Most Recent Tools for Practice
Tools for Practice #280- COVID Vax Fast Facts: Say That 10 Times Fast
What are the benefits and risks of the three COVID-19 vaccines likely available soon in Canada?
Interim results of two large randomized, placebocontrolled trials (RCTs) demonstrate ~95% relative efficacy in preventing COVID-19 (Pfizer, Moderna). The AstraZeneca/Oxford vaccine has ~70% relative efficacy. Absolute benefits will vary with baseline risk and time but if annual risk of developing COVID-19 is 20%, then vaccine would decrease risk to 1% (6% with AstraZeneca/Oxford). These vaccines appear safe and may decrease the likelihood of severe COVID-19. Ongoing studies should provide further details. Read More
Tools for Practice #279- What’s under the Mistletoe? Some fun holiday evidence from PEER
Are there any therapeutic benefits to kissing?
Bottom Line: Kissing freely for 30 minutes while listening to soft music may improve surrogate markers of atopy (like wheal reactions on allergy test). Another small RCT found that advice to increase kissing improved relationship satisfaction and even slightly reduced (0.15mmol/L) total cholesterol. We did not identify studies of mistletoe. Further research is required. Read More
Tools for Practice #278 – Gabapentin for Alcohol Use Disorder: Decrease pints with a pill?
Is gabapentin effective in treating alcohol use disorder (AUD)?
Bottom Line: More patients on gabapentin (27%) could avoid heavy drinking days (example >5 standard drinks/day) compared to those on placebo (9%). There is mixed evidence for gabapentin and abstinence. Gabapentin may be considered as a second-line option (off-label) for AUD (after acamprosate or naltrexone). Concerns regarding abuse/misuse and drug related harms should inform therapeutic discussion. Read More
Tools for Practice #277 – Somethin’ Fishy: Prescription variants of Omega-3 to prevent cardiovascular disease
Do prescription variants of omega-3’s, like icosapent, reduce the risk of cardiovascular events when added to statins?
Bottom Line: In high risk patients, icosapent reduced cardiovascular events to 17% from 22% on placebo after 5 years. In lower risk patients, Eicosapentaenoic Acid (EPA) ethyl ester reduced major cardiovascular events to 2.8% from 3.5% with control after 5 years. Whether these products differ from each other or traditional omega-3 fatty acids (that don’t show cardiovascular benefit) is unknown. Cost will likely limit use. Read More
Tools for Practice #276 – Glucosamine & Chondroitin: Natural remedies for osteoarthritis?
Does glucosamine and/or chondroitin improve pain for patients with osteoarthritis?
Bottom Line: Glucosamine and chondroitin do not appear to be effective in higher-quality, larger and/or publicly funded studies. If studies at high risk of bias are included, at best ~10% more people will have meaningful reduction in pain with either treatment over 35-45% of people with placebo. There is reason to doubt the effectiveness of either treatments. 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.
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