30-Second Takeaway
- App-based psychological interventions in primary care moderately improve depressive symptoms and distress but show no clear anxiety benefit.
- Annual Wellness Visits substantially increase timely advance care planning for patients with new cognitive impairment.
- EHR-embedded tobacco treatment systems modestly boost maternal smoking cessation in pediatric primary care.
- Team-based, virtual benzodiazepine tapering with brief CBT appears feasible and substantially reduces doses in older adults.
- Structured nurse-led postdischarge phone calls reduce short-term ED visits without changing readmission rates.
Week ending March 21, 2026
Primary care levers for mental health, preventive care, and high‑risk transitions
Mobile mental health apps in primary care modestly improve depression and distress
Across 11 RCTs in primary care adults with depression or anxiety, app-based psychological interventions improved overall distress vs treatment as usual. Depressive symptoms showed a moderate benefit (SMD about -0.5), while limited data showed no significant improvement in anxiety symptoms. Quality of life improved slightly, suggesting modest functional gains rather than transformational change. Dropout was higher with apps, highlighting adherence and engagement as key implementation challenges in family medicine. Follow-up reporting was sparse and heterogeneous, so durability of benefit remains uncertain.
Insurance loss in low-income patients with diabetes is linked to worse outcomes
This case-control study examined how losing insurance coverage affects diabetes outcomes among low-income patients at community health centers. Findings link coverage loss to poorer glycemic and complication outcomes, underscoring insurance stability as a core diabetes intervention. For family physicians, proactive outreach around coverage changes may be as critical as medication intensification. Results support advocacy for continuous insurance coverage as a population-level diabetes control strategy.
EHR-embedded tobacco treatment modestly increases maternal cessation in pediatric care
Twelve pediatric practices implemented either screening alone or an automated EHR-linked tobacco treatment system for parents. The system combined screening, motivational messaging, and automatic connection to nicotine replacement, SmokefreeTXT, and quitline referral. Among mothers who smoked, cessation was higher with the system than screening alone (37.4% vs 33.5%). Overall maternal smoking prevalence and fathers’ cessation rates did not significantly change, suggesting sex-specific engagement differences. The approach is scalable and illustrates how pediatric or family visits can trigger adult cessation treatment.
Annual Wellness Visits drive earlier advance care planning after new cognitive diagnoses
Nearly one million Medicare beneficiaries aged 68 and older with new MCI or ADRD were followed using claims data. Those receiving an Annual Wellness Visit had substantially higher ACP initiation over four years than nonrecipients (27.6% vs 17.5%; HR 1.86). Many ACP discussions occurred on the same day as the AWV, highlighting this visit as a practical trigger point. Associations were consistent across subgroups and particularly strong in Hispanic and nonmetropolitan patients, suggesting disparity reduction potential. Results support embedding structured ACP into AWV workflows for patients with cognitive impairment.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.