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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
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- Cancer (2)
- Cancer: Breast Cancer (1)
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- Chronic Conditions (2)
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- (-) Opioids (14)
- Orthopedics (1)
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- (-) Practice Patterns (14)
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- Substance Abuse (1)
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- Women (1)
- Young Adults (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 14 of 14 Research Studies DisplayedAgbalajobi OM, Gmelin T, Moon AM
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
This retrospective cohort study investigated opioid prescribing patterns among patients with chronic liver disease (CLD) at a single medical center. These patients (12,425) were followed for one year from October 2015 to September 2016. Nearly half (47%) were prescribed opioids over a one-year period, with 17% receiving high-risk prescriptions. Characteristics associated with high-risk opioid prescriptions included female gender, Medicaid insurance, cirrhosis and baseline chronic pain, depression, anxiety, substance use disorder, and Charlson comorbidity score. Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions.
AHRQ-funded; HS019461.
Citation: Agbalajobi OM, Gmelin T, Moon AM .
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
PLoS One 2021 Dec 17;16(12):e0261377. doi: 10.1371/journal.pone.0261377..
Keywords: Opioids, Medication, Practice Patterns, Pain, Chronic Conditions
Cerda M, Wheeler-Martin K, Bruzelius E
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
The authors investigated the impact of pain management clinic laws. They analyzed data on county-level, opioid overdose deaths via the National Vital Statistics System and patients filling long-duration or high-dose opioid prescriptions in the US 2010-2018. Their findings suggested that laws with criminal penalties were associated with intended reductions in high-risk opioid prescribing and some opioid overdoses but raised concerns regarding unintended consequences on heroin/synthetic overdoses.
AHRQ-funded; HS023258.
Citation: Cerda M, Wheeler-Martin K, Bruzelius E .
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
Am J Epidemiol 2021 Dec;190(12):2592-603. doi: 10.1093/aje/kwab192..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Practice Patterns, Policy
Renny MH, Yin HS, Jent V
Temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018.
Prescription opioids are involved in more than half of opioid overdoses among younger persons. Understanding opioid prescribing practices is essential for developing appropriate interventions for this population. The objective of this study was to examine temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018.
AHRQ-funded; HS026120.
Citation: Renny MH, Yin HS, Jent V .
Temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018.
JAMA Pediatr 2021 Oct;175(10):1043-52. doi: 10.1001/jamapediatrics.2021.1832..
Keywords: Children/Adolescents, Young Adults, Opioids, Practice Patterns, Medication
Enzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Heins SE, Castillo RC
Changes in opioid prescribing following the implementation of state policies limiting morphine equivalent daily dose in a commercially insured population.
The study’s objective was to evaluate the impact of state-level morphine equivalent daily dose (MEDD) policies on opioid prescribing among the privately insured using claims data from 9 policy states and 2 control states and a comparative interrupted time series design. Findings showed that MEDD policies were associated with decreased use of any opioids relative to control states, but with no change in high-dose prescribing. Recommendations included further research to understand the mechanisms through which MEDD policies may influence prescribing behavior.
AHRQ-funded; HS025557.
Citation: Heins SE, Castillo RC .
Changes in opioid prescribing following the implementation of state policies limiting morphine equivalent daily dose in a commercially insured population.
Med Care 2021 Sep;59(9):801-07. doi: 10.1097/mlr.0000000000001587..
Keywords: Opioids, Medication, Policy, Practice Patterns
Morden NE, Chyn D, Wood A
Racial inequality in prescription opioid receipt - role of individual health systems.
The purpose of this study was to explore the contribution of individual health systems in the receipt of prescription opioids among racial groups in the United States. Medicare claims data for 2016-2017 was used to obtain a random 40% national sample of fee-for-service, Black and White beneficiaries 18 to 64 years of age and identify 310 racially diverse systems. Findings showed that, within individual health systems, Black and White patients received markedly different opioid doses. These system-specific findings could facilitate exploration of the causes and consequences of these differences.
AHRQ-funded; HS024075.
Citation: Morden NE, Chyn D, Wood A .
Racial inequality in prescription opioid receipt - role of individual health systems.
N Engl J Med 2021 Jul 22;385(4):342-51. doi: 10.1056/NEJMsa2034159..
Keywords: Opioids, Medication, Racial and Ethnic Minorities, Disparities, Practice Patterns
Pritchard KT, Baillargeon J, Raji Ma
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees.
The purpose of this study was to establish whether non-pharmacological interventions, such as occupational and physical therapy, were associated with a shorter duration of prescription opioid use after hip or knee arthroplasty. The investigators concluded that occupational and physical therapy with home health were associated with a shorter duration of prescription opioid use after hip and knee arthroplasty.
AHRQ-funded; HS026133.
Citation: Pritchard KT, Baillargeon J, Raji Ma .
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees.
Arch Phys Med Rehabil 2021 Jul;102(7):1257-66. doi: 10.1016/j.apmr.2021.01.086..
Keywords: Orthopedics, Surgery, Opioids, Pain, Practice Patterns
Teoh L, Thompson W, Hubbard CC
Comparison of dental benzodiazepine prescriptions from the U.S., England, and Australia from 2013 to 2018.
Benzodiazepines contribute to substance use disorder and are often part of polydrug abuse, most frequently with opioids. Although dental opioid prescribing differs significantly between countries, little is known about the patterns of dental benzodiazepine prescribing. The aim of this study was to compare dental prescribing of benzodiazepines among the U.S., England, and Australia in 2013-2018.
AHRQ-funded; HS025177.
Citation: Teoh L, Thompson W, Hubbard CC .
Comparison of dental benzodiazepine prescriptions from the U.S., England, and Australia from 2013 to 2018.
Am J Prev Med 2021 Jul;61(1):73-79. doi: 10.1016/j.amepre.2021.01.025..
Keywords: Opioids, Medication, Practice Patterns, Dental and Oral Health
Worsham CM, Woo J, Jena AB
Adverse events and emergency department opioid prescriptions in adolescents.
Understanding the risks associated with opioid prescription in adolescents is critical for informing opioid policy, but the risks are challenging to quantify given the lack of randomized trial data. Using a regression discontinuity design, the investigators exploited a discontinuous increase in opioid prescribing in the emergency department (ED) when adolescents transitioned from "child" to "adult" at age eighteen to estimate the effect of an ED opioid prescription on subsequent opioid-related adverse events.
AHRQ-funded; HS026753.
Citation: Worsham CM, Woo J, Jena AB .
Adverse events and emergency department opioid prescriptions in adolescents.
Health Aff 2021 Jun;40(6):970-78. doi: 10.1377/hlthaff.2020.01762..
Keywords: Children/Adolescents, Emergency Department, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Practice Patterns
Hubbard CC, Evans CT, Calip GS
Characteristics associated with opioid and antibiotic prescribing by dentists.
The objective of this study was to identify county-level characteristics that may be high-impact targets for opioid and antibiotic interventions to improve dental prescribing. The investigators concluded that dental prescribing of opioids was decreasing, whereas dental antibiotic prescribing was increasing. High prescribing of antibiotics was associated with high prescribing of opioids. The investigators suggested that strategies focused on optimizing dental antibiotics and opioids are needed given their impact on population health.
AHRQ-funded; HS025177.
Citation: Hubbard CC, Evans CT, Calip GS .
Characteristics associated with opioid and antibiotic prescribing by dentists.
Am J Prev Med 2021 May;60(5):648-57. doi: 10.1016/j.amepre.2020.11.017..
Keywords: Antibiotics, Opioids, Medication, Practice Patterns
McCarthy DM, Kim HS, Hur SI
Patient-reported opioid pill consumption after an ed visit: how many pills are people using?
This study examined opioid use patterns after an emergency department (ED) visit. The study was conducted at an urban academic emergency department and included patients 18 years or older, not chemically using opioids, and had been newly prescribed hydrocodone-acetaminophen. They were asked to complete and return a 10-day medication diary. Two-hundred sixty patients returned completed medication diaries that included treatment for different conditions. The mean age was 45 years and 59% of the sample was female. The median number of pills prescribed was 12. Patients with renal colic used the least number of pills and patients with back pain used the most. Almost all (92.5%) of patients had leftover pills by the end of the 10 days.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Kim HS, Hur SI .
Patient-reported opioid pill consumption after an ed visit: how many pills are people using?
Pain Med 2021 Feb 23;22(2):292-302. doi: 10.1093/pm/pnaa048..
Keywords: Opioids, Medication, Emergency Department, Practice Patterns, Pain
Feder SL, Canavan ME, Wang S
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
This study’s objective was to compare patterns of opioid prescribing among older adults reporting pain with cardiopulmonary conditions, cancer, or both. Data from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey resource linked to Medicare Part D prescription claims was used to identify patients who self-reported moderate- to-severe pain interference with daily activities. Patients included were stratified by 1) self-reported history of cardiopulmonary conditions; 2) were within five years of cancer diagnosis; 3) had both conditions; or 4) neither. Of 10,516 patients identified, 1758 had cardiopulmonary conditions, 3383 cancer, 2861 both, and 2514 neither: with 46% aged 75 or more, 65% non-Hispanic white, and 10% non-Hispanic black. At the time of the survey, 1627 (15.5%) received opioids. Adjusted proportions of opioid use were similar for all conditions, with 14% for cardiopulmonary conditions only, 17% with cancer only, and 17% for both conditions. Patients with neither condition had a 13.1% opioid use rate.
AHRQ-funded; HS022882; HS025164.
Citation: Feder SL, Canavan ME, Wang S .
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
J Palliat Med 2021 Feb;24(2):195-204. doi: 10.1089/jpm.2020.0193..
Keywords: Elderly, Opioids, Medication, Practice Patterns, Medicare
Ali MM, McClellan C, West KD
AHRQ Author: McClellan C
Medical marijuana laws, marijuana use, and opioid-related outcomes among women in the United States.
This study examined whether state medical marijuana laws (MMLs) was associated with lower levels of opioid-related outcomes. Data was drawn from the 2002-2014 National Survey on Drug Use and Health to compare opioid misuse in states with and without MMLs among all women, pregnant women, and parenting women. It also invested the impact of MMLs on marijuana use and marijuana use disorder. There was found to be no association of MMLs with opioid misuse, opioid misuse initiation, or opioid use disorder among all women, pregnant women and parenting women. However there was a positive correlation with marijuana use and marijuana use disorder among all women and women with children. MMLs were also associated with an increase in the frequency of opioid misuse in pregnant women and a decrease in the frequency of opioid misuse for parenting women.
AHRQ-authored.
Citation: Ali MM, McClellan C, West KD .
Medical marijuana laws, marijuana use, and opioid-related outcomes among women in the United States.
Womens Health Issues 2021 Jan-Feb;31(1):24-30. doi: 10.1016/j.whi.2020.09.003..
Keywords: Women, Opioids, Substance Abuse, Medication, Policy, Practice Patterns
Eyrich NW, Sloss KR, Howard RA
Opioid prescribing exceeds consumption following common surgical oncology procedures.
Researchers aimed to compare opioid prescribing to opioid consumption for common surgical oncology procedures. They found that the median quantity of opioid prescribed was significantly larger than consumed following breast biopsy, lumpectomy, and mastectomy or wide local excision. The majority of patients reported receiving education on taking opioids, but only 27% received instructions on proper disposal; 82% of prescriptions filled resulted in unused opioids, and only 11% of these patients safely disposed of them. They concluded that their study demonstrated that opioid prescribing exceeds consumption following common surgical oncology procedures, thus indicating the potential for reductions in prescribing.
AHRQ-funded; HS023313.
Citation: Eyrich NW, Sloss KR, Howard RA .
Opioid prescribing exceeds consumption following common surgical oncology procedures.
J Surg Oncol 2021 Jan;123(1):352-56. doi: 10.1002/jso.26272..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Practice Patterns, Pain