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 (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Caregiving (1)
- Children/Adolescents (3)
- Elderly (1)
- Emergency Department (1)
- Guidelines (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Infectious Diseases (2)
- Influenza (1)
- Medication (14)
- Medication: Safety (4)
- Opioids (6)
- Patient-Centered Healthcare (1)
- Patient and Family Engagement (1)
- Patient Safety (6)
- Policy (1)
- Practice Patterns (2)
- Provider (9)
- Provider: Clinician (1)
- (-) Provider: Pharmacist (20)
- Provider: Physician (2)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (2)
- Risk (1)
- Shared Decision Making (2)
- Substance Abuse (3)
- Transitions of Care (1)
- Vaccination (5)
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 20 of 20 Research Studies DisplayedAilabouni NJ, Marcum ZA, Schmader KE
Medication use quality and safety in older adults: 2018 update.
This study identified four key articles from 2018 that address medication use quality and safety for older adults. The first study highlighted a cluster-randomized trial that utilized a pharmacist-led education-based intervention delivered to both patients and doctors to deprescribe four types of inappropriate medications. The second study from the UK examined the association between anticholinergic exposure, overall and by medication class, and dementia risk in 40,770 older adults. The third study was a Swedish longitudinal cohort study examining the association between antihypertensive medications and incident dementia. The fourth and last study was a randomized, double-blind, placebo-controlled trial and examined the effect of daily low-dose aspirin for primary prevention of cardiac events and hemorrhage in 19,144 community-dwelling older adults.
AHRQ-funded; HS022982.
Citation: Ailabouni NJ, Marcum ZA, Schmader KE .
Medication use quality and safety in older adults: 2018 update.
J Am Geriatr Soc 2019 Dec;67(12):2458-62. doi: 10.1111/jgs.16243..
Keywords: Elderly, Medication, Medication: Safety, Patient Safety, Quality of Care, Provider: Pharmacist, Provider
Reddy A, Lester CA, Stone JA
Applying participatory design to a pharmacy system intervention.
Researchers used participatory design (PD) to develop a patient-centered prototype for a community pharmacy. The stakeholders recruited for the intervention were pharmacy staff and older adult patients who received prescriptions at the pharmacy corporation involved in this study. The PD process is a series of six adaptive sessions: 1) problem identification, 2) solution generation, 3) convergence, 4) prototyping, 5) initial evaluation, and 6) formative evaluation. The sessions resulted in the development of a patient-centered community pharmacy prototype.
AHRQ-funded; HS024490.
Citation: Reddy A, Lester CA, Stone JA .
Applying participatory design to a pharmacy system intervention.
Res Social Adm Pharm 2019 Nov;15(11):1358-67. doi: 10.1016/j.sapharm.2018.11.012..
Keywords: Provider: Pharmacist, Patient-Centered Healthcare, Medication, Patient Safety
Kurian S, Baloy B, Baird J
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
AHRQ-funded; HS024021.
Citation: Kurian S, Baloy B, Baird J .
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
J Am Pharm Assoc 2019 Nov-Dec;59(6):824-31. doi: 10.1016/j.japh.2019.08.009..
Keywords: Medication, Medication: Safety, Opioids, Substance Abuse, Provider: Pharmacist, Provider, Patient Safety
Gilson AM, Stone JA, Reddy A
Exploring how pharmacists engage with patients about over-the-counter medications.
This study used an innovative information-gathering approach to provide insight into the nature and structure of pharmacy staff encounters with patients seeking over-the-counter (OTC) medications and revealed specific activities of pharmacy staff around these encounters. Through an 8-item OTC Encounter Form, results showed that pharmacists play a key role in ensuring that the benefits of OTC medications outweigh the risks, thereby providing an important resource for patient engagement about safe medication selection and use. Examining the features of OTC encounters creates an evidence base to promote best practices for OTC encounters, increasing pharmacists' ability to help people, especially older adults, navigate the intricacies of OTC medication use, without significantly increasing pharmacy staff workload.
AHRQ-funded; HS024490.
Citation: Gilson AM, Stone JA, Reddy A .
Exploring how pharmacists engage with patients about over-the-counter medications.
J Am Pharm Assoc 2019 Nov - Dec;59(6):852-56. doi: 10.1016/j.japh.2019.08.001..
Keywords: Medication, Provider: Pharmacist, Provider, Patient and Family Engagement
Bach P, Hartung D
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy.
AHRQ-funded; HS024227; 2902015000091.
Citation: Bach P, Hartung D .
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
Addict Sci Clin Pract 2019 Sep 2;14(1):30. doi: 10.1186/s13722-019-0158-0..
Keywords: Medication, Opioids, Provider, Provider: Pharmacist, Substance Abuse
McCarthy DM, Russell AM , Effler MR
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
The authors assessed implementation of a patient-centered "PRN" (as needed) label entitled "Take-Wait-Stop" (TWS) with three deconstructed steps replacing traditional wording. They found that exact intervention adherence was not achieved in the majority of cases, limiting impact, but that community pharmacies were responsive to new instructions, with higher implementation reliability requiring additional supports.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Russell AM , Effler MR .
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
Pharmacoepidemiol Drug Saf 2019 Sep;28(9):1251-57. doi: 10.1002/pds.4795..
Keywords: Opioids, Patient Safety, Health Literacy, Medication, Provider: Pharmacist, Provider
Nolan K, Zullo AR, Bosco E
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
This study’s purpose was to demonstrate the utility of failure modes and effects analysis (FMEA) to identify potential sources of controlled substance diversion and developing solutions in an academic health system. A cross-functional team of 18 members was developed from the department of pharmacy. Scoring criteria was developed and ways were identified in which step of the medication supply there could be failure and result in diversion of controlled substances. Failure was indicated with a vulnerability score of 48 or 64. A total of 10 major steps and 30 substeps in the supply process was identified. From this 103 potential failure modes were identified, with 24 modes (23%) considered failing. Notable failure included controlled substance activity under temporary patients and discrepancy trends. Expanded use of cameras in high-risk areas and added verification checks were implemented after the analysis.
AHRQ-funded; HS022998.
Citation: Nolan K, Zullo AR, Bosco E .
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
Am J Health Syst Pharm 2019 Jul 18;76(15):1158-64. doi: 10.1093/ajhp/zxz116..
Keywords: Medication, Provider: Pharmacist, Hospitals, Quality Improvement, Quality of Care
Snyder ME, Jaynes H, Gernant SA
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation.
This study evaluated the effectiveness of alerts for community pharmacist-provided medication therapy management (MTM). The alerts come in five categories: indication, effectiveness, safety, adherence, and cost-containment. The heuristic evaluation used the Instrument for Evaluating Human-Factors Principles in Medication-Related Decision Support Alerts (I-MeDeSA). Four analysts’ individual ratings were summed for each alert, and a mean score on the modified I-MeDeSA was computed. The analysts’ scores were similar. The scores indicated opportunities for improvement across all MTM alert categories including principles of alert prioritization; text-based information; alarm philosophy; and corrective actions.
AHRQ-funded; HS025005.
Citation: Snyder ME, Jaynes H, Gernant SA .
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation.
BMC Med Inform Decis Mak 2019 Jul 16;19(1):135. doi: 10.1186/s12911-019-0866-0..
Keywords: Shared Decision Making, Health Information Technology (HIT), Medication, Provider, Provider: Pharmacist
Donovan E, Case P, Bratberg JP
Beliefs associated with pharmacy-based naloxone: a qualitative study of pharmacy-based naloxone purchasers and people at risk for opioid overdose.
The purpose of this study was to understand factors that impact the likelihood of obtaining pharmacy-based naloxone. Results showed that several themes emerged from the interview data: individual, interpersonal, pharmacy, community, and societal, suggesting that these factors can be used to inform interventions seeking to increase the provision of pharmacy-based naloxone.
AHRQ-funded; HS024021.
Citation: Donovan E, Case P, Bratberg JP .
Beliefs associated with pharmacy-based naloxone: a qualitative study of pharmacy-based naloxone purchasers and people at risk for opioid overdose.
J Urban Health 2019 Jun;96(3):367-78. doi: 10.1007/s11524-019-00349-1..
Keywords: Medication, Provider, Provider: Pharmacist, Opioids, Risk, Substance Abuse
Schiff GD, Klinger E, Salazar A
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
In this study, the investigators evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist- to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. Systematic automated telephone outreach monitoring coupled with real-time phone referral to a pharmacist identified a substantial number of previously unidentified potentially drug-related symptoms, many of which were validated as probably or possibly related to the drug by the pharmacist or their physicians.
AHRQ-funded; HS021094.
Citation: Schiff GD, Klinger E, Salazar A .
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
J Gen Intern Med 2019 Feb;34(2):285-92. doi: 10.1007/s11606-018-4672-7..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Health Information Technology (HIT), Provider: Pharmacist, Provider, Patient Safety
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
Hartung DM, Hall J, Haverly SN
Pharmacists' role in opioid safety: a focus group investigation.
This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Using focus groups, results showed that pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing; and that patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
Citation: Hartung DM, Hall J, Haverly SN .
Pharmacists' role in opioid safety: a focus group investigation.
Pain Med 2018 Sep;19(9):1799-806. doi: 10.1093/pm/pnx139..
Keywords: Provider: Pharmacist, Opioids, Medication: Safety, Medication, Patient Safety
Shah PD, Trogdon JG, Golden SD
Impact of pharmacists on access to vaccine providers: a geospatial analysis.
This study analyzed the impact of pharmacists on access to vaccines. The study concluded that pharmacists are more geographically dispersed across census tracts than primary care physicians. As a result, adding pharmacists to the workforce would increase the availability of vaccine providers in areas with inadequate primary care provider coverage.
AHRQ-funded; HS000032.
Citation: Shah PD, Trogdon JG, Golden SD .
Impact of pharmacists on access to vaccine providers: a geospatial analysis.
Milbank Q 2018 Sep;96(3):568-92. doi: 10.1111/1468-0009.12342.
.
.
Keywords: Access to Care, Provider: Pharmacist, Vaccination
Johnston K, Alley L, Novak K
Pharmacists' attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: a brief scoping review.
Researchers sought to identify and synthesize findings from current literature on community pharmacists' attitudes toward, knowledge of, and registration and utilization behaviors regarding prescription drug monitoring programs (PDMPs). While considered studies varied greatly in methodological approach, generally, pharmacists' attitudes and knowledge of PDMPs positively influenced likelihood to register and use state's program. The researchers recommended pharmacist-targeted PDMPs and opioid safety training in order to increase knowledge of and insight into behavioral change.
AHRQ-funded; HS024227.
Citation: Johnston K, Alley L, Novak K .
Pharmacists' attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: a brief scoping review.
J Am Pharm Assoc 2018 Sep - Oct;58(5):568-76. doi: 10.1016/j.japh.2018.06.003..
Keywords: Medication, Provider: Pharmacist, Policy
Jones CD, Anthony A, Klein MD
The effect of a pharmacist-led multidisciplinary transitions-of-care pilot for patients at high risk of readmission.
The purpose of this study was to evaluate the feasibility and effect of a pharmacist-led transitions-of-care (TOC) pilot targeted to patients at high risk of readmission on process measures, hospital readmissions, and emergency department visits. Results showed that a pharmacist-led TOC pilot demonstrated potential for reducing hospital readmissions. The intervention was time intensive and led to the creation of a TOC pharmacist role to implement medication-related transitional care.
AHRQ-funded; HS024569.
Citation: Jones CD, Anthony A, Klein MD .
The effect of a pharmacist-led multidisciplinary transitions-of-care pilot for patients at high risk of readmission.
J Am Pharm Assoc 2018 Sep - Oct;58(5):554-60. doi: 10.1016/j.japh.2018.05.008..
Keywords: Hospital Readmissions, Provider: Pharmacist, Transitions of Care
Shah PD, Calo WA, Marciniak MW
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380..
Keywords: Caregiving, Children/Adolescents, Infectious Diseases, Provider, Provider: Pharmacist, Provider: Physician, Vaccination
Shah PD, Marciniak MW, Golden SD
Pharmacies versus doctors' offices for adolescent vaccination.
This study sought to understand the relative advantage of pharmacies compared to doctors' offices for delivering HPV vaccination to adolescents. The authors concluded that to be more appealing to parents as HPV vaccine providers, pharmacy providers within community and hospital settings should build on their relative advantage with respect to accessibility and enhance their appeal of their healthcare environment.
AHRQ-funded; HS000032.
Citation: Shah PD, Marciniak MW, Golden SD .
Pharmacies versus doctors' offices for adolescent vaccination.
Vaccine 2018 Jun 7;36(24):3453-59. doi: 10.1016/j.vaccine.2018.04.088..
Keywords: Children/Adolescents, Health Services Research (HSR), Ambulatory Care and Surgery, Provider: Pharmacist, Vaccination
Shah PD, Calo WA, Marciniak MW
Service quality and parents' willingness to get adolescents HPV vaccine from pharmacists.
The researchers sought to examine whether pharmacy service quality was associated with parents' willingness to have immunizing pharmacists administer human papillomavirus (HPV) vaccine to their adolescent children. They found that parents who went to independent pharmacies had lower willingness to get HPV vaccine from pharmacists compared to parents who went to chain pharmacies, but there was no difference in willingness for parents who went to clinic versus chain pharmacies.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Service quality and parents' willingness to get adolescents HPV vaccine from pharmacists.
Prev Med 2018 Apr;109:106-12. doi: 10.1016/j.ypmed.2018.01.002.
.
.
Keywords: Children/Adolescents, Shared Decision Making, Infectious Diseases, Provider: Pharmacist, Vaccination
Chang AC, Lincoln J, Lantaff WM
Characterization of actions taken during the delivery of medication therapy management: a time-and-motion approach.
The purpose of this study was to characterize actions performed by pharmacists and support staff during provision of medication therapy management (MTM) and to compare actions performed according to practice characteristics. The investigators found that MTM activities were longer at Later Maturity Level practices, and these practices were more likely to use paid pharmacy interns and to receive physician referrals for MTM.
AHRQ-funded; HS022119.
Citation: Chang AC, Lincoln J, Lantaff WM .
Characterization of actions taken during the delivery of medication therapy management: a time-and-motion approach.
J Am Pharm Assoc 2018 Jan - Feb;58(1):61-66.e7. doi: 10.1016/j.japh.2017.09.059.
.
.
Keywords: Medication, Practice Patterns, Provider: Pharmacist
Kim HS, McCarthy DM, Hoppe JA
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
This study examined attitudes of emergency department residents, attending physicians, and pharmacists from three hospitals on coprescribing benzodiazepines and opioids. There is mounting evidence that this increases overdose risk. Focus groups were conducted using semistructured interviews which were audio-recorded and transcribed. Participants were reluctant to admit coprescribing and said when they did that specific discharge instructions were provided. The decision was also influenced by a provider’s belief in the efficacy of combination therapy as well as self-imposed pressure to escalate care or avoid hospital admission. They did not like the idea of using computerized alerts, but were support of pharmacist-assisted interventions.
AHRQ-funded; HS023011; HS000078.
Citation: Kim HS, McCarthy DM, Hoppe JA .
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
Acad Emerg Med 2018 Jan;25(1):15-24. doi: 10.1111/acem.13273..
Keywords: Emergency Department, Guidelines, Medication, Opioids, Practice Patterns, Provider: Clinician, Provider: Pharmacist, Provider: Physician