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- Access to Care (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedCerda M, Wheeler-Martin K, Bruzelius E
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
The authors investigated the impact of pain management clinic laws. They analyzed data on county-level, opioid overdose deaths via the National Vital Statistics System and patients filling long-duration or high-dose opioid prescriptions in the US 2010-2018. Their findings suggested that laws with criminal penalties were associated with intended reductions in high-risk opioid prescribing and some opioid overdoses but raised concerns regarding unintended consequences on heroin/synthetic overdoses.
AHRQ-funded; HS023258.
Citation: Cerda M, Wheeler-Martin K, Bruzelius E .
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
Am J Epidemiol 2021 Dec;190(12):2592-603. doi: 10.1093/aje/kwab192..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Practice Patterns, Policy
Heins SE, Castillo RC
Changes in opioid prescribing following the implementation of state policies limiting morphine equivalent daily dose in a commercially insured population.
The study’s objective was to evaluate the impact of state-level morphine equivalent daily dose (MEDD) policies on opioid prescribing among the privately insured using claims data from 9 policy states and 2 control states and a comparative interrupted time series design. Findings showed that MEDD policies were associated with decreased use of any opioids relative to control states, but with no change in high-dose prescribing. Recommendations included further research to understand the mechanisms through which MEDD policies may influence prescribing behavior.
AHRQ-funded; HS025557.
Citation: Heins SE, Castillo RC .
Changes in opioid prescribing following the implementation of state policies limiting morphine equivalent daily dose in a commercially insured population.
Med Care 2021 Sep;59(9):801-07. doi: 10.1097/mlr.0000000000001587..
Keywords: Opioids, Medication, Policy, Practice Patterns
Ali MM, McClellan C, West KD
AHRQ Author: McClellan C
Medical marijuana laws, marijuana use, and opioid-related outcomes among women in the United States.
This study examined whether state medical marijuana laws (MMLs) was associated with lower levels of opioid-related outcomes. Data was drawn from the 2002-2014 National Survey on Drug Use and Health to compare opioid misuse in states with and without MMLs among all women, pregnant women, and parenting women. It also invested the impact of MMLs on marijuana use and marijuana use disorder. There was found to be no association of MMLs with opioid misuse, opioid misuse initiation, or opioid use disorder among all women, pregnant women and parenting women. However there was a positive correlation with marijuana use and marijuana use disorder among all women and women with children. MMLs were also associated with an increase in the frequency of opioid misuse in pregnant women and a decrease in the frequency of opioid misuse for parenting women.
AHRQ-authored.
Citation: Ali MM, McClellan C, West KD .
Medical marijuana laws, marijuana use, and opioid-related outcomes among women in the United States.
Womens Health Issues 2021 Jan-Feb;31(1):24-30. doi: 10.1016/j.whi.2020.09.003..
Keywords: Women, Opioids, Substance Abuse, Medication, Policy, Practice Patterns
Reynolds EL, Kerber KA, Hill C
The effects of the Medicare NCS reimbursement policy: utilization, payments, and patient access.
The purpose of this research was to determine whether the 2013 nerve conduction study (NCS) reimbursement reduction changed Medicare use, payments, and patient access to Medicare physicians by performing a retrospective analysis of Medicare data. The investigators found that the Medicare NCS reimbursement policy resulted in a larger decrease in NCS providers than in EMG providers. Despite fewer neurologists and physiatrists performing NCS, Medicare access to these physicians for E/M services was not affected.
AHRQ-funded; HS017690; HS022258.
Citation: Reynolds EL, Kerber KA, Hill C .
The effects of the Medicare NCS reimbursement policy: utilization, payments, and patient access.
Neurology 2020 Aug 18;95(7):e930-e35. doi: 10.1212/wnl.0000000000010090..
Keywords: Payment, Medicare, Policy, Practice Patterns
Heins SE, Frey KP, Alexander GC
Reducing high-dose opioid prescribing: state-level morphine equivalent daily dose policies, 2007-2017.
This paper looked at current state-level policies in the United States from January 2007-May 2017 limiting high morphine equivalent daily dose (MEDD) prescribing. State-level threshold policies were reviewed using LexisNexis and Westlaw Next for legislative acts and Google for nonlegislative state-level policies. State websites were also reviewed to identify additional policies. Policies were then independently double-coded on the categories: state, agency/organization, policy type, effective date, threshold level, and policy exceptions. Currently 22 states have at least 1 MEDD policy, most commonly guidelines (14 states). Other states have prior authorizations (4 states), rules/regulations (4 states), legislative acts (3 states), claim denials (2 states), and alert systems/automatic patient reports (2 states). Thresholds vary widely (30-300 mg MEDD), with higher thresholds corresponding to more restrictive policies (claim denial), and lower thresholds corresponding to less restrictive policies (guidelines). The majority of policies exclude patients with terminal illnesses or acute pain.
AHRQ-funded; HS025557.
Citation: Heins SE, Frey KP, Alexander GC .
Reducing high-dose opioid prescribing: state-level morphine equivalent daily dose policies, 2007-2017.
Pain Med 2020 Feb;21(2):308-16. doi: 10.1093/pm/pnz038..
Keywords: Opioids, Medication, Policy, Practice Patterns, Substance Abuse
Springer R, Marino M,, Bailey SR
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication-assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion.
AHRQ-funded; HS024270.
Citation: Springer R, Marino M,, Bailey SR .
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
Addiction 2019 Oct;114(10):1775-84. doi: 10.1111/add.14667..
Keywords: Opioids, Medication, Substance Abuse, Medicaid, Practice Patterns, Health Insurance, Access to Care, Policy
Raji MA, Kuo YF, Adhikari D
Decline in opioid prescribing after federal rescheduling of hydrocodone products.
This study examined differences in opioid prescribing by patient characteristics and variation in hydrocodone combination product (HCP) prescribing attributed to states, before and after the 2014 Drug Enforcement Administration's reclassification of HCP from schedule III to the more restrictive schedule II. It found that HCP prescribing decreased by 26 percent from June 2013 to June 2015; the rate of prescriptions for any opioid decreased by 11 percent.
AHRQ-funded; HS022134.
Citation: Raji MA, Kuo YF, Adhikari D .
Decline in opioid prescribing after federal rescheduling of hydrocodone products.
Pharmacoepidemiol Drug Saf 2018 May;27(5):513-19. doi: 10.1002/pds.4376.
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Keywords: Policy, Opioids, Practice Patterns, Policy
Kuo YF, Raji MA, Liaw V
Opioid prescriptions in older Medicare beneficiaries after the 2014 federal rescheduling of hydrocodone products.
The authors sought to examine how an October 2014 Drug Enforcement Administration policy reclassified hydrocodone product from schedule III to II has affected older adults. They found that the 2014 change in hydrocodone from schedule III to schedule II was associated with modest decreases in rates of opioid use in the elderly. They also found an unexpected increase in opioid-related hospitalizations without documented opioid prescriptions, which may represent an increase in illegal use.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Liaw V .
Opioid prescriptions in older Medicare beneficiaries after the 2014 federal rescheduling of hydrocodone products.
J Am Geriatr Soc 2018 May;66(5):945-53. doi: 10.1111/jgs.15332.
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Keywords: Elderly, Medicare, Opioids, Policy, Practice Patterns
Fleischman W, Ross JS, Melnick ER
Financial ties between emergency physicians and industry: insights from open payments data.
The authors sought to describe nonresearch, nonroyalty Open Payments made to emergency physicians in the United States. They found that nearly a third of emergency physicians received such payments from industry in 2014, and that most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs.
AHRQ-funded; HS021271.
Citation: Fleischman W, Ross JS, Melnick ER .
Financial ties between emergency physicians and industry: insights from open payments data.
Ann Emerg Med 2016 Aug;68(2):153-58.e4. doi: 10.1016/j.annemergmed.2016.01.014.
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Keywords: Emergency Medical Services (EMS), Medication, Policy, Practice Patterns, Provider: Physician
Sommers BD, Kronick R
AHRQ Author: Kronick R
Measuring Medicaid physician participation rates and implications for policy.
The authors’ objective was to describe several alternative measures of provider participation in Medicaid using recently publicly available data, to compare state rankings across these different metrics, and to discuss potential advantages and disadvantages of each measure for research and policy purposes. Overall, they found that Medicaid participation as measured by raw percentages of physicians taking new Medicaid patients is only weakly correlated with population-based measures that account for both participation rates and the numbers of physicians per capita or physicians per Medicaid beneficiary.
AHRQ-authored.
Citation: Sommers BD, Kronick R .
Measuring Medicaid physician participation rates and implications for policy.
J Health Polit Policy Law 2016 Jan 5;41(2):211-24. doi: 10.1215/03616878-3476117.
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Keywords: Medicaid, Policy, Access to Care, Practice Patterns, Policy
Yeh JS, Austad KE, Franklin JM
Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.
The study’s goal was to determine which medical school characteristics and which conflict of interest policy dimensions were most predictive of students’ reported behaviors. It found that students at schools with the highest ranked interaction policies based on the American Medical Student Association (AMSA) score were 63 percent less likely to accept gifts as students at the lowest ranked schools.
AHRQ-funded; HS018465.
Citation: Yeh JS, Austad KE, Franklin JM .
Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.
PLoS Med 2014 Oct;11(10):e1001743. doi: 10.1371/journal.pmed.1001743..
Keywords: Medical Devices, Medication, Policy, Practice Patterns
Larkin I, Ang D, Avorn J
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
The researchers estimated the effect of anti-detailing policies on off-label prescribing of antidepressants and antipsychotics by pediatricians and by child and adolescent psychiatrists in the period January 2006-June 2009. They found that prescriptions for off-label use of promoted drugs fell by 11 percent and that prescriptions for on-label use of promoted drugs fell by 34 percent. Conversely, prescriptions for on-label use of nonpromoted drugs rose by 14 percent, and those for off-label use of nonpromoted drugs rose by 35 percent. They concluded that these results suggest that pharmaceutical sales representatives promoted drugs not approved for pediatric use and that policies that restrict detailing by those representatives reduced such off-label prescribing.
AHRQ-funded; HS018465.
Citation: Larkin I, Ang D, Avorn J .
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
Health Aff 2014 Jun;33(6):1014-23. doi: 10.1377/hlthaff.2013.0939.
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Keywords: Medication, Children/Adolescents, Communication, Policy, Practice Patterns