{"id":172,"date":"2007-04-02T09:57:37","date_gmt":"2007-04-02T08:57:37","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/04\/02\/arch-intern-med-26-mar-2007\/"},"modified":"2007-04-02T09:57:37","modified_gmt":"2007-04-02T08:57:37","slug":"arch-intern-med-26-mar-2007","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/02\/arch-intern-med-26-mar-2007\/","title":{"rendered":"Arch Intern Med  26 Mar 2007"},"content":{"rendered":"<p>We dole them out, but 20-50% of the pills we prescribe remain on the shelf.<!--more--> This <a href=\"http:\/\/archinte.ama-assn.org\/cgi\/content\/abstract\/167\/6\/540\">systematic review of interventions to enhance medication adherence in chronic medical conditions<\/a> finds 37 eligible trials, which show that a number of different interventions can improve adherence, but none definitely improve clinical outcomes.<br \/>\nIn UK primary care, we have been shoved towards a chronic care model for the management of chronic obstructive pulmonary disease, and I can\u2019t help feeling this must be a good thing, even though the only intervention which makes much difference is smoking cessation. What does a <a href=\"http:\/\/archinte.ama-assn.org\/cgi\/content\/abstract\/167\/6\/551\">systematic review<\/a> show? As usual, that there is a need for further well-designed trials: those that have been done show fewer hospital admissions with managed care, but no differences in function or mortality.<br \/>\nNearly 80,000 nurses contributed information on health and medication to the Nurses\u2019 Health Study from 1980 onwards. <a href=\"http:\/\/archinte.ama-assn.org\/cgi\/content\/abstract\/167\/6\/562\">The ones who took aspirin<\/a> showed a reduction in cardiovascular death after 5 years and a reduction in cancer death after 10 years. Does this amount to proof that all women over a certain age should take low-dose aspirin? Not quite, but it\u2019s beginning to look that way.<br \/>\nAfrican Americans have higher rates of cardiovascular disease (and die on average five years younger) than white Americans.\u00a0 <a href=\"http:\/\/archinte.ama-assn.org\/cgi\/content\/abstract\/167\/6\/573\">Do we know why?<\/a> Actually, we do: 90% of their events are explicable on the basis of known major risk factors, compared with only 65% in white subjects. We need a similar study in the UK Afro-Caribbean population.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>We dole them out, but 20-50% of the pills we prescribe remain on the shelf. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/02\/arch-intern-med-26-mar-2007\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-172","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Arch Intern Med 26 Mar 2007 - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/02\/arch-intern-med-26-mar-2007\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Arch Intern Med 26 Mar 2007 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"We dole them out, but 20-50% of the pills we prescribe remain on the shelf. 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