Homepage Round-Up: Reducing PTSD Symptoms Can Lower Diabetes Risk, Pay-for-Performance Programs May Lead to Increased Hospital Readmissions, and More

Here are the top stories covered by DocWire News this week in the Homepage section. In this week’s edition of the round-up: reducing PTSD symptoms can lower the risk of type 2 diabetes, pay-for-performance incentive programs can lead to higher hospital readmissions, there exists a link between e-cigarette use and marijuana use among the youth, and many patients are withholding imminent health information from their physicians.

Patients with posttraumatic stress disorder(PTSD) who exhibit clinically significant reductions in symptoms have a lower risk of developing type 2 diabetes (T2D), according to the findings of a study published in JAMA Psychiatry. In this retrospective cohort study, researchers assessed Veterans Health Affairs medical record data from 5,916 patients (mean age, 42, 84% male, 66% white) who received PTSD specialty care between 2008 and 2012 and were subsequently followed up through 2015. Subsequent to adjustment for confounding, the results suggest patients with a clinically meaningful PCL score decrease were significantly less likely to develop T2DM compared with those without a clinically meaningful decrease (hazard ratio, 0.51; 95% CI, 0.26-0.98). The study authors wrote that “a decrease in PCL score, whether through treatment or spontaneous improvement, may help mitigate the greater risk of T2D in patients with PTSD.”

Pay for performance (P4P) incentive programs, which have been implemented in various hospitals worldwide, can lead to patient discharges associated with return visits and readmissions (RA), according to a study published in Academic Emergency Medicine. To conduct this study, researchers analyzed 813,491 patient visits to the four major EDs in the metro Vancouver area. The study authors wrote that: “Our findings suggest that the pay‐for‐performance program implemented in British Columbia affected the timing of patient disposition in the participating EDs. Such influence includes reduction in the ED length of stay for admitted patients, but possibly higher return‐and‐admission rate for patients who were discharged right before the target time in certain EDs.”

The results of a new study suggest a link between e-cigarette use and marijuana use among adolescents and young adults. The findings were published in JAMA Pediatrics. In this study, researchers combed databases including PubMed, Embase, and Web of Science & ProQuest Dissertations for studies that compared rates of marijuana use among youth between the ages of 10 and 24 years old who had used e-cigarettes vs those who had not from inception to October 2018. According to the results of the study, the odds of marijuana use were higher in youth who had an e-cigarette use history juxtaposed to those who did not (AOR=3.47 [95% CI, 2.63 to 4.59]; I2, 94%). “To our knowledge, this study is the first meta-analysis to summarize the evidence to date about the association between ENDS use and marijuana use among youths,” the study authors wrote in their conclusion.

According to a study published in JAMA Network Open, many patients withhold information from their physicians about imminent health threats that they face. In this survey study, researchers assessed the results of two national nonprobability samples that comprised 2,011 US adults enrolled from Amazon’s Mechanical Turk from March 16-30, 2015. According to the results of this study, among those participants who reported experiencing at least 1 of the 4 imminent threats, 613 of 1,292 MTurk participants (47.5%) and 581 of 1,453 SSI participants (40.0%) withheld information from their clinician. The study authors wrote that: “A better understanding of how to increase patients’ comfort with reporting this information is critical to allowing clinicians to help patients mitigate these potentially life-threatening risks.”