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BMJ No 7110 Volume 315 This week in brief Saturday 20 September 1997
Paying patients improves compliance with treatment Paying patients improves compliance with treatmentNon-compliance with medical treatment is a widespread problem that may increase costs by making an illness more difficult and expensive to treat in future. Giuffrida and Torgerson's systematic review of the use of financial incentives to improve treatment compliance identified 11 randomised trials, all carried out in the United States (p 703). Ten trials showed that financial payments improved compliance. The use of financial incentives may be relatively cost effective in such areas as the treatment of tuberculosis. Growth hormone treatment is not as effective as has been thoughtKnowledge about the long term results of growth hormone in children of short stature is limited. Coste et al (p 708) conducted a register based cohort study of all children of short stature whose treatment started in France between 1973 and 1989. The outcome for those with growth hormone deficiency who were treated with growth hormone was less favourable than initially assumed. Treatment did not restore the genetic growth potential and thus should not be considered as a panacea for children of short stature. The old risk factors are still best for predicting death and coronary diseaseThe Scottish heart health study began in 1984, when Scotland was in the
premier league for death from coronary heart disease in both men and
women. It measured lifestyle and risk factor status for
representative samples of men and women. The in The incidence of childhood diabetes has risen over the past 30
years. Gardner et al (p 713) report on a prospective survey of
children aged under 15 presenting with insulin dependent diabetes in
the Oxford region during 1985-95, which found an overall increase in
incidence of 4% per year. Most of this increase was in children aged
under 5, in whom the incidence rose by 11% a year and doubled over the
course of the study. The increase is probably due to as yet unknown
environmental factors encountered in utero or in early postnatal life.
Early diabetes has a greater impact on patients and their f The prevalence of childhood eczema and hay fever is increasing in
many countries. On p 717 Butland et al report results from two cohort
studies of British children born in 1958 and 1970 and f In this week's controversy (p 736) R J Jarrett argues that the
concept of gestational diabetes is muddled and there is little point in
screening for it. The maternal glucose values that define gestational
diabetes also include non-insulin dependent diabetes, and there is, he
says, no e
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