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Quality & safety in the literature
Quality and safety in the literature: November 2020
  1. James Uebel1,2,
  2. Ashwin Gupta1,2,
  3. Nathan Houchens1,2
  1. 1Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
  2. 2Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
  1. Correspondence to Dr James Uebel, University of Michigan and Veterans Affairs Ann Arbor Healthcare System, Michigan, MI 48105, USA; juebel{at}med.umich.edu

https://doi.org/10.1136/bmjqs-2020-012276

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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, while others will highlight unique publications from high-impact medical journals.

    Key points

    • For patients who have sustained a myocardial infarction, low-cost interventions (eg, mail-outs and telephone calls) to augment secondary prevention increase uptake of cardiac rehabilitation but not adherence to medications. BMJ. 08 April 2020.

    • A policy change that eliminated reimbursement for population-based screening of vitamin D deficiency led to a marked decrease in low-value testing, while recommendations from the Choosing Wisely campaign had only a small effect on vitamin D screening and no effect on low-value testing of triiodothyronine. JAMA Intern Med. 10 February 2020.

    • In a cluster randomised clinical trial, a decision aid for women aged 75–89 years led to fewer mammograms and increased knowledge about mammography screening. JAMA Intern Med. 20 April 2020.

    Interventions Supporting Long-term Adherence and Decreasing (ISLAND) cardiovascular events after MI: a pragmatic randomised controlled trial

    BMJ. 8 April 2020

    Medications have received substantial attention in the field of patient safety in the form of attention to medication errors and preventable adverse drug events.1–6 Other efforts to measure and improve healthcare quality have focused on problems of underprescribing of effective medications and overprescribing of ineffective ones.6 7 By contrast, the well-known problem of medication non-adherence, when patients do not consistently take their medications as prescribed, has received relatively little attention in the healthcare quality literature.8 Yet, why bother to focus on evidence-based medications if non-adherence prevents the intended health outcome improvements from occurring? When the medications in question have well-established benefits on morbidity and mortality, as in the case of medications indicated for …

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    Footnotes

    • Twitter @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.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.