JAMA internal medicine
Audio Summaries

Treatment of Anxiety for Adults in Primary Care Settings: A Review

May 4, 2026

This review aims to address the treatment of anxiety disorders in primary care settings, highlighting the prevalence and under-treatment of these conditions. The authors recommend screening for anxiety in patients under 65, and they discuss effective behavioral and pharmacological treatment options, emphasizing the importance of shared decision-making and the Collaborative Care Management model to enhance patient outcomes. The findings suggest that integrating cognitive-behavioral therapy and appropriate pharmacotherapy can significantly improve anxiety management in primary care.

Federal Enforcement Actions Against Medicare Advantage Plans

May 4, 2026

The authors aimed to examine the enforcement actions taken by the Centers for Medicare & Medicaid Services (CMS) against Medicare Advantage (MA) contracts from 2010 to 2023, focusing on the characteristics of the contracts and beneficiaries involved. They found that enforcement actions were variable over the years, predominantly consisting of monetary penalties, and raised concerns about their effectiveness in ensuring compliance with federal standards. The study suggests a need for further evaluation of oversight mechanisms to better protect beneficiaries and uphold program integrity.

Mailed Outreach for Colorectal Cancer Screening in Community Health Centers: The CARES Pragmatic Cluster Randomized Clinical Trial

Apr 27, 2026

The authors aimed to compare the effectiveness of two mailed outreach strategies—fecal immunochemical test (FIT) with automated text messaging versus FIT-DNA with manufacturer outreach—in increasing colorectal cancer (CRC) screening rates among eligible adults in community health centers. The study found that the FIT-DNA group had significantly higher screening participation at both 90 and 180 days compared to the FIT group, with notable differences in uptake between locations. Despite these improvements, the follow-up colonoscopy completion rate after abnormal test results remained low.

The Oncology Care Model and Initiation of Systemic Therapy for Cancer

Apr 27, 2026

The authors aimed to determine whether the Oncology Care Model (OCM) was associated with an increase in the initiation of systemic therapy for cancer among Medicare beneficiaries. Their findings revealed no significant increase in systemic therapy initiation for newly diagnosed cancers, but a notable decrease in initiation for patients with poor-prognosis cancers, alongside lower Medicare spending in this group. This suggests that the OCM may have led to more conservative treatment approaches without increasing systemic therapy use.

Fecal Microbiota Transplant and Multidrug-Resistant Organism Decolonization in Gastrointestinal Disease: A Randomized Clinical Trial

Apr 20, 2026

This randomized clinical trial aimed to evaluate the efficacy of fecal microbiota transplant (FMT) in decolonizing multidrug-resistant organisms (MDROs) and reducing antimicrobial resistance (AMR) genes in patients with gastrointestinal diseases. The results showed no significant differences in MDRO decolonization or AMR gene reduction between the FMT and sham intervention groups, although FMT did lead to changes in gut microbiome composition. Ultimately, the study suggests that while FMT may not effectively combat MDRO colonization, it can influence gut microbiome diversity.

Benefits and Harms of Dementia Screening for Family Members of Older Adults: A Randomized Clinical Trial

Apr 20, 2026

This randomized clinical trial aimed to evaluate the benefits and risks of dementia screening for family members of older adults in primary care settings. The study found that screening did not lead to significant improvements in family members' health-related quality of life, caregiver preparedness, or caregiving self-efficacy, nor did it increase levels of depression or anxiety among family members. The low rates of positive screenings and high refusal rates for follow-up assessments may explain these findings.

Palliative Care Intervention for Patients With End-Stage Liver Disease: A Cluster Randomized Clinical Trial

Apr 13, 2026

This study aimed to compare the effectiveness of palliative care delivered by trained hepatologists versus conventional palliative care specialists in improving quality of life (QoL) for patients with end-stage liver disease (ESLD). The results indicated that while both groups showed significant QoL improvements, the hepatologist-led care was noninferior to that provided by specialists and resulted in higher patient satisfaction. Overall, the findings suggest that hepatologists can effectively deliver palliative care to ESLD patients.

Deprescribing Intervention and Reduction of Proton Pump Inhibitor Use in Primary Care: A Cluster Randomized Clinical Trial

Apr 13, 2026

The authors aimed to evaluate the effectiveness of a deprescribing intervention designed for both patients and general practitioners (GPs) in reducing inappropriate use of proton pump inhibitors (PPIs) in primary care settings. The study found that the combined intervention led to a significant reduction in PPI use compared to usual care and a GP-only intervention, while having no meaningful impact on gastroesophageal reflux disease activity.

Out-of-Pocket Spending for Insulin by Medicare Beneficiaries After Monthly Caps

Apr 6, 2026

This study aimed to evaluate the impact of the $35 monthly cap on out-of-pocket insulin spending for Medicare beneficiaries with type 2 diabetes, implemented in 2021 and expanded in 2023. The findings indicated that the cap significantly reduced insulin costs, increased insulin usage, and led to modest improvements in blood glucose levels, suggesting that such federal cost-sharing policies could enhance medication access and adherence for chronic disease management.

Management of Orthostatic Hypotension: A Review

Apr 6, 2026

The authors review the management of orthostatic hypotension, a condition that is often underrecognized and linked to increased morbidity and mortality, particularly in older adults. They emphasize the importance of screening for this condition in symptomatic and high-risk patients, as well as the need for a comprehensive treatment approach that prioritizes nonpharmacological strategies before considering medication. The paper highlights that treatment should focus on symptom relief and fall prevention rather than solely on blood pressure measurements.