JAMA internal medicine
Audio Summaries

Multilevel Stewardship Intervention for Use of Anticoagulation-Antiplatelet Therapy

Jun 22, 2026

The authors aimed to evaluate the effectiveness of a multilevel antithrombotic stewardship initiative in reducing unnecessary antiplatelet use among patients prescribed direct oral anticoagulants (DOACs). The study found that the combined interventions, which included educational outreach and modifications to electronic health records, led to a significant reduction in antiplatelet prescriptions, particularly in patients with stable coronary artery disease. This highlights the potential of scalable stewardship approaches to improve medication safety and adherence to evidence-based practices.

Apolipoprotein L1 Gene Genotype and Kidney Outcomes After Living Kidney Donation

Jun 22, 2026

The authors aimed to investigate the association between apolipoprotein L1 gene (APOL1) polymorphisms and kidney function outcomes following living kidney donation. Their findings indicate that Black kidney donors with high-risk APOL1 genotypes are at a significantly increased risk of developing reduced kidney function post-donation, suggesting that APOL1 genotyping should be considered for Black living donor candidates to improve risk assessment.

2024-2025 COVID-19 Vaccine and Major Adverse Cardiovascular Events Among US Veterans

Jun 15, 2026

The study aimed to determine whether the 2024-2025 COVID-19 vaccine reduces the risk of COVID-19-associated major adverse cardiovascular events (MACEs) among US veterans. The findings indicated that the vaccine was associated with a 37.7% reduction in COVID-19-associated MACEs, particularly in individuals over 75 years old and those with comorbidities, while also showing a more substantial reduction in all-cause MACEs. This suggests that the vaccine may provide broader protective benefits beyond COVID-19-related complications.

Estimated Effectiveness of 2024-2025 COVID-19 Vaccines in Adults

Jun 15, 2026

The authors aimed to assess the effectiveness of the 2024-2025 COVID-19 vaccines in preventing medically attended COVID-19 cases among adults in the U.S. Their findings indicate that vaccination was associated with a 26% to 41% reduction in the likelihood of COVID-19-related emergency department visits, hospitalizations, and critical illness, with effectiveness waning over time since vaccination. This underscores the importance of COVID-19 vaccinations for both immunocompetent and immunocompromised adults.

Structured Telehealth Community Health Worker-Clinician Feedback and Diabetes Outcomes: A Randomized Clinical Trial

Jun 8, 2026

The authors aimed to evaluate the effectiveness of a multidimensional intervention involving telementored community health workers (CHWs) and a structured feedback loop on improving diabetes outcomes among low-income, uninsured adults with type 2 diabetes. The randomized clinical trial demonstrated that the intervention significantly reduced hemoglobin A1c and cholesterol levels while enhancing adherence to diabetes care guidelines, suggesting that structured feedback may help address care fragmentation in underserved populations.

Rehospitalization and the Association of Postoperative Delirium With Cognitive Decline in Older Adults

Jun 8, 2026

This study aimed to determine whether the cognitive decline associated with postoperative delirium in older adults is mediated by illness and frailty, as indicated by recurrent hospitalizations. The findings revealed that while delirium was linked to greater cognitive decline and increased rehospitalization rates, rehospitalization did not significantly mediate the relationship between delirium and long-term cognitive decline. The authors suggest that further research is necessary to explore the underlying mechanisms connecting delirium to cognitive deterioration.

Evaluating the Consequences of a Hypertension Management Incentive

Jun 1, 2026

The authors aimed to evaluate the impact of a physician-facing quality metric and financial incentive for hypertension control on clinical decisions and health outcomes. Their study found that while the incentive increased the likelihood of blood pressure remeasurement and documentation of hypertension control in patients with marginally high blood pressure, it did not significantly improve overall hypertension management or reduce cardiovascular hospitalizations, which actually increased among this subgroup. These findings suggest that financial incentives may lead to selective practices without enhancing patient health outcomes.

Spinal Manipulation and Clinician-Supported Self-Management for Preventing Chronic Low Back Pain Impact: The PACBACK Randomized Clinical Trial

Jun 1, 2026

The study aimed to determine the effectiveness of spinal manipulation and clinician-supported biopsychosocial self-management compared to standard medical care in preventing chronic impactful low back pain (LBP) in patients at elevated risk. Results indicated that clinician-supported self-management led to a statistically significant reduction in LBP impact scores and improved secondary outcomes compared to medical care, while spinal manipulation did not provide additional benefits. Overall, the findings suggest that clinician-supported self-management may be a more effective approach for managing acute or subacute LBP to prevent chronicity.

Medication Management Among Older Adults Living Alone With Cognitive Impairment

May 26, 2026

The authors aimed to identify the barriers and facilitators to medication management faced by older adults living alone with cognitive impairment and their social contacts. Through qualitative interviews with 116 older adults and 54 social contacts, the study revealed significant individual, interpersonal, and systemic challenges that hinder effective medication management. The findings underscore the need for targeted interventions and increased support services to assist this vulnerable population in managing their medications safely.

Rapid Respiratory Microbiological Point-of-Care Testing and Antibiotic Use in Primary Care: A Randomized Clinical Trial

May 18, 2026

This randomized clinical trial aimed to determine whether rapid multiplex microbiological point-of-care testing (RM-POCT) could safely reduce same-day antibiotic prescribing for patients with respiratory infections in primary care settings. The results indicated that RM-POCT did not significantly decrease antibiotic prescriptions compared to usual care, nor did it negatively impact patient-reported symptom severity. However, the study found some evidence of reduced prescribing in specific subgroups, such as those with detected viral infections.