In 2012 UBC CPD received the Royal College Accredited CPD Provider Innovation Award for This Changed My Practice.
Seeking collateral information when clinical practice guidelines deliver strong recommendations for drug therapies on the basis of a single clinical trial
By Cait O'Sullivan on May 31, 2017
When I identify strong drug therapy recommendations of particular relevance to my practice scope, I seek collateral information and there are two resources I routinely incorporate into my literature search. I start with the Cochrane Library and then check to see whether a FDA advisory committee has weighed in on key issues.
By Dr. Randall White on May 10, 2017
When psychiatric patients are treated in an emergency department, they are often hypervigilant, manic, or otherwise in an excited, agitated state. The current standard of care to manage acute agitation in adults is using an antipsychotic medication and a benzodiazepine, often loxapine or haloperidol and lorazepam.
By Drs. Charlie Chen and Hayden Rubensohn on April 12, 2017
What is the patient willing to consent to as treatment if his/her condition were to seriously deteriorate? The Serious Illness Conversation Guide developed by Ariadne Labs provides a framework for physicians to engage in care planning with patients in a manner acceptable to the patient.
By Dr. Dan Bilsker on March 8, 2017
Treatment plan should specifically target psychological problems that are barriers to occupational, relationship or emotional function, rather than broadly defined issues. Being able to return to work is a substantial benefit for the individual: staying at home for an extended time is damaging to the individual’s self-esteem, coping ability and psychological health. Practice “positive psychology”, emphasizing the outcomes that determine the meaning and success of one’s life and focus on individual’s strengths to reach goals.
By Dr. Martha Spencer on February 22, 2017
Martha Spencer, MD, FRCPC, Providence Health Care, Clinical Instructor, UBC (biography and disclosures) Disclosures: Education grant from Pfizer to help support my incontinence fellowship in Edmonton, Grant from Pfizer ($10 000) to support start-up costs for the Geriatric Continence Clinic at SPH. Mitigating potential bias: Only published trial data is presented and recommendations are consistent […]
By Dr. Ric Arseneau on February 8, 2017
The PLEASE trial (Persistent Lyme Empiric Antibiotic Study Europe) was published in the New England Journal of Medicine in March 2016. This randomized, double-blind, placebo-controlled study assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment.
By Dr. Alissa Wright on January 25, 2017
Canadians travel a lot and are increasingly traveling to more exotic and remote destinations. Unfortunately, travel does carry certain risks with respect to infection. Post-travel assessment of a febrile patient must be comprehensive, but completed in a timely manner so that patients get the care they need.
By Dr. Ric Arseneau on November 30, 2016
Chronic Fatigue Syndrome (CFS) – also known as Myalgic Encephalomyelitis (ME) and Systemic Exertion Intolerance Disease (SEID) – is a common clinical condition. Yet, it is under- recognized and diagnosed. An estimated 84–91% of patients with the condition remain undiagnosed.
By Dr. Heather Leitch on November 8, 2016
The MDS Clear Path algorithm is an internet-based interactive tool that was developed to support health care providers in the workup, diagnosis and management of MDS. The Clear Path was developed by a group of 60 Canadian hematologists with an interest in MDS.
By Dr. Paul Mullins on October 26, 2016
Alcoholic hepatitis (AH), perhaps more accurately described as alcohol-related cholestatic liver failure, is a clinical syndrome with high mortality. In severe AH at 28 days: 30-40%. STOPAH is a UK multi-centre, double-blind, randomized trial in severe AH to assess the effect of Prednisolone and/or Pentoxifylline on mortality at 28 days, and mortality or liver transplantation at 90 days and at one year.
By Dr. Karen Buhler on October 12, 2016
In BC women are receiving maternity care from fewer providers. To assist practitioners Perinatal Services BC created the Primary Maternity Pathway and the Vancouver Division of Family Practice in 2014 developed a 2-page Early Prenatal Care Summary Checklist for Primary Care.
By Dr. Shelina Babul and Hadley Pearce on August 24, 2016
Concussions are the most common form of brain injury in British Columbia, yet they are often under reported due to lack of awareness and education among the general public. The Concussion Awareness Training Tool (CATT) is a free online resource dedicated to providing resources and training to help increase the recognition, treatment and management of concussions.
By Dr. Jan Hajek on August 3, 2016
For diabetes in particular, observational studies suggest that persons who follow a plant-based diet have a lower risk for diabetes, and an RCT demonstrated reductions in HbA1c in patients with diabetes randomized to a vegan diet compared to the standard American Diabetes Association diet.
By Dr. Roberto Leon on July 12, 2016
Up until recently, pain management with IUDs (intrauterine devices) insertion was not commonly performed, as most users were multiparous women and the insertion was reasonably straightforward. However, because the IUDs provide unsurpassed protection against a pregnancy along with many other advantages, its acceptance is dramatically increasing, especially in nulliparous women and adolescents.
By Dr. Taryl Felhaber on May 25, 2016
Every woman transitions through menopause, although not all women have bothersome symptoms. Some women’s symptoms may be so disturbing as to lead them to think they are dying, as was the case with a patient in my practice several years ago.
By Dr. Eileen Murray on May 11, 2016
Fungal infections particularly of the feet are a common problem. If only the skin is involved topical treatment with any of the antifungal creams works well. However, often fungal infections are ignored by patients and chronic skin infection can lead to infection of the nails.
By Dr. Roberto Leon on April 27, 2016
Intrauterine devices (IUDs) are a safe, very effective, rapidly reversible and highly acceptable contraception amongst women. Yet it is resisted by many physicians. A recent study in Seattle (1) found that half or fewer of the physicians sampled do not follow the recommended guidelines, advising against using an IUD to nulliparous women, 20 years old or less, or women with a prior history of STI, PID or ectopic pregnancy.
By Dr. Kevin Fairbairn on April 13, 2016
Appendicitis can often present itself in the black box of abdominal pain. Fortunately at times the history and physical can give practitioners a clear window, straight through the fascia, to an unhappy appendix.
By Drs. Neda Amiri and Kam Shojania on March 30, 2016
Despite being one of the most common forms of arthritis afflicting adults, optimal care of patients with gout including treatment of acute attacks as well as long-term management is not always achieved.
By Dr. N. John Bosomworth on January 6, 2016
There is no evidence for benefit of weight loss in healthy people. The safest body size trajectory in healthy people is a stable weight. It takes a modest amount of exercise to attain good metabolic benefit. It takes substantial exercise commitment to produce weight loss or to prevent weight regain. Mediterranean diet reduces cardiac risk factors and mortality.
By Sue Barlow, OT and Jennifer Loffree, OT on December 2, 2015
The statistics regarding recovery from concussion indicate that the majority of individuals will be symptom-free at 3 months; within 6 months 70-75% will be symptom free; and within a year 10% will have 1 persisting symptom and 5% will have 4 or more persisting symptoms
By Dr. Ric Arseneau on October 13, 2015
Fatigue, pain, and unexplained symptoms are commonly seen in physician offices, however they are often experienced as “unsatisfying” for doctors. Our patients need an explanatory model to help them understand their illness. If we don’t provide one, patients will create their own or seek one elsewhere.
By Dr. Karen Nordahl on September 30, 2015
It has been shown that 55% of pregnant patients reported some form of back pain during their pregnancy when questioned. Studies have demonstrated that if we get pregnant women moving, specifically working their pelvic floor with Kegel exercises and their ‘core’ they may have better pregnancy outcomes.
By James McCormack on September 16, 2015
Numerous observational studies have consistently shown in many (but not all) patient populations a correlation between people with higher blood pressure, glucose, and cholesterol numbers, and a greater risk of cardiovascular events such as heart attacks, strokes, and other unwanted outcomes.
By Andrea Warnick on April 29, 2015
Serious illness, dying, or death of a family member is one of the most significant life events a child will ever experience. I no longer wait for them to share their concerns and questions with me. I invite questions and address the grief.
By Dr. Susan Hollenberg on April 15, 2015
In December, 2013, Health Canada approved a 4- component Meningitis type B (4CMenB) vaccine. The vaccine approved in Canada utilizes technology based on ‘outer membrane vesicles. These are unique capsular identifiers that comprise fingerprints for a serogroup B strain. The challenge has been that over 8000 MenB strains exist!
By Drs. Kam Shojania and Neda Amiri on March 31, 2015
Gout is one of the most common forms of arthritis, affecting 1.4% of the population. Primary care physicians diagnose and manage most patients with gout. While the gold standard for diagnosing gout is visualization of monosodium urate crystals (MSU) in joint fluid under polarization microscopy, this is not always the case.
By Dr. Daniel Dodek on March 18, 2015
Mental health problems including anxiety, depression and stress make up a large proportion of a typical day in primary care medicine. They also contribute a huge comorbid burden in specialty care. These conditions all require an intense amount of time to help and manage patients.
By Dr. Suren Sanmugasunderam on February 3, 2015
There are 2 major forms of Age-Related Macular Degeneration (ARMD). The dry form is characterized by drusen, pigmentary mottling and retinal and retinal pigment epithelial atrophy. The wet form is characterized by choroidal neovascular membranes (CNVM).
By Dr. Alexander Chapman on January 6, 2015
Often, self-injury is managed and treated in the context of therapy work with a psychologist or psychiatrist. Family physicians, however, are in an excellent position to be first responders, to offer helpful suggestions, and to help refer the patient to appropriate care.