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Sleep Disorders in Adults - American Family Physician

Oct 1, 2020 - Advertisement AFP BY TOPIC Sleep Disorders in Adults Editors' Choice of Best Available Content This collection features the best content from AFP, as identified by the AFP editors, on sleep disorders in adults and related issues, including continuous positive airway pressure...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=83

Alcohol Use Disorder: Pharmacologic Treatment Options - FPIN's Clinical Inquiries - ... Restricted content. Login required.

Oct 1, 2020 - Acamprosate and naltrexone should be used as first-line agents for treatment of alcohol use disorder and are effective for reducing relapse rates. Agent selection should be based on comorbid conditions and adherence to the dosing regimen.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/1001/od1.html

Appropriate Use of Opioids for Chronic Pain - Lown Right Care: Reducing Overuse and ... Restricted content. Login required.

Sep 15, 2020 - A collaboration between AFP and the Lown Institute promotes a vision of delivering health 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/2020/0915/p335.html

Smoking Cessation with Text Messaging and App-Based Interventions - Cochrane for ... Restricted content. Login required.

Aug 1, 2020 - Automated text messaging interventions are more effective than minimal smoking cessation support (absolute risk reduction [ARR] = 3%; 95% CI, 1% to 5%).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0801/p148.html

Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder ...

Jul 1, 2020 - Buprenorphine prescribing in primary care is a key bottleneck in the access to medications for opioid use disorder (OUD). In a Medicare claims study including family medicine, internal medicine, general practice, and psychiatry, the largest share of buprenorphine prescribers were family...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2020/0701/p10.html

Screening for Cognitive Impairment in Older Adults: Recommendation Statement - U.S. ...

Jun 15, 2020 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults.

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

https://www.aafp.org/afp/2020/0615/od1.html

Screening for Cognitive Impairment in Older Adults - Putting Prevention into Practice -... Restricted content. Login required.

Jun 15, 2020 - L.C. is a 70-year-old Asian American woman who retired from teaching middle school five years ago. She lives independently and has a daughter and grandchildren who live within 30 miles of her. She presents for a follow-up visit to renew her hypertension medications. Her blood pressure ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0615/p753.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ... Restricted content. Login required.

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.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

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

Prescribing Opioids for Chronic Pain: Unintended Consequences of the 2016 CDC Guideline...

Apr 15, 2020 - Since the 2016 CDC guideline for the use of opioid pain relievers was released, there has been a significant reduction in opioid prescribing, and the guideline has been adopted by state Medicaid agencies, insurers, and others. Widespread implementation of the guideline has had ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0415/p458.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

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ... Restricted content. Login required.

Apr 1, 2020 - Evidence does not support the routine use of haloperidol or second-generation antipsychotics for the treatment or prevention of delirium in hospitalized patients. Although second-generation antipsychotics may reduce the incidence of delirium in the postoperative setting, more research ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435a.html

Esketamine (Spravato) for Treatment-Resistant Depression - STEPS - American Family ... Restricted content. Login required.

Mar 15, 2020 - Esketamine is an in-office treatment for patients with a severe major depressive disorder to be used in addition to oral antidepressant therapy.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0315/p339.html

Treatments for Postmenopausal Hypoactive Sexual Desire Disorder - FPIN's Clinical ... Restricted content. Login required.

Feb 1, 2020 - Transdermal testosterone for the treatment of hypoactive sexual desire disorder in postmenopausal women results in an additional 0.92 sexually satisfying events per month, acne, and increased androgenic effects without major complications

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0201/p182.html

Adverse Events of Pharmacologic Treatments of Major Depression in Older Adults - ... Restricted content. Login required.

Feb 1, 2020 - What are the adverse events of antidepressants prescribed to treat major depressive disorder in adults 65 years and older?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0201/p179.html

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician Restricted content. Login required.

Jan 1, 2020 - My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2020/0101/p49.html

Opioid Use Disorder: Medical Treatment Options - American Family Physician

Oct 1, 2019 - Opioid use disorder is highly prevalent and can be fatal. At least 2.1 million Americans 12 years and older had opioid use disorder in 2016, and approximately 47,000 Americans died from opioid overdoses in 2017. Opioid use disorder is a chronic relapsing condition, the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p416.html

Common Misperceptions About Buprenorphine Prescribing for Opioid Use Disorder - ...

Oct 1, 2019 - The antidote to the opioid use disorder epidemic is the thoughtful use of evidence-based medicine and an honest understanding of what we know—and what we don't know—about caring for people with substance use disorders.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1001/p396.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

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 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/2019/0915/p369.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

Depression After ACS Events: AAFP Releases Updated Guidelines - Practice Guidelines - ...

Jun 15, 2019 - The American Academy of Family Physicians has released a guideline focusing on depression in adults within three months of an ACS event (unstable angina or myocardial infarction). The guideline is based on a systematic review of randomized controlled trials and observational studies and...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/p785.html

An Unhappily Married Patient - Curbside Consultation - American Family Physician

Jun 1, 2019 - Overall, marriage enhances health. Men gain greater health benefits from marriage than their wives. Conversely, wives are more negatively affected by a bad marriage than their husbands. In general, the health benefit of marriage is maximized in a good marriage but negated in a bad ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0601/p708.html

Psychological and Pharmacologic Treatments for Adults with PTSD - Implementing AHRQ ...

May 1, 2019 - What are the benefits and harms of psychotherapies and pharmacologic agents for the treatment of adults with posttraumatic stress disorder (PTSD)?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0501/p577.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.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

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

Pharmacologic Treatment of Borderline Personality Disorder - FPIN's Help Desk Answers -...

Mar 1, 2019 - There is no pharmacotherapy regimen that improves the overall symptoms of borderline personality disorder. When used for six months or less, antipsychotics can improve paranoia, dissociation, mood lability, anger, and global functioning.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0301/od2.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

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

Deprescribing Benzodiazepine Receptor Agonists for Insomnia in Adults - Practice ...

Jan 1, 2019 - A multidisciplinary group of clinicians as part of the Deprescribing Guidelines in the Elderly project has developed evidence-based guidelines focused on deprescribing long-term Benzodiazepine receptor agonists (BZRAs) in patients taking them for insomnia, with the goal of helping ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0101/p57.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.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

Deprescribing Antipsychotics for Behavioral and Psychological Symptoms of Dementia and ...

Sep 15, 2018 - As part of the Deprescribing Guidelines in the Elderly Project, a Canadian team consisting of two family physicians, one geriatric psychiatrist, two geriatricians, and four pharmacists has provided recommendations to guide physicians in deprescribing antipsychotics for behavioral and ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0915/p394.html

Management of Insomnia Disorder in Adults - Implementing AHRQ Effective Health Care ...

Sep 1, 2018 - What are the effectiveness, comparative effectiveness, and adverse effects of interventions for insomnia disorder in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0901/p319.html

Counseling Parents and Adolescents About Marijuana - Editorials - American Family ...

Jul 15, 2018 - Physicians are increasingly likely to be asked by adolescents or their parents whether recreational marijuana use is safe. Although many adults view marijuana as benign, there are major concerns about its use in adolescents because all illicit drug use, including marijuana, may have ...

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0715/p80.html

Evaluating Medical Decision-Making Capacity in Practice - American Family Physician

Jul 1, 2018 - Medical decision-making capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment). Capacity is the basis of informed consent. Patients have medical decision-making capacity if they...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p40.html

Individual Behavioral Counseling for Smoking Cessation - Cochrane for Clinicians - ...

Jul 1, 2018 - Individual behavioral counseling conducted by a trained therapist provides some benefit when compared with brief counseling and support; however, this benefit is less pronounced in the context of pharmacotherapy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0701/p21.html

Adults with Developmental Disabilities: A Comprehensive Approach to Medical Care - ...

May 15, 2018 - Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p649.html

Implantable Buprenorphine (Probuphine) for Maintenance Treatment of Opioid Use Disorder...

May 15, 2018 - Implantable buprenorphine is an expensive alternative for patients on a stable dosage of transmucosal buprenorphine. Based on current research and guidance, implantable buprenorphine should not be used as initial treatment for opioid dependence or as a substitute for medication-assisted...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0515/p668.html

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.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

Buprenorphine Therapy for Opioid Use Disorder - American Family Physician

Mar 1, 2018 - Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0301/p313.html

Treating Opioid Use Disorder as a Family Physician: Taking the Next Step - Editorials -...

Mar 1, 2018 - An AHRQ review showed that there are different ways in which buprenorphine-based MAT can be safely and effectively delivered in primary care settings.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0301/p302.html

Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life Cancer ...

Feb 15, 2018 - Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with cancer and...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od4.html

The AAFP Cognitive Care Kit: A Resource for Family Physicians - Editorials - American ...

Nov 15, 2017 - The AAFP Cognitive Care Kit was designed to give primary care physicians access to recommended materials to identify, screen, care for, and educate patients with cognitive impairment, as well as assist caregivers.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1115/p630.html

Interventions for Tobacco Cessation in Patients Being Treated for or Recovering from ...

Nov 1, 2017 - Pharmacotherapy alone and pharmacotherapy plus counseling are effective for tobacco cessation among patients being treated for or recovering from alcohol and substance use disorders. Counseling interventions without pharmacotherapy are not effective for tobacco cessation among patients ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1101/p572.html

Varenicline for Smoking Cessation - Medicine by the Numbers - American Family Physician

Sep 1, 2017 - Do the benefits outweigh the harms of using varenicline (Chantix) for smoking cessation? Read more to find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0901/od1.html

Pregabalin for Fibromyalgia Pain in Adults - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p291.html

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