From the Guidelines
Ad circa refers to the consideration of time-of-day effects in research and medicine, particularly in relation to circadian rhythms and their impact on human health and disease management. This concept is crucial in understanding how physiological processes, such as metabolism and glucose regulation, vary throughout the day and how these variations can affect treatment outcomes and disease management. For instance, research has shown that the glucose response to meals depends on the circadian phase of eating, which has implications for metabolism and diabetes management 1. Understanding and accounting for these time-of-day effects can lead to more effective and personalized treatment strategies. Key terms related to ad circa include circadian rhythm, diurnal rhythm, zeitgeber, and photoperiod, which are essential in comprehending the complex interactions between internal biological clocks and external environmental factors 1. In clinical research and practice, considering ad circa involves assessing the endogenous circadian component of observed daily rhythms and distinguishing it from behaviorally or environmentally evoked components 1. This distinction is vital for developing targeted interventions in health and disease, such as timing medications to specific clock or circadian times to enhance their efficacy or reduce side effects 1. Recent consensus recommendations emphasize the importance of standardized data elements, scales, and time segmentations in studies of human circadian/diurnal biology, particularly in the context of stroke research 1. By prioritizing ad circa and incorporating circadian medicine principles into clinical practice, healthcare providers can improve patient outcomes, enhance treatment efficacy, and reduce morbidity and mortality. Some of the key evidence-based recommendations for implementing ad circa in clinical research and medicine include:
- Assessing the endogenous circadian component of observed daily rhythms
- Distinguishing between circadian and behaviorally or environmentally evoked components
- Using standardized data elements, scales, and time segmentations
- Considering the timing of medications and treatments in relation to the circadian clock
- Accounting for individual differences in circadian rhythms and preferences.
From the Research
Adherence to Medication
- The effectiveness of interventions to enhance patient adherence to prescribed medications is a subject of ongoing research 2
- Studies have shown that people who are prescribed self-administered medications typically take only about half their prescribed doses 2
- Efforts to assist patients with adherence to medications might improve the benefits of prescribed medications, but current methods are mostly complex and not very effective 2
Treatment-Resistant Depression
- Quetiapine augmentation therapy is more clinically effective than lithium for patients with treatment-resistant depression over 12 months 3
- Quetiapine is probably more cost-effective than lithium for the long-term management of treatment-resistant depression 3
Type 2 Diabetes Treatment
- SGLT-2 inhibitors and GLP-1 receptor agonists reduce all-cause death and have other benefits for patients with type 2 diabetes 4
- Finerenone probably reduces mortality and admissions to hospital for heart failure and end-stage kidney disease in patients with chronic kidney disease 4
- Tirzepatide probably results in the largest reduction in body weight among treatments for type 2 diabetes 4
Obesity Treatment
- Antiobesity medications (AOMs) can improve outcomes such as type 2 diabetes, hypertension, and dyslipidemia when used in combination with lifestyle interventions 5
- Different AOMs have varying degrees of effectiveness and adverse effects, including gastrointestinal issues and changes in appetite regulation 5
Self-Medication
- Self-medication with over-the-counter (OTC) and non-OTC drugs can have serious consequences for users and societies 6
- Predictors of self-medication behavior include having a minor illness, health care costs, lack of adequate time to visit a physician, prior experience with a drug, and long waiting times to visit a qualified practitioner 6