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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.
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1. ACP encourages all adults to receive the 2025-2026 influenza vaccine
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04056
URL goes live when the embargo lifts
The American College of Physicians (ACP) issued new influenza vaccine practice points that say everyone ages 18 to 64 years who are not pregnant or immunocompromised should receive either a standard-dose trivalent or a standard-dose quadrivalent (cell-based, egg-based, MF59-adjuvanted, or recombinant) influenza vaccine for the 2025-2026 influenza season. Those aged 65 years or older who are not immunocompromised should receive either a high-dose trivalent or a high-dose quadrivalent egg-based influenza vaccine. ACP did not examine evidence or make recommendations for pregnant women or immunocompromised adults. The practice points are published in Annals of Internal Medicine.
Influenza A and B drive seasonal epidemics because they are highly infectious, rapidly mutate, and cause a respiratory infection known as the flu. Incidence and severity of influenza vary by year and season but is greatest in the fall and winter. Adults aged ≥ 65 years and adults with comorbidities, such as diabetes, asthma, or chronic obstructive pulmonary disease (COPD), are at greater risk for morbidity and mortality.
To develop its practice points, ACP explored new evidence and analyzed the comparative effectiveness and harms of influenza vaccines in adults aged ≥ 18 years who are not pregnant or immunocompromised. Influenza vaccines help prevent morbidity and mortality.
ACP’s Practice Points are based on a rapid review of the best available evidence of the benefits and harms of trivalent (three different influenza viruses or viral proteins) and quadrivalent (four different influenza viruses or viral proteins) influenza vaccines in nonpregnant and nonimmunocompromised adults aged ≥ 18 years. The ACP Center for Evidence Reviews (ACP CER) team evaluated 42 studies, which had two comparators. The most common comparator was the standard dose trivalent or quadrivalent egg-based influenza vaccine. The other comparator was the high-dose trivalent or quadrivalent egg-based influenza vaccine. The ACP considered evidence on benefits (influenza-associated pneumonia/lower respiratory tract disease, influenza-related mortality influenza-related hospitalization, and laboratory-confirmed influenza) and harms (fever, idiopathic thrombocytopenic purpura, and serious adverse events) of the influenza vaccines to develop the Practice Points.
Media contacts: For an embargoed PDF or to speak with someone at ACP, please contact Angela Collom at acollom@acponline.org.
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2. 1 in 10 physicians receive mental health and substance abuse care
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01069
URL goes live when the embargo lifts
A brief research report examined temporal patterns in mental health and substance use (MHSU)-related health care visits among physicians in Ontario, CA over a 19-year period. The findings revealed 1 in 10 physicians received mental health care over the study period, with substantial increases seen during the first two years of the COVID-19 pandemic. The findings highlight a longstanding pattern of physician mental health that was exacerbated by the pandemic. The report is published in Annals of Internal Medicine.
Researchers from North York General Hospital and colleagues studied health administrative data from 29,662 of early (first five years of independent practice) and mid-career (sixth through 15th year of independent practice) physicians who registered with the College of Physicians and Surgeons of Ontario between 1990 and 2018. The researchers examined MHSU visits overall, by visit type (anxiety, mood, and substance use disorders; attention deficit–hyperactivity disorder; adjustment reactions; and other), and by specialty (family medicine, psychiatry, and all other specialties). In a cohort of physician spanning all specialties they found that 11.0% of physicians had one or more outpatient MHSU visits during the study period. During the prepandemic period (2003-2019), the proportion of physicians with MHSU visits per year was stable at around 12%. This proportion increased during the COVID-19 pandemic, going from 14.6% in 2020–2021 to 15.2% in 2021–2022. This increase could reflect the reduced barriers to and stigma around mental health care seen during the pandemic, but it also might reflect greater mental distress in physicians because of the pandemic. MHSU visits by physicians for anxiety disorders and adjustment reactions saw the greatest increases. The authors suggest that system-level changes and target interventions for higher-risk physician groups are needed.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To contact corresponding author Daniel T. Myran, MD, MPH please email Misty Pratt at misty.pratt@ices.on.ca.
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3. Mindfulness interventions and professional coaching are effective strategies for managing health care professional burnout
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00469
Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04277
URL goes live when the embargo lifts
A systematic review and meta-analysis evaluated the effectiveness of all interventions to mitigate burnout among health care professionals (HCPs). The review found that mindfulness-based interventions may reduce burnout in nurses, midwives, and a mixture of HCPs. However, professional coaching likely reduces burnout among doctors, especially when sustained for more than 4 weeks. The findings are published in Annals of Internal Medicine.
Researchers from Queen Mary University of London and Barts Healthcare NHS Trust and colleagues analyzed findings from 93 randomized controlled trials (RCTs) and 6 cluster RCTs evaluating interventions to mitigate burnout compared with no active intervention among HCPs. Included studies had to have been conducted for HCPs directly involved in patient care, evaluate modifiable intervention strategies against no active intervention, and include a continuous outcome related to burnout measured with a validated assessment tool. Components of burnout evaluated were emotional exhaustion (EE), depersonalization, and personal accomplishment (PA). Interventions examined in the studies included mindfulness-based interventions, resilience or stress-management training, skills training for specific job functions, Baliant group sessions, and professional coaching. The analysis found that different interventions were effective for different HCP roles. There was evidence, albeit of low certainty, that mindfulness–meditation-based interventions may result in a significant reduction in EE among nurses and midwives and may result in a moderate reduction in EE among a mixture of various HCP samples, but the same was not observed among medical doctors. For medical doctors, there was evidence of moderate certainty that professional coaching may result in a significant reduction in EE among medical doctors. For depersonalization, mindfulness-based programs may reduce depersonalization among a mixture of various HCP samples, and professional coaching was significantly associated with reduced depersonalization among medical doctors. For PA, there was moderate-certainty evidence that mindfulness–meditation-based interventions improved PA for a mixture of HCPs, but evidence was of very low certainty among nurses and midwives. These results can be used to inform support strategies to mitigate and address burnout for HCPs, especially primary care physicians and nurses.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To contact corresponding author Ajay Gupta, please email Faustine Akwa at f.akwa@qmul.ac.uk.
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4. Temperature-related deaths disproportionately affect older adults, men, and non-Hispanic Black persons
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-01006
URL goes live when the embargo lifts
A brief research report analyzed long-term national trends in temperature-related mortality in the United States. The report found that heat- and cold-related deaths accounted for 0.1% of total mortality over the study period, disproportionately affecting older adults, males, and Non-Hispanic Black persons (NHBPs). The findings highlight the need for targeted public health strategies such as improved housing insulation, accessible cooling/heating centers, and robust early warning systems to mitigate temperature-related mortality disparities. The report is published in Annals of Internal Medicine.
Researchers from Massachusetts General Hospital-Harvard Medical School, Harvard T.H. Chan School of Public Health, and Suez Canal University used the Centers for Disease Control and Prevention’s WONDER platform to analyze death certificates of 69,256 deaths between 1999 and 2024 in which temperature was recorded as a contributing or underlying cause. They found that of the 69,256 temperature-related deaths, 35% were heat-related and 65% were cold-related. In demographic-specific analyses, adults 65 years and older and males had higher temperature-related mortality than their respective counterparts. NHBPs had the highest heat-related mortality rates, which were twice that of Non-Hispanic White persons, and the highest cold-related mortality rates, which were close to twice that of Non-Hispanic White persons. There was not a consistent increase in temperature-related mortality throughout the study period, but crude estimates were higher during the latter years.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To contact corresponding author Shady Abohashem, MD, MPH please email SAbohashem@mgh.harvard.edu
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END
ACP encourages all adults to receive the 2025-2026 influenza vaccine
2025-11-17
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