Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
Improving Medication Adherence through Graphically Enhanced Interventions in Coronary Heart Disease (IMAGE-CHD): a randomized controlled trial.
Up to 50 % of patients do not take medications as prescribed. Interventions to improve adherence are needed, with an understanding of which patients benefit most. ⋯ The interventions did not improve adherence overall. Illustrated medication schedules may improve adherence among patients with low self-efficacy, polypharmacy, or baseline non-adherence, though this requires confirmation.
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Comparative Study
Symptom burden of adults with type 2 diabetes across the disease course: diabetes & aging study.
Reducing symptom burden is paramount at the end-of-life, but typically considered secondary to risk factor control in chronic disease, such as diabetes. Little is known about the symptom burden experienced by adults with type 2 diabetes and the need for symptom palliation. ⋯ In a diverse cohort of adults with type 2 diabetes, pain and non-pain symptoms were common among all patients, not only among those near the end of life. However, symptoms were more prevalent among patients with shorter survival. Older adults reported more physical symptoms, whereas younger adults reported more psychosocial symptoms. Diabetes care management should include not only good cardiometabolic control, but also symptom palliation across the disease course.
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Randomized Controlled Trial Comparative Study
Racial differences in the effect of a telephone-delivered hypertension disease management program.
African Americans are significantly more likely than whites to have uncontrolled hypertension, contributing to significant disparities in cardiovascular disease and events. ⋯ The combination of home BP monitoring, remote medication management, and telephone tailored behavioral self-management appears to be particularly effective for improving BP among African Americans. The effect was not seen among non-Hispanic white patients.
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It is increasingly apparent that human health is reliant on our fellow travellers, the innumerable microorganisms that inhabit our bodies. This realization has led to the concept of the superorganism, which suggests that shared metabolic and signalling pathways are crucial for optimal existence of both host and commensal microflora. This commentary focuses on implications of this paradigm for personalized medicine and therapeutics. ⋯ Probiotics can potentially modulate the superorganism for therapeutic benefit. However, the probiotics industry will need to undergo a transformation, with increased focus on stringent manufacturing guidelines and high-quality clinical trials. Ultimately, we suggest that healthcare will move beyond its prevailing focus on human physiology, and embrace the superorganism as a paradigm to understand disease.