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May/June 2012 Annals of Family Medicine tip sheet
Date:5/14/2012

ief of face pain and congestion. The effect was most marked when patients were given longer durations of treatment (21 days) and higher doses of medication. In their analysis, the researchers found that whereas 66 percent of patients would experience improvement or resolution of symptoms at 14 to 21 days using a placebo, an additional 7 percent of patients would achieve this outcome with corticosteroids, equating to a number needed to treat of 13. This clinical benefit, the authors note, must be set against the potential harms of medication and cost implications. They call for additional research comparing intranasal corticosteroids with placebo in the absence of antibiotics to clarify the time-course of clinical benefit and the impact on work and quality of life.

In an accompanying editorial, a family physician argues nasal steroids are not the answer for most patients. Most patients, he asserts, want to get better in a few days, not three weeks. Furthermore, he argues, the symptom relief offered by nasal steroids is minimal, and the cost is high relative to other over-the-counter drugs, like pseudoephedrine and ibuprofen, that offer similar relief at a fraction of the cost. He concludes instead of writing a prescription, treatment should focus on symptom relief.

Intranasal Corticosteroids in Management of Acute SinusitisA Systematic Review and Meta-Analysis

By Gail Hayward, MBBChir, DPhil, et al

Oxford University, England

Intranasal Steroids for Acute Sinusitis?

By John Hickner, MD, MSc

Case Western Reserve School of Medicine, Cleveland

Study: Electronic Health Record Use Does Not Lead to Better Diabetes Care

Even after the potentially disruptive phase of initial electronic health record implementation, quality improvements may remain elusive. Analyzing data over three years for 798 diabetic patients at 16 EHR-using and 26 non‒EHR-using practices, researchers found EHR use was not associated with better
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

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