Tag: Liao

Reading of the Week: GLP-1 Receptor Agonists for Obesity & Alcohol – the New Lancet Study; Also, Drs. Liao and Fombonne on Autism Overdiagnosis

From the Editor

It could be lifesaving for those with diabetes. And many others are taking GLP-1 receptor agonists, ranging from people with medical conditions such as obesity to those who have cosmetic interests. GLP-1 receptor agonists are having a moment. Could they also be helpful for patients with substance problems? Some small studies suggest yes.

In a major new Lancet study, Dr. Mette Kruse Klausen (of Copenhagen University) and her co-authors attempt to answer that question. They report on a RCT involving patients with both obesity and alcohol use disorder. 108 Danish participants were randomized to the GLP-1 receptor agonist semaglutide or placebo. At six months, adults taking semaglutide reported five heavy drinking days in the previous months (down 41%) compared to nine days in the placebo group. “To our knowledge, this RCT is the first to show that once-weekly semaglutide reduces heavy drinking days and WHO drinking-risk levels in treatment-seeking patients with alcohol use disorder and comorbid obesity.” We consider the paper, the accompanying editorial, and its implications.

In this week’s other selection, a Viewpoint paper from JAMA Pediatrics, Drs. Lester Liao (of McGill University) and Eric Fombonne (of the Oregon Health & Science University) write on autism and overdiagnosis. “Diagnostic practices geared to accessing resources, incorrect diagnostic practices, increased attention, changes to diagnostic criteria and thresholds, and fundamental cultural shifts have contributed.”

DG

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Reading of the Week: How to Change Docs? Send Them a Letter. The New JAMA Psychiatry Paper on Prescribing

From the Editor

How do we get doctors to practice better medicine?

Here’s a simple idea: what if we send them a sternly written letter? In this week’s Reading, we consider a paper by Columbia University’s Adam Sacarny and his co-authors who did just that. Targeting primary care physicians who were heavily prescribing quetiapine (or Seroquel), they looked at the effects of letters written by government officials, comparing prescribing habits of these physicians with their peers. The result? In the new JAMA Psychiatry paper, they find that prescriptions of quetiapine dropped markedly.

nudge

A little nudge, better care?

The core of the idea is that a nudge – that is, the behavioural economic idea of a positive reinforcement and/or an indirect suggestion – can change outcomes. In this Reading, we consider doctors and nudges (and behavioural economics). We also look at a recent study on opioid prescribing, also involving letters.

DG

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