Mortality Risk Reduced Among COPD Patients Who Use Bilevel Positive Airway Pressure Machines

AHRQ Stats: Inappropriate Medications for Seniors

The total percentage of adults age 65 and older who received at least one of 33 inappropriate prescription medications declined from 19 percent in 2002 to 10 percent in 2016. (Source: AHRQ, National Healthcare Quality and Disparities Report Chartbook on Patient Safety, 2019.)

Today's Headlines:

• Mortality Risk Reduced Among COPD Patients Who Use Bilevel Positive Airway Pressure Machines.
• Inappropriate Prescribing of Antibiotics Was Common for Medicaid Beneficiaries .
• Glucose Control After Vascular Surgery Recommended To Reduce Adverse Events.
• Highlights From AHRQ’s Patient Safety Network.
• Webcast on AHRQ’s Surveys on Patient Safety Culture .
• AHRQ in the Professional Literature. 

Mortality Risk Reduced Among COPD Patients Who Use Bilevel Positive Airway Pressure Machines

For people with chronic obstructive pulmonary disease (COPD) and hypercapnia, home use of bilevel positive airway pressure (BPAP) machines was shown to lower the risks of death and intubations as well as result in fewer patients with hospital admissions, according to an AHRQ technology assessment published today in JAMA. BPAP machines are bedside devices that help push air into the lungs of people who have trouble breathing, such as people with sleep apnea. They utilize a technology known as noninvasive positive pressure ventilation (NIPPV). Researchers who analyzed data on more than 51,000 COPD patients found that home mechanical ventilators, another NIPPV technology, also resulted in fewer patients with hospital admissions and intubations but did not reduce mortality risk. Neither technology was shown to have a significant impact on quality of life. Access the abstract. 

Inappropriate Prescribing of Antibiotics Was Common for Medicaid Beneficiaries

Twenty-eight percent of antibiotic prescriptions for Medicaid beneficiaries filled between 2004 and 2013 were not associated with a clinician visit, according to an AHRQ-funded study published in Health Affairs. The analysis also found that 17 percent of antibiotics prescriptions were given at a clinician visit but without an infection diagnosis. The study analyzed claims data from 53 million Medicaid beneficiaries who filled 298 million antibiotic prescriptions during the 10-year period. Study authors concluded that policies aimed at improving antibiotic stewardship should include comprehensive measurements of antibiotic use and appropriateness, including diagnosis and whether a clinician visit occurred. Access the abstract.

Glucose Control After Vascular Surgery Recommended To Reduce Adverse Events

Inadequate glucose control after carotid artery surgery puts patients at risk for adverse events such as strokes, according to an AHRQ-funded study published in the journal Vascular. Researchers assessed about 4,300 patients admitted for an elective carotid procedure and found that 13 percent had high glucose levels after surgery. On average, these patients experienced higher stroke rates, more cardiac complications, longer hospital stays and higher rates of post-procedure infection than patients with optimal glucose control. Since carotid procedures are meant to prevent stroke, the authors suggest that health practitioners incorporate postoperative glucose control into treatment of carotid disease as a standard practice. Access the abstract. 

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• International evaluation of an AI system for breast cancer screening.
• Failure mode and effects analysis to reduce risk of heparin use.
• Identifying potential patient safety issues from the Federal Electronic Health Record Surveillance Program.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web). 

Webcast on AHRQ’s Surveys on Patient Safety Culture

An AHRQ webcast "Understanding SOPS Surveys: A Primer for New Users," is on February 19, 2020. AHRQ’s Surveys on Patient Safety Culture (SOPS) are designed to help healthcare organizations assess how staff members perceive various aspects of organizational culture in promoting a safe patient environment. Webinar speakers will describe the SOPS program, surveys, databases and resources available to users, and will highlight what is new in 2020. 

AHRQ in the Professional Literature

Social isolation, loneliness, and violence exposure in urban adults. Tung EL, Hawkley LC, Cagney KA, et al. Health Aff (Millwood) 2019 Oct;38(10):1670-8. Access the abstract on PubMed®.

Inclusion of children in the initial conversation about their cancer diagnosis: impact on parent experiences of the communication process. Brand McCarthy SR, Kang TI, Mack JW. Support Care Cancer 2019 Apr;27(4):1319-24. Epub 2019 Jan 23. Access the abstract on PubMed®. 

Predicting hospital readmissions from home healthcare in Medicare beneficiaries. Jones CD, Falvey J, Hess E, et al. J Am Geriatr Soc 2019 Dec;67(12):2505-10. Epub 2019 Aug 29. Access the abstract on PubMed®.

Comparison of 3 safety-net hospital definitions and association with hospital characteristics. Popescu I, Fingar KR, Cutler E, et al. JAMA Netw Open 2019 Aug 2;2(8):e198577. Access the abstract on PubMed®.

Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections. Desai S, Aronson PL, Shabanova V, et al. Pediatrics 2019 Sep;144(3). Epub 2019 Aug 20. Access the abstract on PubMed®.

Advance care planning in skilled nursing facilities: a multisite examination of professional judgments. Baughman KR, Ludwick R, Jarjoura D, et al. Gerontologist 2019 Mar 14;59(2):338-46. Access the abstract on PubMed®.

A taxonomy of hospitals participating in Medicare accountable care organizations. Bazzoli GJ, Harless DW, Chukmaitov AS. Health Care Manage Rev 2019 Apr/Jun;44(2):93-103. Access the abstract on PubMed®.

Verification of a portable motion tracking system for remote management of physical rehabilitation of the knee. Bell KM, Onyeukwu C, McClincy MP, et al. Sensors (Basel) 2019 Feb 28;19(5). Access the abstract on PubMed®.