Post by Kim Duir, MD
Make it a POEMs one! The AAFP American Family Physician journal does us a great service with their annual article that summarizes the 20 best POEMs of the previous year*. POEMs, which stands for Patient Oriented Evidence That Matters, is the result of scanning all major journals for research that:
Even better, primary care physicians in Canada receive these all these POEMs free throughout the year via their national health service and then rank them for relevance to their practice. Their collective top 20 are gathered and presented to you once a year in this article. I know we all worry about keeping up with the changes in recommended medical practice and it is easy to be buried by all the sources of medical information that are competing loudly for our attention. This article gives us a big heads up on the things we really need to know via a process free of commercial interests.
By definition, each of these POEMs suggest that we may need to change our usual way of doing things and that can be challenging. It is unlikely any of us will immediately incorporate all of these changes into practice, but having a chance to rethink “business as usual” in light of new evidence is how change begins. I find it helpful to read and reread this article and focus on different POEMs each time, imagining how and if I could incorporate this new information into my practice, and what strategies I would use to initiate and maintain the change. For instance, prescribing shorter courses of antibiotics for many common infections is something that I can do myself, though I will need a paper reminder by my computer for a while until my prescribing habits shift. Ambulatory BP monitoring may be preferable for diagnosing hypertension but will likely remain out of reach for my low-income clinic patients for some time. However, I can certainly repeat elevated BP measurements in clinic and work with my MAs to make that our standard practice.
I hope this article will also stimulate some of you to check the references and read the original papers to help you decide where you want to focus your change efforts this year.
Top 20 Research Studies of 2018 for Primary Care Physicians, Roland Grad and Mark Ebell, American Family Physician, May 1, 2019, Vol. 99, Number 9, p. 565