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Medicine by the numbers

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Statins in Persons at Low Risk of Cardiovascular Disease - Medicine by the Numbers - ...

Nov 1, 2017 - Despite the small reductions in nonfatal heart attacks and strokes, statins were not associated with a reduction in serious illness overall.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1101/od1.html

Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality - POEMs - American ...

Oct 15, 2017 - This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od2.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Prolonged Dual Antiplatelet Therapy After MI Reduces Major Adverse Cardiac Events - ...

Oct 1, 2017 - In patients who are stable one year post-MI, prolonged use of dual antiplatelet therapy may be an effective treatment to decrease major cardiac events and cardiovascular mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1001/od1.html

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

Treatments for Nocturnal Leg Cramps - FPIN's Help Desk Answers - American Family Physician

Oct 1, 2017 - Calcium channel blockers or B vitamins may lead to short-term improvement in nocturnal leg cramps. Stretching has mixed results. Quinine is effective but is no longer recommended, and it is not approved for treatment of leg cramps because of potential toxicity.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1001/od3.html

Varenicline for Smoking Cessation - Medicine by the Numbers - American Family Physician

Sep 1, 2017 - Do the benefits outweigh the harms of using varenicline (Chantix) for smoking cessation? Read more to find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0901/od1.html

Differences Between the AAFP Atrial Fibrillation Guideline and the AHA/ACC/HRS ...

Sep 1, 2017 - The AAFP updated its guideline on pharmacologic management of newly detected atrial fibrillation, which differs in part from the AHA/ACC/HRS guideline. It specifically highlights two questions commonly faced by family physicians, and is based on updated data from the Agency for ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0901/p284.html

Dexamethasone May Reduce Sore Throat Symptoms in Adults at 48 Hours - POEMs - American ...

Aug 15, 2017 - A single dose of oral dexamethasone is no more effective than placebo in resolving acute sore throat symptoms at 24 hours in adults who do not receive immediate antibiotic therapy. However, among a multitude of exploratory secondary outcomes, the authors found that, compared with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260a.html

Antipsychotics for Fibromyalgia in Adults - Medicine by the Numbers - American Family ...

Aug 1, 2017 - Quetiapine may be considered for a limited period (less than 12 weeks) to improve pain, sleep, and depression in fibromyalgia, while considering the potential for weight gain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0801/od1.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Efficacy of Direct-Acting Antivirals Compared with Older Agents for Hepatitis C - ...

Jun 1, 2017 - Although they help patients achieve sustained viralogic response, expensive direct-acting antivirals have yet to show that they can succeed in meeting top-priority treatment goals.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0601/od1.html

Self-Monitoring and Self-Management of Oral Anticoagulation - Cochrane for Clinicians -...

Jun 1, 2017 - In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p700.html

Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK - American...

May 15, 2017 - A variety of refractive surgery techniques, which reshape the corneal stroma using laser energy, have been marketed as simple and safe alternatives to glasses or contact lenses. Laser-assisted in-situ keratomileusis (LASIK) is the most common of these procedures. Although there are few ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p637.html

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older: A Guideline ...

May 1, 2017 - A high standard must be met when guidelines recommend lifelong preventive medications, knowing that at best, a small minority of patients will benefit and that all are risking harm.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0501/p547.html

Effects of Altered Dietary Salt Intake in Patients with Chronic Kidney Disease - ...

Apr 1, 2017 - Reducing salt intake lowers blood pressure and reduces proteinuria in patients with CKD, but there is no evidence to determine whether lowering salt consumption leads to clinically significant reductions in end-stage renal disease, cardiovascular events, or all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0401/p423.html

Placebo Plus Message of Benefit Decreases Chronic Low Back Pain - POEMs - American ...

Apr 1, 2017 - These investigators gave twice daily placebo to patients with chronic back pain and told them it was placebo. They also told them that placebos can have a pronounced effect (which is true). The addition of placebo to usual care improved patients' pain and disability scores over the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p456.html

End-of-Life Care: Managing Common Symptoms - American Family Physician

Mar 15, 2017 - Physicians should be proficient at managing symptoms as patients progress through the dying process. When possible, proactive regimens that prevent symptoms should be used, because it is generally easier to prevent than to treat an acute symptom. As swallowing function diminishes, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p356.html

Buprenorphine Maintenance vs. Placebo for Opioid Dependence - Medicine by the Numbers -...

Mar 1, 2017 - Buprenorphine causes lower physical dependence, milder withdrawal symptoms, and is less likely to cause an overdose than methadone in the treatment of opioid dependence.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0301/od1.html

Management of Binge-Eating Disorder in Adults - Implementing AHRQ Effective Health Care...

Mar 1, 2017 - What are the benefits and harms of treatments for adults with binge-eating disorder?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0301/p324.html

Rifaximin (Xifaxan) for Irritable Bowel Syndrome - STEPS - American Family Physician

Feb 15, 2017 - Rifaximin has good overall tolerability. A relatively short course of treatment results in sustained clinical benefit for at least 10 weeks, eliminating the need for continued therapy, with an NNT of 10. However, it is expensive and should be reserved for patients who cannot tolerate or...

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0215/p258.html

Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults - American Family ...

Jan 15, 2017 - Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p78.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: ...

Jan 15, 2017 - The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/0115/od1.html

Tamsulosin Beneficial for Passage of 5- to 10-mm Distal Ureteral Stones - POEMs - ...

Jan 15, 2017 - Tamsulosin promotes stone passage of distal ureteral stones that are 5 to 10 mm in size. You would need to treat five such patients to get one stone passage. Smaller stones tend to pass on their own at a rate of 86% in this study.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123a.html

Heart Failure Due to Reduced Ejection Fraction: Medical Management - American Family ...

Jan 1, 2017 - Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p13.html

Alpha-adrenergic Agonists for the Management of Opioid Withdrawal - Medicine by the ...

Jan 1, 2017 - Alpha-adrenergic agonists were more efficacious than placebo in the management of opioid withdrawal, but are best reserved as an alternative to methadone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0101/od1.html

Extended-Release Bupropion for Preventing Seasonal Affective Disorder in Adults - ...

Jan 1, 2017 - When started in the fall, extended-release bupropion, 300 mg once daily, is effective in preventing recurrent symptoms in high-risk adults with a history of SAD (number needed to treat [NNT] = 5), as well as those at lower risk (NNT = 8). Headaches, nausea, and insomnia may limit ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0101/p10.html

Impact of Exercise-Based Cardiac Rehabilitation - Cochrane for Clinicians - American ...

Dec 1, 2016 - Exercise-based cardiac rehabilitation reduces cardiovascular mortality and hospitalization. There is no evidence that it reduces the rates of total mortality, myocardial infarctions, coronary artery bypass grafts, or percutaneous coronary interventions.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p881.html

Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

ACE Inhibitors or ARBs to Prevent CKD in Patients with Microalbuminuria - FPIN's ...

Oct 15, 2016 - ACE inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/1015/p652.html

Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill Patients - ...

Oct 15, 2016 - For patients in the intensive care unit (ICU) who receive antibiotics for presumed or proven bacterial infections, the use of procalcitonin levels to determine when to stop antibiotic therapy results in decreased duration and consumption of antibiotics without increasing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663a.html

Rivaroxaban vs. Warfarin for Anticoagulation in Patients with Atrial Fibrillation ...

Oct 1, 2016 - Studies showed that 433 patients needed to be treated with rivaroxaban to prevent one stroke and 629 patients needed to be treated with rivaroxaban to prevent one thromboembolic event. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1001/od1.html

Family Medicine: An Underutilized Resource in Addressing the Opioid Epidemic? - Graham ...

Sep 1, 2016 - Opioid overdose rates have tripled since 2000, and although overprescribing of opioids by physicians is widely accepted as a causal factor, the physician's role in providing medication-assisted treatment for opioid use disorder is less appreciated. Despite a clear willingness to ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/0901/p350.html

Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women - POEMs - ...

Sep 1, 2016 - Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384a.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Caring for Patients with Job Insecurity Who Are Experiencing Chronic Work-Related Pain ...

Jul 15, 2016 - In addition to providing direct medical care, the physician can help this patient by obtaining an occupational history, formulating hypotheses about the cause of the pain and potential interventions, and establishing a therapeutic relationship.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0715/p145.html

Liraglutide (Saxenda) for Weight Loss - STEPS - American Family Physician

Jul 15, 2016 - Liraglutide, combined with lifestyle counseling, produces a clinically significant and sustained weight loss that continues as long as it is used. Nausea and vomiting, however, are common adverse effects, and about one in 10 patients will discontinue treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0715/p161.html

Cardiac Rehabilitation: Improving Function and Reducing Risk - American Family Physician

Jul 1, 2016 - Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p37.html

Topical NSAIDs for Acute Musculoskeletal Pain in Adults - Medicine by the Numbers - ...

Jul 1, 2016 - Studies show that patients had improved pain control with diclofenac gel, ketoprofen gel, and ibuprofen gel with no increase in local or systemic adverse events. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0701/od1.html

Primary Care of the Prostate Cancer Survivor - American Family Physician

May 1, 2016 - This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p764.html

Ivabradine (Corlanor) for Heart Failure - STEPS - American Family Physician

Apr 15, 2016 - In patients with stable systolic heart failure already on maximal medication therapy, adding ivabradine may reduce the number of hospitalizations related to heart failure (NNT for two years = 20), but it does not reduce cardiovascular mortality. In addition, many patients will not ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0415/p682.html

Medications for Alcohol Use Disorder - American Family Physician

Mar 15, 2016 - The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p457.html

Conjugated Estrogens/Bazedoxifene (Duavee) for Menopausal Symptoms - STEPS - American ...

Feb 15, 2016 - Conjugated estrogens/bazedoxifene is effective for the treatment of menopausal symptoms and may be better tolerated than conjugated estrogens/medroxyprogesterone. It will maintain bone mineral density in the lumbar spine and hip, but its effect on fractures is not known. Cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0215/p307.html

Treating Low Vitamin D Levels Is Ineffective in Postmenopausal Women - POEMs - American...

Feb 15, 2016 - You do not have to treat a low vitamin D level if your patient is a typical community-dwelling postmenopausal woman younger than 75 years. The usual dosage of vitamin D, 800 IU (20 mcg) daily, will not increase levels even after a year of therapy and has little effect on calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315.html

Cyclobenzaprine in the Treatment of Low Back Pain - Medicine by the Numbers - American ...

Feb 1, 2016 - Studies show that 1 in 3 patients experiences global improvement in back pain symptoms at 10 days, while 1 in 4 patients experiences medication adverse effects. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0201/od2.html

Quinine for Leg Cramps - Cochrane for Clinicians - American Family Physician

Feb 1, 2016 - Quinine is moderately effective in decreasing the frequency and intensity of muscle cramps, but it is also associated with an increase in minor adverse effects. In addition, there is a risk of rare but serious adverse effects.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0201/p177.html

Gabapentin for Chronic Neuropathic Pain - Medicine by the Numbers - American Family ...

Dec 1, 2015 - Studies show that 1 in 6 patients were helped with diabetic neuropathy and 1 in 8 were helped with postherpetic neuralgia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1201/od1.html

Some Benefit to Treating Mild Hypertension to Prevent Stroke, CV Deaths, and Overall ...

Dec 1, 2015 - Treating mild hypertension over five years decreases the risk of stroke, cardiovascular (CV) death, and overall mortality in a small proportion of patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020.html

Effectiveness of Selective Serotonin Reuptake Inhibitors for Irritable Bowel Syndrome -...

Nov 1, 2015 - Studies show that 1 in 4 had improved bloating and stool consistency, and less interference with daily life, while only 1 in 9 experiences medication related adverse effects. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1101/od1.html

Exercise for Osteoarthritis of the Knee - Cochrane for Clinicians - American Family ...

Nov 1, 2015 - Land-based exercise programs reduce knee pain and improve quality of life and physical function following treatment in patients with knee osteoarthritis.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1101/p774.html

Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE - ...

Nov 1, 2015 - Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814.html

Gabapentin Equals Epidural Steroid for Radicular Pain - POEMs - American Family Physician

Nov 1, 2015 - After controlling for the placebo effect that may accompany an epidural steroid injection, treatment with gabapentin is as effective as the injection in reducing radicular leg pain in the short term (three months). A placebo bump in response, if present, is likely to be transient.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814a.html

Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - STEPS - ...

Aug 15, 2015 - Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0815/p304.html

Common Questions About the Pharmacologic Management of Depression in Adults - American ...

Jul 15, 2015 - One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p94.html

Nicotine Replacement Therapy for Smoking Cessation - Medicine by the Numbers - American...

Jul 1, 2015 - Studies show that 1 in 15 patients successfully quit smoking and 1 in 94 patients experienced chest pain or palpitations. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0701/od1.html

Tight Glycemic Control for Type 2 Diabetes Mellitus (Over Five Years) - Medicine by the...

Jun 1, 2015 - Studies show that none were helped and 1 in 6 patients were harmed. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0601/od2.html

Colchicine for Acute Gout - Cochrane for Clinicians - American Family Physician

Jun 1, 2015 - Low-quality evidence shows that low-dose colchicine (up to 1.8 mg over one hour) is an effective therapy for acute gout.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0601/p759.html

Treatments for Sciatica - FPIN's Clinical Inquiries - American Family Physician

May 1, 2015 - Surgical diskectomy can be offered to patients with refractory sciatica, but there is only modest, short-term improvement in leg pain and disability scores. Epidural steroid injections may be offered to patients with sciatica of more than six months' duration.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0501/p612.html

Increased GI Bleeding After Switch from Warfarin to Dabigatran - POEMs - American ...

May 1, 2015 - The risk of bleeding increases (though remains small) when patients with atrial fibrillation are switched from warfarin to dabigatran to prevent stroke or transient ischemic attack. This study, conducted almost exclusively in male veterans, found an increase in gastrointestinal (GI) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p648.html

Naltrexone/Bupropion (Contrave) for Weight Loss - STEPS - American Family Physician

Apr 15, 2015 - Naltrexone/bupropion produces clinically significant weight loss when combined with a diet and exercise program. It decreases body weight in patients with diabetes, but its effect on diabetic outcomes is not known. A significant proportion of patients will experience adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0415/p554.html

Advance Directives: Navigating Conflicts Between Expressed Wishes and Best Interests - ...

Apr 1, 2015 - Clinicians and surrogates can be faced with challenging decisions when a patient loses the capacity to participate in medical decision making. A significant number of hospitalized and critically ill adults lose decision-making capacity during hospital stays and cannot make treatment ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0401/p480.html

Immediate-Release Methylphenidate for the Treatment of ADHD in Adults - Cochrane for ...

Apr 1, 2015 - In adults with ADHD, immediate-release methylphenidate improves symptoms of hyperactivity, impulsiveness, and inattentiveness compared with placebo. Short-term adverse effects such as weight loss and decreased appetite do not appear to be serious. However, larger studies of longer ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0401/p445.html

Post-Myocardial Infarction Beta Blockers Do Not Decrease Mortality - POEMs - American ...

Mar 15, 2015 - Although recommended by guidelines and used as a so-called quality indicator of hospital care, the use of beta blockers following myocardial infarction, when combined with optimal acute and chronic treatment, does not provide a further survival benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p402a.html

Controlled-Release Oxycodone for Neuropathic Pain and Fibromyalgia in Adults - Cochrane...

Mar 1, 2015 - Oxycodone CR has limited effectiveness for the treatment of diabetic neuropathy or postherpetic neuralgia. Evidence is lacking regarding treatment benefit for other neuropathic pain syndromes or fibromyalgia. Adverse effects of oxycodone CR therapy are common.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0301/p286.html

Alpha Blockers to Speed Ureteral Stone Passage - Cochrane for Clinicians - American ...

Feb 1, 2015 - Compared with patients receiving standard therapy (e.g., fluids, analgesics), placebo, or calcium channel blockers, patients receiving alpha blockers had about three fewer days to ureteral stone expulsion and were less likely to be hospitalized. Adverse effects of alpha blocker therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0201/p164.html

Antidepressants and Psychological Therapies Are Effective for IBS - POEMs - American ...

Jan 15, 2015 - Antidepressants and psychological therapies are effective in treating the symptoms of IBS. This study, an update of a similar systematic review and meta-analysis completed five years ago, found the same level of effectiveness for both treatment approaches as the previous analysis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p134.html

Surveillance of the Adult Cancer Survivor - American Family Physician

Jan 1, 2015 - The term cancer survivor refers to anyone living with a diagnosis of cancer. As the U.S. population ages, cancer screening increases, and cancer treatments improve, millions more Americans will be classified as cancer survivors in the future. Although many survivors wish to continue ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0101/p29.html

Methotrexate Therapy for Rheumatoid Arthritis - Cochrane for Clinicians - American ...

Jan 1, 2015 - Methotrexate monotherapy demonstrated statistically significant and clinically relevant improvement of symptoms and physical function compared with placebo at 12 to 52 weeks. Multiple adverse effects were reported with methotrexate use, and patients were twice as likely to discontinue ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0101/p26.html

Phentermine/Topiramate (Qsymia) for Chronic Weight Management - STEPS - American Family...

Oct 15, 2014 - Phentermine/topiramate has been shown to be a good option for sustained weight loss in patients who are unable to lose weight with diet and exercise alone. It should not be given to patients with a history of significant heart disease, and women of childbearing age should use ...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/1015/p576.html

Effectiveness of Outpatient Case Management for Adults - Implementing AHRQ Effective ...

Oct 1, 2014 - Does outpatient case management for adults with medical illness and complex care needs improve patient-centered outcomes, quality of care, or resource utilization?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2014/1001/p481.html

Exercise Programs for Older Patients with Dementia - Cochrane for Clinicians - American...

Sep 1, 2014 - There is some evidence that exercise improves cognitive function and the ability to perform activities of daily living in patients with dementia.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0901/p287.html

Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Not ...

Aug 15, 2014 - The recommendations should have paid more attention to the inherent uncertainties in risk estimates and the importance of individual patient circumstances and preferences.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0815/p223.html

Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Yes: ...

Aug 15, 2014 - The recommendations appropriately focus treatment on those most likely to benefit.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0815/p212.html

Indacaterol (Arcapta) for COPD - STEPS - American Family Physician

Aug 15, 2014 - Indacaterol provides a similar benefit to other long-acting bronchodilators for the treatment of moderate to severe COPD, with once-daily dosing. As with other LABAs, it should be used only as add-on therapy in patients already taking inhaled corticosteroids.

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0815/p252.html

Botulinum Toxin Injection for Facial Wrinkles - American Family Physician

Aug 1, 2014 - Botulinum toxin injection for treatment of facial wrinkles is the most frequently performed cosmetic procedure in the United States, and it is one of the most common entry procedures for clinicians seeking to incorporate aesthetic treatments into their practice. Treatment of frown lines...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p168.html

Intra-articular Corticosteroid Injections for Osteoarthritis of the Knee - FPIN's ...

Jul 15, 2014 - Intra-articular corticosteroid injections can be used to reduce pain by about 20% in the short term (one to three weeks) in patients with osteoarthritis of the knee.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0715/p115.html

Prophylactic Antibiotics for the Prevention of COPD Exacerbation - Cochrane for ...

Jun 1, 2014 - Continuous prophylactic antibiotic therapy significantly decreases COPD exacerbations for up to three years. However, it does not decrease mortality, and it puts the patient at risk of antibiotic-resistant colonization and infection.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0601/p870.html

Common Questions About Pacemakers - American Family Physician

Feb 15, 2014 - Pacemakers are indicated in patients with certain symptomatic bradyarrhythmias caused by sinus node dysfunction, and in those with frequent, prolonged sinus pauses. Patients with third-degree or complete atrioventricular (AV) block benefit from pacemaker placement, as do those with type...

American Family Physician : Article

https://www.aafp.org/afp/2014/0215/p279.html

Roflumilast (Daliresp) for Chronic Obstructive Pulmonary Disease - STEPS - American ...

Feb 15, 2014 - Roflumilast therapy has a limited role in patients with severe COPD, and no role in patients with mild to moderate COPD. It will not decrease the number of hospitalizations.

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0215/p300.html

Aspirin With or Without Antiemetic for Acute Migraine Headaches in Adults - Cochrane ...

Feb 1, 2014 - Aspirin, with or without an antiemetic, is an effective treatment for acute migraine headache. Adding the antiemetic metoclopramide (Reglan) significantly reduces migraine-related nausea and vomiting compared with aspirin alone.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0201/p176.html

Pioglitazone Exposure Increases Bladder Cancer Risk - POEMs - American Family Physician

Jan 15, 2014 - This review of all available data found a significantly increased risk of bladder cancer among adults with type 2 diabetes treated with pioglitazone. Pioglitazone also significantly increases the risk of heart failure, and there is minimal, if any, patient-oriented evidence of benefit ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0115/p136.html

Ticagrelor (Brilinta) for Secondary Prevention of Thrombotic Events Following Acute ...

Dec 15, 2013 - Ticagrelor is an alternative to clopidogrel for secondary prevention of cardiovascular death in patients with acute coronary syndrome. In an international study it was found to be more effective, but patients in the United States did not experience superior outcomes.

American Family Physician : STEPS

https://www.aafp.org/afp/2013/1215/p821.html

Common Questions About Vasectomy - American Family Physician

Dec 1, 2013 - Vasectomy offers a safe, effective, and permanent method of male contraception, with an overall failure rate of less than 1% in pooled studies. Men older than 30 years in a stable, committed relationship appear to be the best candidates for vasectomy. The no-scalpel technique reduces ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1201/p757.html

Treatment of Stable Chronic Obstructive Pulmonary Disease: the GOLD Guidelines - ...

Nov 15, 2013 - Chronic obstructive pulmonary disease (COPD) is a common problem in primary care. COPD is diagnosed with spirometry only in clinically stable patients with a postbronchodilator forced expiratory volume in one second/forced vital capacity ratio of less than 0.70. All patients with COPD ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1115/p655.html

Risks of Bisphosphonate Use - FPIN's Clinical Inquiries - American Family Physician

Nov 15, 2013 - Bisphosphonates are associated with a small risk of atypical femoral shaft fractures, which increases with duration of use. Bisphosphonates are associated with a small risk of osteonecrosis of the jaw, which is more common in patients who are older, female, or have poor dental hygiene ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/1115/p697.html

Myocardial Infarction: Management of the Subacute Period - American Family Physician

Nov 1, 2013 - Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p581.html

Treatments for Urinary Incontinence in Women - Implementing AHRQ Effective Health Care ...

May 15, 2013 - What are the effectiveness, benefits, and adverse effects of options for diagnosis and treatment of urinary incontinence (UI) that are available in primary care?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2013/0515/p726.html

Clinical Management of Urinary Incontinence in Women - American Family Physician

May 1, 2013 - Most cases of urinary incontinence in women fall under one of three major subtypes: urge, stress, or mixed. A stepped-care approach that advances from least invasive (behavioral modification) to more invasive (surgery) interventions is recommended. Bladder retraining and pelvic floor ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0501/p634.html

Caffeine as an Analgesic Adjuvant for Acute Pain in Adults - Cochrane for Clinicians - ...

Jan 1, 2013 - Overall, there appears to be a small but clinically significant benefit to adding caffeine to analgesic therapy for various types of acute pain. More research is needed to determine the optimal dosing.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/0101/p11.html

Insulin for Glycemic Control in Acute Ischemic Stroke - Cochrane for Clinicians - ...

Dec 1, 2012 - Administering insulin to maintain glycemic control does not improve the rates of mortality or dependency, or the final neurologic outcome after an acute ischemic stroke. Additionally, in randomized controlled trials, patients in the intervention groups (those under tight glycemic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/1201/p1008.html

Updated Guidelines from AASM for the Treatment of Central Sleep Apnea Syndromes - ...

Nov 15, 2012 - The updated guidelines on central sleep apnea from the American Academy of Sleep Medicine (AASM) includes levels of recommendations (standard or option) based on the overall quality of evidence (high, moderate, low, or very low). Central sleep apnea syndromes are characterized by ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2012/1115/p968.html

Transient Ischemic Attack: Part II. Risk Factor Modification and Treatment - American ...

Sep 15, 2012 - Interventions following a transient ischemic attack are aimed at preventing a future episode or stroke. Hypertension, current smoking, obesity, physical inactivity, diabetes mellitus, and dyslipidemia are all well-known risk factors, and controlling these factors can have dramatic ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p527.html

Advantages of the No-Scalpel Vasectomy Technique - FPIN's Clinical Inquiries - American...

Jun 15, 2012 - NSV should be used instead of the standard incisional method.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/0615/od1.html

Exercise for the Treatment of Knee Osteoarthritis - FPIN's Clinical Inquiries - ...

Sep 1, 2011 - Regular exercise reduces osteoarthritic knee pain and improves functioning.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/0901/od1.html

Treatment Options for Localized Prostate Cancer - American Family Physician

Aug 15, 2011 - In the United States, more than 90 percent of prostate cancers are detected by serum prostate-specific antigen testing. Most patients are found to have localized prostate cancer, and most of these patients undergo surgery or radiotherapy. However, many patients have low-risk cancer and ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0815/p413.html

Treatment of Alzheimer Disease - American Family Physician

Jun 15, 2011 - Alzheimer disease is the most common form of dementia, affecting more than one-third of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid plaque accumulation, neurofibrillary tau tangles, and depletion of acetylcholine are among...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1403.html

Treatment of Knee Osteoarthritis - American Family Physician

Jun 1, 2011 - Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease...

American Family Physician : Article

https://www.aafp.org/afp/2011/0601/p1287.html

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