A year of primary-care evidence, and why referral beats advice for quitting

The edition in brief

Five findings for family physicians, led from primary-care journals. An American Family Physician roundup of the top patient-oriented studies of 2025 gathers practice-ready conclusions: clopidogrel is slightly better than aspirin for secondary prevention, 12 months of apixaban beats three for provoked venous thromboembolism with an ongoing risk factor, bright light therapy helps non-seasonal depression, platelet-rich plasma does not help knee osteoarthritis, and an oral challenge can safely rule out sulfonamide allergy. A retrospective English cohort of 468,172 patients with multimorbidity found higher attainment of multimorbidity-specific quality indicators was associated with lower odds of elective admissions and outpatient visits, especially in complex multimorbidity, though higher overall quality tracked with more care use generally. The ASGARD feasibility trial of anakinra versus intramuscular methylprednisolone for gout flares in chronic kidney disease under-recruited but suggested faster pain relief with anakinra, needing a larger trial. A pearl covers managing acute gout when kidney disease limits the usual drugs. The practice-changer: in COPD smokers, immediate referral to a cessation clinic produced one-year quit rates of 25.8% versus 10.1% with usual care.