Overview
This week’s general health update highlights several notable studies that have implications for clinicians, patients, and public health policy. From hormone therapy and fracture risk to the impact of post-discharge exercise, the effectiveness of brief alcohol counselling, and the evolving landscape of COVID-19 treatments, the evidence base is continually shifting. Below is a concise synthesis of the latest findings, with practical takeaways for everyday care and decision-making.
Risk of fracture after stopping menopausal hormone therapy
Researchers examined fracture risk among women aged 40 and older in the UK who had a first recorded fracture and were previously using menopausal hormone therapy (MHT). The study found that current MHT use reduced fracture risk compared with never-use (estrogen-only OR 0.76; estrogen–progestin OR 0.75). However, the protective effect waned after stopping: 1–10 years post-cessation showed a slight uptick in risk (estrogen-only OR 0.99; estrogen–progestin OR 1.06), while >10 years after stopping the risk levelled to a lower baseline again (estrogen-only OR 0.93; estrogen–progestin OR 0.95).
The absolute increase in fractures in the 1–10 year window post-cessation translated to approximately 14 extra fractures per 10,000 woman-years for shorter exposure and about 5 per 10,000 for longer exposure. The authors emphasize that risk varies by MHT type and duration, underscoring the importance of individualized counselling when considering stopping MHT. Clinicians should balance fracture risk against other menopausal symptoms and cardiovascular considerations when advising patients on discontinuation.
The effectiveness of an exercise program post-hospital-discharge
Older adults face a higher risk of functional decline after hospital discharge. A comprehensive systematic review and meta-analysis synthesized randomized trials (2000–2025) assessing post-discharge exercise programs focused on strength and endurance. Among 1,458 participants across 17 studies of moderate to high quality, post-discharge exercise yielded meaningful improvements in physical function. However, the evidence did not show clear benefits for health-related quality of life or hospital readmission rates, and results for secondary outcomes such as cognitive function, frailty, and mortality were mixed or inconclusive due to limited data.
Takeaway: Structured, supervised or home-based exercise programs after discharge can help older adults regain physical function, which may contribute to greater independence. While these interventions are not a guaranteed fix for all outcomes, they represent a valuable component of comprehensive post-hospital care. Clinicians should tailor programs to individual capabilities and safety considerations.
Brief alcohol counselling in primary care
Alcohol misuse remains a global health challenge. A large pragmatic cluster-randomized trial in 40 primary care clinics in Japan evaluated whether doctor-delivered screening with a ultra-brief intervention (<1 minute) plus a short information leaflet could reduce hazardous drinking, compared with a simplified assessment using AUDIT-C alone. Participants were 1,133 outpatients aged 20–74 with AUDIT-C scores indicating hazardous drinking. After 24 weeks, total alcohol consumption did not differ significantly between groups, suggesting that the ultra-brief intervention did not provide added benefit over the simplified assessment approach in this setting.
Implication: While brief counselling is appealing for its efficiency, this study indicates that in some contexts, ultra-brief physician-delivered interventions may not outperform standard brief assessments. Ongoing exploration of optimal duration, content, and delivery mode (including digital or allied health professionals) remains essential to curb hazardous drinking in primary care.
COVID-19 treatment update
The COVID-19 evidence landscape continues to evolve. A recent systematic review and network meta-analysis focusing on non-severe COVID-19 identified several drugs that may reduce hospital admission: nirmatrelvir-ritonavir and remdesivir appear most likely to reduce progression to hospitalization, while molnupiravir and systemic corticosteroids may also offer benefits. Additionally, some therapies may shorten symptom duration, though not all reduce the risk of hospitalisation. As trials continue and variants shift, treatment choices should consider disease severity, timing, and individual patient factors.
Clinical priorities remain: early identification of high-risk patients, timely initiation of effective antivirals when appropriate, and balancing potential benefits against risks and drug interactions. Ongoing high-quality trials will further refine these recommendations.
