30-Second Takeaway
- EHR-integrated obesity workflows and mailed FIT programs can shift panel-level weight and colorectal screening outcomes.
- Young adults with markedly elevated LDL-C remain undertreated, missing a key window for ASCVD prevention.
- Clinic time-of-day and team-based models meaningfully affect hypertension adherence and treatment intensification.
- PAD, metabolic syndrome, and cervical screening gaps cluster in socially patterned ways, requiring targeted outreach.
- Rising ADHD prescribing underscores growing behavioral health demand and need for careful medication stewardship.
Week ending December 13, 2025
Practice-Level Levers for Cardiometabolic, Cancer, and Behavioral Risk in Primary Care
EHR-Integrated PATHWEIGH Workflow Slightly Reduces Population Weight Gain
In 56 Colorado primary care clinics, PATHWEIGH produced small but statistically significant population-level weight reductions over 18 months. Among 274,182 adults with BMI ≥25 kg/m², PATHWEIGH lowered weight by 0.29 kg at 6 months versus counterfactual usual care. The total adjusted weight difference reached 0.58 kg through 18 months, indicating durable but modest impact. PATHWEIGH increased odds of receiving weight-related care (OR 1.23; 95% CI 1.16–1.31). Patients receiving weight-related care lost 2.36 kg more over 18 months, while even those without such care had attenuated weight gain.
Culturally Tailored Mailed FIT Plus Navigation Improves CRC Screening at 45–49
A safety-net primary care clinic mailed FIT kits with bilingual, health-belief–based messaging to unscreened adults aged 45–49. Of 589 mailed FITs, 24% were returned, with higher return among Hispanic versus non-Hispanic patients (29% vs 21%). Navigation with tailored education, bilingual calls, and reminders led to 16% of outstanding FITs eventually returned. Eleven FITs were positive; eight had colonoscopy, revealing three advanced adenomas. This QI project shows mailed FIT plus culturally tailored navigation can raise screening and narrow disparities in newly eligible adults.
Statin Initiation and Follow-Up Lipids Are Rare in Young Adults with High LDL-C
Among 771,681 Kaiser Southern California adults aged 18–39 with first elevated LDL-C, follow-up testing and statin use were low. Only 1.9% had LDL-C ≥190 mg/dL, and just 28.4% of them started statins within 1 year, 45.7% within 5 years. For LDL-C 160–189 mg/dL plus high 30-year ASCVD risk, 25.3% initiated statins within 1 year, rising to 46.4% by 5 years. From 2008 to 2018, 1-year follow-up lipid testing fell from 52.5% to 35.4% in high-risk young adults, and statin initiation also declined. These data highlight substantial care gaps and missed opportunities to limit lifetime LDL exposure and premature ASCVD.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.