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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedMcPheeters M, O'Connor EA, Riley S
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
Researchers conducted a literature review and analysis to compare efficacy of therapies for alcohol use disorder. Their findings supported the use of oral naltrexone at 50 mg/d and acamprosate as first-line pharmacotherapies in conjunction with psychosocial interventions for treating alcohol use disorder.
AHRQ-funded; 75Q80120D00007.
Citation: McPheeters M, O'Connor EA, Riley S .
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
JAMA 2023 Nov 7; 330(17):1653-65. doi: 10.1001/jama.2023.19761..
Keywords: Medication, Alcohol Use, Evidence-Based Practice, Patient-Centered Outcomes Research
Lee AK, Bobb JF, Richards JE
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
This study’s goal was to evaluate an implementation intervention to increase (1) population-based alcohol-related prevention with brief interventions and (2) treatment of alcohol use disorder (AUD) in primary care implemented with a broader program of behavioral health integration. This stepped-wedge cluster randomized trial called the Sustained Patient-Centered Alcohol-Related Care (SPARC) trial included 22 primary care practices in an integrated health system in Washington state. Participants consisted of all adult patients 18 years or older with primary care visits from January 2015 to July 2018. The study included 7 waves, with practices randomly assigned launch dates. A total of 333,596 patients visited primary care (mean age, 48 years; 193,583 [58%] female; 234,764 [70%] White individuals). The proportion of patients with brief intervention was higher during SPARC intervention than usual care periods (57 vs 11 per 10,000 patients per month). The proportion with AUD treatment engagement did not differ during intervention and usual care. However, it did increase intermediate outcomes: screening (83.2% vs 20.8%), new AUD diagnosis (33.8 vs 28.8 per 10,000), and treatment initiation (7.8 vs 6.2 per 10,000).
AHRQ-funded; HS023173.
Citation: Lee AK, Bobb JF, Richards JE .
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
JAMA Intern Med 2023 Apr;183(4):319-28. doi: 10.1001/jamainternmed.2022.7083.
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Patient-Centered Healthcare
Alexandre W, Muhammad H, Agbalajobi O
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
The purpose of this study was to investigate the relationships between medical dialogues concerning alcohol use disorder (AUD) treatment, AUD treatment engagement, and mortality rates. The retrospective cohort study encompassed all patients diagnosed with cirrhosis and AUD receiving hepatology care within a single healthcare system in 2015. Baseline data on demographics, medical history, liver disease, and AUD treatment were examined. Information on AUD treatment discussions, initiation, alcohol cessation, and the subsequent 5-year mortality rates was gathered. Out of 436 patients with alcohol-related cirrhosis, 15% received AUD treatment at baseline, with 11% undergoing behavioral therapy, 2% receiving pharmacotherapy, and 1% obtaining both. Within the first year after the initial hepatology visit, 37 patients had AUD treatment, 51 remained in treatment, and 14 discontinued. Hepatology-documented AUD treatment recommendations were provided to 30% of patients, while 26% received primary care-documented recommendations. The majority of hepatology (86%) and primary care (88%) recommendations focused on behavioral therapy. Among patients with persistent alcohol use at baseline, AUD treatment after one year was significantly and independently associated with hepatology or primary care treatment discussions, and negatively associated with Medicaid insurance. When treatment discussions occurred in both settings, high treatment rates followed. Over five years, 35% of patients died. Ongoing alcohol use, age, hepatic decompensation, and hepatocellular carcinoma significantly contributed to mortality in the final survival model. In patients with alcohol-related cirrhosis, AUD treatment discussions were documented in fewer than half of hepatology and primary care encounters; however, such discussions were significantly correlated with AUD treatment receipt.
AHRQ-funded; HS019461.
Citation: Alexandre W, Muhammad H, Agbalajobi O .
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
BMC Gastroenterol 2023 Feb 2; 23(1):29. doi: 10.1186/s12876-023-02656-z..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Clinician-Patient Communication, Communication
Cano MA, Vaughan EL, de Dios MA
Alcohol use severity among Hispanic emerging adults in higher education: Understanding the effect of cultural congruity.
This study examined associations of behavioral acculturation, behavioral enculturation, and cultural congruity (perception of cultural fit between the values of the academic environment and the student's personal values) with alcohol use severity (AUS); and tested if gender moderated those associations. It concluded that after controlling for demographic variables and depressive symptoms, behavioral acculturation and enculturation did not have a statistically significant association with AUS.
AHRQ-funded; HS017586.
Citation: Cano MA, Vaughan EL, de Dios MA .
Alcohol use severity among Hispanic emerging adults in higher education: Understanding the effect of cultural congruity.
Subst Use Misuse 2015;50(11):1412-20. doi: 10.3109/10826084.2015.1018538.
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Keywords: Alcohol Use, Substance Abuse, Racial and Ethnic Minorities, Lifestyle Changes
Ludman EJ, Curry SJ
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
This study, Options Regarding Consumption of Alcohol (ORCA), was designed to test whether a primary care-based intervention would reduce alcohol misuse among patients who screened positive for risky or hazardous drinking. This paper assesses the study features using the Pragmatic-Explanatory Continuum Indicator Summary Model domains. As a randomized trial, the study included some explanatory features (e.g., standardized follow-up surveys administered by study personnel); however, several aspects of the study were highly pragmatic.
AHRQ-funded; 290201000004I.
Citation: Ludman EJ, Curry SJ .
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S194-9. doi: 10.1016/j.amepre.2015.05.016.
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Keywords: Alcohol Use, Behavioral Health, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Lapham GT, Rubinsky AD, Shortreed SM
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
This study sought to determine if differences in how brief intervention (BI) was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. It found that the association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Shortreed SM .
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
Drug Alcohol Depend 2015 Aug 1;153:159-66. doi: 10.1016/j.drugalcdep.2015.05.027..
Keywords: Alcohol Use, Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse
Williams EC, Achtmeyer CE, Thomas RM
Factors underlying quality problems with alcohol screening prompted by a clinical reminder in primary care: a multi-site qualitative study.
The researchers aimed to understand factors that might contribute to low sensitivity of alcohol screening. Their qualitative study in nine clinics found that implementation of alcohol screening facilitated by a clinical reminder resulted primarily in verbal screening in which questions were not asked verbatim and were otherwise adapted.
AHRQ-funded; HS022800; HS013853.
Citation: Williams EC, Achtmeyer CE, Thomas RM .
Factors underlying quality problems with alcohol screening prompted by a clinical reminder in primary care: a multi-site qualitative study.
J Gen Intern Med 2015 Aug;30(8):1125-32. doi: 10.1007/s11606-015-3248-z..
Keywords: Alcohol Use, Screening, Primary Care, Health Information Technology (HIT)
Cochran G, Field C, Caetano R
Changes in classes of injury-related risks and consequences of risk-level drinking: a latent transition analysis.
The researchers conducted a secondary analysis of data from a brief alcohol intervention study. They concluded that although a large portion of intervention recipients improved risks and consequences of alcohol use following discharge, more intensive intervention services may be needed for a subset of patients who showed little or no improvement.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, Caetano R .
Changes in classes of injury-related risks and consequences of risk-level drinking: a latent transition analysis.
J Behav Health Serv Res 2015 Jul;42(3):355-66. doi: 10.1007/s11414-013-9378-3.
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Keywords: Alcohol Use, Injuries and Wounds, Lifestyle Changes, Risk, Substance Abuse
Roth JA, Bradley K, Thummel KE
Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting.
The researchers conducted a case–control study to assess the association between screening positive for moderate/severe alcohol misuse and the risk of major bleeding in a community sample of patients using warfarin. They found that alcohol screening questionnaires, potentially coupled with genetic testing, could have clinical utility in selecting patients for warfarin therapy, as well as refining dosing and monitoring practices.
AHRQ-funded; HS022982.
Citation: Roth JA, Bradley K, Thummel KE .
Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting.
Pharmacoepidemiol Drug Saf 2015 Jun;24(6):619-27. doi: 10.1002/pds.3769..
Keywords: Alcohol Use, Blood Thinners, Community-Based Practice, Substance Abuse
Witt WP, Mandell KC, Wisk LE
Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
The purpose of the study was to understand the association between stressful life events prior to conception (PSLEs) and women’s alcohol and tobacco use prior to and during pregnancy, and the continuation of such use through pregnancy. It finds that PSLEs are associated with increased tobacco use prior to and during pregnancy, as well as an increased amount of alcohol use during pregnancy among U.S. women.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
Arch Womens Ment Health 2015 Jun;18(3):523-37. doi: 10.1007/s00737-014-047-9.
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Keywords: Pregnancy, Lifestyle Changes, Alcohol Use, Tobacco Use, Maternal Care
Okuda M, Olfson M, Wang S
Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey.
This study presents data on the association of intimate partner violence (IPV) perpetration and rates of psychiatric disorders, and other correlates. It finds that being younger, having an alcohol use disorder, a personality disorder, low levels of social support, and low income were associated with perpetration. Across a wide range of factors, IPV victimization itself had the strongest association with perpetration.
AHRQ-funded; HS021112.
Citation: Okuda M, Olfson M, Wang S .
Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey.
J Trauma Stress 2015 Feb;28(1):49-56. doi: 10.1002/jts.21986..
Keywords: Domestic Violence, Alcohol Use, Behavioral Health, Social Determinants of Health
Chavez LJ, Ornelas IJ, Lyles CR
Racial/ethnic workplace discrimination: association with tobacco and alcohol use.
The authors examined the association between workplace discrimination and tobacco and alcohol use in a large, multistate sample of U.S. adult respondents to the Behavioral Risk Factor Surveillance System survey Reactions to Race Module (2004-2010). They found that, among Hispanics, workplace discrimination was associated with increased heavy and binge drinking, but not any alcohol use or smoking. Workplace discrimination among black non-Hispanics and white Non-Hispanics was associated with increased current and daily smoking, but not alcohol outcomes.
AHRQ-funded; HS013853; HS022408; HS022800.
Citation: Chavez LJ, Ornelas IJ, Lyles CR .
Racial/ethnic workplace discrimination: association with tobacco and alcohol use.
Am J Prev Med 2015 Jan;48(1):42-9. doi: 10.1016/j.amepre.2014.08.013.
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Keywords: Alcohol Use, Lifestyle Changes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Tobacco Use