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Less Is More Collection - JAMA Network

Eric C. T. Geijteman, et al. JAMA Intern Med. 2015;175(3):346.

Decreasing or discontinuing medication use at the end of life may run counter to previous management and lead patients to worry that they are being abandoned. Physicians need, therefore, to consider both the physical and psychosocial effects of withdrawing treatment. Pharmacotherapy in terminally ill patients is not a simple task because physicians must adapt drug treatments to new objectives. This case illustrates that such adapted management may improve quality of life and potentially reduce ...

Less Is More Collection - JAMA Network

Austin Lammers, et al. JAMA Intern Med. 2015;175(3):341-342.

Exercising restraint in an era of brief visits coupled with diagnostic uncertainty can be difficult. Viewed through the narrowlens of a single encounter, early CT imaging in cases of hearing loss may seem reasonable. However, in this case and many others, an unnecessary test could have been avoided through better communication of diagnostic assessment and evidence-based guidelines between a primary care physician and specialist. Often the path of least resistance for clincians working inside ...

Less Is More Collection - JAMA Network

Mahmood Al-Abri, et al. JAMA Intern Med. 2015;175(2):163.

The use of daily reminders, prewritten advanced directives, or automatic stop orders are each effective methods of ensuring that conversations about urinary catheter appropriateness occur every day.

Less Is More Collection - JAMA Network

Korenstein D, et al. JAMA Intern Med. 2015;175(2):287-288.

Quantification of benefits and harms must be informed by the best available evidence; the patient’s perspective is central to shaping the interpretation of those benefits and harms and thus is of critical importance in discussions of value. Ultimately, then, high-value care is care for which the evidence suggests maximal benefit and minimal harm in the context of a particular patient’s values and priorities. Whereas there are some interventions with clear benefits and negligible harms that ...

Less Is More Collection - JAMA Network

Anupam B. Jena, et al. JAMA Intern Med. 2015;175(2):237-244.

High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive percutaneous coronary intervention, without any mortality effect. One explanation for these findings is that the intensity of care provided during meeting dates is lower and that for high-risk patients with ...