In keeping with its mission of serving members' needs "with professionalism and creativity," the AAFP developed a number of resources in 2016 that members can use in daily practice throughout 2017 and beyond.
Addressing one of the hottest health topics of the year -- opioid misuse and abuse -- the Academy released a new chronic pain management toolkit and a free, members-only CME webcast focused on chronic opioid therapy for pain management.
Also, after carefully evaluating the CDC's final "Guideline for Prescribing Opioids for Chronic Pain -- United States, 2016," the AAFP awarded it an "affirmation of value" designation, finding it useful for family physicians overall despite concerns about some of its conclusions based on the methodology used. The guideline offers 12 recommendations on the use of opioid therapy for chronic pain.
Also dominating health news in 2016 was the spread of Zika virus infection from South America to other parts of the world, including the United States, and the particular danger the infection poses for pregnant women and their infants.
In response, the AAFP created a Zika Virus Outbreak resource page with information and resources on the disease and the Academy's associated advocacy efforts. The page also features links to a map of cases reported in the United States, information for patients from familydoctor.org and various external resources.
Additionally, the Academy hosted separate webinars in May and September to update members on the evolving Zika virus situation; the latest is now available as a members-only webcast.
Keeping Members Up-to-Date on Immunizations
Immunizations are among the family physician's most important tools to help patients stay healthy, and the recommended immunization schedules the AAFP releases each year for children, teens and adults play a key role in ensuring members have access to the very latest vaccine-related information. Laminated copies of the schedules were mailed mid-year to all active and resident members, along with other helpful materials.
In addition, 2015-2016 AAFP Vaccine Science Fellows Nina Ahmad, M.D., and Melissa Martinez, M.D., created an FAQ on the appropriate use of two serogroup B meningococcal vaccines in patients ages 16-23 for short-term protection against the disease.
Putting Recommendations Into Practice
The AAFP also issued or endorsed numerous clinical preventive services recommendations to aid family physicians in caring for their patients, many of which aligned with recommendations from the U.S. Preventive Services Task Force (USPSTF).
For example, the AAFP joined the USPSTF in issuing a "B" grade final recommendation to screen women ages 50-74 for breast cancer using mammography every two years. Both groups agreed that any decision to screen women younger than 50 should be individualized, and both also concluded that evidence is lacking to recommend for or against screening women 75 or older.
However, the AAFP differed slightly from the USPSTF in giving a "B" grade -- rather than the task force's "A" designation -- to its final recommendation on screening adults ages 50-75 for colorectal cancer. Even so, the AAFP agreed with the USPSTF's recommendation that the decision to screen for colorectal cancer in adults ages 76-85 be an individualized one, as well as with its recommendation that those 85 and older not be screened.
Other recommendation statements the AAFP and USPSTF issued last year dealt with a wide range of health topics.
Both organizations recommended a low-dose aspirin regimen for certain patients ages 50-59 for primary prevention of cardiovascular disease (CVD) and colorectal cancer. Decisions to initiate aspirin therapy in patients 60-69 should be made individually, the groups agreed, and for adults younger than 50 or older than 70, current evidence is insufficient to assess the balance of benefits and harms of aspirin use.
The Academy also joined the task force in recommending that middle-aged patients at particular risk for CVD use low- to moderate-dose statins to prevent CVD events.
Regarding screening for depression, the AAFP and USPSTF each recommended routine depression screening for adults, including pregnant and postpartum women, in a primary care setting with adequate systems in place to ensure accurate diagnosis, effective treatment and appropriate follow-up.
The two groups followed up with a recommendation to screen adolescents ages 12-18 for major depressive disorder when the same systems are in place, but both concluded that evidence was lacking to assess the balance of benefits and harms of screening children 11 and younger.
The health benefits of breastfeeding were acknowledged in another recommendation statement in which the AAFP and USPSTF called for physicians to provide interventions during pregnancy and after birth to support breastfeeding.
The Academy also concurred with the task force in recommending that at-risk adults and teens be screened for syphilis and in calling for adults at increased risk for latent tuberculosis infection to be screened for the infection. In addition, both organizations agreed that asymptomatic adults should not be screened for chronic obstructive pulmonary disease. http://www.aafp.org/patient-care/clinical-recommendations/all/copd.html
Finally, the AAFP endorsed the American Academy of Otolaryngology-Head and Neck Surgery Foundation's updated guideline for managing otitis media with effusion.
This list is far from exhaustive; the full collection of AAFP clinical recommendations and practice guidelines can be accessed by topic online.
Highlighting Other AAFP Resources
The Academy fielded other resources on various issues in 2016 that members and their patients will no doubt find beneficial in the coming year, including a comprehensive preconception care position paper intended to provide members evidence-based information to support and direct their patient care activities in this area, as well as resources on safe OTC drug use, storage and disposal posted to familydoctor.org(familydoctor.org).
AAFP experts also worked with colleagues from other medical organizations to develop and disseminate a new team physician consensus statement(11 page PDF) that provides an overview of selected medical issues important to team physicians who are responsible for the care and treatment of athletes.
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