Debbie Rigby rounds up the latest in research news

Effect of monthly high-dose vitamin D on bone density in community-dwelling older adults

A two year substudy of a trial with 452 participants randomised to receive monthly doses of 1000,000IU vitamin D3 found no clinically important benefit to bone mineral density. However there was meaningful benefit in those with baseline 25-hydroxyvitamin D of 30nmol/L or less.

Journal of Internal Medicine 2017;282(5):452-60.

Editorial

 

Statin use and risk of developing diabetes

Long-term follow-up of the Diabetes Prevention Program Outcomes Study (n=3234) has shown significantly higher rates of diabetes with statin therapy. At 10 years, the cumulative incidence of statin initiation prior to diabetes diagnosis was 33%–37%. Statin use was associated with a 36% increased risk of diabetes.

BMJ Open Diab Res Care 2017;5:e000438.

Medscape summary

 

Patient Beliefs Have a Greater Impact Than Barriers on Medication Adherence

Focusing on patients’ beliefs about medicines is an important factor affecting adherence. Negative beliefs about medicines are more significantly associated with adherence than external barriers to accessing medicines. The most commonly reported negative belief about medicines was fear of dependence. These findings suggest that in order to reduce chronic disease mortality by improving adherence rates, clinicians should identify and address the range of negative beliefs that patients hold regarding adherence to medicine regimens.

J Am Board Fam Med. 2017;30(3):331-336. 

 

Why and how to step down chronic asthma drugs

Following a period of stable asthma, guidelines recommend clinicians should consider stepping down treatment. Step-down approaches include optimizing inhaled corticosteroid dosing when stepping down oral corticosteroid, reducing inhaled corticosteroid from a higher dose, lowering inhaled corticosteroid-long acting bronchodilator (ICS-LABA) dose while adding ICS-LABA on-demand, adding leukotriene receptor antagonist (LTRA) while lowering inhaled corticosteroid dose, and using allergen immunotherapy when reducing inhaled corticosteroid from a higher dose.

BMJ 2017;359:j4438.