Top 10 AFP Community Blog Posts of 2023

Kenny Lin, MD, MPH
Posted on December 26, 2023

Toward the end of 2022, the blog transitioned to the AAFP platform, which resulted in increased numbers of page views, particularly for current health topics such as xylazine-associated opioid overdoses, weight loss supplements, and the new RSV vaccines. Below are excerpts from the top 10 most-read blog posts in 2023. Season’s greetings from all of us at AFP!

1. Opioid Epidemic Updates: “Frankenstein Opioids” and Xylazine-Induced Skin Ulcers (February 13, 2023)—40,563 views

Family physicians have several responsibilities related to the spread of nitazines and xylazine. We need to recognize complications of their use: difficulty in reversing overdose in the case of nitazines and the potentially life-threatening skin infections from xylazine. 

2. ACP Updates Clinical Recommendations on Treatment of Osteoporosis (January 9, 2023)—19,423 views

In the updated guideline, the ACP now recommends that physicians preferentially use bisphosphonates as first-line therapy in women and men with osteoporosis, with the exception of women at very high risk of fracture. In this group, either romosozumab or teriparatide can be used, followed by a bisphosphonate.

3. Weight Loss Fad Berberine (“Nature’s Ozempic”) Lacks Rigorous Evidence, Has Potential Harms (July 3, 2023)—10,609 views

With a lack of rigorous efficacy and safety studies, a known risk of interacting with several common medications, and the inability to trust that any supplement actually contains what’s on its label, advise patients to exercise caution regarding berberine’s use.

4. FDA Advisory Panel Rules that Oral Phenylephrine Is Ineffective (September 25, 2023)—9,473 views

Phenylephrine may be ineffective, but it’s not dangerous in OTC doses, and patients with common cold symptoms may still find some relief from the other ingredients in multiproduct formulations.

5. FDA Approves RSV Vaccine for Adults 60 Years and Older (May 8, 2023)—9,027 views

RSV causes only mild upper respiratory infections for most people, but in young children and older adults, it can lead to severe disease. The CDC estimates that in the United States, RSV annually causes between 6,000 and 10,000 deaths in adults older than 65 years.

6. New COVID "Eris" Variant Now Dominant as U.S. Cases Tick Up (August 28, 2023)—5,562 views

Despite concerns about EG.5’s ability to evade antibodies, most scientists still believe that the fall COVID booster in the United States will still provide reasonable protection against EG.5.

7. Semaglutide Shortage Highlights Inequities in Diabetic Medication Access (January 16, 2023)—4,170 views

As is the case in so many other facets of health care in the United States, the semaglutide shortage illustrates the gulf between those who can afford to pay out of pocket for it and those who cannot.

8. For Accurate Blood Pressure Measurement, Cuff Size Matters (August 21, 2023)—3,575 views

Participants for whom a large or extra-large cuff size was appropriate had their systolic BPs overestimated by about 5 and 20 mm Hg, respectively, when using a regular size cuff.… A recent analysis found that more than one-half of U.S. adults need a large or extra-large size.

9. Individualizing Therapy for Adults With Major Depressive Disorder (February 20, 2023)—2,785 views

A Canadian group recently developed a visual evidence-informed decision support tool that comprises two figures that guide primary care physicians in antidepressant selection based on specifiers (e.g., sleep disturbance, cognitive dysfunction, anxious distress, somatic symptoms), comorbid conditions, adverse effects, drug interactions, and administration.

10. USPSTF Proposes Breast Cancer Screening Changes (May 22, 2023)—2,158 views

The systematic review … did not explicitly support changing the 2016 USPTSF grade C recommendation for screening women between 40 to 49 years of age; the USPSTF instead cited its modeling study’s conclusions and the increasing prevalence of breast cancer in younger women to justify this change.