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Getting Medicine Right: Overcoming the Problem of Overscreening, Overdiagnosis, and ...

Jan 1, 2015 - Introduction to AFP’s series of editorials on overscreening, overdiagnosis, and over-treatment, providing practical guidance on reducing unnecessary medical practices.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0101/p18.html

Lorcaserin (Belviq) for Weight Loss - STEPS - American Family Physician

Dec 15, 2014 - Lorcaserin, combined with diet and exercise, can be used to produce additional weight loss, although the effect on morbidity and mortality is not known. It should be discontinued in patients who do not lose at least 5% of their body weight in the first 12 weeks because they are unlikely...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/1215/p863.html

Incidentalomas: Initial Management - American Family Physician

Dec 1, 2014 - Incidentalomas are increasingly common findings on radiologic studies, causing worry for physicians and patients. Physicians should consider the risk of discovering incidentalomas when contemplating imaging. Patients may assume that incidentalomas are cancer, and may not be aware of the...

American Family Physician : Article

https://www.aafp.org/afp/2014/1201/p784.html

Optimal Duration of Treatment Regimens for H. pylori Eradication - Cochrane for ...

Dec 1, 2014 - When using proton pump inhibitor (PPI) triple therapy, increasing the duration of treatment from seven to 10 days or from 10 to 14 days significantly increases the eradication of H. pylori. When using other treatment regimens, it is unclear whether increasing duration of treatment ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1201/p766.html

Management of Atopic Dermatitis: Guideline from the American Academy of Dermatology - ...

Dec 1, 2014 - Atopic dermatitis, a common and chronic skin condition, affects persons of all ages. Topical therapy is the mainstay of treatment, and in severe cases, it is often combined with systemic therapy. This guideline from the American Academy of Dermatology provides information about the ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/1201/p798.html

Desmopressin Effective for Treating Nocturia in Adults - POEMs - American Family Physician

Dec 1, 2014 - Desmopressin is a safe and effective treatment to offer adults with clinically significant nocturia. The initial starting dose should be 50 to 100 mcg, with lower dosing for the advanced older patient. All patients should be monitored for hyponatremia.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p796a.html

How Should We Manage Incidentalomas? - Editorials - American Family Physician

Dec 1, 2014 - The patient-centered medical home model advocates that diagnostic testing be performed based on shared decision making between the patient and physician. This goal can be challenging when findings are uncertain or incidental to the original reason for ordering the test. For this reason,...

American Family Physician : Editorials

https://www.aafp.org/afp/2014/1201/p758.html

Epidural Steroid Injections Ineffective for Lumbar Spinal Stenosis - POEMs - American ...

Dec 1, 2014 - Epidural glucocorticoid injections are ineffective for lumbar spinal stenosis. Whether this will change practice for this lucrative procedure will be an interesting question.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p795a.html

Pelvic Inflammatory Disease - Clinical Evidence Handbook - American Family Physician

Nov 15, 2014 - How do different antimicrobial regimens compare when treating women with confirmed PID and what are the effects of routine antibiotic prophylaxis to prevent PID before IUD insertion?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/1115/p725.html

Oral Contraceptives Are Not an Effective Treatment for Ovarian Cysts - Cochrane for ...

Nov 1, 2014 - Oral contraceptives are not an effective treatment for ovarian cysts, whether the cysts are spontaneous or associated with medically induced ovulation. Most cysts resolve without intervention within two to three months. Those that do not resolve in this time frame are more likely to be ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1101/p623.html

Bronchodilators for Bronchiolitis - Cochrane for Clinicians - American Family Physician

Nov 1, 2014 - Albuterol does not improve any clinical outcomes in the outpatient or inpatient setting and should not be used in the treatment of bronchiolitis in a child 24 months or younger.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1101/p622.html

Epley Maneuver Effective in the Long Term for Positional Vertigo - POEMs - American ...

Nov 1, 2014 - How often do patients walk into our offices with a problem and walk out cured? The Epley maneuver, which is not particularly difficult to do, results in the long-term (at least one year) resolution of posterior canal benign paroxysmal positional vertigo. A video of the maneuver can be ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p660.html

Niacin Does Not Improve Clinical Outcomes in Patients with Vascular Disease - POEMs - ...

Nov 1, 2014 - This large, adequately powered trial did not find any clinically meaningful benefit to the use of niacin in patients who are already taking a statin, even with several study design features that should bias the result in favor of niacin. Niacin should not be prescribed to reduce the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p660a.html

Net Benefit with Azithromycin Use in Older Hospitalized Patients with Pneumonia - POEMs...

Nov 1, 2014 - For older patients hospitalized with pneumonia, the use of combination antibiotic therapy including azithromycin is associated with decreased mortality but an increased risk of myocardial infarction (MI). You would need to treat 21 patients with azithromycin to prevent one death within ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p661.html

Over-the-Counter Medications in Pregnancy - American Family Physician

Oct 15, 2014 - Many pregnant women take over-the-counter (OTC) medications despite the absence of randomized controlled trials to guide their use during pregnancy. Most data come from case-control and cohort studies. In 1979, the U.S. Food and Drug Administration began reviewing all prescription and ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1015/p548.html

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

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

American Family Physician : STEPS

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

Management of Influenza in the 2014-2015 Season: Recommendations and Limitations - ...

Oct 15, 2014 - This editorial summarizes the extent of benefits expected from immunization, testing, and antiviral treatment of influenza for the 2014–2015 season.

American Family Physician : Editorials

https://www.aafp.org/afp/2014/1015/p535.html

JNC8 Guidelines for the Management of Hypertension in Adults - Practice Guidelines - ...

Oct 1, 2014 - Hypertension is one of the most important preventable contributors to disease and death in the United States, leading to myocardial infarction, stroke, and renal failure when it is not detected early and treated appropriately. The Eighth Joint National Committee (JNC 8) recently ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/1001/p503.html

JNC 8: Relaxing the Standards - Editorials - American Family Physician

Oct 1, 2014 - The Eighth Joint National Committee (JNC 8) recently issued the most anticipated hypertension guideline in some time. The most significant change in the JNC 8 guideline is relaxation of the systolic and diastolic blood pressure goals for adults 60 years and older. As a result of the new...

American Family Physician : Editorials

https://www.aafp.org/afp/2014/1001/p449.html

Safety of Long-Acting Beta Agonists in Adults with Asthma - Cochrane for Clinicians - ...

Oct 1, 2014 - LABAs appear to be safe when used with inhaled corticosteroids. LABA monotherapy is associated with an increase in asthma-related mortality and nonfatal serious adverse events, but not in all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1001/p453.html

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

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

American Family Physician : Implementing AHRQ Effective Health Care Reviews

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

Oseltamivir Slightly Decreases Influenza Symptom Duration but Not Hospitalizations - ...

Oct 1, 2014 - Treatment of children with oseltamivir will decrease symptom duration by approximately one day, but will not reduce hospitalizations and does not seem to be effective in children with asthma. In adults, symptom reduction is less striking (less than one day), and hospitalization will not...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1001/p497.html

Psychological Therapies for Chronic Posttraumatic Stress Disorder - Cochrane for ...

Oct 1, 2014 - Trauma-focused cognitive behavior therapy (CBT) and eye movement desensitization and reprocessing (EMDR) are more effective than other therapies in reducing PTSD symptom severity up to four months after treatment, but more robust studies are needed to evaluate the long-term effectiveness.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1001/p454.html

No Benefit to Prolonged Dual Antiplatelet Therapy After Drug-Eluting Stent Placement - ...

Oct 1, 2014 - Prolonging dual antiplatelet therapy with aspirin plus clopidogrel (Plavix) for more than one year after the placement of a drug-eluting stent confers no clinical benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1001/p502.html

Physical Therapy No Better Than Sham Therapy for Hip Osteoarthritis - POEMs - American ...

Oct 1, 2014 - In this study, physical therapy was no more effective than sham therapy in reducing pain and improving function in adults with hip osteoarthritis.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1001/p497a.html

Primary Raynaud Phenomenon - Clinical Evidence Handbook - American Family Physician

Sep 15, 2014 - What are the effects of drug treatments for primary Raynaud phenomenon?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0915/p403.html

Prostaglandins to Induce Labor in Women with Asthma - FPIN's Clinical Inquiries - ...

Sep 15, 2014 - There is little evidence evaluating whether prostaglandins used to induce labor increase the risk of bronchospasm in patients with asthma. The use of dinoprostone to induce labor is not associated with asthma exacerbations or reduced oxygen saturation in patients with active asthma or a...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0915/p415.html

Rosiglitazone, Medical Reversal, and Back to Basics for Diabetes - Editorials - ...

Sep 15, 2014 - For too long, the debate in diabetes has centered on the question: Is this medication harmful? It's time to revisit the more fundamental question: Is this treatment beneficial?

American Family Physician : Editorials

https://www.aafp.org/afp/2014/0915/p368.html

Management of External Genital Warts - American Family Physician

Sep 1, 2014 - Genital warts affect 1% of the sexually active U.S. population and are commonly seen in primary care. Human papillomavirus types 6 and 11 are responsible for most genital warts. Warts vary from small, flat-topped papules to large, cauliflower-like lesions on the anogenital mucosa and ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0901/p312.html

ACOG Releases Clinical Guidelines on Management of Menopausal Symptoms - Practice ...

Sep 1, 2014 - The American College of Obstetricians and Gynecologists (ACOG) has provided recommendations for the treatment of vasomotor and vaginal symptoms related to menopause.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/0901/p338.html

Intranasal Corticosteroids for Acute Bacterial Sinusitis - Cochrane for Clinicians - ...

Sep 1, 2014 - Compared with patients not treated with intranasal corticosteroids, those who receive them have greater improvement or resolution of symptoms at two to three weeks, regardless of whether antibiotics are used. In a single head-to-head study, patients taking intranasal corticosteroids ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0901/p286.html

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

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

American Family Physician : Cochrane for Clinicians

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

Cold Symptoms Unaffected by Regular Analgesic Dosing or Use of Steam - POEMs - American...

Sep 1, 2014 - Advice regarding the use of steam inhalation, ibuprofen alone or with acetaminophen, acetaminophen alone, and regular vs. as-needed use of analgesics did not show any improved effectiveness in treating symptoms of acute respiratory tract infections. Ibuprofen may be beneficial in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p335.html

Dog and Cat Bites - American Family Physician

Aug 15, 2014 - Animal bites account for 1% of all emergency department visits in the United States and more than $50 million in health care costs per year. Most animal bites are from a dog, usually one known to the victim. Most dog bite victims are children. Bite wounds should be cleaned, copiously ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0815/p239.html

ACC/AHA Release Updated Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD...

Aug 15, 2014 - The Blood Cholesterol Expert Panel from the American College of Cardiology (ACC) and the American Heart Association (AHA) issued an updated evidence-based guideline in 2013 that addresses the use of fixed doses of cholesterol-lowering drugs (statins) to reduce the risk of ASCVD in ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/0815/p260.html

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

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

American Family Physician : Editorials: Controversies in Family Medicine

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

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

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

American Family Physician : Editorials: Controversies in Family Medicine

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

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

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

American Family Physician : STEPS

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

Opioids for Chronic Back Pain: Short-Term Effectiveness, Long-Term Uncertain - POEMs - ...

Aug 15, 2014 - Overall, in patients with chronic low-back pain, opioids are moderately more effective than placebo in the short term for pain relief and slightly more effective in the short term for improving function. However, data for long-term use are virtually nonexistent. The long-term use of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od5.html

Anastrozole Decreases Rate of Breast Cancer in High-Risk Postmenopausal Women - POEMs -...

Aug 15, 2014 - Postmenopausal women at high risk of developing breast cancer who take anastrozole for five years have a lower rate of developing invasive breast cancer during that time frame.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od7.html

Botulinum Toxin Injection for Facial Wrinkles - American Family Physician

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

American Family Physician : Article

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

Common Questions About Late-Term and Postterm Pregnancy - American Family Physician

Aug 1, 2014 - Pregnancy is considered late term from 41 weeks, 0 days’ to 41 weeks, 6 days’ gestation, and postterm at 42 weeks’ gestation. Early dating of the pregnancy is important for accurately determining when a pregnancy is late- or postterm, and first-trimester ultrasonography should be ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p160.html

Recurrent Epistaxis in Children - Clinical Evidence Handbook - American Family Physician

Jul 15, 2014 - What are the effects of treatments for recurrent idiopathic epistaxis in children?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0715/p105.html

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

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

American Family Physician : FPIN's Clinical Inquiries

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

Delayed Prescription Strategies Decrease Antibiotic Use - POEMs - American Family ...

Jul 15, 2014 - A delayed prescription approach in children and adults with acute respiratory tract infections, combined with explicit instructions for symptom control, is effective in decreasing antibiotic use, while not adversely affecting patient satisfaction or symptom duration or severity.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p110.html

Stable TSH Can Be Rechecked in Two Years - POEMs - American Family Physician

Jul 15, 2014 - Most patients receiving thyroid replacement therapy with less than 125 mcg of levothyroxine per day can wait two years before monitoring thyroid-stimulating hormone (TSH) levels if their results are normal. Fewer than one in 10 patients who take less than 125 mcg of levothyroxine per ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p114.html

New Anticoagulants vs. Warfarin in Atrial Fibrillation: No Clear Winner - POEMs - ...

Jul 15, 2014 - In this meta-analysis, newer anticoagulants appear to be slightly more effective than warfarin in the short term (two years) in preventing strokes of all kinds in patients with atrial fibrillation. However, they are no more effective than warfarin in preventing ischemic strokes, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p110a.html

Prevention and Treatment of Motion Sickness - American Family Physician

Jul 1, 2014 - Motion sickness is a common syndrome that occurs upon exposure to certain types of motion. It is thought to be caused by conflict between the vestibular, visual, and other proprioceptive systems. Although nausea is the hallmark symptom, it is often preceded by stomach awareness, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p41.html

Pharmacologic Management of Pain at the End of Life - American Family Physician

Jul 1, 2014 - Although many patients experience debilitating pain at the end of life, there are many options to improve analgesia and quality of life. Pain assessment using a validated tool, with attention to patient function and specific goals, helps tailor individual treatment plans. The World ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p26.html

Antibiotics for Sore Throat - Cochrane for Clinicians - American Family Physician

Jul 1, 2014 - Compared with placebo, antibiotics can shorten the duration of sore throat symptoms by about 16 hours and can reduce complications. In countries where the absolute rates of complications are higher, antibiotic therapy is more likely to be effective. The effectiveness of antibiotic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0701/p23.html

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