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Medicine by the numbers

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Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.html

Clinically Relevant Drug-Drug Interactions in Primary Care - American Family Physician

May 1, 2019 - Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p558.html

Sepsis: Diagnosis and Management - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Guidelines published in 2016 provide a revised definition of sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection. The guidelines define septic shock as sepsis with circulatory, cellular, and metabolic dysfunction that is associated with a ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p409.html

Treatment of the Common Cold - American Family Physician

Sep 1, 2019 - Acute upper respiratory tract infections are extremely common in adults and children, but only a few safe and effective treatments are available. Patients typically present with nasal congestion, rhinorrhea, sore throat, cough, general malaise, and/or low-grade fever. Informing patients...

American Family Physician : Article

https://www.aafp.org/afp/2019/0901/p281.html

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Antibiotics for Acute Bronchitis - Medicine by the Numbers - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Acute bronchitis is a lower respiratory tract infection, most commonly viral, that accounts for a significant number of health care visits. This review discusses the benefits and harms of antibiotics for acute bronchitis or acute productive cough.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/1101/od2.html

Type 2 Diabetes Therapies: A STEPS Approach - American Family Physician

Feb 15, 2019 - A concise way to evaluate pharmacotherapy options for type 2 diabetes mellitus is to use the five patient-oriented STEPS criteria: safety, tolerability, efficacy, price, and simplicity. The first-line treatment option, metformin, is safe and fairly well-tolerated, has excellent ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p237.html

Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care - American Family ... Restricted content. Login required.

Jan 15, 2020 - Short-term systemic corticosteroids, also known as steroids, are frequently prescribed for adults in the outpatient setting by primary care physicians. There is a lack of supporting evidence for most diagnoses for which steroids are prescribed, and there is evidence against steroid use ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p89.html

Primary Care of Breast Cancer Survivors - American Family Physician

Mar 15, 2019 - With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p370.html

Noninvasive Positive Pressure Ventilation for Exacerbation of Chronic Obstructive ... Restricted content. Login required.

Jun 1, 2020 - Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by hyperinflation of the lungs, including emphysema and chronic bronchitis. Learn more about the benefits and harms of using noninvasive positive pressure ventilation for exacerbation of COPD.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0601/od1.html

Blood Product Transfusion in Adults: Indications, Adverse Reactions, and Modifications ... Restricted content. Login required.

Jul 1, 2020 - Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in patients with or at high risk of developing symptomatic anemia. Restrictive transfusion thresholds with lower hemoglobin ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p30.html

Newborn Circumcision Techniques - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Newborn male circumcision is a common elective surgical procedure for the removal of foreskin covering the glans penis. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the American Academy ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p680.html

Aspirin after Acute Ischemic Stroke - Medicine by the Numbers - American Family Physician Restricted content. Login required.

Sep 1, 2020 - Learn more about the effect of aspirin therapy given within 48 hours of acute ischemic stroke in reducing the risk of death, dependence, or recurrent stroke, and the chance of complete recovery.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0901/od2.html

Antibiotics for Uncomplicated Diverticulitis - Medicine by the Numbers - American ... Restricted content. Login required.

Dec 1, 2020 - Learn more about the benefits and harms of antibiotics for uncomplicated diverticulitis.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/1201/od2.html

Antibiotic Prophylaxis for Operative Vaginal Delivery - Medicine by the Numbers - ... Restricted content. Login required.

Oct 1, 2020 - Current guidelines from the World Health Organization do not recommend routine antibiotic prophylaxis for operative vaginal birth because of insufficient evidence of effectiveness.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/1001/od2.html

Cutaneous Cryosurgery for Common Skin Conditions - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Cryosurgery is the application of freezing temperatures to achieve the destruction of tissue. Cutaneous cryosurgery has become a commonly performed outpatient procedure because of the combination of its safety, effectiveness, low cost, ease of use, lack of need for injectable ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p399.html

Benzodiazepines for Panic Disorder in Adults - Medicine by the Numbers - American ... Restricted content. Login required.

Apr 1, 2020 - Should benzodiazepeines continue to be prescribed during the initiation phase of selective serotonin reuptake inhibitors for acute relief of panic attacks? Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0401/od1.html

Interventional Radiology: Indications and Best Practices - American Family Physician

May 1, 2019 - Interventional radiology employs image-guided techniques to perform minimally invasive procedures for diagnosis and treatment. Interventional radiology is often used to place central venous catheters and subcutaneous ports, with some evidence of benefit over surgical placement. Arterial...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p547.html

Tranexamic Acid for Postpartum Hemorrhage - Medicine by the Numbers - American Family ... Restricted content. Login required.

May 1, 2020 - Postpartum hemorrhage is the most common cause of maternal death worldwide. Tranexamic acid is an antifibrinolytic agent that has shown to decrease bleeding in surgical patients and all-cause death in trauma patients. Does early administration of tranexamic acid reduce the rate of death...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0501/od2.html

Antibiotics for Exacerbations of Chronic Obstructive Pulmonary Disease - Medicine by ... Restricted content. Login required.

Feb 1, 2020 - Prescription of antibiotics for the treatment of chronic obstructive pulmonary disease (COPD) is controversial due to the variety of etiologies. This review examined the use of antibiotics to treat COPD in outpatient, inpatient, and ICU settings. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0201/od1.html

Pelvic Floor Muscle Training for Treatment of Urinary Incontinence in Women - Medicine ... Restricted content. Login required.

Dec 1, 2019 - Urinary incontinence is common in adult women, leading to health complications such as rash and urinary tract infections. This review discusses pelvic floor muscle training for the treatment of urinary incontinence in women.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1201/od1.html

Branched-chain Amino Acids for Patients with Hepatic Encephalopathy - Medicine by the ... Restricted content. Login required.

Jan 1, 2020 - Hepatic encephalopathy is a brain dysfunction that can be mild with minimal confusion, or overt and severe with coma. Learn more about branched-chain amino acids for the treatment of hepatic encephalopathy.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0101/od1.html

Antibiotics for Acute Rhinosinusitis in Adults - Medicine by the Numbers - American ...

Oct 1, 2019 - Because of the relatively high rate of reported adverse effects and the high likelihood of resolution of symptoms with supportive care and symptomatic management, the authors recommend selective antibiotic use in patients with acute sinusitis. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1001/od1.html

Ticagrelor Compared to Clopidogrel in Acute Coronary Syndrome and Stable Coronary ...

Nov 1, 2019 - The authors determined there is no benefit from the use of ticagrelor in patients with acute coronary syndrome and stable coronary artery disease because of the uncertainty about benefits and evidence of potential harms.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1101/od1.html

Denosumab for Reducing Risk of Fractures in Postmenopausal Women - Medicine by the ...

May 1, 2019 - Denosumab appears to be effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Treatment with denosumab does not increase the risk of cancer or death but might increase the risk of infection. However, more studies are required.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0501/od1.html

Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Management of Chronic Tendon Injuries - American Family Physician

Aug 1, 2019 - Chronic tendon injuries are common athletic and occupational injuries that account for many physician visits. Tendons have a complex biology that provides a unique combination of strength, flexibility, and elasticity but also predisposes them to injury. The term tendinopathy is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p147.html

Antibiotic Prophylaxis in Patients with COPD - Medicine by the Numbers - American ...

Jun 1, 2019 - This research fails to determine whether the modest potential benefits of antibiotic prophylaxis in patients with chronic obstructive pulmonary disease outweigh the risk of resistance. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0601/od1.html

Dyspnea Due to Acute Heart Failure Syndrome - Medicine by the Numbers - American Family...

Feb 1, 2019 - This review concluded that the individual components of the clinical history and physical examination, electrocardiography, and chest radiography are not useful independently for confirming or excluding the diagnosis of acute heart failure syndrome in patients presenting to the ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0201/od1.html

Metformin for Improving Maternal and Infant Outcomes in Pregnant Women Who Are Obese - ...

Mar 1, 2019 - This meta-analysis showed no clear benefit for metformin in reducing the risk of large for gestational age infants. Additionally, there was no difference in important secondary outcomes such as gestational diabetes, hypertensive disease in pregnancy, shoulder dystocia, advanced perineal...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0301/od1.html

Liberal vs. Conservative Oxygen Therapy in the Acutely Ill - Medicine by the Numbers - ...

Jan 1, 2019 - This review compares liberal and conservative oxygen therapy in acutely ill adults and their effect on mortality (in-hospital, 30-day, and longest follow-up) and morbidity (disability at longest follow-up, risk of hospital-acquired pneumonia, any hospital-acquired infection, and length ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0101/od1.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - Discussing with patients the pros and cons of medications for borderline glucose values could distract us from more important topics such as lifestyle changes, smoking cessation, and blood pressure control. Time is the most valuable resource in a physician-patient partnership, and there...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p136.html

Metformin to Prevent Diabetes in Patients at Increased Risk - Cochrane for Clinicians -... Restricted content. Login required.

Nov 1, 2020 - In patients at increased risk of developing type 2 diabetes, metformin reduces the risk (number needed to treat [NNT] = 7; 95% CI, 6 to 10) compared with counseling on standard diet and exercise.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/1101/p531.html

OnabotulinumtoxinA for Prevention of Migraine in Adults - Cochrane for Clinicians - ... Restricted content. Login required.

Feb 1, 2020 - OnabotulinumtoxinA reduces the number of migraine days per month by two days compared with placebo in adults with chronic migraines.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0201/p144.html

Trifarotene (Aklief) for the Treatment of Acne - STEPS - American Family Physician Restricted content. Login required.

Oct 15, 2020 - Trifarotene is a monotherapy option for acne affecting the face and trunk and offers an alternative to topical antibiotics or anti-inflammatory agents for the management of moderate inflammatory and noninflammatory acne.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/1015/p499.html

Combined Hormonal Contraceptives for Heavy Menstrual Bleeding - Cochrane for Clinicians... Restricted content. Login required.

Dec 1, 2019 - Combined oral contraceptives decrease the number of women reporting menorrhagia over six months compared with placebo (absolute risk reduction = 36.7%; number needed to treat = 2.7).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1201/p677.html

Acute Altitude Illness: Updated Prevention and Treatment Guidelines from the Wilderness... Restricted content. Login required.

Apr 15, 2020 - Acute altitude illness comprises acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. The Wilderness Medical Society has updated prevention and treatment guidelines on acute altitude illness.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0415/p505.html

Small Reduction in Cardiovascular Outcome After Ischemic Stroke with Lower LDL Target, ... Restricted content. Login required.

Aug 15, 2020 - A lower LDL target slightly reduced the likelihood of a broad composite outcome (number needed to treat [NNT] = 43 over 3.5 years), largely by reducing nonfatal strokes (NNT = 77; statistical significance not reported).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p247.html

Gabapentinoids for Pain: Potential Unintended Consequences - Editorials - American ...

Dec 1, 2019 - The widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1201/p672.html

Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy - ...

Oct 1, 2019 - Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during pregnancy does ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p403.html

Lithium for Acute Mania - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

May 1, 2020 - Lithium is more effective at inducing a reduction of at least 50% on the validated Young Mania Rating Scale compared with placebo (number needed to treat [NNT] = 6; 95% CI, 5 to 8; six studies; n = 1,707).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p528.html

Pharmacologic Therapy for Heart Failure - FPIN's Help Desk Answers - American Family ...

Jul 1, 2019 - Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0701/p49.html

Treatment of Threatened Miscarriage with Progestogens - Cochrane for Clinicians - ...

Sep 1, 2019 - Progestogens reduce the risk of miscarriage when compared with placebo in patients with threatened miscarriage (number needed to treat [NNT] = 10.) Use of progestogens poses no significant risks to mother or baby.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p279.html

Intravenous Magnesium Sulfate for Acute Asthma Exacerbations - FPIN's Clinical ...

Jan 15, 2019 - 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.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0115/p127.html

Therapies for COPD Exacerbations in Adults - Implementing AHRQ Effective Health Care ... Restricted content. Login required.

May 1, 2020 - What are the benefits and harms of pharmacologic and nonpharmacologic treatments for exacerbations of chronic obstructive pulmonary disease (COPD) in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0501/p557.html

Integrating Medical Acupuncture into Family Medicine Practice - Editorials - American ...

Jul 15, 2019 - Acupuncture is an evidence-based therapy to reduce pain that can meet patient demand for nonpharmacologic treatment. Now is the time to offer training in medical acupuncture to more family physicians.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0715/p76.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ... Restricted content. Login required.

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Understanding the High Cost of Insulin: What Family Physicians Can Do to Help Our ...

Apr 1, 2019 - Through clinical and system-level interventions, family physicians can push back against the high cost of insulin and help patients with type 2 diabetes afford these essential medications.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0401/p416.html

Evaluating Benefits and Harms of Anticoagulation in Patients with Atrial Fibrillation -...

Dec 15, 2018 - In patients with NVAF, anticoagulants decrease the risk of stroke by approximately 60%. However, they also significantly increase the risk of a major bleeding event or intracranial hemorrhage.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/1215/p751.html

Corticosteroids for Hospitalized Patients with Community-Acquired Pneumonia - Cochrane ... Restricted content. Login required.

Sep 1, 2020 - For adults hospitalized with severe CAP, the use of corticosteroids may reduce the likelihood of mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0901/p272.html

Antiemetics for Acute Gastroenteritis in Children - FPIN's Clinical Inquiries - ... Restricted content. Login required.

Jul 1, 2020 - Oral ondansetron (Zofran) may be given to children presenting to the emergency department with vomiting and mild to moderate dehydration from acute gastroenteritis. It reduces hospital admissions and the need for intravenous hydration.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0701/p51.html

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ... Restricted content. Login required.

Jan 1, 2020 - Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p16.html

Antidepressants Plus Benzodiazepines for Adults with Major Depression - Cochrane for ... Restricted content. Login required.

May 1, 2020 - A combination of tricyclic antidepressants and benzodiazepines is more effective for major depression in adults than tricyclic antidepressants alone in the first four weeks of treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p527.html

Heavy Menstrual Bleeding in Premenopausal Patients and the Role of NSAIDs - Cochrane ... Restricted content. Login required.

Aug 1, 2020 - NSAIDs are effective for reducing heavy menstrual bleeding in premenopausal patients with menorrhagia when compared with placebo.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0801/p147.html

Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer - Cochrane ...

Jun 1, 2019 - Low-molecular-weight heparin (LMWH), vitamin K antagonists, and direct oral anticoagulants, when used to prevent recurrent VTE, have a similar impact on all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p676.html

Bridging Warfarin Before Colonoscopy in Patients with Atrial Fibrillation - FPIN's ...

Apr 15, 2019 - 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 ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0415/p519.html

Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults - Cochrane ...

Sep 1, 2019 - Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p278.html

Music Therapy for Depression - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

Mar 1, 2020 - Moderate-quality evidence shows that music therapy added to standard care is more effective in the first three months than standard care alone for depressive symptoms based on clinician-rated outcomes and patient-reported outcomes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0301/p273.html

Low-Dose Aspirin Beneficial for the Prevention of Preterm Birth in Nulliparous Patients... Restricted content. Login required.

Nov 15, 2020 - The routine use of low-dose aspirin, 81 mg daily, starting as early as six weeks' gestational age provided a statistically significant absolute risk reduction (nearly 2 percentage points) in the incidence of preterm birth among nulliparous patients with singleton gestation in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1115/od4.html

Management of Acute Pain from Musculoskeletal Injuries: Guidance for Family Physicians ...

Dec 1, 2020 - Primary care plays a large role in the management of acute pain; therefore, the American College of Physicians and the American Academy of Family Physicians developed a clinical practice guideline for the nonpharmacologic and pharmacologic management of acute pain from non–low back, ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/1201/p649.html

Community-Acquired Pneumonia: Determining Safe Treatment in the Outpatient Setting - ...

Jun 15, 2019 - When is it safe to treat a patient with community-acquired pneumonia a an outpatient?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0615/p768.html

Denosumab No Better than Bisphosphonates for Preventing Fracture, and the Cost Is Much ... Restricted content. Login required.

Sep 15, 2020 - This meta-analysis found no evidence that the monoclonal antibody denosumab reduces the risk of fracture more than bisphosphonates.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p375a.html

Gabapentin for Treatment of Radicular Low Back Pain - FPIN's Clinical Inquiries - ...

Sep 1, 2019 - Gabapentin is not effective for the treatment of radicular low back pain and is associated with adverse effects.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0901/p309.html

Medication Management for Chronic Heart Failure with Preserved Ejection Fraction - ...

Jul 1, 2019 - Mineralocorticoid receptor antagonists reduce hospitalizations for patients with HFpEF. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not been shown to change the morbidity or mortality in patients with HFpEF.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p17.html

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.html

Galcanezumab (Emgality) for Migraine and Cluster Headaches - STEPS - American Family ... Restricted content. Login required.

Apr 15, 2020 - In otherwise healthy adults with severe and frequent migraine or cluster headaches, galcanezumab may provide a modest reduction in debilitating headache frequency in the short term.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0415/p502.html

A Specific Probiotic Decreases Crying in Infants Younger than Two Months with Colic - ... Restricted content. Login required.

Nov 15, 2020 - Is probiotic supplementation effective in decreasing crying in infants with colic?

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1115/od5.html

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ... Restricted content. Login required.

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - High-quality evidence supports metformin use for diabetes prevention among younger or more obese individuals or for women with a history of gestational diabetes. Clinicians should consider prescribing metformin, in addition to intensive lifestyle interventions, in accordance with ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p134.html

Complementary and Integrative Treatments for Pain Management in Labor - Cochrane for ...

Feb 1, 2019 - There is evidence that all of the studied interventions have some benefit in labor, but the evidence is of low to very low quality. Massage, thermal interventions (warm and cold packs), relaxation techniques, yoga, and music reduce pain during latent labor, but not during active labor.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0201/p154.html

Coaching Patients About Successful Blood Pressure Management - Lown Right Care: ...

Mar 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0315/p357.html

Antibiotic and Corticosteroid Treatment Effective for Acute Exacerbations of COPD - ... Restricted content. Login required.

Nov 15, 2020 - Short-term antibiotic treatment and short-term systemic corticosteroids are both associated with a faster resolution of COPD symptoms and fewer treatment failures.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1115/od2.html

No Short-Term Extra Benefit when Muscle Relaxants Are Added to Ibuprofen for Acute Low ... Restricted content. Login required.

Jun 1, 2020 - Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695.html

Effectiveness of PPAR Gamma Agonists in Preventing Recurrent Stroke and Other Vascular ... Restricted content. Login required.

Sep 1, 2020 - PPAR gamma agonists are probably effective in preventing recurrent stroke in people with previous stroke or TIA.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0901/p271.html

Allopurinol Hypersensitivity Assay HLA-B*58:01 Genotyping - Diagnostic Tests: What ...

Nov 1, 2019 - The allopurinol hypersensitivity assay, or HLA-B*58:01 test, is a blood test to detect the presence of a human leukocyte antigen B (HLA-B) genetic variant that increases the risk of life-threatening, severe cutaneous adverse reactions in patients taking allopurinol.

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2019/1101/p530.html

Ketorolac vs. Morphine for Pain Relief After Fractures - FPIN's Help Desk Answers - ... Restricted content. Login required.

Apr 15, 2020 - 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.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2020/0415/p495.html

Deprescribing Is an Essential Part of Good Prescribing - Editorials - American Family ...

Jan 1, 2019 - 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.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0101/p7.html

Glycopyrronium (Qbrexza) Topical Wipes for Hyperhidrosis - STEPS - American Family ...

Sep 15, 2019 - Glycopyrronium wipes are a useful alternative for the topical treatment of hyperhidrosis of the axillae in patients nine years and older who do not respond to or tolerate nonprescription antiperspirants or topical aluminum chloride.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0915/p372.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American... Restricted content. Login required.

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Prasterone (Intrarosa) for Dyspareunia - STEPS - American Family Physician

Jan 15, 2019 - Prasterone is similarly effective to nonprescription options for treating vaginal dryness and itching associated with menopause and may offer a small benefit in the treatment of dyspareunia.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0115/p117.html

Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis - POEMs ... Restricted content. Login required.

Feb 15, 2020 - Based on a review of low-quality evidence, adding a topical intervention after cryosurgery for actinic keratosis improves the likelihood of complete clearance from 46% to 79% (number needed to treat = 3).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p249.html

Misoprostol Dosing for First-Trimester Abortion - FPIN's Clinical Inquiries - American ... Restricted content. Login required.

Sep 1, 2020 - Vaginal, oral, and sublingual misoprostol in single doses of 600 to 800 mcg are equally effective for promoting completed abortion in patients with an incomplete first-trimester spontaneous abortion.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0901/od1.html

Baloxavir Reduces Symptom Duration Similar to Oseltamivir, Primarily Within 24 Hours of... Restricted content. Login required.

Dec 15, 2019 - Baloxavir has similar efficacy to oseltamivir (Tamiflu) (33-hour reduction in duration of symptoms compared with placebo) and, like oseltamivir, is most effective when given within 24 hours of the onset of symptoms.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od4.html

Risks of Elective Labor Induction vs. Expectant Management - FPIN's Help Desk Answers -...

May 1, 2019 - Elective labor induction at 39 weeks’ gestation leads to a mean 145-g (5.1-oz) lower birth weight compared with expectant management, but there is conflicting evidence about the effects on rates of cesarean delivery, perinatal mortality, operative vaginal birth, and admission to the ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0501/p587.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion -...

Jul 15, 2019 - Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p119.html

Elagolix (Orilissa) for Endometriosis Pain - STEPS - American Family Physician

Oct 15, 2019 - Elagolix can decrease pain in women with endometriosis, but it is expensive and has adverse effects similar to those of other medications that decrease estrogen levels.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1015/p502.html

H. pylori Screening Before Initiation of Long-term NSAIDs - FPIN's Clinical Inquiries -...

Jun 15, 2019 - 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.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0615/p783.html

Fecal Microbiota Transplant Effective for Irritable Bowel Syndrome - POEMs - American ... Restricted content. Login required.

Sep 15, 2020 - This is the largest and best study to date of fecal microbiota transplant for irritable bowel syndrome —with impressive results.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p377.html

Semaglutide (Ozempic) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2019 - Semaglutide can be added to existing treatment to improve glycemic control and induce weight loss. It may also protect against cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0715/p116.html

Dual Antiplatelet Therapy for Patients with Cardiovascular Disease - FPIN's Clinical ...

Oct 15, 2019 - 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 ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1015/p463.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ... Restricted content. Login required.

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

Vaginal Bleeding Decreases over Time with a Levonorgestrel Intrauterine System - POEMs ... Restricted content. Login required.

Dec 1, 2020 - Bleeding decreased over time for most women after the insertion of a levonorgestrel-releasing intrauterine system.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1201/p693.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ...

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ... Restricted content. Login required.

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs... Restricted content. Login required.

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

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