Most Recent Tools for Practice
Tools for Practice #248 – Hydrochlorothiazide and Squamous Cell Skin Cancer: Remember when hypertension was easy?
Does hydrochlorothiazide increase the risk of squamous cell carcinoma (SCC) of the skin?
Bottom Line: Observational data suggest an association between hydrochlorothiazide and the risk of SCC. Causation has not been proven. Risk appears to consistently increase with dose and duration (example: 5 years of use increases risk 3-4 times). Baseline incidence of SCC is <0.1% annually. The same risk has not been established with thiazide-like diuretics (like indapamide or chlorthalidone). The benefit of switching from hydrochlorothiazide to another agent should be weighed against the risk of changing medications. Read More
Tools for Practice #247 – Fact or Fad: Intermittent fasting for sustained weight loss
Does intermittent fasting result in greater sustained (>6 month) weight loss than continuous dieting in adults?
Bottom Line: Although inconsistently defined, intermittent fasting (example 500 kcal/day for 2 days/week) and continuous dieting (~25% reduction in caloric intake daily) result in similar weight loss, usually ~5-9kg at 6 months-1 year. Discontinuation rates with both diets is up to ~60%. Read More
Tools for Practice #246 – Just wait a minute: Point-of-care testing for Group A Streptococcal pharyngitis
In patients with sore throat, how accurate are point-of-care tests in the diagnosis of Group A beta-hemolytic streptococcal (GABHS) pharyngitis?
Bottom Line: Point-of-care testing, including rapid antigen detection tests and newer nucleic acid detection tests for GABHS pharyngitis are useful for ruling in a diagnosis of GABHS when positive (specificity 95%-99%). Nucleic acid detection tests may be more sensitive than rapid antigen detection tests (92% versus 85%). While immediate testing and treatment may not always be required, populations at increased risk of GABHS complications, such as Canada’s Indigenous populations, are more likely to benefit. Read More
Tools for Practice #245 – Taking a hard look at the evidence: Phosphodiesterase-5-inhibitors in erectile dysfunction
What is the efficacy and safety of phosphodiesterase-5-inhibitors (PDE5 inhibitors) for erectile dysfunction?
Bottom Line: PDE5 inhibitors increase the proportion of successful sexual intercourse attempts to ~65% versus ~30% for placebo. For every 3 men given a PDE5 inhibitor compared to placebo, an additional 1 will have “improved erections”. Read More
Tools for Practice #244 – Injecting Evidence into Platelet-Rich Plasma Injections
How effective is platelet-rich plasma for treating Achilles tendinopathy, lateral epicondylitis, and rotator cuff tendinopathy?
Bottom Line: The best quality evidence shows no difference in pain, function, or return to sport between platelet-rich plasma, dry needling, or saline for patients with Achilles tendinopathy, lateral epicondylitis, or rotator cuff tendinopathy. Read More
When creating primary care education and programs, the PEER team focuses on minimizing bias, patient orientated outcomes, shared decision making, collaboration and most importantly simplicity.
Who is PEER?
Patients, Experience, Evidence and Research (PEER) was formed between a group of primary care providers who shared a common belief that evidence should be made accessible to all primary care providers.