AFP DEPARTMENT COLLECTION
FPIN's Clinical Inquiries
Clinical Inquiries 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 15, 2019 Issue
Dual Antiplatelet Therapy for Patients with Cardiovascular Disease
Patients with established cardiovascular disease or risk factors (e.g., ischemic cerebrovascular disease, peripheral arterial disease, high risk of atherothrombotic disease) should receive dual antiplatelet therapy with aspirin plus clopidogrel, which confers additional benefit over aspirin alone.
Sep 1, 2019 Issue
Gabapentin for Treatment of Radicular Low Back Pain
Gabapentin is not effective for the treatment of radicular low back pain and is associated with adverse effects.
Jun 15, 2019 Issue
H. pylori Screening Before Initiation of Long-term NSAIDs
Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.
Apr 15, 2019 Issue
Bridging Warfarin Before Colonoscopy in Patients with Atrial Fibrillation
A limited number of trials that examined the risk of temporary interruption of anticoagulation before a variety of procedures did not find a reduction in the risk of stroke, but they did show an increased risk of bleeding events and venous thromboembolism (VTE) in patients who were bridged during warfarin interruption.
Feb 15, 2019 Issue
Metformin for Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis
Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or death from liver failure.
Jan 15, 2019 Issue
Intravenous Magnesium Sulfate for Acute Asthma Exacerbations
Patients presenting to the emergency department with an acute asthma exacerbation that has not responded to first-line therapy (bronchodilators and corticosteroids) can be treated effectively with intravenous magnesium sulfate.
Oct 15, 2018 Issue
Morning vs. Evening Administration of Levothyroxine
The effectiveness of levothyroxine for reducing TSH levels is most dependent on the timing of meals in relation to drug administration. There is conflicting evidence. In two studies, levothyroxine taken at least two hours after eating in the evening maintained or improved TSH levels compared with morning administration.
Apr 15, 2018 Issue
Antibiotic Prophylaxis for COPD Exacerbations
Prophylactic antibiotics may be used to reduce the overall rate of COPD exacerbations and delay their onset. However, the appropriate antibiotic regimen and target population are unclear.
Feb 15, 2018 Issue
Diabetes Education and Glycemic Control
Counseling by a diabetes educator or a team of educators delivered in a variety of formats may reduce A1C levels by 0.2% to 0.8% compared with usual care alone. Diabetes educators should be considered for patients who have higher baseline A1C levels (8% to 9%) because this group had greater improvement in glycemic control after diabetes self-management education.