30-Second Takeaway
- Mail-based PPI deprescribing tools for patients and GPs meaningfully reduce long-term PPI exposure without worsening GERD symptoms.
- PREVENT equations show strong CVD risk discrimination in real-world EHRs, even with median imputation for missing data.
- Primary care–based AUD clinics reduce short-term alcohol-related hospital use, especially for patients already linked to a PCP.
- Youth anxiety, mood disorders, and ADHD visits surged after COVID, especially among older adolescent girls, though rates are now slowly declining.
- Food insecurity, frailty, and cost-related barriers strongly predict future clinical and social risk, highlighting targets for screening and intervention.
Week ending April 18, 2026
From PPIs to PREVENT: Practical Updates for Risk, Resilience, and Resource-Sensitive Primary Care
Mailed deprescribing package cuts chronic PPI use without worsening GERD
In this French cluster RCT of 34,409 long-term PPI users, a combined patient- and GP-facing package increased ≥50% annual PPI dose reduction to 14.9%. This compared with 7.0% under usual care and 7.7% with a GP-only algorithm letter, with adjusted absolute differences around 7 percentage points. The intervention mailed patients an educational deprescribing brochure and sent GPs a structured deprescribing algorithm. Gastroesophageal Reflux Disease Impact Scale scores were similar across groups, suggesting symptom control was maintained despite dose reductions.
PREVENT CVD equations perform well in a large real-world EHR cohort
This Duke EHR study evaluated PREVENT CVD risk equations in over 400,000 adults aged 30–79 without baseline CVD. PREVENT discrimination was strong in both complete and missing-data cohorts, with C-indices around 0.75–0.77 for men and women. Allowing missing labs and vital signs with race-sex median imputation preserved discrimination, suggesting robustness to common primary care data gaps. Calibration was generally acceptable, though strict complete-data cohorts showed more risk underestimation, indicating possible need for local recalibration.
Primary care–based AUD clinic engagement lowers short-term alcohol-related hospital use
This retrospective cohort included 463 adults referred to a primary care–based alcohol use disorder clinic at a public hospital. Clinic attendees were more likely to have prior PCP visits and referrals from primary care, and less pre-referral alcohol-related ED or hospital use. Attending at least one clinic visit was associated with lower odds of alcohol-related ED visits or hospitalizations at 6 months (OR 0.59) and 12 months (OR 0.63). The association was not statistically significant at 18 months, suggesting attenuation without sustained engagement.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.