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Medicine by the numbers

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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

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

Screening for Cervical Cancer: Recommendation Statement - U.S. Preventive Services Task...

Feb 15, 2019 - The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus ...

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

https://www.aafp.org/afp/2019/0215/od1.html

Are Your Patients Wasting Money on Supplements?

According to the latest Fresh Perspectives blog post, a recent survey found that nearly 90 percent of adults take vitamins or supplements, but less than 25 percent of respondents had a confirmed nutrient deficiency.

AAFP News : Fresh Perspectives: New Docs in Practice | AAFP News Blog : Blogs

https://www.aafp.org/news/blogs/freshperspectives/entry/20190213fp-supplements.html

Can Design Thinking Improve Health Care for Patients, Physicians?

Design thinking requires decision-makers to empathize with, and test potential solutions with, users and stakeholders. Lalita Abhyankar, M.D., M.H.S., shares insights from a crash course on the process.

AAFP News : Fresh Perspectives: New Docs in Practice | AAFP News Blog : Blogs

https://www.aafp.org/news/blogs/freshperspectives/entry/20190205fp-designthinking.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

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

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

Increased Quantity but Not Proportion: U.S. Medical Schools and Family Medicine Entry ...

Feb 1, 2019 - Expansion in the number of American medical schools since 2005 led to an absolute increase in graduates matching into family medicine (FM) residency programs from 2008 to 2018. Proportionally, however, FM training has become increasingly reliant on osteopathic physicians and U.S. ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2019/0201/p153.html

Point-of-Care Ultrasonography: An Effective Tool When Used Appropriately - Letters to ...

Feb 1, 2019 - Letters to the Editor from AFP readers regarding previously published articles.

American Family Physician : Letter

https://www.aafp.org/afp/2019/0201/p143.html

The 2019 Medicare Documentation, Coding, and Payment Update -- FPM

Feb 1, 2019 - This year’s changes include some welcome documentation relief, new codes for portal and telephone encounters, and much more.

Family Practice Management : Articles

https://www.aafp.org/fpm/2019/0100/p23.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

Using Empowered CMAs and Nursing Staff to Improve Team-based Care -- FPM

Feb 1, 2019 - Highly trained workers can perform more visit-related tasks, boosting care quality and reducing physician burnout.

Family Practice Management : Articles

https://www.aafp.org/fpm/2019/0100/p17.html

Tools for Better Dementia Care -- FPM

Feb 1, 2019 - Quality measures and clinical tools can bring focus and clarity to caring for patients with cognitive impairment and supporting their caregivers.

Family Practice Management : Articles

https://www.aafp.org/fpm/2019/0100/p11.html

Antibiotic Prophylaxis for UTIs in Patients with Neurogenic Bladder - FPIN's Help Desk ...

Feb 1, 2019 - Daily antibiotic prophylaxis should not be used in patients with acute and nonacute spinal cord injuries.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0201/p186.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit ...

Feb 1, 2019 - This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188.html

Primary Care for Persons Who Inject Drugs - American Family Physician

Jan 15, 2019 - More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p109.html

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.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

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

No Margin, No Mission: Better Physician Pay = Better Patient Care

AAFP Senior Vice President for Advocacy, Practice Advancement and Policy Shawn Martin outlines six areas of focus where the Academy's advocacy work is aimed at improving payment for primary care.

AAFP News : In the Trenches : Blogs

https://www.aafp.org/news/blogs/inthetrenches/entry/20190108itt-betterpayment.html

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

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

Urine Drug Tests: Ordering and Interpreting Results - American Family Physician

Jan 1, 2019 - 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 capabilities ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p33.html

Inborn Errors of Metabolism: From Preconception to Adulthood - American Family Physician

Jan 1, 2019 - Inborn errors of metabolism (IEM), although individually rare, occur in 1 out of every 1,500 births. The first opportunity to detect IEM occurs during preconception counseling, when pregnant women and couples considering future pregnancies can undergo carrier screening. For individuals ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p25.html

Prophylactic Vaccination Against Human Papillomavirus to Prevent Cervical Cancer and ...

Jan 1, 2019 - 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 the HPV ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p15.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

Correction - Corrections - American Family Physician

Jan 1, 2019 - ...Incorrect vaccine recommendations. The Medicine by the Numbers Pneumococcal Vaccines in Chronic Obstructive Pulmonary Disease (April 1, 2018, p. 463) included inaccurate details regarding the recommendations for administering pneumococcal vaccinations in patients with chronic...

American Family Physician : Corrections

https://www.aafp.org/afp/2019/0101/p5a.html

LABA Plus Inhaled Corticosteroid Reduces Exacerbations, But Not Hospitalizations - ...

Jan 1, 2019 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53.html

The Adult Well-Male Examination - American Family Physician

Dec 15, 2018 - The adult well-male examination should provide evidence-based guidance toward the promotion of optimal health and well-being. The medical history should focus on tobacco and alcohol use, risk of human immunodeficiency virus and other sexually transmitted infections, and diet and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p729.html

School Absenteeism in Children and Adolescents - American Family Physician

Dec 15, 2018 - Frequent school absenteeism has immediate and long-term negative effects on academic performance, social functioning, high school and college graduation rates, adult income, health, and life expectancy. Previous research focused on distinguishing between truancy and anxiety-driven ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p738.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

Why Are We So Slow to Adopt Some Evidence-Based Practices? - Editorials - American ...

Dec 15, 2018 - Physicians must accept that change is uncomfortable, recognizing the pain of giving up an old idea or practice as medical knowledge evolves around us. We need to remain flexible in our thinking if we are to meet our goal of doing our best when caring for every patient.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1215/p709.html

AAFP News - Dec 15, 2018 - American Family Physician

Dec 15, 2018 - Selected policy and health issues news briefs from AAFP News.

American Family Physician : AAFP News: AFP Edition

https://www.aafp.org/afp/2018/1215/p707.html

Why I Love Working in a Community Health Center

Luis Garcia, M.D., spoke with several colleagues who work in community health centers, as he does, about what makes these practices so rewarding for family physicians.

AAFP News : Fresh Perspectives: New Docs in Practice | AAFP News Blog : Blogs

https://www.aafp.org/news/blogs/freshperspectives/entry/20181211fp-chc.html

Teaching Health Centers Funding a Top Priority for 2019

AAFP Senior Vice President for Advocacy, Practice Advancement and Policy Shawn Martin writes that securing funding for the teaching health center program will be a top priority for the Academy when the new Congress convenes.

AAFP News : In the Trenches : Blogs

https://www.aafp.org/news/blogs/inthetrenches/entry/20181204itt-thcgme.html

Early Invasive Management of Acute Coronary Syndromes - Medicine by the Numbers - ...

Dec 1, 2018 - Does early invasive management help patients with unstable angina or acute non–ST-segment elevation myocardial infarction (NSTEMI) in reducing occurence of death, myocardial infarction, angina symptoms, and rehospitalization at six- to 12-month follow-up? Find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1201/od1.html

Caring for Transgender and Gender-Diverse Persons: What Clinicians Should Know - ...

Dec 1, 2018 - Persons whose experienced or expressed gender differs from their sex assigned at birth may identify as transgender. Transgender and gender-diverse persons may have gender dysphoria (i.e., distress related to this incongruence) and often face substantial health care disparities and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p645.html

Dental Problems in Primary Care - American Family Physician

Dec 1, 2018 - Oral health directly affects overall health and quality of life. More Americans lack dental insurance than medical insurance. Patients with poor oral health are more likely to have respiratory and cardiovascular diseases, adverse pregnancy outcomes, and diabetes mellitus. Early ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p654.html

Preventing or Delaying Type 2 Diabetes Mellitus with Diet and Exercise - Cochrane for ...

Dec 1, 2018 - There is moderate-quality evidence that in patients with impaired glucose tolerance (IGT) defined by an abnormal 75-g two-hour glucose tolerance test, implementing changes in diet and adding physical activity together can prevent or delay the development of type 2 diabetes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p643.html

Six Mobile Apps to Make Prescribing Easier -- FPM

Dec 1, 2018 - These apps can help you more effectively make medication decisions on the go.

Family Practice Management : SPPACES: App Reviews

https://www.aafp.org/fpm/2018/1100/p11.html

Five Ways to Communicate Risks So That Patients Understand -- FPM

Dec 1, 2018 - When discussing a patient’s risk of developing a disease or the risks associated with a screening test, these simple techniques can ensure clarity.

Family Practice Management : Articles

https://www.aafp.org/fpm/2018/1100/p28.html

How to Prepare for and Survive a Violent Patient Encounter -- FPM

Dec 1, 2018 - When the unthinkable happens, having a plan that you have practiced regularly can make all the difference.

Family Practice Management : Articles

https://www.aafp.org/fpm/2018/1100/p5.html

Practice Pearls - Nov-Dec 2018 -- FPM

Dec 1, 2018 - Know your RVUs | Set antibiotic expectations before a sore throat exam | Use a white board to track high-risk patients

Family Practice Management : Practice Pearls

https://www.aafp.org/fpm/2018/1100/p34.html

Deep Venous Thrombosis: Home vs. Inpatient Treatment - Cochrane for Clinicians - ...

Dec 1, 2018 - Patients treated at home with low-molecular-weight heparin (LMWH) have lower rates of recurrent VTE than those treated in a hospital.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p642.html

Communicating Risks: Let's Talk Numeracy -- FPM

Dec 1, 2018 - Understanding numeracy will make your risk conversations with patients more effective.

Family Practice Management : From the Editor

https://www.aafp.org/fpm/2018/1100/p4.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.html

Help Patients Know Their HIV Status

An estimated 15 percent of Americans living with HIV infection are unaware of it. Ada Stewart, M.D., writes in this Leader Voices Blog post that World AIDS Day offers a reminder to help patients know their status.

AAFP News : AAFP Leader Voices | AAFP News Blog : Blogs

https://www.aafp.org/news/blogs/leadervoices/entry/20181127lv-hivstatus.html

The Votes Were Cast. What Does It Mean for Family Medicine?

AAFP Senior Vice President for Advocacy, Practice Advancement and Policy Shawn Martin sets the stage for an analysis of the 2018 midterm elections and looks at Wall Street's growing interest in health care.

AAFP News : In the Trenches : Blogs

https://www.aafp.org/news/blogs/inthetrenches/entry/20181120itt-postelection.html

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