National Healthcare Quality and Disparities Report
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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
151 to 169 of 169 Research Studies DisplayedFeinstein J, Dai D, Zhong W
Potential drug-drug interactions in infant, child, and adolescent patients in children's hospitals.
This study assessed the prevalence and characteristics of potential drug-drug interactions (PDDI) among pediatric patients treated in children’s hospitals. It found that exposure to “major” potential drug2drug interactions occurs in 41 percent of pediatric hospitalizations in children’s hospitals. One-half of all these exposures were due to less common specific drug pairs (3 percent of patients exposed per hospital day).
AHRQ-funded; HS018425.
Citation: Feinstein J, Dai D, Zhong W .
Potential drug-drug interactions in infant, child, and adolescent patients in children's hospitals.
Pediatrics 2015 Jan;135(1):e99-108. doi: 10.1542/peds.2014-2015..
Keywords: Children/Adolescents, Patient Safety, Medication
Christian RB, Gaynes BN, Saavedra LM
Use of antipsychotic medications in pediatric and young adult populations: future research needs.
This article describes and prioritizes future research needs regarding antipsychotic treatment in youth, focusing on within-class and between-class drug comparisons with regard to key population subgroups, efficacy and effectiveness outcomes, and adverse event outcomes. Future research needs are delineated in detail as well as study designs that could be used to address them.
AHRQ-funded; 290200710056I.
Citation: Christian RB, Gaynes BN, Saavedra LM .
Use of antipsychotic medications in pediatric and young adult populations: future research needs.
J Psychiatr Pract 2015 Jan;21(1):26-36. doi: 10.1097/01.pra.0000460619.10429.4c..
Keywords: Medication, Children/Adolescents, Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research
Raghavan R, Brown DS, Allaire BT
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
The authors aimed to quantify the magnitude of Medicaid expenditures incurred in the purchase of psychotropic drugs for children with histories of abuse or neglect. They concluded that Medicaid agencies should focus their cost containment strategies on antidepressants and antimanic drugs, consider expanding primary care case management arrangements, and expand use of instruments such as the Child Behavior Checklist to identify and treat high-need children.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
Psychiatr Serv 2014 Dec;65(12):1445-51. doi: 10.1176/appi.ps.201400028.
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Keywords: Children/Adolescents, Healthcare Costs, Medicaid, Medication, Behavioral Health
Saloner B, Matone M, Kreider AR
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
The authors compared differences in second-generation antipsychotic utilization among Medicaid-enrolled children across fee-for-service, integrated managed care, and managed behavioral health carve-out organizational structures. They found that carve-outs, versus other arrangements, were associated with lower second-generation antipsychotic use.
AHRQ-funded; HS020269; HS018550.
Citation: Saloner B, Matone M, Kreider AR .
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
Psychiatr Serv 2014 Dec;65(12):1458-64. doi: 10.1176/appi.ps.201300574.
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Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Medication, Behavioral Health
Vanderwerker L, Akincigil A, Olfson M
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
The researchers investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. They found that foster care youths had higher rates of externalizing disorders than the comparison group and greater antipsychotic use. Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates.
AHRQ-funded; HS017918; HS019937; HS021112.
Citation: Vanderwerker L, Akincigil A, Olfson M .
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
Psychiatr Serv 2014 Oct;65(10):1281-4. doi: 10.1176/appi.ps.201300455.
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Keywords: Children/Adolescents, Medication, Medicaid, Vulnerable Populations, Behavioral Health
Freedman JL, Faerber JI, Kang TI
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
The purpose of this study was to gain better knowledge of patient and cancer treatment factors associated with nausea/vomiting (NV) in order to enhance prophylaxis in children being treated for acute myeloid leukemia (AML). It found that treatment-related NV, as evidenced by antiemetic alterations, is more prevalent with increasing age.
AHRQ-funded; HS018425
Citation: Freedman JL, Faerber JI, Kang TI .
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
Pediatr Blood Cancer. 2014 Oct;61(10):1798-805. doi: 10.1002/pbc.25108..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Children/Adolescents, Medication, Prevention
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
Kealey E, Scholle SH, Byron SC
Quality concerns in antipsychotic prescribing for youth: a review of treatment guidelines.
The authors reviewed treatment guidelines relevant to 7 quality concepts for appropriate use and management of youth on antipsychotics.They found that all 7 quality concepts were strongly endorsed by 1 or more guidelines, and 2 or more guidelines assigned their highest strength of recommendation ratings to 6 of the 7 concepts. Two guidelines rated evidence, providing high strength of evidence for 2 quality concepts.
AHRQ-funded; HS020503.
Citation: Kealey E, Scholle SH, Byron SC .
Quality concerns in antipsychotic prescribing for youth: a review of treatment guidelines.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S68-75. doi: 10.1016/j.acap.2014.05.009.
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Keywords: Evidence-Based Practice, Children/Adolescents, Guidelines, Quality of Care, Medication
Wu AC, Li L, Fung V
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
The researchers compared the effectiveness of different controller medication regimens under real-life conditions. They found that the risk of emergency department visits, hospitalizations, and oral corticosteroids did not differ between children who initiated leukotriene antagonist and those who initiated inhaled corticosteroid. These findings may be explainable by leukotriene antagonist having similar effectiveness as inhaled corticosteroid in real-life usage.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
J Allergy Clin Immunol Pract 2014 Sep-Oct;2(5):607-13. doi: 10.1016/j.jaip.2014.05.009..
Keywords: Comparative Effectiveness, Medication, Children/Adolescents, Asthma, Risk
Feudtner C, Freedman J, Kang T
Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
The researcher investigated senna’s effectiveness, compared with other prophylactic oral bowel medications, in reducing opioid-induced constipation in pediatric cancer patients. They found that initiating senna therapy within two days of starting opioids, compared with initiating another oral bowel medication, was significantly associated with a lower risk of problematic constipation.
AHRQ-funded; HS018425.
Citation: Feudtner C, Freedman J, Kang T .
Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
J Pain Symptom Manage 2014 Aug;48(2):272-80. doi: 10.1016/j.jpainsymman.2013.09.009..
Keywords: Cancer, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research, Medication
Gillette C, Blalock SJ, Rao JK
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
The objectives of the study were to: (1) describe the extent to which primary care pediatric providers discuss risks associated with asthma control medications with families and (2) examine the relationship between child, caregiver, provider, and clinic visit characteristics and discussions about risks associated with asthma control medications. It found that providers discussed asthma control medication risks during 23% of visits.
AHRQ-funded; HS020534.
Citation: Gillette C, Blalock SJ, Rao JK .
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
Pediatr Pulmonol 2014 Aug;49(8):727-33. doi: 10.1002/ppul.22892..
Keywords: Medication, Asthma, Children/Adolescents, Clinician-Patient Communication, Primary Care
Downes KJ, Rao MB, Kahill L
Daily serum creatinine monitoring promotes earlier detection of acute kidney injury in children and adolescents with cystic fibrosis.
The purpose of this study was to determine the impact of daily serum creatinine (SCr) measurement on amino-glycoside (AG)-associated acute kidney injury detection among patients with cystic fibrosis (CF). The study included 87 patients at a children’s hospital who received a total of 227 AG courses of 3 days or more.
AHRQ-funded; HS021114
Citation: Downes KJ, Rao MB, Kahill L .
Daily serum creatinine monitoring promotes earlier detection of acute kidney injury in children and adolescents with cystic fibrosis.
J Cyst Fibros. 2014 Jul;13(4):435-41. doi: 10.1016/j.jcf.2014.03.005..
Keywords: Adverse Drug Events (ADE), Antibiotics, Children/Adolescents, Medication, Respiratory Conditions
Larkin I, Ang D, Avorn J
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
The researchers estimated the effect of anti-detailing policies on off-label prescribing of antidepressants and antipsychotics by pediatricians and by child and adolescent psychiatrists in the period January 2006-June 2009. They found that prescriptions for off-label use of promoted drugs fell by 11 percent and that prescriptions for on-label use of promoted drugs fell by 34 percent. Conversely, prescriptions for on-label use of nonpromoted drugs rose by 14 percent, and those for off-label use of nonpromoted drugs rose by 35 percent. They concluded that these results suggest that pharmaceutical sales representatives promoted drugs not approved for pediatric use and that policies that restrict detailing by those representatives reduced such off-label prescribing.
AHRQ-funded; HS018465.
Citation: Larkin I, Ang D, Avorn J .
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
Health Aff 2014 Jun;33(6):1014-23. doi: 10.1377/hlthaff.2013.0939.
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Keywords: Medication, Children/Adolescents, Communication, Policy, Practice Patterns
Kirkendall ES, Spires WL, Mottes TA
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
The authors described an approach and provided a technical framework for the creation of risk-stratifying acute kidney injury (AKI) triggers and the development of an application to manage the AKI trigger data. Their report summarizes the construction of a trigger-based application, the performance of the triggers, and the challenges uncovered during the design, build, and implementation of the system.
AHRQ-funded; HS021114.
Citation: Kirkendall ES, Spires WL, Mottes TA .
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
Appl Clin Inform 2014 Apr 2;5(2):313-33. doi: 10.4338/aci-2013-12-ra-0102.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Health Information Technology (HIT), Electronic Health Records (EHRs)
Li L, Vollmer WM, Butler MG
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Using three confounding adjustment procedures—covariate-adjusted regression, propensity score regression, and high-dimemsional propensity score regression—on a population of 24,680 children with asthma, researchers found that patients treated with leukotriene antagonists were no more likely than those treated with inhaled corticosteroids to experience adverse outcomes.
AHRQ-funded; HS019669
Citation: Li L, Vollmer WM, Butler MG .
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Am J Epidemiol. 2014 Mar 1;179(5):648-59. doi: 10.1093/aje/kwt323..
Keywords: Comparative Effectiveness, Outcomes, Children/Adolescents, Asthma, Medication
Lomotan EA, Dougherty D
AHRQ Author: Lomotan EA, Dougherty D
Pediatric health care quality measures: considerations for pharmacotherapy.
The authors used the Pediatric Quality Measures Program that arose from the Children's Health Insurance Program Reauthorization Act in the United States to illustrate the challenges in developing quality measures of pediatric pharmacotherapy. They identified the challenges aw being twofold: (i) weak evidence base for the specific pharmacotherapy in children and (ii) limited data to calculate the measure. They concluded that health information technology is emerging as a tool to improve quality measurement but presents additional challenges.
AHRQ-authored.
Citation: Lomotan EA, Dougherty D .
Pediatric health care quality measures: considerations for pharmacotherapy.
Paediatr Drugs 2013 Dec;15(6):441-7. doi: 10.1007/s40272-013-0042-4.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Medication, Children/Adolescents, Quality Measures
Sarpong EM, Miller GE
AHRQ Author: Sarpong EM, Miller GE
Racial and ethnic differences in childhood asthma treatment in the United States.
The authors examined racial-ethnic differences in asthma controller medication use among insured U.S. children. They found that non-Hispanic black and Hispanic children were less likely to use controllers than non-Hispanic white children. They concluded that the large observed differences in controller use highlight the continuing challenges of ensuring that all U.S. children have access to quality asthma care.
AHRQ-authored.
Citation: Sarpong EM, Miller GE .
Racial and ethnic differences in childhood asthma treatment in the United States.
Health Serv Res 2013 Dec;48(6 Pt 1):2014-36. doi: 10.1111/1475-6773.12077.
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Keywords: Asthma, Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Medication, Racial and Ethnic Minorities
Dharmar M, Kuppermann N, Romano PS
Telemedicine consultations and medication errors in rural emergency departments.
This study compared the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). It found that the use of telemedicine to provide pediatric critical care consultations to rural EDs is associated with less frequent physician-related ED medication errors among seriously ill and injured children.
AHRQ-funded; HS013179; HS019712.
Citation: Dharmar M, Kuppermann N, Romano PS .
Telemedicine consultations and medication errors in rural emergency departments.
Pediatrics 2013 Dec;132(6):1090-7. doi: 10.1542/peds.2013-1374..
Keywords: Children/Adolescents, Medical Errors, Medication, Rural Health, Telehealth
Bobo WV, Cooper WO, Stein CM
Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
This study found that in a group of 25, 834 Medicaid-enrolled children and youth who had recently initiated use of either an antipsychotic or a control psychotropic drug, antipsychotic users had a risk of a newly diagnosed type 2 diabetes 3 times greater than the propensity-score matched controls. This group was confined to those who had not been diagnosed with conditions for which antipsychotics were the only recognized pharmacotherapy.
AHRQ-funded; HS0116974
Citation: Bobo WV, Cooper WO, Stein CM .
Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
JAMA Psychiatry. 2013 Oct;70(10):1067-75. doi: 10.1001/jamapsychiatry.2013.2053..
Keywords: Children/Adolescents, Behavioral Health, Diabetes, Medication, Medicaid