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» This Changed My Practice » patient handouts

patient handouts

Sinusitis: appropriate diagnosis and management

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.

Read More | 8 Comments

mental-health

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.

Read More | 10 Comments

dry-eye

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.

Read More | 2 Comments

Dietary and physical activity recommendations for cancer survivors

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.

Read More | 1 Comment

Boy-with-cerebral-palsy

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!

Read More | No Comments

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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.

Read More | 5 Comments

Adverse events following immunizations (AEFI)

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.

Read More | No Comments

Guidelines for working with formerly incarcerated people

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.

Read More | 1 Comment

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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.

Read More | 11 Comments

Evaluation of penicillin allergy

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.

Read More | 8 Comments

"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.

Read More | 6 Comments

tick-majasimenc-freeimages

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.

Read More | 11 Comments

Fatigue

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.

Read More | 6 Comments

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

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.

Read More | 2 Comments

Gaps in recognizing, treating and managing concussions

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.

Read More | 4 Comments

Plant based diet

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.

Read More | 8 Comments

IUD

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.

Read More | 7 Comments

IUD

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.

Read More | 11 Comments

Gout in Primary Care

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.

Read More | 11 Comments

Headache

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

Read More | 3 Comments

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.

Read More | 9 Comments

Exercise during pregnancy

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.

Read More | 3 Comments

father comforting his crying little son - parenthood concept

The unvoiced questions of children experiencing an illness, dying, or death in their family

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.

Read More | 3 Comments

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      • Rate versus Rhythm Control in Patients with Atrial Fibrillation: Time to Change the Paradigm?
      • Specialists and Family Practice: Tackling the Pseudo-Penicillin Allergy Epidemic Together
      • Sodium Glucose Cotransporter 2 (SGLT2) Inhibitors: New drug class in the treatment of Heart Failure with Reduced Ejection Fraction — DAPA-HF and EMPEROR-Reduced trials
      • Letter from the editor
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      • “Can you prescribe me cannabis, doc?”
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      • Portable ultrasound
      • Giant Cell Arteritis Part 1: Diagnosis
      • Icosapent Ethyl to Reduce Atherosclerotic Events in Patients with Hypertriglyceridemia
      • Stress First Aid as a form of Peer Support
      • Transforming Management of Stable Ischemic Heart Disease – To Revascularize or Not? How the ISCHEMIA trial will affect clinical practice
      • Interpretation of Syphilis Serology
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      • Nurturing Resilience in Clinical Supervision
      • Healthcare Professional Well-Being
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      • Evolving in the era of COVID-19
      • Taking care of each other during COVID-19 – peer support for physicians
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      • Preparing children for the medically assisted death of a loved one
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      • Hiding in plain sight: men's mental health
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      • ACEs (Adverse Childhood Experiences): One Family Physician's Experience
      • Practice Tip: Cutaneous larva migrans
      • Presenteeism
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      • Facing a College Physician Practice Enhancement Program Assessment? What you need to know in 2019?
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      • Help - the steroids are not working - Helping women with refractory vulvar lichen sclerosus
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      • Letter from the editor
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      • New insight into “HFpEF” – cardiac amyloid no longer a zebra diagnosis?
      • Learning to meet my patient where they are at - how letting go changed my practice
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      • Wellness and self-care for professional excellence
      • Hip surveillance in children with cerebral palsy
      • The power of storytelling in clinical encounters
      • Concussion management: time to give “brain rest” a rest
      • Trauma as a determinant of health
      • Practice Tip: “SAIL" through a vulvovaginal examination
      • The practice of mindfulness
      • Guidelines
      • Adverse events following immunizations (AEFI)
      • Guidelines for working with formerly incarcerated people
      • Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure with Reduced Ejection Fraction (HFrEF): Sacubiltril/Valsartan and the PARADIGM HF Trial
      • Letter from the editor
      • Managing your passwords
      • Managing opioid use disorder: buprenorphine/naloxone opioid agonist treatment
      • Indications and value of self-administered vaginal swabs for STIs and vaginitis
      • MOVE an injury not RICE
      • Whether or not to use systemic corticosteroids to treat a skin disease
      • The risks of worklessness
      • Evaluation of penicillin allergy
      • Management of Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation
      • Backward Course Design
      • Review of the topic of Autism Spectrum Disorder
      • Step by step approach to determine the safety of prescribing Hormone Replacement Therapy
      • Seeking collateral information when clinical practice guidelines deliver strong recommendations for drug therapies on the basis of a single clinical trial
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      • Elevated Lipoprotein (a) is a common reason for unexplained premature or recurrent coronary heart disease and stroke
      • Serious illness conversations and capturing advance care planning
      • First Canadian guideline on perioperative cardiac risk assessment and management for patients undergoing non-cardiac surgery
      • Outcome-focused cognitive behavioral therapy (CBT)
      • Why does my student seem disengaged? A perspective on learner engagement in new environments
      • Geriatric urinary incontinence: just ask!
      • Symptoms attributed to Chronic Lyme Disease
      • Outbreak overload: fever in the returning traveller
      • Pyogenic granulomas
      • Letter from the editor
      • BC Take Home Naloxone Program - updated article
      • Chronic Fatigue Syndrome upgraded to disease
      • Two causes of anemia
      • Prednisolone or pentoxifylline for alcoholic hepatitis
      • Pyogenic granulomas
      • But I don’t do maternity care… (yes you do!)
      • Diagnosing processing disorders
      • Best practice: a tip from an employment lawyer
      • Gaps in recognizing, treating and managing concussions
      • Recommending a plant-based diet
      • Part 2: Minimizing the pain of the IUD insertion: all effort required
      • Comparing intensive versus standard blood-pressure control: The SPRINT Trial
      • Diagnosis and management of congenital cytomegalovirus infection
      • Non-hormonal treatments for menopausal symptoms
      • Nail fungus
      • Part 1: Who should be offered an IUD, and selection of the appropriate IUD
      • The Alvarado Score in Acute Appendicitis
      • Part 2: Treating Gout - Practice Tips and Clinical Pearls
      • Surgery versus IVF in endometriosis infertility
      • When quality trumps quantity: a clinician’s perspective
      • Screening for occult cancer in unprovoked venous thromboembolism (VTE)
      • Enhance the valsalva to (actually) terminate SVT
      • Screening for developmental dysplasia of the hip: an evidence-based approach to practice
      • Weight loss in healthy people
      • Letter from the editor
      • Concussion rehabilitation
      • A simple new technique for collecting urine in infants
      • Postnatal investigation of antenatally detected hydronephrosis
      • Hope for patients with fatigue, pain, and unexplained symptoms
      • Exercise during pregnancy
      • Cardiovascular outcomes and blood pressure, glucose, and cholesterol numbers
      • Management of cyclical pelvic pain
      • This app changed my practice - Read by QxMD
      • Recognizing the Potential Influence of the Interpersonal Gap in Teaching
      • This app changed my practice - Treatable Intellectual Disability Endeavor in B.C. (TIDE) - Treatable ID App www.treatable-id.org
      • Measurement of depressive symptoms improves outcomes in primary care
      • Open book exams - something to consider?
      • BC Take Home Naloxone Program
      • Role of imaging in management of undescended testis (UDT)
      • Mineralocorticoid Receptor Antagonists in Heart Failure with Preserved Ejection Fraction: The TOPCAT and ALDO-DHF trials
      • Evolving use of multi parametric MRI in prostate cancer detection
      • The unvoiced questions of children experiencing an illness, dying, or death in their family
      • Meningococcal Serogroup B Vaccine
      • Why Am I Talking?
      • Part 1: Diagnosing Gout in Primary Care Settings: Do we have to tap?
      • This app changed my practice: Mindshift App
      • Does my patient have a food allergy?
      • Incretin Safety: What is the Evidence?
      • Age-Related Macular Degeneration: New treatments that changed my practice
      • Knee arthroscopy for conditions of the degenerative knee
      • Non-suicidal self-injury
      • Letter from the editor
      • Fecal biomarkers in the diagnosis and management of inflammatory bowel disease
      • Can my patient safely drive on long-term daily opioid medication?
      • Ovarian cancer and hereditary predisposition
      • Tinnitus – The Essentials of Patient Care in BC
      • Diuretic strategies in patients with acute decompensated heart failure
      • Early diagnosis of autism
      • What blood pressure should I target in my patients with chronic kidney disease?
      • Routine neonatal oximetry screening for critical congenital heart defects in British Columbia: It's time!
      • Meniscectomy
      • Contributed Works Dr. Sylvia Stockler
      • DrugCocktails.ca resource
      • Managing opioid withdrawal
      • Minimal evidence of benefit from medications to increase sexual desire
      • Myocardial infarction in women without obstructive coronary artery disease
      • Compassion Fatigue What you don't know will hurt you
      • Update on the guidelines for Subacute Bacterial Endocarditis (SBE) prophylaxis
      • Using domperidone to enhance lactation
      • Midshaft Clavicle Fractures
      • Five clinical points on Rheumatoid Arthritis in Family Practice
      • Lateral Epicondyle Tendinopathy (Tennis Elbow) Toolkit
      • Letter from the editor
      • When vulvovaginal atrophy involves loss of genital sexual sensitivity: local (vaginal) dehydroepiandrosterone (DHEA) shows promise
      • Swaddling and developmental dysplasia of the hips
      • B.C. Cancer Agency Colon Cancer Program
      • Choosing Wisely - A resource to help reduce unnecessary or harmful tests and interventions
      • HIV in Family Practice: testing & diagnosis
      • Effects of glucocorticoids on cardiovascular risks in patients with rheumatoid arthritis
      • Managing the complicated somatoform disorder patient
      • Evaluation of familial cancer risk: it starts at www.screeningbc.ca
      • Reduce falls by improving cognitive function
      • Traveller’s diarrhea
      • Use exams to guide, not drive, learning; the importance of intrinsic motivation
      • RACE Hotline
      • Provoked vestibulodynia (PVD) needs holistic management and a chronic pain approach
      • Pharmacogenetics and pharmacogenomics: practice tips
      • How a family physician can help patients with chronic pain: a guide to navigating patient internet resources in BC
      • Clostridium difficile infection (CDI)
      • Aldosterone antagonists for the treatment of systolic heart failure
      • Barrier repair in atopic dermatitis
      • Care gaps in schizophrenia: male/female differences
      • Appropriate use of sedation in palliative care
      • Never ignore an elevated eosinophil count - especially in travellers, immigrants and refugees
      • Thyroid Nodules: Get more information from your ultrasound
      • Acute limping in children
      • Stuck in Transmission: Time to Change Gears
      • This app changed my practice: My Fitness Pal
      • The Importance of Words in Clinical Teaching
      • Letter from the editor
      • Direct-to-Consumer genetic testing: What it means for the general practitioner
      • Contributed Works
      • Rivaroxaban for treatment of symptomatic pulmonary embolism: exploring new territories
      • Rotavirus vaccine
      • "Bleach baths" and atopic dermatitis - help from under the kitchen sink
      • Undergoing the College’s practice review assessment
      • This app changed my practice: DizzyFix
      • Depression in the elderly
      • What's new in dyslipidemia
      • May I add an HIV test to your bloodwork today?
      • The whole cell cholera and travellers’ diarrhea vaccine – Looking for evidence in the prevention of travellers’ diarrhea
      • Active video games and child's physical activity
      • Going Experiential
      • This app changed my practice: Dropbox
      • Diabetes and exercise
      • Role of inhaled steroids in acute asthma exacerbations
      • Screening for depression in pregnancy using the Edinburgh Depression Scale
      • Apps, websites and guidelines for osteoporosis management in primary care in 2012
      • Advance care plan (ACP) for patients with multiple co-morbidities
      • Paradigm shift in treatment of hemangiomas
      • Understanding breast cancer responsiveness
      • Something as basic as wax cleaning!
      • Tailoring therapy for type 2 diabetes: the role of incretins
      • This app changed my practice: CCS lipid guidelines
      • Letter from the editor
      • What is the correct dosing for Vitamin D?
      • Vapor rub for treatment of nocturnal cough and cold symptoms in children
      • Non-suicidal self-injury: reducing future risk
      • The most important question never asked about sleep
      • Improving end-of-life care for patients with advanced cancer
      • It’s just a runny nose!
      • Spreading pain with neuropathic features may be induced by opioid medications
      • Community acquired pneumonia
      • Don’t request testosterone levels for women’s low sexual desire
      • This app changed my practice: Pocket A1C
      • Treating Hepatitis C - the future is now!
      • Proton pump inhibitors and Clostridium difficile infection
      • New targets for Diabetes (A1C): Why we are aiming at 'only' 7 percent
      • Advocating Fallopian Tube removal at the time of hysterectomy to prevent ovarian cancer
      • Weed is not just an herb
      • Prostate Specific Antigen – Does the new data support its utility for prostate cancer screening?
      • Acute Ischemic Stroke: Thombolysis is an Effective Therapy
      • Self-management of mood problems
      • New therapies and new end points in the treatment of Crohn’s Disease
      • Management of maternal thyroid disease in pregnancy
      • Chronic ulcers and biofilms
      • The outcomes of prematurity
      • Monitoring of cardiovascular disease risk in people with chronic mental illness
      • Smoking Cessation
      • Transient Ischemic Attacks: High Risk and Treatable
      • Use of HAART as a strategy to stop HIV and AIDS
      • Early prenatal screening
      • Leaving warfarin for the rats? A new option in anticoagulation for atrial fibrillation
      • Minimizing radiation exposure – decision to order imaging?
      • An Update: BPH Management for Family Physicians
      • The Intra-Uterine Device
      • Pediatric allergy
      • The natural history of severe dementia
      • Understanding eGFR in the clinical context: who does and does not need referral?
      • Probiotic therapy has changed my approach to treating patients with irritable bowel syndrome
      • New fee codes and treatment options have improved my care of patients with mental health problems
      • Evidence shows that chemotherapy holidays may not be in the best interest for patients with metastatic colorectal carcinoma
      • New study on the use of erythropoietin stimulating agents in chronic kidney disease has made us evaluate the risk-benefit of ESA’s in CKD patients not on dialysis.
      • Choosing antihypertensive combos: does it matter how you do it?
      • MRSA skin and soft tissue infections
      • What are the CV risks of TZDs: have the safety questions been answered?

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