JAMA internal medicine
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JAMA internal medicine · Oct 2014
Comparative Study Observational StudyAssociation of treatment with carvedilol vs metoprolol succinate and mortality in patients with heart failure.
The β-blockers carvedilol and metoprolol succinate both reduce mortality in patients with heart failure (HF), but the comparative clinical effectiveness of these drugs is unknown. ⋯ These findings from real-world clinical practice indicate that the effectiveness of carvedilol and metoprolol succinate in patients with HF is similar.
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JAMA internal medicine · Oct 2014
How cardiologists present the benefits of percutaneous coronary interventions to patients with stable angina: a qualitative analysis.
Patients with stable coronary artery disease (CAD) attribute greater benefit to percutaneous coronary interventions (PCI) than indicated in clinical trials. Little is known about how cardiologists' presentation of the benefits and risks may influence patients' perceptions. ⋯ Few cardiologists discussed the evidence-based benefits of angiogram and PCI for stable CAD, and some implicitly or explicitly overstated the benefits. The etiology of patient misunderstanding is likely multifactorial, but if future quantitative studies support the findings of this hypothesis-generating analysis, modifications to cardiologists' approach to describing the risks and benefits of the procedure may improve patient understanding.
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JAMA internal medicine · Oct 2014
Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.
Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. ⋯ Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.
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JAMA internal medicine · Oct 2014
Hypoglycemia after antimicrobial drug prescription for older patients using sulfonylureas.
Certain antimicrobial drugs interact with sulfonylureas to increase the risk of hypoglycemia. ⋯ Prescription of interacting antimicrobial drugs to patients on sulfonylureas is very common, and is associated with substantial morbidity and increased costs.