Effect of a Telephone Health Coaching Intervention on Hypertension Control in Young Adults: The MyHEART Randomized Clinical Trial

“[Introduction] [..] MyHEART is a multicomponent, patient-centered, and theoretically based; it includes 4 evidence-based self-management components: (1) telephone-based health coaching with adult education specialists to teach and monitor self-management skills, (2) documentation of coach-patient telephone contacts, (3) individualized hypertension education materials, and (4) home BP monitoring. [..] The primary aim of this study was to evaluate the effect of MyHEART on clinical outcomes, ie, the change in systolic and diastolic BP (primary) and hypertension control (secondary) after 6 and 12 months, compared with usual care. [..] [Methods] [..] The inclusion criteria included (1) aged 18 to 39 years at enrollment; … Read More

Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake

“The perpetual diet wars between factions promoting low-carbohydrate, keto, paleo, high-protein, low-fat, plant-based, vegan, and a seemingly endless list of other diets have led to substantial public confusion and mistrust in nutrition science. While debate rages about the relative merits and demerits of various so-called healthy diets, less attention is paid to the fact that otherwise diverse diet recommendations often share a common piece of advice: avoid ultra-processed foods. [..] The rise in obesity and type 2 diabetes prevalence occurred in parallel with an increasingly industrialized food system characterized by large-scale production of high-yield, inexpensive, agricultural “inputs” (primarily corn, soy, … Read More

The New Hospital at Home Movement: Opportunity or Threat for Patient Care?

Select Key Findings Policy Issues Debating the Future: Does H@H Save Costs and Improve Patient Care? “[..] Recent studies of cost savings from H@H programs range from 20 percent (Reese 2021) to 40 percent (Brigham and Women’s Hospital in Boston, Levine et al. 2020). But these findings are not generalizable as they are based entirely on single case studies of highly structured programs involving small samples of very carefully selected patients. For example, the study of Brigham and Women’s program examined 91 adults who were admitted to the hospital’s ED and randomly assigned to the hospital vs home for treatment. [..] While … Read More

Can Employer-sponsored Insurance Be Saved? A Review of Policy Options: Price Regulation

“[..] spending on hospital care makes up the largest single component of personal health care spending, an estimated 39 percent of the total in 2023, compared to 24 percent for physician and clinical services and 10 percent for prescription drugs. National spending on hospital care is projected to exceed $1.5 trillion in 2023, and is expected to grow by about 5.6 percent per year over the coming decade (a rate likely to significantly exceed general inflation). Much of this growth is driven by consolidation among hospitals and health systems, which then use their size and local market power to demand … Read More

Prevalence of Colorectal Neoplasia 10 or More Years After a Negative Screening Colonoscopy in 120 000 Repeated Screening Colonoscopies

“Screening colonoscopy has been shown to reduce colorectal cancer (CRC) incidence and mortality by enabling detection and removal of precancerous lesions. However, the available evidence about the optimal screening interval is limited. [..] More targeted screening offers would potentially reduce the burden of testing and demand of capacities and costs associated with colonoscopy, thereby also counteracting the frequently reported overuse and underuse of screening examinations in considerable proportions of the population. [..] Anonymized registration of screening colonoscopy findings and the use of the anonymized data for program evaluation by the Central Research Institute of Ambulatory Health Care in Germany is … Read More

Risk Adjustment And Promoting Health Equity In Population-Based Payment: Concepts And Evidence

“[Introduction] [..] population-based payment models, as in the Medicare Shared Savings Program or Medicare Advantage (MA) program, can facilitate the resource reallocations necessary to address health care disparities. Risk adjustment is the mechanism by which payment is allocated in these models. Traditionally, risk adjustment has been conceived and executed purely as a predictive exercise. Regression is used to predict total annual per person spending as a function of demographic and clinical characteristics. A person’s predicted spending is converted to a risk score, which is applied to a base regional rate to determine the prospective payment or benchmark for that person. … Read More

Advancing the commercial determinants of health agenda

“By the 1990s, worsening patterns of population health began to raise concerns about their association with these changes in the global political economy. The sharp rise in non-communicable diseases, now accounting for 74% of deaths worldwide, were difficult to explain solely as related to individual behavioural choices. The links between population health outcomes, the strategies and products of corporations, and the political contexts that facilitate such practices began to receive closer scrutiny. Over the next two decades, detailed analyses of an increasingly globalised tobacco industry, enabled by a flood of internal documents into the public domain, were followed by similar … Read More

What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss

“we examine real-world data from a cohort based in a UK primary care clinic offering a low-carbohydrate approach to people with T2D [type 2 diabetes] from 2013 to 2021. The physiological mechanisms behind remission induced by dietary weight loss were first demonstrated in 2011. Since then the idea of drug-free T2D remission has gained international momentum. [..] Advice on lowering dietary carbohydrate was offered routinely by our team of nine specially trained GPs and three practice nurses to patients with T2D (defined as HbA1c >48 mmol/mol on two occasions) starting in March 2013. Our protocol includes important information around the deprescribing of … Read More

Telehealth Best Practices: Dr Geoff Rutledge Of HealthTap On How To Best Care For Your Patients When They Are Not Physically In Front Of You

“[Authority Magazine’s Jake Frankel] can you articulate for our readers a few of the main benefits of having a patient in front of you? [Co-founder and CMO of HealthTap Geoff Rutledge] The most important point to emphasize is that the essential physician–patient interaction is direct face-to-face communication that allows a doctor to connect with their patient, engage with them, and enable them to share in detail what is going on with their lives and their health. And that this critical face-to-face communication can occur equally well either in an in-person, in-office setting or via high-resolution video and audio consultation. It’s … Read More

The Habit America’s Historians Just Can’t Give Up

“In its attempt to explode particular myths, however, Myth America engages in its own mythmaking. The book fundamentally misunderstands the crises facing the U.S. and the world. By implying that misinformation is the principal cause of the partisan rancor, violence, and general dysfunction that mark our current political moment, the collection obscures our much bigger problems. And by localizing the threat of misinformation and disinformation almost exclusively within certain far-right segments of the conservative movement and the Republican Party, Myth America absolves not only other stripes of conservatism, but also the milquetoast technocratic liberalism that helped set the stage for this moment. It’s not … Read More