Most Recent Tools for Practice
Tools for Practice #287 – How to Slow the Flow: NSAIDs for Heavy Menstrual Bleeding
In premenopausal heavy menstrual bleeding without pathological cause, do nonsteroidal anti-inflammatory drugs (NSAIDs) improve patient outcomes?
Bottom Line: Based on low-quality evidence, NSAIDs reduce relative mean menstrual blood loss by ~30%, and ~20-50% fewer sanitary products used than placebo. Effects on bleeding duration are inconsistent. Read More
Tools for Practice #286 – Vaccine hesitancy in the office: What can I do?
What office-based interventions in primary care help reduce vaccine hesitancy?
Bottom Line: Clinicians should explicitly recommend vaccination and focus discussion on the disease-prevention benefits to the individual more than correcting misinformation or on benefits to society. Interventions are more likely to be effective in those with neutral attitudes towards vaccination than those opposed. Read More
Tools for Practice #285 – Should a ‘flozin be chosen to play a part for a failing heart?
What is the role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with chronic heart failure with reduced ejection fraction?
Bottom Line: SGLT2i reduce mortality, heart failure hospitalizations, and improve quality of life when added to other medications in patients with heart failure with reduced ejection fraction, with or without diabetes. For every 100 patients treated with an SGLT2i for ~1.5 years, ~2 fewer will die, ~4 fewer will be hospitalized for heart failure, and ~7 will have improved quality of life (at 8 months) compared to placebo. Read More
Tools for Practice #282 – Osteoporosis treatment for post-menopausal women
How effective are bisphosphonates and denosumab in preventing fractures in post-menopausal women?
Bottom Line: Bisphosphonates and denosumab are similarly effective at reducing risk of fracture in post-menopausal women. Over 1-4 years, bisphosphonates or denosumab provide an absolute reduction of ~0.5-1.0% for hip fractures, ~1.5-3% for non-vertebral fractures and ~3-6% for vertebral fractures compared to placebo. Read More
Tools for Practice #284 – Iron dosing frequency: Is less more or just less?
How does once daily iron dosing compare with dosing every second day or twice weekly?
Bottom Line: Once daily dosing of iron yields similar or slightly better hemoglobin (~3 g/L) versus twice weekly or alternate day over ~3 months. Daily dosing increased ferritin similarly or up to 12 mg/L better. Adverse events (like abdominal pain) are reduced by up to 30% (absolute) with intermittent dosing. Research focused on females aged 14-22. 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.