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In This Issue of JAMA Internal Medicine
January 2017


JAMA Intern Med. 2017;177(1):1-3. doi:10.1001/jamainternmed.2016.6124

In this randomized trial of 302 nursing home residents with advanced dementia, Hanson and colleagues tested the Goals of Care decision aid intervention and found that it was effective to improve quality of communication and palliative care treatment plans, and reduce hospitalization rates for nursing home residents with advanced dementia. Unroe and colleagues provide the Invited Commentary.

Invited Commentary

In this randomized clinical trial, Agar and colleagues assigned 247 adults with a palliative diagnosis and delirium to 1 of 3 groups if they were experiencing behavioral, communication, and/or perceptual delirium symptoms: dose-titrated risperidone, haloperidol, or placebo oral solution for 72 hours. Delirium symptoms were better controlled in the placebo group compared with either the haloperidol or risperidone groups. These data suggest that approaches that identify delirium early, treat underlying precipitant(s) if appropriate, and provide other evidence-based supportive measures provide better reduction in delirium symptoms associated with distress than the addition of an antipsychotic. Maust and Kales provide the Invited Commentary.