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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
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- Children/Adolescents (2)
- Comparative Effectiveness (2)
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- Screening (2)
- (-) Substance Abuse (15)
- Tobacco Use (2)
- Tobacco Use: Smoking Cessation (1)
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- U.S. Preventive Services Task Force (USPSTF) (3)
- Young Adults (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 15 of 15 Research Studies DisplayedCalcaterra SL, Martin M, Bottner R
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
This paper discusses the findings of a Society of Hospital Medicine working group convened to develop a Consensus Statement on the management of opioid use disorder (OUD) and associated conditions among hospitalized adults. The statement is intended for clinicians practicing medicine in the inpatient setting (e.g., hospitalists, primary care physicians, family physicians, advanced practice nurses, and physician assistants) and is intended to apply to hospitalized adults at risk for, or diagnosed with, OUD. The first step of the working group to develop the statement was to conduct a systematic review of relevant guidelines and compose a draft statement based on extracted recommendations. In the next step the working group obtained feedback on the draft statement from external experts in addiction medicine, SHM members, professional societies, harm reduction organizations and advocacy groups, and peer reviewers. This iterative development process resulted in a final Consensus Statement consisting of 18 recommendations covering the following topics: (1) identification and treatment of OUD and opioid withdrawal, (2) perioperative and acute pain management in patients with OUD, and (3) methods to optimize care transitions at hospital discharge for patients with OUD.
AHRQ-funded; HS026215.
Citation: Calcaterra SL, Martin M, Bottner R .
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
J Hosp Med 2022 Sep;17(9):744-56. doi: 10.1002/jhm.12893..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
Calcaterras SL, Bottner R, Martin M
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
This study evaluated the quality and content of existing guidelines for in-hospital opioid use disorder (OUD) treatment and management. A literature search was done on several databases, websites of relevant societies and advocacy organizations, and selected international search engines. Nineteen guidelines published between January 2010 and June 2020 met the selection criteria. The majority of guidelines were based on observational studies or expert consensus. They recommended the use of nonstigmatizing language among patients with OUD; to assess patients with unhealthy opioid use for OUD using the Diagnostic Statistical Manual of Diseases-5th Edition criteria; use of methadone or buprenorphine to treat OUD and opioid withdrawal; use of multimodal, nonopioid therapy, and when needed, short-acting opioid analgesics in addition to buprenorphine or methadone, for acute pain management; ensuring linkage to ongoing methadone or buprenorphine treatment; referring patients to psychosocial treatment; and ensuring access to naloxone for opioid overdose reversal.
AHRQ-funded; HS026215.
Citation: Calcaterras SL, Bottner R, Martin M .
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
J Hosp Med 2022 Sep;17(9):679-92. doi: 10.1002/jhm.12908..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
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.
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
Lewis JA, Senft N, Chen H
Evidence-based smoking cessation treatment: a comparison by healthcare system.
The authors surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated Veterans Health Administration (VHA) in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment at least once in the past 12 months. They found that VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers.
AHRQ-funded; HS026122.
Citation: Lewis JA, Senft N, Chen H .
Evidence-based smoking cessation treatment: a comparison by healthcare system.
BMC Health Serv Res 2021 Jan 7;21(1):33. doi: 10.1186/s12913-020-06016-5..
Keywords: Health Systems, Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice, Substance Abuse
Chan B, Gean E, Arkhipova-Jenkins I
Retention strategies for medications for opioid use disorder in adults: a rapid evidence review.
This AHRQ-sponsored rapid evidence review looked at studies which include interventions to improve medications for opioid use disorder (MOUD) retention. A search of MEDLINE and the Cochrane Library from February 2009 to August 2019 was conducted for systematic reviews and randomized trials of care settings, services, logistical support, continency management, HIT, extended-release (XR) formulations, and psychosocial interventions that assessed retention for at least 3 months. Two systematic reviews and 39 primary studies were included. Some studies showed initiating MOUD in soon-to-be-released incarcerated people improved retention following release. Fewer than half the studies reviewed focused on retention as a primary outcome.
AHRQ-funded; 290201700003C; HS022981.
Citation: Chan B, Gean E, Arkhipova-Jenkins I .
Retention strategies for medications for opioid use disorder in adults: a rapid evidence review.
J Addict Med 2020 Jan-Feb;15(1):74-84. doi: 10.1097/adm.0000000000000739..
Keywords: Opioids, Substance Abuse, Medication, Evidence-Based Practice
Chan B, Freeman M, Ayers C
A systematic review and meta-analysis of medications for stimulant use disorders in patients with co-occurring opioid use disorders.
This systematic review and meta-analysis looked at medication efficacy for stimulant use disorders in patients with co-occurring opioid use disorders. Multiple databases were searched through April 2019 for randomized controlled trials, and dual-screened studies using pre-specified inclusion criteria. Thirty-four trials of 22 medications focused on cocaine use disorder in patients with opioid use disorder. Most studies used methadone treatment for patients with opioid use disorder. Primary outcomes were abstinence, defined as stimulant-negative urine for three or more consecutive weeks. However, none of the six studies that assessed abstinence found significant differences among groups. The authors found moderate strength evidence that antidepressants and disulfiram worsened treatment retention. There was low-strength evidence that psychostimulants reduced cocaine use. There was only 1 trial for methamphetamine use disorder which had insufficient strength evidence for naltrexone.
AHRQ-funded; HS022981.
Citation: Chan B, Freeman M, Ayers C .
A systematic review and meta-analysis of medications for stimulant use disorders in patients with co-occurring opioid use disorders.
Drug Alcohol Depend 2020 Nov 1;216:108193. doi: 10.1016/j.drugalcdep.2020.108193..
Keywords: Opioids, Substance Abuse, Medication, Evidence-Based Practice
Mills J, Wonoprabowo L
AHRQ Author: Mills J
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
This case study concerns a 14-year-old patient who presents for a well-child visit. The patient eats a healthy diet, is part of a local soccer league, is an overall good student, and just started high school in the fall. The patient denies trying any illicit substances but reports trying to “get high” from cough syrup. Three questions are presented, and answers provided.
AHRQ-authored.
Citation: Mills J, Wonoprabowo L .
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
Am Fam Physician 2020 Oct 15;102(8):493-94..
Keywords: Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study, Guidelines, Evidence-Based Practice
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
Patnode CD, Perdue LA, Rushkin M
Screening for unhealthy drug use: updated evidence report and systematic review for the US Preventive Services Task Force.
Illicit drug use is among the most common causes of preventable morbidity and mortality in the US. The objective of this study was to conduct a systematic review of the literature on screening and interventions for drug use to inform the US Preventive Services Task Force. The investigators concluded that several screening instruments with acceptable sensitivity and specificity are available to screen for drug use, although there is no direct evidence on the benefits or harms of screening.
AHRQ-funded; 290201500007I.
Citation: Patnode CD, Perdue LA, Rushkin M .
Screening for unhealthy drug use: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Jun 9;323(22):2310-28. doi: 10.1001/jama.2019.21381..
Keywords: U.S. Preventive Services Task Force (USPSTF), Substance Abuse, Screening, Evidence-Based Practice, Guidelines, Primary Care, Prevention
O'Connor E, Thomas R, Senger CA
Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors reviewed the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force. They found that the evidence for behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Health, social, and legal outcomes were sparsely reported, and few showed improvements.
AHRQ-funded; 2902015000017I.
Citation: O'Connor E, Thomas R, Senger CA .
Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 May 26;323(20):2067-79. doi: 10.1001/jama.2020.1432..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, Guidelines, Evidence-Based Practice
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
Richards JE, Bobb JF, Lee AK
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites.
This pilot study examined whether integrating evidence-based implementation strategies to implement Behavioral Health Integration (BHI) into primary care to increase diagnosis and treatment of substance use disorders (SUDs). Three pilot sites were used and patients were given annual screening for past-year cannabis and drug use, a Symptom Checklist for DSM-5 SUDs, and shared decision-making about different treatment options. Out of 39,599 eligible patients, almost 60% were screened for cannabis and other drug use. Daily cannabis use was reported with 2% of patients, and other drug use 1%. Of those patients, 51% and 37% completed an SUD Symptom Checklist. There was a higher proportion of patients diagnosed with cannabis use disorder (CUD) but not drug use disorder. However, the reverse was true for patients receiving treatment for drug-use disorders.
AHRQ-funded; HS023173.
Citation: Richards JE, Bobb JF, Lee AK .
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites.
Drug Alcohol Depend 2019 Aug 1;201:134-41. doi: 10.1016/j.drugalcdep.2019.04.015..
Keywords: Substance Abuse, Behavioral Health, Evidence-Based Practice, Primary Care, Patient-Centered Healthcare, Screening, Diagnostic Safety and Quality
Cartmell KB, Dooley M, Mueller M
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
This study explored the effect of an inpatient tobacco dependence treatment services (TDTS) on 30-, 90-, and 180-day hospital readmissions. The investigators suggest that findings from their study, which are supported by prior studies, provide evidence that delivery of TDTS is a strategy that may help to reduce hospital readmissions.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dooley M, Mueller M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
Med Care 2018 Apr;56(4):358-63. doi: 10.1097/mlr.0000000000000884..
Keywords: Evidence-Based Practice, Hospital Readmissions, Substance Abuse, Tobacco Use