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Tag: American College of Physicians (ACP)

  • Symptom and viral rebound uncommon after untreated COVID-19 infection

    Symptom and viral rebound uncommon after untreated COVID-19 infection

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    Abstract: https://www.acpjournals.org/doi/10.7326/M22-2381

    URL goes live when the embargo lifts

    An analysis of a COVID-19 trial has found that a combination of symptom and viral rebound after untreated COVID-19 infection is rare, occurring in only 3 percent of study participants. The analysis is published in Annals of Internal Medicine.

    Nirmatrelvir–ritonavir is a recommended treatment for outpatients with mild to moderate COVID-19 and risk factors for severe disease. Widespread use of nirmatrelvir has been accompanied by reports of worsening symptoms and virologic rebound after treatment completion. Virologic rebound has also been reported in persons who did not receive nirmatrelvir therapy, but studies that can define the frequencies of symptom and viral rebound during the natural course of COVID-19 are lacking.

    Researchers from Brigham and Women’s Hospital conducted an analysis of 563 participants receiving placebo in the ACTIV-2/A5401 (Adaptive Platform Treatment Trial for Outpatients With COVID-19) platform trial. The authors found that a combination of symptom and high-level viral rebound occurred in only 3 percent of participants. Symptom rebound alone occurred in 26 percent of participants 11 days after initial symptom onset and viral rebound alone occurred in 31 percent of participants. High-level viral rebound was observed in 13 percent of participants. The researchers note that both symptom and viral rebound were short, lasting only one day in most participants. According to the authors, these results highlight the importance of accounting for underlying rates of symptom relapse in the absence of antiviral therapy when evaluating the effects of antiviral treatments.

     

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    American College of Physicians (ACP)

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  • Internal medicine physicians call for improved access and quality in health care for incarcerated patients

    Internal medicine physicians call for improved access and quality in health care for incarcerated patients

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    Abstract: https://www.acpjournals.org/doi/10.7326/M22-2370

    URL goes live when the embargo lifts

    Note: Sound bites from ACP President Ryan Mire, MD, MACP available for download at https://www.dssimon.com/MM/ACP-Incarceration

    Adequately funded policies and procedures are needed to reduce health care disparities in access to, and quality of, health care for the U.S. jail and prison population says the American College of Physicians (ACP). Health Care During Incarceration: A Policy Position Paper of the American College of Physicians details recommendations to improve the health and wellbeing of individuals incarcerated in adult correctional facilities. The paper is published in Annals of Internal Medicine.

    ACP’s recommendations include adequate funding for, and timely access to, necessary health care services that are evidence-based and meet community standards. They also recommend measures to ensure adequate nutrition; opportunity for physical activity; smoke-free policies and smoking cessation interventions; and access to recommended preventive health services. ACP further calls for policies to adequately treat both chronic noncommunicable diseases and infectious diseases. This should include infectious disease prevention and control programs developed with public health authorities. In addition, all persons entering correctional facilities should be screened for substance use disorders and behavioral health conditions and provided with treatment if necessary.  ACP also supports policies that promote the treatment of patients with substance use disorders as an alternative incarceration.

    The paper also details recommendations for population segments within correctional facilities. This includes recommendations for how to better meet the needs of incarcerated women; LGBTQ+ patients; aging patients and those living with disabilities or life-limiting illnesses; and immigrant populations.

    Lastly, the paper details how health care needs must be included in community re-entry planning for individuals who are released from jail or prison, so that they are able to continue to access health care and social services once they return to their communities. ACP specifically makes recommends for policies that would help to facilitate or reinstate state Medicaid enrollment.

     

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  • ACP says Federal Government Needs to Improve Health Support for Indigenous Communities

    ACP says Federal Government Needs to Improve Health Support for Indigenous Communities

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    ACP says Federal Government Needs to Improve Health Support for Indigenous Communities 

    Abstract: https://www.acpjournals.org/doi/10.7326/M22-1891  

    URL goes live when the embargo lifts    

    Indigenous populations continue to suffer significant barriers and disparities in health care, due in part to the federal government failing to provide adequate health support and services for these communities, says the American College of Physicians (ACP) in a new position paper. ACP says that policymakers have an obligation to fulfill the federal trust responsibility to provide equitable health care and other services to Indigenous populations in the U.S., including sufficient financial resources to support their care. The full policy paper is published in Annals of Internal Medicine.  

    In recent years, Indigenous populations have experienced high rates of chronic diseases, death due to unintentional and intentional injuries, and infant mortality. These disparities have arisen in-part from the historical trauma associated with decades of racism, discrimination, and violence; subsequent poor social drivers of health; the degradation of Indigenous traditions, culture, and society; and inadequate access to and chronic insufficient funding of health care services for Indigenous populations.  

    ACP offers several recommendations for public policymakers at the federal level to strengthen the health and well-being of Indigenous populations in a manner that reflects the need for self-determination and collaboration while ensuring federal obligations are met. Specifically, ACP believes: 

    • Increased funding is needed for health services for Indigenous people, particularly given the identified disparities and inequities in federal funding.  
    • Community-driven public policy, developed under the leadership of Indigenous leaders is necessary to remedy the injustices, disparities, and inequities experienced by Indigenous individuals and communities.   
    • Improved support is needed to prioritize health and wellness promotion, chronic disease prevention, and other public health interventions addressing morbidities with high incidence in Indigenous communities; and that policy makers must team with Indigenous leaders to address the full range of underlying social drivers of health associated with disproportionately high rates of poverty experienced by Indigenous communities.   
    • A multidisciplinary approach, developed by Indigenous populations in collaboration with other experts in the field, is necessary to implement culturally appropriate interventions to address the underlying drivers that exacerbate physical, mental, and behavioral health issues and contribute to catastrophic rates of suicide in Indigenous communities.   
    • Community-driven collaboration is needed among relevant governments, agencies, and Indigenous leaders to develop plans to mitigate the high rates of violence experienced in Indigenous populations. ACP also supports actions to increase Indigenous representation in medical school student bodies and the medical workforce. 

     

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    American College of Physicians (ACP)

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