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Medication reviews focusing on deprescribing can reduce potentially inappropriate medication; however, evidence regarding effects on health‐related outcomes is sparse. In a real‐life quality improvement project using a newly developed chronic care model, we investigated how a general practitioner‐led medication review intervention focusing on deprescribing affected health‐related outcomes. We performed a before–after intervention study including care home residents and community‐dwelling patients affiliated with a large Danish general practice. The primary outcomes were changes in self‐reported health status, general condition and functional level from baseline to 3–4 months follow‐up. Of the 105 included patients, 87 completed the follow‐up. From baseline to follow‐up, 255 medication changes were made, of which 83% were deprescribing. Mean self‐reported health status increased (0.55 [95% CI: 0.22 to 0.87]); the proportion with general condition rated as 'average or above' was stable (0.06 [95% CI: −0.02 to 0.14]); and the proportion with functional level 'without any disability' was stable (−0.05 [95% CI: −0.09 to 0.001]). In conclusion, this general practitioner‐led medication review intervention was associated with deprescribing and increased self‐reported health status without the deterioration of general condition or functional level in real‐life primary care patients. The results should be interpreted carefully given the small sample size and lack of control group. [ABSTRACT FROM AUTHOR]

Background: Poor cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular and all-cause mortality. Yet, our knowledge about the prevalence of poor CRF is limited. We investigated the prevalence of poor CRF among middle-aged Danish adults from a community-based health promotion program, including identification of a subgroup with high cardiovascular mortality risk. Methods: This cross-sectional study included 2,253 middle-aged adults, who completed a preventive health check including CRF testing. CRF (ml O2/min/kg) was assessed using the Astrand-Ryhming cycle ergometer test. High 10-year cardiovascular mortality risk as defined in the Danish 2016 guidelines was assessed using questionnaires, health examinations, and prescription data from the Danish National Prescription Registry. Results: The prevalence of poor CRF was 51.7% (95% confidence interval [CI] 48.7-54.7) among men and 31.3% (95% CI 28.7-34.1) among women. A total of 216 (19.4%) men and 220 (19.3%) women were identified with a high 10-year cardiovascular mortality risk. Among these, 65.0% of men (95% CI 58.2-71.3) and 44.1% of women (95% CI 37.4-50.9) had poor CRF. Conclusion: Half of men and one third of women participating in a community-based health promotion program were identified with poor CRF. Among high-risk individuals, two thirds of men and almost every second woman had a poor CRF. Our results emphasise the need for effective public health strategies and interventions to increase CRF in the general population and among high-risk individuals in particular in order to improve public health and reduce mortality. [ABSTRACT FROM AUTHOR]

Multimorbidity and polypharmacy increasingly challenge healthcare systems. In this review, we discuss the deprescribing of inappriopriate medication, which is essential for improved patient care and optimal use of healthcare resources. Barriers of deprescribing in primary care are multifaceted and exist not only at the general practitioner level or the patient level but also at the organizational, structural, and sociocultural levels. New approaches and tools are emerging. However, the complexity of this challenge calls for broad healthcare initiatives and policies to reduce inappropriate prescribing.

Primary autoimmune neutropenia (AIN) is characterised by severe neutropenia and the presence of granulocyte reactive autoantibodies. The pathogenesis of the disease remains unknown and the disease is believed to be underdiagnosed. AIN occurs predominantly at the age of 6-24 months and despite severe neutropenia the symptomatology covers mainly benign infections. Serious bacterial infections might occur and some patients thus may benefit from treatment with prophylactic antibiotics or granulocyte growth factor. Spontaneous remission usually occurs within 30 months from the time of diagnosis.

Neonatal alloimmune neutropenia (NIN) results from the destruction of foetal neutrophils by maternal immunoglobulin G-class neutrophil-reactive antibodies crossing the foeto-placental barrier. We report two cases of neonatal patients presenting with unspecific symptoms and persisting neutropenia accompanied by thrombocytosis. Both were subsequently diagnosed with NIN. These two cases of persisting neutropenia highlight the diversity of symptoms and the diagnostic challenges remaining in NIN. Furthermore, the cases remind us that neutropenia in neonates may be rooted in several different pathophysiological mechanisms.