Most Recent Tools for Practice
Tools for Practice #320 – Oh Baby: Combined oral contraceptives during breastfeeding
Do combined oral contraceptives (COCs) affect breastfeeding or infant outcomes?
Trials are older (>35 years), small (<300 mom/infants) and highly unreliable. If results are real, COCs may lower infant growth (by~240g) and rates of exclusive breastfeeding (81% versus 92%) compared to placebo at 90 days. Progestin-only pill (POP) evidence is inconsistent/unreliable. If results are real, infant growth is not different compared to placebo. If early postpartum contraception is desired, guidelines recommend progestin-only methods due to increased venous thromboembolism risk. Read More
Tools for Practice #319 – Should a ‘flozin’ be chosen? Part 2: SGLT2 inhibitors in patients with chronic kidney disease
What are the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on patient-relevant outcomes in chronic kidney disease (CKD)?
For every 100 patients with CKD treated with an SGLT2i for 5 years, ~3-4 fewer will develop end-stage kidney disease (ESKD) and ~3-4 fewer will die from any cause compared to placebo. Sotagliflozin is not better than placebo for these outcomes. Read More
Tools for Practice #318 Tranexamic Acid – Golden in the golden hours of trauma?
Does Tranexamic acid (TXA) in general adult trauma or traumatic head injuries improve mortality or disability without increased risk of adverse events?
Giving TXA to adult trauma patients within 3 hours of injury reduces overall mortality from 16% with placebo to 14.5% at 28 days. Giving TXA to isolated head injury patients within 3 hours decreases head injury death in patients with Glasgow Coma Scale (GCS) >3 (from 14% with placebo to 12.5%), largely driven by improvements in patients with GCS 9-15. Serious adverse events were similar to placebo. Read More
Tools for Practice #317 – Antihistamines for allergic rhinosinusitis: ‘Achoo’sing the right treatment
Do oral antihistamines improve symptoms in adults with allergic rhinosinusitis?
Oral antihistamines reduce rhinosinusitis symptoms by ~10-30% versus placebo over 2-12 weeks. Individual antihistamines appear to have comparable efficacy. More patients attain moderate or better improvement with intranasal corticosteroids (~50%) versus antihistamines (~30%). There appears to be no meaningful differences between antihistamines and leukotriene receptor antagonists or in adding antihistamines to intranasal corticosteroids. Read More
Tools for Practice #316 Pipi au tapis : Agents d’association contre l’hypertrophie bénigne de la prostate
Chez les patients atteints d’hypertrophie bénigne de la prostate (HBP), le traitement d’association par alpha-bloquant et inhibiteur de la 5α-réductase est-il plus efficace que les alpha-bloquants seuls?
Dans le meilleur des cas, l’ajout aux alpha-bloquants d’un inhibiteur de la 5α-réductase réduit le nombre d’hommes qui ont une progression clinique (5 % c. 10 % sous alpha-bloquants seuls) et le nombre qui nécessite la chirurgie (2 % c. 8 % sous alpha-bloquants seuls). Les effets indésirables liés aux médicaments passent de 19 % sous alpha-bloquants seuls à 28 % sous l’association. 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.