National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (3)
- Adverse Events (3)
- Ambulatory Care and Surgery (1)
- Antibiotics (4)
- Antimicrobial Stewardship (2)
- Anxiety (1)
- Asthma (2)
- Behavioral Health (4)
- Blood Clots (1)
- Blood Pressure (1)
- Cancer (1)
- Caregiving (1)
- Care Management (1)
- Children's Health Insurance Program (CHIP) (1)
- (-) Children/Adolescents (19)
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- Diabetes (1)
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- Evidence-Based Practice (1)
- Health Information Technology (HIT) (1)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- (-) Medication (19)
- Medication: Safety (4)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neurological Disorders (1)
- Obesity (1)
- Opioids (4)
- Outcomes (1)
- Pain (1)
- Patient Adherence/Compliance (1)
- Patient Experience (1)
- Patient Safety (3)
- Policy (1)
- Practice Patterns (3)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- Risk (2)
- Skin Conditions (1)
- Surgery (1)
- Treatments (1)
- Vulnerable Populations (1)
- Young Adults (3)
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 19 of 19 Research Studies DisplayedGoyal 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
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
Bushnell GA, Rynn MA, Crystal S
Simultaneous benzodiazepine and SSRI initiation in young people with anxiety disorders.
Researchers investigated how often adolescents and young adults with anxiety disorders simultaneously initiate benzodiazepine (BZD) treatment with selective serotonin reuptake inhibitor (SSRI) treatment and examined whether SSRI treatment duration varies by simultaneous BZD initiation. Using a commercial claims database, they found that 4% of adolescents and 17% of young adults simultaneously initiated BZD treatment, varying by age, anxiety disorder, comorbidities, health care utilization, and provider type. They concluded that simultaneous initiation of both treatments is relatively common in young adults with anxiety disorders and was not associated with longer SSRI persistence.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Rynn MA, Crystal S .
Simultaneous benzodiazepine and SSRI initiation in young people with anxiety disorders.
J Clin Psychiatry 2021 Oct 19;82(6). doi: 10.4088/JCP.20m13863..
Keywords: Anxiety, Behavioral Health, Medication, Practice Patterns, Children/Adolescents, Young Adults
Renny MH, Yin HS, Jent V
Temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018.
Prescription opioids are involved in more than half of opioid overdoses among younger persons. Understanding opioid prescribing practices is essential for developing appropriate interventions for this population. The objective of this study was to examine temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018.
AHRQ-funded; HS026120.
Citation: Renny MH, Yin HS, Jent V .
Temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018.
JAMA Pediatr 2021 Oct;175(10):1043-52. doi: 10.1001/jamapediatrics.2021.1832..
Keywords: Children/Adolescents, Young Adults, Opioids, Practice Patterns, Medication
Hoffmann JA, Pergjika A, Konicek CE
Pharmacologic management of acute agitation in youth in the emergency department.
In this article, the authors reviewed the definition of agitation and pharmacologic management for youth with acute agitation, including common classes of medications, indications for use, and adverse effects. They also discussed the need to integrate the use of medications into a comprehensive strategy for agitation management that begins with proactive prevention of aggressive behavior, creation of a therapeutic treatment environment, and verbal de-escalation strategies.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Pergjika A, Konicek CE .
Pharmacologic management of acute agitation in youth in the emergency department.
Pediatr Emerg Care 2021 Aug;37(8):417-22. doi: 10.1097/pec.0000000000002510..
Keywords: Children/Adolescents, Emergency Department, Medication, Care Management
Bushnell GA, Crystal S, Olfson M
Trends in antipsychotic medication use in young privately insured children.
This study’s objective was to estimate trends in annual antipsychotic medication use by privately insured young children (aged 2-7 years) in the United States and to describe the clinical and treatment characteristics of these children. Young children from a nationwide commercial claims database from 2007-2017 was used to estimate annual antipsychotic use by age and sex. Annual antipsychotic use decreased over the time period, from a peak of 0.29% in 2009 and significantly declined to 0.17% in 2017. Antipsychotic use was higher in boys than in girls with a greater proportion receiving a mental disorder diagnosis in 2017 than in 2009. The most common clinical diagnoses were pervasive development disorder, conduct or disruptive behavior disorder, and attention-deficit/hyperactivity disorder. In 2017, 32% had 4+ psychotherapy claims, 43% had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant.
AHRQ-funded; HS023258; HS026001.
Citation: Bushnell GA, Crystal S, Olfson M .
Trends in antipsychotic medication use in young privately insured children.
J Am Acad Child Adolesc Psychiatry 2021 Jul;60(7):877-86. doi: 10.1016/j.jaac.2020.09.023..
Keywords: Children/Adolescents, Medication, Behavioral Health
Mackie TI, Kovacs KM, Simmel C
A best-worst scaling experiment to identify patient-centered claims-based outcomes for evaluation of pediatric antipsychotic monitoring programs.
This study utilized a best-worst scaling (BWS) experiment to identify the claims-based outcomes that matter most to patients and other relevant parties when evaluating pediatric antipsychotic monitoring programs, specifically in foster care children. Relevant parties included policymakers (n = 31), foster care alumni (n = 28), caseworkers (n=23), prescribing clinicians (n = 32), and caregivers (n = 18). Participants received surveys with a scenario on antipsychotic monitoring programs and ranked 11 candidate claims-based outcomes as most and least important. Safety indicators ranked among the top three candidate outcomes across respondent groups. Foster care alumni put “antipsychotic treatment reduction” and “increased psychosocial treatment” as the highest ranking. Caseworkers, prescribers, and caregivers gave top priority to “increased follow-up after treatment initiation”. Potential unintended consequences ranked lowest, including increased use of other psychotropic medication classes, increased psychiatric hospital stays, and increased emergency room utilization.
AHRQ-funded; HS026001.
Citation: Mackie TI, Kovacs KM, Simmel C .
A best-worst scaling experiment to identify patient-centered claims-based outcomes for evaluation of pediatric antipsychotic monitoring programs.
Health Serv Res 2021 Jun;56(3):418-31. doi: 10.1111/1475-6773.13610..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Policy
Worsham CM, Woo J, Jena AB
Adverse events and emergency department opioid prescriptions in adolescents.
Understanding the risks associated with opioid prescription in adolescents is critical for informing opioid policy, but the risks are challenging to quantify given the lack of randomized trial data. Using a regression discontinuity design, the investigators exploited a discontinuous increase in opioid prescribing in the emergency department (ED) when adolescents transitioned from "child" to "adult" at age eighteen to estimate the effect of an ED opioid prescription on subsequent opioid-related adverse events.
AHRQ-funded; HS026753.
Citation: Worsham CM, Woo J, Jena AB .
Adverse events and emergency department opioid prescriptions in adolescents.
Health Aff 2021 Jun;40(6):970-78. doi: 10.1377/hlthaff.2020.01762..
Keywords: Children/Adolescents, Emergency Department, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Practice Patterns
Simmel C, Bowden CF, Neese-Todd S
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
AHRQ-funded; HS026001.
Citation: Simmel C, Bowden CF, Neese-Todd S .
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
Am J Orthopsychiatry 2021;91(2):258-70. doi: 10.1037/ort0000532..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Medication, Patient Experience
Gurka MJ, Siddiqi SU, Filipp SL
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Investigators estimated the proximal change in BMI associated with start of medication and to assess whether medication-specific departures in BMI varied by age and sex in patients with attention deficit hyperactivity disorder (ADHD). Longitudinal electronic health records from children aged 4-19 years with an ADHD diagnosis at one healthcare system were analyzed. They found that all medications had larger impacts at younger ages; decreased BMI was observed with stimulants, while antidepressants and antipsychotics led to BMI increases as did alpha-agonists, significantly varying by sex and age. They recommended future research to study further the interactions of these medications on long-term impacts on obesity.
AHRQ-funded; HS025298.
Citation: Gurka MJ, Siddiqi SU, Filipp SL .
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Pediatr Obes 2021 Apr;16(4):e12738. doi: 10.1111/ijpo.12738..
Keywords: Children/Adolescents, Behavioral Health, Medication, Obesity
Walsh KE, Bacic J, Phillips BD
Misuse of pediatric medications and parent-physician communication: an interactive voice response intervention.
Children take 1 medication each week on average at home. Better communication between parents and providers could support safer home medication use and prevent misuse of pediatric medications, such as intentional underdosing or overdosing. The primary objective of the study was to assess the impact of an interactive voice response system on parent-provider communication about medications. The investigators concluded that pediatric medication misuse was common in this study.
AHRQ-funded; HS017248.
Citation: Walsh KE, Bacic J, Phillips BD .
Misuse of pediatric medications and parent-physician communication: an interactive voice response intervention.
J Patient Saf 2021 Apr 1;17(3):e207-e13. doi: 10.1097/pts.0000000000000375..
Keywords: Children/Adolescents, Medication: Safety, Medication, Clinician-Patient Communication
Malone S, McKay VR, Krucylak C
A cluster randomized stepped-wedge trial to de-implement unnecessary post-operative antibiotics in children: the optimizing perioperative antibiotic in children (OPerAtiC) trial.
This paper describes an upcoming clinical trial to determine best strategies to de-implement inappropriate antibiotic use in pediatric post-operative surgical cases deemed low risk for infection. This study will provide important information on the impact of two potential strategies while assessing important clinical outcomes.
AHRQ-funded; HS026742.
Citation: Malone S, McKay VR, Krucylak C .
A cluster randomized stepped-wedge trial to de-implement unnecessary post-operative antibiotics in children: the optimizing perioperative antibiotic in children (OPerAtiC) trial.
Implement Sci 2021 Mar 19;16(1):29. doi: 10.1186/s13012-021-01096-1..
Keywords: Children/Adolescents, Antimicrobial Stewardship, Antibiotics, Medication, Surgery
Neubauer HC, Hall M, Lopez MA
Antibiotic regimens and associated outcomes in children hospitalized with staphylococcal scalded skin syndrome.
Controversy exists regarding the optimal antibiotic regimen for use in hospitalized children with staphylococcal scalded skin syndrome (SSSS). Various regimens may confer toxin suppression and/or additional coverage for methicillin-susceptible Staphylococcus aureus (MSSA) or methicillin-resistant S aureus (MRSA). The purpose of this study was to describe antibiotic regimens in hospitalized children with SSSS and examine the association between antistaphylococcal antibiotic regimens and patient outcomes.
AHRQ-funded; HS026006.
Citation: Neubauer HC, Hall M, Lopez MA .
Antibiotic regimens and associated outcomes in children hospitalized with staphylococcal scalded skin syndrome.
J Hosp Med 2021 Mar;16(3):149-55. doi: 10.12788/jhm.3529..
Keywords: Children/Adolescents, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Skin Conditions, Infectious Diseases
Jones TW, Fino N, Olson J
The impact of beta-lactam allergy labels on hospitalized children.
Investigators sought to determine the impact of beta-lactam allergy labels in hospitalized children with regards to clinical and economic outcomes. Subjects were pediatric patients hospitalized at Intermountain Healthcare facilities from 2007 to 2017 who received one or more 1 dose of an antibiotic during their admission. The researchers found that patients with beta-lactam allergy received broader-spectrum antibiotics and experienced higher antibiotic costs than nonallergic controls. However, there were no differences in the length of stay, readmission rates, or total number of days of antibiotics between allergic and nonallergic patients.
AHRQ-funded; HS023320.
Citation: Jones TW, Fino N, Olson J .
The impact of beta-lactam allergy labels on hospitalized children.
Infect Control Hosp Epidemiol 2021 Mar;42(3):318-24. doi: 10.1017/ice.2020.424..
Keywords: Children/Adolescents, Antibiotics, Medication, Antimicrobial Stewardship
Heneghan MB, Hussain T, Barrera L
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
This study’s objectives were to examine access to mobile technology and preferences for an mHealth intervention to improve medication adherence in pediatric acute lymphoblastic leukemia (ALL). Parents of children with ALL as well as adolescents and young adults (AYAs) with ALL who received maintenance chemotherapy were given a cross-sectional survey. Findings showed that parents, adolescents, and AYAs reported ubiquitous access to mobile technology and strong interest in multiple adherence-specific mHealth app features. Parents and AYAs provided valuable insight into preferred features for a multifunctional behavioral intervention to promote medication adherence in pediatric ALL.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
J Med Internet Res 2021 Feb 18;23(2):e24893. doi: 10.2196/24893..
Keywords: Children/Adolescents, Young Adults, Caregiving, Cancer, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Treatments
Turi KN, Gebretsadik T, Ding T
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
The potential for prenatal antibiotic exposure to influence asthma risk is not clear. The investigators aimed to determine the effect of timing, dose, and spectrum of prenatal antibiotic exposure on the risk of childhood asthma. The investigators concluded that increased cumulative dose, early pregnancy first course, and broad-spectrum antibiotic exposure were associated with childhood asthma risk.
AHRQ-funded; HS026395; HS018454.
Citation: Turi KN, Gebretsadik T, Ding T .
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
Clin Infect Dis 2021 Feb 1;72(3):455-62. doi: 10.1093/cid/ciaa085.
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Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Antibiotics, Medication, Risk
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Ing C, Jackson WM, Zaccariello MJ
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.
This systematic review and meta-analysis tried to answer the question whether exposure to a single general anesthetic (GA) in early childhood causes long-term neurodevelopmental problems. Databases searched from inception to October 2019 were PubMed/MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library. Outcomes common to at least three studies were evaluated using a random-effects meta-analyses. A total of 841 out of 1644 children who had a single exposure to GA were evaluated. Findings were that there were statistically significant increases in parent reports of behavioral problems but no difference in general intelligence.
AHRQ-funded; HS026493.
Citation: Ing C, Jackson WM, Zaccariello MJ .
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.
Br J Anaesth 2021 Feb;126(2):433-44. doi: 10.1016/j.bja.2020.10.022..
Keywords: Children/Adolescents, Neurological Disorders, Medication, Adverse Drug Events (ADE), Adverse Events, Evidence-Based Practice, Outcomes
Shenkman E, Thompson L, Bussing R
AHRQ Author: Mistry KB
Provider specialty and receipt of metabolic monitoring for children taking antipsychotics.
Metabolic monitoring is important for children taking antipsychotic medication, given the risk for increased BMI, impaired glucose metabolism, and hyperlipidemia. The purpose of this study was to examine the influence of provider specialty on the receipt of metabolic monitoring. Specifically, differences in the receipt of recommended care when a child receives outpatient care from a primary care provider (PCP), a mental health provider with prescribing privileges, or both was examined.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Thompson L, Bussing R .
Provider specialty and receipt of metabolic monitoring for children taking antipsychotics.
Pediatrics 2021 Jan;147(1):e20200658. doi: 10.1542/peds.2020-0658..
Keywords: Children/Adolescents, Medication: Safety, Medication, Ambulatory Care and Surgery