Patient handouts

Palliative approach to care and serious illness conversations

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.

Changing the game for Acute Infectious Diarrhea — IDP for the win!

By Dr. Ken Tan, Dr. Julia Stewart, Dr. Doug McTaggart, Dr. Sandra Lee, Chase Simms (MPH) on September 26, 2023

A new laboratory test has been introduced in BC: the Infectious Diarrhea Panel (IDP). This combines the previous three tests with a single-specimen test, and replaces the stool C&S and O&P in BC. Note, however, that standalone C. difficile tests are still available.

Management of Helicobacter pylori in 2023: who should be tested, treated, and how

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).

Help, “hive” got a rash! – Article 2: Practical tips in the management of chronic spontaneous urticaria (CSU)

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.

Pharmacotherapy for Tobacco Use Disorder

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.

Women with ADHD — Practice Tips

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.

Why I talk about all Long Term Reversible Contraception (LARC)

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.

Concussion rehabilitation update and a free self-management concussion tool

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”.

Sinusitis: appropriate diagnosis and management

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.

ACEs (Adverse Childhood Experiences): One Family Physician’s Experience

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.

Dry Eye Syndrome

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.

Dietary and physical activity recommendations for cancer survivors

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.

Hip surveillance in children with cerebral palsy

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!

Practice Tip: “SAIL” through a vulvovaginal examination

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.

Adverse events following immunizations (AEFI)

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.

Guidelines for working with formerly incarcerated people

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.

Indications and value of self-administered vaginal swabs for STIs and vaginitis

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.

Evaluation of penicillin allergy

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.

"Autism Awareness Ribbon" by White_ribbon.svg: MesserWolandJigsaw_Puzzle.svg: Psyonderivative work: Melesse (talk) - White_ribbon.svgJigsaw_Puzzle.svg. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Autism_Awareness_Ribbon.png#mediaviewer/File:Autism_Awareness_Ribbon.png

Review of the topic of Autism Spectrum Disorder

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.

Symptoms attributed to Chronic Lyme Disease

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.

Chronic Fatigue Syndrome upgraded to disease

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.

But I don’t do maternity care… (yes you do!)

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.

Gaps in recognizing, treating and managing concussions

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.

Recommending a plant-based diet

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.

Part 2: Minimizing the pain of the IUD insertion: all effort required

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.

Part 1: Who should be offered an IUD, and selection of the appropriate IUD

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.

Part 2: Treating Gout – Practice Tips and Clinical Pearls

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.

Concussion rehabilitation

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

Advance care plan (ACP) for patients with multiple co-morbidities

Hope for patients with fatigue, pain, and unexplained 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.

Exercise during pregnancy

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.

Awards
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In 2014 TCMP won the CFPC Continuing Professional Development (CPD) Award. This award recognizes a MAINPRO®-accredited educational program that has provided an exceptional learning experience to practicing or practice-eligible CFPC members.
In 2012 UBC CPD received the Royal College Accredited CPD Provider Innovation Award for This Changed My Practice.