AFP DEPARTMENT COLLECTION

POEMs: Patient-Oriented Evidence that Matters

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.

Mar 1, 2020 Issue
Thromboembolism Recurrence Likely; Consider It a Chronic Disease
Perhaps it is time to start thinking about VTE as a chronic disease. Approximately one in 10 patients that have a VTE will have a second VTE over the next 12 months and almost four in 10 will have a second VTE over 10 years.


Mar 1, 2020 Issue
Guideline for Chronic Diarrhea: Screening for IBD and Celiac Disease Is In, Screening for Ova and Parasites Is Out
Although an algorithm to guide the workup is not offered, the American Gastroenterological Association suggests the following tests for patients with chronic diarrhea (i.e., watery diarrhea for at least four weeks): fecal calprotectin or fecal lactoferrin to screen for inflammatory bowel disease, and testing for giardiasis, celiac disease, and bile acid diarrhea.


Mar 1, 2020 Issue
Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus
This study found that linagliptin is noninferior to glimepiride for reducing the risk of cardiovascular death, myocardial infarction, and stroke in adults with type 2 diabetes at an increased risk of cardiovascular disease.


Mar 1, 2020 Issue
Fewer Severe Exacerbations in Patients with Mild to Moderate Asthma Treated with As-Needed Budesonide Plus Formoterol Compared with Maintenance Budesonide
Patients with mild to moderate asthma only need relief treatment. In this study, patients taking the combination of budesonide/formoterol (Symbicort) as needed had slightly fewer severe exacerbations than patients treated with twice daily budesonide (Pulmicort).


Feb 15, 2020 Issue
No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria
Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.


Feb 15, 2020 Issue
Increased Readmissions and Adverse Events with Intensification of Antihypertensive Regimen on Hospital Discharge
The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.


Feb 15, 2020 Issue
Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis
Based on a review of low-quality evidence, adding a topical intervention after cryosurgery for actinic keratosis improves the likelihood of complete clearance from 46% to 79% (number needed to treat = 3).


Feb 15, 2020 Issue
Do Not Change Antidepressant Treatment Early Based on a Lack of Response
Do not be in a hurry to change treatment in patients with severe depression who do not respond to treatment within the first two weeks. Early response to treatment predicts eventual response or remission, but a lack of early response does not predict treatment failure.


Jan 1, 2020 Issue
Adding Ultrasonography to Mammography Increases False-Positive Findings Without an Increase in Cancer Detection
Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent follow-up.


Jan 1, 2020 Issue
Addition of Steroids Improves Outcomes in Children and Adults with CAP
Adding corticosteroid treatment to the management of CAP is beneficial for children and adults. Treatment decreases clinical failures, time in the hospital, and the risk of death in adults with severe pneumonia.


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