The edition · Family Medicine
Alcohol use disorder is treatable in the consulting room — screen, intervene briefly, offer treatment
An American Family Physician review sets out primary care for alcohol use disorder; a decision-support tool cut poor musculoskeletal care when GPs used it; one ECG found unrecognised atrial fibrillation in one in sixteen older patients; and women describe what helps after pregnancy complications.
The edition in brief
A clinical review in American Family Physician sets out primary care for alcohol use disorder: screen adults with a short tool such as AUDIT-C, give a brief counselling intervention to everyone with the disorder, offer treatment or referral, assess withdrawal risk, and treat co-occurring mental illness. In a UK cluster-randomised trial in 19 practices, a web-based decision-support tool for musculoskeletal consultations was used in only 8.6% of eligible cases; when it was used, care judged non-evidence-based fell from 25% to 3% of reviewed records. In a single Turkish family health centre, one 12-lead ECG in 357 adults aged 65 and over found atrial fibrillation in 11.8%, half of it previously unrecognised; 5.6% of all screened had unrecognised AF and met an anticoagulation threshold without treatment. A BJGP qualitative review of 18 studies found that women after pregnancy complications were helped by personalised advice and proactive follow-up, and held back by slow recovery and family demands.
A decision-support tool cut poor musculoskeletal care — when GPs used it
Lead musculoskeletal consultations with self-management and activity; decision support helped when used, but most clinicians did not use it.
One ECG found unrecognised atrial fibrillation in one in sixteen older patients
Check the pulse in older patients and consider an ECG when it is irregular; a single tracing found untreated AF in about 1 in 18 here.
After pregnancy complications, personal advice and proactive follow-up help women act on heart risk
Ask about pregnancy complications when assessing a woman's heart risk, tell her what they mean, and invite her back for checks.
No imaging for non-specific low back pain without red flags
Without red flags, manage low back pain with reassurance and activity rather than imaging.
Alcohol use disorder can be screened for and treated in primary care
Screen adults for alcohol use with a short tool, give a brief intervention to those who screen positive, and offer treatment from primary care.
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