July 13, 2012
Cardiac stent procedure rates fell by 27 percent between 2006 and 2009, after a 61 percent rise during the previous 7 years. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #128: Hospital Stays with Cardiac Stents, 2009.]
- Clinician and patient resources now available on ADHD treatment options.
- Deadline extended for nominations to workgroups on conversion of AHRQ Quality Indicators.
- Insulin pump and glucose monitoring improve blood sugar control for diabetes patients.
- AHRQ releases projections for cardiovascular and cerebrovascular conditions and procedures.
- July issue of AHRQ Web M&M discusses approaches to improve clinical competence in medical trainees.
- Behavioral counseling is effective treatment for alcohol misuse.
- AHRQ in the professional literature.
1. Clinician and Patient Resources Now Available on ADHD Treatment Options
A new set of clinician and patient resources from AHRQ's Effective Health Care Program evaluates the latest research on the benefits and side effects of attention deficit hyperactivity disorder (ADHD) treatments for children and adolescents. Among preschool children with disruptive behavior disorder (which includes ADHD), the research review found that parental behavior training reduces ADHD symptoms. The review also found that medications are thought to generally be safe and effective for improving school-age children's behavior, but long-term side effects are unknown. The new resources include a patient summary, clinician summary, CME/CE activity, and faculty slide set, based on the review, Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-Risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment.
2. Deadline Extended for Nominations to Workgroups on Conversion of AHRQ Quality Indicators
The deadline for nominations for members of workgroups on ICD-10-CM/PCS Conversion of AHRQ Quality Indicators (QIs) has been extended through July 22 to provide greater opportunity for participation. Nominations are being sought for members of approximately 10 multidisciplinary workgroups on ICD-10-CM/PCS conversion of the AHRQ QIs. These workgroups are being formed as part of a structured approach to convert the existing QI specifications from ICD-9-CM to ICD-10-CM/PCS, incorporating coding expertise, clinical expertise, and health services research/quality measurement expertise. These workgroups will evaluate the results of automated "code mapping" from ICD-9-CM to ICD-10-CM/PCS, providing input and advice about similarities and differences between mapped codes. This workgroup process will lead to specific recommendations about how the existing QIs should be re-specified using ICD-10-CM/PCS codes, retaining the clinical intent of each indicator while exploiting the greater specificity of ICD-10-CM/PCS to improve validity. Self-nominations are welcome. Third-party nominations must indicate that the individual has been contacted and is willing to serve on one of the workgroups. Select to read the July 10 Federal Register notice.
3. Insulin Pump and Glucose Monitoring Improve Blood Sugar Control for Diabetes Patients
Sensor-augmented insulin pumps (insulin pump combined with real time continuous glucose-blood sugar monitoring) are superior to multiple daily insulin injections and self-monitoring of blood glucose (finger sticks) to reduce high blood sugar in patients with type 1 diabetes, a new review from AHRQ's Effective Health Care Program has found. The review found an improved quality of life for type 1 diabetic patients who are using continuous insulin infusion rather than multiple daily injections of insulin. Additional research should focus on assessing the impact of these technologies on long-term clinical outcomes and evaluating the effectiveness of insulin delivery methods and glucose monitoring technologies in different patient populations. These findings and future research needs are summarized in Methods of Insulin Delivery and Glucose Monitoring: Comparative Effectiveness.
4. AHRQ Releases Projections for Cardiovascular and Cerebrovascular Conditions and Procedures
AHRQ has released a new, comprehensive report that provides trend data for cardiovascular and cerebrovascular conditions and procedures that are among the top causes of hospital stays. These conditions are costly and important to patients' quality of life, and most of them are linked to prevalent chronic conditions of hypertension, diabetes, high cholesterol, and obesity. The report found that women tend to have lower average costs, despite higher average lengths of stay, and that women generally experience higher mortality rates for these conditions than men, despite the increased attention on screening and preventing less-prevalent breast and cervical cancers in women. This report produces hospital projections through 2012. Select to access the report (PDF File; Plugin Software Help).
5. July Issue of AHRQ Web M&M Discusses Approaches to Improve Clinical Competence in Medical Trainees
The July issue of AHRQ Web M&M features a Spotlight Case involving a second-year resident and intern who performed a diagnostic and therapeutic fluid removal on a 67-year-old patient without supervision. The resident had performed this procedure several times in the past, and did not seek the supervision of the night hospitalist, who was available to supervise procedures overnight. Shortly after the procedure, the patient had significant internal bleeding, which was resolved by emergency surgery and a long hospital stay. A commentary on the case is provided by Jeffrey H. Barsuk, M.D., associate professor of medicine at Northwestern University Feinberg School of Medicine, Chicago. The Perspectives on Safety section features an interview with David Blumenthal, M.D., chief information officer and innovation officer at Partners HealthCare System, Boston, and the former National Coordinator for Health Information Technology. Physicians and nurses can receive free CME, CEU, or training certification by taking the Spotlight Quiz. Select to access AHRQ's Web M&M site.
6. Behavioral Counseling is Effective Treatment for Alcohol Misuse
AHRQ's Effective Healthcare Program has released a new research review that found behavioral counseling interventions improved certain behavioral outcomes for adults with risky/hazardous drinking habits. The research review assesses the effectiveness of screening followed by behavioral counseling for alcohol misuse in adolescents and adults in primary care settings. For most medical outcomes (kidney/liver damage, etc.), available evidence either found no difference between interventions and controls or was insufficient to draw conclusions. Select to access Screening, Behavioral Counseling, and Referral in Primary Care to Reduce Alcohol Misuse.
7. 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.
Bertakis KD, Azari R. Patient-centered care: the influence of patient and resident physician gender and gender concordance in primary care. J Womens Health 2012 Mar; 21(3):326-33. Select to access the abstract on PubMed.®
McHugh MD, Brooks Carthon M, Sloane DM, et al. Impact of nurse staffing mandates on safety-net hospitals: lessons from California. Milbank Q 2012 Mar; 90(1):160-86. Select to access the abstract on PubMed.®
Fitzgibbon ML, Tussing-Humphreys LM, Porter JS, et al. Weight loss and African-American women: a systematic review of the behavioural weight loss intervention literature. Obes Rev 2012 Mar; 13(3):193-213. Select to access the abstract on PubMed.®
Powell ES, Khare RK, Courtney DM, et al. Lower mortality in sepsis patients admitted through the ED vs direct admission. Am J Emerg Med 2012 Mar; 30(3):432-9. Select to access the abstract on PubMed.®
Souter KJ, Gallagher TH. The disclosure of unanticipated outcomes of care and medical errors: what does this mean for anesthesiologists? Anesth Analg 2012 Mar; 114(3):615-21. Select to access the abstract on PubMed.®
Song PH, Robbins J, Garman AN, et al. High-performance work systems in health care, part 3: The role of the business case. Health Care Manage Rev 2012 Apr; 37(2):110-21. Select to access the abstract on PubMed.®
Nagykaldi Z, Aspy CB, Chou A, et al. Impact of a wellness portal on the delivery of patient-centered preventive care. J Am Board Fam Med 2012 Mar; 25(2):158-67. Select to access the abstract on PubMed.®
Singleton RJ, Holman RC, Folkema AM, et al. Trends in lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general U.S. child population. J Pediatr 2012 Mar 19. [Epub ahead of print.]
Select to access the abstract on PubMed.®
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Current as of July 2012
AHRQ Electronic Newsletter, July 13, 2012, Issue 349. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews349.htm