Report Affirms Effectiveness of Some Non-Opioid Alternatives for Managing Chronic Pain
June 12, 2018
AHRQ Stats: Increased Medicaid Hospitalizations
From 2000 to 2015, the share of hospitalizations with Medicaid as primary payer grew 74 percent for patients ages 18 to 44 and 68 percent for those ages 45 to 64. Those rates do not include hospitalizations for pregnancies or newborns. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #235: Trends in Hospital Inpatient Stays by Age and Payer, 2000-2015.)
- Report Affirms Effectiveness of Some Non-Opioid Alternatives for Managing Chronic Pain.
- New AHRQ Views Blog Post—One Clear Path to Better Health: Wider Participation in Preventive Services.
- EvidenceNOW Practice Facilitators Face Data-Related Challenges, Study Finds.
- Brief Online Survey Will Guide Improvements to AHRQ Quality Indicators.
- AHRQ Seeks Input on Library of Patient-Centered Outcomes Research Resources.
- Highlights From AHRQ’s Patient Safety Network.
- Register Now for TeamSTEPPS Online Course To Improve Safety in Office Settings.
- AHRQ in the Professional Literature.
A new AHRQ evidence review concludes that exercise, cognitive behavioral therapy, chiropractic care and acupuncture are among non-drug treatments that can effectively manage some chronic pain conditions for more than one month after treatment. The report follows an update to Centers for Disease Control and Prevention guidelines, which recommend non-pharmacological interventions as a first line of treatment for chronic pain before initiating opioid therapy. Authors of AHRQ’s report reviewed the evidence on non-pharmacological therapies for common conditions including chronic low back and neck pain, knee and hip osteoarthritis, chronic headache tension and fibromyalgia. The AHRQ review found no published studies that directly compared opioids to alternatives for pain management, and most lacked evidence on long-term effectiveness. The findings in this report can help clinicians, patients and policymakers make better-informed decisions to improve the management of chronic pain.
New AHRQ Views Blog Post—One Clear Path to Better Health: Wider Participation in Preventive Services
A new AHRQ Views blog post by Amanda Borsky, Dr.P.H, dissemination and implementation adviser to the U.S. Preventive Services Task Force and the AHRQ Evidence-based Practice Center Program, describes a new analysis of 2015 data that found only 8 percent of adults over 35 received all highly recommended preventive services. The analysis, published in Health Affairs, was based on a new AHRQ Medical Expenditure Panel Survey that gauged the use of a broad spectrum of high-priority preventive services, including screening, counseling, preventive medications and vaccinations. The analysis also concluded that more than 20 percent of adults reported receiving more than 75 percent of the recommended services, a finding that showed improvement is possible.
Primary care practices need support to conduct data-driven quality improvement activities, especially when they have trouble extracting reliable data from electronic health records, a new AHRQ-funded study concluded. The study, based on interviews with participants in AHRQ’s EvidenceNOW initiative, was published in the Journal of the American Board of Family Medicine. It found that practice facilitators, who serve as quality improvement consultants, face challenges when clinical data are missing, incomplete or inaccurate. Facilitators respond to these challenges by using other data sources or tools to fill in for missing data; approximating performance reports and generating patient lists; and teaching practices how to document care. EvidenceNOW is an AHRQ grant initiative that helps small- and medium-sized practices use the latest evidence to improve heart health, supporting the Department of Health and Human Services’ Million Hearts® campaign. Access the abstract.
A new online survey from AHRQ is collecting feedback from quality improvement organizations about their use of quality indicators. The AHRQ Quality Indicator (QI) Survey invites feedback on QIs developed by AHRQ and other organizations. Survey respondents are asked about challenges faced in their use of QIs, as well as helpful measurement tools and resources that have guided quality improvement efforts. Feedback will support improvements to AHRQ QIs, the AHRQ QI Toolkit, AHRQ QI resources and QI software. The survey is available until June 29.
AHRQ seeks feedback about its Library of Patient-Centered Outcomes Research (PCOR) Resources. The library is a comprehensive Web-based resource that helps make available the PCOR research, findings, tools and other resources that have been developed as a result of investments by public, private, nonprofit and academic organizations. Access more information about AHRQ’s request for feedback.
Please note: the comment deadline has been extended to June 29, and feedback should be emailed to PCORResources@ahrq.hhs.gov.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Effect of increased inpatient attending physician supervision on medical errors, patient safety, and resident education: a randomized clinical trial.
- Tackling ambulatory safety risks through patient engagement: what 10,000 patients and families say about safety-related knowledge, behaviors, and attitudes after reading visit notes.
- Pediatric ADHD medication exposures reported to US poison control centers.
Registration is open for a free TeamSTEPPS® patient safety training course that begins June 15 and is designed to enhance communication and teamwork skills among office-based professionals. Attendees may receive credit for quality improvement under the Merit-based Incentive Payment System. Participants may begin pre-course work now and will earn free continuing education credits for completing the training modules. Master Trainer certificates will be awarded for completing course requirements.
Needs of stroke survivors as perceived by their caregivers: a scoping review. Krishnan S, Pappadis MR, Weller SC, et al. Am J Phys Med Rehabil 2017 Jul;96(7):487-505. Access the abstract on PubMed®.
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting. Lee SY, Cherian R, Ly I, et al. Jt Comm J Qual Patient Saf 2017 Jul;43(7):353-60. Epub 2017 Apr 20. Access the abstract on PubMed®.
Functional gain and pain relief after total joint replacement according to obesity status. Li W, Ayers DC, Lewis CG, et al. J Bone Joint Surg Am 2017 Jul 19;99(14):1183-9. Access the abstract on PubMed®.
Predicting domain-specific health-related quality of life using acute infarct volume. Lin C, Lee J, Chatterjee N, et al. Stroke 2017 Jul;48(7):1925-31. Epub 2017 May 23. Access the abstract on PubMed®.
Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients. McDonald KM, Su G, Lisker S, et al. Implement Sci 2017 Jun 24;12(1):79. Access the abstract on PubMed®.
Screening for obstructive sleep apnea in adults. McNellis RJ, Thomas S. Am Fam Physician 2017 Jul 15;96(2):123-4. Access the abstract on PubMed®.
Serologic screening for genital herpes infection. Meyers D, Duncan J. Am Fam Physician 2017 Jun 15;95(12):801-2. Access the abstract on PubMed®.
Hospital variation in rates of new institutionalizations within 6 months of discharge. Middleton A, Zhou J, Ottenbacher KJ, et al. J Am Geriatr Soc 2017 Jun;65(6):1206-13. Epub 2017 Mar 6. Access the abstract on PubMed®.