Empowering Primary Care Through Evidence

PEER is a primary care led evidence based medicine team focused on providing relevant evidence to family physicians and primary care providers.

PEIP Conference 2020

PEER hosts an annual conference that provides practical primary care focused education based on the highest quality evidence and is free of industry bias.

Most Recent Tools for Practice

Tools for Practice #271 – Be still my quivering heart: alcohol and atrial fibrillation

Does advising patients to abstain from alcohol prevent atrial fibrillation recurrence?

Bottom Line: Observational studies consistently report a doseresponse association between alcohol and new onset atrial fibrillation. Based on 1 randomized controlled trial (RCT) of “regular drinkers” with paroxysmal atrial fibrillation, recurrence of atrial fibrillation happened in ~50% who abstain compared to ~70% who continue drinking. Abstaining can prevent 1 atrial fibrillation-related hospital visit for every 9 people compared to those who continue to drink at 6 months. Read More

Tools for Practice #270 – Burning Evidence for Fosfomycin in Cystitis

What is the efficacy of fosfomycin for uncomplicated cystitis in non-pregnant women?

Bottom Line: At best, single dose fosfomycin has similar efficacy to other antibiotics for uncomplicated cystitis. However, the best quality, publicly funded trial showed it was not as efficacious as nitrofurantoin, with 58% of cases clinically resolving at 28 days compared to 70% for nitrofurantoin. Read More

Tools for Practice #269 – Osteoarthritis pain getting you down? Duloxetine

Do Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), specifically duloxetine, improve pain in patients with osteoarthritis?

Bottom Line: Duloxetine can meaningfully reduce osteoarthritis pain scores (by at least 30%) for ~60% of patients compared to ~40% on placebo. An average pain of ~6 (scale 0-10) will be reduced by ~2.5 points, compared to 1.7 on placebo. Duloxetine adverse effects lead to withdrawal in 12% of patients versus 6% on placebo.  Read More

Tools for Practice #268 – Is 45 really the new 50 in colorectal cancer screening?

Should we lower the age that average risk patients commence colorectal cancer screening from 50 to 45?

In developed countries, the incidence of colorectal cancer in persons under 50 years old has increased by 20-30% in the last 20 years. However, the absolute risk increase is only 1-4 per 100,000 persons. Screening average risk patients under age 50 should not be encouraged at this time. Read More

Tools for Practice #267 – Serology, Serology: How Accurate and Prevalent Art Thou?

What is the role of serology testing in the COVID-19 pandemic?

Bottom Line: IgM and IgG antibodies may reveal an individual's recent (after ~2 weeks) exposure to COVID-19. How long serology remains positive and whether antibodies confer immunity to subsequent infection is unknown. Many different tests exist, each with different accuracy. Current evidence does not support routine use of serology testing in COVID-19 management.    Read More

PEER Values

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.

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