Primary Study

A Danish register-based cohort of 19,080 patients finds uptake of exercise-based cardiac rehabilitation rose by 16% after decentralisation to primary care, and by 45% among those living furthest away, with uptake as the outcome and not clinical benefit.

A cohort of 133,846 veterans aged 65 and over with dementia finds enrolees in home-based primary care were 3.60 percentage points less likely to use emergency or urgent care, although the raw rate was higher among enrolees and the estimate rests on the instrument.

A six-country cluster-randomised trial of 1,260 older multimorbid patients found no difference in unplanned hospitalisation, in a population with high baseline guideline adherence and low app use.

A US Medicare claims cohort of 23,036 older adults finds rurality, ethnicity, marital status and Medicaid eligibility were independently associated with less home health and outpatient rehabilitation within 90 days of discharge.

A cohort of 1,064 outpatient antibiotic episodes at a large UK teaching hospital finds self-administration no less safe than nurse-delivered or clinic-based care overall, while identifying the patients in whom it failed more often.

A population-based matched cohort of 51,377 hospital patients in Ontario finds delayed-discharge designation 9.1% for patients with recent homelessness against 2.0% for matched patients from the most materially deprived neighbourhoods.

A multicentre prospective cohort of 465 older adults across ten Spanish hospitals finds frailty and medical comorbidity, more than psychiatric history or diagnosis, associated with early mortality after liaison psychiatry assessment.

A national insurance-backed pilot across seven Taiwanese nursing homes finds hospital-at-home care for acute infections cut costs by up to 65% with safety preserved against hospitalised matched controls.

A multi-method study of 3,282 patient experience surveys and 52 interviews in an Australian acute respiratory virtual hospital finds patients and carers took on new technical and digital support roles, with carers acting as extensions or substitutes for patients who could not perform them.

A Taiwanese retrospective cohort study, matched against both an inpatient and an outpatient comparator, finds emergency-department-initiated outpatient parenteral antimicrobial therapy saves hospital bed-days but carries a transient early return-visit risk.

A prospective multicentre cohort study of 1,730 patients across eight Spanish hospitals finds 19.7% reattempted suicide within 12 months, with medication burden, suicidal ideation frequency, prior attempts, childhood emotional neglect and non-suicidal self-injury as independent predictors.

A Japanese multicentre prospective study of 65 older adults finds apathy severity after ward transfer independently predicts poorer functional recovery following hip-fracture surgery, distinct from delirium or behavioural and psychological symptoms of dementia.

A double-blind placebo-controlled trial in the Netherlands finds no significant difference in xerostomia symptoms between pilocarpine drops and placebo in frail or life-limited patients, though the trial was underpowered.

The first large pragmatic English trial of Open Dialogue crisis care finds no difference in relapse rates but significantly lower psychiatric admission and re-referral, with better patient-rated recovery and satisfaction.

A retrospective cohort study of over 8,000 emergency department attendances finds that comprehensive geriatric assessment embedded at first contact converts most encounters into home discharge with hospital-at-home support, rather than admission.

A quasi-experimental stewardship intervention for patients receiving outpatient parenteral antibiotic therapy for urinary tract infection raised appropriate-duration prescribing from 44% to 83% and cut 90-day recurrence, without increasing readmissions.

A randomised controlled trial finds adjunctive neuromuscular electrical stimulation produces significantly faster recovery of functional oral intake than swallowing therapy alone in acute and subacute post-stroke dysphagia.

A retrospective cohort of over three million adults using NHS Talking Therapies in England finds people with diagnosed ADHD have significantly poorer recovery and higher deterioration rates than a matched comparison group, despite both groups improving overall.

A mixed-methods US study across Veterans Affairs hospitals finds marked heterogeneity in outpatient parenteral antimicrobial therapy governance, with postdischarge coordination gaps concentrated at sites lacking a designated OPAT lead and checklist-based processes.

A large randomised trial across 13 hospitals in five sub-Saharan African countries finds stepping down to oral amoxicillin once children with severe community-acquired pneumonia improve, with total treatment as short as four to five days, is non-inferior to prolonged intravenous-only care.

A retrospective diagnostic study of 152,877 emergency department attendances across three Birmingham hospitals derives and internally validates a new triage tool for identifying patients suitable for same-day emergency care, outperforming existing prediction scores.

A secondary analysis of a large US trial in 977 community-dwelling older adults finds that retest effects on repeat neuropsychological testing are large enough to offset roughly a year of expected age-related cognitive decline.

A study backed by the BSAC OPAT Initiative finds citrate-buffered continuous-infusion amoxicillin fails UK stability criteria for community use, but probenecid-boosted intermittent or extended infusion regimens achieve adequate target attainment against clinically relevant organisms.

A Norwegian multicentre cohort of 693 stroke patients followed for five years finds fatigue prevalence stable at 24-30% throughout, but latent trajectory modelling identifies four distinct fatigue subgroups requiring different follow-up approaches.