Family Medicine

Telehealth DSMES with family involvement improves perceived support but not HbA1c vs standard DSMES

This telehealth RCT randomized 550 diverse adults with type 2 diabetes and their support persons to Family-DSMES or Standard-DSMES across eight clinics. Both groups had statistically and clinically significant HbA1c reductions at all time points, with no between-arm differences in biometric or behavioral outcomes. Attendance and engagement were similar across arms, with slightly higher mean attendance in the Family-DSMES group. Family-DSMES produced greater improvement in diabetes-related helpful family involvement compared with Standard-DSMES. 1

Adolescent depression and suicide screening is high, but interim monitoring remains uncommon

This EHR-based cohort analyzed 406,192 well-visits for adolescents aged 12–17 years from 2018–2024 in a large primary care network. PHQ-9-M screening compliance rose from 82.1% to 96.0%, with high overall compliance after universal screening implementation. Depression and suicide risk detection rates were generally stable, with the highest rates observed in 2021. Fewer than 8% of adolescents screening positive for depression and fewer than 7% for suicide risk received interim symptom monitoring between well-visits. 2

Patient portal lung screening tool modestly improves eligibility identification and CT ordering

This pragmatic RCT tested MyLungHealth, a patient portal tool plus clinician decision support, versus clinician-facing support alone in primary care. Over 31,000 adults aged 50–79 years with smoking history were randomized across two health systems. Among patients with uncertain eligibility, the intervention more than doubled new identification of lung cancer screening eligibility (adjusted OR 2.19; 95% CI 1.99–2.42). Among clearly eligible patients, low-dose CT ordering increased modestly with MyLungHealth (20.5% vs 19.2%; adjusted OR 1.16; 95% CI 1.04–1.30). 3

Lipid therapy and LDL monitoring are declining in diabetes, especially for primary prevention

This population-level cohort from Wales followed 282,581 patients with diabetes between 2010 and 2023 using linked health data. Diabetes incidence and prevalence increased substantially over the study period. Among patients with established ASCVD, lipid-lowering therapy use dropped from 87.5% to 81.8%, and LDL-C testing rates decreased modestly. In primary prevention, lipid therapy declined markedly, including from 78.9% to 54.9% in diabetes with CKD and from 70.7% to 55.6% without CKD. 4