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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
1 to 25 of 28 Research Studies DisplayedShapiro HFJ, Loder E, Shapiro DJ
Association between clinician specialty and prescription of preventive medication for young adults with migraine: a retrospective cohort study.
The purpose of this multicenter retrospective cohort study was to compare prescribing patterns of preventive medications between pediatric and adult neurologists for young adults with migraine. The primary study outcome was whether the patient received a prescription for any preventive medication during the study period. Among the 767 included patients, 37.8% were seen by a pediatric neurologist. Preventive medications were prescribed for 45.2% of patients seen by a pediatric neurologist and 43.2% of patients seen by an adult neurologist. In the mixed effects logistic regression model, clinician specialty was not related with preventive medication use Female sex and number of visits during the study period were related with receiving preventive medication. The study concluded that proportion of young adults being prescribed migraine medications did not differ according to clinician specialty.
AHRQ-funded; HS000063.
Citation: Shapiro HFJ, Loder E, Shapiro DJ .
Association between clinician specialty and prescription of preventive medication for young adults with migraine: a retrospective cohort study.
Headache 2023 Oct; 63(9):1232-39. doi: 10.1111/head.14628..
Keywords: Young Adults, Medication, Pain, Neurological Disorders
Ramirez M, Duran MC, Penfold RB
STAR-Caregivers Virtual Training and Follow-up: a cultural adaptation for Latino caregivers of people with dementia.
This paper describes what is needed to adapt the STAR-Caregivers Virtual Training and Follow-up (STAR-VTF), an evidence-based intervention that teaches family caregivers how to manage behavioral and psychological symptoms of dementia to Latino caregivers. This qualitative research study interviewed Spanish- and English-speaking caregivers of people with dementia who self-identify as Hispanic/Latino (N = 30) and healthcare and social service providers of older Latino clients and/or Latino family caregivers (N = 14). The authors identified three themes: (i) there was a need to increase awareness about dementia and decrease stigma; (ii) semantics mattered as certain words and phrases could be stigmatizing, offensive, or culturally inappropriate; and (iii) there was a need to incorporate into program materials the traditional family structure and nature of caregiving in Latino families. Based on findings, STAR-VTF was adapted to expand content to improve understanding of dementia, language was revised that was viewed as problematic, and cultural examples were added to reflect the range of family involvement in caring for people living with dementia and multigenerational living.
AHRQ-funded; HS026369.
Citation: Ramirez M, Duran MC, Penfold RB .
STAR-Caregivers Virtual Training and Follow-up: a cultural adaptation for Latino caregivers of people with dementia.
Transl Behav Med 2023 Sep 12; 13(9):625-34. doi: 10.1093/tbm/ibad028..
Keywords: Education: Patient and Caregiver, Cultural Competence, Racial and Ethnic Minorities, Dementia, Neurological Disorders
Ramirez M, De Anda S, Jin H
Health information-seeking behavior of Latino caregivers of people living with dementia: a mixed-methods study.
This study examined the health information-seeking behavior of Latino caregivers of people living with dementia. This mixed-methods study used a structured survey and semi-structured interviews with 21 Latino caregivers in Los Angeles, California. Semi-structured interviews were also conducted with six healthcare and social service providers. The results showed that caregivers sought information on what changes to expect as dementia progresses to be better prepared. The most common action they used was to search the Internet. However, those who did were concerned about the quality of information.
AHRQ-funded; HS00046,HS026369.
Citation: Ramirez M, De Anda S, Jin H .
Health information-seeking behavior of Latino caregivers of people living with dementia: a mixed-methods study.
J Appl Gerontol 2023 Aug; 42(8):1738-48. doi: 10.1177/07334648231163430..
Keywords: Caregiving, Dementia, Neurological Disorders, Racial and Ethnic Minorities
Hua Y, Temkin-Greener H, Cai S
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
The purpose of this study was to explore primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD) who resided in Assisted Living Facilities (Als) during the early stage of the COVID-19 pandemic, with a focus on possible racial and socioeconomic differences. The study found that at the start of the pandemic in quarter 2 of 2020, Black residents were less likely to have telemedicine visits than their White counterparts. In the following two quarters, Black residents were more likely to receive primary care via telemedicine than White residents; a similar difference was observed between Hispanic and White residents, but with smaller effect sizes. Compared with nondual residents, dual residents were more likely to receive primary care via telemedicine in Q3. In addition, residents in AL communities with a higher proportion of dual residents, compared with those in low-dual ALs, were less likely to receive primary care via telemedicine throughout the study period. However, the difference in telemedicine use between higher vs lower dual ALs narrowed over time.
AHRQ-funded; HS026893.
Citation: Hua Y, Temkin-Greener H, Cai S .
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
J Am Med Dir Assoc 2023 Aug; 24(8):1157-58.e3. doi: 10.1016/j.jamda.2023.05.005..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Racial and Ethnic Minorities, Elderly
Wissel BD, Greiner HM, Glauser TA
Automated, machine learning-based alerts increase epilepsy surgery referrals: a randomized controlled trial.
Researchers conducted a prospective, randomized controlled trial of a natural language processing-based clinical decision support system in the electronic health record at 14 pediatric neurology outpatient clinics to determine whether automated, electronic alerts increased referrals for epilepsy surgery. Children with epilepsy and at least two prior neurology visits were screened by the system prior to their scheduled visit to identify potential surgical candidates, and the potential candidates randomized 2:1 for their providers to receive an alert or standard of care (no alert). The results showed that patients whose providers received an alert were more likely to be referred for a presurgical evaluation. The researchers concluded that machine learning-based automated alerts may improve the utilization of referrals for epilepsy surgery evaluations.
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Automated, machine learning-based alerts increase epilepsy surgery referrals: a randomized controlled trial.
Epilepsia 2023 Jul; 64(7):1791-99. doi: 10.1111/epi.17629..
Keywords: Neurological Disorders, Surgery, Health Information Technology (HIT)
Sideman AB, Gilissen J, Harrison KL
Caregiver experiences navigating the diagnostic journey in a rapidly progressing dementia.
This mixed-methods study examined the diagnostic journey experience from the perspective of caregivers of people who died from sporadic Creutzfeldt-Jakob Disease (sCJD). Qualitative data were drawn from interviews with former caregivers of 12 people who had died from sCJD. Four overarching themes were identified, as well as 4 phases along the diagnostic journey. Findings suggested that more work was needed to improve clinician diagnostic knowledge and communication practices. The authors also noted that caregivers need better support during the diagnostic journey and concluded that lessons learned from studying sCJD and other rapidly progressive dementias is likely to be applicable to more common dementias.
AHRQ-funded; HS022241.
Citation: Sideman AB, Gilissen J, Harrison KL .
Caregiver experiences navigating the diagnostic journey in a rapidly progressing dementia.
J Geriatr Psychiatry Neurol 2023 Jul; 36(4):282-94. doi: 10.1177/08919887221135552..
Keywords: Caregiving, Dementia, Neurological Disorders
Couch E, Ashford MT, Zhang W
Psychosocial and behavioral outcomes for persons with cognitive impairment and caregivers following amyloid-β PET scan disclosure: a systematic review.
This systematic review investigated the psychosocial and behavioral outcomes for persons with cognitive impairment and caregivers following amyloid-β pet scan disclosure. The authors identified 10 papers from 7 studies. While there was little evidence of an association between disclosure and depression, persons with mild cognitive impairment and their caregivers with elevated levels of amyloid had an increased risk of distress or anxiety compared with those without elevated amyloid. They did not identify any studies measuring behavioral outcomes.
AHRQ-funded; HS000011.
Citation: Couch E, Ashford MT, Zhang W .
Psychosocial and behavioral outcomes for persons with cognitive impairment and caregivers following amyloid-β PET scan disclosure: a systematic review.
Alzheimer Dis Assoc Disord 2023 Jul-Sep; 37(3):246-58. doi: 10.1097/wad.0000000000000569..
Keywords: Neurological Disorders, Imaging
Earla JR, Li J, Hutton GJ
Comparative adherence trajectories of oral disease-modifying agents in multiple sclerosis.
This study’s objective was to compare the adherence trajectories of fingolimod (FIN), teriflunomide (TER), and dimethyl fumarate (DMF) users with multiple sclerosis (MS) as there is limited evidence regarding the comparative adherence patterns of different oral disease-modifying agents (DMAs). The authors used data from the IBM MarketScan Commercial Claims Database from 2015 to 2019. The study cohort included adults (≥18 years) with MS (International Classification of Diseases [ICD]-9/10-Clinical Modification [CM]:340/G35) diagnosis and ≥1 DMA prescription. 1913 patients with MS who were initiated with FIN (24.2%, n = 462), TER (24.0%, n = 458), and DMF (51.9%, n = 993) during 2016-2018 were included. The adherence rate among FIN, TER, and DMF users was found to be 70.8% (n = 327), 59.6% (n = 273), and 61.0% (n = 606), respectively. The Group-Based Trajectory Modeling (GBTM) grouped patients into three adherence trajectories: Complete Adherers-59.1%, Slow Decliners-22.6%, and Rapid Discontinuers-18.3%. DMF and TER users had higher odds to be rapid discontinuers than FIN users. In addition, TER users were more likely to be slow decliners compared with FIN users.
AHRQ-funded; HS028502.
Citation: Earla JR, Li J, Hutton GJ .
Comparative adherence trajectories of oral disease-modifying agents in multiple sclerosis.
Pharmacotherapy 2023 Jun; 43(6):473-84. doi: 10.1002/phar.2810..
Keywords: Medication, Patient Adherence/Compliance, Neurological Disorders
Growdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization
Urtecho M, Wagner B, Wang Z
A qualitative evidence synthesis of patient perspectives on migraine treatment features and outcomes.
This quality evidence synthesis examined patient perspectives on migraine treatment features and outcomes. A literature review was conducted, and 19 studies (21 publications) involving 459 patients were included. Eight themes were identified encompassing features preferred by patients in a migraine treatment process. Themes described include a treatment process that included shared decision-making, a tailored approach, trust in health-care professionals, sharing of knowledge and diversity of treatment options, a holistic approach that does not just address the headache, ease of communication especially for complex treatments, a non-undermining approach, and reciprocity with mutual respect between patient and provider. Seven themes emerged including patients' preferences for nonpharmacologic treatment, high effectiveness, rapidity of action, long-lasting effect, lower cost and more accessibility, self-management/self-delivery option that increases autonomy, and a mixed preference for abortive versus prophylactic treatments. High value treatment outcomes to patients included maintaining or improving function; avoiding side effects, potential for addiction to medications, and pain reoccurrence; and avoiding non-headache symptoms such as nausea, vomiting, and sensitivity to light or sounds.
AHRQ-funded; 290201500008I; 290201500013I; 290201700003C.
Citation: Urtecho M, Wagner B, Wang Z .
A qualitative evidence synthesis of patient perspectives on migraine treatment features and outcomes.
Headache 2023 Feb; 63(2):185-201. doi: 10.1111/head.14430..
Keywords: Neurological Disorders, Evidence-Based Practice, Outcomes
Coley RY, Smith JJ, Karliner L RY, Smith JJ, Karliner L
External validation of the eRADAR risk score for detecting undiagnosed dementia in two real-world healthcare systems.
Drupal date: Feb, 2023
It is estimated that half of the individuals with dementia remain undiagnosed. The electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule (eRADAR) was designed to detect older adults at risk of undiagnosed dementia using routinely gathered clinical information. The purpose of this retrospective cohort study was to externally validate eRADAR in two real-world healthcare systems, examining its performance over time and across race/ethnicity. The study found a total of 7631 dementia diagnoses were observed at KPWA and 216 at UCSF. The area under the curve was 0.84 (95% confidence interval: 0.84-0.85) at KPWA and 0.79 (0.76-0.82) at UCSF. Using the 90th percentile as the cut point for identifying high-risk patients, sensitivity was 54% (53-56%) at KPWA and 44% (38-51%) at UCSF. Performance was consistent over time, including across the transition from International Classification of Diseases, version 9 (ICD-9) to ICD-10 codes, and across racial/ethnic groups (although small samples limited precision in some groups). The study concluded that eRADAR demonstrated strong external validity for identifying undiagnosed dementia in two healthcare systems with diverse patient populations and varying availability of external healthcare data for risk calculations. This study showed that eRADAR is generalizable from a research sample to real-world clinical populations, transportable across health systems, resilient to temporal changes in healthcare, and exhibits similar performance across major racial/ethnic groups.
It is estimated that half of the individuals with dementia remain undiagnosed. The electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule (eRADAR) was designed to detect older adults at risk of undiagnosed dementia using routinely gathered clinical information. The purpose of this retrospective cohort study was to externally validate eRADAR in two real-world healthcare systems, examining its performance over time and across race/ethnicity. The study found a total of 7631 dementia diagnoses were observed at KPWA and 216 at UCSF. The area under the curve was 0.84 (95% confidence interval: 0.84-0.85) at KPWA and 0.79 (0.76-0.82) at UCSF. Using the 90th percentile as the cut point for identifying high-risk patients, sensitivity was 54% (53-56%) at KPWA and 44% (38-51%) at UCSF. Performance was consistent over time, including across the transition from International Classification of Diseases, version 9 (ICD-9) to ICD-10 codes, and across racial/ethnic groups (although small samples limited precision in some groups). The study concluded that eRADAR demonstrated strong external validity for identifying undiagnosed dementia in two healthcare systems with diverse patient populations and varying availability of external healthcare data for risk calculations. This study showed that eRADAR is generalizable from a research sample to real-world clinical populations, transportable across health systems, resilient to temporal changes in healthcare, and exhibits similar performance across major racial/ethnic groups.
AHRQ-funded; HS026369.
Citation: Coley RY, Smith JJ, Karliner L RY, Smith JJ, Karliner L .
External validation of the eRADAR risk score for detecting undiagnosed dementia in two real-world healthcare systems.
J Gen Intern Med 2023 Feb; 38(2):351-60. doi: 10.1007/s11606-022-07736-6..
Keywords: Dementia, Neurological Disorders, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Difazio RL, Shore BJ, Melvin P
Pneumonia after hip surgery in children with neurological complex chronic conditions.
The purpose of this retrospective cohort study was to estimate rates of postoperative pneumonia in children with neurological complex chronic conditions (CCC) undergoing hip surgery, to determine the effect of pneumonia on postoperative hospital resource use, and to identify predictors. Researchers used data from the Pediatric Health Information System for children 4 years and older with a neurological CCC who had undergone hip surgery from 2016 to 2018 in U.S. children's hospitals. Findings indicate that postoperative pneumonia in children with a neurological CCC was associated with longer length-of-stay, readmissions, and higher costs. Children who had undergone pelvic osteotomies and who had multimorbidity needed additional clinical support to prevent postoperative pneumonia and to decrease resource utilization.
AHRQ-funded; HS024453.
Citation: Difazio RL, Shore BJ, Melvin P .
Pneumonia after hip surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2023 Feb; 65(2):232-42. doi: 10.1111/dmcn.15339..
Keywords: Children/Adolescents, Surgery, Neurological Disorders, Pneumonia, Respiratory Conditions, Hospital Readmissions, Adverse Events
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Nelson KE, Finlay M, Huang E
Clinical characteristics of children with severe neurologic impairment: a scoping review.
This study’s aim was to extrapolate the clinical features of children with severe neurologic impairment (SNI) based on the functional characteristics and comorbidities described in published studies. The authors searched four databases and included studies that describe clinical features of a group of children with SNI (≥20 subjects <19 years of age with >1 neurologic diagnosis and severe functional limitation) using data from caregivers, medical charts, or prospective collection. They included 102 studies, spanning 5 continents over 43 years using 41 distinct terms for SNI. Most studies (79%) described ≥3 types of functional characteristics, such as technology assistance and motor impairment. All studies noted 59 comorbidities and surgeries across 10 categories. The most common comorbidities were related to feeding, nutrition, and the gastrointestinal system, which was described in 79 studies. Studies investigated seven clinical topics, with "Gastrointestinal reflux and feeding tubes" as the most common research focus (56%). The next most common topic was “Aspiration and respiratory issues” which was included in 13 studies (13%). Most studies were retrospective cohort or case series.
AHRQ-funded; HS025138.
Citation: Nelson KE, Finlay M, Huang E .
Clinical characteristics of children with severe neurologic impairment: a scoping review.
J Hosp Med 2023 Jan; 18(1):65-77. doi: 10.1002/jhm.13019..
Keywords: Children/Adolescents, Neurological Disorders
Thomson J, Richardson T, Auger KA
Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment.
The purpose of this multicenter retrospective cohort study was to explore the effect of the early COVID-19 pandemic on hospital utilization for children with neurologic impairment (NI). The study found that compared with the pre-COVID period, there was a 14.4% decrease in the weekly median number of hospitalizations in the early-COVID era. Hospitalizations decreased for both noninfectious and infectious illnesses in the early-COVID era. Researchers reported that the decrease was the largest in spring 2020 and continued throughout 2020.
AHRQ-funded; HS024735; HS025138; HS026763.
Citation: Thomson J, Richardson T, Auger KA .
Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment.
J Hosp Med 2023 Jan; 18(1):33-42. doi: 10.1002/jhm.13021..
Keywords: Children/Adolescents, COVID-19, Neurological Disorders, Hospitalization
Siegler JE, Albright KC, George AJ
Time to neurological deterioration in ischemic stroke.
This study examined the time to neurological deterioration (ND) in ischemic stroke. The study concluded that despite having similar stroke severity and age, patients with nonreversible causes of ND had significantly shorter median time to ND when compared to patients with reversible causes of ND.
AHRQ-funded; HS013852.
Citation: Siegler JE, Albright KC, George AJ .
Time to neurological deterioration in ischemic stroke.
Med Student Res J 2017 Winter;4:18-24. doi: 10.15404/msrj/03.2016.0005..
Keywords: Neurological Disorders, Outcomes, Stroke
Williams CN, Kirby A, Piantino J
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
To address morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals applied to all Pediatric Neurocritical Care patients regardless of admission severity of illness. Here, the authors report an initial case series, which revealed a population that is heterogenous in age, ranging from 1 month to 18 years, and in diagnoses.
AHRQ-funded; HS022981.
Citation: Williams CN, Kirby A, Piantino J .
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
Children 2017 Sep 19;4(9). doi: 10.3390/children4090083.
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Keywords: Brain Injury, Critical Care, Neurological Disorders, Patient-Centered Healthcare, Children/Adolescents
Ing C, Hegarty MK, Perkins JW
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
A study was done of children age 10 years who had volatile anaesthetic (VA) exposure sometime during their early childhood. Researchers were trying to determine if the duration of exposure affected long-term language and cognitive ability. Data was obtained from the Western Australian Pregnancy Cohort (Raine) Study. The cohort was divided by duration of total VA exposure before age three years. They concluded that children exposed to less than 35 minutes VA did not differ from unexposed children, but there were lower language scores in children who had experienced greater than 35 minutes.
AHRQ-funded; HS022941.
Citation: Ing C, Hegarty MK, Perkins JW .
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
Br J Anaesth 2017 Sep 1;119(3):532-40. doi: 10.1093/bja/aew413..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Neurological Disorders, Patient Safety
Fosnacht AM, Patel S, Yucus C
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
This study aimed to primarily prevent Alzheimer's disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. The investigators are translating research into primary prevention of Alzheimer's disease and related disorders in their health system and aim to shift the paradigm in Neurology from brain disease to brain health.
AHRQ-funded; HS024057.
Citation: Fosnacht AM, Patel S, Yucus C .
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
J Prev Alzheimers Dis 2017;4(3):157-64. doi: 10.14283/jpad.2017.3..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Prevention
Jorgensen SM, Carnahan RM, Weckmann MT
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting. This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients. It concluded that the DOS appears to be an accurate way to screen for delirium in home hospice patients.
AHRQ-funded; HS022666.
Citation: Jorgensen SM, Carnahan RM, Weckmann MT .
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
Am J Hosp Palliat Care 2017 Sep;34(8):744-47. doi: 10.1177/1049909116658468.
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Keywords: Diagnostic Safety and Quality, Elderly, Home Healthcare, Neurological Disorders, Palliative Care
Jutkowitz E, Kuntz KM, Dowd B
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
This study used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. It found that no clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kuntz KM, Dowd B .
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
Alzheimers Dement 2017 Jul;13(7):801-09. doi: 10.1016/j.jalz.2016.12.011.
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Keywords: Caregiving, Dementia, Elderly, Healthcare Costs, Long-Term Care, Neurological Disorders, Nursing Homes
Krishnan S, York MK, Backus D
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
It is important for you to know if you have caregiver burnout, or the common triggers that may cause your burnout. By recognizing and addressing these factors, you will be able to take healthy and manageable control over your caregiver duties. The authors offer a number of specific recommendations to relieve caregiver stress and burden.
AHRQ-funded; HS022134.
Citation: Krishnan S, York MK, Backus D .
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
Arch Phys Med Rehabil 2017 Apr;98(4):805-07. doi: 10.1016/j.apmr.2016.11.002.
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Keywords: Caregiving, Neurological Disorders, Stress
Curtin CM, Kenney D, Suarez P
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release and trigger finger release. It found that oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms.
AHRQ-funded; HS024096.
Citation: Curtin CM, Kenney D, Suarez P .
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
J Hand Surg Am 2017 Mar;42(3):166-74. doi: 10.1016/j.jhsa.2016.12.011.
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Keywords: Neurological Disorders, Medication, Pain, Stress, Surgery
Stone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Jutkowitz E, MacLehose RF, Gaugler JE
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
This study examined the effect of sociodemographic and clinical risk factors on cognitive, functional, and behavioral declines in incident dementia patients. Age of onset, region of residence, and history of hypertension and psychiatric problems predicted behaviors at diagnosis. Cognition explained changes in behavior. Sociodemographic characteristics and clinical comorbidities predicted cognitive and functional changes. Only cognitive status explained behavioral decline.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, MacLehose RF, Gaugler JE .
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
J Gerontol A Biol Sci Med Sci 2017 Feb;72(2):251-58. doi: 10.1093/gerona/glw079.
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Keywords: Dementia, Elderly, Behavioral Health, Neurological Disorders, Risk, Social Determinants of Health