EMB COMMENTARY
PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. The main organisers of the Cochrane Primary Care Field are Bruce Arroll (1), Jaap van Binsbergen (2), Tom Fahey (3), Tim Kenealy (1), Floris van de Laar (2).
The Cochrane Primary Health Care Field is a collaboration between:
- New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the New Zealand Guidelines Group;
- Academic Departments of General Practice in The Netherlands, The Dutch College of General Practitioners, and the Netherlands Institute for Health Services Research;
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin.
PEARLS are prepared as an educational resource and do not replace clinician judgment in the management of individual cases.
View PEARLS online at www.cochraneprimarycare.org
Subscribe to PEARLS at http://lists.cochrane.org/mailman/listinfo/primarycare. Subscribers get the PEARLS directly in their mailbox on a regular basis.
The PEARLS published so far are as follows:
- Antibiotics appear to have no benefit in treating acute laryngitis in adults
- Antibiotics or ‘watch and wait’ for acute otitis media
- Anticholinergics are effective for overactive bladder syndrome in adults
- Antidepressants are effective for neuropathic pain
- Antihistamines and/or decongestants not recommended in children with otitis media with effusion
- Aquatic exercise beneficial in knee and hip osteoarthritis
- A simple whisper test is effective for diagnosing hearing impairment
- Autoinflation for otitis media with effusion helpful in the short term
- Brief alcohol interventions (BAIs) in primary care populations are effective in reducing alcohol consumption in men
- Bupropion and nortriptyline aid long-term smoking cessation but selective serotonin uptake inhibitors (SSRIs) do not
- Cardioselective beta blockers do not produce adverse respiratory effects in chronic obstructive pulmonary disease
- Chinese herbal medicine promising for menstrual pain
- Cognitive behavioural therapy (CBT) has a positive effect on some of the qualitative aspects of tinnitus
- Colchicine is a second line therapy for acute gout
- Combined psychotherapy plus antidepressants or psychotherapy alone is an effective first line treatment for panic disorder with or without agoraphobia, depending on patient preferences
- Contracts for improving patients’ adherence cannot be recommended
- Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities
- Effectiveness of prolotherapy injections for chronic low-back pain uncertain
- Exercise beneficial in fibromyalgia syndrome
- Exercise improves balance in older people
- Glue may be better than stitches, staples or adhesive tape for simple cuts
- Insoles do not prevent back pain
- Is routine therapeutic monitoring of antiepileptic drugs for epilepsy necessary
- Lamotrigine unlikely to benefit chronic pain or neuropathic pain
- Local corticosteroid injections for carpal tunnel syndrome
- Local oestrogen for vaginal atrophy in postmenopausal women
- Low molecular weight heparin (LMWH) and non-steroidal anti-inflammatory drugs (NSAIDs) are the best treatment for superficial thrombophlebitis (ST)
- Nasal saline irrigations effective for chronic rhinosinusitis symptoms
- Nicotine receptor partial agonists help people stop smoking
- Oral erythromycin may be effective in treating the symptoms of pityriasis rosea
- Oral tetracyclines are effective for acne vulgaris
- Prophylactic antibiotics in mammalian bites may prevent wound infection?
- Proton pump inhibitors (PPIs) most effective treatment for oesophagitis
- Psychological therapy based on cognitive behavioural therapy (CBT) principles is effective in reducing anxiety symptoms for short-term treatment of generalised anxiety disorder (GAD)
- Response rates to postal questionnaires can be increased
- School feeding programs may have some small benefits for disadvantaged children
- Screening for abdominal aortic aneurysm.
- Skin grafting effective for venous leg ulcers
- Stimulating the involvement of older patients in their primary care may enhance their health
- Stop using beta-blockers as first-line treatment for hypertension
- Surgical discectomy can benefit some patients
- There is no evidence supporting the use of Chinese medicinal herbs for the common cold
- Topical pimecrolimus is less effective for treating eczema than moderate and potent corticosteroids and tacrolimus
- Topical treatments for chronically discharging ears with underlying eardrum perforations (CSOM) are better than systemic antibiotics
- Vitamin C supplementation may have preventive effects in populations with a high incidence of pneumonia, and may have therapeutic effects in populations with low plasma vitamin C levels
Some examples of PEARLS are provided in the following pages, courtesy of
Bruce Arroll MBChB, PhD, FRNZCGP, FAFPHM
Professor and Head of Department of General Practice and Primary Health Care
University of Auckland
Private Bag 92019
Auckland
