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.

Jun 15, 2018 Issue
Injectable Extended-Release Naltrexone Effective for Opioid Use Disorder
Injectable extended-release naltrexone administered every four weeks is similar in efficacy to daily oral buprenorphine/naloxone for the treatment of opioid use disorder. Patients using extended-release naltrexone reported higher satisfaction with treatment and were more likely to recommend it to others.


Jun 15, 2018 Issue
FIT More Acceptable with Better Detection Rate Than gFOBT for Colorectal Cancer Screening
FIT is more sensitive and specific than the older guaiac-based fecal occult blood tests (gFOBTs) when screening for colorectal cancer. We now know that it is also more acceptable to patients and increases uptake in a centrally administered screening program.


Jun 15, 2018 Issue
Drugs for Chronic Idiopathic Constipation Are Similarly Effective
If nondrug measures are unsuccessful for chronic idiopathic constipation, the choice of a pharmacologic agent should be based on cost, tolerability, and long-term adherence rather than efficacy, because the efficacy is similar among drugs and drug classes.


Jun 1, 2018 Issue
Ultrasound Is Reasonably Accurate in Detecting Synovitis in Patients with Rheumatoid Arthritis
In this systematic review of patients with rheumatoid arthritis, ultrasonography was reasonably accurate compared with magnetic resonance imaging (MRI) in detecting synovitis in fingers and wrists. The use of MRI as a reference standard is convenient, but problematic.


May 1, 2018 Issue
Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant Complication Rates
Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.


May 1, 2018 Issue
Single Question Is Useful for Identifying Acute Mountain Sickness in Travelers at High Altitude
Three different diagnostic scoring tools have similar accuracy for identifying adults at risk of AMS. One tool, the clinical functional score, is the simplest to use and consists of asking a single question.


May 1, 2018 Issue
Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious Falls in Older Adults
Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium supplementation, and vitamin D supplementation are all effective interventions for reducing the risk of injurious falls in older adults.


May 1, 2018 Issue
One-Third of Patients with Anxiety Disorder Will Relapse When Antidepressant Treatment Stops
Discontinuing the antidepressant treatment in patients with anxiety disorders will cause a relapse in almost one-third of them. One in six patients previously treated successfully will also relapse despite continued treatment.


Apr 15, 2018 Issue
Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes
For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of time to see most of the meaningful recovery from stroke.


Apr 1, 2018 Issue
Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull’s Eye"
For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of children thought to have Lyme disease did not have serologic findings at that time or within 30 days.


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