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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 9302 Research Studies Displayed
Magee LA, Ranney ML, Fortenberry JD
Identifying nonfatal firearm assault incidents through linking police data and clinical records: cohort study in Indianapolis, Indiana, 2007-2016.
Nonfatal firearm assault incidents are more prevalent than gun homicides, however, little is understood about nonfatal firearm assault incidents due to a lack of accurate data in the United States. This is a descriptive study of all nonfatal firearm assault incidents identified through police and clinical records from 2007 to 2016 in Indianapolis, Indiana.
Citation: Magee LA, Ranney ML, Fortenberry JD . Identifying nonfatal firearm assault incidents through linking police data and clinical records: cohort study in Indianapolis, Indiana, 2007-2016. Prev Med 2021 Aug;149:106605. doi: 10.1016/j.ypmed.2021.106605..
Keywords: Injuries and Wounds
Johnson CL, Schwartz H, Greenberg A
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. The investigators concluded that eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
Citation: Johnson CL, Schwartz H, Greenberg A . Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic. J Surg Res 2021 Aug;264:30-36. doi: 10.1016/j.jss.2021.01.028..
Keywords: COVID-19, Surgery, Access to Care, Patient Experience, Public Health
Delaney LD, Kattapuram M, Haidar JA
The impact of surgeon adherence to preoperative optimization of hernia repairs.
This study looked at the ways that surgeon-level adherence to preoperative optimization impacts postoperative outcomes. A cohort of patients receiving hernia repair surgery were studied using data from the Michigan Surgical Quality Collaborative from 2014 to 2018. Adherence to preoperative optimization was defined as operating on patients who were nontobacco users with a body mass index of >18.5 kg/m2 and <40 kg/m2. Risk- and reliability-adjusted adherence rates were used to divide surgeons into tertiles. Across 70 Michigan hospitals, 15,016 patients underwent ventral and incisional hernia repair, cared for by 454 surgeons. Preoperative optimization rates ranged from 51% to 76%. Surgeons in the lowest tertile had higher rates of emergency department visits and serious complications versus any complication than middle and high optimization tertiles.
Citation: Delaney LD, Kattapuram M, Haidar JA . The impact of surgeon adherence to preoperative optimization of hernia repairs. J Surg Res 2021 Aug;264:8-15. doi: 10.1016/j.jss.2021.01.044..
Keywords: Surgery, Provider: Physician, Provider, Outcomes
Calabrese SK, Lane SB, Caldwell A
Electronic dissemination of a web-based video promotes PrEP contemplation and conversation among US women engaged in care at Planned Parenthood.
This study evaluated the acceptability and impact of a web-based PrEP educational video among women (n = 126) by comparing two Planned Parenthood centers: one using a Web Video and the other using standard education tools. Most women reported the video helped them understand better what PrEP is (92%), how it works (93%), and how to take PrEP (92%). One month post-intervention, more women in the Web Video group reported a high level of comfort discussing PrEP with a provider (82% vs 48%) and commonly thinking about PrEP (36.% vs. 4%).
Citation: Calabrese SK, Lane SB, Caldwell A . Electronic dissemination of a web-based video promotes PrEP contemplation and conversation among US women engaged in care at Planned Parenthood. AIDS Behav 2021 Aug;25(8):2483-500. doi: 10.1007/s10461-021-03210-2..
Keywords: Human Immunodeficiency Virus (HIV), Sexual Health, Education: Patient and Caregiver, Health Promotion, Prevention, Health Information Technology (HIT), Communications, Women
Bunting AM, Oser CB, Staton M
Pre-incarceration polysubstance use involving opioids: a unique risk factor of postrelease return to substance use.
This study explored pre-incarceration polysubstance use involving opioids as a unique risk factor for postrelease relapse to substance use. Data from a cohort of 502 justice-involved persons who were enrolled in a therapeutic community treatment program while incarcerated was used. Six unique polysubstance opioid patterns prior to incarceration were found using latent profile validation. Two of these profiles, primarily alcohol and primarily buprenorphine were at increased and accelerated risk for relapse postrelease relative to a lesser polysubstance use profile. Both profiles at increased risk had a pre-incarceration co-use of marijuana and nonmedical use of opioids but were unique in their respective near daily use of alcohol and nonmedical buprenorphine.
Citation: Bunting AM, Oser CB, Staton M . Pre-incarceration polysubstance use involving opioids: a unique risk factor of postrelease return to substance use. J Subst Abuse Treat 2021 Aug;127:108354. doi: 10.1016/j.jsat.2021.108354..
Keywords: Opioids, Substance Abuse, Risk
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
Citation: Lange EMS, Toledo P . Peripartum racial/ethnic disparities. Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords: Maternal Care, Pregnancy, Disparities, Racial / Ethnic Minorities, Women
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M . Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords: Veterans, Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Cifra CL, Sittig DF, Singh H
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
This paper discusses challenges to the development of systems for effective patient outcome feedback to improve diagnosis and proposes the application of a sociotechnical approach using health information technology (HIT) to support the implementation of such systems. It discusses current barriers to effective clinician feedback, reasons for them, and features of potential IT solutions. Evaluation and implementation of the feedback process within a sociotechnical health system are then discussed. The authors use an eight-dimension sociotechnical model for studying health IT by authors Sittig and Singh. The eight dimensions are hardware and software; clinical content; human–computer interface; people; workflow and communication; organisational policies and procedures; external rules, regulations and pressures; and system measurement and monitoring. A table is included that shows the potential considerations for each dimension.
AHRQ-funded; 33201500022I; HS027363.
Citation: Cifra CL, Sittig DF, Singh H . Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes. BMJ Qual Saf 2021 Jul;30(7):591-97. doi: 10.1136/bmjqs-2020-012464..
Keywords: Health Information Technology (HIT), Diagnostic Safety and Quality, Diagnosis, Patient Safety, Quality Improvement, Quality of Care
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
Citation: Bramante CT, Buse J, Tamaritz L . Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity. J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes
Fan T, Lee G
AHRQ Author: Fan T
Interventions for tobacco smoking cessation in adults, including pregnant persons.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on interventions for tobacco smoking cessation in adults, including pregnant persons. A case study is presented with questions on the best behavioral interventions, e-cigarette use, and pharmacotherapy for tobacco cessation in pregnant persons. References are also provided at the end of the answers.
Citation: Fan T, Lee G . Interventions for tobacco smoking cessation in adults, including pregnant persons. Am Fam Physician 2021 Jun 15;103(12):753-54..
Keywords: U.S. Preventive Services Task Force (USPSTF), Tobacco Use, Prevention, Case Study, Pregnancy, Women, Substance Abuse
Liss DT, Uchida T, Wilkes CL
General health checks in adult primary care: a review.
General health checks, also known as general medical examinations, periodic health evaluations, checkups, routine visits, or wellness visits, are commonly performed in adult primary care to identify and prevent disease. Although general health checks are often expected and advocated by patients, clinicians, insurers, and health systems, others question their value. Randomized trials and observational studies with control groups reported in prior systematic reviews and an updated literature review through March 2021 were included in this study.
AHRQ-funded; HS026506; HS028127.
Citation: Liss DT, Uchida T, Wilkes CL . General health checks in adult primary care: a review. JAMA 2021 Jun 8;325(22):2294-306. doi: 10.1001/jama.2021.6524..
Keywords: Primary Care, Prevention
Links AR, Callon W, Wasserman C
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
A deeper understanding of the dialogue clinicians use to relay treatment recommendations is needed to fully understand their influence on patient decisions about surgery. In this study, the authors characterize how otolaryngologists provide treatment recommendations and suggest a classification framework. The investigators concluded that clinicians provide treatment recommendations in a variety of ways that may introduce more or less certainty and choice to parental treatment decisions.
Citation: Links AR, Callon W, Wasserman C . Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language. Patient Educ Couns 2021 Jun;104(6):1371-79. doi: 10.1016/j.pec.2020.11.015..
Keywords: Children/Adolescents, Surgery, Caregiver, Decision Making, Clinician-Patient Communication, Communications, Provider: Physician, Provider
Kruse J, Toledo P, Belton TB
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
The internet is a frequently used resource for providing patient education materials (PEMs). The aim of this study was to evaluate the readability, content, and quality of web-based PEMs on COVID-19 from US academic medical centers. Despite availability of web-based PEMs for COVID-19, the readability was significantly higher than the National Institute of Health and US Department of Health and Human Services recommended sixth grade reading level and actionability of PEMs was low.
AHRQ-funded; HS025267; HS026169.
Citation: Kruse J, Toledo P, Belton TB . Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States. Am J Infect Control 2021 Jun;49(6):690-93. doi: 10.1016/j.ajic.2020.11.023..
Keywords: COVID-19, Education: Patient and Caregiver, Health Literacy, Public Health, Infectious Diseases
Campbell NL, Holden RJ, Tang Q
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
This study tested the effectiveness of a multicomponent behavioral intervention to reduce the use of high-risk anticholinergic medications in primary care older adults. Ten primary care clinics within Eskenazi Health in Indianapolis were selected to test the intervention. The intervention included provider- and patient-focused components. The provider-focused component was a computerized decision support system alerting the presence of a high-risk anticholinergic and offering dose- and indication-specific alternatives; while the patient-focused component was a story-based video providing education and modeling an interaction with a healthcare provider. The intervention occurred from April 2019 through March 2020. A total of 552 older adults had primary care visits during the study period. Only 3 out of 259 provider-focused alerts led to a medication change. Of the 276 staff alerts, 4.7% were confirmed to activate the patient-focused intervention.
Citation: Campbell NL, Holden RJ, Tang Q . Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults. J Am Geriatr Soc 2021 Jun;69(6):1490-99. doi: 10.1111/jgs.17121..
Keywords: Elderly, Medication, Primary Care, Clinical Decision Support (CDS), Decision Making
Brown CS, Albright J, Henke PK
Modeling the elective vascular surgery recovery after coronavirus disease 2019: implications for moving forward.
This study looked at the impact of delays in elective vascular surgery caused by the coronavirus pandemic. Data from a 35-hospital regional vascular surgical collaborative consisting of all hospitals performing vascular surgery in the state of Michigan was used to estimate the number of delayed surgical cases for adults undergoing carotid endarterectomy, carotid stenting, endovascular and open abdominal aortic aneurysm repair, and lower extremity bypass. Median statewide monthly vascular surgical volume before the pandemic was 439 procedures, with a maximum statewide monthly case volume of 519 procedures. For the month of April 2020, elective vascular surgery procedure volume decreased by ~90%. Modelling estimated it would take approximately 8 months to catch up with the backlog. The authors suggest that if hospitals across the collaborative shared the burden of backlogged cases, the recovery should be shortened to ~3 months.
Citation: Brown CS, Albright J, Henke PK . Modeling the elective vascular surgery recovery after coronavirus disease 2019: implications for moving forward. J Vasc Surg 2021 Jun;73(6):1876-80.e1. doi: 10.1016/j.jvs.2020.11.025..
Keywords: COVID-19, Infectious Diseases, Cardiovascular Conditions, Surgery
Arkhipova-Jenkins I, Helfand M, Armstrong C
Antibody response after SARS-CoV-2 infection and implications for immunity : a rapid living review.
This rapid literature review synthesizes evidence on the prevalence, levels, and durability of detectable antibodies after SARS-CoV-2 infection and whether the antibodies confer natural immunity. Seven databases were searched from January 1 to December 15, 2020, limited to peer-reviewed publications in English. Two investigators extracted study data and rated quality. Moderate-strength evidence suggested that most adults develop detectable levels of IgM and IgG antibodies after infection with SARS-CoV-2 and IgG levels peak approximately 25 days after symptom onset and can remain detectable for at least 120 days. Moderate-strength evidence suggested that IgM levels peak at approximately 20 days and then decline. There is low-strength evidence that most adults generate neutralizing antibodies. Reasons why some adults do not develop antibodies after SARS-CoV-2 are unclear.
Citation: Arkhipova-Jenkins I, Helfand M, Armstrong C . Antibody response after SARS-CoV-2 infection and implications for immunity : a rapid living review. Ann Intern Med 2021 Jun;174(6):811-21. doi: 10.7326/m20-7547..
Keywords: COVID-19, Infectious Diseases, Genetics, Evidence-based Practice
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
Citation: Anderson MC, Evans E, Zonfrillo MR . Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury. J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords: Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Adams V, Song J, Shang J
Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses.
This study’s aim was to examine the impact of individual, home environment, and organization factors on Infection Prevention and Control (IPC) practices in home health care. A survey of 350 nurses across two large home care agencies was conducted to examine the relationship between IPC adherence and these factors. Multiple barriers to IPC practices in patients’ homes were reported including clutter (74.5%), and a dirty environment (70.3%). They also reported limited availability of some IPC supplies including personal protective equipment.
Citation: Adams V, Song J, Shang J . Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses. Am J Infect Control 2021 Jun;49(6):721-26. doi: 10.1016/j.ajic.2020.10.021..
Keywords: Home Healthcare, Community-Acquired Infections, Infectious Diseases, Prevention, Provider: Nurse, Provider
Tedesco D, Moghavem N, Weng Y
Improvement in patient safety may precede policy changes: trends in patient safety indicators in the United States, 2000-2013.
This study’s aim was to assess changes in national patient safety trends that corresponded to U.S. pay-for-performance reforms. The study analyzed 13 patient safety indicators (PSIs) that were developed by AHRQ. PSI trends, Center for Medicaid and Medicare Services payment policy changes, and Inpatient Prospective Payment System regulations and notices between 2000 and 2013 were analyzed. Twelve of the thirteen PSIs had decreasing or stable trends in the last 5 years of the study. Central-line bloodstream infections had the greatest annual decrease (-31.1 annual percent change between 2006 and 2013) whereas postoperative respiratory failure had the smallest annual percent change (-3.5 between 2005 and 2013). Significant decreases in trends preceded federal payment reform initiatives in all but postoperative hip fracture. These findings suggest that intense public discourses targeting patient safety may drive national policy reforms.
Citation: Tedesco D, Moghavem N, Weng Y . Improvement in patient safety may precede policy changes: trends in patient safety indicators in the United States, 2000-2013. J Patient Saf 2021 Jun 1;17(4):e327-e34. doi: 10.1097/pts.0000000000000615..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Policy
Popejoy LL, Vogelsmeier AA, Wang Y
Testing re-engineered discharge program implementation strategies in SNFs.
This paper describes a trial of the redesigned Re-Engineered Discharge (RED) program, which was originally designed for hospitals, for use at skilled nursing facilities (SNFs). This tool’s objective is to reduce rehospitalizations after discharge. Two different RED implementation strategies (Enhanced and Standard) were compared pretest-posttest. The Standard group had higher odds of being readmitted in the pre-intervention versus post-intervention program. After adjusting coefficients using Poisson regression, the adjusted number of hospitalizations in the Standard group was 45% higher at 30 days, 50% higher at 60 days, and 39% higher at 180 days.
Citation: Popejoy LL, Vogelsmeier AA, Wang Y . Testing re-engineered discharge program implementation strategies in SNFs. Clin Nurs Res 2021 Jun;30(5):644-53. doi: 10.1177/1054773820982612..
Keywords: Hospital Discharge, Hospital Readmissions, Implementation, Hospitals
Piantino JA, Lin A, Luther M
Simultaneous heart rate variability and electroencephalographic monitoring in children in the emergency department.
This study’s objective was to determine the clinical value of using changes in heart rate variability (HRV) and electroencephalographic (EEG) background in children with acute trauma seen in the Emergency Department (ED) as early predictors of outcome. A novel wireless monitoring device was piloted in 17 patients with 15 patients having EEG data rated as appropriate for clinical interpretation. This was compared to EEG and HRV data successfully collected in 167 subjects. Results showed recording early HRV and EEG is feasible in children with acute injury. This new tool may offer an early, non-invasive marker for injury stratification and prognosis in children.
Citation: Piantino JA, Lin A, Luther M . Simultaneous heart rate variability and electroencephalographic monitoring in children in the emergency department. J Child Adolesc Trauma 2021 Jun;14(2):165-75. doi: 10.1007/s40653-020-00313-1..
Keywords: Children/Adolescents, Emergency Department, Trauma, Outcomes
Pasalic D, Barocas DA, Huang LC
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
This retrospective cohort study’s objective was to determine if there were differences in treatment-related regret or survival between prostate cancer patients who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), over a 5-year period. The cohort included 695 men who met inclusion criteria and received either EBRT (n=583) or EBRT-LDR (n=112). Men who received either treatment reported clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate- to-big problems with urinary function bother and frequent urination at 5 years. There was no difference in treatment-related regret or survival between patients who received either treatment.
AHRQ-funded; HS019356; HS022640.
Citation: Pasalic D, Barocas DA, Huang LC . Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer. Cancer 2021 Jun 1;127(11):1912-25. doi: 10.1002/cncr.33388..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-based Practice, Outcomes, Patient-Centered Outcomes Research, Treatments
Papaleontiou M, Zebrack B, Reyes-Gastelum D
Physician management of thyroid cancer patients' worry.
This study’s purpose was to understand physician management of thyroid cancer-related worry. Endocrinologists, general surgeons, and otolaryngologists identified by Surveillance, Epidemiology, and End Results (SEER) patients were surveyed in 2018 to 2019. The response rate was 69% with 448 physicians responding. Physicians reported their patients as quite/very worried (65%), very worried (27%), and a little/not worried (8%) at diagnosis, with half telling their patients that thyroid cancer is a “good cancer”. Otolaryngologists, private practice, and West Coast (Los Angeles versus Georgia) were associated with using the term “good cancer”. Physician response to worries were good, with 97% of physicians making themselves available for discussion, 44% referring their patients to educational websites, 18% encouraging communication with family/friends, 13% referring their patients to support groups, and 7% referring them to counselors. Physicians who perceived their patients as being quite/very worried were less likely to use the term “good cancer” and more likely to encourage patients to seek help outside the physician-patient relationship.
Citation: Papaleontiou M, Zebrack B, Reyes-Gastelum D . Physician management of thyroid cancer patients' worry. J Cancer Surviv 2021 Jun;15(3):418-26. doi: 10.1007/s11764-020-00937-0..
Keywords: Cancer, Provider: Physician, Provider
Michelson KA, Neuman MI, Pruitt CM
Height of fever and invasive bacterial infection.
This study evaluated the association of higher fevers with invasive bacterial infection (IBI) among febrile infants ≤60 days of age. Maximum temperatures of febrile infants with IBI were compared to infants without IBI. The median temperature was higher for infants with IBI (38.8°C) compared to those without IBI (38.4°C). Temperatures ranges of 39°C-39.4°C and 39.5°C-39.9°C were associated with a higher likelihood of IBI, although 30.4% of febrile infants with IBI had maximum temperatures <38.5°C.
AHRQ-funded; HS026006; HS026503.
Citation: Michelson KA, Neuman MI, Pruitt CM . Height of fever and invasive bacterial infection. Arch Dis Child 2021 Jun;106(6):594-96. doi: 10.1136/archdischild-2019-318548..
Keywords: Newborns, Infectious Diseases, Diagnosis, Risk
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.
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