Family Medicine

Behavioral EHR nudges increased deprescribing of sedating and anticholinergic drugs in older adults

This cluster RCT included 201 PCPs and 1146 patients aged 65 or older on benzodiazepines, Z-drugs, or multiple anticholinergics. Two EHR-based behavioral nudges prompted PCPs to discuss and initiate deprescribing at index and subsequent visits. Overall, 32.5% of patients had at least one targeted medication deprescribed during roughly 9 months of follow-up. Deprescribing occurred in 36.8% of patients in the precommitment arm and 34.3% with boostering versus 26.8% with usual care. 1

Serious vascular events at ages 30–44 often occur despite low 10-year risk scores

This UK population-based study identified 217 incident vascular events in adults aged 30–44 over 433,797 person-years. Among 155 individuals eligible for a proposed earlier NHS health check, median premorbid QRISK3 10-year risk was only 2.5%. Ninety-five percent were below the 10% treatment threshold, and none of 49 affected women exceeded this cutoff. Yet the mean healthy-heart-age gap was 9 years, and 88% had at least one treatable risk factor above target. 2

Statewide QI support modestly improved blood pressure control in nearly 300,000 adults

The Heart Healthy Ohio Initiative used EHR data from 48 primary care clinics caring for 293,638 adults, including 107,216 with hypertension. Clinics implemented standardized hypertension strategies: accurate BP measurement, timely follow-up, treatment protocols, and outreach, supported by monthly coaching and data feedback. BP control (<140/90 mmHg) improved from 67.7% pre-intervention to 70.7% post-intervention. Rural and uninsured patients saw control gains greater than 6%, while Medicaid enrollees, younger adults, and women improved by about 2%. 3