geoffrey modest medical blogs

  A recent study compared mindfulness training and cognitive behavioral therapy in patients who had chronic low back pain and were being treated with opiates, finding improved back pain symptoms with decreased opiate doses in both cohorts at both 6 months and 12 months (see  lbp opioids mindfulness and CBT helps JAMA2025  in dropbox, or doi:10.1001/jamanetworkopen.2025.3204)   Details : -- 770 patients were enrolled in this community partner-informed, partially masked, multisite, randomized controlled trial with participants from primary and specialty care clinics and community settings who were randomly assigned to mindfulness-based therapy (MBT) or cognitive behavioral therapy (CBT) -- participants had never had either MBT or CBT previously, had moderate-to-severe chronic low back pain (CLBP) (score of at least 3 on the Brief Pain Inventory (BPI)), functional limitations (score at least 20 on the Oswestry Disability Index (ODI)), and were treated with opiates ...

  Another recent article just came out on positive benefits for GLP-1 receptor agonists as well as SGLT-2 inhibitors, finding a decreased risk of Alzheimer’s disease and related dementias (see  dm GLP1 SGLT2 less dementia JamaNeuro2025  in dropbox, or  doi:10.1001/jamaneurol.2025.0353 )   Details : -- this was a target trial emulation study using electronic health record data from 2014-2023, from the OneFlorida+ Clinical Research Consortium of patients who were at least 50 years old with type II diabetes and no prior diagnosis of Alzheimer’s disease and related dementias (ADRD)     -- this database integrates longitudinal electronic health records linked with the National Death Index for multiple healthcare partners in Florida, with more than 21 million persons covering approximately 86% of Florida’s population, also extending into Georgia and Alabama -- 33,858 eligible patients were included in the GLP1 versus the other second-line glucose loweri...