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Purpose: Nifedipine is commonly prescribed for the treatment of chilblains (pernio, perniosis) on the basis of observational studies and a single small, older clinical trial. We aimed to confirm the proposed superiority of oral nifedipine 60 mg per day over placebo for treatment of chronic chilblains in primary care.Methods: We performed a randomized, placebo-controlled, double-blind, crossover trial, closely following the design of the older trial. A total of 32 patients with chronic chilblains were randomly assigned to nifedipine (30 mg controlled release twice a day) or placebo. The primary outcome was patient-reported complaints; the secondary outcome was patient-reported disability. Both were assessed from daily ratings on 100-mm visual analogue scales recorded in a diary. We took ambient temperatures into account and checked for a carry-over effect, and monitored for adverse effects.Results: After 6 weeks of treatment, mean scores on the visual analogue scale on complaints showed a nonsignificant difference of 1.84 mm (95% CI, -6.67 to 2.99 mm) in favor of nifedipine (P = .44). Mean scores on the visual analogue scale on disability showed a nonsignificant difference of 0.56 mm (95% CI, -2.97 to 4.09 mm) in favor of placebo (P = .75). There was no carry-over effect of prior study treatment. Nifedipine was associated with significantly lower systolic blood pressure and a significantly higher incidence of edema.Conclusions: In our study, nifedipine was not superior to placebo for treating chronic chilblains. These findings contrast with those of the older study and do not support routine use of nifedipine for this condition. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the integrated management of type 2 diabetes mellitus and depression treatment to improve medication adherence to oral hypoglycemic agents and antidepressant medications. The study utilizes a randomized controlled trial of 180 patients prescribed pharmacotherapy for type 2 diabetes and depression in primary care. It concludes that an integrated approach to depression and type 2 diabetes treatments was successful in improving outcomes in primary care.

The article presents a study that examines the integration of depression treatment into care for hypertension among older primary care patients. The researchers employed randomized controlled trials on older adults under care for hypertension in West Philadelphia, and were subjected to an integrated care intervention or usual care. Results indicated improvement in patient outcomes using depression and hypertension treatment procedure.