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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

Counseling Patients in Primary Care: Evidence-Based Strategies - American Family Physician

Dec 15, 2018 - Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling strategies developed ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p719.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

Direct Oral Anticoagulants Preferred Over Warfarin for Nonvalvular Atrial Fibrillation ...

Dec 1, 2018 - The balance of benefits and harms favors direct oral anticoagulants over warfarin (Coumadin) for patients with nonvalvular atrial fibrillation who require anticoagulation and are already taking low-dose aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683.html

Evidence Supporting Niacin Therapy Is More Nuanced Than Article States - Letters to the...

Dec 1, 2018 - ...event (cardiac death, nonfatal myocardial infarction, revascularization procedure, hospitalization for acute coronary syndrome, or stroke),2 to no effect on any outcome.3 Although the two latest niacin trials did not show a benefit for niacin, it has been suggested that different...

American Family Physician : Letter

https://www.aafp.org/afp/2018/1201/p630.html

Does Niacin Have Cardiovascular Benefits in Patients with Dyslipidemia? - Letters to ...

Dec 1, 2018 - ...To the Editor: In this Cochrane for Clinicians the authors concluded that niacin does not reduce myocardial infarction (MI), strokes, or overall mortality when used for primary or secondary prevention, either alone or in addition to statins. In 2016, the U.S. Food and Drug...

American Family Physician : Letter

https://www.aafp.org/afp/2018/1201/p631.html

Urinary Retention in Adults: Evaluation and Initial Management - American Family Physician

Oct 15, 2018 - Urinary retention is the acute or chronic inability to voluntarily pass an adequate amount of urine. The condition predominantly affects men. The most common causes are obstructive in nature, with benign prostatic hyperplasia accounting for 53% of cases. Infectious, inflammatory, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p496.html

Family Physicians Can Manage Adults with Hepatitis C - Editorials - American Family ...

Oct 1, 2018 - The Centers for Disease Control and Prevention encourages family physicians to treat patients with hepatitis C. Outcomes when primary care physicians prescribe direct-acting antivirals to patients with uncomplicated hepatitis C are comparable to those of subspecialists.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1001/p413.html

Hormone Therapy for Primary Prevention of Cardiovascular Disease in Postmenopausal ...

Oct 1, 2018 - No benefit was observed in postmenopausal women receiving hormone therapy for primary prevention of cardiovascular disease. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1001/od1.html

I Hired a Community Health Worker and Now We Work Miracles

Patients need doctors, but some need more help to achieve better health. Kimberly Becher, M.D., writes about the dramatic difference a community health worker has made in her practice.

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

https://www.aafp.org/news/blogs/freshperspectives/entry/20180917fp-commhealth.html

Screening for Cardiovascular Disease Risk with Electrocardiography: Recommendation ...

Sep 15, 2018 - The USPSTF recommends against screening with resting or exercise electrocardiography (ECG) to prevent cardiovascular disease (CVD) events in asymptomatic adults at low risk of CVD events.

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

https://www.aafp.org/afp/2018/0915/od1.html

Blood Pressure Targets for Patients with Hypertension and Cardiovascular Disease - ...

Sep 1, 2018 - Achieving a target BP of 135/85 mm Hg or less does not decrease the risk of total cardiovascular events vs. treating to a target of 140 to 160/90 to 100 mm Hg. Further, treating to the lower BP target does not improve total mortality, cardiovascular mortality, or serious adverse effects.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0901/p276.html

Type 1 Diabetes: Management Strategies - American Family Physician

Aug 1, 2018 - There is considerable benefit of tight glucose control in patients with type 1 diabetes mellitus. Tight blood glucose control dramatically decreases the incidence of microvascular and macrovascular complications. Although glycemic goals should be individualized, most nonpregnant adults ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0801/p154.html

Quality Measures: How to Get Them Right -- FPM

Aug 1, 2018 - Pay-for-performance programs have produced disappointing results. Fewer and more appropriate, evidence-based quality measures could help.

Family Practice Management : Articles

https://www.aafp.org/fpm/2018/0700/p23.html

What You Should Know About Type 1 Diabetes - American Family Physician

Aug 1, 2018 - ...People with type 1 diabetes have a higher risk of heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage, and gum disease. These things happen two to four times more often in people with diabetes than in people without diabetes. Untreated type 1 diabetes...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2018/0801/p154-s1.html

Stimulant and Designer Drug Use: Primary Care Management - American Family Physician

Jul 15, 2018 - Approximately 10% of the U.S. population 12 years and older reported using illicit substances in 2015. This article reviews the clinical effects and treatment of persons who use cocaine, methamphetamines, 3,4-methylenedioxymethamphetamine (MDMA), synthetic cannabinoids, and synthetic ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0715/p85.html

Top POEMs of 2017 Consistent with the Principles of the Choosing Wisely Campaign - ...

Jul 15, 2018 - This article discusses the POEMs (patient-oriented evidence that matters) of 2017 judged to be most consistent with the principles of the Choosing Wisely campaign. A POEM is a synopsis of a research study that reports patient-oriented outcomes, such as improvement in symptoms, quality ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0715/p93.html

The Risk of Cardiovascular Disease, Fracture, Dementia, and Cancer After Long-Term ...

Jul 15, 2018 - Long-term hormone therapy decreased the risk of all fractures, including hip and vertebral fractures. However, the risks far outweighed the benefits of this intervention.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0715/p117.html

Club Drugs: What You Should Know - American Family Physician

Jul 15, 2018 - ...use meth, they feel excited and have a lot of energy. This feeling lasts about six to 24 hours. But using meth can cause heart attack, stroke, high body temperature, or seizures. Women who use meth while they are pregnant can harm the baby or go into labor early. What happens if...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2018/0715/p85-s2.html

Statins Effective for LDL 190 mg per dL or Higher, Regardless of Risk Level - POEMs - ...

Jul 1, 2018 - These results confirm that the use of statins for men with an LDL cholesterol level of at least 190 mg per dL, regardless of calculated risk, is associated with a clinically and statistically significant reduction in cardiovascular events and probably cardiovascular and all-cause ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54a.html

Localized Prostate Cancer: Treatment Options - American Family Physician

Jun 15, 2018 - In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. The National Comprehensive ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p798.html

Advocating for Myself: My Journey Through Poststroke Depression - Close-ups - American ...

Jun 1, 2018 - Although the association between stroke and depression is well known and prevalent, it is often overlooked.

American Family Physician : Close-ups

https://www.aafp.org/afp/2018/0601/p706.html

Exercise Is Medicine. Here's How I Get Patients Started

Ninety percent of Americans don't meet recommendations for physical activity. Alex Mroszczyk-McDonald, M.D., has seen the good that exercise can do, and in this Fresh Perspectives blog post he shares ways to get more patients off the couch.

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

https://www.aafp.org/news/blogs/freshperspectives/entry/20180516fp-exercise.html

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues - ...

May 15, 2018 - Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p642.html

Top 20 Research Studies of 2017 for Primary Care Physicians - American Family Physician

May 1, 2018 - Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0501/p581.html

What If Everyone Had a Family Physician?

Securing funding for vital primary care programs is a start, but Leonard Reeves, M.D., writes in this Leader Voices Blog post that the fight continues for the kind of physician workforce our country needs.

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

https://www.aafp.org/news/blogs/leadervoices/entry/20180501lv-whatif.html

Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes ...

Apr 15, 2018 - For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0415/p533.html

Edoxaban (Savaysa) for the Prevention of Thromboembolic Events - STEPS - American ...

Apr 15, 2018 - Edoxaban is an alternative to warfarin and other oral anticoagulants for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of deep venous thrombosis and pulmonary embolism.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0415/p529.html

Clarification for Apixaban Dosing in Patients with Impaired Renal Function - Letters to...

Apr 15, 2018 - ...(anti–factor Xa activity) data.2,3 The dosing the authors list in Table 1 is most similar to dosing guidelines for reduction of the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. However, t hat recommendation requires an adjustment to the...

American Family Physician : Letter

https://www.aafp.org/afp/2018/0415/p496.html

Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal ...

Apr 15, 2018 - The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal women and the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal women who have had a hysterectomy.

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

https://www.aafp.org/afp/2018/0415/od1.html

Geometric Rash on the Leg - Photo Quiz - American Family Physician

Apr 15, 2018 - A healthy 62-year-old woman presented with a pruritic rash on her ankle three days after applying a lidocaine patch.

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2018/0415/p531.html

Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal ...

Apr 15, 2018 - D.M. is a 52-year-old woman who presents to your office for a well-woman visit. She has been menopausal since 50 years of age and has no significant medical or surgical history. She is up to date on her recommended screenings, with normal mammography and colonoscopy results, and has no ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0415/p541.html

Qvar for Treatment of Chronic Asthma - Medicine by the Numbers - American Family Physician

Apr 15, 2018 - Learn the results of a Cochrane review which studied the effectiveness of Qvar in two sets of patients with chronic asthma: those receiving oral corticosteroids and those not receiving them.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0415/p538.html

Use of Niacin for Primary or Secondary Prevention of Cardiovascular or Cerebrovascular ...

Apr 1, 2018 - Prescription niacin (nicotinic acid, vitamin B3) does not reduce myocardial infarctions, strokes, or overall mortality when used for primary or secondary prevention.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0401/p436.html

Diagnosis Coding for Value-Based Payment: A Quick Reference Tool -- FPM

Apr 1, 2018 - Use this cheat sheet to identify diagnosis codes that are weighted for risk adjustment.

Family Practice Management : Articles

https://www.aafp.org/fpm/2018/0300/p26.html

Is Your Diagnosis Coding Ready for Risk Adjustment? -- FPM

Apr 1, 2018 - As payment models change, diagnosis coding is more important than ever. Here’s how to be sure your codes capture your patients’ severity of illness.

Family Practice Management : Articles

https://www.aafp.org/fpm/2018/0300/p21.html

Syncope Evaluation and Treatment Guidelines from ACC, AHA, and HRS - Practice ...

Apr 1, 2018 - The American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) have released guidelines to assist physicians in evaluating and treating syncope.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0401/p478.html

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.html

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.html

High Blood Pressure: ACC/AHA Releases Updated Guideline - Practice Guidelines - ...

Mar 15, 2018 - The American College of Cardiology (ACC) and American Heart Association (AHA) recently updated their guideline on the prevention, detection, evaluation, and treatment of high BP in adults. The ACC/AHA recommendations were based on a systematic review that addressed four questions ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0315/p413.html

ACC/AHA Hypertension Guideline: What Is New? What Do We Do? - Editorials - American ...

Mar 15, 2018 - Choosing a threshold and target for treatment should be based on the science supporting CVD risk reduction, while considering the benefits and harms in individual patient circumstances and respecting patient choice.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0315/p372.html

Acute Migraine Headache: Treatment Strategies - American Family Physician

Feb 15, 2018 - Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p243.html

Tremor: Sorting Through the Differential Diagnosis - American Family Physician

Feb 1, 2018 - Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p180.html

Beta Blockers Compared with Other Drug Options for the Treatment of Hypertension - ...

Feb 1, 2018 - Although beta blockers seem to have a positive impact on patient-oriented evidence that matters in patients with hypertension, they appear to be inferior when compared with other medications.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0201/od1.html

Your Family Medicine Practice Is Whatever You Make It

A new physician survey prompted our bloggers to reflect on their scope of practice and how they've tailored their work to fit the needs of their patients and their own interests.

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

https://www.aafp.org/news/blogs/freshperspectives/entry/20180116fp-scope.html

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

Jan 15, 2018 - The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy.

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

https://www.aafp.org/afp/2018/0115/od1.html

Type 2 Diabetes Mellitus: Outpatient Insulin Management - American Family Physician

Jan 1, 2018 - In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p29.html

Stents for Stable Coronary Artery Disease - Medicine by the Numbers - American Family ...

Jan 1, 2018 - Most published trials fail to show a benefit from coronary stenting in patients with stable obstructive coronary artery disease. However, stent technology has evolved significantly in recent years, and it is possible that newer-generation drug-eluting stents may offer different results.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0101/od1.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

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