Most Recent Tools for Practice
Tools for Practice #289 – Keeping it Simple for Emergency Room Dyspepsia
Should lidocaine or anti-spasmodics be added to antacids when treating emergency room patients with dyspepsia?
BOTTOM LINE: Best evidence suggests adding lidocaine and/or anti-spasmodics to antacids is unlikely to add meaningful pain relief compared to antacids alone. Evidence is inconsistent with one study finding antacids alone better, another no added benefit and a third (unblinded, older) showing lidocaine provided additional benefit. Patients (especially females) who present to emergency with new onset dyspepsia should have cardiac diagnosis ruled out. Read More
Tools for Practice #288 – Clearing up the evidence for topical acne combination products
How effective are topical combination products for moderate facial acne?
BOTTOM LINE: For patients using combination products, including benzoyl peroxide/adapalene and benzoyl peroxide/clindamycin, about 40- 50% will perceive complete or near complete improvement in their acne, compared to 30-40% using individual products, and 20-30% using vehicle. No direct head-to-head trials with patient reported outcomes exist between combination products. Cost may influence product choice. Read More
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
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.