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Academy Takes Aim at Rural Health Challenges

Rural Americans tend to be older, poorer and sicker than their urban counterparts. In his latest In the Trenches blog post, AAFP Senior Vice President for Advocacy, Practice Advancement and Policy Shawn Martin looks at the issues the Academy's new rural health initiative aims to address.

AAFP News : In the Trenches : Blogs

https://www.aafp.org/news/blogs/inthetrenches/entry/20190723itt-rural.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.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

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Correction - Corrections - American Family Physician

Jul 15, 2019 - ...in combination with aspirin to reduce the risk of major cardiovascular events (cardiovascular [CV] death, myocardial infarction [MI] and stroke) in patients with chronic coronary artery disease (CAD) or peripheral artery disease. Before publication, the article was not updated to...

American Family Physician : Corrections

https://www.aafp.org/afp/2019/0715/p74.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

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

Physical Activity: Updated Recommendations from HHS - Practice Guidelines - American ...

Jul 1, 2019 - The U.S. Department of Health and Human Services recently published updated recommendations on physical activity based on a systematic review of the effect of physical activity on health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0701/p58.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Rethinking Aspirin for the Primary Prevention of Cardiovascular Disease - Editorials - ...

Jun 1, 2019 - Aspirin's routine use for primary prevention has been the subject of controversy because of questionable benefits and increased bleeding risk. Aspirin therapy may reduce the relative risk of a first heart attack or stroke, but this benefit could be outweighed by the risk of ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0601/p670.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.html

Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.html

Postoperative Pain, Acute Stroke, Hormone Therapy, Diet to Improve Cardiovascular Risk,...

May 15, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0515/p606.html

Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones - American ...

May 15, 2019 - Apophysitis and osteochondrosis are common causes of pain in growing bones but have differing etiologies and required management. Apophysitis results from a traction injury to the cartilage and bony attachment of tendons in children and adolescents. Most often it is an overuse injury in...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p610.html

What Evidence Do We Need Before Recommending Routine Screening for Social Determinants ...

May 15, 2019 - Social determinants have a large effect on patients' health and well-being. Primary care clinicians need more evidence about their role in addressing social determinants of health, and community resources and public health support are needed to help patients with unmet social needs.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0515/p602.html

Cholesterol Management: ACC/AHA Updates Guideline - Practice Guidelines - American ...

May 1, 2019 - The American College of Cardiology/American Heart Association (ACC/AHA) task force on clinical practice guidelines has updated its 2013 cholesterol guideline.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0501/p589.html

Heat-Related Illnesses - American Family Physician

Apr 15, 2019 - Heat-related illnesses comprise a spectrum of syndromes resulting from disruption of thermoregulation in people exposed to high environmental heat. Symptoms range from heat edema and exercise-associated muscle cramps to exercise-associated collapse, heat exhaustion, and life-threatening...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p482.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

Common Breast Problems - American Family Physician

Apr 15, 2019 - Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p505.html

Colorectal Cancer, Osteoporosis, Knee Osteoarthritis, Suspected Dementia, Pacifier Use ...

Apr 15, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0415/p478.html

Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in ...

Apr 1, 2019 - Direct oral anticoagulants are as likely as warfarin to prevent all strokes and systemic embolic events in patients with atrial fibrillation and CKD stage 3. They do not increase the risk of major bleeding events. The evidence remains insufficient to make recommendations for the use of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p422.html

Will a Feeding Tube Help? Deciding for a Father at the End of Life - Close-ups - ...

Apr 1, 2019 - Making caring, difficult choices on behalf of loved ones at the end of life.

American Family Physician : Close-ups

https://www.aafp.org/afp/2019/0401/p420.html

Pulse Oximetry Screening for Critical Congenital Heart Defects in Newborns - Cochrane ...

Apr 1, 2019 - Pulse oximetry is an accurate screening test for critical congenital heart defects in newborns. Pulse oximetry is simple to use, widely available, and has moderate sensitivity (76.3%) and good specificity (99.9%). However, the prevalence of critical congenital heart defects is low, and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p421.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Testicular Cancer, Onset of Labor, Respiratory Tract Infection, Thyroid Cancer, Running...

Apr 1, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0401/p424.html

Not Tough Enough? What More Do You Want?

Leonard Reeves, M.D., offers a rebuttal to a speaker who questioned the toughness of physicians amid a burnout crisis.

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

https://www.aafp.org/news/blogs/leadervoices/entry/20190325lv-toughenough.html

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment - American Family ...

Mar 15, 2019 - Lower extremity peripheral artery disease (PAD) affects 12% to 20% of Americans 60 years and older. The most significant risk factors for PAD are hyperlipidemia, hypertension, diabetes mellitus, chronic kidney disease, and smoking; the presence of three or more factors confers a 10-fold...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p362.html

Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients - Editorials - ...

Mar 15, 2019 - Despite the lack of outcomes evidence, the rise of wearable ECG sensors will cause many individuals to seek care for misdiagnosed AF. The best intervention for patients with correct diagnoses remains unclear. Primary care physicians must use their skills in discussing uncertainty and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0315/p354.html

Screening for Atrial Fibrillation with Electrocardiography: Recommendation Statement - ...

Mar 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with electrocardiography.

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

https://www.aafp.org/afp/2019/0315/od1.html

Screening for Atrial Fibrillation with Electrocardiography - Putting Prevention into ...

Mar 15, 2019 - M.T. is a 67-year-old woman who presents to your office requesting electrocardiography (ECG). Her brother was recently diagnosed with atrial fibrillation after screening with ECG, and she is concerned that she may have the same condition.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0315/p383.html

Lofexidine (Lucemyra) for Treatment of Opioid Withdrawal Symptoms - STEPS - American ...

Mar 15, 2019 - Lofexidine has been shown to be as effective as clonidine at controlling some of the symptoms of withdrawal from opioid use. It may have a small additional benefit for maintaining abstinence in patients switched to buprenorphine or methadone for long-term maintenance.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0315/p392.html

2020 CME Session Topics

View the CME topics that will be discussed at the 2020 AAFP Family Medicine Experience (FMX) Conference: Chicago, October 13-17.

Events : Family Medicine Experience (FMX) Virtual

https://www.aafp.org/events/fmx/cme/opportunities/session-topics.html

What's Included With FMX On Demand

FMX On Demand is your online library of the most popular FMX sessions. Earn a year's worth of credit!

Events : Family Medicine Experience (FMX) Virtual

https://www.aafp.org/events/fmx/cme/opportunities/on-demand/packages.html

Shift Health System's Focus From Profit to Prevention

Leonard Reeves, M.D., writes in this Leader Voices Blog post that a single-payer system reserved for primary care would put the focus on keeping people healthy rather than on treating illness.

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

https://www.aafp.org/news/blogs/leadervoices/entry/20190221lv-change.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

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

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

An Asymmetric Pupil - Photo Quiz - American Family Physician

Feb 1, 2019 - ...Additionally, magnetic resonance imaging with and without contrast media was obtained during a prior emergency department visit as part of a stroke workup. It showed chronic microvascular ischemic disease with no evidence of a mass. Enlarge Print FIGURE 1 FIGURE 1 Question Based...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/0201/p191.html

Digital Media Use Associated with ADHD Symptom Development Among Adolescents - POEMs - ...

Feb 1, 2019 - High school students who reported a high frequency (many times per day) of digital media use (e.g., social networking, streaming movies or music, texting) were significantly more likely to self-report symptoms of ADHD over two years of follow-up (10% higher symptom reporting rate).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p189.html

Our Health Care System Is Sick

The U.S. health care system focuses more on care of the sick than prevention. Leonard Reeves, M.D., writes that even our sick care is less than ideal.

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

https://www.aafp.org/news/blogs/leadervoices/entry/20190128lv-sickcare.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

Fitness-Related Cardiac Arrhythmias - Editorials - American Family Physician

Jan 15, 2019 - How many clinicians are aware that high levels of physical fitness predispose patients to cardiac rhythm abnormalities? Find out more.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0115/p78.html

Risk Assessment for Cardiovascular Disease with Nontraditional Risk Factors: ...

Jan 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adding the ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, or coronary artery calcium score to traditional risk assessment for cardiovascular ...

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

https://www.aafp.org/afp/2019/0115/od1.html

Corrections - Jan 15, 2019 - American Family Physician

Jan 15, 2019 - ...The sentence should have read: Vitamin K antagonists are the first-line option, with high-quality data indicating that they have a lower stroke risk and all-cause mortality vs. placebo. The online version of the article has been corrected. Read the full article. Get immediate...

American Family Physician : Corrections

https://www.aafp.org/afp/2019/0115/p77c.html

Papular Lesions on Bilateral Elbows and Knees - Photo Quiz - American Family Physician

Jan 1, 2019 - A man presented with new-onset foot pain, as well as long-standing red-yellow lesions on his elbows and knees.

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/0101/p47.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

Nausea in Pregnancy, Knee Osteoarthritis, Hormone Replacement Therapy, Shingles - AFP ...

Jan 1, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0101/p10.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

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