How pharmacists can be deprescribing heroes
How can we remove the barriers and make pharmacists our deprescribing heroes? In their recent piece in Senior Care Pharmacist, Judith Garber and Don Downing create a roadmap for collaboration. More
Employers Cut Health Costs With Incentives for Patients, Doctors
Employers can cut their health-care expenses by paying top medical providers a flat rate for a bundle of related services while offering incentives to the patients who use them, a study suggests. More
Adverse Drug Events After Hospitalization—Are We Missing the Mark?
At least 20% of older adults will experience an adverse event in the weeks following hospitalization, with most being secondary to adverse drug-related events (ADEs). Of these, half are considered preventable or ameliorable. More
Another Failed Study of “Personalized” Depression Treatment
Due to lackluster antidepressant study results, researchers test if subgroups of depressed patients show greater improvement. More
Could Efforts to Fight the Coronavirus Lead to Overuse of Antibiotics?
Study shows more than half of hospitalized COVID-19 patients in U.S. received antibiotics in pandemic’s first six months More
Evidence conflicts over efficacy of monoclonal antibodies in severe COVID
"We are left with evidence of benefit from interleukin-6 inhibitors, at least under some circumstances." More
Emerging Lessons From COVID-19 for the US Clinical Research Enterprise
In this issue of JAMA, Janiaud et al present a meta-analysis of randomized clinical trials (RCTs) of convalescent plasma for the treatment of patients with COVID-19. More
Assessment of Outcomes Associated With the Use of Newly Approved Oncology Drugs in Medicare Beneficiaries
This cohort study evaluates the differences in survival, duration of therapy, and treatment patterns between clinical trial patients and older adults with Medicare receiving cancer drugs for metastatic solid cancers in usual practice. More
Overuse in Medicare slow to change, study finds
A recent analysis in JAMA finds that overuse in Medicare barely budged from 2014-2018. How can we move further toward value-based care? More
Approval and Coverage of Cancer Drugs in England, Canada, and the US
Most drug approvals are based on surrogate markers, such as tumor shrinkage in a fraction of patients (response rate) or delayed tumor growth (progression-free survival). These surrogates use arbitrary percentage cutoffs and are not optimized to ensure that a drug can improve the length or quality of life. More
What Americans Don’t Know About Their Medications
People who have faced debilitating side effects say we need better warnings on drugs. The FDA hasn’t been enthusiastic. More
Assessment of Outpatient Dispensing of Products Proposed for Treatment or Prevention of COVID-19 by US Retail Pharmacies During the Pandemic
This cross-sectional study examines changes in the outpatient retail dispensing frequency of proposed treatments for coronavirus disease 2019 after the March 13, 2020, declaration of a national emergency due to the pandemic. More
‘A natural experiment’: Pandemic-driven drop in cancer screening may aid research on overdiagnosis
The government will fund reseach asking whether cancer patients "really do worse because of being diagnosed later" during the pandemic. More
Is a cancer crisis trailing the pandemic?
The way the pandemic has deferred some primary and preventive care is rekindling debate over whether the U.S. is spending too much on diagnostic tests. Lown Institute President Vikas Saini doesn’t think Covid will move the needle on how doctors and patients approach medical care, with demand for tests and services returning once the crisis lifts. “There's been chatter, and people speculating or saying it's a great opportunity because there's all this elective stuff that got stopped [so] when we resume, maybe we should be more thoughtful — yeah, we should," he says. "But what's actually going to happen? I don't see any reason to think it won't go back to business-as-usual." More
Pandemic Lessons in Improving the Medical System
The pandemic may prompt American medicine to become less expensive, more efficient and more effective at protecting people’s health. More
Advocacy from independent experts reflected in new ob-gyn guideline
A group of independent doctors spoke out in 2019 against what they saw as a potentially harmful recommendation that was influenced by financial conflicts of interest. Now it appears that the independent doctors' advocacy has helped to change that recommendation. More
Variations in Persistent Use of Low-Value Breast Cancer Surgery
This study identifies variation and determinants of persistent use of low-value breast cancer surgical care. More
Screening for Asymptomatic Carotid Artery Stenosis in Adult Patients
The US Preventive Services Task Force (USPSTF) has reaffirmed its 2014 recommendation3 against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation) based on an assessment of no benefit and possible harm. More
Categorizing and measuring harm from medical treatments
Truly informed decision making cannot happen without a good understanding of both the benefits and the harms of medical treatments. In a recent paper, researchers break new ground by identifying different types of harms from medical care that all clinicians and researchers should be aware of. More
Hospital Revenue Under Maryland’s Total Cost of Care Model During the COVID-19 Pandemic, March-July 2020
This study compares revenue of Maryland hospitals in March-July 2020 vs historical trends and assesses whether rate increases for inpatient and outpatient services that were permitted to offset pandemic-related decines in revenues were associated with changes to state hospital revenue. More