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.

Oct 15, 2018 Issue
Long-Acting Muscarinic Antagonists plus Inhaled Steroids is Equal to Long-Acting Beta-Agonists Plus Inhaled Steroids
Long-acting muscarinic antagonists added to inhaled corticosteroids are a superior treatment to placebo for improving asthma control in adults and children 12 years or older. Long-acting muscarinic antagonist add-on therapy is not superior to long-acting beta agonist (LABA) add-on therapy.


Oct 15, 2018 Issue
Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated UTI
A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.


Oct 15, 2018 Issue
Ambulatory Blood Pressure Important for Decision-Making About Treatment
This study supports the guidelines recommending that treatment decisions be based on ambulatory blood pressure measurements rather than in-office blood pressure results. The difference between the two measurements in this cohort was 19/11 mm Hg, which is enough to change the decision to prescribe a medication at all, or to add a second or third medication.


Oct 15, 2018 Issue
Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not Helpful for Nonneuropathic Pain
This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose, duration, and outcome measures, so any conclusions should be taken with a grain of salt.


Sep 15, 2018 Issue
Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol
For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.


Sep 15, 2018 Issue
HPV Testing Better Than Cytology for Women Vaccinated Against HPV
In women who had received the HPV vaccine, screening for HPV every five years, with cytology and colposcopy follow-up as needed, resulted in higher rates of identification of high-grade pre-cancerous disease than standard liquid-based cytology every 2.5 years with HPV follow-up cotesting as needed.


Sep 15, 2018 Issue
Single Maintenance and Reliever Therapy More Effective Than Inhaled Corticosteroids and Beta Agonists for Asthma
When compared with standard therapy (inhaled corticosteroids with or without LABAs and SABAs as relief therapy), SMART is associated with a reduced risk of acute asthma exacerbations in patients 12 years or older.


Sep 1, 2018 Issue
Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer Adverse Outcomes
Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute pain continues to mount.


Aug 15, 2018 Issue
Systolic Blood Pressure of At Least 140 mm Hg Best Place to Begin Treatment
Beginning antihypertensive treatment when the systolic blood pressure is greater than 140 mm Hg delays death and prevents major cardiovascular events in some persons without preexisting heart disease; in patients with existing heart disease, it prevents further events, but does not extend life.


Aug 15, 2018 Issue
Medications Ineffective to Prevent Cognitive Decline or Dementia
None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.


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