National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (3)
- Adverse Drug Events (ADE) (32)
- Adverse Events (31)
- Ambulatory Care and Surgery (6)
- Antibiotics (38)
- Antimicrobial Stewardship (24)
- Anxiety (1)
- Arthritis (1)
- Asthma (3)
- Behavioral Health (18)
- Blood Clots (4)
- Blood Pressure (3)
- Blood Thinners (9)
- Cancer (8)
- Cancer: Breast Cancer (1)
- Cancer: Lung Cancer (2)
- Cardiovascular Conditions (5)
- Caregiving (1)
- Care Management (3)
- Children's Health Insurance Program (CHIP) (2)
- Children/Adolescents (23)
- Chronic Conditions (20)
- Clinical Decision Support (CDS) (6)
- Clinician-Patient Communication (3)
- Clostridium difficile Infections (2)
- Communication (5)
- Community-Acquired Infections (1)
- Community-Based Practice (1)
- Comparative Effectiveness (8)
- COVID-19 (6)
- Dementia (2)
- Dental and Oral Health (2)
- Depression (3)
- Diabetes (8)
- Diagnostic Safety and Quality (2)
- Disparities (3)
- Education: Patient and Caregiver (3)
- Elderly (20)
- Electronic Health Records (EHRs) (7)
- Electronic Prescribing (E-Prescribing) (7)
- Emergency Department (5)
- Evidence-Based Practice (10)
- Eye Disease and Health (2)
- Falls (2)
- Genetics (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (7)
- Health Information Technology (HIT) (21)
- Health Insurance (4)
- Health Literacy (2)
- Health Promotion (1)
- Heart Disease and Health (4)
- Hepatitis (2)
- Home Healthcare (2)
- Hospital Discharge (3)
- Hospitalization (7)
- Hospitals (5)
- Human Immunodeficiency Virus (HIV) (5)
- Implementation (6)
- Infectious Diseases (7)
- Injuries and Wounds (2)
- Inpatient Care (4)
- Intensive Care Unit (ICU) (3)
- Kidney Disease and Health (1)
- Learning Health Systems (1)
- Long-Term Care (5)
- Low-Income (3)
- Maternal Care (2)
- Medicaid (6)
- Medical Errors (11)
- Medical Expenditure Panel Survey (MEPS) (4)
- Medicare (7)
- (-) Medication (196)
- Medication: Safety (41)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Mortality (6)
- Neonatal Intensive Care Unit (NICU) (1)
- Neurological Disorders (1)
- Newborns/Infants (3)
- Nursing Homes (5)
- Obesity (3)
- Opioids (52)
- Orthopedics (1)
- Outcomes (7)
- Pain (16)
- Palliative Care (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (7)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (34)
- Patient Self-Management (1)
- Pneumonia (2)
- Policy (4)
- Practice Patterns (25)
- Pregnancy (4)
- Prevention (7)
- Primary Care (11)
- Provider (6)
- Provider: Clinician (1)
- Provider: Nurse (1)
- Provider: Pharmacist (10)
- Provider: Physician (3)
- Public Health (2)
- Quality Improvement (4)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (8)
- Quality of Life (1)
- Racial and Ethnic Minorities (7)
- Respiratory Conditions (8)
- Risk (16)
- Rural Health (4)
- Screening (2)
- Sepsis (3)
- Sex Factors (2)
- Sexual Health (1)
- Shared Decision Making (10)
- Skin Conditions (2)
- Social Determinants of Health (1)
- Social Media (1)
- Stroke (2)
- Substance Abuse (26)
- Surgery (7)
- Telehealth (5)
- Tools & Toolkits (1)
- Transitions of Care (3)
- Transplantation (3)
- Trauma (1)
- Treatments (4)
- Urinary Tract Infection (UTI) (4)
- Vaccination (1)
- Vulnerable Populations (2)
- Web-Based (1)
- Women (6)
- Young Adults (3)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 196 Research Studies DisplayedLi LX, Szymczak JE, Keller SC
Antibiotic stewardship in direct-to-consumer telemedicine: translating interventions into the virtual realm.
This article discusses using the core elements for outpatient antibiotic stewardship as a framework for direct-to-consumer (DTC) telemedicine. There is limited scholarship regarding adapting and implementing antibiotic stewardship principles in this setting. The authors discussed utilizing the core elements for outpatient antibiotic stewardship as a framework for efforts moving forward.
AHRQ-funded; HS027819.
Citation: Li LX, Szymczak JE, Keller SC .
Antibiotic stewardship in direct-to-consumer telemedicine: translating interventions into the virtual realm.
J Antimicrob Chemother 2021 Dec 24;77(1):13-15. doi: 10.1093/jac/dkab371..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Telehealth, Health Information Technology (HIT)
Agbalajobi OM, Gmelin T, Moon AM
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
This retrospective cohort study investigated opioid prescribing patterns among patients with chronic liver disease (CLD) at a single medical center. These patients (12,425) were followed for one year from October 2015 to September 2016. Nearly half (47%) were prescribed opioids over a one-year period, with 17% receiving high-risk prescriptions. Characteristics associated with high-risk opioid prescriptions included female gender, Medicaid insurance, cirrhosis and baseline chronic pain, depression, anxiety, substance use disorder, and Charlson comorbidity score. Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions.
AHRQ-funded; HS019461.
Citation: Agbalajobi OM, Gmelin T, Moon AM .
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
PLoS One 2021 Dec 17;16(12):e0261377. doi: 10.1371/journal.pone.0261377..
Keywords: Opioids, Medication, Practice Patterns, Pain, Chronic Conditions
Villa-Zapata L, Carhart BS, Horn JR
Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: a systematic review and meta-analysis.
The purpose of this study was to provide evidence of serum potassium changes in individuals taking angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) concomitantly with spironolactone compared to ACEI/ARB therapy alone. The investigators concluded that treatment with spironolactone in combination with ACEI/ARB therapy increases the mean serum potassium concentration by less than 0.20 mEq/L compared to ACEI/ARB therapy alone.
AHRQ-funded; HS025984.
Citation: Villa-Zapata L, Carhart BS, Horn JR .
Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: a systematic review and meta-analysis.
Am J Health Syst Pharm 2021 Dec 9;78(24):2245-55. doi: 10.1093/ajhp/zxab215..
Keywords: Medication, Comparative Effectiveness, Heart Disease and Health, Cardiovascular Conditions
Vaughn VM, Gandhi TN, Chopra V
Antibiotic overuse after hospital discharge: a multi-hospital cohort study.
Antibiotics are commonly prescribed to patients as they leave the hospital. In this study, the investigators aimed to create a comprehensive metric to characterize antibiotic overuse after discharge among hospitalized patients treated for pneumonia or urinary tract infection (UTI) and determine whether overuse varied across hospitals and conditions. The investigators concluded that antibiotic overuse after discharge was common and varied widely between hospitals.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Gandhi TN, Chopra V .
Antibiotic overuse after hospital discharge: a multi-hospital cohort study.
Clin Infect Dis 2020 Dec 6;73(11):e4499-e506. doi: 10.1093/cid/ciaa1372..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Hospital Discharge
Moehring RW, Ashley ESD, Davis AE
Development of an electronic definition for de-escalation of antibiotics in hospitalized patients.
The authors defined antibiotic de-escalation as reduction in either the number of antibiotics or spectrum rank and performed a retrospective study among 5 hospitals. They found that their electronic de-escalation metric demonstrated variation among hospitals, units, and diagnoses. They suggested that their metric may be useful for assessing stewardship opportunities and impact.
AHRQ-funded; HS023866.
Citation: Moehring RW, Ashley ESD, Davis AE .
Development of an electronic definition for de-escalation of antibiotics in hospitalized patients.
Clin Infect Dis 2021 Dec 6;73(11):e4507-e14. doi: 10.1093/cid/ciaa932..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Inpatient Care
Nanji KC, Shaikh SD, Jaffari A
A Monte Carlo simulation to estimate the additional cost associated with adverse medication events leading to intraoperative hypotension and/or hypertension in the United States.
This study’s objective was to estimate the rates of clinically significant intraoperative hypotension and hypertension. Systematic literature reviews were conducted to estimate incidence and additional costs of acute kidney injury (AKI), acute myocardial injury, and stroke after intraoperative hypotension and hypertension. The authors used Monte Carlo simulation to estimate annual costs to the U.S. healthcare system. Intraoperative hypotension occurred in 11 of 277 operations (3.97%), a >30% drop in baseline mean arterial pressure hypotension in patients with coronary artery disease in 9 operations (3.25%), and hypertension in 14 operations (5.05%). After hypertension, incremental stroke incidence was 4.76%. The authors estimated 11,513 cases of AKI, 5914 cases of acute myocardial injury, 345 cases of stroke after intraoperative hypotension, and 47,774 cases of stroke after intraoperative hypertension. Estimated costs were $1.7 billion, of which $923 million are preventable.
AHRQ-funded; HS024764.
Citation: Nanji KC, Shaikh SD, Jaffari A .
A Monte Carlo simulation to estimate the additional cost associated with adverse medication events leading to intraoperative hypotension and/or hypertension in the United States.
J Patient Saf 2021 Dec 1;17(8):e758-e64. doi: 10.1097/pts.0000000000000926..
Keywords: Medication, Adverse Drug Events (ADE), Adverse Events, Healthcare Costs
Sankar A, Swanson KM, Zhou J
Association of fluoroquinolone prescribing rates with black box warnings from the US Food and Drug Administration.
This study examined the association of black box warnings in 2013 and 2016 with prescribing rates for fluoroquinolone. This cross-sectional study used Medicare fee-for-service beneficiaries and OneKey data on physicians and their organizations from 2011 through 2017. Sample eligibility was restricted to outpatient visits for sinusitis, bronchitis, and uncomplicated urinary tract infections. Prescription rates were compared with the prewarning period (baseline period), before and after the 2013 warning (postwarning period 1), and before and after the 2016 warning (postwarning period 2). The sample consisted of 1,238,397 unique patients with a total of 2,720,071 outpatient acute care visits. The immediate prescribing levels in postwarning period 1 increased by 3.42 percentage points and declined by -0.77 percentage points in postwarning period 2. In postwarning period 1, prescribing levels for physicians who were affiliated with hospitals with a top 10th percentile case mix index compared to those without an affiliation decreased by -1.13 percentage points, whereas the levels for primary care physicians declined by -1.34 percentage points compared with non-primary care physicians in postwarning period 2. Physicians at teaching hospitals were the only clinicians who showed a decline in postwarning period 1.
AHRQ-funded; HS025164; HS025402.
Citation: Sankar A, Swanson KM, Zhou J .
Association of fluoroquinolone prescribing rates with black box warnings from the US Food and Drug Administration.
JAMA Netw Open 2021 Dec;4(12):e2136662. doi: 10.1001/jamanetworkopen.2021.36662..
Keywords: Antibiotics, Medication, Practice Patterns
Iqbal AR, Parau CA, Kazi S
Identifying electronic medication administration record (eMAR) usability issues from patient safety event reports.
This study investigated the contribution of usability challenges associated with the electronic medication administration record (eMAR) to medication errors using patient safety event reports (PSEs). The authors analyzed free-text descriptions of 849 medication-related PSEs selected from 2.3 million reports. Specific health IT components, usability challenge categories, and nuanced usability themes that contributed to each PSE were identified by coders. Usability challenges included workflow support, alerting, and display/visual clutter.
AHRQ-funded; HS025136.
Citation: Iqbal AR, Parau CA, Kazi S .
Identifying electronic medication administration record (eMAR) usability issues from patient safety event reports.
Jt Comm J Qual Patient Saf 2021 Dec;47(12):793-801. doi: 10.1016/j.jcjq.2021.09.004..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Medication, Medical Errors, Patient Safety
Adams KT, Pruitt Z, Kazi S
Identifying health information technology usability issues contributing to medication errors across medication process stages.
Researchers sought to identify the types of medication errors associated with health IT use, whether they reached the patient, where in the medication process those errors occurred, and the specific usability issues contributing to those errors. They found that health IT usability issues were a prevalent contributing factor to medication errors, many of which reach the patient. They recommended that data entry, workflow support, and alerting be prioritized during usability and safety optimization efforts.
AHRQ-funded; HS025136.
Citation: Adams KT, Pruitt Z, Kazi S .
Identifying health information technology usability issues contributing to medication errors across medication process stages.
J Patient Saf 2021 Dec 1;17(8):e988-e94. doi: 10.1097/pts.0000000000000868..
Keywords: Medication, Health Information Technology (HIT), Medical Errors, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Deshpande BR, McCarthy EP, Jung Y
Initiation of long-acting opioids following hospital discharge among Medicare beneficiaries.
This study investigated the incidence of long-acting opioid initiation following acute care hospitalization among a retrospective cohort of Medicare beneficiaries in 2016 who were 65 years or older, who did not have cancer or hospice care, and had not filled an opioid prescription within the preceding 90 days. Among 258,193 hospitalizations, 18.6% were associated with a claim for a new opioid prescription in the week after hospital discharge: 0.3% with both short- and long-acting opioids, 0.1% with long-acting opioids only, and 18.2% with short-acting opioids only. Most long-acting opioid prescriptions occurred with surgical patients (81.7%). Beneficiaries of long-acting opioids were younger, had a higher prevalence of diseases of the musculoskeletal and connective tissues, and had more known risk factors of opioid-related adverse events compared to patients prescribed short-acting opioids.
AHRQ-funded; HS026215.
Citation: Deshpande BR, McCarthy EP, Jung Y .
Initiation of long-acting opioids following hospital discharge among Medicare beneficiaries.
J Hosp Med 2021 Dec;16(12):724-26. doi: 10.12788/jhm.3721..
Keywords: Opioids, Medication, Hospital Discharge
McGrath SP, McGovern KM, Perreard IM
Inpatient respiratory arrest associated with sedative and analgesic medications: impact of continuous monitoring on patient mortality and severe morbidity.
Inpatient respiratory arrest associated with sedative and analgesic medications: impact of continuous monitoring on patient mortality and severe morbidity.
The purpose of this study was to investigate the impact of surveillance monitoring on mortality and severe morbidity associated with administration of sedative/analgesic medications in the general care setting. A review of available rescue event and patient safety data from a tertiary care hospital in a rural setting was conducted. Findings showed that, for a 10-year period, the rescue system with continuous surveillance monitoring had a profound effect on prevention of death due to sedative/analgesic administration in the general care setting.
The purpose of this study was to investigate the impact of surveillance monitoring on mortality and severe morbidity associated with administration of sedative/analgesic medications in the general care setting. A review of available rescue event and patient safety data from a tertiary care hospital in a rural setting was conducted. Findings showed that, for a 10-year period, the rescue system with continuous surveillance monitoring had a profound effect on prevention of death due to sedative/analgesic administration in the general care setting.
AHRQ-funded; HS024403.
Citation: McGrath SP, McGovern KM, Perreard IM .
Inpatient respiratory arrest associated with sedative and analgesic medications: impact of continuous monitoring on patient mortality and severe morbidity.
J Patient Saf 2021 Dec 1;17(8):557-61. doi: 10.1097/pts.0000000000000696..
Keywords: Respiratory Conditions, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Clark AW, Durkin MJ, Olsen MA
Rural-urban differences in antibiotic prescribing for uncomplicated urinary tract infection.
This study examined rural-urban differences in temporal trends and risk of inappropriate antibiotic use by agent and duration among women with uncomplicated urinary tract infection (UTI). This observational cohort study identified US commercially insured women aged 18-44 coded for uncomplicated UTI and prescribed an antibiotic from the IBM MarketScan Commercial Database (2010-2015). Of the 670,450 women with uncomplicated UTIs, a large proportion received antibiotic prescriptions for inappropriate agents (46.7%) or durations (76.1%). Rural women were more likely to receive prescriptions with inappropriately long durations than urban women. There was a slight decline in patients who received inappropriate agents and durations from 2011 to 2015. Rural-urban differences varied over time by agent, geographic region, and provider specialty.
AHRQ-funded; HS019455.
Citation: Clark AW, Durkin MJ, Olsen MA .
Rural-urban differences in antibiotic prescribing for uncomplicated urinary tract infection.
Infect Control Hosp Epidemiol 2021 Dec;42(12):1437-44. doi: 10.1017/ice.2021.21..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Urinary Tract Infection (UTI), Practice Patterns
Cerda M, Wheeler-Martin K, Bruzelius E
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
The authors investigated the impact of pain management clinic laws. They analyzed data on county-level, opioid overdose deaths via the National Vital Statistics System and patients filling long-duration or high-dose opioid prescriptions in the US 2010-2018. Their findings suggested that laws with criminal penalties were associated with intended reductions in high-risk opioid prescribing and some opioid overdoses but raised concerns regarding unintended consequences on heroin/synthetic overdoses.
AHRQ-funded; HS023258.
Citation: Cerda M, Wheeler-Martin K, Bruzelius E .
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
Am J Epidemiol 2021 Dec;190(12):2592-603. doi: 10.1093/aje/kwab192..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Practice Patterns, Policy
Duvalyan A, Pandey A, Vaduganathan M
Trends in anticoagulation prescription spending among Medicare Part D and Medicaid beneficiaries between 2014 and 2019.
Researchers examined contemporary direct oral anticoagulant (DOAC) spending patterns within Medicare Part D and Medicaid between 2014 and 2019. They found that, although overall DOAC spending is increasing, DOAC use may be associated with lower downstream medical expenditures compared with warfarin stemming from decreased risk of major bleeding and stroke and reduced drug monitoring.
AHRQ-funded; HS022418.
Citation: Duvalyan A, Pandey A, Vaduganathan M .
Trends in anticoagulation prescription spending among Medicare Part D and Medicaid beneficiaries between 2014 and 2019.
J Am Heart Assoc 2021 Dec 21;10(24):e022644. doi: 10.1161/jaha.121.022644..
Keywords: Blood Thinners, Medication, Medicare, Medicaid, Healthcare Costs
Schirle L, Jeffery A, Yaqoob A
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Although electronic health records (EHR) have significant potential for the study of opioid use disorders (OUD), detecting OUD in clinical data is challenging. Models using EHR data to predict OUD often rely on case/control classifications focused on extreme opioid use. IN this study, the investigators discussed two data-driven approaches to identifying the spectrum of problematic opioid use. The investigators concluded that risk scores comprising comorbidities and text offer differing but synergistic insights into characterizing problematic opioid use.
AHRQ-funded; HS026395.
Citation: Schirle L, Jeffery A, Yaqoob A .
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Int J Med Inform 2021 Dec;156:104621. doi: 10.1016/j.ijmedinf.2021.104621..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Health Information Technology (HIT)
Xiong KZ, Shah S, Stone JA
Using a scenario-based hybrid approach to understand participant health behavior.
This study described a scenario-based hybrid approach that included a simulation exercise and a situational interview to understand how older adults first select and then take OTC medication. The authors concluded that the scenario-based hybrid approach not only yielded detailed information about behavior, but also allowed investigators to discern participants' decision-making, influences, and the rationales they used when selecting and taking OTC medications.
AHRQ-funded; HS024490.
Citation: Xiong KZ, Shah S, Stone JA .
Using a scenario-based hybrid approach to understand participant health behavior.
Res Social Adm Pharm 2021 Dec;17(12):2070-74. doi: 10.1016/j.sapharm.2021.02.020..
Keywords: Elderly, Medication, Shared Decision Making
Morris AO, Gilson A, Chui MA
Utilizing a cognitive engineering approach to conduct a hierarchical task analysis to understand complex older adult decision-making during over-the-counter medication selection.
This study characterized older adults' cognitive decision-making process when seeking to self-medicate with over-the-counter (OTC) medications from their community pharmacy, and demonstrated how hierarchical task analysis (HTA) can be used to evaluate a pharmacy intervention's impact on their decision-making. Findings showed that, while selecting an OTC, older adults considered quantity, cost, form, regimen, safety, strength, appropriateness of OTC safety, generic/name-brand, past experiences, and ingredients. The study intervention reduced by half the number of factors considered. Findings suggested that HTA-informed decision profiles may provide pharmacists with critical insights into safety issues that older adults may not be considering so that pharmacists can support their decision-making.
AHRQ-funded; HS024490.
Citation: Morris AO, Gilson A, Chui MA .
Utilizing a cognitive engineering approach to conduct a hierarchical task analysis to understand complex older adult decision-making during over-the-counter medication selection.
Res Social Adm Pharm 2021 Dec;17(12):2116-26. doi: 10.1016/j.sapharm.2021.07.005..
Keywords: Elderly, Shared Decision Making, Medication
Moehring RW, Yarrington ME, Davis AE
Effects of a collaborative, community hospital network for antimicrobial stewardship program implementation.
The authors investigated expertise, data resources, and educational tools to support antimicrobial stewardship programs (ASP) in hospitals. They found that network hospitals increased ASP activities and demonstrated decline in antimicrobial use over the 42-month study period. They concluded that their collaborative, consultative network proved a unique model in which hospitals can access ASP implementation expertise to support long-term program growth.
AHRQ-funded; HS023866.
Citation: Moehring RW, Yarrington ME, Davis AE .
Effects of a collaborative, community hospital network for antimicrobial stewardship program implementation.
Clin Infect Dis 2021 Nov 2;73(9):1656-63. doi: 10.1093/cid/ciab356..
Keywords: Antimicrobial Stewardship, Antibiotics, Hospitals, Implementation, Medication
Wyse JJ, Morasco BJ, Dougherty J
Adjunct interventions to standard medical management of buprenorphine in outpatient settings: a systematic review of the evidence.
A growing body of research has examined adjunctive interventions supportive of engagement and retention in treatment among patients receiving buprenorphine for opioid use disorder (OUD). In this study the investigators conducted a systematic review of the literature addressing the effect on key outcomes of adjunctive interventions provided alongside standard medical management of buprenorphine in outpatient settings.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Morasco BJ, Dougherty J .
Adjunct interventions to standard medical management of buprenorphine in outpatient settings: a systematic review of the evidence.
Drug Alcohol Depend 2021 Nov 1;228:108923. doi: 10.1016/j.drugalcdep.2021.108923..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication
Cook RR, Torralva R, King C
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
This study examined the associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder (OUD) among people living with uncontrolled HIV disease. Data from a multisite clinical trial was used to compare extended-release naltrexone (XR-NTX) with treatment as usual (TAU: buprenorphine or methadone) to achieve HIV viral suppression among people with OUD and uncontrolled HIV disease. Exposure to fentanyl use was measured by urine drug screening. The cohort was 11 participants had an average age of 47 years, were 62% male, 57% Black and 13% Hispanic. Baseline fentanyl use was 64% for participants. Participants with baseline fentanyl use were 11 times less likely to initiative XR-NTX than those negative for fentanyl, but there was no evidence that fentanyl use impacted the likelihood of TAU initiation.
AHRQ-funded; HS026370.
Citation: Cook RR, Torralva R, King C .
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
Drug Alcohol Depend 2021 Nov 1;228:109077. doi: 10.1016/j.drugalcdep.2021.109077..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV), Chronic Conditions
Pestka DL, Brummel AR, Wong MT
Characterizing the reach of comprehensive medication management in a population health primary care model.
As care teams adopt team-based models of care, it is important to examine the reach of interdisciplinary services, such as pharmacists providing comprehensive medication management (CMM). This study examined the reach of pharmacist-delivered CMM in the first 10 months of a population health-focused primary care transformation (PCT). This study illustrated that pharmacists providing CMM see complex patients with a high propensity for medication therapy problems.
AHRQ-funded; HS026379.
Citation: Pestka DL, Brummel AR, Wong MT .
Characterizing the reach of comprehensive medication management in a population health primary care model.
J Am Coll Clin Pharm 2021 Nov;4(11):1410-19. doi: 10.1002/jac5.1525..
Keywords: Medication, Care Management, Provider: Pharmacist, Implementation
Vaughan CP, Hwang U, Vandenberg AE
Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme.
Enhancing quality of prescribing practices for older adults discharged from the Emergency Department (EQUIPPED) aims to reduce the monthly proportion of potentially inappropriate medications (PIMs) prescribed to older adults discharged from the ED to 5% or less. In this paper, the investigator described prescribing outcomes at three academic health systems adapting and sequentially implementing the EQUIPPED medication safety programme.
AHRQ-funded; HS024499.
Citation: Vaughan CP, Hwang U, Vandenberg AE .
Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme.
BMJ Open Qual 2021 Nov;10(4). doi: 10.1136/bmjoq-2021-001369..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Emergency Department, Quality Improvement, Quality of Care
Goyal MK, Drendel AL, Chamberlain JM
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
The purpose of this study was to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have decreased over time. Findings showed that, as provision of opioid prescriptions declined over time, previously marked racial and/or ethnic disparities in opioid
prescription rates at ED discharge decreased.
prescription rates at ED discharge decreased.
AHRQ-funded; HS020270.
Citation: Goyal MK, Drendel AL, Chamberlain JM .
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
Pediatrics 2021 Nov;148(5):e2021052481. doi: 10.1542/peds.2021-052481..
Keywords: Children/Adolescents, Opioids, Emergency Department, Racial and Ethnic Minorities, Injuries and Wounds, Pain, Medication
Sussman AL, Crawford JN, Brakey HR
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
Barriers to the expansion of opioid use disorder (OUD) treatment in primary care using buprenorphine are well documented. Providers require support along a continuum. A systematic tracking framework to enhance provider progress along this continuum is lacking. The investigators developed a benchmark tracking assessment (BTA) as part of data collection in a 5-year study to examine the impact of provider participation in an online intervention to support expansion of buprenorphine treatment for OUD in rural primary care.
AHRQ-funded; HS025345.
Citation: Sussman AL, Crawford JN, Brakey HR .
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
J Am Board Fam Med 2021 Nov-Dec;34(6):1216-20. doi: 10.3122/jabfm.2021.06.210111..
Keywords: Opioids, Primary Care, Medication, Substance Abuse, Behavioral Health
Nair AA, Farber HJ, Chen H
Utilization of opioid versus non-opioid analgesics in Medicaid and CHIP enrolled children with current asthma.
Opioid analgesics are frequently dispensed in children despite its known risk in children with a compromised airway function. The objectives of the study were to assess the prevalence of opioid analgesic dispensing in children with current asthma and to identify patient and prescriber factors associated with the dispensing of opioid versus non-opioid analgesics. The investigators concluded that opioid analgesics are frequently dispensed to children with asthma. A higher dispensing rate was observed among non-Hispanic White children and among those with a history of uncontrolled asthma.
AHRQ-funded; HS026790.
Citation: Nair AA, Farber HJ, Chen H .
Utilization of opioid versus non-opioid analgesics in Medicaid and CHIP enrolled children with current asthma.
Pharmacoepidemiol Drug Saf 2021 Nov;30(11):1520-31. doi: 10.1002/pds.5336..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Opioids, Medication, Asthma, Respiratory Conditions