National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Blood Thinners (1)
- (-) Cardiovascular Conditions (6)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (5)
- Hospitalization (1)
- Imaging (1)
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- Shared Decision Making (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 6 of 6 Research Studies DisplayedAngraal 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
Wang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Shared Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Durstenfeld MS, Katz SD, Park H
Mineralocorticoid receptor antagonist use after hospitalization of patients with heart failure and post-discharge outcomes: a single-center retrospective cohort study.
The purpose of this paper was to describe contemporary mineralocorticoid receptor antagonists (MRA) prescription for heart failure patients before and after the full scope of hospitalizations and the association between MRA discharge prescription and post-hospitalization outcomes. Results showed that, among hospitalized patients with heart failure with a reduced ejection fraction, 75% did not receive MRA before or after hospitalization, and nearly 90% of eligible patients did not have MRA initiated. These results suggest that hospitalization may represent an opportunity to initiate guideline-directed heart failure therapy.
AHRQ-funded; HS023683.
Citation: Durstenfeld MS, Katz SD, Park H .
Mineralocorticoid receptor antagonist use after hospitalization of patients with heart failure and post-discharge outcomes: a single-center retrospective cohort study.
BMC Cardiovasc Disord 2019 Aug 9;19(1):194. doi: 10.1186/s12872-019-1175-3..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medication, Practice Patterns, Outcomes
Shah NR, Ahmed ST, Winchester DE
Facility-level variation in stress test utilization in veterans with ischemic heart disease.
The aim of this study was to quantify variation in cardiac stress test utilization across the Veterans Health Administration (VA) in patients with established ischemic heart disease (IHD). The investigators used VA datasets to identify adults with IHD (myocardial infarction, percutaneous coronary intervention, and/or coronary artery bypass grafting) with a primary care clinic visit at the VA in fiscal year 2014.
AHRQ-funded; HS022998.
Citation: Shah NR, Ahmed ST, Winchester DE .
Facility-level variation in stress test utilization in veterans with ischemic heart disease.
JACC Cardiovasc Imaging 2019 Jul;12(7 Pt 1):1292-93. doi: 10.1016/j.jcmg.2019.02.020..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality, Healthcare Utilization, Practice Patterns, Imaging
Khan NNS, Kelly-Blake K, Luo Z
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
The study’s purpose was to determine differences in the rate of statin prescribing by sex based on the Adult Treatment Panel (ATP) III and 2013 American College of Cardiology (ACC/American Heart Association) cholesterol guidelines in Federally Qualified Health Centers (FQHCs). The study also wanted to determine adherence to those guidelines based on the 2013 recommendations. Two FQHCs were used and patients with coronary heart disease and diabetes mellitus (DM) were recruited. There was no difference between men and women in statin prescribing under ATPIII; however there was underprescribing for both men and women with atherosclerotic cardiovascular disease (ASCVD).
AHRQ-funded; HS018104.
Citation: Khan NNS, Kelly-Blake K, Luo Z .
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
Health Serv Res Manag Epidemiol 2019 Mar 5;6:2333392818825414. doi: 10.1177/2333392818825414..
Keywords: Cardiovascular Conditions, Diabetes, Medication, Practice Patterns, Sex Factors
Morden NE, Woloshin S, Brooks CG
Trends in testosterone prescribing for age-related hypogonadism in men with and without heart disease.
A study in 2010 (Basaria et al) revealed more cardiovascular events in men randomized to take testosterone than among men receiving a placebo. By 2015 the FDA had revised testosterone labels to highlight lack of efficacy evidence and possible increased cardiovascular risk. This study examines trends in testosterone use among Medicare-insured men over the age of 50 with and without coronary artery disease (CAD). A random sample was used of Medicare fee-for-service recipients from January 1, 2007 to December 31, 2016 using prescription fills under Medicare Parts B and D. Results showed that testosterone use was consistently higher among men with CAD than for men without CAD. Prescription rates had lowered after the warnings in 2013 but has remained higher than in 2007 and was largely off-label.
AHRQ-funded; HS024075.
Citation: Morden NE, Woloshin S, Brooks CG .
Trends in testosterone prescribing for age-related hypogonadism in men with and without heart disease.
JAMA Intern Med 2019 Mar;179(3):446-48. doi: 10.1001/jamainternmed.2018.6505..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Practice Patterns, Men's Health, Medication