In this edition, we look at the most-read articles in BMJ Open from August. The Top 10 is compiled based on full text views, including downloads of the full article PDFs. In August, there were five new entries from researchers around the world investigating a broad range of topics.

Life expectancy trends

As highlighted in recent communications on this site (see details here and here), two of our new Top 10 entries this month, investigate trends in mortality and inequalities in life expectancy in high-income countries. At number one, Wilkie and Ho found that, among six high-income Anglophone countries (USA, UK, Canada, Australia, Ireland and New Zealand), Australia leads the way in life expectancy at birth at the national level. Further analysis of geographic trends revealed that in contrast to Australia, Ireland, New Zealand and the USA tend to experience the highest levels of within-country inequality in mortality. The authors propose that Australia may serve as a potential model for other countries to follow in efforts to improve life expectancy and reduce premature mortality. In fifth place in our Top 10, Bergeron-Boucher et al., analysed the interplay between social determinants of health and inequalities in lifespan in the USA. The authors report a complex interaction among social determinants of health (i.e. sex, race, marital status and education level) and lifespan inequalities. In addition, the authors propose a scoring system that may aid the assessment of this risk and help identify subgroups at higher risk of mortality. 

Intellectual disability liaison nurse care

Sheehan et al., used data from the Learning from Lives and Deaths mortality review programme to investigate the association between intellectual disability liaison nurse input and quality of care of adults with intellectual disability accessing in-patient care in general hospitals in England. The authors report that 34.1% of adults with intellectual disability who died in hospital between 2016 and 2021 received input from an intellectual disability liaison nurse, and this input was associated with region, cause of death and multimorbidity. Although intellectual disability liaison nurse input was not associated with a rating of overall quality of care, it was associated with increased likelihood of reasonable adjustments and of best practice being identified.

COVID-19 health outcomes

In their follow-up observational study, Dai et al., analysed the health outcomes of hospitalised COVID-19 patients in Wuhan, China, three years post-hospital discharge. The authors found that, although the majority of patients returned to an asymptomatic state,182 (11.4%) patients still complained of at least one symptom such as fatigue, myalgia, chest tightness, cough, anxiety, shortness of breath and expectoration. The authors highlight the need for larger scale longitudinal studies to comprehensively investigate the long-term effects of COVID-19 on patients.

Antibiotic prescribing

And finally, Zimbwe et al. investigated antibiotic prescribing and use patterns for inpatients in Dodoma, Tanzania. Using the World Health organisation-Point Prevalence Survey on 286 prescriptions, 30.07% of these prescriptions included antibiotics, which the authors report is half the rate reported previously in 2019 (65.6%). Although improvements in prescribing trends were found, the authors note that this study represents a snapshot survey and that further work is needed to boost adherence to the National Treatment guidelines, including improved use of antimicrobial susceptibility testing.