National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (3)
- (-) Adverse Events (10)
- Blood Clots (1)
- Blood Thinners (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- (-) Evidence-Based Practice (10)
- Eye Disease and Health (1)
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- Long-Term Care (1)
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- Medication: Safety (2)
- Mortality (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (4)
- (-) Patient Safety (10)
- Pregnancy (1)
- Quality Improvement (1)
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- Registries (1)
- Risk (2)
- Surgery (2)
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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 10 of 10 Research Studies DisplayedVilla Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Dhruva SS, Ross JS, Mortazavi BJ
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
This study examines outcomes among patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock. Two interventions are compared: intravascular microaxial left ventricular assist devices (LVADs) versus intra-aortic balloon pumps (IABPs). The American College of Cardiology’s National Cardiovascular Data Registry was used to identify patients with AMI complicated by cardiogenic shock from hospitals participating in the CathPCI and Chest Pain-MI registries and identified 28,304 patients. Over the study period (2015 to 2017), LVAD was used in 6.2% of patients and IABP in 29.9%. LVAD was shown to have higher rates of in-hospital death and major bleeding complications compared to IABP.
AHRQ-funded; HS022882; HS025402; HS025517; HS026379.
Citation: Dhruva SS, Ross JS, Mortazavi BJ .
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
JAMA 2020 Feb 25;323(8):734-45. doi: 10.1001/jama.2020.0254..
Keywords: Medical Devices, Heart Disease and Health, Cardiovascular Conditions, Mortality, Adverse Events, Registries, Patient Safety, Patient-Centered Outcomes Research, Evidence-Based Practice
Goswami E, Ogden RK, Bennett WE
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
This paper describes an initiative to develop an evidence-based list of nephrotoxic medications to screen for acute kidney injury (AKI) risk in hospitalized children. This initiative, called the Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative, convened a Nephrotoxic Medication (NTMx) Subcommittee composed of pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists, conducted a literature review of the disputed medications, and assigned an evidence grade based on the association between nephrotoxicity and the quality of the data. The subcommittee then came to a majority consensus to which medications should be included on the list. The list was presented to the larger collaborative and voted on. This list will be continually updated and voted on annually.
AHRQ-funded; HS023763.
Citation: Goswami E, Ogden RK, Bennett WE .
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
Am J Health Syst Pharm 2019 Oct 30;76(22):1869-74. doi: 10.1093/ajhp/zxz203..
Keywords: Children/Adolescents, Medication: Safety, Medication, Patient Safety, Risk, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events
Mixon AS, Kripalani S, Stein J
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
This paper examined evidence-based interventions implemented in five US hospitals to improve inpatient medication reconciliation. The sites implemented one to seven interventions in 791 patients during a 25-month implementation period. Three interventions were associated with significant decreases in potentially harmful reconciliation rates while two interventions were associated with significant increases. The positive interventions included: defining clinical roles and responsibilities, training, and hiring staff to perform discharge medication reconciliation. The negative interventions were training staff to take medication histories and implementing a new electronic health record (EHR) system.
AHRQ-funded; HS019598.
Citation: Mixon AS, Kripalani S, Stein J .
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
J Hosp Med 2019 Oct;14(10):614-17. doi: 10.12788/jhm.3308..
Keywords: Medication, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Hospitals, Healthcare Delivery, Inpatient Care
Balk EM, Adam GP, Corsi K
Adverse events associated with nonsurgical treatments for urinary incontinence in women: a systematic review.
Investigators systematically reviewed nonsurgical interventions for urgency, stress, or mixed urinary incontinence (UI) in women, focusing on adverse events (AEs). They found that behavioral therapies and neuromodulation have a low risk of adverse events, while anticholinergics and alpha agonists have high rates of dry mouth and constitutional effects. Further, onabotulinum toxin A (BTX) is associated with UTIs and voiding dysfunction, and periurethral bulking agents are associated with erosion and voiding dysfunction. They concluded that these AEs should be considered when selecting appropriate UI treatment options, noting that AE reporting is inconsistent and that AE rates across studies tended to vary widely.
AHRQ-funded; 290201500002.
Citation: Balk EM, Adam GP, Corsi K .
Adverse events associated with nonsurgical treatments for urinary incontinence in women: a systematic review.
J Gen Intern Med 2019 Aug;34(8):1615-25. doi: 10.1007/s11606-019-05028-0.
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Keywords: Adverse Events, Patient Safety, Women, Evidence-Based Practice, Patient-Centered Outcomes Research
Nanji KC, Roberto SA, Morley MG
Preventing adverse events in cataract surgery: recommendations from a Massachusetts expert panel.
The purpose of this article is to identify contributing factors to the adverse events (AEs) reported in Massachusetts and present the panel's recommended strategies to prevent them. The panel identified 2 principal categories of contributing factors to the state's cataract surgery-related AEs: systems failures and choice of anesthesia technique. The panel recommended several strategies to prevent AEs during cataract surgery, including performing a distinct time-out with at least 2 care-team members before block administration.
AHRQ-funded; HS024764.
Citation: Nanji KC, Roberto SA, Morley MG .
Preventing adverse events in cataract surgery: recommendations from a Massachusetts expert panel.
Anesth Analg 2018 May;126(5):1537-47. doi: 10.1213/ane.0000000000002529.
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Keywords: Adverse Events, Evidence-Based Practice, Eye Disease and Health, Patient Safety, Surgery
Chang SH, Freeman NLB, Lee JA
Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis.
This systematic review and meta-analysis assesses <30-d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. The review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre-surgery body mass index of 46.5 kg m(-2).
AHRQ-funded; HS022330.
Citation: Chang SH, Freeman NLB, Lee JA .
Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis.
Obes Rev 2018 Apr;19(4):529-37. doi: 10.1111/obr.12647..
Keywords: Adverse Events, Evidence-Based Practice, Obesity, Patient Safety, Surgery
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Simmons SF, Schnelle JF, Sathe NA
Defining safety in the nursing home setting: Implications for future research.
AHRQ’s Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them.
AHRQ-funded; 290201500003I.
Citation: Simmons SF, Schnelle JF, Sathe NA .
Defining safety in the nursing home setting: Implications for future research.
J Am Med Dir Assoc 2016 Jun;17(6):473-81. doi: 10.1016/j.jamda.2016.03.005..
Keywords: Nursing Homes, Long-Term Care, Adverse Events, Patient Safety, Evidence-Based Practice
Fallouh N, McGuirk HM, Flanders SA
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
To better guide clinicians, the researchers performed a comprehensive literature review to summarize best practices for peripherally inserted central catheter-related deep vein thrombosis (PICC-DVT). They concluded that centrally positioned, otherwise functional and clinically necessary PICCs need not be removed despite concomitant DVT. Anticoagulation with low-molecular-weight heparin or warfarin for at least 3 months represents the mainstay of treatment.
AHRQ-funded; HS022835.
Citation: Fallouh N, McGuirk HM, Flanders SA .
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
Am J Med 2015 Jul;128(7):722-38. doi: 10.1016/j.amjmed.2015.01.027..
Keywords: Adverse Events, Blood Clots, Evidence-Based Practice, Patient Safety