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FPIN's Help Desk Answers

Help Desk Answers from the Family Physicians Inquiries Network (FPIN) provide short, concise, evidence-based answers to clinical questions common in family medicine. The answers include a summary of the evidence and commentary that puts the answers into perspective.

Oct 01, 2021 Issue
Community Vision Screening in Older Adults
The available evidence does not support screening adults 65 years and older for visual impairment in the primary care setting.


Aug 01, 2021 Issue
Hydrochlorothiazide vs. Chlorthalidone for the Treatment of Hypertension
Chlorthalidone reduces systolic blood pressure by 10 mm Hg more than hydrochlorothiazide at equal dosages in patients using monotherapy. Low-dose chlorthalidone and controlled-release hydrochlorothiazide reduce 24-hour ambulatory systolic blood pressure and diastolic blood pressure, whereas immediate-release hydrochlorothiazide may only reduce daytime systolic blood pressure.


Apr 15, 2021 Issue
Nerve Blocks for Pancreatic Cancer Pain
Celiac plexus blocks can be used for pain associated with pancreatic cancer. They slightly reduce pain while decreasing opioid consumption, with fewer adverse effects compared with standard analgesic therapy.


Jan 15, 2021 Issue
Antepartum Perineal Massage for Intrapartum Lacerations
Digital antepartum and intrapartum perineal massage did not decrease perineal lacerations compared with a control group.


Oct 15, 2020 Issue
School-Based Asthma Management Programs
Comprehensive public school–based programs providing supervised administration of asthma medication and/or education for staff, children, and parents markedly decrease asthma-related ED visits for school-aged children.


Jul 15, 2020 Issue
Acetaminophen for Pain Relief in Osteoarthritis
Acetaminophen is no better than placebo for relief of hip or knee pain due to osteoarthritis. Although acetaminophen does provide some pain relief, the effect is small and not clinically significant.


Apr 15, 2020 Issue
Ketorolac vs. Morphine for Pain Relief After Fractures
Parenteral ketorolac is as effective as parenteral morphine for short-term pain relief in patients with long bone fractures, and it results in fewer adverse effects.


Jan 15, 2020 Issue
Pain Medications Before IUD Placement
Topical lidocaine preparations including gels, creams, and sprays may modestly decrease pain with tenaculum placement but not during IUD insertion.


Oct 1, 2019 Issue
Thickened Feedings for Infants with Gastroesophageal Reflux
Bottle-fed infants with gastroesophageal reflux should be given thickened formula feedings.


Aug 15, 2019 Issue
Cognitive Behavior Therapy for Postpartum Depression
In women with postpartum depression, the addition of CBT reduces depressive symptoms more effectively than usual care alone (medication and other therapies), with a medium effect size at the end of the intervention and a residual small effect size six months later.


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