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Quality and safety in the literature: August 2024
  1. Abiola Alaka1,
  2. Ashwin Gupta1,2,
  3. Nathan Houchens1,2
  1. 1 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  2. 2 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Abiola Alaka, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA; alakaa{at}

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from high-impact medical journals.

Key points

  • In a multiclinic, randomised clinical trial, a clinical decision support (CDS) tool that nudged primary care practitioners to evidence-based monitoring and treatment for patients with chronic kidney disease and hypertension led to a greater mean systolic blood pressure change as well as more patients receiving an action aligned with the CDS recommendations in the intervention group compared with the usual care group. JAMA Intern Med, 11 Mar 2024

  • A systematic review that examined system-level interventions implemented to enhance guideline-directed medical therapy (GDMT) for heart failure found that interdisciplinary interventions (eg, heart failure clinics) were the most common and effective—particularly for GDMT titration—whereas other types of interventions (eg, audits, electronic health record alerts, education) yielded variable results. JAMA Cardiol, 1 Apr 2024

  • A pragmatic randomised trial showed that maintenance weight loss interventions in a primary care setting can effectively sustain weight loss over 2 years in patients with obesity, with both monthly and refresher online interventions preventing weight regain significantly more than a control group receiving only educational newsletters. JAMA Intern Med, 11 Mar 2024

Clinical Decision Support for Hypertension Management in Chronic Kidney Disease: A Randomized Clinical Trial

JAMA Intern Med, 11 Mar 2024

Chronic kidney disease (CKD) is a global health challenge, affecting approximately 8–16% of the world’s population,1 and is associated with comorbidities such as hypertension.2 Hypertension is independently associated with significant morbidity and cost.2 3 In the USA alone, healthcare costs of hypertension were estimated to be greater than $130 billion between 2003 and 2014.3 …

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  • X @ashwin_b_gupta, @nate_houchens

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.