AFP DEPARTMENT COLLECTION

POEMs

POEMs (Patient-Oriented Evidence that Matters) are summaries of research that is relevant to physicians and their patients and meet three criteria: address a question that primary care physicians face in day-to-day practice; measure outcomes important to physicians and patients, including symptoms, morbidity, quality of life, and mortality; and have the potential to change the way physicians practice.

Sep 1, 2016 Issue
Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women
Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.


Sep 1, 2016 Issue
Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe Asthma
The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of potential harms, such as intubation or asthma-related death.


Sep 1, 2016 Issue
CBT Effective in Adolescents with Depression Who Do Not Want Medication
In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.


Sep 1, 2016 Issue
Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes
In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.


Aug 15, 2016 Issue
Single-Dose Dexamethasone Equals Three Days of Steroids in Children with Acute Asthma
In addition to usual beta-agonist treatment, a single dose of oral dexamethasone is as effective as three days of prednisolone (with less vomiting) in decreasing respiratory symptoms without increasing hospitalizations, follow-up visits, and days lost from school. Additional treatment with a steroid was more common in the group receiving the single dose of dexamethasone.


Aug 15, 2016 Issue
Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal Tear
Removing the torn bits of meniscus in middle-aged patients who have intermittent knee catches or locking does not decrease their likelihood of experiencing symptoms in the following year compared with diagnostic arthroscopy (i.e., looking but not touching). In general, meniscectomy does not improve knee pain, regardless of the symptoms.


Aug 15, 2016 Issue
Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo
The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.


Aug 15, 2016 Issue
Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms
In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm [NNTH] =14), edema (NNTH = 9), and fracture (NNTH = 53).


Jul 15, 2016 Issue
No Reduction in Readmissions with Telemonitoring, Coaching for Patients with Heart Failure
A care transition intervention that incorporates remote monitoring of weight, blood pressure, and heart rate with scheduled telephone coaching did not reduce readmission rates at 30 days or 180 days for patients with heart failure. However, patients in the study were only modestly adherent to the intervention strategies.


Jul 15, 2016 Issue
Genetic Test Results That Identify Increased Risk Do Not Change Behavior
Patients informed via genetic test results that they were at increased risk of disease did not subsequently alter their behaviors. For example, persons at increased risk of diabetes mellitus or hypertension were no more likely to change their diet or increase their physical activity. Fancy tests do not appear to be motivators for behavior change.


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