National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (6)
- Adverse Events (2)
- Antibiotics (5)
- Antimicrobial Stewardship (2)
- Back Health and Pain (1)
- Behavioral Health (4)
- Blood Thinners (2)
- Brain Injury (2)
- Cancer (11)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (2)
- Cancer: Lung Cancer (4)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (3)
- Care Coordination (4)
- Caregiving (7)
- Care Management (6)
- Case Study (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Chronic Conditions (6)
- Colonoscopy (1)
- Communication (3)
- Community-Acquired Infections (1)
- Community-Based Practice (2)
- Comparative Effectiveness (4)
- Critical Care (1)
- Dementia (5)
- Depression (2)
- Diabetes (6)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Education: Patient and Caregiver (1)
- (-) Elderly (107)
- Electronic Health Records (EHRs) (6)
- Emergency Department (3)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (2)
- Eye Disease and Health (1)
- Falls (6)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Costs (12)
- Healthcare Delivery (5)
- Healthcare Utilization (6)
- Health Information Technology (HIT) (6)
- Health Literacy (1)
- Health Services Research (HSR) (4)
- Health Status (3)
- Heart Disease and Health (4)
- Home Healthcare (7)
- Hospital Discharge (5)
- Hospitalization (9)
- Hospital Readmissions (4)
- Hospitals (4)
- Injuries and Wounds (3)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (1)
- Long-Term Care (8)
- Low-Income (1)
- Medicaid (1)
- Medical Devices (1)
- Medical Errors (1)
- Medicare (17)
- Medication (30)
- Medication: Safety (5)
- Mortality (6)
- Neurological Disorders (3)
- Nursing (1)
- Nursing Homes (18)
- Nutrition (1)
- Obesity (1)
- Opioids (3)
- Osteoporosis (1)
- Outcomes (5)
- Pain (3)
- Palliative Care (10)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (11)
- Patient Adherence/Compliance (3)
- Patient and Family Engagement (4)
- Patient Experience (2)
- Patient Safety (14)
- Patient Self-Management (2)
- Payment (1)
- Pneumonia (3)
- Policy (1)
- Practice Patterns (6)
- Prevention (5)
- Primary Care (3)
- Provider (1)
- Provider: Health Personnel (1)
- Provider: Nurse (1)
- Provider: Pharmacist (2)
- Provider Performance (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Rehabilitation (1)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (9)
- Rural Health (2)
- Screening (2)
- Sex Factors (2)
- Shared Decision Making (3)
- Skin Conditions (1)
- Social Determinants of Health (2)
- Stroke (1)
- Substance Abuse (1)
- Surgery (7)
- Telehealth (2)
- Transitions of Care (3)
- Trauma (1)
- Urinary Tract Infection (UTI) (3)
- Vaccination (1)
- Web-Based (2)
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
51 to 75 of 107 Research Studies DisplayedGalambos C, Rantz M, Back J
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study found that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation.
AHRQ-funded; HS018477.
Citation: Galambos C, Rantz M, Back J .
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
Comput Inform Nurs 2017 Jul;35(7):331-37. doi: 10.1097/cin.0000000000000330.
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Keywords: Elderly, Falls, Risk, Patient Safety
Koronkowski MJ, Semla TP, Schmader KE
Recent literature update on medication risk in older adults, 2015-2016.
Medications can pose considerable risk in older adults. This article intended to provide a narrative review of key publications in medication safety for clinicians and researchers committed to improving medication safety in older adults. It annotates four articles addressing this concern from 2016.
AHRQ-funded; HS023779.
Citation: Koronkowski MJ, Semla TP, Schmader KE .
Recent literature update on medication risk in older adults, 2015-2016.
J Am Geriatr Soc 2017 Jul;65(7):1401-05. doi: 10.1111/jgs.14887.
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Keywords: Elderly, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Dharmarajan K, Qin L, Bierlein M
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
This study characterized rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays. Hospital revisits are common after discharge from observation stays, frequently result in inpatient hospitalizations, and have increased over time among Medicare beneficiaries.
AHRQ-funded; HS023000.
Citation: Dharmarajan K, Qin L, Bierlein M .
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
BMJ 2017 Jun 20;357:j2616. doi: 10.1136/bmj.j2616.
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Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
Hanlon JT, Zhao X, Naples JG
Central nervous system medication burden and serious falls in older nursing home residents.
The researchers examined the association between CNS medication burden and serious falls in those with a recent fall history. They found that CNS medication burden, approximately 3 + standardized daily doses, was associated with an increased risk of serious falls in nursing home residents with recent fall.
AHRQ-funded; HS023779.
Citation: Hanlon JT, Zhao X, Naples JG .
Central nervous system medication burden and serious falls in older nursing home residents.
J Am Geriatr Soc 2017 Jun;65(6):1183-89. doi: 10.1111/jgs.14759.
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Keywords: Elderly, Falls, Medication, Nursing Homes, Patient Safety
Iyer AS, Bakitas M
Early palliative care in advanced illness: do right by mama.
This letter describes a case study where the doctor and the family decided not to do aggressive treatment on their mother in her 80’s with metastatic lung cancer and pneumonia. After describing the intubation procedure and the use of mechanical ventilation, the family decided that palliative care was the best option. The doctor emphasizes the use of palliative care as the best outcome for many terminally ill patients.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Bakitas M .
Early palliative care in advanced illness: do right by mama.
JAMA Intern Med 2017 Jun;177(6):761-62. doi: 10.1001/jamainternmed.2017.0764.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Shared Decision Making, Elderly, Palliative Care, Patient-Centered Outcomes Research
Winters-Stone KM, Moe E, Graff JN
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
This study compared the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). It concluded that current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment.
AHRQ-funded; HS022981.
Citation: Winters-Stone KM, Moe E, Graff JN .
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
J Am Geriatr Soc 2017 Jul;65(7):1414-19. doi: 10.1111/jgs.14795.
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Keywords: Cancer: Prostate Cancer, Cancer, Falls, Medication, Elderly
Middleton A, Zhou J, Ottenbacher KJ
Hospital variation in rates of new institutionalizations within 6 months of discharge.
The primary objective of this study was to examine the hospital-level variation in rates of new institutionalizations among Medicare beneficiaries. The overall observed rate of new institutionalizations was 3.6 percent (N = 173,998). Older age, white race, Medicaid eligibility, longer hospitalization, and having a skilled nursing facility stay over the 6 months before hospitalization were associated with higher adjusted odds. Observed rates ranged from 0.9 percent to 5.9 percent across states.
AHRQ-funded; HS022134.
Citation: Middleton A, Zhou J, Ottenbacher KJ .
Hospital variation in rates of new institutionalizations within 6 months of discharge.
J Am Geriatr Soc 2017 Jun;65(6):1206-13. doi: 10.1111/jgs.14760.
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Keywords: Hospitalization, Elderly, Nursing Homes, Hospital Discharge
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Regenbogen SE, Cain-Nielsen AH, Norton EC
Costs and consequences of early hospital discharge after major inpatient surgery in older adults.
This study evaluated the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions. It concluded that early routine postoperative discharge after major inpatient surgery is associated with lower total surgical episode payments. There is no evidence that savings from shorter postsurgical hospitalization are offset by higher postdischarge care spending.
AHRQ-funded; HS024698.
Citation: Regenbogen SE, Cain-Nielsen AH, Norton EC .
Costs and consequences of early hospital discharge after major inpatient surgery in older adults.
JAMA Surg 2017 May 17;152(5):e170123. doi: 10.1001/jamasurg.2017.0123.
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Keywords: Elderly, Surgery, Hospital Discharge, Healthcare Costs, Outcomes
Morrow D, Hasegawa-Johnson M, Huang T
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
The authors describe a project intended to improve the use of Electronic Medical Record (EMR) patient portal information by older adults with diverse numeracy and literacy abilities, so that portals can better support patient-centered care. Their approach combines quantitative measures, as well as experimental and individual difference methods in order to investigate which formats are more effective, and whether some formats benefit some types of patients more than others.
AHRQ-funded; HS022948.
Citation: Morrow D, Hasegawa-Johnson M, Huang T .
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
J Biomed Inform 2017 May;69:63-74. doi: 10.1016/j.jbi.2017.03.015.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Literacy, Patient Self-Management, Web-Based
Vyas A, Madhavan SS, Sambamoorthi U
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
The objective of this study was to determine Medicare expenditures during the initial phase of care among women in West Virginia (WV) who were Medicare beneficiaries with BC and compare them with national estimates. It found that the difference in average Medicare expenditures between the elderly beneficiaries with BC from a rural state (WV) and their national counterparts narrowed but remained significantly lower after multivariate adjustment.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan SS, Sambamoorthi U .
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
J Natl Compr Canc Netw 2017 May;15(5):578-87.
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Keywords: Cancer: Breast Cancer, Elderly, Healthcare Costs, Medicare, Rural Health
Meddings J, Saint S, Krein SL
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
This paper is a systematic literature review of strategies to reduce urinary tract infections (UTIs) in nursing home residents. It concludes that several practices, often implemented in bundles, such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions, appear to reduce UTI or catheter-associated UTI in nursing home residents.
AHRQ-funded; HS019767; HS018334; 290201000025I.
Citation: Meddings J, Saint S, Krein SL .
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
J Hosp Med 2017 May;12(5):356-68. doi: 10.12788/jhm.2724.
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Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Evidence-Based Practice, Long-Term Care, Nursing Homes, Patient Safety, Prevention, Urinary Tract Infection (UTI)
Goins RT, Noonan C, Gonzales K
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
Among older American Indian women with type 2 diabetes (T2DM), the researchers examined the association between mental health and T2DM control and if social support modifies the association. They found that there was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support.
AHRQ-funded; HS000078.
Citation: Goins RT, Noonan C, Gonzales K .
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
J Diabetes Complications 2017 Apr;31(4):669-74. doi: 10.1016/j.jdiacomp.2017.01.004.
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Keywords: Diabetes, Elderly, Behavioral Health, Racial and Ethnic Minorities, Trauma
Zullo AR, Lee Y, Daiello LA
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
This study evaluated how often beta-blockers were started after acute myocardial infarction (AMI) in nursing home (NH) residents who previously did not use these drugs and to evaluate which factors were associated with post-AMI use of beta-blockers. It found that almost half of older NH residents in the United States do not initiate a beta-blocker after AMI.
AHRQ-funded; HS022998.
Citation: Zullo AR, Lee Y, Daiello LA .
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
J Am Geriatr Soc 2017 Apr;65(4):754-62. doi: 10.1111/jgs.14671.
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Keywords: Elderly, Healthcare Utilization, Nursing Homes, Heart Disease and Health, Medication
Hoffman GJ, Hays RD, Wallace SP
Depressive symptomatology and fall risk among community-dwelling older adults.
The directionality of observed relationship between falls and depressive symptoms (DS) is in need of elaboration given that cross-sectional study designs can yield biased estimates of the DS-falls relationship. This study found that the DS-falls relationship was not significant when use of psychiatric medications, which was positively associated with falls, was included in the model.
AHRQ-funded; HS000046.
Citation: Hoffman GJ, Hays RD, Wallace SP .
Depressive symptomatology and fall risk among community-dwelling older adults.
Soc Sci Med 2017 Apr;178:206-13. doi: 10.1016/j.socscimed.2017.02.020.
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Keywords: Depression, Elderly, Falls, Patient Safety, Risk
Welsh RL, Graham JE, Karmarkar AM
Effects of postacute settings on readmission rates and reasons for readmission following total knee arthroplasty.
This study examined the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. Inpatient rehabilitation facility (IRF), skilled nursing facility (SNF) concluded that patients discharged to either inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF), in comparison with those discharged to the community, had greater likelihood of readmission within 30 and 90 days.
AHRQ-funded; HS022907.
Citation: Welsh RL, Graham JE, Karmarkar AM .
Effects of postacute settings on readmission rates and reasons for readmission following total knee arthroplasty.
J Am Med Dir Assoc 2017 Apr;18(4):367.e1-67.e10. doi: 10.1016/j.jamda.2016.12.068.
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Keywords: Elderly, Nursing Homes, Hospital Readmissions, Rehabilitation, Surgery
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Hollis RH, Graham LA, Richman JS
Hospital readmissions after surgery: how important are hospital and specialty factors?
Researchers hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. However, they found that hospital readmission rates for orthopaedic, vascular, and general surgery were not correlated between specialties; within each of the 3 specialties, modest correlations were found between 2 procedures within 2 of these specialties.
AHRQ-funded; HS013852.
Citation: Hollis RH, Graham LA, Richman JS .
Hospital readmissions after surgery: how important are hospital and specialty factors?
J Am Coll Surg 2017 Apr;224(4):515-23. doi: 10.1016/j.jamcollsurg.2016.12.034.
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Keywords: Surgery, Hospital Readmissions, Quality Indicators (QIs), Elderly
Venkatesh AK, Mei H, Kocher KE
Identification of emergency department visits in Medicare administrative claims: approaches and implications.
The researchers sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers. They concluded that current operational definitions of ED visitation using administrative claims produce different estimates of ED visitation based on the underlying assumptions applied to billing data and data set availability.
AHRQ-funded; HS024160.
Citation: Venkatesh AK, Mei H, Kocher KE .
Identification of emergency department visits in Medicare administrative claims: approaches and implications.
Acad Emerg Med 2017 Apr;24(4):422-31. doi: 10.1111/acem.13140.
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Keywords: Emergency Medical Services (EMS), Medicare, Policy, Elderly, Hospitalization
Rocque GB, Dionne-Odom JN, Sylvia Huang CH
Implementation and impact of patient lay navigator-led advance care planning conversations.
Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). This study evaluated implementation of lay navigator-led ACP and concluded that a navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL.
AHRQ-funded; HS023009.
Citation: Rocque GB, Dionne-Odom JN, Sylvia Huang CH .
Implementation and impact of patient lay navigator-led advance care planning conversations.
J Pain Symptom Manage 2017 Apr;53(4):682-92. doi: 10.1016/j.jpainsymman.2016.11.012.
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Keywords: Communication, Elderly, Palliative Care, Patient-Centered Healthcare, Provider: Health Personnel
Wright NC, Delzell ES, Smith WK
Improving medical record retrieval for validation studies in Medicare data.
The purpose of the study is to describe medical record retrieval for a study validating claims-based algorithms used to identify seven adverse events of special interest (AESI) in a Medicare population. It concluded that the national medical record validation study of claims-based algorithms produced a modest retrieval rate. The medical record procedures outlined in this paper could have led to the improved retrieval from the researchers’ previous medical record retrieval study.
AHRQ-funded; HS023009.
Citation: Wright NC, Delzell ES, Smith WK .
Improving medical record retrieval for validation studies in Medicare data.
Pharmacoepidemiol Drug Saf 2017 Apr;26(4):393-401. doi: 10.1002/pds.4131.
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Keywords: Medicare, Electronic Health Records (EHRs), Osteoporosis, Elderly
Buys DR, Campbell AD, Godfryd A
Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial.
This pilot study's objective was to evaluate the feasibility of conducting a randomized controlled trial assessing a post-discharge home-delivered meal program's impact on older adults' nutritional intake and hospital readmissions and to assess patient acceptability and satisfaction with the program. It found that participants were overwhelmingly satisfied (82 percent to 100 percent satisfied or very satisfied) with staff performance, meal quality, and delivery processes.
AHRQ-funded; HS013852.
Citation: Buys DR, Campbell AD, Godfryd A .
Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial.
J Acad Nutr Diet 2017 Apr;117(4):599-608. doi: 10.1016/j.jand.2016.11.005.
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Keywords: Nutrition, Patient Experience, Elderly, Home Healthcare, Hospital Discharge
Duckworth M, Leung E, Fuller T
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined. Differences emerged stemming from each group of end users' role on the care team.
AHRQ-funded; HS023535.
Citation: Duckworth M, Leung E, Fuller T .
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
J Gerontol Nurs 2017 Apr;43(4):15-22. doi: 10.3928/00989134-20170313-05.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Caregiving, Patient Safety, Patient and Family Engagement, Care Coordination
Dimou FM, Adhikari D, Mehta HB
Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis.
The Tokyo Guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. The researchers compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a cohort of patients with grade III cholecystitis. Cholecystostomy tube placement was associated with lower rates of definitive treatment with cholecystectomy, higher mortality, and higher readmission rates.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis.
J Am Coll Surg 2017 Apr;224(4):502-11.e1. doi: 10.1016/j.jamcollsurg.2016.12.021.
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Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Guidelines, Practice Patterns
Hanlon JT, Perera S, Newman AB
Potential drug-drug and drug-disease interactions in well-functioning community-dwelling older adults.
The objective of this study was to describe the prevalence of potential drug-drug and drug-disease interactions and associated factors in community-dwelling older adults. It found that drug interactions are common among community-dwelling older adults and are associated with the number of medications and hospitalization in the previous year.
AHRQ-funded; HS023779.
Citation: Hanlon JT, Perera S, Newman AB .
Potential drug-drug and drug-disease interactions in well-functioning community-dwelling older adults.
J Clin Pharm Ther 2017 Apr;42(2):228-33. doi: 10.1111/jcpt.12502.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication, Patient Safety