Updated Effective Health Care Guides on Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes are Available

Black children were four times more likely than white children to be hospitalized for a severe asthma attack in 2007. [Source: Agency for Healthcare Research and Quality, ]

Today's Headlines

1. Updated effective health care guides on safety of oral diabetes medications for adults with Type 2 diabetes are available
2. New toolkit helps medical practices examine the impact of health IT on workflow
3. New AHRQ effective health care guides on comparative effectiveness of therapies for autism are available
4. New brief outlines strategies to put patients at the center of primary care
5. New AHRQ effective health care guides on comparative effectiveness of pain management interventions for hip fracture are available
6. AHRQ's Health Care Innovations Exchange highlights medical electronic alerts
7. E-health project boosts physicians' ability to use patient registries
8. 2009 HCUP Kids' Inpatient Database now available
9. AHRQ in the professional literature

1. Updated Effective Health Care Guides on Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes are Available

An update to the 2007 AHRQ research review Comparative Effectiveness and Safety of Oral Medications for Adults With Type 2 Diabetes is available from AHRQ's Effective Health Care Program. In 2007, AHRQ published its first systematic review on the comparative effectiveness of oral medications for type 2 diabetes. The 2011 update includes newer medications and two-drug combinations. The management of hyperglycemia is an important focus of treatment to achieve improved macrovascular and microvascular outcomes in patients with type 2 diabetes. Controlling blood-glucose levels often requires several strategies, including weight loss if needed, dietary control, increased physical activity, and antidiabetic medications. Treatment regimens include single drugs and combinations of drugs from different classes. Choosing among the available medications requires consideration of benefits, adverse effects, and mechanism of action.

2. New Toolkit Helps Medical Practices Examine the Impact of Health IT on Workflow

A new AHRQ-funded toolkit prepared by the University of Wisconsin-Madison's Center for Quality and Productivity Improvement will assist small and medium sized practices in workflow analysis and redesign before, during, and after health IT implementation. To toolkit, Workflow Assessment for Health IT, includes tools to analyze workflow, examples of workflow analysis and redesign, and others' experiences with health IT and workflow.

3. New AHRQ Effective Health Care Guides on Comparative Effectiveness of Therapies for Autism Are Available

AHRQ's Effective Health Care Program has released new consumer and clinician summary guides to help families of children living with Autism Spectrum Disorders (ASDs) and their clinicians work together to make important decisions about how to treat and manage the condition. These free guides examine treatment therapies for children ages 2-12 with ASDs that focus on improving key deficits in social communication, addressing challenging behaviors, treating commonly associated difficulties (e.g., anxiety, attention difficulties, sensory difficulties), promoting functional independence, and improving quality of life. The new guides do not address potential causes of autism. The consumer guide, Therapies for Children with Autism Spectrum Disorders, A Review of the Research for Caregivers, provides an overview of the types of programs and therapies available to children with ASDs, available evidence on each program or therapy and questions to ask when planning therapies and programs for ASD. The clinician guide, Comparative Effectiveness of Therapies for Children with Autism Spectrum Disorders, summarizes key findings, presents the clinician bottom line, and highlights areas for further autism-related research. There is also a continuing education module, Comparative Effectiveness of Therapies for Children with Autism Spectrum Disorders to supplement existing clinician resources on ASDs.

4. New Brief Outlines Strategies to Put Patients at the Center of Primary Care

AHRQ has released a new brief, The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care, highlighting opportunities to improve patient engagement in primary care. The brief focuses on involvement at three levels: the engagement of patients and families in their own care, in quality improvement activities in the primary care practice, and in the development and implementation of policy and research related to the patient-centered medical home (PCMH). Strategies to Put Patients at the Center of Primary Care provides a clear and concise definition of the patient-centered medical home and outlines six strategies that can be used to support primary care practices in their efforts to engage patients and families. This brief and other resources, including white papers and a searchable database of PCMH-related articles, is available from AHRQ's online PCMH Resource Center at PCMH_Patients at the Center of Primary Care [PDF File].

5. New AHRQ Effective Health Care Guides on Comparative Effectiveness of Pain Management Interventions for Hip Fracture Are Available

AHRQ's Effective Health Care Program has released new consumer and clinician summary guides on recent comparative effectiveness review on pain management interventions for hip fracture. The clinician guide, Pain Management Interventions for Elderly Patients With Hip Fracture, focused comparative effectiveness, benefits, and adverse events associated with interventions for acute-pain management, as compared to usual care, in elderly patients with hip fractures from low-impact injury and the consumer guide, Managing Pain From a Broken Hip: A Guide for Adults and Their Caregivers, provides plain-language information on treatment for older adults who have pain from a broken hip and helps patients and caregivers work with clinicians for treatment and pain management. In addition, slide talks are available.

6. AHRQ's Health Care Innovations Exchange Highlights Medical Electronic Alerts

This week's issue of AHRQ's Health Care Innovations Exchange features three profiles of innovative programs that use electronic alerts or reminders along with clinical guidelines or other best practices to improve patient care and physician performance. One such innovation is an AHRQ-funded program in internal medicine at Northwestern University that integrates unobtrusive alert based on 16 standardized quality measures into its electronic medical record system. Physicians are reminded to order relevant tests or treatment or document legitimate exceptions. The program improved physician performance on most of the 16 targeted measures by increasing recommended care and/or documentation of exceptions. Read more innovations about electronic alerts on AHRQ's Health Care Innovations Exchange Web site.

7. E-Health Project Boosts Physicians' Ability to Use Patient Registries

A new AHRQ-funded study showed that Massachusetts physicians who took part in a 4-year, $50 million health information technology (IT) program increased their ability to generate and use registries that provide information about laboratory test results and medication use. The ability to use patient registries, or lists of patients with specific conditions, medications or test results, is considered an essential tool for improving health care and is in the "meaningful use" criteria developed by the Centers for Medicare and Medicaid Services. A total of 163 physicians from 134 practices in three communities participated in the health IT program between 2005 through 2009. Sponsored by the Massachusetts eHealth Collaborative, the program consisted of robust electronic health records and work-flow redesign and technical support at no cost to the practices. Compared with all physicians who were surveyed in 2005, all respondents in 2009 were more likely to be able to generate significantly more laboratory and medication registries. The study was published in the July 7 issue of Health Affairs. Select to access the abstract on PubMed.®

8. 2009 HCUP Kids' Inpatient Database Now Available

AHRQ's Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) featuring 2009 data has been released. Released every three years, the KID is designed for studying a broad range of conditions and procedures related to hospitalizations of children. The sample design of the KID enable analyses of common conditions and procedures as well as rare ones, such as congenital anomalies or organ transplantations. The KID allows researchers and policymakers to identify, track, and analyze trends in pediatric healthcare utilization, access charges, quality, and outcomes. The KID can be purchased through the HCUP Central Distributor. Many statistical tables from the KID can be accessed free on HCUPnet. Select for additional information on the KID on the HCUP-US Web site.

9. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Kmetik KS, O'Toole MF, Bossley H, et al. Exceptions to outpatient quality measures for coronary artery disease in electronic health records. Ann Intern Med 2011 Feb 15; 154(4):227-34. Select to access the abstract on PubMed®.

Nicholas LH, Dimick JB, Iwashyna TJ. Do hospitals alter patient care effort allocations under pay-for-performance? Health Serv Res 2011 Feb; 46(1 Pt 1):61-81. Select to access the abstract on PubMed®.

Delgado MK, Acosta CD, Ginde AA, et al. National survey of preventive health services in US emergency departments. Ann Emerg Med 2011 Feb; 57(2):104-108.e2. Select to access the abstract on PubMed®.

Persell SD, Kaiser D, Dolan NC, et al. Changes in performance after implementation of a multifaceted electronic-health-record-based quality improvement system. Med Care 2011 Feb;49(2):117-25. Select to access the abstract on PubMed®.

Curtis JR, Xie F, Chen L, et al. The incidence of gastrointestinal perforations among rheumatoid arthritis patients. Arthritis Rheum 2011 Feb; 63(2):346-51. Select to access the abstract on PubMed®.

Brokel JM, Schwichtenberg TJ, Wakefield DS, et al. Evaluating clinical decision support rules as an intervention in clinician workflows with technology. Comput Inform Nurs 2011 Jan-Feb; 29(1):36-42. Select to access the abstract on PubMed.®

Higgins L, Brown M, Murphy JE, et al. Community pharmacy and pharmacist staff call center: assessment of medication safety and effectiveness. J Am Pharm Assoc 2011 Jan-Feb; 51(1):82-9. Select to access the abstract on PubMed.®

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