Analysis Recommends Steps To Reduce Dentists’ Overprescribing of Opioids

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Today's Headlines:

• Analysis Recommends Steps To Reduce Dentists’ Overprescribing of Opioids.
• Study Explores Changes in Quality of Care After Hospital Mergers and Acquisitions.
• Satisfaction With Electronic Health Records Did Not Improve Between 2014 and 2015.
• Highlights From AHRQ’s Patient Safety Network.
• Office of National Coordinator for Health Information Technology (IT) Releases National Health IT Priorities for Research: A Policy and Development Agenda.
• AHRQ in the Professional Literature.

Analysis Recommends Steps To Reduce Dentists’ Overprescribing of Opioids

Twenty-nine percent of opioid prescriptions written by U.S. dentists exceeded recommended morphine equivalents for appropriately managing acute pain between 2011 and 2015, according to an AHRQ-funded study in the American Journal of Preventive Medicine. In addition, 53 percent of the prescriptions exceeded the recommended days supplied, the analysis concluded. The study analyzed records of nearly 550,000 adult dental visits and compared opioid prescribing practices with the 2016 Centers for Disease Control and Prevention guidelines for pain management. Interventions tailored to dentists, such as pharmacist-delivered audits of prescriptions and mandatory queries of the state prescription drug monitoring program, are needed to help curtail excessive opioid prescribing by U.S. dentists, the study’s authors asserted. Access the abstract.

Study Explores Changes in Quality of Care After Hospital Mergers and Acquisitions

Hospitals that are acquired or merged with another hospital or hospital system have worse patient experiences and their readmission and mortality rates remain unchanged, according to an AHRQ-funded study in the New England Journal of Medicine. Researchers followed the performance of 246 hospitals that were acquired or merged between 2009 and 2013. Using Medicare claims and Hospital Compare data, as well as survey results from AHRQ’s Hospital Consumer Assessment of Healthcare Providers and Systems, researchers tracked hospital performance according to four measures: patient experience, 30-day mortality, 30-day readmissions and clinical processes. Compared with 1,986 control hospitals, acquired or merged hospitals had a modest decline in the patient-experience measure but no significant changes in mortality or readmission rates. Researchers said their findings challenge the assumption that hospital mergers improve quality of care. The study was funded via AHRQ’s Comparative Health System Performance Initiative. Access the abstract.

Satisfaction With Electronic Health Records Did Not Improve Between 2014 and 2015

Clinician satisfaction with using electronic health records (EHRs) did not significantly improve between 2014 and 2015, according to an AHRQ-funded study in JAMA Network Open. Poor usability of EHR systems is associated with job dissatisfaction and burnout and could impact patient safety, researchers noted. To conduct their analysis, authors reviewed usability testing results required by HHS’ Office of the National Coordinator for Health Information Technology. After analyzing results on 27 EHR products that met the study criteria, researchers found that between 2014 and 2015, usability scores declined for 44 percent of the products and increased for 48 percent. In 2015, about a quarter of products were below an established average benchmark score. 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:

• The harms of promoting 'Zero Harm'.
• Implementation of a discharge education program to improve transitions of care for patients at high risk of medication errors.
• Oral chemotherapy: a home safety educational framework for healthcare providers, patients, and caregivers.

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).

Office of National Coordinator for Health Information Technology (IT) Releases National Health IT Priorities for Research: A Policy and Development Agenda

The HHS Office of the National Coordinator for Health Information Technology has released an agenda that articulates a vision of a health information technology infrastructure that supports alignment between the clinical and research ecosystems. Developed in collaboration with federal partners, including AHRQ, and with input from stakeholders, the agenda outlines nine priorities, including concrete steps that stakeholders can take to achieve that vision and enable research to happen more quickly and effectively. Learn more.

AHRQ in the Professional Literature

Information flow during pediatric trauma care transitions: things falling through the cracks. Hoonakker PLT, Wooldridge AR, Hose BZ, et al. Intern Emerg Med 2019 Aug;14(5):797-805. Epub 2019 May 28. Access the abstract on PubMed®.

The association between loss of Medicare, immunosuppressive medication use, and kidney transplant outcomes. Hart A, Gustafson SK, Wey A, et al. Am J Transplant 2019 Jul;19(7):1964-71. Epub 2019 Mar 5. Access the abstract on PubMed®.

Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV. Hill LM, Golin CE, Gottfredson NC, et al. AIDS Behav 2019 Aug;23(8):2037-47. Access the abstract on PubMed®.

Toward understanding the use of gastrostomy in critically ill adults. Hope AA. Ann Am Thorac Soc 2019 Jun;16(6):677-9. Access the abstract on PubMed®.

Ambulance diversions following public hospital emergency department closures. Hsuan C, Hsia RY, Horwitz JR, et al. Health Serv Res 2019 Aug;54(4):870-9. Epub 2019 Apr 2. Access the abstract on PubMed®.

An algorithm strategy for precise patient monitoring in a connected healthcare enterprise. Hu X. NPJ Digit Med 2019 Apr 30;2:30. eCollection 2019. Access the abstract on PubMed®.

Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions. Huguet N, Valenzuela S, Marino M, et al. Ann Fam Med 2019 Jul;17(4):336-44. Access the abstract on PubMed®.

Call for improved design and reporting in soft tissue sarcoma studies: a systematic review and meta-analysis of chemotherapy and survival outcomes in resectable STS. Istl AC, Ruck JM, Morris CD, et al. J Surg Oncol 2019 Jun;119(7):824-35. Epub 2019 Feb 8. Access the abstract on PubMed®.