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
1 to 25 of 87 Research Studies DisplayedCampbell AM, Mattoni M, Yefimov MN
Improving cognitive workload in radiation therapists: a pilot EEG neurofeedback study.
The authors employed an accelerated alpha-theta neurofeedback (NF) protocol to test if 12 radiation therapy therapists (RTTs) could learn the protocol and exhibit behavior and brain performance-related benefits. Following the 3-week protocol, participants showed a decrease in subjective cognitive workload and a decrease in response time during a performance task, as well as a decrease in desynchrony of the alpha electroencephalogram band. The authors concluded that the RTTs successfully learned the protocol and improved in perceived cognitive workload following 3 weeks of neurofeedback.
AHRQ-funded; HS025597.
Citation: Campbell AM, Mattoni M, Yefimov MN .
Improving cognitive workload in radiation therapists: a pilot EEG neurofeedback study.
Front Psychol 2020 Dec 3;11:571739. doi: 10.3389/fpsyg.2020.571739..
Keywords: Provider, Burnout, Stress, Workforce
Byrnes ME, Varlamos CJ, Rivard SJ
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
This viewpoint article reflects the narratives of 58 colorectal surgeons who engaged in an in-depth qualitative interview during the COVID-19 shutdown of elective surgeries. The goal for reporting these findings is to offer a snapshot of surgeon perspectives on the delays of elective surgeries and to give voice to surgeons who were unable to perform most or all their duties as a surgeon.
AHRQ-funded; HS025365; HS000053.
Citation: Byrnes ME, Varlamos CJ, Rivard SJ .
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
Dis Colon Rectum 2020 Dec;63(12):1575-78. doi: 10.1097/dcr.0000000000001818..
Keywords: Surgery, Provider: Physician, Provider, COVID-19, Public Health, Infectious Diseases
O'Leary KJ, Manojlovich M, Johnson JK
A multisite study of interprofessional teamwork and collaboration on general medical services.
This multisite study of four mid-sized hospitals measured teamwork climate of nurses, nurse assistants, and physicians working on general medical services. Teamwork climate scores for 380 participants (80 hospitalists, 13 resident physicians, 193 nurses, and 94 nurses) were measured using the Safety Attitudes Questionnaire. Hospitalists had the highest median teamwork climate score and nurses had the lowest, but it was not a statistically significant difference. A higher percentage of hospitalists (63.3%) rated the quality of collaboration with nurses as high or very high, but only 48.7% of nurses rated the collaboration with hospitalists as high or very high. There were significant differences in perceptions of teamwork climate across sites and across professional categories.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Manojlovich M, Johnson JK .
A multisite study of interprofessional teamwork and collaboration on general medical services.
Jt Comm J Qual Patient Saf 2020 Dec;46(12):667-72. doi: 10.1016/j.jcjq.2020.09.009..
Keywords: Teams, Hospitals, Patient Safety, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider
Heinze K, Suwanabol PA, Vitous CA
A survey of patient perspectives on approach to health care: focus on physician competency and compassion.
This study is a cross-sectional survey of 764 patients to gain insight into perceptions of physician qualities of compassion and competence. The participants response rate was 85%, with mean age 52.4, 70.8% female, and 84% identified as white. Predictors of compassion over competence included female gender and whether the respondent had a personal connection to the vignette used. Preferences were found to be influenced by: 1) explicit beliefs regarding the value of physician compassion and competence; 2) impact of emotional and mental health on medical experiences; 3) type and frequency of health care exposure, and; 4) perceived role of the physician in various clinical vignettes.
AHRQ-funded; HS026772.
Citation: Heinze K, Suwanabol PA, Vitous CA .
A survey of patient perspectives on approach to health care: focus on physician competency and compassion.
J Patient Exp 2020 Dec;7(6):1044-53. doi: 10.1177/2374373520968447..
Keywords: Provider: Physician, Provider, Patient Experience, Provider Performance, Quality of Care
Everson J, Cheng AK, Patrick SW
Association of electronic prescribing of controlled substances with opioid prescribing rates.
The purpose of this study was to assess the association between use of electronic prescribing of controlled substances (EPCS) and trends in opioid prescribing. Results suggested that an increased use of EPCS was not associated with decreased opioid prescribing or a decrease in the amount prescribed and may have been associated with a small increase in opioid prescribing. Recommendations included levers to ensure that EPCS is integrated with outside data and that information is actively used to inform prescribing decisions.
AHRQ-funded; HS026395.
Citation: Everson J, Cheng AK, Patrick SW .
Association of electronic prescribing of controlled substances with opioid prescribing rates.
JAMA Netw Open 2020 Dec;3(12):e2027951. doi: 10.1001/jamanetworkopen.2020.27951..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Opioids, Medication, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Dossett LA, Waljee JF, Dimick JB
Ensuring equal access to mentorship and sponsorship for surgeons through structured team-based mentoring.
This perspective paper describes how Michigan Medicine has developed early- and mid-career mentoring programs for surgeons in the hopes of reducing inequities in access to mentorship and foster a culture of mentorship for women and underrepresented minorities. The university hospital developed a mentoring program with Launch Teams for early career surgeons and Boost Teams for mid-career surgeons. The Launch Teams consist of 5-7 members meeting as a group 4 to 6 times yearly for 3 years. Members are selected jointly by the mentee and a member of the departmental leadership and include a clinical mentor, research mentors (if applicable), one or more external mentors and other members with specific research, administrative, educational, or leadership positions. Mid-career surgeons can elect to join a Boost Team after promotion or making a mid-career institutional transition. The team consists of a larger number of members outside the department or institution than Launch Teams. This team also meets every other month and the goal is to establish a leadership phenotype and long-term goals.
AHRQ-funded; HS026030.
Citation: Dossett LA, Waljee JF, Dimick JB .
Ensuring equal access to mentorship and sponsorship for surgeons through structured team-based mentoring.
Ann Surg 2020 Dec;272(6):939-40. doi: 10.1097/sla.0000000000004500..
Keywords: Provider: Physician, Provider, Surgery
Militello LG, Hurley RW, Cook RL
Primary care clinicians' beliefs and strategies for managing chronic pain in an era of a national opioid epidemic.
Investigators sought a better understanding of primary care clinicians’ approaches to managing patients with chronic pain and explored implications for technological and administrative interventions. They found that primary care clinicians’ beliefs about opioid therapy generally align with the clinical evidence but may have some important gaps, suggesting the potential value of interventions that include improved access to research findings, organizational changes to support spending time with patients to develop rapport, and the need for innovative clinical cognitive support.
AHRQ-funded; HS023306.
Citation: Militello LG, Hurley RW, Cook RL .
Primary care clinicians' beliefs and strategies for managing chronic pain in an era of a national opioid epidemic.
J Gen Intern Med 2020 Dec;35(12):3542-48. doi: 10.1007/s11606-020-06178-2..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Provider: Physician, Provider: Clinician, Provider, Care Management
Benson NM, Myong C, Newhouse JP
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Using 2013 Massachusetts licensing data and the All-Payer Claims Database, researchers performed a cross-sectional analysis of licensed psychiatrists in Massachusetts to examine the extent of participation in private insurance. They found that, among Massachusetts psychiatrists, participation in the private insurance market appeared to be limited. Older psychiatrists were more likely to participate, and patients' access to psychiatrists who accept insurance could worsen as these psychiatrists retire.
AHRQ-funded; HS024725.
Citation: Benson NM, Myong C, Newhouse JP .
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Psychiatr Serv 2020 Dec;71(12):1232-38. doi: 10.1176/appi.ps.202000022..
Keywords: Health Insurance, Behavioral Health, Access to Care, Provider: Physician, Provider
Ehlers AP, Vitous CA, Sales A
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
Investigators explored factors associated with surgeon choice of approach (minimally invasive vs open) in inguinal hernia repair as a tool to gain an understanding of guideline-discordant care. They found that decision-making for the approach to inguinal hernia repair was largely influenced by surgeon preference and access to resources rather than patient factors. Although a one-size-fits-all approach is not recommended, the operative approach should ideally be informed by patient factors, including hernia characteristics. They recommended addressing surgeon preference and available resources with a clinician-facing decision aid to provide an opportunity to optimize care for patients undergoing inguinal hernia repair.
AHRQ-funded; HS025778.
Citation: Ehlers AP, Vitous CA, Sales A .
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
JAMA Netw Open 2020 Nov 2;3(11):e2023684. doi: 10.1001/jamanetworkopen.2020.23684..
Keywords: Surgery, Guidelines, Provider: Physician, Provider, Shared Decision Making, Evidence-Based Practice
Lim H, Raffel KE, Harrison JD
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
An educational intervention was created for medical residents during night float rotations where they admit patients to the hospital. The intervention was designed to provide feedback on their diagnostic and management reasoning using feedback solicitation and chart review. Second- and third-year internal medicine residents on a 1-month night float rotation were recruited. Residents performed chart review of a subset of patients they admitted and completed reflection worksheets detailing patients’ clinical courses. Sixty-eight of 82 eligible residents participated in the intervention. The authors evaluated 248 reflection worksheets using content analysis. Major themes that emerged from chart review included residents’ identification of reasoning gaps and evaluation of resident-provider interactions.
AHRQ-funded; HS026383.
Citation: Lim H, Raffel KE, Harrison JD .
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
J Gen Intern Med 2020 Nov;35(11):3363-67. doi: 10.1007/s11606-020-05913-z..
Keywords: Provider: Physician, Provider, Education: Continuing Medical Education, Shared Decision Making
Smith JG, Rogowski JA, Lake ET
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes. The purpose of this study was to determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses.
AHRQ-funded; HS024918.
Citation: Smith JG, Rogowski JA, Lake ET .
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
J Nurs Manag 2020 Nov;28(8):1940-47. doi: 10.1111/jonm.12943..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Provider: Nurse, Provider, Burnout, Nursing
Kapoor N, Lacson R, Hammer M
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
This survey of physicians was used to determine agreement with recommendations in the national guideline for the management of incidental pulmonary nodules from the 2017 Fleischner Society Guidelines for Management of Incident Pulmonary Nodules (FSG). The FSG contains 18 unique recommendations which were codified into a clinical evidence logic statement (CELS) for this study. The FSG also included ratings for strength of evidence based on the American Society of Chest Physicians grading system. In order to internally grade the strength of evidence behind each recommendation, two medical librarians from the Harvard Library of Evidence analyzed each CELS independently and graded the recommendations based on the supporting clinical studies using the Oxford Centre for Evidence-Based levels of evidence and the US Preventive Service Task Force I-scores. Nine physicians from a single large academic institution were then surveyed via SurveyMonkey to assess agreement with each of the 18 CELS. Agreement on each recommendation ranged from 0 to 100%. This study was meant to be exploratory and to test the hypothesis that guideline nonadherence may be partly affected by lack of physician agreement with guideline component recommendations.
AHRQ-funded; HS024722.
Citation: Kapoor N, Lacson R, Hammer M .
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
J Am Coll Radiol 2020 Nov;17(11):1437-42. doi: 10.1016/j.jacr.2020.07.020..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Respiratory Conditions, Practice Patterns, Provider: Physician, Provider
Yansane A, Lee JH, Hebballi N
Assessing the patient safety culture in dentistry.
Medical errors are among the leading causes of death within the United States. Studies have shown that patients can be harmed while receiving care, sometimes resulting in permanent injury or, in extreme cases, death. To reduce the risk of patient safety incidents, it is imperative that a robust culture of safety be established. The primary objective of this study was to evaluate the patient safety culture among providers at 4 US dental institutions, comparing the results with their medical counterparts in 2016.
AHRQ-funded; HS024406.
Citation: Yansane A, Lee JH, Hebballi N .
Assessing the patient safety culture in dentistry.
JDR Clin Trans Res 2020 Oct;5(4):399-408. doi: 10.1177/2380084419897614..
Keywords: Surveys on Patient Safety Culture, Patient Safety, Dental and Oral Health, Provider, Medical Errors, Adverse Events
Alley L, Novak K, Havlin T
Development and pilot of a prescription drug monitoring program and communication intervention for pharmacists
The authors developed the Resources Encouraging Safe Prescription Opioid and Naloxone Dispensing (RESPOND) Toolkit to enhance community pharmacists' understanding of their role in addressing opioid safety; to improve integration of prescription drug monitoring program (PDMP) into daily workflow; and to enhance communication between pharmacists, prescribers, and patients. In this paper, they described the development of the RESPOND Toolkit and summarized their findings from initial pilot testing. They concluded that the RESPOND Toolkit has promise as an effective and scalable approach to providing community pharmacist-tailored training to promote behavioral shifts supporting opioid safety for patients.
AHRQ-funded; HS024227.
Citation: Alley L, Novak K, Havlin T .
Development and pilot of a prescription drug monitoring program and communication intervention for pharmacists
Res Social Adm Pharm 2020 Oct;16(10):1422-30. doi: 10.1016/j.sapharm.2019.12.023..
Keywords: Opioids, Substance Abuse, Medication, Medication: Safety, Patient Safety, Tools & Toolkits, Communication, Provider: Pharmacist, Provider, Training
Shubeck SP, Newman EA, Vitous CA
Hiring practices of US academic surgery departments-challenges and opportunities for more inclusive hiring.
To increase workforce diversity among academic medical centers, the Association of American Medical Colleges recommends multiple inclusive strategies for evaluating and hiring candidates. The objective of this study was to determine (1) usual and inclusive hiring practices used among academic surgery departments and (2) the barriers to utilization of inclusive hiring practices. The investigators concluded that many chairs rely heavily on internal hires or trusted networks, which may limit both demographic and cognitive diversity.
AHRQ-funded; HS026030.
Citation: Shubeck SP, Newman EA, Vitous CA .
Hiring practices of US academic surgery departments-challenges and opportunities for more inclusive hiring.
J Surg Res 2020 Oct;254:23-30. doi: 10.1016/j.jss.2020.03.054..
Keywords: Surgery, Provider: Physician, Provider, Workforce, Hospitals
Ellis RJ, Yuce TK, Hewitt DB
National evaluation of patient preferences in selecting hospitals and health care providers.
This study examined patient views of public databases for hospital quality. Interviews and focus groups were conducted at local outpatient clinics as well as a national administered survey on an anonymous digital platform. A 42% response rate was received (4672 responses). Measures patients considered most important were hospital reputation, physician experience, and primary care recommendations. Unimportant factors included guideline adherence, hospital academic affiliation, and morbidity and mortality outcome measures. This was true irrespective of age, sex, education status, or income of the respondent.
AHRQ-funded; HS023011; HS026385; HS021857; HS000078.
Citation: Ellis RJ, Yuce TK, Hewitt DB .
National evaluation of patient preferences in selecting hospitals and health care providers.
Med Care 2020 Oct;58(10):867-73. doi: 10.1097/mlr.0000000000001374..
Keywords: Hospitals, Quality of Care, Provider
Varban OA, Thumma JR, Carlin AM
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. In this article, the investigators described their study in which the review of de-identified videos of practicing bariatric surgeons was conducted by a minimum of 10 peer surgeons. The videos were assessed on the technical quality of 9 operative maneuvers (ie mobilization of the fundus, stapler location, and sleeve width).
AHRQ-funded; HS017765.
Citation: Varban OA, Thumma JR, Carlin AM .
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
J Am Coll Surg 2020 Oct;231(4):470-77. doi: 10.1016/j.jamcollsurg.2020.06.016..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Provider: Physician, Provider
Donovan E, Bratberg J, Baird J
Pharmacy leaders' beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community.
The objective of this qualitative study was to understand how leaders in pharmacy organizations perceive pharmacies and pharmacy staff can optimize dispensing of naloxone. Five main themes emerged: importance of staff training to increase comfort; strength through coordination of efforts; pharmacies acting as community leaders in the opioid crisis; persisting stigma; ongoing workflow challenges. These results uniquely reflect the experiences and insights of pharmacy leaders implementing public health initiatives during the opioid crisis and can be used for gaining insight into how pharmacists can efficiently provide naloxone to their communities.
AHRQ-funded; HS024021.
Citation: Donovan E, Bratberg J, Baird J .
Pharmacy leaders' beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community.
Res Social Adm Pharm 2020 Oct;16(10):1493-97. doi: 10.1016/j.sapharm.2020.01.006..
Keywords: Provider: Pharmacist, Provider, Community-Based Practice, Opioids, Medication, Substance Abuse
Fraze TK, Briggs ADM, Whitcomb EK
Role of nurse practitioners in caring for patients with complex health needs.
The objective of this study was to estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012 to 2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse practitioners varies by practice characteristics. Findings showed that nurse practitioners are caring for Medicare beneficiaries with complex needs at rates that match or exceed their physician colleagues. The growing role of nurse practitioners, especially in health care systems, warrants attention as organizations embark on payment and delivery reform.
AHRQ-funded; HS024075.
Citation: Fraze TK, Briggs ADM, Whitcomb EK .
Role of nurse practitioners in caring for patients with complex health needs.
Med Care 2020 Oct;58(10):853-60. doi: 10.1097/mlr.0000000000001364..
Keywords: Provider: Clinician, Provider: Nurse, Provider, Chronic Conditions, Primary Care, Medicare
Jones AE, King JB, Kim K
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
The objective of this study was to describe direct oral anticoagulant (DOAC) management in patients who were and were not managed by an anticoagulation management service (AMS). Subjects were patients with atrial fibrillation at the University of Utah Health (UUH) who received DOAC therapy. Results showed that patients managed by AMS providers were more complex and had more frequent encounters regarding their DOAC therapy than those managed by non-AMS providers. However, there was evidence of duplicative DOAC therapy management efforts. No difference between AMS and non-AMS groups in the composite clinical endpoint was detected.
AHRQ-funded; HS026156.
Citation: Jones AE, King JB, Kim K .
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
J Thromb Thrombolysis 2020 Oct;50(3):739-45. doi: 10.1007/s11239-020-02064-0..
Keywords: Blood Thinners, Medication, Provider: Pharmacist, Provider, Care Management, Healthcare Delivery
Temkin-Greener H, Cen X, Li Y
Nursing home staff turnover and perceived patient safety culture: results from a national survey.
In this study, the investigators examined the association between turnover of registered nurses (RNs) and certified nurse assistants (CNAs) and perceived patient safety culture (PSC) in nursing homes (NHs). The investigators suggest that the effect of turnover on PSC depends on who leaves and to a lesser extent on the organizational characteristics. In NHs, improvements in PSC may depend on the ability to retain a well-trained and skilled nursing staff.
AHRQ-funded; HS024923.
Citation: Temkin-Greener H, Cen X, Li Y .
Nursing home staff turnover and perceived patient safety culture: results from a national survey.
Gerontologist 2020 Sep 15;60(7):1303-11. doi: 10.1093/geront/gnaa015..
Keywords: Nursing Homes, Long-Term Care, Surveys on Patient Safety Culture, Patient Safety, Provider: Nurse, Provider
Vitous CA, Jafri SM, Seven C
Exploration of surgeon motivations in management of abdominal wall hernias: a qualitative study.
Although evidence-based guidelines designed to minimize health care variation and promote effective care are widely accepted, creating guidelines alone does not often lead to the desired practice change. Such knowledge-to-practice gaps are well-recognized in the management of patients with abdominal wall hernia. The purpose of this study was to evaluate the systematic application of the Theoretical Domains Framework (TDF) to explore motivations and behaviors associated with surgical decision-making in abdominal wall hernia practice to help inform the future design of theory-based interventions for desired practice and behavior change.
AHRQ-funded; HS025778.
Citation: Vitous CA, Jafri SM, Seven C .
Exploration of surgeon motivations in management of abdominal wall hernias: a qualitative study.
JAMA Netw Open 2020 Sep;3(9):e2015916. doi: 10.1001/jamanetworkopen.2020.15916..
Keywords: Surgery, Digestive Disease and Health, Provider: Physician, Provider
Lozada MJ, Raji MA, Goodwin JS
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
The purpose of this study was to identify prescription opioid over-prescribers by comparing prescribing patterns of primary care physicians (MDs), nurse practitioners (NPs), and physician assistants (PAs). Participants were a national sample of 2015 Medicare Part D enrollees. Findings showed that most NPs/PAs prescribed opioids in a pattern similar to MDs, but NPs/PAs had more outliers who prescribed high-frequency, high-dose opioids than did MDs. Recommendations included efforts to reduce opioid overprescribing including targeted provider education, risk stratification, and state legislation.
AHRQ-funded; HS020642.
Citation: Lozada MJ, Raji MA, Goodwin JS .
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
J Gen Intern Med 2020 Sep;35(9):2584-92. doi: 10.1007/s11606-020-05823-0..
Keywords: Opioids, Medication, Primary Care, Practice Patterns, Medication: Safety, Provider: Nurse, Provider: Physician, Provider: Physician Assistant, Provider
Blackley SV, Schubert VD, Goss FR
Physician use of speech recognition versus typing in clinical documentation: a controlled observational study.
Researchers studied the usability and quality of documentation with speech recognition (SR) versus typing; participants were ten physicians at Brigham and Women's Hospital, Boston, who had used SR for at least six months. The researchers found that participants felt that SR saved them time, increased their efficiency, and allowed them to quickly document more relevant details. Quality analysis supported the perception that SR allowed for more detailed notes, but whether dictation was objectively faster than typing remains unclear, and participants described some scenarios where typing was still preferred. They concluded that dictation can be effective for creating comprehensive documentation, especially when physicians like and feel comfortable using SR.
AHRQ-funded; HS024264.
Citation: Blackley SV, Schubert VD, Goss FR .
Physician use of speech recognition versus typing in clinical documentation: a controlled observational study.
Int J Med Inform 2020 Sep;141:104178. doi: 10.1016/j.ijmedinf.2020.104178.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician, Provider
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider