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- Adverse Drug Events (ADE) (1)
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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 14 of 14 Research Studies DisplayedKorthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
McClellan C, Maclean JC, Saloner B
AHRQ Author: McClellan C
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
This study provided the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. As of 2016, 16 states had adopted an HH for enrollees with serious mental illness and/or substance use disorder. Using data from the National Survey on Drug Use and Health, the authors found that HH adoption increased service use among enrollees and enrollee self-reported health improved post-HH.
AHRQ-authored.
Citation: McClellan C, Maclean JC, Saloner B .
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
Health Econ 2020 Sep;29(9):1086-97. doi: 10.1002/hec.4027..
Keywords: Behavioral Health, Medicaid, Substance Abuse, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Patient-Centered Outcomes Research
Shoemaker-Hunt SJ, Wyant BE
The effect of opioid stewardship interventions on key outcomes: a systematic review.
In this study, the investigators sought to identify potential patient safety practices to reduce high-risk opioid prescribing. They conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. The investigators concluded that the strength of the evidence was low to moderate that OS efforts decreased numbers of opioid prescriptions, proportion of patients on long-term opioids, or days' supply. The strength of the evidence for OS initiatives producing significant reductions in opioid dosages was moderate.
AHRQ-funded; 233201500013I.
Citation: Shoemaker-Hunt SJ, Wyant BE .
The effect of opioid stewardship interventions on key outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S36-s41. doi: 10.1097/pts.0000000000000710..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Substance Abuse, Prevention
Rogal S, Youk A, Zhang H
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Despite significant medical and economic consequences of coexisting alcohol use disorder (AUD) in patients with cirrhosis, little is known about AUD treatment patterns and their impact on clinical outcomes in this population. In this study the investigators aimed to characterize the use of and outcomes associated with AUD treatment in patients with cirrhosis. This retrospective cohort study included Veterans with cirrhosis who received Veterans Health Administration (VA) care and had an index diagnosis of AUD between 2011 and 2015.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Zhang H .
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Hepatology 2020 Jun;71(6):2080-92. doi: 10.1002/hep.31042..
Keywords: Alcohol Use, Substance Abuse, Patient-Centered Outcomes Research, Outcomes
Samples H, Williams AR, Crystal S
Impact of long-term buprenorphine treatment on adverse health care outcomes In Medicaid.
The optimal, or even minimum, duration of medication treatment for opioid use disorder (OUD) needed to improve long-term outcomes has not been established empirically. As a result, health plans set potentially restrictive treatment standards to guide benefits and payment. To address this gap, the investigators used a National Quality Forum measure for OUD medication treatment duration (180 days) to examine the impact of longer treatment on health care outcomes within a key population of Medicaid enrollees.
AHRQ-funded; HS023258; HS021112.
Citation: Samples H, Williams AR, Crystal S .
Impact of long-term buprenorphine treatment on adverse health care outcomes In Medicaid.
Impact of long-term buprenorphine treatment on adverse health care outcomes In Medicaid..
Keywords: Medication, Substance Abuse, Opioids, Medicaid, Adverse Drug Events (ADE), Adverse Events, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Chan B, Kondo K, Freeman M
Pharmacotherapy for cocaine use disorder-a systematic review and meta-analysis.
The authors sought a better understanding of the effectiveness of pharmacotherapy for cocaine use disorder. Their search included multiple data sources for systematic reviews and randomized controlled trials of pharmacological interventions in adults with cocaine use disorder. They found that most of the pharmacotherapies studied, including antidepressants, were not effective for treating cocaine use disorder. Bupropion, psychostimulants, and topiramate may improve abstinence, and antipsychotics may improve treatment retention. They recommend further study of contingency management and behavioral interventions along with pharmacotherapy.
AHRQ-funded; HS022981.
Citation: Chan B, Kondo K, Freeman M .
Pharmacotherapy for cocaine use disorder-a systematic review and meta-analysis.
J Gen Intern Med 2019 Dec;34(12):2858-73. doi: 10.1007/s11606-019-05074-8..
Keywords: Medication, Substance Abuse, Comparative Effectiveness, Treatments, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Chan B, Freeman M, Kondo K
Pharmacotherapy for methamphetamine/amphetamine use disorder-a systematic review and meta-analysis.
The authors reviewed the effectiveness of pharmacotherapy for methamphetamine/amphetamine (MA/A) use disorder to assess the quality, publication bias, and overall strength of the evidence. They found that, on the basis of low- to moderate-strength evidence, most medications evaluated for methamphetamine/amphetamine use disorder have not shown a statistically significant benefit; however, there is low-strength evidence that methylphenidate may reduce use.
AHRQ-funded; HS022981.
Citation: Chan B, Freeman M, Kondo K .
Pharmacotherapy for methamphetamine/amphetamine use disorder-a systematic review and meta-analysis.
Addiction 2019 Dec;114(12):2122-36. doi: 10.1111/add.14755..
Keywords: Medication, Substance Abuse, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research
Klueh MP, Hu HM, Howard RA
Transitions of care for postoperative opioid prescribing in previously opioid-naive patients in the USA: a retrospective review.
The purpose of this study was to identify specialties prescribing opioids to surgical patients who develop new persistent opioid use. Results showed that, among surgical patients who developed new persistent opioid use, surgeons provided the majority of opioid prescriptions during the first 3 months after surgery, but by 9 to 12 months after surgery, the majority of opioid prescriptions were provided by primary care physicians. Recommendations included enhanced care coordination between surgeons and primary care physicians to allow earlier identification of patients at risk for new persistent opioid use in order to prevent misuse and dependence.
AHRQ-funded; HS023313.
Citation: Klueh MP, Hu HM, Howard RA .
Transitions of care for postoperative opioid prescribing in previously opioid-naive patients in the USA: a retrospective review.
J Gen Intern Med 2018 Oct;33(10):1685-91. doi: 10.1007/s11606-018-4463-1..
Keywords: Transitions of Care, Opioids, Substance Abuse, Surgery, Pain, Medication, Patient-Centered Outcomes Research
Westover AN, Nakonezny PA, Halm EA
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. The investigators concluded that in their cohort comorbid substance use disorders were common and were risk factors for development of (AUD).
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Halm EA .
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
Addiction 2018 May;113(5):857-67. doi: 10.1111/add.14122..
Keywords: Substance Abuse, Medication, Risk, Mortality, Patient-Centered Outcomes Research, Outcomes
Gaither JR, Goulet JL, Becker WC
The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality.
The objective of this study was to determine whether the presence of a substance use disorder (SUD) modifies the association between guideline-concordant care and 1-year all-cause mortality among patients receiving long-term opioid therapy (LtOT) for pain. It found that for clinicians prescribing LtOT to patients with untreated SUDs, engaging patients with psychotherapeutic and SUD treatment services may reduce mortality.
AHRQ-funded; U19 HS021112.
Citation: Gaither JR, Goulet JL, Becker WC .
The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality.
J Addict Med 2016 Nov/Dec;10(6):418-28. doi: 10.1097/adm.0000000000000255.
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Keywords: Care Management, Medication, Mortality, Substance Abuse, Opioids, Patient-Centered Outcomes Research
Smith LR, Earnshaw VA, Copenhaver MM
Substance use stigma: reliability and validity of a theory-based scale for substance-using populations.
The researchers aimed to advance measurement efforts of substance use stigma by drawing on stigma theory to develop and evaluate the Substance Use Stigma Mechanisms Scale (SU-SMS). Their findings support the structural and construct validity of the SU-SMS, suggesting the scale was able to capture enacted, anticipated, and internalized stigma as distinct stigma experiences, also differentiating between two distinct stigma sources, family and healthcare providers. They concluded that the SU-SMS may serve as a valuable tool for better understanding the processes through which substance use stigma serves to undermine key health behaviors and outcomes among persons with substance use disorders.
AHRQ-funded; HS022986.
Citation: Smith LR, Earnshaw VA, Copenhaver MM .
Substance use stigma: reliability and validity of a theory-based scale for substance-using populations.
Drug Alcohol Depend 2016 May 1;162:34-43. doi: 10.1016/j.drugalcdep.2016.02.019.
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Keywords: Behavioral Health, Patient-Centered Outcomes Research, Social Stigma, Substance Abuse
Gaither JR, Goulet JL, Becker WC
The association between receipt of guideline-concordant long-term opioid therapy and all-cause mortality.
The researchers' objective was to determine the association between receipt of guideline-concordant long-term opioid therapy (LtOT) and 1-year all-cause mortality. They found no association between all-cause mortality and primary care visits or urine drug testing and recommended that providers use caution in initiating LtOT in conjunction with benzodiazepines and untreated substance use disorders.
AHRQ-funded; HS021112.
Citation: Gaither JR, Goulet JL, Becker WC .
The association between receipt of guideline-concordant long-term opioid therapy and all-cause mortality.
J Gen Intern Med 2016 May;31(5):492-501. doi: 10.1007/s11606-015-3571-4.
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Keywords: Guidelines, Mortality, Opioids, Patient-Centered Outcomes Research, Substance Abuse
Westover AN, Nakonezny PA, Barlow CE
Exercise outcomes in prevalent users of stimulant medications.
This study compared prevalent stimulant medication users to matched nonusers undergoing a maximal treadmill test for differences in peak systolic blood pressure, average rise in SBP during exercise, peak heart rate (HR), and aerobic exercise capacity. It found that stimulant use was associated with a decreased peak HR as well as an increased risk of chronotropic incompetence.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Barlow CE .
Exercise outcomes in prevalent users of stimulant medications.
J Psychiatr Res 2015 May;64:32-9. doi: 10.1016/j.jpsychires.2015.03.011.
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Keywords: Medication, Substance Abuse, Patient-Centered Outcomes Research
Okuda M, Picazo J, Olfson M
Prevalence and correlates of anger in the community: results from a national survey.
This study assessed the prevalence, as well as the sociodemographic and clinical correlates of anger, in the general population and characterize adults that report inappropriate, intense, or poorly controlled anger. It found the overall prevalence of inappropriate, intense, or poorly controlled anger in the U.S. population was 7.8 percent. Anger was especially common among men and younger adults, and was associated with decreased psychosocial functioning.
AHRQ-funded; HS021112.
Citation: Okuda M, Picazo J, Olfson M .
Prevalence and correlates of anger in the community: results from a national survey.
CNS Spectr 2015 Apr;20(2):130-9. doi: 10.1017/s1092852914000182..
Keywords: Patient-Centered Outcomes Research, Behavioral Health, Substance Abuse, Social Determinants of Health