By Dr. Katelyn Halpape on March 26, 2025
One in five Canadians live with chronic non-cancer pain (CNCP). Due to the historical role opioids had as a key component of CNCP treatment, a number of patients living with CNCP are on long-term opioid therapy (LTOT). I discuss the off-label use of buprenorphine/naloxone as a distinctive treatment option for CNCP and LTOT.
By Dr. Heather Fulton on November 26, 2024
I recommend Community Reinforcement and Family Training (CRAFT) for families who have a loved one with substance use challenges. It is a is a science-backed approach that helps family members change the way they interact with their loved one that makes change more likely while also helping themselves in the process.
By Dr. Michelle C. Chan on October 22, 2024
Recent studies on options in family planning have changed my practice, and I now routinely take the opportunity when reviewing family planning options for people who are at risk of becoming pregnant and do not want to be pregnant to review emergency contraception and abortion as options in family planning.
By Dr. Paxton Bach on March 12, 2024
The new Canadian guideline situates alcohol-related harms along a continuum, recognizing that negative health and social consequences of alcohol can arise even at rates previously consistent with low risk.
By Drs. Carson Chin, Nathan Hitchman, and Jordan Friedmann on January 24, 2024
Guidelines recommend that ULT be directed by SUA, but interpretation of such differs in acute and chronic phases of gout. Therapies require renal dose adjustment and can lead to serious and even fatal adverse events. Preventable adverse events continue to occur in BC due to underutilization of testing.
By Dr. Shirley Samuel-Haynes on November 21, 2023
I learned that a palliative approach to care and serious illness conversations address and manage patients’ and families’ psychological, practical, social, loss/grief, spiritual, and physical issues like pain and symptom management in line with their goals of care and help prepare for eventual life closure. Here are practical tips on how to implement this in your practice.
By Dr. Sander Veldhuyzen van Zanten on August 9, 2023
Helicobacter pylori (H. pylori) continues to be an important pathogen, associated with peptic ulcer disease, dyspepsia, and gastric cancer. The conventional triple combination of a PPI, clarithromycin, and either amoxicillin or metronidazole is no longer recommended because its success rates have decreased to less than 60%. The recommended first-line therapy is concomitant therapy (PPI, clarithromycin, amoxicillin, and metronidazole) and second-line therapy is bismuth-based therapy (PPI, bismuth, metronidazole, and tetracycline).
By Drs. Kevin Lee and Persia Pourshahnazari on May 31, 2023
While not a fundamentally dangerous condition, CSU can have a significant impact on a patient’s quality of life and can be challenging to manage. Symptoms can be prolonged and can recur even after a long symptom-free period. Escalate and taper non-sedating H1-antihistamines, encourage daily antihistamine use, and add corticosteroids or refer to an allergist if needed.
By Drs. Clara Lu and Renée Janssen on March 7, 2023
Since the publication of the 2020 ATS Clinical Practice Guideline on pharmacologic treatment in tobacco-dependent adults, I now explain the goals of pharmacotherapy for tobacco use disorder in terms of reducing the compulsion to smoke and increasing readiness to quit, rather than abstinence alone. If patients are open to the conversation, I will discuss and offer all pharmacotherapy options — but emphasize the efficacy and safety of varenicline as my preferred first-line agent.
By Dr. Elisabeth Baerg Hall on October 19, 2022
October is ADHD Awareness Month. Until recently, female presentations of ADHD have been largely overlooked in both clinical and research settings. With increasing awareness and media attention to women and ADHD, adult women are asking if ADHD could explain their longstanding challenges.
By Dr. Konia Trouton on September 12, 2022
Patient satisfaction and continuation rates are very well documented for various contraceptives in Canada. Among the combined hormonal contraceptives — the pill, patch, and ring — only 50% of people are still using them after a year, despite all efforts to improve compliance and reduce side effects. In contrast, over 80% of people are still using long-acting and reversible IUDs a year later.
By Sue Barlow and Carolyn Rondeau on June 3, 2021
Concussions or mild traumatic brain injury are the most common type of traumatic brain injury. It is estimated that every year in British Columbia (BC), there are approximately 14,500 visits to the emergency department and that this number is most likely an underestimate of the “true burden of concussion”.
By Dr. Amin Javer on September 11, 2019
Sinusitis is a commonly encountered condition for the Canadian family physician. Chronic sinusitis has worse quality of life scores than COPD, CHF or angina. The total cost of diagnosing and treating sinusitis remains one of the most expensive chronic disorders experienced by the North American population and continues to increase yearly.
By Dr. Tahmeena Ali on August 21, 2019
I now ask all patients, young and old, new to my practice and established for years, male and female, to complete an ACEs questionnaire in my clinic. I garner a new level of respect for my patients’ resilience and for the ongoing turmoil many of my young patients face. I make finding supports for these young vulnerable patients one of my top priorities—as important as a referral to a specialist or for diagnostic imaging.
By Drs. Nawaaz Nathoo and Samir Nazarali on May 29, 2019
Much difficulty is faced by clinicians in identifying DES as there is no single diagnostic tool to indicate the condition. Furthermore, patient symptoms do not always correlate with clinical exam findings. Rather, when diagnosing DES, the clinician must consider the full constellation of patient history combined with various clinical findings.
By Andrea Holmes on January 16, 2019
Breast and prostate cancer survivors want to know what to eat to prevent cancer from coming back. HealthLink BC healthy eating resources that support successful dietary and physical activity change for prostate and breast cancer survivors are available for your patients.
By Dr. Min S. Phang, MRCP, FRCPC and Stacey Miller, PT on June 13, 2018
I now refer all children with cerebral palsy, or suspected cerebral palsy, to the Child Health BC Hip Surveillance Program. Information about the program is available at www.childhealthbc.ca/hips, including a referral form for physicians. The incidence of hip dislocations can be significantly reduced!
By Dr. Leslie Sadownik on April 4, 2018
Women with chronic vulvar disorders will often report years of symptoms before an accurate diagnosis is made, and effective treatment is started.
By Dr. Laura Sauvé on February 7, 2018
Vaccines are safe, but sometimes adverse events following immunizations do happen, and can be very concerning to families. If your patient has an AEFI, there is a voluntary reporting system. Public Health Officers in your local Health Authority will be able to answer most questions or concerns.
By Ruth Elwood Martin on January 23, 2018
To address the issue of health care discrimination and coordination of care people with incarceration history, the CCPHE has collaboratively developed Guidelines for Family Physicians working with Formerly Incarcerated People.
By Dr. Roberto Leon on November 1, 2017
I came across a publication in the British Medical Journal by Sarah A. Schoeman: Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study. Participants took a vaginal swab before a routine gynecological exam, and clinicians then took an endocervical swab during examination.
By Dr. Jennifer Grant on September 6, 2017
Recent data show that up to 90% of patients with a reported penicillin allergy are mislabelled and of those who are allergic, many beta-lactams can still be safely prescribed due to low risk of cross-reactivity. Mislabelling of penicillin allergy is due to many things including misdiagnosis (confusing a viral exanthema for allergy), purer formulations of antibiotics, loss of allergy and differences in side-chain structure.
By Dr. Anne Antrim on July 18, 2017
The current definition of Autism Spectrum Disorder has 2 criteria: “persistent impairment in reciprocal social communication and social interactions” AND “restricted, repetitive patterns of behavior”. The symptoms must be present from early childhood, but may not manifest till the social demands exceed the capacity of the child to respond.
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. 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. 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.
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