Overview: A concise look at recent clinical studies with broad relevance
This week’s general health update highlights several studies that matter to a wide audience. From how stopping menopausal hormone therapy affects fracture risk to the effectiveness of post-hospital exercise and ultra-brief alcohol counselling, the findings offer practical insights for patients, carers, and healthcare professionals. A section on COVID-19 treatment updates rounds out the update, reflecting the continuing evolution of evidence in infectious disease management.
1) Stopping menopausal hormone therapy and fracture risk
Researchers examined whether stopping menopausal hormone therapy (MHT) changes long-term fracture risk. Using UK primary and secondary care data, the nested case–control study looked at women aged 40 and older who experienced a fracture and compared them with controls without fractures. The average fracture case was about 68.5 years old.
Key findings show that current MHT use was associated with a reduced fracture risk: oestrogen-only use had an odds ratio (OR) of 0.76 and oestrogen–progestogen use 0.75 when compared with never-use. However, risk rose 1–10 years after stopping MHT, with ORs near or slightly above 1.0 for estrogen-only (0.99) and estrogen–progestin (1.06). The risk appeared to lower again more than 10 years post-cessation (0.93 for estrogen-only and 0.95 for combination therapy).
In practical terms, the study suggests that the fracture risk associated with MHT varies by therapy type and duration of exposure. The authors estimate extra fracture cases per 10,000 women-years in the 1–10 year window after stopping: about 14 cases for shorter MHT exposure and about 5 cases for longer exposure. While complex, the report provides useful data for clinicians counseling patients about the risks and benefits of continuing or stopping MHT.
2) Exercise after hospital discharge improves physical function
Older adults face higher risks of disability after acute hospitalisation. A systematic review and meta-analysis assessed whether post-discharge exercise programs can improve outcomes. The review combined evidence from randomized controlled trials published between 2000 and 2025, focusing on adults aged 60 and over who were discharged from acute care.
Among 17 eligible trials (1,458 participants) of moderate-to-high quality, post-discharge exercise interventions significantly improved physical function. However, the analysis did not show clear benefits for health-related quality of life or hospital readmission rates. Data on areas such as functional independence, cognitive function, frailty, and mortality were mixed and often insufficient for meta-analysis, leaving some questions unanswered.
Overall, the findings support incorporating structured post-discharge exercise to improve physical function in older adults. The nuances regarding quality of life, cognitive outcomes, and long-term health require further high-quality studies to draw firm conclusions across all domains.
3) Brief alcohol counselling in primary care: a mixed outcome
Harmful alcohol use remains a major global health issue, contributing to millions of deaths annually. Brief interventions in primary care—screening followed by short counselling—are widely recommended to reduce hazardous drinking. A large pragmatic cluster randomized trial in 40 primary care clinics in Japan tested a doctor-delivered ultra-brief intervention (less than 1 minute) against simplified assessment alone, in adults aged 20–74 with hazardous drinking (AUDIT-C scores ≥4/5).
The intervention combined AUDIT-C screening with brief oral advice and an information leaflet delivered in under a minute. The control group used AUDIT-C screening with a simpler assessment. After 24 weeks, the primary outcome was total alcohol consumption. The trial found no evidence that the ultra-brief, doctor-delivered intervention reduced alcohol intake compared with the simplified assessment alone. This suggests that, in this setting, ultra-brief counselling may not add measurable benefit over standard screening in affecting short-term drinking levels. Nonetheless, the study contributes to the ongoing evaluation of how best to tailor brief interventions for maximum impact in primary care.
4) COVID-19 treatment: what helps in mild to moderate disease
Even as the pandemic moves into a different phase, evidence on COVID-19 treatment remains dynamic. A comprehensive network meta-analysis examined mild to moderate cases across 259 randomized trials, focusing on 40 drug treatments in 187 trials. Overall, certain treatments appear to reduce hospital admission risk in mild-to-moderate disease: nirmatrelvir–ritonavir and remdesivir were highlighted as likely beneficial, with molnupiravir and systemic corticosteroids potentially providing benefits as well. In terms of symptom duration, several drugs show potential reductions, though the data vary by treatment and timing. The review underscores that treatment decisions depend on disease stage and individual patient factors, and that ongoing trials continue to refine these insights.
Putting it all together: practical takeaways
– Menopausal hormone therapy can lower fracture risk while in use, with nuanced changes after discontinuation that depend on therapy type and duration. Clinicians should tailor counseling to each patient’s fracture history and aging trajectory.
– Post-discharge exercise programs offer meaningful improvements in physical function for older adults, supporting rehabilitation strategies that emphasize mobility and strength after hospital care.
– Ultra-brief alcohol counselling in primary care may not outperform standard screening approaches in reducing short-term alcohol intake, indicating a need for context-specific strategies and perhaps longer or more targeted interventions.
– For COVID-19, treatment choices should consider disease stage and patient risk profiles, recognizing that some therapies reduce hospitalizations and symptom duration, while others may have limited impact.
As always, clinicians and patients should consult current guidelines and consider individual risks, preferences, and clinical context when applying these findings. This update reflects ongoing efforts to synthesize evolving evidence into actionable health decisions.
