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Good Research Leads to Better Care

Good Research Leads to Better Care I wish to applaud the Archives and Vincendeau and colleagues on the article titled “Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones” in the December 13/27, 2010 issue.1 As a practicing emergency physician, I diagnose kidney stones daily and have the following typical conversation with patients: Me: “You have a 3-mm kidney stone and it is the reason for your pain.” Patient: “How long must I suffer and what can you do about it? Should I see a specialist?” The answers Vincendeau and colleagues provide are clear and practical. Me: “Half the stones pass in a week, but half take longer, some up to a month. You need to stay hydrated and take pain medicine. You should see a specialist in a week and return to the emergency department if you cannot control your pain or tolerate food.” Many of my colleagues and I have customarily prescribed tamsulosin hydrochloride for these patients, as well as a 2- to 3-day follow-up and only a couple of days of pain therapy. It appears that we should reconsider tamsulosin ($42 for a 2-week course at a local pharmacy). At least a week's course of pain medication (a substantial number of pills) is a logical choice. Patients also ask about how soon they will be able to return to work, and now I can provide them with realistic expectations. The article is instrumental in improving my own and my department's practice. Thank you. Back to top Article Information Correspondence: Dr Veysman, Department of Emergency Medicine, Robert Wood Johnson Medical School–University of Medicine and Dentistry of New Jersey, One Robert Wood Johnson Place, MEB 104, New Brunswick, NJ 08901 (veysmabo@umdnj.edu). Financial Disclosure: None reported. References 1. Vincendeau S, Bellissant E, Houlgatte A, et al; Tamsulosin Study Group. Tamsulosin hydrochloride vs placebo for management of distal ureteral stones: a multicentric, randomized, double-blind trial. Arch Intern Med. 2010;170(22):2021-202721149761PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Good Research Leads to Better Care

Veysman, Boris D.
Archives of Internal Medicine , Volume 171 (13) – Jul 11, 2011
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References (1)

Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinternmed.2011.297
Publisher site
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Abstract

I wish to applaud the Archives and Vincendeau and colleagues on the article titled “Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones” in the December 13/27, 2010 issue.1 As a practicing emergency physician, I diagnose kidney stones daily and have the following typical conversation with patients: Me: “You have a 3-mm kidney stone and it is the reason for your pain.” Patient: “How long must I suffer and what can you do about it? Should I see a specialist?” The answers Vincendeau and colleagues provide are clear and practical. Me: “Half the stones pass in a week, but half take longer, some up to a month. You need to stay hydrated and take pain medicine. You should see a specialist in a week and return to the emergency department if you cannot control your pain or tolerate food.” Many of my colleagues and I have customarily prescribed tamsulosin hydrochloride for these patients, as well as a 2- to 3-day follow-up and only a couple of days of pain therapy. It appears that we should reconsider tamsulosin ($42 for a 2-week course at a local pharmacy). At least a week's course of pain medication (a substantial number of pills) is a logical choice. Patients also ask about how soon they will be able to return to work, and now I can provide them with realistic expectations. The article is instrumental in improving my own and my department's practice. Thank you. Back to top Article Information Correspondence: Dr Veysman, Department of Emergency Medicine, Robert Wood Johnson Medical School–University of Medicine and Dentistry of New Jersey, One Robert Wood Johnson Place, MEB 104, New Brunswick, NJ 08901 (veysmabo@umdnj.edu). Financial Disclosure: None reported. References 1. Vincendeau S, Bellissant E, Houlgatte A, et al; Tamsulosin Study Group. Tamsulosin hydrochloride vs placebo for management of distal ureteral stones: a multicentric, randomized, double-blind trial. Arch Intern Med. 2010;170(22):2021-202721149761PubMedGoogle ScholarCrossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Jul 11, 2011

Keywords: follow-up,kidney calculi,pain,analgesics,ureterolithiasis,pain management,nephrolithiasis,tamsulosin,pharmacies,pharmacy (field),emergency service, hospital,job reentry

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