National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- (-) Adverse Drug Events (ADE) (16)
- Adverse Events (11)
- Blood Clots (1)
- Blood Thinners (6)
- Cardiovascular Conditions (9)
- Care Management (1)
- Comparative Effectiveness (1)
- Diabetes (1)
- Elderly (2)
- Evidence-Based Practice (4)
- (-) Heart Disease and Health (16)
- Hospitalization (1)
- Injuries and Wounds (2)
- Kidney Disease and Health (1)
- Medical Errors (1)
- Medication (11)
- Medication: Safety (1)
- Mortality (1)
- Nursing Homes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (6)
- Patient Adherence/Compliance (1)
- Patient Safety (4)
- Practice Patterns (1)
- Quality Improvement (1)
- Quality of Life (1)
- Registries (2)
- Risk (5)
- Stroke (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 16 of 16 Research Studies DisplayedGamyroulas EM, Jones AE, Saunders JA
Trends in antiplatelet strategies 12-months following coronary stent placement in anticoagulated patients.
The guidelines for antithrombotic management in individuals undergoing percutaneous coronary interventions (PCIs) who also necessitate anticoagulant treatment are continually developing. The purpose of this study is to examine adjustments to antithrombotic regimens and correlated outcomes within a year following PCI in patients needing continued anticoagulation therapy. Data from patients discovered through electronic medical record searches were manually assessed to validate alterations in antithrombotic treatment from discharge up to one year post-PCI, as well as episodes of significant bleeding, clinically relevant non-major bleeding (CRNMB), major adverse cardiovascular or neurological events (MACNE), and all-cause mortality outcomes during an extra six-month follow-up period. The study found that one year after PCI, patients (n = 120) undergoing anticoagulation treatment were categorized based on their antiplatelet therapy status: no antiplatelet therapy (n = 16), single antiplatelet therapy (SAPT) (n = 85), or dual antiplatelet therapy (DAPT) (n = 19). Between 12 and 18 months post-PCI, there were two significant bleeds, seven CRNMB events, six MACNE incidents, two venous thromboembolisms, and five fatalities. All but one bleeding occurrence transpired in the SAPT group. The likelihood of maintaining DAPT at 12 months was elevated in patients who underwent PCI for acute coronary syndrome and those who experienced MACNE within one year post-PCI; however, these associations did not reach statistical significance.
AHRQ-funded; HS027960
Citation: Gamyroulas EM, Jones AE, Saunders JA .
Trends in antiplatelet strategies 12-months following coronary stent placement in anticoagulated patients.
BMC Cardiovasc Disord 2023 Mar 8;23(1):117. doi: 10.1186/s12872-023-03161-7.
Keywords: Blood Thinners, Medication, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events
Feng Y, Pai CW, Seiler K
Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.
This retrospective analysis investigated the risk for bleeding events with higher dosing of direct oral anticoagulant (DOAC) in the first 1-3 weeks of treatment for patients with atrial fibrillation (AF). Findings showed that patients who received an inappropriate DOAC prescription were more likely to identify as Black. Rates of ED visits, hospitalizations, and deaths overall were numerically lower in patients with starter pack DOAC prescriptions. In contrast, rates of ED visits and hospitalizations related to significant bleeding were numerically higher in patients with starter pack DOAC prescriptions. Among patients with AF but without acute venous thromboembolism, those who received an inappropriate DOAC starter pack had numerically higher rates of severe bleeding leading to ED visits and hospitalizations compared to those prescribed an appropriate non-starter pack DOAC anticoagulant.
AHRQ-funded; HS026874.
Citation: Feng Y, Pai CW, Seiler K .
Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.
J Thromb Thrombolysis 2021 May;51(4):1144-49. doi: 10.1007/s11239-020-02358-3..
Keywords: Blood Thinners, Medication, Medication: Safety, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Heart Disease and Health, Cardiovascular Conditions
Angraal S, Nuti SV, Masoudi FA
Digoxin use and associated adverse events among older adults.
The authors describe national-level trends of digoxin use, hospitalizations for toxicity, and subsequent outcomes over the past two decades. They found that, while digoxin prescriptions have decreased, the drug is still widely prescribed. However, the rate of hospitalizations for digoxin toxicity and adverse outcomes associated with these hospitalizations have decreased. They concluded that these findings reflect the changing clinical practice of digoxin use, aligned with the changes in clinical guidelines.
AHRQ-funded; HS025164; HS025402; HS025517.
Citation: Angraal S, Nuti SV, Masoudi FA .
Digoxin use and associated adverse events among older adults.
Am J Med 2019 Oct;132(10):1191-98. doi: 10.1016/j.amjmed.2019.04.022.
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Keywords: Medication, Elderly, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Practice Patterns
Mentias A, Briasoulis A, Shantha G
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Differential impact of heart failure (HF) category on thromboembolic and bleeding risk in atrial fibrillation (AF) patients on oral anticoagulation (OAC) is unknown. In this study, the investigators used Medicare data for beneficiaries with new AF diagnosed between 2011 and 2013 to identify patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and no HF. The investigators concluded that in AF patients, HFrEF and HFpEF are both associated with higher risk of ischemic stroke, HF and AMI admissions, even after adjusting for OAC use, compared with patients without HF.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Shantha G .
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Am J Cardiol 2019 May 15;123(10):1649-53. doi: 10.1016/j.amjcard.2019.02.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Elderly, Patient-Centered Healthcare, Registries
Hickson RP, Cole AL, Dusetzina SB
Implications of removing rosiglitazone's black box warning and restricted access program on the uptake of thiazolidinediones and dipeptidyl peptidase-4 inhibitors among patients with type 2 diabetes.
The purpose of this study was to describe trends over time in the initiation of rosiglitazone and pioglitazone-both in the thiazolidinedione (TZD) class-and medications from the dipeptidyl peptidase-4 (DPP-4) inhibitor class before and after the FDA removed a black box warning and restricted access program for rosiglitazone regarding an increased risk of myocardial infarction.
AHRQ-funded; HS000032.
Citation: Hickson RP, Cole AL, Dusetzina SB .
Implications of removing rosiglitazone's black box warning and restricted access program on the uptake of thiazolidinediones and dipeptidyl peptidase-4 inhibitors among patients with type 2 diabetes.
J Manag Care Spec Pharm 2019 Jan;25(1):72-79. doi: 10.18553/jmcp.2019.25.1.072..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Diabetes, Medication, Heart Disease and Health, Patient Safety
Lowenstern A, Al-Khatib SM, Sharan L
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
The purpose of this review was to compare the effectiveness of therapies to prevent thromboembolic events and bleeding complications in adults with nonvalvular atrial fibrillation (AF). Two independent reviewers screened citations in order to identify comparative studies of treatments to prevent stroke in adults with nonvalvular AF who reported thromboembolic or bleeding complications, then abstracted data from 220 selected articles, assessed study quality and applicability, and rated the strength of evidence. The article concludes that available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF and had similar benefits across several patient subgroups.
AHRQ-funded; 290201500004I.
Citation: Lowenstern A, Al-Khatib SM, Sharan L .
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
Ann Intern Med 2018 Dec 4;169(11):774-87. doi: 10.7326/m18-1523..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Lopes RD, Rordorf R, De Ferrari GM
Digoxin and mortality in patients with atrial fibrillation.
This study examined whether digoxin was independently associated with mortality in patients with atrial fibrillation (AF). Digoxin is a widely used medication for AF. The association was assessed in 17,897 patients who were score-matched with control participants. Baseline digoxin was not associated with increased mortality, but patients with a serum digoxin concentration of greater or equal to 1.2 ng/ml had a 56% increased hazard of mortality.
AHRQ-funded; HS024310.
Citation: Lopes RD, Rordorf R, De Ferrari GM .
Digoxin and mortality in patients with atrial fibrillation.
J Am Coll Cardiol 2018 Mar 13;71(10):1063-74. doi: 10.1016/j.jacc.2017.12.060..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Heart Disease and Health, Medication, Mortality, Risk
Smith I, Schmidt R, Halm EA
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
The aim of this study was to examine the association of statins with esophageal conditions. The study concluded that statin therapy was associated with higher odds of being diagnosed with esophagitis and gastroesophageal reflux disease/dyspepsia. Further study is warranted to elucidate the potential role of statins in these commonly diagnosed esophageal conditions.
AHRQ-funded; HS022418.
Citation: Smith I, Schmidt R, Halm EA .
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
Clin Drug Investig 2018 Feb;38(2):135-46. doi: 10.1007/s40261-017-0589-x..
Keywords: Adverse Drug Events (ADE), Heart Disease and Health, Medication, Patient-Centered Outcomes Research, Risk
Steinman MA, Zullo AR, Lee Y
Association of β-blockers with functional outcomes, death, and rehospitalization in older nursing home residents after acute myocardial infarction.
The researchers studied the association of beta-blockers after AMI with functional decline, mortality, and rehospitalization among long-stay nursing home residents 65 years or older. Use of beta-blockers after AMI was associated with functional decline in older nursing home residents with substantial cognitive or functional impairment, but not in those with relatively preserved mental and functional abilities.
AHRQ-funded; HS022998.
Citation: Steinman MA, Zullo AR, Lee Y .
Association of β-blockers with functional outcomes, death, and rehospitalization in older nursing home residents after acute myocardial infarction.
JAMA Intern Med 2017 Feb;177(2):254-62. doi: 10.1001/jamainternmed.2016.7701.
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Keywords: Nursing Homes, Patient-Centered Outcomes Research, Medication, Adverse Drug Events (ADE), Heart Disease and Health
Lambert P, Chaisson K, Horton S, P, Chaisson K, Horton S
Reducing acute kidney injury due to contrast material: how nurses can improve patient safety.
Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. The purpose of this study was to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. The study concluded that standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.
AHRQ-funded; HS018443.
Citation: Lambert P, Chaisson K, Horton S, P, Chaisson K, Horton S .
Reducing acute kidney injury due to contrast material: how nurses can improve patient safety.
Crit Care Nurse 2017 Feb;37(1):13-26. doi: 10.4037/ccn2017178..
Keywords: Adverse Drug Events (ADE), Adverse Events, Injuries and Wounds, Patient Safety, Heart Disease and Health
Cooper LB, Hammill BG, Peterson ED
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). This study found that patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease were at high risk for adverse events after MRA initiation.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Circ Cardiovasc Qual Outcomes 2017 Jan;10(1):pii: e002946. doi: 10.1161/circoutcomes.116.002946.
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Keywords: Care Management, Heart Disease and Health, Kidney Disease and Health, Adverse Drug Events (ADE), Patient Adherence/Compliance
Amin AP, Wang TY, McCoy L
Impact of bleeding on quality of life in patients on DAPT: insights from TRANSLATE-ACS.
This study sought to determine the incidence of post-percutaneous coronary intervention (PCI) bleeding that occurs on contemporary prolonged dual antiplatelet therapy (DAPT) and its impact on quality of life (QOL). Among patients undergoing PCI for acute myocardial infarction, bleeding during follow-up was associated with worse 6-month utility and QOL
AHRQ-funded; HS022481.
Citation: Amin AP, Wang TY, McCoy L .
Impact of bleeding on quality of life in patients on DAPT: insights from TRANSLATE-ACS.
J Am Coll Cardiol 2016 Jan 5;67(1):59-65. doi: 10.1016/j.jacc.2015.10.034.
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Keywords: Quality of Life, Heart Disease and Health, Adverse Drug Events (ADE), Adverse Events
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Desai NR, Sabatine MS
PCSK9 inhibition in patients with hypercholesterolemia.
The authors specified that large, cardiovascular outcomes trials are underway to assess definitively the efficacy and safety of 3 monoclonal antibodies (evolocumab, alirocumab, and bococizumab), while additional non-monoclonal antibody approaches to inhibit PCSK9 continue in the early-phase development.
AHRQ-funded; HS023000.
Citation: Desai NR, Sabatine MS .
PCSK9 inhibition in patients with hypercholesterolemia.
Trends Cardiovasc Med 2015 Oct;25(7):567-74. doi: 10.1016/j.tcm.2015.01.009.
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Keywords: Adverse Drug Events (ADE), Heart Disease and Health, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research
Brown JR, Solomon RJ, Sarnak MJ
Reducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention.
The researchers sought to determine whether a 6-year regional multicenter quality improvement intervention could reduce contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary interventions. They found that benchmark hospitals had no significant changes in CI-AKI, while rates of CI-AKI were significantly reduced in hospitals receiving the intervention. Key qualitative system factors associated with improvement included multidisciplinary teams, limiting contrast volume, standardized fluid orders, intravenous fluid bolus, and patient education about oral hydration.
AHRQ-funded; HS018443.
Citation: Brown JR, Solomon RJ, Sarnak MJ .
Reducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention.
Circ Cardiovasc Qual Outcomes 2014 Sep;7(5):693-700. doi: 10.1161/circoutcomes.114.000903.
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Keywords: Adverse Drug Events (ADE), Injuries and Wounds, Patient Safety, Heart Disease and Health, Quality Improvement