Migraine Headache Prophylaxis

Hien Ha, Annika Gonzalez

Many patients with episodic migraine headaches would benefit from preventive therapy, which reduces frequency, severity, and distress from migraines; preventive therapy could improve quality of life and prevent chronic migraines. Indications for preventive therapy include...

Inborn Errors of Metabolism: From Preconception to Adulthood

Paul Kruszka, Debra Regier

Inborn errors of metabolism (IEM) are rarely occurring genetic conditions that block metabolic pathways, ultimately affecting multiple organ systems. Preconception screening for IEM and non-IEM disorders can be performed in women of all ethnic backgrounds. Specific screening...

Urine Drug Tests: Ordering and Interpretation

Neelima Kale

Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and...

Deprescribing Is an Essential Part of Good Prescribing

Barbara Farrell, Dee Mangin

There are four important medication issues to discuss with patients as they get older. Find out more and learn the five steps to individualize deprescribing practices for each patient.

Nausea in Pregnancy, Knee Osteoarthritis, Hormone Replacement Therapy, Shingles

Sumi M. Sexton

Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease

Jeanmarie B. Rey, Virginia B. Kalish

Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is...

Prophylactic Vaccination Against Human Papillomavirus to Prevent Cervical Cancer and Its Precursors

Corey Fogleman, Laura Leaman

HPV vaccination in women 15 to 26 years of age prevents the development of cervical intraepithelial neoplasia (CIN) 2 and CIN 3 in women regardless of previous HPV exposure (number needed to treat [NNT] = 39). No serious adverse effects are associated with administration of...

Effective Advocacy for Patients and Communities

Cynthia Haq, Melissa Stiles, Debra Rothenberg, Heather Lukolyo

Family physicians play diverse roles in society, often bridging individual and community perspectives. Family physicians' ethics require providing care to all persons regardless of their geographic, economic, political, racial, religious, or sexual orientation status.

Papular Lesions on Bilateral Elbows and Knees

Tracy Persily, Philip Collins

A man presented with new-onset foot pain, as well as long-standing red-yellow lesions on his elbows and knees.

Antibiotic Prophylaxis for Severe Acute Pancreatitis

Stephen D. Cagle, Jr., Aarti Chopra

No, antibiotic prophylaxis does not decrease mortality in patients with severe acute pancreatitis, defined as pancreatitis associated with pancreatic necrosis.

LABA Plus Inhaled Corticosteroid Reduces Exacerbations, But Not Hospitalizations

Mark H. Ebell

Adding a LABA to an inhaled corticosteroid is safe but does not reduce the likelihood of a serious exacerbation requiring hospitalization. There is a small reduction in nonsevere asthma exacerbations, with one fewer exacerbation for every 53 patients treated for six months.

NPH Insulin: Fewer Episodes of Severe Hypoglycemia Than Analogs and Less Than One-Half the Cost

David Slawson

This study found that compared with expensive long-acting insulin analogs costing two to 10 times as much, NPH insulin results in a similar number of episodes of severe hypoglycemia (if not fewer) that result in emergency department visits and hospitalizations.

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in Older Adults

Henry C. Barry

In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

Oral Contraceptives and Antiandrogens Most Effective for Hirsutism Pharmacotherapy

Mark H. Ebell

Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an...

Deprescribing Benzodiazepine Receptor Agonists for Insomnia in Adults

Lisa Croke

A multidisciplinary group of clinicians as part of the Deprescribing Guidelines in the Elderly project has developed evidence-based guidelines focused on deprescribing long-term Benzodiazepine receptor agonists (BZRAs) in patients taking them for insomnia, with the goal of...

Liberal vs. Conservative Oxygen Therapy in Acutely Ill Adults

Christopher Solie, Daniel Runde

Study Population: Acutely ill adults, without chronic respiratory illness, requiring hospital admission and with the potential to be exposed to supplemental oxygen

Pulmonary Embolism Clinical Decision Tools Can Be Helpful During In-Flight Medical Emergencies

Pascal J. de Caprariis, Robert Murayama

Correction