JAMA Internal Medicine

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Official page for JAMA Internal Medicine http://jamainternalmed.com, an international, peer-reviewed journal published weekly online and monthly in print.

In a 2×2 factorial randomized clinical trial of 1000 adults with acute or subacute low back pain (LBP) at moderate or hi...
06/05/2026

In a 2×2 factorial randomized clinical trial of 1000 adults with acute or subacute low back pain (LBP) at moderate or high risk for chronicity, biopsychosocial clinician-supported self-management delivered by physical therapists or chiropractors resulted in a modest but statistically significant reduction in LBP impact scores at 1 year compared with guideline-based medical care.

More participants in the self-management group achieved at least 50% reduction in LBP impact, and this group performed better on most secondary outcomes, including lower rates of frequent activity-limiting pain, reduced health care and medication use, and greater satisfaction, compared to medical care. Spinal manipulation alone did not differ from medical care for LBP impact, and combining spinal manipulation with supported self-management provided no additional benefit.

Mediation analyses indicated that changes in self-efficacy, kinesiophobia, and pain catastrophizing accounted for 76% of the self-management effect at 1 year.

https://ja.ma/4dZwN3i

In a quasi-experimental study of over 330,000 US patients with , introducing a physician-facing quality metric and fina...
06/05/2026

In a quasi-experimental study of over 330,000 US patients with , introducing a physician-facing quality metric and financial incentive for hypertension control was associated with increased rates of repeat measurement and improved adherence to guideline-recommended measurement practices, but did not alter overall rates of hypertension control, antihypertensive prescribing, or cardiovascular hospitalizations.

Among patients with marginally elevated blood pressure (systolic 140-145 mm Hg), the incentive was linked to greater frequency of blood pressure remeasurement and increased documentation of controlled blood pressure, primarily due to selective remeasurement, alongside reduced medication adjustments and an increased risk of hospitalization for acute cardiovascular events.

These findings indicate that simple, binary performance metrics and financial incentives for hypertension control may improve documentation and process adherence but risk unintended harms, including overtreatment or undertreatment, especially among patients close to the control threshold.

https://ja.ma/4vpxZnv

Older adults living alone with cognitive impairment are at elevated risk for medication-related harm due to barriers at ...
05/30/2026

Older adults living alone with cognitive impairment are at elevated risk for medication-related harm due to barriers at multiple levels, including lack of reminders, regimen complexity, and unwitnessed adverse effects.

https://ja.ma/4u9Yuwv

A cohort study of >1 million first-time handgun purchasers in California found no increased risk of homicide during the ...
05/28/2026

A cohort study of >1 million first-time handgun purchasers in California found no increased risk of homicide during the 10-day waiting period compared with matched individuals who had not purchased a handgun. No homicides occurred among purchasers or their cohabitants during this interval.

These findings indicate that California’s waiting period does not result in short-term lethal harm to new handgun owners, providing epidemiologic evidence relevant to firearm policy discussions. https://ja.ma/4tV2y3r

This case report describes a woman in her 60s who had an inferior wall myocardial infarction 1 year prior and presented ...
05/27/2026

This case report describes a woman in her 60s who had an inferior wall myocardial infarction 1 year prior and presented to the emergency department with worsening dyspnea and anasarca for the past 2 months. https://ja.ma/4v0Nan5

Commercial payer–negotiated rates for outpatient services showed over fourfold variation between US hospitals and were...
05/27/2026

Commercial payer–negotiated rates for outpatient services showed over fourfold variation between US hospitals and were lower in rural vs nonrural hospitals. https://ja.ma/3PGV1qK

Older adults living alone with cognitive impairment are at elevated risk for medication-related harm due to barriers at ...
05/26/2026

Older adults living alone with cognitive impairment are at elevated risk for medication-related harm due to barriers at multiple levels, including lack of reminders, regimen complexity, unwitnessed adverse effects, and difficulties navigating health care systems.

Intermittent support from noncohabiting contacts and communication challenges with clinicians further compound these risks. Implementation of home-based services and integration of living alone status into electronic health records may help address medication safety for this population. https://ja.ma/42NpJla

This case report describes a man in his 60s who presented with myxedema coma due to secondary hypothermia, which was rev...
05/26/2026

This case report describes a man in his 60s who presented with myxedema coma due to secondary hypothermia, which was revealed on electrocardiography. https://ja.ma/4doW9IN

In men who had radical prostatectomy for low-grade and hypogonadism, 12 weeks of testosterone therapy improved sexual ...
05/25/2026

In men who had radical prostatectomy for low-grade and hypogonadism, 12 weeks of testosterone therapy improved sexual activity, desire, well-being, and physical function without biochemical recurrence.

https://ja.ma/3RrJIU4

This difference-in-differences analysis demonstrates that the Inflation Reduction Act’s elimination of catastrophic coin...
05/25/2026

This difference-in-differences analysis demonstrates that the Inflation Reduction Act’s elimination of catastrophic coinsurance and expansion of low-income subsidies was associated with a 4.9–percentage point reduction in cost-related medication nonadherence among Medicare beneficiaries.

No significant change in financial strain was observed, suggesting that policy impact was specific to prescription price protections rather than broader medical out-of-pocket costs. https://ja.ma/4dqPTiw

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