Family Medicine

Systematic Review | Outcomes in deprescribing implementation trials and compliance with expert recommendations

20 Jul, 2023 | 10:55h | UTC

Outcomes in deprescribing implementation trials and compliance with expert recommendations: a systematic review – BMC Geriatrics

Related:

Clinical practice guideline for deprescribing opioid analgesics: summary of recommendations – Medical Journal of Australia

RCT | Opioids not more effective than placebo for acute low back and neck pain

Deprescribing considerations for older people in general practice – Australian Journal of General Practice

Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review – Journal of Clinical Medicine

An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults – Journal of Clinical Medicine

Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic: a randomised trial – Diabetic Medicine

RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care

Achieving sustainable healthcare through deprescribing of unnecessary medications: making sense of the evidence – Cochrane Library

Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis – Health Technology Assessment

Barriers and facilitators to deprescribing of cardiovascular medications: a systematic review – BMJ Open

A National Modified Delphi Consensus Process to Prioritize Experiences and Interventions for Antipsychotic Medication Deprescribing Among Adult Patients With Critical Illness – Critical Care Explorations

Deprescribing proton pump inhibitors – Australian Journal of General Practice

Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis – Age and Ageing

Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More – ACP Open Rheumatology

Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy – European Heart Journal – Cardiovascular Pharmacotherapy

Deprescribing in Older Adults with Cardiovascular Disease – Journal of the American College of Cardiology

Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology

Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports

How-to guide for medication reviews in older adults with cancer: A Young International Society of Geriatric Oncology and Nursing & Allied Health Interest Group initiative – Journal of Geriatric Oncology

Deprescribing in Palliative Cancer Care – Life

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360

Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review – Research in Social and Administrative Pharmacy

AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review – Gastroenterology

Development of a Metric to Detect and Decrease Low-Value Prescribing in Older Adults – JAMA Network Open

The MedSafer Study—Electronic Decision Support for Deprescribing in Hospitalized Older Adults: A Cluster Randomized Clinical Trial – JAMA Internal Medicine

Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models – Drugs & Aging

Deprescribing in palliative patients with cancer: a concise review of tools and guidelines – Supportive Care in Cancer

Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review – Exploratory Research in Clinical and Social Pharmacy

A narrative review of evidence to guide deprescribing among older adults – Journal of General and Family Medicine

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens – The Lancet Health Longevity

Polypharmacy Management in Older Patients – Mayo Clinic Proceedings

Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy – Deutsches Ärzteblatt international

Eliminating Medication Overload: A National Action Plan – Lown Institute

International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action – Drugs & Aging

Common ED Medication Errors: Polypharmacy – emDocs

Current and future perspectives on the management of polypharmacy – BMC Family Practice

Routine deprescribing of chronic medications to combat polypharmacy – Therapeutic Advances in Drug Safety

Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international

Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety

 

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Review | Painful diabetic peripheral neuropathy

20 Jul, 2023 | 10:53h | UTC

Painful Diabetic Peripheral Neuropathy: Practical Guidance and Challenges for Clinical Management – Diabetes, Metabolic Syndrome and Obesity

 

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Self-measured blood pressure telemonitoring programs: a pragmatic how-to guide

19 Jul, 2023 | 14:33h | UTC

Self-Measured Blood Pressure Telemonitoring Programs: A Pragmatic How-to Guide – American Journal of Hypertension

 

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Podcast | Hematuria pearls

19 Jul, 2023 | 14:19h | UTC

#404 Hematuria with Dr. Derek Fine – The Curbsiders

 

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IARC, WHO agency, identifies aspartame as potentially carcinogenic but probably safe within established acceptable daily intake

18 Jul, 2023 | 13:58h | UTC

News Release: Aspartame hazard and risk assessment results released – World Health Organization

Commentaries:

Expert reaction to IARC and JEFCA summary on aspartame – Science Media Centre

Does artificial sweetener aspartame really cause cancer? What the WHO listing means for your diet soft drink habit – The Conversation

Aspartame Hazard and Risk Assessment Results Released by IARC and JECFA – The ASCO Post

 

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AHA Scientific Statement | Cardiopulmonary impact of electronic cigarettes and vaping products

18 Jul, 2023 | 13:56h | UTC

Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association – Circulation

News Releases:

Current evidence identifies health risks of e-cigarette use; long-term research needed – American Heart Association

As e-cigarette use grows, more research needed on long-term effects of vaping – American Heart Association

Top Things to Know: Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products – American Heart Association

Commentary: Vaping’s Risks to CV Health Not Yet Fully Known: AHA – CIDRAP

 

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RCT | Direct oral challenge noninferior to skin testing followed by direct oral challenge in low-risk penicillin allergy patients

18 Jul, 2023 | 13:54h | UTC

Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial – JAMA Internal Medicine (free for a limited period)

See also: Visual Abstract

News Release: World-first clinical trial to help millions with penicillin allergies – Vanderbilt University Medical Center

Commentary: Trial supports use of direct oral challenge for penicillin allergy – CIDRAP

 

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RCT | Donanemab slows early symptomatic Alzheimer’s progression, but raises serious safety concerns

18 Jul, 2023 | 13:51h | UTC

Donanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial – JAMA (free for a limited period)

Editorials:

Donanemab for Alzheimer Disease—Who Benefits and Who Is Harmed? – JAMA (free for a limited period)

Amyloid-Targeting Monoclonal Antibodies for Alzheimer Disease – JAMA (free for a limited period)

Ushering in a New Era of Alzheimer Disease Therapy – JAMA (free for a limited period)

See also: Visual Abstract

Commentary: Expert reaction to results from Eli Lilly on its anti-amyloid drug donanemab – Science Media Centre

Related: RCT | Lecanemab slows cognitive decline in early Alzheimer’s disease but raises safety concerns.

 

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Nationwide Cohort Study | Adolescent hypertension linked with increased stroke risk in young adulthood

18 Jul, 2023 | 13:49h | UTC

Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents – Stroke

Commentary: The Relationship Between Adolescent Hypertension and Stroke Risk After Age 40 Years – Neurology Advisor

 

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Guideline | Prevention and management of childhood progressive myopia

18 Jul, 2023 | 13:35h | UTC

Prevention and management of childhood progressive myopia: National consensus guidelines – Indian Journal of Ophthalmology

 

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RCT | Prostatic artery embolization improves symptoms more than combined medical therapy in BPH patients

18 Jul, 2023 | 13:34h | UTC

Prostatic artery embolisation versus medical treatment in patients with benign prostatic hyperplasia (PARTEM): a randomised, multicentre, open-label, phase 3, superiority trial – The Lancet Regional Health – Europe

 

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Guideline | Antibiotic therapy in patients with suspected antibiotic allergy

17 Jul, 2023 | 13:59h | UTC

The Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy – Clinical Microbiology and Infection

 

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Retrospective Analysis | Inconsistencies in pediatric drug dosing found in over half of prehospital emergency drug administrations

17 Jul, 2023 | 13:50h | UTC

Deviation From National Dosing Recommendations for Children Having Out-of-hospital Emergencies – Pediatrics

Commentaries:

Children and Drug Dosing Variations When in Transit to the Hospital – AAP Journals Blog

Variation Seen in Dosing of Meds at Prehospital Pediatric Encounters – HealthDay

 

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M-A | One-year usage of elastic compression stockings comparable to two for post-thrombotic syndrome prevention

17 Jul, 2023 | 13:49h | UTC

Is it necessary to wear compression stockings and how long should they be worn for preventing post thrombotic syndrome? A meta-analysis of randomized controlled trials – Thrombosis Research

Commentary: Are Compression Stockings Beneficial for Preventing Post-Thrombotic Syndrome After Deep Venous Thrombosis? – NEJM Journal Watch

 

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Meta-Analysis | Nearly 6% of first-episode psychosis patients exhibit clinically relevant MRI abnormalities

17 Jul, 2023 | 13:32h | UTC

Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis: A Systematic Review and Meta-analysis – JAMA Psychiatry

News Release: Routine brain scanning may improve clinical care for people with psychosis – University of Oxford

 

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Cohort Study | Mental disorders linked to increased cardiovascular events in young patients

17 Jul, 2023 | 13:20h | UTC

Increased cardiovascular events in young patients with mental disorders: a nationwide cohort study – European Journal of Preventive Cardiology (free for a limited period)

News Release: Under 40s with mental health problems have elevated risks of heart attack and stroke – European Society of Cardiology

 

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M-A | First-line thiazide diuretics show reduced cardiovascular events, comparable mortality vs. other antihypertensive drugs

14 Jul, 2023 | 12:55h | UTC

First‐line diuretics versus other classes of antihypertensive drugs for hypertension – Cochrane Library

Summary: What are the benefits and harms of diuretics given as a first treatment compared to other drug classes for hypertension (high blood pressure)? – Cochrane Library

 

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Quality Improvement Study | Improved asymptomatic bacteriuria management by reduction of unnecessary urine culture requests

14 Jul, 2023 | 12:54h | UTC

A Statewide Quality Initiative to Reduce Unnecessary Antibiotic Treatment of Asymptomatic Bacteriuria – JAMA Internal Medicine

Related:

Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance – Cleveland Clinic Journal of Medicine

Study: Hospital Intervention Resulted in a 45% Reduction in the Urine Cultures Ordered

Optimal Urine Culture Diagnostic Stewardship Practice—Results from an Expert Modified-Delphi Procedure – Clinical Infectious Diseases

USPSTF Recommendation Statement: Screening for Asymptomatic Bacteriuria in Adults

Cohort Study: Antibiotic Treatment of Asymptomatic Bacteriuria in Hospitalized Patients is Common, and May be Associated with Longer Duration of Hospitalization

Inappropriate Management of Asymptomatic Patients With Positive Urine Cultures: A Systematic Review and Meta-analysis – Open Forum Infectious Diseases

IDSA Guideline for the Management of Asymptomatic Bacteriuria

 

Commentary on Twitter

???Powerful message from our new study in @JAMAInternalMed: diagnostic stewardship (better use of diagnostic tests) was responsible for ALL the⬇️in unnecessary antibiotic use for ASB. ➕results??nudge to action. Time to??upstream to improve care! https://t.co/yO4UpA6ZKK pic.twitter.com/hXZGvNmVJP

— Valerie Vaughn (@ValerieVaughnMD) July 11, 2023

 

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Cohort Study | No significant difference in kidney risks between lithium and valproate therapies, but high lithium levels remain a concern

14 Jul, 2023 | 12:46h | UTC

Absolute and Relative Risks of Kidney Outcomes Associated With Lithium vs Valproate Use in Sweden – JAMA Network Open

 

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Cohort Study | Long-term cancer survivors face higher risk of noncancer death

14 Jul, 2023 | 12:38h | UTC

Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US – JAMA Network Open

 

Commentary on Twitter

Patients surviving ≥5 years from initial diagnosis of early breast, prostate, or colorectal cancer, the risk of dying from the cancer varied widely vs noncancer causes of death. Patients at low risk at diagnosis had a 3x higher risk of noncancer death. https://t.co/z2ffG9LqPv pic.twitter.com/HcqFkWAzZf

— JAMA Network Open (@JAMANetworkOpen) July 12, 2023

 

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Review | Cushing Syndrome

13 Jul, 2023 | 13:08h | UTC

Cushing Syndrome: A Review – JAMA (free for a limited period)

Audio clinical review: Diagnosis and Treatment of Cushing Syndrome – JAMA

 

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RCT | Metformin boosts effectiveness of lifestyle interventions for diabetes prevention in individuals with impaired glucose regulation

13 Jul, 2023 | 13:07h | UTC

Safety and effectiveness of metformin plus lifestyle intervention compared with lifestyle intervention alone in preventing progression to diabetes in a Chinese population with impaired glucose regulation: a multicentre, open-label, randomised controlled trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

Related Study: Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin – New England Journal of Medicine (link to abstract – $ for full-text)

 

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Single Arm Trial | Low-carbohydrate diet improves glycemic control in type 1 diabetes

13 Jul, 2023 | 13:04h | UTC

Effects of a low-carbohydrate diet in adults with type 1 diabetes management: A single arm non-randomised clinical trial – PLOS One

Related:

Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet – Pediatrics (link to abstract – $ for full-text)

Meta-analysis of randomized trials: patients adhering to a low carbohydrate diet for six months may experience remission of diabetes without adverse consequences

RCT | A calorie-unrestricted low-carbohydrate, high-fat diet resulted in short-term weight loss and better glycemic control.

Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials – Nutrients

Consensus Statement: Effect of carbohydrate-restricted diets and intermittent fasting on obesity, type 2 diabetes mellitus, and hypertension management.

Effects of a 6-month, low-carbohydrate diet on glycaemic control, body composition, and cardiovascular risk factors in patients with type 2 diabetes: An open-label randomized controlled trial – Diabetes, Obesity and Metabolism

Lower carbohydrate diets for adults with type 2 diabetes – British Journal of Nutrition

Low carbohydrate diet: Insights from a general practice service in patients with type 2 diabetes

Diabetes Canada Position Statement on Low-Carbohydrate Diets for Adults With Diabetes: A Rapid Review – Canadian Journal of Diabetes

Low Carbohydrate Diets for Diabetes: A Review of the Clinical Effectiveness and Guidelines – Canadian Agency for Drugs and Technologies in Health

Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide – British Journal of General Practice

 

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RCT| Exercise during hemodialysis improves physical function in chronic kidney failure patients

13 Jul, 2023 | 13:01h | UTC

Exercise during Hemodialysis in Patients with Chronic Kidney Failure – NEJM Evidence

 

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RCT | Cytisinicline shows significant efficacy in smoking cessation over placebo

13 Jul, 2023 | 12:58h | UTC

Cytisinicline for Smoking Cessation: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

See also: Visual Abstract

News Release: First large US clinical trial of cytisinicline finds the smoking cessation medication effective and well tolerated – Massachusetts General Hospital

 

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