30-Second Takeaway
- Reassess CNS-active and preventive medications in frail older adults, aligning with function, cognition, and life expectancy.
- Expand CGM use for insulin-treated type 2 diabetes while explicitly addressing language, insurance, and age-related access barriers.
- Use team-based QI and pharmacist support to improve hypertension control and deprescribing in polypharmacy.
- Individualize cancer screening and deprescribing in older adults through explicit conversations about goals, trade-offs, and preferences.
- Incorporate local vaccine exemption trends and medical debt–linked housing instability into anticipatory guidance and social risk screening.
Week ending January 17, 2026
Practice pivots from recent evidence: deprescribing, screening, diabetes tech equity, and social risk
Potentially inappropriate CNS-active prescribing remains common in older adults, including those with cognitive impairment
This cohort study examined prescribing patterns of potentially inappropriate CNS-active medications in older adults, comparing those with and without cognitive impairment. Substantial use of CNS-active drugs in this population raises concern for falls, delirium, and accelerated cognitive decline. The findings emphasize routine review of anticholinergics, benzodiazepines, sedative-hypnotics, and other CNS agents in older patients. Family physicians should prioritize deprescribing and nonpharmacologic alternatives, especially for patients with dementia or high fall risk.
CGM prescribing in safety-net primary care is low and inequitable for insulin-treated type 2 diabetes
In a Bronx safety-net network of 11,037 adults with insulin-treated type 2 diabetes, only 17% received first-time CGM prescriptions from primary care. Older, Spanish-speaking, and publicly insured patients were less likely to receive CGM, despite comparable diabetes burden. Higher HbA1c, more intensive insulin regimens, and more experienced PCPs were associated with more CGM prescribing, regardless of race-ethnicity. These patterns suggest workflow, language, and insurance barriers that clinicians and systems must address to expand equitable CGM access.
A hub-and-spoke learning health system improved hypertension control across primary care sites
Ohio’s Medicaid-funded Quality Improvement Hub implemented a hub-and-spoke Learning Health System model across ten primary care sites. Among 22,563 hypertensive adults, blood pressure control improved from 72.9% to 79.1%, a 6.2–percentage point relative gain. Centralized data extraction, an interactive dashboard, and tailored coaching on PDSA cycles enabled near real-time feedback and site-specific changes. Gains varied across clinics, and staffing instability limited progress in under-resourced sites, underscoring the importance of workforce support.
Older Swiss adults with multimorbidity and polypharmacy are frequently screened for cancer despite limited expected benefit
This nationwide Swiss survey analyzed colorectal, breast, cervical, and prostate cancer screening among 2,108 adults older than 75 years. Overall, 24% reported any cancer screening in the previous 12 months, including many with multimorbidity and polypharmacy. Screening was more common in those with multiple morbidities and polypharmacy than in healthier peers, despite lower likelihood of benefit. Screening rates were lower only among those with substantial functional limitations, suggesting incomplete alignment with prognosis-based recommendations.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.