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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Brain Injury (1)
- Dementia (1)
- (-) Elderly (5)
- Emergency Department (1)
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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 5 of 5 Research Studies DisplayedHerzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Min SH, Song J, Evans L
Home healthcare patients with distinct psychological, cognitive, and behavioral symptom profiles and at-risk subgroup for hospitalization and emergency department visits using latent class analysis.
The purpose of this study was to explore subgroups of older adults receiving home healthcare services with similar psychological, cognitive, and behavioral symptom profiles and an at-risk subgroup for future hospitalization and emergency department visits as an indicator of underdiagnosis or undertreatment. The three-class model applied in the study consisted of Class 1: "Moderate psychological symptoms without behavioral issues," Class 2: "Severe psychological symptoms with behavioral issues," and Class 3: "Mild psychological symptoms without behavioral issues." The study found that Class 1 patients had 1.14 higher odds and Class 2 patients had 1.26 higher odds of being hospitalized or visiting emergency departments compared to Class 3. The researchers discovered significant differences in individual characteristics such as age, gender, race/ethnicity, and insurance.
AHRQ-funded; HS027742.
Citation: Min SH, Song J, Evans L .
Home healthcare patients with distinct psychological, cognitive, and behavioral symptom profiles and at-risk subgroup for hospitalization and emergency department visits using latent class analysis.
Clin Nurs Res 2023 Sep; 32(7):1021-30. doi: 10.1177/10547738231183026..
Keywords: Home Healthcare, Emergency Department, Hospitalization, Elderly
Skains RM, Zhang Y, Osborne JD
Hospital-associated disability due to avoidable hospitalizations among older adults.
A frequent complication during the course of acute care hospitalizations in older adults is Hospital-associated disability (HAD). Numerous admissions are for ambulatory care sensitive conditions (ACSCs), which are considered potentially avoidable hospitalizations-conditions that may be able to be treated in outpatient settings to prevent hospitalization and HAD. The purpose of this study was to compare the incidence of HAD between older adults hospitalized for ACSCs versus those hospitalized for other diagnoses. The researchers conducted a retrospective cohort study of 38,960 older adults 65 years of age or older admitted to inpatient (non-ICU) medical and surgical units of a large southeastern regional academic medical center. The primary study outcome was HAD. The study found that 10% of older adults were admitted for an ACSC, with rates of HAD in those admitted for ACSCs lower than those admitted for other conditions. Age, comorbidity, admission functional status, and admission cognitive impairment were significant predictors for development of HAD. Compared with admissions for other conditions, ACSC admissions to medical and medical/surgical services had decreased odds of HAD, with no significant differences between ACSC and non-ACSC admissions to surgical services.
AHRQ-funded; HS013852.
Citation: Skains RM, Zhang Y, Osborne JD .
Hospital-associated disability due to avoidable hospitalizations among older adults.
J Am Geriatr Soc 2023 May; 71(5):1395-405. doi: 10.1111/jgs.18238..
Keywords: Elderly, Hospitalization, Hospital Discharge
Growdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization
Wu A, Zhou J, Quinlan N
Early palliative care consultation offsets hospitalization duration and costs for elderly patients with traumatic brain injuries: insights from a level 1 trauma center.
The purpose of this study was to identify variables and outcomes related to inpatient palliative care (PC) consultation for patients age 65+ with traumatic brain injuries (TBI). The researchers included individuals over age 65 presenting from January 2013-September 2020 with TBI and intracranial hemorrhage. The study found that inpatient PC consultation was uncommon; with only 4% of 576 patients receiving. Features associated with likelihood of consultation were severe TBI and pre-existing dementia. Patients with PC consults had longer overall and intensive care unit (ICU) length of stays (LOS), more days intubated and higher costs. However, those patients with earlier-than-average PC consultation had shorter overall and ICU LOS as well as fewer ventilator days on a ventilator and lower costs. The study concluded that older patients with TBI have a greater likelihood of receiving PC consultation based on pre-existing dementia and severe TBI and patients with PC consultations had worse LOS and higher costs, but those impacts were diminished by earlier involvement from the PC.
AHRQ-funded; HS028747.
Citation: Wu A, Zhou J, Quinlan N .
Early palliative care consultation offsets hospitalization duration and costs for elderly patients with traumatic brain injuries: insights from a level 1 trauma center.
J Clin Neurosci 2023 Feb; 108:1-5. doi: 10.1016/j.jocn.2022.12.013..
Keywords: Elderly, Palliative Care, Hospitalization, Brain Injury