National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Adverse Drug Events (ADE) (42)
- Adverse Events (4)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (2)
- Blood Clots (1)
- Blood Pressure (3)
- Blood Thinners (3)
- Brain Injury (1)
- Cancer (3)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (2)
- Children/Adolescents (6)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- Comparative Effectiveness (3)
- Data (1)
- Dementia (1)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Elderly (2)
- Electronic Health Records (EHRs) (3)
- Electronic Prescribing (E-Prescribing) (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (1)
- Hepatitis (1)
- Hospitalization (2)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (4)
- Medical Errors (2)
- Medication (33)
- Medication: Safety (18)
- Neurological Disorders (1)
- Newborns/Infants (2)
- Nursing Homes (1)
- Opioids (2)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (9)
- Practice Patterns (2)
- Pregnancy (1)
- Prevention (3)
- Primary Care (1)
- Provider: Pharmacist (1)
- Quality of Life (2)
- Registries (1)
- Risk (5)
- Sexual Health (1)
- Social Media (1)
- Substance Abuse (1)
- Surgery (1)
- Transplantation (1)
- Trauma (1)
- Treatments (1)
- Vaccination (1)
- Women (2)
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 25 of 42 Research Studies DisplayedWestover AN, Nakonezny PA, Adinoff B
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
In this study of the impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents, the investigators found that adolescent stimulant medication users, compared to matched nonusers, demonstrated a trend toward decreased heart rate during submaximal exercise (which is potential evidence of chronic adaptation with stimulant exposure). There was no evidence for delayed heart rate recovery in this study, and thus, no evidence for decreased parasympathetic activity during initial exercise recovery.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Adinoff B .
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
J Child Adolesc Psychopharmacol 2016 Dec;26(10):889-99. doi: 10.1089/cap.2016.0064..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Blood Pressure, Medication, Medication: Safety
Ducoffe AR, York A, Hu DJ
AHRQ Author: Perfetto D
National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use.
This article focuses on recommendations from the Adverse Drug Events (ADE) Action Plan to help guide safer opioid use in healthcare delivery settings. Its aim is to discuss current federal methods in place to prevent opioid ADEs while also providing evidence to encourage providers and hospitals to innovate new systems and practices to increase prevention.
AHRQ-authored.
Citation: Ducoffe AR, York A, Hu DJ .
National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use.
Pain Med 2016 Dec;17(12):2291-304. doi: 10.1093/pm/pnw106.
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Keywords: Prevention, Opioids, Patient Safety, Ambulatory Care and Surgery, Adverse Drug Events (ADE)
Cho I, Lee JH, Choi J
National rules for drug-drug interactions: are they appropriate for tertiary hospitals?
This study investigated the potential impact of Korean national drug-drug interactions (DDI) rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Only 0.3 percent of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5 percent, which was much lower than for the overall DDI rules.
AHRQ-funded; HS021094.
Citation: Cho I, Lee JH, Choi J .
National rules for drug-drug interactions: are they appropriate for tertiary hospitals?
J Korean Med Sci 2016 Dec;31(12):1887-96. doi: 10.3346/jkms.2016.31.12.1887.
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Keywords: Adverse Drug Events (ADE), Hospitals, Medication, Medication: Safety
Hochman MJ, Kamal AH, Wolf SP
Anticholinergic drug burden in noncancer versus cancer patients near the end of life.
This article's objective is to determine anticholinergic load (ACL) and its impact in noncancer versus cancer palliative care patients. The authors concluded that ACL is associated with worse fatigue and quality of life and may not differ significantly between cancer and noncancer patients nearing end of life. Symptom management drugs are more responsible for ACL in cancer and noncancer patients, although disease management drugs contribute significantly to ACL in the latter group. They recommend more attention to reducing anticholinergic use in all patients with life-limiting illness.
AHRQ-funded; HS023681.
Citation: Hochman MJ, Kamal AH, Wolf SP .
Anticholinergic drug burden in noncancer versus cancer patients near the end of life.
J Pain Symptom Manage 2016 Nov;52(5):737-43.e3. doi: 10.1016/j.jpainsymman.2016.03.020.
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Keywords: Adverse Drug Events (ADE), Cancer, Medication, Palliative Care, Quality of Life
Hinkle SN, Mumford SL, Grantz KL
AHRQ Author: Mitchell EM
Association of nausea and vomiting during pregnancy with pregnancy loss: a secondary analysis of a randomized clinical trial.
The researchers examined the association of nausea and vomiting during pregnancy with pregnancy loss. They found that nausea and nausea with vomiting were associated with a reduced risk for clinical pregnancy loss.
AHRQ-authored.
Citation: Hinkle SN, Mumford SL, Grantz KL .
Association of nausea and vomiting during pregnancy with pregnancy loss: a secondary analysis of a randomized clinical trial.
JAMA Intern Med 2016 Nov;176(11):1621-27. doi: 10.1001/jamainternmed.2016.5641.
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Keywords: Adverse Drug Events (ADE), Medication, Pregnancy, Risk, Women
Lipska KJ, Flory JH, Hennessy S
Citizen petition to the US Food and Drug Administration to change prescribing guidelines: The metformin experience.
Although healthcare professionals rarely submit citizen petitions, they can exert a powerful impact on the labeling requirements for drugs. Metformin is one such example. The authors filed 2 petitions to the FDA, asking the FDA to change the label and to relax the renal contraindications. In 2016, the FDA issued a safety communication that partially granted our requests by requiring the manufacturers of metformin to change the labeling of metformin in several ways.
AHRQ-funded; HS023898.
Citation: Lipska KJ, Flory JH, Hennessy S .
Citizen petition to the US Food and Drug Administration to change prescribing guidelines: The metformin experience.
Circulation 2016 Nov 1;134(18):1405-08. doi: 10.1161/circulationaha.116.023041.
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Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Kidney Disease and Health, Diabetes
Gagne JJ, Han X, Hennessy S
Successful comparison of US Food and Drug Administration sentinel analysis tools to traditional approaches in quantifying a known drug-adverse event association.
The authors assessed the extent to which the newly developed, semiautomated Sentinel Propensity Score Matching tool could produce the same results as a customized protocol-driven assessment. They found initial evidence that Sentinel analytic tools can produce findings similar to those produced by a highly customized protocol-driven assessment.
AHRQ-funded; HS022193.
Citation: Gagne JJ, Han X, Hennessy S .
Successful comparison of US Food and Drug Administration sentinel analysis tools to traditional approaches in quantifying a known drug-adverse event association.
Clin Pharmacol Ther 2016 Nov;100(5):558-64. doi: 10.1002/cpt.429.
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Keywords: Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety
Kesselheim AS, Bykov K, Gagne JJ
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
The researchers estimated the risk of seizure-related events associated with refilling antiepileptic drugs (AED) with generic AEDs and the effect of switching between different manufacturers of the same generic drug. They found that among patients on a generic AED, refilling the same AED was associated with an elevated risk of seizure-related event; however, there was no additional risk from switching during that refill to a different manufacturer.
AHRQ-funded; HS022193.
Citation: Kesselheim AS, Bykov K, Gagne JJ .
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
Neurology 2016 Oct 25;87(17):1796-801. doi: 10.1212/wnl.0000000000003259.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Neurological Disorders, Patient Safety, Risk
Pinyavat T, Warner DO, Flick RP
Summary of the update session on clinical neurotoxicity studies.
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study.
AHRQ-funded; HS022941.
Citation: Pinyavat T, Warner DO, Flick RP .
Summary of the update session on clinical neurotoxicity studies.
J Neurosurg Anesthesiol 2016 Oct;28(4):356-60. doi: 10.1097/ana.0000000000000347.
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Keywords: Newborns/Infants, Children/Adolescents, Medication: Safety, Adverse Drug Events (ADE), Medication
Zhou L, Dhopeshwarkar N, Blumenthal KG
Drug allergies documented in electronic health records of a large healthcare system.
The authors studied the prevalence of common drug allergies and patient characteristics documented in electronic health records of two large tertiary care hospitals in Boston from 1990 to 2013. They found that drug allergies in general were most prevalent among females and white patients, but that allergies to NSAIDs, ACE inhibitors, and thiazide diuretics were more prevalent in black patients.
AHRQ-funded; HS022728.
Citation: Zhou L, Dhopeshwarkar N, Blumenthal KG .
Drug allergies documented in electronic health records of a large healthcare system.
Allergy 2016 Sep;71(9):1305-13. doi: 10.1111/all.12881.
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Keywords: Adverse Drug Events (ADE), Electronic Health Records (EHRs), Medication: Safety, Medication
Tetrault JM, Tate JP, Edelman EJ
Hepatic safety of buprenorphine in HIV-Infected and uninfected patients with opioid use disorder: the role of HCV-infection.
The purpose of this paper was to examine risk for buprenorphine (BUP)-associated hepatotoxicity among individuals with HIV and HCV. The authors found that liver enzymes and total bilirubin are rarely elevated in HIV-infected and uninfected patients receiving BUP, and that the risk of hepatotoxicity was greater in individuals infected with HIV, HCV, or HIV/HCV co-infection, who may benefit from increased monitoring.
AHRQ-funded; HS021112; HS018372.
Citation: Tetrault JM, Tate JP, Edelman EJ .
Hepatic safety of buprenorphine in HIV-Infected and uninfected patients with opioid use disorder: the role of HCV-infection.
J Subst Abuse Treat 2016 Sep;68:62-7. doi: 10.1016/j.jsat.2016.06.002.
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Keywords: Adverse Drug Events (ADE), Hepatitis, Human Immunodeficiency Virus (HIV), Medication, Risk
Tate JE, Yen C, Steiner CA
AHRQ Author: Steiner CA
Intussusception rates before and after the introduction of rotavirus vaccine.
The researchers examined trends in intussusception hospitalizations before (2000-2005) and after (2007-2013) rotavirus vaccine introduction to assess whether this observed temporal risk translates into more hospitalized cases at the population level. They concluded that, given the magnitude of declines in rotavirus disease compared with this small increase in intussusception, the benefits of rotavirus vaccination outweigh the increase risk of intussusception.
AHRQ-authored.
Citation: Tate JE, Yen C, Steiner CA .
Intussusception rates before and after the introduction of rotavirus vaccine.
Pediatrics 2016 Sep;138(3). doi: 10.1542/peds.2016-1082.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Vaccination, Adverse Drug Events (ADE), Hospitalization
Ing C, Sun LS, Friend AF
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
This study compared spinal anesthesia (SA) versus general anesthesia (GA) in infants undergoing pyloromyotomy. It concluded that infants undergoing pyloromyotomy with SA had shorter operating room times and postoperative length of stay, no significant differences in adverse event rates, and decreased exposure to IV and inhaled anesthetics, although SA infants often still required supplemental anesthetics.
AHRQ-funded; HS022941.
Citation: Ing C, Sun LS, Friend AF .
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
Reg Anesth Pain Med 2016 Jul-Aug;41(4):532-7. doi: 10.1097/aap.0000000000000421.
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Keywords: Newborns/Infants, Surgery, Medication, Medication: Safety, Adverse Drug Events (ADE)
Humble SS, Wilson LD, Leath TC
ICU sedation with dexmedetomidine after severe traumatic brain injury.
This study describes the dexmedetomidine dosage and infusion times, as well as the physiological parameters, neurological status and daily narcotic requirements before, during and after dexmedetomidine infusion. Its findings demonstrate that initiation of dexmedetomidine infusion is not associated with a decline in neurological functioning in adults with severe TBI.
AHRQ-funded; HS013833.
Citation: Humble SS, Wilson LD, Leath TC .
ICU sedation with dexmedetomidine after severe traumatic brain injury.
Brain Inj 2016;30(10):1266-70. doi: 10.1080/02699052.2016.1187289.
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Keywords: Adverse Drug Events (ADE), Brain Injury, Intensive Care Unit (ICU), Medication, Trauma
McCoy RG, Lipska KJ, Yao X
Intensive treatment and severe hypoglycemia among adults with type 2 diabetes.
The objectives of this study were to estimate the prevalence of intensive treatment and the association between intensive treatment, clinical complexity, and incidence of severe hypoglycemia among adults with type 2 diabetes who are not using insulin. The researchers found that over 20% of patients with type 2 diabetes received intensive treatment that might have been unnecessary and that among patients with high clinical complexity, intensive treatment nearly doubled the risk of severe hypoglycemia.
AHRQ-funded; HS018339.
Citation: McCoy RG, Lipska KJ, Yao X .
Intensive treatment and severe hypoglycemia among adults with type 2 diabetes.
JAMA Intern Med 2016 Jul;176(7):969-78. doi: 10.1001/jamainternmed.2016.2275.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Patient-Centered Healthcare, Risk
Raebel MA, Shetterly S, Lu CY
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.
The purpose of this paper was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods. The researchers used the Mini-Sentinel Distributed Database to select three exposure-outcome scenarios with laboratory results as baseline confounders. They found that missing data methods performed similarly.
AHRQ-funded; HS023898.
Citation: Raebel MA, Shetterly S, Lu CY .
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.
Pharmacoepidemiol Drug Saf 2016 Jul;25(7):798-814. doi: 10.1002/pds.4015.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Data, Diagnostic Safety and Quality, Medication
Penti B, Liebschutz JM, Kopcza B
Novel peer review method for improving controlled substance prescribing in primary care.
The authors sought to determine if peer feedback through a chart review tool (CRT) can impact opioid prescribing for patients with chronic noncancer pain in an outpatient family medicine clinic at an urban, safety-net teaching hospital. They reviewed 99 patient charts from 14 physicians over 1 year. They found that the mean dose of opioids decreased 2.6 mg morphine equivalent dose (MED)/day from time of chart review until the end of the project, compared to a 6.9 mg MED/day increase that occurred from 12 months prior to chart review to the time of chart review, and 14 patients were taken off of opioids after the chart review.
AHRQ-funded; HS022242.
Citation: Penti B, Liebschutz JM, Kopcza B .
Novel peer review method for improving controlled substance prescribing in primary care.
J Opioid Manag 2016 Jul-Aug;12(4):269-79. doi: 10.5055/jom.2016.0342.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Primary Care, Practice Patterns
Chatterjee S, Bali V, Carnahan RM
Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression.
The purpose of this study was to examine the risk of dementia with anticholinergic use among elderly nursing home residents with depression. The study concluded that use of clinically significant anticholinergic medications was associated with a 26% increase in risk of dementia among elderly nursing home residents with depression. With increasing safety concerns, there is a significant need to optimize anticholinergic use, especially for those who are at risk for dementia.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression.
Am J Geriatr Psychiatry 2016 Jun;24(6):485-95. doi: 10.1016/j.jagp.2015.12.011..
Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Medication, Nursing Homes
Thomas HN, Evans GW, Berlowitz DR
Antihypertensive medications and sexual function in women: baseline data from the SBP intervention trial (SPRINT).
The researchers evaluated the relations among class of antihypertensive medication from women in the Systolic Blood Pressure Intervention Trial (SPRINT) and the outcomes: sexual activity and sexual function. There were no significant differences in sexual activity among women taking one or more antihypertensives and women not taking any. Women taking an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker had higher odds of sexual activity. The authors concluded that no single class of antihypertensive medication was associated with sexual dysfunction.
AHRQ-funded; HS022989.
Citation: Thomas HN, Evans GW, Berlowitz DR .
Antihypertensive medications and sexual function in women: baseline data from the SBP intervention trial (SPRINT).
J Hypertens 2016 Jun;34(6):1224-31. doi: 10.1097/hjh.0000000000000911.
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Keywords: Medication, Blood Pressure, Sexual Health, Women, Adverse Drug Events (ADE), Adverse Events
Westover AN, Nakonezny PA, Barlow CE
Heart rate recovery and systolic blood pressure recovery after maximal exercise in prevalent users of stimulant medications.
This study examined the impact of stimulant medication use on heart rate recovery (HRR) and systolic blood pressure (SBP) recovery after maximal exercise testing in a large sample with adjustment for confounders such as fitness, obesity, and smoking. It found that stimulant medication users had increased odds of both abnormal HRR and abnormal SBP recovery compared with matched nonusers.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Barlow CE .
Heart rate recovery and systolic blood pressure recovery after maximal exercise in prevalent users of stimulant medications.
J Clin Psychopharmacol 2016 Jun;36(3):295-7. doi: 10.1097/jcp.0000000000000485.
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Keywords: Blood Pressure, Medication, Adverse Drug Events (ADE)
Wang SV, Franklin JM, Glynn RJ
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
The authors compared stratified event rates from randomized controlled trials with predicted event rates from models developed in observational data and assessed their ability to accurately capture observed rates of thromboembolism and major bleeding for patients treated with dabigatran or warfarin as part of routine care. They found that estimated rates of thromboembolism under dabigatran or warfarin treatment in randomized controlled trials were close to observed rates in routine care patients, but that rates of major bleeding were underestimated. They concluded that models developed in routine care patients can provide accurate, tailored estimates of risk and benefit under alternative treatment to enhance patient centered care.
AHRQ-funded; HS022193.
Citation: Wang SV, Franklin JM, Glynn RJ .
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
BMJ 2016 May 24;353:i2607. doi: 10.1136/bmj.i2607.
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Keywords: Blood Thinners, Adverse Drug Events (ADE), Blood Clots, Patient Safety, Medication
Dai D, Feinstein JA, Morrison W
Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children's hospitals.
The authors studied the characteristics and prevalence of exposure of pediatric patients to polypharmacy and potential drug-drug interactions in pediatric intensive care units (PICUs). They found that many PICU patients are exposed to substantial polypharmacy and potential drug-drug interactions. Future research should identify the risk of adverse drug events following specific potential drug-drug interaction exposures.
AHRQ-funded; HS018425.
Citation: Dai D, Feinstein JA, Morrison W .
Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children's hospitals.
Pediatr Crit Care Med 2016 May;17(5):e218-28. doi: 10.1097/pcc.0000000000000684.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Intensive Care Unit (ICU), Medication, Medication: Safety
Topaz M, Seger DL, Slight SP
Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience.
The authors aimed to explore the common drug allergy alerts over the last 10 years and the reasons why providers tend to override these alerts. They found that alarmingly, alerts for immune mediated and life threatening reactions with definite allergen and prescribed medication matches were overridden 72.8 percent and 74.1 percent of the time, respectively.
AHRQ-funded; HS022728.
Citation: Topaz M, Seger DL, Slight SP .
Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience.
J Am Med Inform Assoc 2016 May;23(3):601-8. doi: 10.1093/jamia/ocv143.
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Keywords: Electronic Health Records (EHRs), Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety
Linden S, Bussing R, Kubilis P
Risk of suicidal events with atomoxetine compared to stimulant treatment: a cohort study.
The researchers analyzed whether the observed increased risk of suicidal ideation in clinical trials translates into an increased risk of suicidal events in pediatric patients treated with atomoxetine compared with stimulants in 26 Medicaid programs. They found that first- and second-line treatment of youths age 5 to 18 with atomoxetine compared with stimulants was not significantly associated with an increased risk of suicidal events.
AHRQ-funded; HS018506; HS016097.
Citation: Linden S, Bussing R, Kubilis P .
Risk of suicidal events with atomoxetine compared to stimulant treatment: a cohort study.
Pediatrics 2016 May;137(5):pii: e20153199. doi: 10.1542/peds.2015-3199.
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Keywords: Adverse Drug Events (ADE), Medication, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research
Tilson H, Hines LE, McEvoy G
AHRQ Author: Helwig AL
Recommendations for selecting drug-drug interactions for clinical decision support.
A work group consisting of 20 experts in pharmacology, drug information, and clinical decision support (CDS) from academia, government agencies, health information vendors, and healthcare organizations was convened. It recommended a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization.
AHRQ-authored.
Citation: Tilson H, Hines LE, McEvoy G .
Recommendations for selecting drug-drug interactions for clinical decision support.
Am J Health Syst Pharm 2016 Apr 15;73(8):576-85. doi: 10.2146/ajhp150565.
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Keywords: Clinical Decision Support (CDS), Adverse Drug Events (ADE), Medication: Safety, Medication, Health Information Technology (HIT)