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Grand RoundsWeekly Evidence Brief

Family Medicine

Edition

30-Second Takeaway

  • Use **patient navigation** and **mailed FIT outreach** to meaningfully raise colorectal cancer screening rates, especially where uptake is low.
  • Address pandemic-related **blood pressure control erosion** with proactive, team-based, equity-focused hypertension management.
  • Lower or eliminate **antihypertensive copays** when possible to improve adherence and persistence.

Week ending April 11, 2026

Hypertension control and colorectal cancer screening: practical levers for primary care impact

Patient navigation and mailed FIT outreach most effectively boost colorectal cancer screening

GASTROENTEROLOGYApr 4, 2026

This network meta-analysis of 76 randomized trials compared eight colorectal cancer screening uptake strategies with usual care. Patient navigation increased screening by 58% versus usual care (RR 1.58, 95% CI 1.23-2.02). Mailed FIT outreach increased screening by 36% (RR 1.36, 95% CI 1.07-1.74) and outperformed colonoscopy outreach (RR 1.35, 95% CI 1.11-1.63). In settings with baseline uptake <30%, mailed FIT outreach tripled screening (RR 3.12, 95% CI 1.70-5.71).

Blood pressure control dropped during COVID-19 and has not fully rebounded

JOURNAL OF THE AMERICAN HEART ASSOCIATIONApr 7, 2026

EHR data from 17 US health systems followed 1.2 to 1.5 million adults with hypertension from 2017 to 2022. BP control (<140/<90 mm Hg) fell from 65.3% in 2019 to 61.8% in 2020 and only partially recovered to 62.6% in 2022. The adjusted difference in BP control between 2022 and 2019 was -2.6 percentage points (95% CI -5.0 to -0.2). Non-Hispanic Asian patients had the largest control decline, from 68.4% in 2019 to 63.9% in 2022.

Intensive primary care training improves preparedness to manage youth suicidality

ACADEMIC PEDIATRICSApr 5, 2026

This longitudinal study followed 3,246 primary care clinicians in a pediatric mental health retraining program emphasizing suicidality. The curriculum included a three-day interactive workshop plus six months of twice-monthly group case-based coaching. Clinicians showed significant, sustained gains in suicide-related knowledge, self-efficacy, rating scale use, and self-reported practice changes at six months (all P<.0029). Early improvements in knowledge and self-efficacy predicted later self-reported practice changes in managing suicidal youth.

Nurse-led mHealth program improves post-stroke blood pressure control in Ghana

CIRCULATIONApr 9, 2026

The PINGS multicenter RCT enrolled 500 recent stroke survivors with hypertension at 10 hospitals in Ghana. Participants received usual care or a 12-month nurse-led intervention with home BP monitoring, phone alarms, and weekly telephonic education. At 12 months, systolic BP <140 mm Hg was achieved in 67% of intervention patients versus 43% receiving usual care (difference 24%; 95% CI 15%-33%). Mean systolic BP decreased by an additional -5.5 mm Hg versus control (95% CI -9.6 to -1.4; P=0.008).

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Among colorectal cancer screening strategies, **patient navigation and mailed FIT outreach** provide the largest, most consistent gains versus usual care.
  • Hypertension control still lags pre–COVID-19 performance nationally, emphasizing need for robust QI infrastructure and outreach in primary care.
  • Reducing even modest out-of-pocket costs for antihypertensives improves adherence, though near-term BP and event gains may be limited.