National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Behavioral Health (6)
- Comparative Effectiveness (1)
- (-) Depression (6)
- Elderly (2)
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- Sex Factors (1)
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- Women (1)
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 6 of 6 Research Studies DisplayedGuglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Baik D, Liu J, Cho H
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
Investigators conducted a secondary analysis of data collected from four projects focused on improving health outcomes in persons living with HIV (PLWH). They found that male patients displayed negative association between depression and engagement with healthcare providers and positive association between engagement with healthcare providers and medication adherence, while female patients showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. They concluded that adherence interventions for PLWH should be tailored by biological sex.
AHRQ-funded; HS025071.
Citation: Baik D, Liu J, Cho H .
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
AIDS Behav 2020 Sep;24(9):2656-65. doi: 10.1007/s10461-020-02823-3..
Keywords: Human Immunodeficiency Virus (HIV), Sex Factors, Patient and Family Engagement, Patient Adherence/Compliance, Depression, Behavioral Health, Medication
Davoudian PA, Wilkinson ST
Clinical overview of NMDA-R antagonists and clinical practice.
This study examines the promise of new therapies for treatment of depression, which is only treatable about half the time with medication. Recent research has found that therapies that target the glutamatergic system, especially NMDA receptor antagonists have shown efficacy in several clinical trials. The authors specifically discuss treatment using ketamine as well as other newer compounds that have also shown recent promise in clinical trials.
AHRQ-funded; HS023000.
Citation: Davoudian PA, Wilkinson ST .
Clinical overview of NMDA-R antagonists and clinical practice.
Adv Pharmacol 2020;89:103-29. doi: 10.1016/bs.apha.2020.04.004..
Keywords: Medication, Depression, Behavioral Health, Treatments
Chatterjee S, Bali V, Carnahan RM
Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression.
This study evaluated whether elderly nursing home residents with mild depression and intact cognition experienced cognitive impairment after using anticholinergic drugs. The study was a population-based nested case-control study using Minimum Data Set (MDS)-linked Medicare data where the base cohort were patients 65 years and older with depression who had intact cognition. Cumulative anticholinergic burden was measured within 30, 60, and 90 days preceding the event (cognitive measurement) date using the Anticholinergic Drug Scale (ADS). The end sample compared 3707 cases with mild-to-moderate cognition to 3707 matched controls with intact cognition. There was no association with cumulative anticholinergic exposure at 30 days with cognitive impairment, but the odds of cognitive impairment increased with exposure 60 and 90 days before the event date. This study concludes there should be concern in using anticholinergic drugs for longer than 30 days with elderly nursing home residents.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression.
Res Social Adm Pharm 2020 Mar;16(3):329-35. doi: 10.1016/j.sapharm.2019.05.020..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Medication, Neurological Disorders, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice
Ruaño Ruaño, Robinson S, Holford T
Results of the CYP-GUIDES randomized controlled trial: total cohort and primary endpoints.
CYP-GUIDES (Cytochrome Psychotropic Genotyping Under Investigation for Decision Support) was a randomized controlled trial (RCT) comparing 2 outcomes in hospitalized patients with major depressive disorder (MDD) treated according to the patient's CYP2D6 genotype and functional status versus standard psychotropic therapy. This paper describes the results of that study. The primary outcome was hospital Length of Stay (LOS) and the secondary outcome was the Re-Admission Rate (RAR) 30 days after discharge.
AHRQ-funded; HS022304.
Citation: Ruaño Ruaño, Robinson S, Holford T .
Results of the CYP-GUIDES randomized controlled trial: total cohort and primary endpoints.
Contemp Clin Trials 2020 Feb;89:105910. doi: 10.1016/j.cct.2019.105910..
Keywords: Depression, Behavioral Health, Genetics, Medication