January 10, 2012
AHRQ News and Numbers
The proportion of children who used a prescribed controller drug to treat their asthma nearly doubled from 29 percent in 1997-1998 to 58 percent in 2007-2008. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #341: Changes in Childrens Use and Expenditures for Asthma Medications, United States, 1997-1998 to 2007-2008.]
- New patient-centered medical home brief and white paper now available.
- More research needed on benefits and harms of devices used with percutaneous coronary interventions.
- AHRQ releases 2.0 version of CAHPS® Clinician and Group Surveys.
- New CAHPS®podcasts feature quality improvement topics.
- New research report compares newer, older medications for epilepsy.
- Antibiotics equally effective in treatment of Clostridium difficile infections.
- AHRQ's Health Care Innovations Exchange focuses on redesigning care processes through technology.
- AHRQ announces new information on funding opportunities.
- New publication helps hospital emergency departments improve patient flow.
- HHS Partnership for Patients initiative to improve hospital care.
- AHRQ in the professional literature.
1. New Patient-Centered Medical Home Brief and White Paper Now Available
A new decisionmaker brief and white paper from AHRQ discuss how to improve the quality of the evidence and evaluations for the Patient-Centered Medical Home to ensure optimal policy decisions. The decisionmaker brief offers a concise description of why and how to commission effective evaluations of medical home demonstrations. It provides insights into which outcomes to assess, why to include control practices, and why accounting for clustering is critical to accurate evaluations. The white paper provides information about how to determine the effect sizes a given study can expect to detect, identifies the number of patients and practices required to detect achievable effects, and demonstrates how evaluators can select the outcomes and types of patients included in analyses to improve a study's ability to detect true effects. Select to access the brief and white paper on AHRQ's Web site.
2. More Research Needed on Benefits and Harms of Devices Used with Percutaneous Coronary Interventions
A new AHRQ review has found more research is needed on the benefits and harms associated with using adjunctive devices in patients with acute coronary syndrome (ACS) who are undergoing percutaneous coronary interventions (PCI). PCI is a treatment option available for patients with ACS that opens the coronary arteries to allow better blood flow. The review examines adjunctive device technologies' impacts on intermediate and final health outcomes, compares rates and types of negative or unintended effects, and reviews the impact of patient characteristics on outcomes. Select to access the report, Comparative Effectiveness of Adjunctive Devices to Remove Thrombi or Protect Against Distal Embolization in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention of Native Vessels.
3. AHRQ Releases 2.0 Version of CAHPS® Clinician and Group Surveys
AHRQ's CAHPS® Consortium has updated the CAHPS Clinician & Group Surveys, which are used to assess patients' experiences with care from primary and specialty care providers. As part of the updates, two new supplemental item sets for the surveys are now available. The CAHPS Health Information Technology (HIT) Item Set focuses on patients' experiences with the use of health IT in physicians' offices. The CAHPS Patient-Centered Medical Home (PCMH) Item Set enables users to ask patients about their experiences with the domains of primary care that define a medical home.
4. New CAHPS® Podcasts Feature Quality Improvement Topics
AHRQ's CAHPS® User Network has launched a new series of audio and video podcasts on improving patients' experiences with care. The Quality Improvement podcast series will feature speakers from a variety of organizations around the country who share both their professional expertise and their experiences using CAHPS surveys to assess and improve the quality of care they deliver. The series will cover a range of topics, including leadership, culture, teamwork, and communication. The first podcast features Dr. Larry Morrissey, Medical Director of Quality Improvement for Stillwater Medical Group, in Stillwater, MN, who discusses value of and business case for improving patient experience.
5. New Research Report Compares Newer, Older Medications for Epilepsy
A new AHRQ evidence review evaluates the effectiveness and risks of antiepileptic medications. Among the findings: the older drugs provide similar or better control compared to newer drugs, but with more adverse events. Research review authors found a lack of evidence to support substantive differences in terms of benefits or harms associated with the use of an innovator versus generic treatments. Select to access Comparative Effectiveness of Medications in Patients with Epilepsy.
6. Antibiotics Equally Effective in Treatment of Clostridium difficile Infections
A new report, Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection, examines current evidence for C. difficile diagnosis, treatment, and prevention methods. The report finds that the standard antibiotic treatments—oral vancomycin, metronidazole, and the newly approved fidaxomicin—are equally effective for curing initial C. difficile infections. However, recurrence of these infections was found to be less frequent for those who used fidaxomicin rather than vancomycin. C. difficile is a dangerous healthcare-associated infection and a growing health care problem, especially among older adults and those with weakened immune systems. The report is accompanied by clinician and consumer summaries, as well as a CME activity and faculty slides for clinicians.
7. AHRQ's Health Care Innovations Exchange Focuses on Redesigning Care Processes Through Technology
The December 21 issue of AHRQ's Health Care Innovations Exchange features profiles of two providers that leveraged the use of technology to redesign care processes, leading to greater adherence to recommended care and improved outcomes. One innovation implemented at two rheumatology clinics operated by the Geisinger Health System in Pennsylvania uses a software program to pull data from a separate Electronic Medical Record and patient touch screen questionnaire. This allows clinicians to quickly and systematically analyze each patient's progress and condition right before the visit and devote the time spent with the patient to solving problems and providing necessary interventions and support. Early results suggest that the program has been widely adopted by physicians and has generated improvements in the provision of needed services and patient-reported symptoms. Select to read more about information technology and care processes on AHRQ's Health Care Innovations Exchange Web site.
8. AHRQ Announces New Information on Funding Opportunities
AHRQ is temporarily suspending individual career development Funding Opportunity Announcements (FOAs) due to budget constraints. This change applies to the February 12 new application receipt date and March 12 receipt date for resubmission applications. Select to read the official grant policy notice published in the NIH Guide: Suspension of AHRQ Individual Career Development (K) Funding Opportunity Announcements (FOAs) for February 5 Receipt Date, (NOT-HS-12-003). In another related development, AHRQ has announced a new training opportunity available through its Funding Opportunity Announcements (FOA). This award will provide an opportunity for career development support. Select for more detailed information on the AHRQ Patient Centered Outcomes Research Institutional Award (K12) . The deadline to submit applications is January 30. Finally, as part of AHRQ's efforts to implement the Affordable Care Act funding for capacity development and training, stay tuned for announcements and dissemination of information on funding opportunities for career development and training focused on patient-centered outcomes research in the coming weeks.
9. New Publication Helps Hospital Emergency Departments Improve Patient Flow
A new publication funded by AHRQ aims to help hospitals improve their emergency department (ED) operations by reducing long wait times. Recent Government data has found that only 18 percent of patients at U.S. EDs were seen within 15 minutes, creating delays that cause some patients to become sicker or others to leave without getting treated. Starting in 2013, hospitals' performance in timely care of ED patients will factor in to their Medicare payments. The new guide provides step-by-step instructions for planning and implementing strategies that improve patient flow through EDs. Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals also examines the value of forming a patient flow team, describes how to measure ED performance and provides a framework for selecting improvement strategies. Select to access the new guide on reducing ED crowding.
10. HHS Partnership for Patients Initiative to Improve Hospital Care
Hospitals across the country will have new resources and support to make health care safer and less costly by targeting and reducing the millions of preventable injuries and complications from healthcare-acquired conditions. As a part of the Partnership for Patients initiative, a nationwide public-private collaboration to improve the quality, safety, and affordability of health care for all Americans, $218 million will go to 26 State, regional, national, or hospital system organizations. Select for more information. Select to read the HHS press release.
11. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Access to the abstracts may be blocked because of firewalls or specific settings on individual computer systems. If you are having problems, ask your technical support staff for possible remedies.
Bhatia R, Hartman C, Kallen MA, et al. Persons newly diagnosed with HIV infection are at high risk for depression and poor linkage to care: results from the Steps Study. AIDS Behav 2011 Aug; 15(6):1161-70. Select to access the abstract on PubMed.®
Carthon MB. Making ENDS meet: community networks and health promotion among Blacks in the City of Brotherly Love. Am J Public Health 2011 Aug; 101(8):1392-401. Select to access the abstract on PubMed.®
Sachs GA, Carter R, Holtz LR, et al. Cognitive impairment: an independent predictor of excess mortality: a cohort study. Ann Intern Med 2011 Sep 6; 155(5):300-8. Select to access the abstract on PubMed.®
Feudtner C, Dai D, Hexem KR, et al. Prevalence of polypharmacy exposure among hospitalized children in the United States. Arch Pediatr Adolesc Med 2012 Jan; 166(1):9-16. Select to access the abstract on PubMed.®
Sood N, Huckfeldt PJ, Escarce JJ, et al. Medicare's bundled payment pilot for acute and postacute care: analysis and recommendations on where to begin. Health Aff 2011 Sep; 30(9):1708-17. Select to access the abstract on PubMed.®
Basu J. Medicare managed care and primary care quality: examining racial/ethnic effects across states. Health Care Manag Sci 2011 Sep 3. Select to access the abstract on PubMed.®
DeVoe JE, Tillotson CJ, Lesko SE, et al. The case for synergy between a usual source of care and health insurance coverage. J Gen Intern Med 2011 Sep; 26(9):1059-66. Select to access the abstract on PubMed.®
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Current as of January 2012
AHRQ Electronic Newsletter, January 10, 2012, Issue 333. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews333.htm