National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Arthritis (1)
- Back Health and Pain (2)
- Behavioral Health (1)
- Cancer (1)
- Cancer: Lung Cancer (1)
- Care Management (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (4)
- Elderly (3)
- Emergency Department (2)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (7)
- Guidelines (1)
- Healthcare Utilization (2)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Long-Term Care (1)
- Medicaid (1)
- Medication (15)
- Medication: Safety (1)
- Mortality (3)
- Nursing Homes (1)
- (-) Opioids (17)
- Orthopedics (1)
- Outcomes (6)
- Pain (8)
- Patient-Centered Healthcare (1)
- (-) Patient-Centered Outcomes Research (17)
- Patient Safety (1)
- Practice Patterns (1)
- Prevention (1)
- Quality of Life (1)
- Respiratory Conditions (1)
- Shared Decision Making (1)
- Substance Abuse (6)
- Surgery (3)
- Transitions of Care (1)
- Treatments (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedKorthuis 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
Feliciano JL, Waldfogel JM, Sharma R
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
This systematic review and meta-analysis examined the use of pharmacological interventions for breathlessness in patients with advanced cancer. Studies were identified from database inception to May 2020 using predefined eligibility criteria. Pharmacologic intervention benefits and harms were compared, focusing on breathlessness, anxiety, exercise capacity and health-related quality of life. Out of 7729 unique citations, 19 studies with a total of 1424 patients were included. Opioids were not associated with more effectiveness than placebo for improving breathlessness or exercise capacity. Anxiolytics were also not associated with more effectiveness than placebo for breathlessness or anxiety. There was limited evidence for other pharmacologic interventions. There was some harm, but it was minimal in those short-term studies.
AHRQ-funded; 290201500006I.
Citation: Feliciano JL, Waldfogel JM, Sharma R .
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
JAMA Netw Open 2021 Feb;4(2):e2037632. doi: 10.1001/jamanetworkopen.2020.37632..
Keywords: Cancer: Lung Cancer, Cancer, Respiratory Conditions, Medication, Treatments, Opioids, Evidence-Based Practice, Comparative Effectiveness, Quality of Life, Outcomes, Patient-Centered Outcomes Research
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
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
Marcial LH, Blumenfeld B, Harle C
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
These proceedings report on the AHRQ-sponsored Patient-Centered CDS Learning Network (PCCDS LN) Technical Framework Working Group (TechFWG), which was convened to identify barriers, facilitators, and potential solutions for interoperable clinical decision support, with a specific focus on addressing the opioid epidemic. The key insights were extrapolated to CDS-facilitated care improvement outside of the specific opioid use case. If applied broadly, the recommendations should help advance the availability and impact of interoperable CDS delivered at scale.
AHRQ-funded; HS024849.
Citation: Marcial LH, Blumenfeld B, Harle C .
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
AMIA Annu Symp Proc 2020 Mar 4;2019:637-46..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Opioids, Medication, Pain, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Sobieraj DM, Martinez BK, Miao B
Comparative effectiveness of analgesics to reduce acute pain in the prehospital setting.
The objectives of this study were to assess comparative effectiveness and harms of opioid and nonopioid analgesics for the treatment of moderate to severe acute pain in the prehospital setting. Among the investigators’ conclusions were that as initial analgesia, opioids were no different than ketamine, APAP, and NSAIDs in reducing acute pain in the prehospital setting. Opioids may cause fewer total side effects than ketamine, but more than APAP or NSAIDs.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Martinez BK, Miao B .
Comparative effectiveness of analgesics to reduce acute pain in the prehospital setting.
Prehosp Emerg Care 2020 Mar-Apr;24(2):163-74. doi: 10.1080/10903127.2019.1657213..
Keywords: Opioids, Medication, Pain, Emergency Medical Services (EMS), Comparative Effectiveness, Patient-Centered Outcomes Research
Kim HS, Kaplan SH, McCarthy DM
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Researchers used a retrospective cohort study to examine whether physical therapy (PT) is associated with lower analgesic prescribing in the emergency department (ED) setting. They found that, in this single center study, ED back and neck pain visits receiving PT were no less likely to receive an opioid prescription and were more likely to receive a benzodiazepine than visits receiving usual care. They conclude that, although prior studies demonstrated that PT may reduce opioid utilization in the subsequent year, these results indicated that analgesic prescribing is not reduced at the initial ED encounter.
AHRQ-funded; HS023011.
Citation: Kim HS, Kaplan SH, McCarthy DM .
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Am J Emerg Med 2019 Jul;37(7):1322-26. doi: 10.1016/j.ajem.2018.10.009..
Keywords: Opioids, Medication, Practice Patterns, Emergency Department, Patient-Centered Outcomes Research, Pain, Back Health and Pain, Outcomes, Evidence-Based Practice
Kim SC, Jin Y, Lee YC
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
The purpose of this study was to determine the association of preoperative opioid use among patients 65 years and older with mortality and other complications at 30 days post-total knee replacement (TKR). Findings show that continuous opioid users had a higher risk of revision operations, vertebral fractures, and opioid overdose at 30 days post-TKR but not of in-hospital or 30-day mortality, compared with opioid-naive patients. Highlights include the need for better understanding of patient characteristics associated with chronic opioid use to optimize preoperative assessment of overall risk after TKR.
AHRQ-funded; HS018910.
Citation: Kim SC, Jin Y, Lee YC .
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
JAMA Netw Open 2019 Jul 3;2(7):e198061. doi: 10.1001/jamanetworkopen.2019.8061..
Keywords: Opioids, Medication, Surgery, Orthopedics, Elderly, Patient-Centered Outcomes Research, Mortality, Outcomes, Arthritis, Evidence-Based Practice
Klueh MP, Hu HM, Howard RA
Transitions of care for postoperative opioid prescribing in previously opioid-naive patients in the USA: a retrospective review.
The purpose of this study was to identify specialties prescribing opioids to surgical patients who develop new persistent opioid use. Results showed that, among surgical patients who developed new persistent opioid use, surgeons provided the majority of opioid prescriptions during the first 3 months after surgery, but by 9 to 12 months after surgery, the majority of opioid prescriptions were provided by primary care physicians. Recommendations included enhanced care coordination between surgeons and primary care physicians to allow earlier identification of patients at risk for new persistent opioid use in order to prevent misuse and dependence.
AHRQ-funded; HS023313.
Citation: Klueh MP, Hu HM, Howard RA .
Transitions of care for postoperative opioid prescribing in previously opioid-naive patients in the USA: a retrospective review.
J Gen Intern Med 2018 Oct;33(10):1685-91. doi: 10.1007/s11606-018-4463-1..
Keywords: Transitions of Care, Opioids, Substance Abuse, Surgery, Pain, Medication, Patient-Centered Outcomes Research
Gold LS, Hansen RN, Avins AL
Associations of early opioid use with patient-reported outcomes and health care utilization among older adults with low back pain.
The objective of this study was to compare outcomes and health care utilization of older patients who did versus did not fill opioid prescriptions within 90 days of initiating care for low back pain. Among older patients with new back pain visits, filling 2 or more opioid prescriptions within 90 days of the visit was associated with similar back pain-related outcomes but increased likelihood of filling opioid prescriptions 18 to 24 months later compared with matched patients who did not fill early opioid prescriptions.
AHRQ-funded; HS019222; HS022972.
Citation: Gold LS, Hansen RN, Avins AL .
Associations of early opioid use with patient-reported outcomes and health care utilization among older adults with low back pain.
Clin J Pain 2018 Apr;34(4):297-305. doi: 10.1097/ajp.0000000000000557.
.
.
Keywords: Back Health and Pain, Elderly, Healthcare Utilization, Patient-Centered Outcomes Research, Opioids
Zullo AR, Zhang T, Beudoin FL
Pain treatments after hip fracture among older nursing home residents.
In this retrospective cohort study the investigators examined the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. The investigators concluded that a rigorous study addressing the limitations of their study is critical to validate their preliminary findings and provide evidence about the effect of using opioid versus nonopioid analgesics to optimize acute pain in NH residents with a hip fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Beudoin FL .
Pain treatments after hip fracture among older nursing home residents.
J Am Med Dir Assoc 2018 Feb;19(2):174-76. doi: 10.1016/j.jamda.2017.11.008..
Keywords: Opioids, Pain, Nursing Homes, Long-Term Care, Elderly, Medication, Injuries and Wounds, Patient-Centered Outcomes Research, Healthcare Utilization
Chou R, Korthuis PT, McCarty D
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
This review synthesized evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility. It concluded that higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events.
AHRQ-funded; 290201500009I.
Citation: Chou R, Korthuis PT, McCarty D .
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
Ann Intern Med 2017 Dec 19;167(12):867-75. doi: 10.7326/m17-2224.
.
.
Keywords: Emergency Medical Services (EMS), Evidence-Based Practice, Medication, Opioids, Patient-Centered Outcomes Research
Brummett CM, Waljee JF, Goesling J
New persistent opioid use after minor and major surgical procedures in US adults.
The authors sought to determine the incidence of new persistent opioid use after minor and major surgical procedures. They found that risk factors independently associated with new persistent opioid use included preoperative tobacco use, alcohol and substance abuse disorders, mood disorders, anxiety, and preoperative pain disorders. They concluded that new persistent opioid use after surgery is not significantly different between minor and major surgical procedures but rather associated with behavioral and pain disorders.
AHRQ-funded; HS023313.
Citation: Brummett CM, Waljee JF, Goesling J .
New persistent opioid use after minor and major surgical procedures in US adults.
JAMA Surg 2017 Jun 21;152(6):e170504. doi: 10.1001/jamasurg.2017.0504.
.
.
Keywords: Medication, Opioids, Pain, Patient-Centered Outcomes Research, Surgery
Beaudoin FL, Gutman R, Merchant RC
Persistent pain after motor vehicle collision: comparative effectiveness of opioids vs nonsteroidal antiinflammatory drugs prescribed from the emergency department-a propensity matched analysis.
This study evaluated the effect of opioid analgesics vs NSAIDs initiated from the ED on the presence of moderate to severe musculoskeletal pain and ongoing opioid use at 6 weeks in a large cohort of adult ED patients presenting to the ED after motor vehicle collision. No difference in risk for moderate to severe musculoskeletal pain at 6 weeks was observed between those discharged with opioid analgesics vs NSAIDs.
AHRQ-funded; HS022998.
Citation: Beaudoin FL, Gutman R, Merchant RC .
Persistent pain after motor vehicle collision: comparative effectiveness of opioids vs nonsteroidal antiinflammatory drugs prescribed from the emergency department-a propensity matched analysis.
Pain 2017 Feb;158(2):289-95. doi: 10.1097/j.pain.0000000000000756.
.
.
Keywords: Comparative Effectiveness, Emergency Department, Medication, Opioids, Pain, Patient-Centered Outcomes Research
Gaither JR, Goulet JL, Becker WC
The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality.
The objective of this study was to determine whether the presence of a substance use disorder (SUD) modifies the association between guideline-concordant care and 1-year all-cause mortality among patients receiving long-term opioid therapy (LtOT) for pain. It found that for clinicians prescribing LtOT to patients with untreated SUDs, engaging patients with psychotherapeutic and SUD treatment services may reduce mortality.
AHRQ-funded; U19 HS021112.
Citation: Gaither JR, Goulet JL, Becker WC .
The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality.
J Addict Med 2016 Nov/Dec;10(6):418-28. doi: 10.1097/adm.0000000000000255.
.
.
Keywords: Care Management, Medication, Mortality, Substance Abuse, Opioids, Patient-Centered Outcomes Research
Gaither JR, Goulet JL, Becker WC
The association between receipt of guideline-concordant long-term opioid therapy and all-cause mortality.
The researchers' objective was to determine the association between receipt of guideline-concordant long-term opioid therapy (LtOT) and 1-year all-cause mortality. They found no association between all-cause mortality and primary care visits or urine drug testing and recommended that providers use caution in initiating LtOT in conjunction with benzodiazepines and untreated substance use disorders.
AHRQ-funded; HS021112.
Citation: Gaither JR, Goulet JL, Becker WC .
The association between receipt of guideline-concordant long-term opioid therapy and all-cause mortality.
J Gen Intern Med 2016 May;31(5):492-501. doi: 10.1007/s11606-015-3571-4.
.
.
Keywords: Guidelines, Mortality, Opioids, Patient-Centered Outcomes Research, Substance Abuse
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
AHRQ-funded; 290201200014I
Citation: Chou R, Turner JA, Devine EB .
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559..
Keywords: Chronic Conditions, Comparative Effectiveness, Medication, Opioids, Outcomes, Pain, Patient-Centered Outcomes Research