EHC Program Inside Track Newsletter

Issue 13, April 2013
EHC Inside Track is a newsletter highlighting important news and developments from AHRQ's Effective Health Care Program.

In this issue:

New AHRQ Facebook Pages Help Your Patients Navigate Treatment Options

AHRQ’s Effective Health Care (EHC) Program is pleased to announce the launch of two new Facebook pages to help your patients find unbiased information on treatment options and share these online resources with family and friends. The pages feature sections on diabetes; heart conditions; mental health; muscle, bone, and joint conditions; women’s health; and men’s health, as well as links to EHC summaries for consumers on additional conditions.   

Select the links below to view treatment options by health topic:

AHRQ’s Facebook pages help you share information with your patients about the importance of exploring their treatment options, comparing the benefits and risks of each, and preparing to discuss these options with health care providers. These pages also provide a place for people to connect directly with AHRQ through social media.

  • The launch of these pages marks the beginning of a national initiative to disseminate evidence-based information about the comparative benefits and risks of different treatment options. Additional activities will be launched and featured in EHC Inside Track throughout 2013.

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EHC in Education: Program Tools Used in Pharmacy Training

About 200 students at the University of the Sciences, Philadelphia College of Pharmacy, attended a lecture in a March pharmacoeconomics class that highlighted the benefits of comparative effectiveness research and the practical use of research summaries produced by AHRQ’s EHC Program.

The lecture exemplified how EHC Program resources are valuable not only to practicing clinicians but to health professionals-in-training. In addition to featuring the Program’s clinician and consumer summaries on diabetes and heart disease, Vince Willey, PharmD, vice chair and associate professor of pharmacy, highlighted the EHC Program’s faculty slide decks.

“Great information in one powerful piece that can help guide understanding – whether looking up a drug information question or learning about a topic area,” is how Willey characterized summary products from the EHC Program. Willey is also a member of AHRQ’s EHC Program Pharmacy Workgroup.

After a “live” demonstration on how students could gain access to Web-based EHC Program resources, Willey led a class discussion about how evidence is generated for AHRQ’s evidence reviews and noted that 300-page reports are distilled into accessible summaries for clinicians and patients.

Students voiced enthusiasm for the potential use of EHC Program resources in the pharmacy setting, Willey said, in particular pointing to diabetes materials as tools to help counsel patients.

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More New, Free Effective Health Care Program Resources 

New Research Review Comparing Treatment Options
Each of these reviews compares available evidence from numerous research studies.

Stenting in Patients with Coronary Artery Disease

AHRQ’s Effective Health Care Program has released a new research review that discusses the effectiveness of various methods for determining whether coronary stenting is necessary for patients with coronary artery disease. The review finds that the use of fractional flow reserve to decide whether intermediate coronary lesions require stenting reduces risk of death, myocardial infarction (MI), and major adverse cardiac events, decreases procedure costs, and leads to fewer stents implanted, as compared with stenting decisions based on angiography alone. Access the full research review here: Intravascular Diagnostic Procedures and Imaging Techniques versus Angiography Alone in Coronary Artery Stenting: A Comparative Effectiveness Review.

Cerebral Palsy: Interventions for Feeding and Nutrition Problems

A new AHRQ research review on feeding and nutrition interventions in patients with cerebral palsy (CP) finds that despite a range of surgical and non-surgical feeding interventions for patients, insufficient information is available on the efficacy, safety, and applicability of these interventions. Multiple interventions are often used in combination to treat feeding difficulties in adolescents with cerebral palsy, making it challenging to know the individual effects of each intervention. AHRQ’s research review examines the effects of available interventions for feeding and nutrition problems that have been evaluated in people with CP. Read the full research review here: Interventions for Feeding and Nutrition in Cerebral Palsy.

Combined Oral Contraceptives Effective in Treating Abnormal Uterine Bleeding

According to a new research review from AHRQ, there is strong evidence to show that the use of combined oral contraceptives can improve menstrual regularity and reduce menstrual blood loss for women with abnormal uterine bleeding (AUB). The review finds that effective treatment options (both contraceptive and noncontraceptive) are available in the primary care setting for women who have problematic, irregular, or heavy cyclic menstrual bleeding. Read the full research review here: Primary Care Management of Abnormal Uterine Bleeding.

Review Finds Nasal Allergies and Mild Asthma May Be Safely and Effectively Treated with Allergen-Specific Immunotherapy

According to the latest research review from AHRQ, there is at least a moderate level of evidence that allergen-specific immunotherapy – either injected under the skin (subcutaneous) or placed under the tongue (sublingual) – is effective and safe for the treatment of nasal allergies and mild asthma in both adults and children. The review finds a high strength of evidence that subcutaneous allergen-specific immunotherapy reduces asthma, nasal, and conjunctivitis symptoms, as well as the use of asthma medications, and improves disease-specific quality of life. There is a moderate strength of evidence that subcutaneous immunotherapy reduces the use of rhinoconjunctivitis medication. Currently, there are no FDA-approved sublingual forms of immunotherapy; researchers and physicians in the United States are exploring the off-label use of subcutaneous immunotherapy for sublingual desensitization. The review finds a high strength of evidence that such sublingual immunotherapy reduces asthma symptoms, and moderate evidence that it reduces nasal and conjunctivitis symptoms and asthma and rhinoconjunctivitis medication use and improves disease-specific quality of life. Additional studies are needed to compare if one route of administration is more effective or safer than the other. Read the full research review here: Allergen-Specific Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and/or Asthma.

Prostate Cancer: PCA3 Testing for Diagnosis and Management

In men at risk for prostate cancer, there is low strength of evidence that the prostate cancer antigen 3 gene test (PCA3) has better diagnostic accuracy at predicting prostate cancer than using elevated serum total prostate specific antigen levels, according to a new AHRQ research review. In addition, there is insufficient evidence to conclude that this leads to improved intermediate or long-term health outcomes. More research is needed on PCA3 to assess the comparative effectiveness in predicting prostate cancer at biopsy and to better inform biopsy, management, and treatment decisions. Read the full research review here: PCA3 Testing for the Diagnosis and Management of Prostate Cancer.

Posttraumatic Stress Disorder: Prevention Interventions Need More Research

According to a new AHRQ research review on interventions to prevent posttraumatic stress disorder (PTSD), for civilian victims of trauma with injuries requiring hospital admission for surgery, collaborative care (a combination of care management, psychopharmacology, and cognitive behavioral therapy) is effective at reducing the severity of PTSD symptoms at 6, 9, and 12-month follow-up consultations. In individuals with acute stress disorder, brief trauma-focused cognitive behavioral therapy was more effective in reducing the severity of PTSD symptoms than supportive counseling. Prevention of PTSD can potentially reduce a significant burden on individual and societal suffering, yet more research is needed on other interventions to prevent PTSD. These findings can be found in the full review, Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma.

Posttraumatic Stress Disorder: Effective Treatment Options

According to new AHRQ research review, several psychological and drug treatments appear to be effective for improving outcomes for adults with posttraumatic stress disorder (PTSD). Psychological therapies that improve PTSD symptoms include exposure therapy, cognitive processing therapy, cognitive therapy, cognitive behavioral therapy-mixed therapies, eye movement desensitization and reprocessing, and narrative exposure therapy. Pharmacological treatments that improve PTSD symptoms include fluoxetine, paroxetine, sertraline, topiramate and venlafaxine. Although the evidence supports the effectiveness of several types of psychological and drug treatments for PTSD, clinical uncertainty exists about what treatment to select for individual patients. These findings can be found in the full review, Psychological Treatments and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD).

Spanish Language Patient Resources

Tratamiento de la hepatitis C crónica: Revisión de la investigación para adultos (Treatment for Hepatitis C Virus Infection in Adults)

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Page last reviewed April 2013
Internet Citation: EHC Program Inside Track Newsletter. Content last reviewed April 2013. Agency for Healthcare Research and Quality, Rockville, MD.