to new mothers who plan to breastfeed; the insertion of this contraceptive within the first few days postpartum does not alter breastfeeding outcomes. Strength of Recommendation B: Based ...
  • Prescribing statins for patients with ACS? No need to wait 

    Gov-Ari, Hanna K.; Stevermer, James J. (Family Physicians Inquiries Network, 2014-12)
    PRACTICE CHANGER: Prescribe a high-dose statin before any patient with acute coronary syndrome (ACS) undergoes percutaneous coronary intervention (PCI); it may be reasonable to extend this to patients being evaluated for ACS.1
  • Pulse oximetry for newborns: should it be routine? 

    Swenson, Amanda; Brown, Dionna; Stevermer, James J. (Family Physicians Inquiries Network, 2012-05)
    Ensure that all newborns undergo pulse oximetry screening before discharge -- and that abnormal results are immediately followed up with echocardiography. Strength of recommendation B: Based on a single cohort study ...