EHC Program Inside Track Newsletter

Issue 24, June 2014

Highlighting important news and developments from AHRQ’s Effective Health Care Program

In this issue:

Professional Groups Support Use of AHRQ’s Evidence-Based Resources

Leading health care organizations—including the National Black Nurses Association (NBNA), the American College of Physicians (ACP), the National Hispanic Medical Association (NHMA), and the National Association of Free and Charitable Clinics (NAFC)—have joined efforts to advance the use of evidence-based health information and related tools from the Agency for Healthcare Research and Quality (AHRQ).

More than 600 organizations are using and promoting AHRQ’s Effective Health Care (EHC) Program’s growing body of resources based on the Agency’s patient-centered outcomes research, evidence syntheses, and translational products. These organizations represent health care professionals, patients and caregivers, public health departments, government agencies, medical specialty societies, insurers, universities, and others.

AHRQ’s Effective Health Care (EHC) Program materials “can help us empower our patients to compare their treatment options, regardless of their circumstance,” said NBNA president Deidre Walton, J.D., M.S.N, R.N. “Since we know that one treatment doesn’t fit all, these resources really help advance the nurse-clinician and patient interaction and ultimately improve patient health outcomes.”

Picture of ad featuring photograph of  Deirdra Walton, J.D., M.S.N., R.N.,   president of the National Black Nurses Association.  She is holding a tablet computer with an image of a clinician summary.  Quote from Dr. Walton reads, Let’s share the evidence.  These materials can help us empower our patients regardless of their circumstances. Together we can decide what works best. After all, one treatment doesn’t fit all.NBNA, which represents 150,000 African-American nurses, has shared EHC Program treatment summaries and research with its members to promote the continued use of unbiased, evidence-based research in medical practice.

Walton is among health care leaders whose support for AHRQ’s resources is highlighted in a recent testimonial advertisement campaign (shown right).

“We feel confident giving EHC Program materials to our members, because we know we are equipping them with the highest quality of unbiased research,” she said.

Other organizations are also advocating the use of AHRQ’s evidence-based products in daily clinical practice.

NHMA, for example, featured the EHC Program’s treatment summaries at its annual conference, encouraging attendees to use the bilingual materials in shared decision making between Spanish-speaking health care providers and patients.

Picture of ad featuring photograph of David Bronson, M.D., M.A.C.P. immediate past president of the American College of Physicians.  He is holding a tablet computer with an image of a clinician summary. Quote from Dr. Bronson reads, Thoughtful application of high quality evidence and shared decision-making with informed patients—this produces the best medicine and the best outcomes. ACP recently launched a Web site called “High Value Care,” a broad program that aims to help physicians provide the best possible care to their patients while reducing unnecessary costs to the health care system. As part of their effort to provide resources, clinical research, and educational materials to their physician members, ACP is highlighting several of the Program’s treatment summaries for patients on the new site. Both NHMA and ACP (shown left) also demonstrated their support for the EHC Program in recent advertisements.

NAFC, a long-time supporter of the use of evidence-based resources in clinical practice, distributed EHC Program resources for clinicians and consumers to more than 135 of its member clinics last month. The organization has also hosted Webinars to encourage the use of comparative effectiveness research in shared decision making.

 

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More Resources From the Effective Health Care Program

Acute Migraine: Treatment Options

Cover of “Treating Severe Migraine Headaches in the Emergency Room” consumer summary with woman holding her hands to her forehead.New materials are now available from the EHC Program that compare several types of non-oral treatments for acute migraine in the emergency setting. The resources include information on treatment effectiveness and provide health care providers with information to help make the best possible decisions. Resources include—

 

More Research Needed on the Effectiveness of Bowel Preparation Prior to Undergoing Colorectal Surgery

A research review from AHRQ finds there is low strength of evidence that oral mechanical bowel preparation (OMBP) has similar effectiveness when compared with no preparation with respect to all-cause mortality, anastomotic leakage, wound infection, and peritonitis for patients undergoing elective surgery for colorectal cancer. However, the evidence base was too weak to confidently exclude either modest benefit or modest harm. Evidence on the comparative effectiveness of OMBP versus no preparation was insufficient for all other outcomes, as was evidence on the comparative effectiveness of OMBP versus enema for all outcomes, such as surgical site infection and reoperation. Future research, including pooled reanalyzes of existing data and new comparative studies, both randomized and nonrandomized, is needed to definitively confirm or exclude the possibility of benefit or harm, especially in subgroups of patients. These findings are available in the research review Oral Mechanical Bowel Preparation for Colorectal Surgery.

Medications Acamprosate and Oral Naltrexone Have Best Evidence for Decreasing Alcohol Use

A new research review from AHRQ indicates that a variety of medicines, used in conjunction with psychosocial co-interventions, can decrease alcohol consumption for patients with alcohol-use disorders (AUDs). The medications acamprosate and oral naltrexone have the best evidence for decreasing alcohol consumption. Among medications used off-label, moderate evidence supports the effectiveness of nalmefene and topiramate for improving some alcohol consumption outcomes. Since research has not consistently recognized the superiority of either medication, other factors may impact the choice of medications, including how often a medication is taken, potential adverse reactions, and the availability of treatments. These findings are available in the research review Pharmacotherapy for Adults with Alcohol-Use Disorders in Outpatient Settings.

Updated Guide Available for Developing Registries to Evaluate Patient Outcomes

The EHC Program recently released a new publication entitled Registries for Evaluating Patient Outcomes: A User’s Guide: 3rd Edition. This guide supports the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. It contains 11 new topics in registry methodology and updates the existing chapters to cover new legislation and other changes in registry science. Real-world contemporary case examples are provided to illustrate key principles of registry design, operation, and evaluation and to demonstrate different strategies and perspectives to address common challenges. The Registries User’s Guide can be downloaded for free from the EHC Program and in June it will also be available in eBook file formats, designed to be read with eBook readers (e.g., Nook, Kindle, iPad).

New CME/CE Activities on Improving Quality of Care

Two new online continuing education (CME/CE) courses are now available from AHRQ-funded Centers for Education and Research on Therapeutics:

  • Bone Health, Race/Ethnicity, and Emerging Technologies for Predicting Risk of Fracture and Limitations in Use With Specified Subpopulations (http://chainonline.org/cme-ce/bone-health/) familiarizes clinicians with current issues around osteoporosis and osteoporosis-related fracture risk in different subpopulations and explores issues around assessment of hip fracture risk among specific subpopulations using FRAX®, a tool that is increasingly being applied in clinical practice.
  • Medication Nonadherence Is Associated With Increased Healthcare Utilization in Pediatric Patients With Chronic Diseases (http://chainonline.org/cme-ce/medication-adherence/) reviews the relationship between medication non-adherence and health care use (i.e., hospitalizations, emergency department visits, outpatient visits) and costs in children and adolescents who have a chronic medical condition.

The CME/CE activities have been approved for AMA PRA Category 1 Credit(s).

CHAIN Online (http://chainonline.org) operates as a collaborative effort of the Educational Consortium. It provides timely and practical information to health care professionals, patients, family members, medical faculty, and others about emerging issues concerning the safe and effective use of drugs, devices, and biological products.

Learn more about the Centers for Education and Research on Therapeutics, visit: http://chainonline.org/about-the-certs/about-the-certs/.

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Current as of June 2014
Internet Citation: EHC Program Inside Track Newsletter: Issue 24, June 2014. June 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/insidetrack/24/index.html