Tools for Practice

Tools for Practice articles have been produced by the PEER team in collaboration with the ACFP since 2009.
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Recent Tools for Practice

Tools for Practice #356 – (A)dressing the Christmas Tree? Therapies for pityriasis rosea.

What therapies improve resolution of pityriasis rosea (Christmas tree rash)?

Pityriasis rosea is self-limiting. Based on limited evidence, oral corticosteroids reduce itch and rash for ~95% of patients while acyclovir is effective in ~70% of patients versus 30-60% on placebo at 1-2 weeks. Macrolides likely ineffective. Little/no evidence for topical corticosteroids or oral antihistamines. Read More

Tools for Practice #355 – Gobbling up the evidence for turkey dinner 🙂

What is the evidence surrounding turkey in a holiday meal?

We could find no reliable evidence around sedation from a holiday meal of turkey.  It is unclear if tryptophan changes sleep at all, but according to flawed research, it would take ~1 pound of turkey to reduce time awake after falling asleep by 1 minute.  Really, at this point, evidence is inadequate to say whether there is enough tryptophan in a turkey to make a turkey tired.
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Tools for Practice TFP #354 – Preventing RSV in the elderly

What is the effectiveness and safety of Respiratory Syncytial Virus (RSV) vaccination in older adults?

For every ~380 medically-stable patients aged ≥60, RSV vaccine prevents 1 RSV-associated lower respiratory tract disease (LRTD) per season over placebo. Study conducted during COVID-19 pandemic, potentially lowering baseline RSV incidence. Fatigue occurs in 34% versus 16% (placebo). General guidance suggests administration based on shared decision-making, particularly those at higher-risk (example long-term care, COPD), but higher-risk largely not studied. Read More

Tools for Practice TFP #353 – Turn Down the Heat! Can non-hormonal drugs improve vasomotor symptoms in menopause?

Do non-hormonal medications improve menopausal vasomotor symptoms?

After 12 weeks, approximately 50-75% of women with menopausal vasomotor symptoms experience ≥50% decrease in hot flashes with selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) or gabapentin versus 35-60% on placebo. Placebo reduces the number of hot flashes by about 40-50%, with an additional 10-20% reduction from SSRIs, SNRIs, and gabapentin. Read More

Tools for Practice #352 Do-It-Yourself Hearing Aids

Do self-fitted hearing aids improve hearing for adults with mild to moderate-severe hearing loss?

Some, but not all, direct-to-consumer self-fitted hearing aids are likely comparable to conventional hearing aids fitted via audiogram, at a much lower cost. Access and guidance/regulations on direct-to-consumer self-fitted hearing aids is limited in Canada. See suggestions below. Read More

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