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Gabapentinoids for Pain: Potential Unintended Consequences - Editorials - American ...

Dec 1, 2019 - The widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1201/p672.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ...

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Chronic Neck Pain: Nonpharmacologic Treatment - Implementing AHRQ Effective Health Care...

Aug 1, 2019 - Which noninvasive nonpharmacologic treatments for chronic neck pain improve function or pain for at least one month?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0801/p180.html

Integrating Medical Acupuncture into Family Medicine Practice - Editorials - American ...

Jul 15, 2019 - Acupuncture is an evidence-based therapy to reduce pain that can meet patient demand for nonpharmacologic treatment. Now is the time to offer training in medical acupuncture to more family physicians.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0715/p76.html

Erenumab (Aimovig) for Migraine Prophylaxis in Adults - STEPS - American Family Physician

Jun 15, 2019 - Erenumab is a safe option for migraine prophylaxis in adults. However, it is expensive and should be reserved for patients who have experienced intolerable adverse effects while taking oral migraine prophylaxis medication or who have poor adherence to daily preventive treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0615/p781.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.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

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.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

Osteopathic Manipulative Treatment: A Primary Care Approach - Editorials - American ...

Feb 15, 2019 - Osteopathic manipulative treatment is a valuable modality that has the potential to decrease cost and improve pain/function in patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0215/p214.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

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

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

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

Acupuncture Effective for Chronic Pain Conditions - POEMs - American Family Physician

Nov 15, 2018 - Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od2.html

Epidural Analgesia and Risk of Cesarean Delivery - FPIN's Help Desk Answers - American ...

Nov 1, 2018 - There is no difference in the risk of cesarean delivery in women who receive epidural analgesia before 4 to 5 cm cervical dilation compared with later dilation.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1101/od2.html

Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not ...

Oct 15, 2018 - This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose, duration, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od3.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

Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer ...

Sep 1, 2018 - Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0901/p316.html

Medications Ineffective to Prevent Cognitive Decline or Dementia - POEMs - American ...

Aug 15, 2018 - None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248a.html

NSAIDs for Postpartum Perineal Pain - FPIN's Help Desk Answers - American Family Physician

Jun 1, 2018 - Women with third- or fourth-degree perineal lacerations or who received an episiotomy can be given oral NSAIDs to reduce perineal pain in the first six hours postpartum.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od3.html

Antiepileptic Drug Monotherapy for Epilepsy - Cochrane for Clinicians - American Family...

May 1, 2018 - In patients with partial-onset (focal) seizures, levetiracetam (Keppra), lamotrigine (Lamictal), and carbamazepine (Tegretol) were associated with the longest time to treatment withdrawal (i.e., the recommended patient-oriented outcome measure that balances tolerability with ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0501/p572.html

Pregabalin (Lyrica) for Acute Fibromyalgia Pain - Medicine by the Numbers - American ...

May 1, 2018 - Pregabalin (Lyrica) provides good pain relief to some patients with acute fibromyalgia pain but does not work for most persons. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0501/od1.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

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

Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen Has Fewer...

Mar 15, 2018 - This carefully designed and adequately powered study found no difference in pain reduction between ibuprofen and oral morphine in children with postoperative pain. Adverse effects, however, were much more likely with morphine.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408a.html

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.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

Effectiveness of Skin-to-Skin Care for Procedure-Related Pain in Newborns - Cochrane ...

Feb 1, 2018 - Skin-to-skin care, also known as kangaroo care, effectively reduces physiologic and behavioral measures of pain in neonates during painful procedures and has no identified adverse effects. Infants who received skin-to-skin care during painful procedures had a heart rate of 10.8 beats ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0201/p170.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

Topical Capsaicin for Treatment of Chronic Neuropathic Pain in Adults - Medicine by the...

Dec 1, 2017 - Based on low-quality evidence, high-concentration capsaicin patches reduce neuropathic pain from herpes and human immunodeficiency virus infection by 30% to 50% compared with the low-concentration capsaicin control group.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1201/od1.html

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized ...

Nov 15, 2017 - Compared with psychoeducation, a single 15-minute session of training in mindfulness or self-hypnosis leads to greater immediate pain relief for hospitalized patients with at least moderate pain at baseline.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od6.html

Treatments for Nocturnal Leg Cramps - FPIN's Help Desk Answers - American Family Physician

Oct 1, 2017 - Calcium channel blockers or B vitamins may lead to short-term improvement in nocturnal leg cramps. Stretching has mixed results. Quinine is effective but is no longer recommended, and it is not approved for treatment of leg cramps because of potential toxicity.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1001/od3.html

No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the ...

Aug 15, 2017 - A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p262.html

Pregabalin Does Not Decrease the Pain of Sciatica - POEMs - American Family Physician

Aug 15, 2017 - Pregabalin does not relieve pain in patients with sciatica.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Physical Fitness Training for Patients with Stroke - Cochrane for Clinicians - American...

Jun 1, 2017 - There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p701.html

Treatment of Chronic Insomnia in Adults: ACP Guideline - Practice Guidelines - American...

May 15, 2017 - The American College of Physicians (ACP) has provided recommendations for treatment of chronic insomnia in adults. Treatment, which can include psychological or pharmacologic therapy, alone or combined, as well as complementary and alternative methods, is aimed at improving sleep, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0515/p669.html

Topiramate and Amitriptyline Not Effective for Migraine in Children - POEMs - American ...

May 15, 2017 - Topiramate, amitriptyline, and placebo all led to a similar, substantial improvement in migraine frequency and disability. How to harness this strong placebo effect for our patients is an important, but unanswered, question.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od2.html

Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care - ...

Mar 15, 2017 - For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od3.html

Antiepileptic Drugs After First Unprovoked Seizure - Medicine by the Numbers - American...

Feb 1, 2017 - The decision to start an antiepileptic drug after a first unprovoked seizure has long been a clinically challenging one.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0201/od1.html

AAN Updates Guidelines on the Uses of Botulinum Neurotoxin - Practice Guidelines - ...

Feb 1, 2017 - In 2008, the American Academy of Neurology (AAN) published guidelines on the use of botulinum neurotoxin. This summary highlights updates on four indications: blepharospasm, cervical dystonia, spasticity in adults, and headache.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0201/p198.html

Sertraline Reduces Risk of Depression in Adults After Traumatic Brain Injury - POEMs - ...

Feb 1, 2017 - This study found that sertraline is more effective than placebo (number needed to treat = 6) in preventing the onset of a major depressive disorder in adults following a TBI. This study included patients with mild, moderate, and severe TBI.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194.html

Alpha-adrenergic Agonists for the Management of Opioid Withdrawal - Medicine by the ...

Jan 1, 2017 - Alpha-adrenergic agonists were more efficacious than placebo in the management of opioid withdrawal, but are best reserved as an alternative to methadone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0101/od1.html

Prognosis Following Mild Head Injury in Children - Point-of-Care Guides - American ...

Dec 15, 2016 - Concussion, also referred to as mild traumatic brain injury, is a common injury in children. It is defined as a transient disturbance in mental status following head trauma, and it can cause a variety of physical, cognitive, and emotional sequelae. Symptoms continuing for more than 28 ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/1215/p1006.html

Rural Opioid Use Disorder Treatment Depends on Family Physicians - Graham Center Policy...

Oct 1, 2016 - The nation's growing opioid use disorder epidemic disproportionately impacts rural areas, where physicians who can prescribe buprenorphine are scarcest. Among physicians approved to prescribe buprenorphine, family physicians (FPs) are the most likely to work in rural areas.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1001/p546.html

Family Medicine: An Underutilized Resource in Addressing the Opioid Epidemic? - Graham ...

Sep 1, 2016 - Opioid overdose rates have tripled since 2000, and although overprescribing of opioids by physicians is widely accepted as a causal factor, the physician's role in providing medication-assisted treatment for opioid use disorder is less appreciated. Despite a clear willingness to ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/0901/p350.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Acetaminophen for the Treatment of Pain in Newborns - Cochrane for Clinicians - ...

Aug 1, 2016 - Acetaminophen does not significantly reduce pain associated with heel lance, eye examinations, or assisted vaginal births in newborns. Acetaminophen may reduce the total amount of morphine a newborn needs in the first 48 hours following major abdominal or thoracic surgery.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0801/p216.html

Acupuncture for Frequent Tension-Type Headaches - Medicine by the Numbers - American ...

Aug 1, 2016 - Studies show an NNT of 3 to have at least a 50% reduction of headache frequency compared with routine care. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0801/od1.html

Exercise to Improve Functioning in Patients with Dementia - FPIN's Help Desk Answers - ...

Aug 1, 2016 - Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0801/p242.html

Trigeminal Neuralgia - Clinical Evidence Handbook - American Family Physician

Jul 15, 2016 - What are the effects of ongoing treatments in persons with trigeminal neuralgia?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0715/p133.html

Caring for Patients with Job Insecurity Who Are Experiencing Chronic Work-Related Pain ...

Jul 15, 2016 - In addition to providing direct medical care, the physician can help this patient by obtaining an occupational history, formulating hypotheses about the cause of the pain and potential interventions, and establishing a therapeutic relationship.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0715/p145.html

Topical NSAIDs for Acute Musculoskeletal Pain in Adults - Medicine by the Numbers - ...

Jul 1, 2016 - Studies show that patients had improved pain control with diclofenac gel, ketoprofen gel, and ibuprofen gel with no increase in local or systemic adverse events. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0701/od1.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

CDC Develops Guideline for Opioid Prescribing - Practice Guidelines - American Family ...

Jun 15, 2016 - A recently released guideline aims to establish patient-centered approaches to initiating, managing, and discontinuing opioid use. The recommendations from the Centers for Disease Control and Prevention (CDC) emphasize the serious risks and harms associated with opioids.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0615/p1042.html

The Opioid Epidemic: AMA’s response - Editorials - American Family Physician

Jun 15, 2016 - With Lembke article and opioid PG

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p975.html

Using the CDC Guideline and Tools for Opioid Prescribing in Patients with Chronic Pain ...

Jun 15, 2016 - The new CDC guideline is intended to help clinicians decide whether and how to prescribe opioids for chronic pain; offer safer, more effective care for patients with chronic pain; improve clinician-patient communication; and prevent opioid use disorder and opioid-related overdose.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p970.html

When to Discontinue Antiepileptic Drug Therapy for Patients in Remission - Cochrane for...

Jun 1, 2016 - Children with epilepsy should be seizure-free for at least two years before stopping antiepileptic drug therapy, especially those who have partial seizures or a history of abnormal electroencephalography (EEG) results.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0601/p914.html

Nonoperative Management of Cervical Radiculopathy - American Family Physician

May 1, 2016 - Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p746.html

Alpha-Lipoic Acid for Treatment of Diabetic Peripheral Neuropathy - FPIN's Help Desk ...

May 1, 2016 - Intravenous (IV) ALA can improve neuropathy symptoms when administered for three weeks, but symptom improvement with oral ALA is not clinically significant. There is no evidence evaluating long-term treatment.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0501/p786.html

Antiviral Therapy for Bell Palsy - Cochrane for Clinicians - American Family Physician

May 1, 2016 - The combination of antiviral agents and corticosteroids is more effective than corticosteroids alone for the complete recovery of patients with Bell palsy (number needed to treat [NNT] = 15) and for the resolution of motor synkinesis and excessive tear production (NNT = 12). Antivirals ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0501/p742.html

Ibuprofen for Treatment of Episodic Tension-Type Headaches - Medicine by the Numbers - ...

May 1, 2016 - Studies show that 1 in 14 patients were parin-free at two hours and none experienced adverse events. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0501/od1.html

Gabapentin for Chronic Neuropathic Pain - Medicine by the Numbers - American Family ...

Dec 1, 2015 - Studies show that 1 in 6 patients were helped with diabetic neuropathy and 1 in 8 were helped with postherpetic neuralgia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1201/od1.html

Gabapentin Equals Epidural Steroid for Radicular Pain - POEMs - American Family Physician

Nov 1, 2015 - After controlling for the placebo effect that may accompany an epidural steroid injection, treatment with gabapentin is as effective as the injection in reducing radicular leg pain in the short term (three months). A placebo bump in response, if present, is likely to be transient.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814a.html

Real-World Study Finds Lower Mortality and Stroke Risk with Dabigatran, but More GI ...

Sep 15, 2015 - In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p529.html

The Epley Maneuver for Treatment of Benign Paroxysmal Positional Vertigo - Cochrane for...

Aug 1, 2015 - Treatment with the Epley maneuver resolves benign paroxysmal positional vertigo better than sham therapy or control. Minor adverse effects are uncommon.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0801/p184.html

The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms - Cochrane for ...

Jul 1, 2015 - Based on low-quality evidence, levetiracetam was found to be ineffective for the treatment of chronic neuropathic pain symptoms. Moreover, patients who were taking levetiracetam experienced adverse effects at a significantly higher rate than those who were taking placebo.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0701/p23.html

CEA vs. Stenting: Mixed Results, Mostly Bad - POEMs - American Family Physician

Jul 1, 2015 - These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52.html

AHA and ASA Release Guideline for Prevention of Future Stroke in Patients with Stroke ...

Jan 15, 2015 - The American Heart Association (AHA) and American Stroke Association (ASA) have updated their guideline on prevention of future stroke in patients with a history of stroke or transient ischemic attack (TIA). Currently, the average annual rate of future stroke in these patients is at a ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0115/p136.html

Absence Seizures in Children - Clinical Evidence Handbook - American Family Physician

Jan 15, 2015 - What are the effects of treatments for typical absence seizures in children?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0115/p114.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

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

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

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

Infiltrative Anesthesia in Office Practice - American Family Physician

Jun 15, 2014 - When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p956.html

Acute Migraine Treatment in Emergency Settings - Implementing AHRQ Effective Health ...

May 1, 2014 - What are the comparative benefits and adverse effects of parenteral treatments for adults who present to the emergency department with migraine headaches?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2014/0501/p742.html

Aspirin With or Without Antiemetic for Acute Migraine Headaches in Adults - Cochrane ...

Feb 1, 2014 - Aspirin, with or without an antiemetic, is an effective treatment for acute migraine headache. Adding the antiemetic metoclopramide (Reglan) significantly reduces migraine-related nausea and vomiting compared with aspirin alone.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0201/p176.html

Dementia - Clinical Evidence Handbook - American Family Physician

Jan 15, 2014 - What are the effects of treatments on cognitive, behavioral, and psychological symptoms of dementia (Alzheimer disease, Lewy body dementia, or vascular dementia)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0115/p117.html

Is Intensive Blood Pressure Control Beneficial in Patients with Acute Intracerebral ...

Jan 15, 2014 - It seems to be safe to lower systolic blood pressure to a target of 140 mm Hg in those with an acute hemorrhagic stroke. However, there seems to be no clinical benefit to this approach when the data are adjusted for baseline NIH Stroke Scale scores.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0115/p120.html

Clopidogrel Plus 21 Days of Aspirin Is Superior to Aspirin Alone Within First 24 Hours ...

Jan 1, 2014 - Patients with minor stroke (National Institutes of Health [NIH] Stroke Scale score ≤ 3) or TIA have a decreased risk of recurrent stroke if given aspirin plus clopidogrel vs. aspirin alone if started within 24 hours of the onset of symptoms. There was no significant increase in the risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0101/p55.html

Pharmacologic Therapy for Acute Pain - American Family Physician

Jun 1, 2013 - The approach to patients with acute pain begins by identifying the underlying cause and a disease-specific treatment. The first-line pharmacologic agent for the symptomatic treatment of mild to moderate pain is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). The choice ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p766.html

Multiple Sclerosis - Clinical Evidence Handbook - American Family Physician

May 15, 2013 - What are the effects of interventions aimed at reducing relapse rates and disability and to improve symptoms during acute relapse in persons with multiple sclerosis? What are the effects of treatments for fatigue and spasticity in persons with multiple sclerosis? What are the effects of...

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2013/0515/p712.html

Subacute to Chronic Mild Traumatic Brain Injury - American Family Physician

Dec 1, 2012 - Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1045.html

Dietary Management of Epilepsy - Editorials - American Family Physician

Dec 1, 2012 - The safety and effectiveness of the ketogenic diet for the treatment of epilepsy have been known for decades. However, successful implementation of the diet requires an essential commitment by the patient and his or her family. Compliance with the ketogenic diet involves adjustments and...

American Family Physician : Editorials

https://www.aafp.org/afp/2012/1201/p1000.html

Insulin for Glycemic Control in Acute Ischemic Stroke - Cochrane for Clinicians - ...

Dec 1, 2012 - Administering insulin to maintain glycemic control does not improve the rates of mortality or dependency, or the final neurologic outcome after an acute ischemic stroke. Additionally, in randomized controlled trials, patients in the intervention groups (those under tight glycemic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/1201/p1008.html

Transient Ischemic Attack: Part II. Risk Factor Modification and Treatment - American ...

Sep 15, 2012 - Interventions following a transient ischemic attack are aimed at preventing a future episode or stroke. Hypertension, current smoking, obesity, physical inactivity, diabetes mellitus, and dyslipidemia are all well-known risk factors, and controlling these factors can have dramatic ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p527.html

Opioid Dependence - Clinical Evidence Handbook - American Family Physician

Sep 15, 2012 - What are the effects of drug treatments for stabilization (maintenance), withdrawal, and relapse prevention in persons with opioid dependence?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2012/0915/p565.html

Rational Use of Opioids for Management of Chronic Nonterminal Pain - American Family ...

Aug 1, 2012 - Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Nonmedical use of prescription opioids, diversion, and overdose deaths have also increased sharply, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0801/p252.html

AAN Updates Guideline on Treatment of Essential Tremor - Practice Guidelines - American...

Aug 1, 2012 - Propranolol and primidone (Mysoline) are the most commonly used therapies for essential tremor, but these agents are ineffective for up to one-half of patients. In 2005, the American Academy of Neurology (AAN) published recommendations for the use of other therapies for essential tremor.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2012/0801/p292.html

Epidural Analgesia for Labor Pain - Cochrane for Clinicians - American Family Physician

Aug 1, 2012 - Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. There were no statistically ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/0801/p241.html

Tapentadol (Nucynta) for Treatment of Pain - STEPS - American Family Physician

May 1, 2012 - Tapentadol is a DEA schedule II opioid medication with a safety profile, duration of action, frequency of dosing, and analgesic effect similar to those of other oral narcotics, although it is more expensive. At low doses, immediate-release tapentadol is better tolerated than oxycodone ...

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0501/p910.html

Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with Nonvalvular Atrial ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0315/p577.html

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