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American College of Physicians


Most adults eligible for statins for prevention are not using them

According to a new study published in Annals of Internal Medicine, most adults who qualify for statin use for primary prevention are not receiving them. The study found that despite increased overall statin use over time, only 35% of eligible adults were taking statins between 2013 and 2018. The researchers suggest that innovative effo...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateDec 4, 2023

Trend report: High blood pressure increasing in low-income adults; diabetes and obesity on the rise in higher-income adults

A study of over 20,000 middle-aged US adults found lower income status linked to increased hypertension risk. Higher-income adults faced rising rates of diabetes and obesity. Targeted public health initiatives are needed to address growing cardiovascular mortality among middle-aged adults.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateNov 20, 2023

Virologic rebound observed in 20% of patients treated with nirmatrelvir-ritonavir

A study found that 20% of patients treated with nirmatrelvir-ritavir (N-R) experienced virologic rebound, a phenomenon where viral load increases after initial decline. In contrast, only 1 untreated patient was affected. The researchers suggest considering the risks and benefits of N-R treatment in patients at low risk for severe disease.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateNov 13, 2023

Acupuncture may offer limited relief to patients with chronic hives

Researchers found that acupuncture improved symptoms in patients with chronic spontaneous urticaria (CSU), but the benefits were not significant enough to meet the minimal clinical difference threshold. The study included over 300 participants and suggested that clinicians should consider using acupuncture as an adjunctive treatment.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateNov 13, 2023

Patients more likely to lose weight if physicians offer advice using optimistic tone

A study found that physicians who presented treatments for obesity as good news and an opportunity were more successful in helping patients lose weight. Patients who received counseling with a positive and optimistic tone had significantly higher weight loss outcomes compared to those who received neutral or negative advice.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateNov 6, 2023

Virtual cognitively enhanced tai chi program improves cognition and executive function in older adults with mild cognitive impairment

A virtual, home-based exercise program using cognitively enriched tai ji quan improved global cognition and reduced walking interference associated with dual tasking in older adults with mild cognitive impairment. The intervention also showed favorable improvements in cognition, function, executive function, and working memory.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateOct 30, 2023

Nurse practitioners and physicians are similarly likely to inappropriately prescribe medications to older patients

A recent study published in Annals of Internal Medicine found that both nurse practitioners (NPs) and physicians are similarly likely to inappropriately prescribe medications to older patients, with an average of 1.7 inappropriate prescriptions for every 100 prescriptions written. The authors suggest that use of clinician-level perform...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateOct 23, 2023

History of parental infertility associated with small increased risk for birth defects among children conceived through fertility treatment

A study of over 850,000 Australian children born between 2009 and 2017 found a small increased risk of birth defects among those conceived through fertility treatment, partly attributed to parental infertility. The use of intracytoplasmic sperm injection (ICSI) was also associated with an increased risk for genitourinary abnormalities.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateOct 9, 2023

One in 3 adults with new-onset AFib occurring during hospitalization will have recurrent episode within a year

A study of hospitalized adults with new-onset atrial fibrillation found that 1 in 3 patients experienced a recurrent episode of AF within a year. This rate is approximately 7 times higher than in matched control participants, suggesting that oral anticoagulation therapy may be warranted for these patients.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateOct 2, 2023

High blood pressure in males in late adolescence associated with increased risk of major cardiovascular events later in life

A study of over 1 million Swedish men found that high blood pressure at age 18 was associated with a higher risk of major cardiovascular events, including heart failure, heart attacks, and strokes. Early intervention for hypertension may be critical to reducing later cardiovascular events.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateSep 25, 2023

Self-reported “night owls” more likely to have unhealthy lifestyle behaviors, significantly increased diabetes risk

A large study found that people with an evening chronotype were more likely to engage in unhealthy lifestyle behaviors such as smoking, poor sleep, and physical inactivity. These individuals had a 72% higher risk of developing diabetes compared to those with a morning chronotype.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateSep 11, 2023

Pharmacy discount card programs like Amazon Prime and GoodRx gold could save patients millions of dollars in out-of-pocket costs for commonly prescribed generic medications

A nationally representative study found that at least one out of five prescriptions for commonly prescribed generic medications were cheaper through Amazon Prime or GoodRx Gold discount cards compared to actual out-of-pocket payments made by patients. The findings highlight the disproportionately higher frequency of out-of-pocket payme...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateSep 4, 2023

Two studies demonstrate the benefits and limitations of artificial intelligence in colonoscopy

Two studies demonstrate that artificial intelligence in colonoscopy can increase adenoma detection rates and reduce miss rates, but also lead to increased removal of non-neoplastic polyps. The findings suggest the need for additional research on more defined detection parameters before AI can be integrated into routine clinical care.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateAug 28, 2023

Some experts believe that routine mask-wearing should continue in health care settings

Public health experts recommend continuing routine mask-wearing in healthcare settings to protect vulnerable patients and staff from COVID-19. The authors argue that while severe cases have decreased, asymptomatic spread remains a threat, particularly among high-risk patients and healthcare workers who may not be aware they are infected.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateAug 21, 2023

Social determinants of health contribute to higher CVD mortality rates in Black persons

A large US study found that social determinants of health are a major factor contributing to higher cardiovascular disease mortality rates in Black individuals compared to Whites. The study analyzed data from over 50,000 adults and found significant associations between social factors such as unemployment and food insecurity with CVD m...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateAug 14, 2023

ACP issues updated guidance for colorectal cancer screening of asymptomatic adults

The American College of Physicians recommends starting colorectal cancer screening at age 50 for asymptomatic adults with average risk. The guideline aims to balance benefits and harms of screening in this population. Screening in younger adults may not offer significant net benefit due to lower incidence rates.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateJul 31, 2023

COVID-19 case studies offer insights into what it will take to combat misleading medical information online

A team of medical leaders recommends a sustainably funded public-private partnership to combat misinformation, citing challenges faced by the TIOS-VY organization. The American College of Physicians calls for modernizing public health infrastructure, including increased funding and addressing disinformation, especially on social media.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeNews article·DateJul 17, 2023

Acute kidney injury not associated with worsening kidney function in persons with CKD

Researchers found that acute kidney injury does not predict worsening of kidney function trajectory in patients with CKD, suggesting that pre-existing kidney disease may be a major contributor. The study recommends focusing on flattening the eGFR slope and treating proteinuria to slow CKD progression.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeObservational study·DateJul 10, 2023

State medical cannabis laws not associated with reduced use of opioid or nonopioid pain treatments

A study of commercially insured adults with chronic noncancer pain found that state medical cannabis laws did not lead to a reduction in the use of opioid or nonopioid pain treatments. The researchers also suggested slow implementation and reluctance among healthcare leaders may have contributed to these findings.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateJul 3, 2023

Even with insurance, many patients with diabetes turn to GoFundMe to offset high cost of care

A study found that even insured patients with diabetes use crowdfunding platforms like GoFundMe to cover excess medical expenses, including uncovered co-pays and life-saving care. Researchers urge policymakers to consider these needs when developing affordable diabetes care policies.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateJun 12, 2023

A supervised hospital walking program may reduce nursing facility admissions for older adults

A supervised hospital walking program has been shown to reduce nursing facility admissions for older adults by lowering the proportion of patients discharged to skilled nursing facilities from 13% to 8%. However, low participation rates and limited impact on length of stay or inpatient falls were noted.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateJun 5, 2023

Study finds similar quality and cost of care for patients treated by an allopathic (M.D.) or osteopathic (D.O.) physician

An observational study of 329,000 Medicare admissions found that older persons receiving hospital care from allopathic (M.D.) or osteopathic (D.O.) physicians experience similar quality and cost of care. Researchers also highlight systemic health inequities faced by persons with sickle cell disease.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateMay 29, 2023

Metabolic syndrome with heavy alcohol use may have contributed to recent surge in alcoholic liver disease-related mortality

Researchers found that heavy alcohol use and the presence of metabolic syndrome were associated with a higher risk for advanced liver disease. The study suggests an increasing interaction effect between MetS, heavy alcohol use, and a recent surge in alcoholic liver disease-related mortality.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeSurvey·DateMay 8, 2023

Wakefulness-promoting agents effective for excessive daytime sleepiness but patients may discontinue due to side effects

Researchers found that solriamfetol, armodafinil–modafinil, and pitolisant reduce excessive daytime sleepiness in patients with obstructive sleep apnea already using conventional therapy. However, patients may be more likely to discontinue the use of these medications due to adverse events including headache, anxiety, and insomnia.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeLiterature review·DateMay 8, 2023

HIV status is not associated with mpox treatment outcomes in persons using tecovirimat

A cohort study of 196 people treated with tecovirimat found that HIV status did not impact treatment outcomes. Only 22% of participants experienced nonsevere adverse effects, and 4 serious adverse events occurred, with 3 being persons with HIV. The findings contradict previous uncertainty about HIV's role in mpox acquisition.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateMay 1, 2023

Growing number of states provide coverage for outpatient hemodialysis for undocumented immigrants

A growing number of states have implemented policies to cover outpatient hemodialysis for undocumented immigrants with kidney failure. This expansion may be due to increased awareness of poor outcomes with emergency hemodialysis and advocacy efforts. The move towards covering dialysis in all 50 states is called for by experts, who also...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateApr 24, 2023

Risks of removing ovaries at benign hysterectomy may outweigh the benefits for women at low risk for ovarian cancer

Researchers found that removing ovaries during a benign hysterectomy increases the risk of hospitalization for cardiovascular disease in premenopausal women, but not necessarily for cancer. The study supports current recommendations to conserve ovaries in premenopausal patients at low risk for ovarian cancer.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeObservational study·DateApr 17, 2023

Use of monoclonal antibodies reduces death, hospitalization risk by more than one-third after COVID-19 diagnosis

Researchers found that using monoclonal antibodies within two days of a COVID-19 diagnosis reduced the risk of hospitalization or death by 39% compared to those who did not receive treatment. This finding suggests that early treatment with monoclonal antibodies significantly reduced the severity of COVID-19.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeObservational study·DateApr 3, 2023

A video-based decision support tool may aid decision-making for Black individuals considering ICD implantation

A randomized clinical trial found that a video-based decision support tool increased patient knowledge, but not assent, to ICD implantation among Black patients. The study also highlighted the complexity of aversion to cardiac procedures in Black communities, emphasizing the need for further research on social determinants of health.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateApr 3, 2023

Asymptomatic, CT angiography-detected coronary artery disease associated with 8-fold increased risk for heart attack

A cohort study of over 9,000 persons found that asymptomatic middle-aged individuals with subclinical coronary atherosclerosis are at an 8-fold increased risk for myocardial infarction. The study highlights the importance of identifying and addressing obstructive coronary artery disease in patients without known cardiovascular disease.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeObservational study·DateMar 27, 2023

Cases and transmission of highly contagious fungal infections see dramatic increase between 2019 and 2021

Cases of Candida auris, a highly contagious fungal infection, rose drastically between 2019 and 2021, with an increase in echinocandin-resistant cases. The findings emphasize the need for improved detection and infection control practices to prevent the spread of C auris.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateMar 20, 2023

More than 80% of American adults with type 2 diabetes meet treatment criteria for GLP-1 RAs or SGLT2is but most are not getting them

A study found that over 80% of American adults with type 2 diabetes meet the criteria to use GLP-1 RAs or SGLT2is, but only a small percentage are using them. The medications have a substantially higher cost than current first-line treatments, making it difficult for patients to access them.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateFeb 27, 2023

Overweight and obesity prevalent and poorly managed among adults with type 1 diabetes

A recent study found that adults with type 1 diabetes are at a high risk of being overweight or obese, but only half receive lifestyle recommendations to manage their weight. The study also highlighted the importance of individualized patient education in improving weight management for these patients.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateFeb 13, 2023

ICD detection and treatment of arrhythmias not impacted by MRI

A cohort study of over 600 persons with non-MRI-conditional implantable cardioverter defibrillators found that these devices continue to appropriately treat detected tachyarrhythmias after MRI scans. The findings suggest that patients with non-MRI-conditional ICDs can safely undergo MRI exams without compromising device function.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateJan 30, 2023

American College of Physicians recommends cognitive behavioral therapy or second-generation antidepressants for adults with major depressive disorder

The American College of Physicians recommends using cognitive behavioral therapy (CBT) or second-generation antidepressants as initial treatment for adults with moderate to severe major depressive disorder. The guideline also suggests considering combination therapy and discussing patient preferences when selecting a treatment.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeMeta-analysis·DateJan 23, 2023