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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

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

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

American Family Physician : POEMs

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

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.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

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

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

American Family Physician : POEMs

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

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.html

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

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

American Family Physician : POEMs

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

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Aspirin, Eicosapentaenoic Acid, and Placebo Equally Effective in Preventing Colorectal ...

Jun 1, 2019 - After 12 months, neither aspirin nor EPA, alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p717.html

FIT Has Similar Yield as Colonoscopy for Colorectal Cancer and Advanced Adenoma Over 10...

May 15, 2019 - Over a 10-year period, the rates of detection of colorectal cancer (CRC) and advanced adenomas using FIT are similar to those seen in studies of screening colonoscopy. This does not prove that FIT reduces morbidity and mortality due to CRC as effectively as colonoscopy.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od5.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

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

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

American Family Physician : POEMs

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

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.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

Ambulatory Blood Pressure Important for Decision-Making About Treatment - POEMs - ...

Oct 15, 2018 - This study supports the guidelines recommending that treatment decisions be based on ambulatory blood pressure measurements rather than in-office blood pressure results. The difference between the two measurements in this cohort was 19/11 mm Hg, which is enough to change the decision to...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od5.html

HPV Testing Better Than Cytology for Women Vaccinated Against HPV - POEMs - American ...

Sep 15, 2018 - In women who had received the HPV vaccine, screening for HPV every five years, with cytology and colposcopy follow-up as needed, resulted in higher rates of identification of high-grade pre-cancerous disease than standard liquid-based cytology every 2.5 years with HPV follow-up ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p384.html

Aspirin No Different Than Rivaroxaban for Prevention of VTE After TKA or THA - POEMs - ...

Aug 15, 2018 - Extended prophylaxis with low-dose aspirin is similar in efficacy to rivaroxaban for the prevention of symptomatic VTE following TKA or THA. Aspirin is cheap, widely available, and effective, making it a good alternative to the more costly direct oral anticoagulants.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248.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

Systolic Blood Pressure of At Least 140 mm Hg Best Place to Begin Treatment - POEMs - ...

Aug 15, 2018 - Beginning antihypertensive treatment when the systolic blood pressure is greater than 140 mm Hg delays death and prevents major cardiovascular events in some persons without preexisting heart disease; in patients with existing heart disease, it prevents further events, but does not ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p249.html

FIT More Acceptable with Better Detection Rate Than gFOBT for Colorectal Cancer ...

Jun 15, 2018 - FIT is more sensitive and specific than the older guaiac-based fecal occult blood tests (gFOBTs) when screening for colorectal cancer. We now know that it is also more acceptable to patients and increases uptake in a centrally administered screening program.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p818.html

Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious ...

May 1, 2018 - Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p606.html

In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

High False-Positive Rate with Lung Cancer Screening - POEMs - American Family Physician

Jul 15, 2017 - If you are thinking about adding lung cancer screening to your delivery of preventive care, be sure to prepare patients. They are likely to receive a positive result, most of the positive results will not be lung cancer, and one in four patients will require additional tracking (i.e., ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p128a.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

Bariatric Surgery Improves Quality of Life and Results in More Weight Loss Than ...

Jun 15, 2017 - Bariatric surgery using Roux-en-Y gastric bypass or sleeve gastrectomy was more effective than intensive medical therapy at improving quality of life and helping patients lose weight and reduce the need for medications. Anemia was more common with sleeve gastrectomy, and approximately ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0615/p805.html

Repeat Cytology Within Six Months Equals Colposcopy for Younger Women with ASCUS or ...

Apr 1, 2017 - Among women 22 to 27 years of age with an index cervical cytology showing abnormal squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL), the incidence of invasive cervical cancer did not differ between repeat cytology within six months ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p455.html

Brief Interventions for Weight Management in Kids Are Not Effective - POEMs - American ...

Feb 1, 2017 - Calculating the BMI of children and adolescents in primary care practices and counseling those who are overweight is ineffective to reduce BMI in children over several years of follow-up.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194a.html

Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke, and MI...

Oct 15, 2016 - Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663.html

Mediterranean Diet Produces Moderate Weight Loss - POEMs - American Family Physician

Jul 1, 2016 - In addition to improving cardiovascular outlook, a Mediterranean diet produced greater sustained weight loss than a low-fat diet and similar weight loss to other diets in patients who were overweight or obese, most of whom had type 2 diabetes mellitus.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59.html

Colorectal Cancer Screening Modalities: Variable Uptake, Variable Yield - POEMs - ...

Jun 15, 2016 - Based on the initial round of screening in this randomized trial, it appears that more patients complete fecal immunochemical testing than colonography or colonoscopy. Using the most conservative estimate, the yields of advanced adenomas and advanced neoplasms are similar.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032a.html

Meta-Analysis: Intensive BP Control Decreases Major CV Events and Stroke, but Not MI, ...

Jun 15, 2016 - Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart failure,...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1036.html

Preexposure Prophylaxis with Tenofovir/Emtricitabine Prevents HIV Infection in Men Who ...

Mar 15, 2016 - Preexposure prophylaxis in high-risk men who have unprotected anal intercourse reduces the likelihood of developing HIV (number needed to treat = 17 per year). Participants averaged 15 pills per month, which costs approximately $700 per month ($8,400 per year). Condoms would be a much ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0315/p520.html

Treating Low Vitamin D Levels Is Ineffective in Postmenopausal Women - POEMs - American...

Feb 15, 2016 - You do not have to treat a low vitamin D level if your patient is a typical community-dwelling postmenopausal woman younger than 75 years. The usual dosage of vitamin D, 800 IU (20 mcg) daily, will not increase levels even after a year of therapy and has little effect on calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315.html

9-Valent HPV Vaccine Offers Only Small Advantage Over Quadrivalent Vaccine - POEMs - ...

Jul 1, 2015 - A new 9-valent HPV vaccine is generally similar in effectiveness to the older quadrivalent vaccine. There is a small benefit of the new vaccine compared with the older vaccine for women who are initially uninfected (2.4 vs. 4.2 cases per 1,000 person-years), but you would have to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p54.html

No Benefit to Screening with CTA for Asymptomatic CAD in Adults with Diabetes - POEMs -...

Apr 15, 2015 - Using coronary CTA to screen for CAD in adults with type 1 or type 2 diabetes and no indication of existing CAD does not improve outcomes more than standard care.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0415/p566.html

Lung Cancer Screening Is Cost-Effective, but Only If Done Correctly - POEMs - American ...

Mar 1, 2015 - The U.S. Preventive Services Task Force (USPSTF) gave lung cancer screening a B recommendation on the basis of the reductions in disease-specific mortality and all-cause mortality seen in the National Lung Screening Trial (NLST). The NLST does not consider cost or cost-effectiveness in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0301/p328.html

Low-Carbohydrate Diet Better Than Low-Fat Diet to Reduce Cardiovascular Risk Factors ...

Feb 15, 2015 - More than 40 years ago, Dr. Robert Atkins wrote his first book advocating for a low-carbohydrate diet to cause and sustain weight loss. This study (of mostly women) found that a low-carbohydrate diet—though not as severe a diet as the Atkins approach—caused an average 3.5 kg (7.7 lb) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p262.html

High-Dose Vaccine Reduces Clinical Influenza in Older Adults Compared with Standard ...

Dec 1, 2014 - High-dose influenza vaccine provided a 25% relative reduction in the likelihood of developing laboratory-confirmed influenza compared with standard-dose vaccine in patients 65 years and older. This corresponds to a number needed to treat of approximately 220 to prevent a ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p796.html

Accuracy of Fecal DNA and Fecal Immunochemical Test for Colorectal Cancer Detection - ...

Sep 1, 2014 - Fecal DNA testing is more sensitive but less specific than fecal immunochemical testing (FIT), and as a result, has a higher false-positive rate. It is also more expensive than other noninvasive alternatives such as FIT. We do not know which test will be better at reducing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p326a.html

Omega-3 Fatty Acid Supplementation Does Not Decrease CVD-Related Outcomes - POEMs - ...

Nov 1, 2014 - Omega-3 fatty acid supplementation does not decrease the risk of cardiovascular outcomes in this older population. Although the numbers are small, supplementation may prevent heart disease in patients already at low risk; that is, patients without a history of cardiovascular disease ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p662.html

ACE Inhibitors Decrease Cardiovascular Events in Patients with Diabetes, ARBs Do Not - ...

Sep 1, 2014 - In patients with diabetes, ACE inhibitors decrease cardiovascular events and all-cause mortality. ARBs do not. Both drug classes decrease heart failure incidence. Although both drug classes have been available for almost 15 years, there is only one study of 250 patients that directly ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p326.html

Immunochemical FOBTs Moderately Sensitive and Highly Specific for Colorectal Cancer - ...

Aug 15, 2014 - Immunochemical FOBTs, such as OC-Micro, OC-Sensor, or OC-Light, are moderately sensitive (73% to 89%) and highly specific (92% to 95%) for identifying colorectal cancer. In comparison, Hemoccult Sensa has a lower sensitivity (64% to 80%) and specificity (87% to 90%). Immunochemical ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od4.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

HPV Screening Every Five Years Equal to Pap Smear Every Three Years - POEMs - American ...

Jun 1, 2014 - A single HPV test provides the same degree of protection over five years as a Papanicolaou (Pap) smear does for three years. We may soon see a recommendation for HPV testing as a stand-alone screen, with cytology reserved for women who have an HPV-positive result. We may also be able to...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0601/p907a.html

Varenicline Plus Bupropion SR No Better Than Varenicline Alone for Tobacco Cessation - ...

Jun 1, 2014 - Combination therapy with varenicline and sustained-release bupropion was associated with a significantly higher prolonged abstinence rate compared with varenicline monotherapy at 12 weeks and 26 weeks in adult smokers attempting to quit. By 52 weeks, however, the difference was no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0601/p912.html

Long-Term Results of Drug Treatment for Obesity - POEMs - American Family Physician

Mar 1, 2014 - This review of commonly used weight-loss medications, including orlistat (Xenical), lorcaserin (Belviq), phentermine/topiramate (Qsymia), bupropion (Wellbutrin), metformin (Glucophage), and zonisamide (Zonegran), reported an average weight loss for participants of 2.5 to 8.0 kg (5.5 to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0301/p389a.html

Screening Echocardiography Not Beneficial - POEMs - American Family Physician

Feb 1, 2014 - Population-based screening for heart disease or valve disease with echocardiography will identify cardiac pathology in patients but does not decrease mortality, myocardial infarction risk, or stroke risk.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p224.html

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