National Healthcare Quality and Disparities Report
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- Hospitalization (4)
- Hospital Readmissions (2)
- Human Immunodeficiency Virus (HIV) (4)
- Implementation (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
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- Risk (2)
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- Social Determinants of Health (1)
- Substance Abuse (40)
- Surgery (2)
- Telehealth (4)
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- Transplantation (2)
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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
26 to 50 of 62 Research Studies DisplayedShen NT, Londono C, Gold S
Systematic review with meta-analysis on transplantation for alcohol-related liver disease: very low evidence of improved outcomes.
Under the hypothesis that, while liver transplantation for patients with alcohol-related liver disease (ALD) may improve mortality and relapse, findings will be limited by pre-specified causes of heterogeneity, researchers conducted a systematic review. Data from 10 studies comparing use of liver transplant in ALD to no-transplant was analyzed. Primary outcome of both was short- and long-term mortality and relapse. The results of the review indicate that liver transplantation for ALD patients suggests reduced mortality and relapse in heterogeneous, institution-specific populations. The authors note that, to understand efficacy of transplanting ALD, their research approach must change.
AHRQ-funded; HS000066.
Citation: Shen NT, Londono C, Gold S .
Systematic review with meta-analysis on transplantation for alcohol-related liver disease: very low evidence of improved outcomes.
World J Gastroenterol 2019 Apr 7;25(13):1628-39. doi: 10.3748/wjg.v25.i13.1628..
Keywords: Alcohol Use, Evidence-Based Practice, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery, Transplantation
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Heslin KC, Barrett ML
AHRQ Author: Heslin KC
Shifts in alcohol-related diagnoses after the introduction of International Classification of Diseases, Tenth Revision, clinical modification coding in U.S. hospitals: implications for epidemiologic research.
This study examined the impact of the ICD-10-CM coding system on estimates of hospital stays involving alcohol-related diagnoses. Using 2014 to 2017 HCUP data, results indicated that, on average, the number of stays involving any alcohol-related diagnosis in the 6 quarters before and after the ICD-10-CM transition was stable. However, substantial shifts in stays occurred for alcohol abuse, alcohol-induced mental disorders, and intoxication or toxic effects. Researchers conducting trend analyses of inpatient stays involving alcohol-related diagnoses should consider how ongoing modifications in the ICD-10-CM code system and coding guidelines might affect their work.
AHRQ-authored; AHRQ-funded.
Citation: Heslin KC, Barrett ML .
Shifts in alcohol-related diagnoses after the introduction of International Classification of Diseases, Tenth Revision, clinical modification coding in U.S. hospitals: implications for epidemiologic research.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Alcohol Use, Diagnostic Safety and Quality, Substance Abuse
Heslin KC, Barrett ML
AHRQ Author: Heslin KC
Shifts in alcohol-related diagnoses after the introduction of International Classification of Diseases, Tenth Revision, clinical modification coding in U.S. hospitals: implications for epidemiologic research.
This study examined the impact of the ICD-10-CM coding system on estimates of hospital stays involving alcohol-related diagnoses. This analysis used 2014 to 2017 administrative data from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project State Inpatient Databases for 17 states. The investigators found that on average, the number of stays involving any alcohol-related diagnosis in the 6 quarters before and after the ICD-10-CM transition was stable. However, substantial shifts in stays occurred for alcohol abuse, alcohol-induced mental disorders, and intoxication or toxic effects.
AHRQ-authored.
Citation: Heslin KC, Barrett ML .
Shifts in alcohol-related diagnoses after the introduction of International Classification of Diseases, Tenth Revision, clinical modification coding in U.S. hospitals: implications for epidemiologic research.
Alcohol Clin Exp Res 2018 Nov;42(11):2205-13. doi: 10.1111/acer.13866..
Keywords: Alcohol Use, Diagnostic Safety and Quality, Healthcare Cost and Utilization Project (HCUP), Substance Abuse
Weitzman ER, Magane KM, Wisk LE
Alcohol use and alcohol-interactive medications among medically vulnerable youth.
Information about the prevalence of alcohol use among youth with chronic medical conditions (YCMCs) who take alcohol-interactive (AI) medications is scant. This study attempts to address gaps and inform interventions by quantifying simultaneous exposure to alcohol use and AI medications among YCMCs. Participants were adolescents with a variety of chronic conditions: type 1 diabetes, juvenile idiopathic arthritis, moderate persistent asthma, cystic fibrosis, attention-deficit/hyperactivity disorder, inflammatory bowel disease. Participants completed an electronic survey designed to measure prevalence of exposure to AI medications and associations with alcohol usage in the past year. Many of the participants reported alcohol use, but drinking was less likely among those who took AI medications. The authors conclude that perceptions about alcohol-medication interference mediated the association between drinking and AI medication exposure.
AHRQ-funded; HS022986.
Citation: Weitzman ER, Magane KM, Wisk LE .
Alcohol use and alcohol-interactive medications among medically vulnerable youth.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2017-4026..
Keywords: Alcohol Use, Children/Adolescents, Chronic Conditions, Medication, Medication: Safety, Patient Safety, Vulnerable Populations
Glass JE, Bobb JF, Lee AL
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial).
Implementation researchers and clinical leaders at Kaiser Permanente Washington (KPWA) partnered to design a high-quality program of evidence-based care for unhealthy alcohol use: the Sustained Patient-centered Alcohol-related Care (SPARC) program. This paper describes the cluster-randomized trial implementing SPARC.
AHRQ-funded; HS023173.
Citation: Glass JE, Bobb JF, Lee AL .
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial).
Implement Sci 2018 Aug 6;13(1):108. doi: 10.1186/s13012-018-0795-9..
Keywords: Alcohol Use, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Joseph D, Vogel JA, Smith CS
Alcohol as a factor in 911 calls in Denver.
This study analyzed data from 911 calls in Denver, Colorado to determine the impact of excessive alcohol consumption on those calls. The number of calls made from July 1, 2012 to June 30, 2014 was 169,642 and of those calls 30% had alcohol consumption has a main factor, and 29% as a contribution factor. These calls were more likely associated with male sex, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation.
AHRQ-funded; HS023901.
Citation: Joseph D, Vogel JA, Smith CS .
Alcohol as a factor in 911 calls in Denver.
Prehosp Emerg Care 2018 Jul-Aug;22(4):427-35. doi: 10.1080/10903127.2017.1413467..
Keywords: Alcohol Use, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
Kazemi DM, Borsari B, Levine MJ
REMIT: Development of a mHealth theory-based intervention to decrease heavy episodic drinking among college students.
This paper discusses development of a mHealth theory-based intervention to decrease heavy episodic drinking among college students. Informed by current theories of Ecological Momentary Interventions (EMI), Motivational Interviewing (MI), and the Transtheoretical Model (TTM) of Change, investigators developed a self-monitoring app-Reductions through Ecological Momentary/Motivational Intervention/Transtheoretical (REMIT)-with the aim of reducing hazardous drinking among college students. The app was developed using the Integrate, Design, Assess, and Share (IDEAS) framework.
AHRQ-funded; HS023875.
Citation: Kazemi DM, Borsari B, Levine MJ .
REMIT: Development of a mHealth theory-based intervention to decrease heavy episodic drinking among college students.
Addict Res Theory 2018;26(5):377-85. doi: 10.1080/16066359.2017.1420783..
Keywords: Alcohol Use, Young Adults
Chavez LJ, Liu CF, Tefft N
The association between unhealthy alcohol use and acute care expenditures in the 30 days following hospital discharge among older Veterans Affairs patients with a medical condition.
Heavy alcohol use could predict increased risk for post-discharge acute care. This study assessed 30-day acute care utilization and expenditures for different categories of alcohol use, using VA and Medicare health care utilization data.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Liu CF, Tefft N .
The association between unhealthy alcohol use and acute care expenditures in the 30 days following hospital discharge among older Veterans Affairs patients with a medical condition.
J Behav Health Serv Res 2017 Oct;44(4):602-24. doi: 10.1007/s11414-016-9529-4..
Keywords: Alcohol Use, Hospital Discharge
Bobb JF, Lee AK, Lapham GT
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). The authors describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. They found that alcohol screening increased from 8.9 percent of patients pre-implementation to 62 percent post-implementation.
AHRQ-funded; HS023173.
Citation: Bobb JF, Lee AK, Lapham GT .
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Int J Environ Res Public Health 2017 Sep 8;14(9). doi: 10.3390/ijerph14091030.
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Keywords: Alcohol Use, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Kazemi DM, Borsari B, Levine MJ
A systematic review of the mhealth interventions to prevent alcohol and substance abuse.
This systematic review evaluated the recent body of research on mHealth-based interventions for substance use, with aims of (a) examining the functionality and effectiveness of these interventions, (b) evaluating the available research on the effectiveness of these interventions for substance use, and (c) evaluating the design, methodology, results, theoretical grounding, limitations, and implications of each study.
AHRQ-funded; HS023875.
Citation: Kazemi DM, Borsari B, Levine MJ .
A systematic review of the mhealth interventions to prevent alcohol and substance abuse.
J Health Commun 2017 May;22(5):413-32. doi: 10.1080/10810730.2017.1303556.
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Keywords: Alcohol Use, Prevention, Substance Abuse, Telehealth, Young Adults
Bensley KM, Harris AH, Gupta S
Racial/ethnic differences in initiation of and engagement with addictions treatment among patients with alcohol use disorders in the Veterans Health Administration.
In this study, the researchers investigated racial/ethnic variation in initiation of and engagement with specialty addictions treatment in a national sample of Black, Hispanic, and White patients with clinically recognized alcohol use disorders (AUD) from the US Veterans Health Administration (VA). The investigators found, after accounting for facility- and patient-level characteristics, Black and Hispanic patients with AUD were more likely than Whites to initiate specialty addictions treatment, and Black patients were more likely than Whites to engage.
AHRQ-funded; HS013853.
Citation: Bensley KM, Harris AH, Gupta S .
Racial/ethnic differences in initiation of and engagement with addictions treatment among patients with alcohol use disorders in the Veterans Health Administration.
J Subst Abuse Treat 2017 Feb;73:27-34. doi: 10.1016/j.jsat.2016.11.001..
Keywords: Alcohol Use, Racial and Ethnic Minorities, Substance Abuse
Cochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Bradley KA, Lapham GT
Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults?
The authors commented that brief motivational interviewing-based interventions could probably impact drinking at the population level. They noted that there is a critical need to develop and test more effective interventions and recommended that the public health approach to preventing alcohol-related harm among young adults include known effective approaches, including those that decrease alcohol use by reducing the availability of alcohol.
AHRQ-funded; HS023173.
Citation: Bradley KA, Lapham GT .
Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults?
Addiction 2016 Sep;111(9):1531-2. doi: 10.1111/add.13235.
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Keywords: Alcohol Use, Lifestyle Changes, Prevention, Substance Abuse, Young Adults
Clark BJ, Rubinsky AD, Ho PM
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
This study sought to determine whether alcohol misuse was associated with admission to an intensive care unit (ICU) among patients receiving outpatient care. Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0 percent for abstinent patients, 1.6 percent for patients with lower-risk alcohol use, 1.8 percent for patients with moderate alcohol misuse, and 2.5 percent for patients with severe alcohol misuse.
AHRQ-funded; HS022800.
Citation: Clark BJ, Rubinsky AD, Ho PM .
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
Subst Abus 2016 Jul-Sep;37(3):466-73. doi: 10.1080/08897077.2015.1137259.
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Keywords: Alcohol Use, Hospital Readmissions, Intensive Care Unit (ICU), Ambulatory Care and Surgery, Screening, Substance Abuse
Chavez LJ, Williams EC, Lapham GT
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
The researchers examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. They found that among patients with alcohol misuse, the adjusted prevalence of alcohol-related advice increased from 40.4% in 2007 to 55.5% in 2011. Rates of alcohol-related advice increased significantly each year except the last.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Williams EC, Lapham GT .
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
J Stud Alcohol Drugs 2016 May;77(3):500-8.
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Keywords: Alcohol Use, Behavioral Health, Primary Care, Substance Abuse
Heslin KC, Elixhauser A, Steiner CA
AHRQ Author: Heslin KC, Elixhauser A, Steiner CA
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
The aim of this study was to compare the average costs of hospitalizations with alcoholic liver disease (ALD) and the costs of hospitalizations with other alcohol-related diagnoses that do not involve the liver. It found that costs of hospital care for patients with ALD are higher than those for patients with other alcohol-related diagnoses.
AHRQ-authored.
Citation: Heslin KC, Elixhauser A, Steiner CA .
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
Addiction 2016 May;112(5):782-91. doi: 10.1111/add.13702.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Alcohol Use, Healthcare Costs, Nutrition, Hospitalization
Chavez LJ, Bradley K, Tefft N
Preference weights for the spectrum of alcohol use in the U.S. population.
One barrier to research has been the lack of preference weights needed to calculate Quality Adjusted Life Years (QALYs). Preference weights can be estimated from measures of health-related quality of life (HRQOL). The objective of this study was to describe preference weights for the full spectrum of alcohol use. It concluded that self-reported alcohol consumption may not be associated with preference weights.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Bradley K, Tefft N .
Preference weights for the spectrum of alcohol use in the U.S. population.
Drug Alcohol Depend 2016 Apr 1;161:206-13. doi: 10.1016/j.drugalcdep.2016.02.004.
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Keywords: Medical Expenditure Panel Survey (MEPS), Alcohol Use, Substance Abuse, Health Status
Rentsch C, Tate JP, Akgun KM
Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States veterans from 1997 to 2011.
From 1997 to 2011, 46,428 HIV-infected and 93,997 uninfected patients were followed for 1,497,536 person-years. Overall hospitalization rates decreased among HIV-infected and uninfected patients. However, cardiovascular and renal insufficiency admissions increased for all groups while gastrointestinal and liver, endocrine, neurologic, and non-AIDS cancer admissions increased among those with an alcohol-related diagnosis.
AHRQ-funded; HS018372.
Citation: Rentsch C, Tate JP, Akgun KM .
Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States veterans from 1997 to 2011.
AIDS Behav 2016 Mar;20(3):555-64. doi: 10.1007/s10461-015-1025-y.
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Keywords: Alcohol Use, Hospitalization, Human Immunodeficiency Virus (HIV)
Liu L, Strawderman RL, Johnson BA
Analyzing repeated measures semi-continuous data, with application to an alcohol dependence study.
The authors reviewed and considered three extensions of two-part random effects models. They compared the performance through applications to daily drinking records in a secondary data analysis from a randomized controlled trial of topiramate for alcohol dependence treatment. They found that all three models provide a significantly better fit than the log-normal model, and there exists strong evidence for heteroscedasticity.
AHRQ-funded; HS020263.
Citation: Liu L, Strawderman RL, Johnson BA .
Analyzing repeated measures semi-continuous data, with application to an alcohol dependence study.
Stat Methods Med Res 2016 Feb;25(1):133-52. doi: 10.1177/0962280212443324.
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Keywords: Alcohol Use, Behavioral Health, Substance Abuse
Williams EC, Achtmeyer CE, Young JP
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
The researchers conducted a qualitative key informant study to describe local implementation of alcohol screening and brief intervention from the perspectives of frontline adopters in VA primary care . Findings suggest that the local process of implementing alcohol screening and brief intervention may have inadequately addressed important adopter needs.
AHRQ-funded; HS022800.
Citation: Williams EC, Achtmeyer CE, Young JP .
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
J Subst Abuse Treat 2016 Jan;60:27-35. doi: 10.1016/j.jsat.2015.07.011.
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Keywords: Alcohol Use, Screening, Primary Care
Chavez LJ, Liu CF, Tefft N
Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge.
This study examined the association between AUDIT-C alcohol screening results and 30-day readmissions or ED visits. Alcohol screening results indicating high-risk drinking that were available in medical records were modestly associated with risk for 30-day readmissions and were not associated with risk for ED visits.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Liu CF, Tefft N .
Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge.
Drug Alcohol Depend 2016 Jan;158:94-101. doi: 10.1016/j.drugalcdep.2015.11.008.
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Keywords: Alcohol Use, Elderly, Emergency Department, Hospital Readmissions, Lifestyle Changes
Cano MA, Vaughan EL, de Dios MA
Alcohol use severity among Hispanic emerging adults in higher education: Understanding the effect of cultural congruity.
This study examined associations of behavioral acculturation, behavioral enculturation, and cultural congruity (perception of cultural fit between the values of the academic environment and the student's personal values) with alcohol use severity (AUS); and tested if gender moderated those associations. It concluded that after controlling for demographic variables and depressive symptoms, behavioral acculturation and enculturation did not have a statistically significant association with AUS.
AHRQ-funded; HS017586.
Citation: Cano MA, Vaughan EL, de Dios MA .
Alcohol use severity among Hispanic emerging adults in higher education: Understanding the effect of cultural congruity.
Subst Use Misuse 2015;50(11):1412-20. doi: 10.3109/10826084.2015.1018538.
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Keywords: Alcohol Use, Substance Abuse, Racial and Ethnic Minorities, Lifestyle Changes
Ludman EJ, Curry SJ
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
This study, Options Regarding Consumption of Alcohol (ORCA), was designed to test whether a primary care-based intervention would reduce alcohol misuse among patients who screened positive for risky or hazardous drinking. This paper assesses the study features using the Pragmatic-Explanatory Continuum Indicator Summary Model domains. As a randomized trial, the study included some explanatory features (e.g., standardized follow-up surveys administered by study personnel); however, several aspects of the study were highly pragmatic.
AHRQ-funded; 290201000004I.
Citation: Ludman EJ, Curry SJ .
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S194-9. doi: 10.1016/j.amepre.2015.05.016.
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Keywords: Alcohol Use, Behavioral Health, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Lapham GT, Rubinsky AD, Shortreed SM
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
This study sought to determine if differences in how brief intervention (BI) was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. It found that the association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Shortreed SM .
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
Drug Alcohol Depend 2015 Aug 1;153:159-66. doi: 10.1016/j.drugalcdep.2015.05.027..
Keywords: Alcohol Use, Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse