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BackgroundThe prevalence of medical misinformation on the Internet has received much attention among researchers concerned that exposure to such information may inhibit patient adherence to prescriptions. Yet, little is known about information people see when they search for medical information and the extent to which exposure is directly related to their decisions to follow physician recommendations. These issues were examined using statin prescriptions as a case study.MethodsWe developed and used a tool to rank the quality of statin-related web pages based on the presence of information about side effects, clinical benefits, management of side effects, and misinformation. We then conducted an experiment in which students were presented with a hypothetical scenario in which an older relative was prescribed a statin but was unsure whether to take the medication. Participants were asked to search the web for information about statins and make a recommendation to this relative. Their search activity was logged using a web-browser add-on. Websites each participant visited were scored for quality using our tool, quality scores were aggregated for each participant and were subsequently used to predict their recommendation.ResultsExposure to statin-related benefits and management of side effects during the search was significantly associated with a higher probability of recommending that an older relative adhere to their physician's recommendation. Exposure to misinformation and side effects were not associated, nor were any other participant characteristics. Bigram analyses of the top reasons participants gave for their recommendation mirrored the statistical findings, except that among participants who did not recommend following the prescription order, myriad side effects were mentioned.ConclusionsOur findings suggest that units of information people see on health-related websites are not treated equally. Our methods offer new understanding at a granular level about the impact of Internet searches on health decisions regarding evidence-based recommended medications. Our findings may be useful to physicians considering ways to address non-adherence. Preventive care should include actively engaging patients in discussions about health information they may find on the web. The effectiveness of this strategy should be examined in future studies.

AimsTo examine the relative contribution of glycaemic control (HbA1C) and depressive symptoms on diabetes-related symptom burden (hypoglycaemia and hyperglycaemia) in order to guide medication modification.MethodsSecondary analysis of medical records data and questionnaires collected from a racially/ethnically diverse sample of adult patients with type 2 diabetes (n = 710) from seven outpatient clinics affiliated with an academic medical centre over a 1-year period as part of the Reducing Racial Disparities in Diabetes: Coached Care (R2D2C2) study.ResultsResults from linear regression analysis revealed that patients with high levels of depressive symptoms had more diabetes-related symptom burden (both hypoglycaemia and hyperglycaemia) than patients with low levels of depressive symptoms (βs = 0.09-0.17, Ps < 0.02). Furthermore, results from two logistic regression analyses suggested that the odds of regimen intensification at 1-year follow-up was marginally associated with patient-reported symptoms of hypoglycaemia [adjusted odds ratio (aOR) = 1.24, 95% CI: 0.98-1.58; P = 0.08] and hyperglycaemia (aOR = 1.21, 95% CI: 1.00-1.46; P = 0.05), after controlling for patients' HbA1C, comorbidity, insulin use and demographics. These associations, however, were diminished for patients with high self-reported hypoglycaemia and high levels of depressive symptoms, but not low depressive symptoms (interaction terms for hypoglycaemia by depressive symptoms, aOR = 0.98, 95% CI: 0.97-0.99; P = 0.03).ConclusionsMental health symptoms are associated with higher levels of patient-reported of diabetes-related symptoms, but the association between diabetes-related symptoms and subsequent regimen modifications is diminished in patients with greater depressive symptoms. Clinicians should focus attention on identifying and treating patients' mental health concerns in order to address the role of diabetes-related symptom burden in guiding physician medication prescribing behaviour.

Patients who acquire hepatitis C from blood transfusions may become seriously ill. Researchers studied the long-term complications of 131 hepatitis C patients from 1980 to 1994. The most common initial complaints were fatigue, abdominal pain, and enlargement of the liver. The range of symptoms included 67 patients with cirrhosis, 30 patients with chronic active hepatitis, 27 patients with chronic hepatitis, and 7 patients with liver cancer. Seven additional patients developed liver cancer. Liver disease developed years after the transfusion. For example, cirrhosis was diagnosed 3 to 42 years after receiving a blood transfusion. A total of 20 patients died during the follow-up period. All but one died as a direct consequence of liver failure or liver cancer.

In severe osteoporosis, anabolic agents such as teriparatide (Forteo) are more commonly used. As a PTH analog, teripararide has a limited side effect profile with potential for mild hypercalcemia and dyspepsia. In this report we highlight another less common side effect, asymptomatic elevation in alkaline phosphatase., Competing Interests: Conflicts of interest: All authors declare that they have no conflicts of interest., (© 2024 Greater Baltimore Medical Center.)