National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (3)
- Adverse Events (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Data (1)
- Diabetes (1)
- Education: Academic (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Health Information Technology (HIT) (2)
- Health Literacy (1)
- Hospitals (1)
- Infectious Diseases (1)
- Medical Errors (1)
- Medication (17)
- Medication: Safety (5)
- Nursing Homes (1)
- Opioids (5)
- Patient-Centered Healthcare (2)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (5)
- Provider (8)
- (-) Provider: Pharmacist (20)
- Quality Improvement (1)
- Quality of Care (2)
- Risk (1)
- Sexual Health (1)
- Shared Decision Making (1)
- Social Media (1)
- Social Stigma (1)
- Substance Abuse (5)
- Telehealth (1)
- Vaccination (1)
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 20 of 20 Research Studies DisplayedAilabouni NJ, Marcum ZA, Schmader KE
Medication use quality and safety in older adults: 2018 update.
This study identified four key articles from 2018 that address medication use quality and safety for older adults. The first study highlighted a cluster-randomized trial that utilized a pharmacist-led education-based intervention delivered to both patients and doctors to deprescribe four types of inappropriate medications. The second study from the UK examined the association between anticholinergic exposure, overall and by medication class, and dementia risk in 40,770 older adults. The third study was a Swedish longitudinal cohort study examining the association between antihypertensive medications and incident dementia. The fourth and last study was a randomized, double-blind, placebo-controlled trial and examined the effect of daily low-dose aspirin for primary prevention of cardiac events and hemorrhage in 19,144 community-dwelling older adults.
AHRQ-funded; HS022982.
Citation: Ailabouni NJ, Marcum ZA, Schmader KE .
Medication use quality and safety in older adults: 2018 update.
J Am Geriatr Soc 2019 Dec;67(12):2458-62. doi: 10.1111/jgs.16243..
Keywords: Elderly, Medication, Medication: Safety, Patient Safety, Quality of Care, Provider: Pharmacist, Provider
Reddy A, Lester CA, Stone JA
Applying participatory design to a pharmacy system intervention.
Researchers used participatory design (PD) to develop a patient-centered prototype for a community pharmacy. The stakeholders recruited for the intervention were pharmacy staff and older adult patients who received prescriptions at the pharmacy corporation involved in this study. The PD process is a series of six adaptive sessions: 1) problem identification, 2) solution generation, 3) convergence, 4) prototyping, 5) initial evaluation, and 6) formative evaluation. The sessions resulted in the development of a patient-centered community pharmacy prototype.
AHRQ-funded; HS024490.
Citation: Reddy A, Lester CA, Stone JA .
Applying participatory design to a pharmacy system intervention.
Res Social Adm Pharm 2019 Nov;15(11):1358-67. doi: 10.1016/j.sapharm.2018.11.012..
Keywords: Provider: Pharmacist, Patient-Centered Healthcare, Medication, Patient Safety
Kurian S, Baloy B, Baird J
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
AHRQ-funded; HS024021.
Citation: Kurian S, Baloy B, Baird J .
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
J Am Pharm Assoc 2019 Nov-Dec;59(6):824-31. doi: 10.1016/j.japh.2019.08.009..
Keywords: Medication, Medication: Safety, Opioids, Substance Abuse, Provider: Pharmacist, Provider, Patient Safety
Gilson AM, Stone JA, Reddy A
Exploring how pharmacists engage with patients about over-the-counter medications.
This study used an innovative information-gathering approach to provide insight into the nature and structure of pharmacy staff encounters with patients seeking over-the-counter (OTC) medications and revealed specific activities of pharmacy staff around these encounters. Through an 8-item OTC Encounter Form, results showed that pharmacists play a key role in ensuring that the benefits of OTC medications outweigh the risks, thereby providing an important resource for patient engagement about safe medication selection and use. Examining the features of OTC encounters creates an evidence base to promote best practices for OTC encounters, increasing pharmacists' ability to help people, especially older adults, navigate the intricacies of OTC medication use, without significantly increasing pharmacy staff workload.
AHRQ-funded; HS024490.
Citation: Gilson AM, Stone JA, Reddy A .
Exploring how pharmacists engage with patients about over-the-counter medications.
J Am Pharm Assoc 2019 Nov - Dec;59(6):852-56. doi: 10.1016/j.japh.2019.08.001..
Keywords: Medication, Provider: Pharmacist, Provider, Patient and Family Engagement
Bach P, Hartung D
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy.
AHRQ-funded; HS024227; 2902015000091.
Citation: Bach P, Hartung D .
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
Addict Sci Clin Pract 2019 Sep 2;14(1):30. doi: 10.1186/s13722-019-0158-0..
Keywords: Medication, Opioids, Provider, Provider: Pharmacist, Substance Abuse
McCarthy DM, Russell AM , Effler MR
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
The authors assessed implementation of a patient-centered "PRN" (as needed) label entitled "Take-Wait-Stop" (TWS) with three deconstructed steps replacing traditional wording. They found that exact intervention adherence was not achieved in the majority of cases, limiting impact, but that community pharmacies were responsive to new instructions, with higher implementation reliability requiring additional supports.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Russell AM , Effler MR .
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
Pharmacoepidemiol Drug Saf 2019 Sep;28(9):1251-57. doi: 10.1002/pds.4795..
Keywords: Opioids, Patient Safety, Health Literacy, Medication, Provider: Pharmacist, Provider
Nolan K, Zullo AR, Bosco E
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
This study’s purpose was to demonstrate the utility of failure modes and effects analysis (FMEA) to identify potential sources of controlled substance diversion and developing solutions in an academic health system. A cross-functional team of 18 members was developed from the department of pharmacy. Scoring criteria was developed and ways were identified in which step of the medication supply there could be failure and result in diversion of controlled substances. Failure was indicated with a vulnerability score of 48 or 64. A total of 10 major steps and 30 substeps in the supply process was identified. From this 103 potential failure modes were identified, with 24 modes (23%) considered failing. Notable failure included controlled substance activity under temporary patients and discrepancy trends. Expanded use of cameras in high-risk areas and added verification checks were implemented after the analysis.
AHRQ-funded; HS022998.
Citation: Nolan K, Zullo AR, Bosco E .
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
Am J Health Syst Pharm 2019 Jul 18;76(15):1158-64. doi: 10.1093/ajhp/zxz116..
Keywords: Medication, Provider: Pharmacist, Hospitals, Quality Improvement, Quality of Care
Snyder ME, Jaynes H, Gernant SA
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation.
This study evaluated the effectiveness of alerts for community pharmacist-provided medication therapy management (MTM). The alerts come in five categories: indication, effectiveness, safety, adherence, and cost-containment. The heuristic evaluation used the Instrument for Evaluating Human-Factors Principles in Medication-Related Decision Support Alerts (I-MeDeSA). Four analysts’ individual ratings were summed for each alert, and a mean score on the modified I-MeDeSA was computed. The analysts’ scores were similar. The scores indicated opportunities for improvement across all MTM alert categories including principles of alert prioritization; text-based information; alarm philosophy; and corrective actions.
AHRQ-funded; HS025005.
Citation: Snyder ME, Jaynes H, Gernant SA .
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation.
BMC Med Inform Decis Mak 2019 Jul 16;19(1):135. doi: 10.1186/s12911-019-0866-0..
Keywords: Shared Decision Making, Health Information Technology (HIT), Medication, Provider, Provider: Pharmacist
Donovan E, Case P, Bratberg JP
Beliefs associated with pharmacy-based naloxone: a qualitative study of pharmacy-based naloxone purchasers and people at risk for opioid overdose.
The purpose of this study was to understand factors that impact the likelihood of obtaining pharmacy-based naloxone. Results showed that several themes emerged from the interview data: individual, interpersonal, pharmacy, community, and societal, suggesting that these factors can be used to inform interventions seeking to increase the provision of pharmacy-based naloxone.
AHRQ-funded; HS024021.
Citation: Donovan E, Case P, Bratberg JP .
Beliefs associated with pharmacy-based naloxone: a qualitative study of pharmacy-based naloxone purchasers and people at risk for opioid overdose.
J Urban Health 2019 Jun;96(3):367-78. doi: 10.1007/s11524-019-00349-1..
Keywords: Medication, Provider, Provider: Pharmacist, Opioids, Risk, Substance Abuse
Schiff GD, Klinger E, Salazar A
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
In this study, the investigators evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist- to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. Systematic automated telephone outreach monitoring coupled with real-time phone referral to a pharmacist identified a substantial number of previously unidentified potentially drug-related symptoms, many of which were validated as probably or possibly related to the drug by the pharmacist or their physicians.
AHRQ-funded; HS021094.
Citation: Schiff GD, Klinger E, Salazar A .
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
J Gen Intern Med 2019 Feb;34(2):285-92. doi: 10.1007/s11606-018-4672-7..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Health Information Technology (HIT), Provider: Pharmacist, Provider, Patient Safety
Ndefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
Chui MA, Stone JA, Holden RJ
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
This study proposes to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention.
AHRQ-funded; HS024490.
Citation: Chui MA, Stone JA, Holden RJ .
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
Res Social Adm Pharm 2017 Sep - Oct;13(5):930-37. doi: 10.1016/j.sapharm.2016.11.006.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Provider: Pharmacist
Rowan CG, Flory J, Gerhard T
Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: a validation study from a US electronic health record database.
The researchers conducted a retrospective cohort study among patients with linked claims and EHR data in OptumLabs Data Warehouse. Their aim was to evaluate the validity of classifying medication exposure using EHR prescribing (EHR-Rx) data. They concluded that, despite substantial variability among different medications, there was very good agreement between EHR-Rx data and PC-Rx data.
AHRQ-funded; HS023898.
Citation: Rowan CG, Flory J, Gerhard T .
Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: a validation study from a US electronic health record database.
Pharmacoepidemiol Drug Saf 2017 Aug;26(8):963-72. doi: 10.1002/pds.4234.
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Keywords: Data, Electronic Health Records (EHRs), Medication, Provider: Pharmacist
Calo WA, Gilkey MB, Shah P
Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy.
The researchers sought to examine parents' willingness to get human papillomavirus (HPV) vaccination for their children at pharmacies. Overall, their national survey found that 29 percent of parents would be willing to get HPV vaccine for their children at a pharmacy. Parental willingness was associated with believing that pharmacists are skilled at administering vaccines.
AHRQ-funded; HS000032.
Citation: Calo WA, Gilkey MB, Shah P .
Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy.
Prev Med 2017 Jun;99:251-56. doi: 10.1016/j.ypmed.2017.02.003.
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Keywords: Children/Adolescents, Infectious Diseases, Provider: Pharmacist, Sexual Health, Vaccination
Roy B, Gottlieb AS
The career advising program: a strategy to achieve gender equity in academic medicine.
This paper discusses the significant gender disparities in academic rank which exist at US medical schools, even after controlling for age, time since training, specialty, and measures of productivity, and despite increasing numbers of women entering medicine over the past 30 years. They highlight the Society of General Internal Medicine’s Women and Medicine Task Force and the model they launched in 2013 to address these disparities- the Career Advising Program (CAP).
AHRQ-funded; HS023000.
Citation: Roy B, Gottlieb AS .
The career advising program: a strategy to achieve gender equity in academic medicine.
J Gen Intern Med 2017 Jun;32(6):601-02. doi: 10.1007/s11606-016-3969-7..
Keywords: Education: Academic, Education: Continuing Medical Education, Provider: Pharmacist
Schroeder SR, Salomon MM, Galanter WL
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
The researchers conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. They found that across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception.
AHRQ-funded; HS021093.
Citation: Schroeder SR, Salomon MM, Galanter WL .
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
BMJ Qual Saf 2017 May;26(5):395-407. doi: 10.1136/bmjqs-2015-005099.
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Keywords: Adverse Drug Events (ADE), Medical Errors, Medication: Safety, Medication, Provider: Pharmacist
Green TC, Potter N, Bratberg J
Detecting naloxone prejudices in the pharmacy setting.
This survey asked pharmacists how concerned they would be about dispensing pain medications (or Suboxone) to customers who are getting or already have naloxone. Fifty-nine percent of respondents indicated no or little increased concern about dispensing either medication to a known naloxone recipient. Greater concern was reported by pharmacists when considering dispensing pain medications to a known naloxone recipient.
AHRQ-funded; Letter related to AHRQ-funded MOON project (HS024021).
Citation: Green TC, Potter N, Bratberg J .
Detecting naloxone prejudices in the pharmacy setting.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S10-s11. doi: 10.1016/j.japh.2016.12.068.
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Keywords: Medication, Provider: Pharmacist, Social Media, Substance Abuse
Green TC, Case P, Fiske H
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
This study examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists. It found that consumer groups differed in awareness of naloxone and availability at pharmacies, but all groups expressed support for the pharmacist's role and preferences for a universal offer of naloxone based on clear criteria.
AHRQ-funded; HS024021.
Citation: Green TC, Case P, Fiske H .
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S19-S27.e4. doi: 10.1016/j.japh.2017.01.013.
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Keywords: Opioids, Provider: Pharmacist, Social Stigma, Substance Abuse
Kernodle AR, Frail CK, Gernant SA
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
The researchers explored patient perceptions and the practical implication of using a brief 9-item scale to screen for medication-related problems in community pharmacies. After interviewing 40 patients who completed the scale and reviewed its results with their pharmacist, they concluded that it may have value in increasing patients' understanding of and confidence in their medications, enhancing pharmacist-patient relationships, and identifying problems requiring additional interventions.
AHRQ-funded; HS022119.
Citation: Kernodle AR, Frail CK, Gernant SA .
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
J Pharm Pract 2017 Feb;30(1):49-57. doi: 10.1177/0897190015605015.
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Keywords: Medication, Patient Experience, Education: Patient and Caregiver, Provider: Pharmacist
Kane-Gill SL, Niznik JD, Kellum JA
Use of telemedicine to enhance pharmacist services in the nursing facility.
The researchers conducted a systematic literature review to determine what telemedicine services are provided by pharmacists and the impact of these services in the nursing facility setting. Since only three manuscripts met inclusion criteria, the researchers concluded that there is a general paucity of practice-related research to demonstrate potential benefits of pharmacists' services incorporating telemedicine.
AHRQ-funded; HS024208.
Citation: Kane-Gill SL, Niznik JD, Kellum JA .
Use of telemedicine to enhance pharmacist services in the nursing facility.
Consult Pharm 2017 Feb;32(2):93-98. doi: 10.4140/TCP.n.2017.93.
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Keywords: Telehealth, Nursing Homes, Medication, Elderly, Provider: Pharmacist