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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
26 to 50 of 209 Research Studies DisplayedChen C, Winterstein AG, Lo-Ciganic WH
Concurrent use of prescription gabapentinoids with opioids and risk for fall-related injury among older US Medicare beneficiaries with chronic noncancer pain: a population-based cohort study.
This study compared the risk of fall-related injury in two cohorts who used gabapentinoids concurrently with opioid use and those who used opioids only. The authors created 2 cohorts based on whether concurrent users initiated gabapentinoids on the day of opioid initiation (Cohort 1) or after opioid initiation (Cohort 2). Both cohorts were identified from a sample of older Medicare beneficiaries with chronic non-cancer pain (CNCP). Four concurrent users were matched up with 1 opioid-only user. They identified 6,733 concurrent users and 27,092 matched opioid-only users in Cohort 1 and 5,709 concurrent users and 22,388 matched opioid-only users in Cohort 2. Cohort 1’s incidence rate of fall-related injury was 24.5 per 100 person-users during follow-up and was 18.0 per 100-person-years during follow-up for Cohort 2. Concurrent users had had similar risk of fall-related injury as opioid-only users in Cohort 1 but had higher risk for fall-related injury than opioid-only users in Cohort 2.
AHRQ-funded; HS027230.
Citation: Chen C, Winterstein AG, Lo-Ciganic WH .
Concurrent use of prescription gabapentinoids with opioids and risk for fall-related injury among older US Medicare beneficiaries with chronic noncancer pain: a population-based cohort study.
PLoS Med 2022 Mar;19(3):e1003921. doi: 10.1371/journal.pmed.1003921..
Keywords: Elderly, Opioids, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Falls, Patient Safety, Injuries and Wounds, Pain, Chronic Conditions
Encinosa W, Bernard D, Selden TM
AHRQ Author: Encinosa W, Bernard D, Selden TM
Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.
This study examined opioid and non-opioid prescribing before and after the issuing of CDC’s 2016 opioid guideline. The authors developed a theory of physician prescribing behavior under the CDC’s two-pronged incentive structure. They used MEPS survey data to empirically corroborate the theory that the regulations and guidelines have the intended effects of reducing opioid prescriptions for acute and chronic pain, as well as the predicted unintended effects-income effects cause regulations on acute pain treatment to increase chronic pain opioid prescriptions and the chronic pain treatment guidelines spillover to reduce opioids for acute pain. They also found that the guidelines work as intended in terms of the reduced usage, with chronic pain patients shifting to non-opioids and tapering off opioid doses.
AHRQ-authored.
Citation: Encinosa W, Bernard D, Selden TM .
Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.
Int J Health Econ Manag 2022 Mar;22(1):1-52. doi: 10.1007/s10754-021-09307-4..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Practice Patterns, Medication, Pain, Chronic Conditions
Wei YJ, Chen C, Lewis MO
Trajectories of prescription opioid dose and risk of opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
This study used a sample of older patients who are Medicare beneficiaries who were newly prescribed opioids to determine rates of 4 prescription opioid dose trajectories and the risk of opioid-related adverse events (ORAEs). A 5% random sample of Medicare beneficiaries from 2011 to 2018 was used to conduct a nested case-control study of patients age 65 and older who were newly diagnosed with chronic noncancer pain (CNCP). Among the cases and controls, 2,192 (70.6%) were women and mean age was 77.1 years. Four prescribed opioid trajectories before the incident ORAE diagnosis or matched date emerged: gradual dose discontinuation (from ≤3 to 0 daily morphine milligram equivalent (MME), 1,456 [23.5%]), gradual dose increase (from 0 to >3 daily MME, 1,878 [30.3%]), consistent low dose (between 3 and 5 daily MME, 1,510 [24.3%]), and consistent moderate dose (>20 daily MME, 1,362 [22.0%]). Less than 5% were prescribed a mean daily dose of ≥90 daily MME during 6 months before diagnosis or matched date. Patients with gradual dose discontinuation versus those with a consistent low or moderate dose, and increase dose were more likely to be 65 to 74 years, Midwest US residents, and receiving no low-income subsidy. Those with gradual dose increase and consistent moderate dose had a higher risk of ORAE, after adjustment for covariates.
AHRQ-funded; HS027230.
Citation: Wei YJ, Chen C, Lewis MO .
Trajectories of prescription opioid dose and risk of opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
PLoS Med 2022 Mar;19(3):e1003947. doi: 10.1371/journal.pmed.1003947..
Keywords: Elderly, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Chronic Conditions, Pain, Substance Abuse, Behavioral Health, Medication: Safety, Patient Safety
Meisel ZF, Shofer F, Dolan A
AHRQ Author: Rhodes KV
A multicentered randomized controlled trial comparing the effectiveness of pain treatment communication tools in emergency department patients with back or kidney stone pain.
The purpose of this trial was to compare the effectiveness of three approaches for communicating opioid risk during an emergency department visit for a common painful condition. Participants were adult patients with kidney stone or musculoskeletal back pain, randomly assigned to one of three risk communication strategies: a personalized probabilistic risk visual aid, a visual aid and video narrative, or general risk information. Findings showed that an emergency medicine communication tool incorporating probabilistic risk and patient narratives was more effective than general information in mitigating preferences for opioids in the treatment of pain but was not more effective with respect to opioid use or risk recall.
AHRQ-authored.
Citation: Meisel ZF, Shofer F, Dolan A .
A multicentered randomized controlled trial comparing the effectiveness of pain treatment communication tools in emergency department patients with back or kidney stone pain.
Am J Public Health 2022 Feb;112(S1):S45-s55. doi: 10.2105/ajph.2021.306511..
Keywords: Pain, Emergency Department, Education: Patient and Caregiver, Opioids, Comparative Effectiveness, Clinician-Patient Communication, Communication
Joseph JM, Gori D, Curtin C
Gaps in standardized postoperative pain management quality measures: a systematic review.
Poor pain control in patients can lead to chronic pain, chronic opiate use or addiction, and patient suffering, making postoperative pain an important clinical issue. The researchers state that it is unclear whether measures for managing pain after surgery exist, warranting the study goal of assessment of the availability of postoperative pain management quality measures, including National Quality Forum-endorsed measures. In November 2019, the researchers conducted a systematic literature review using the National Quality Forum Quality Positioning System, the Agency for Healthcare Research and Quality Indicators, and the Centers for Medicare and Medicaid Services Measures Inventory Tool databases, to identify quality measures for the period between March 11, 2015, and March 11, 2020. The review identified 19 pain management quality measures, 5 of which were endorsed by the National Quality Forum. Three of the non-endorsed measures were specific to postoperative pain, with none of the endorsed measures specific to post-operative pain. The study concluded that there is a need for published, endorsed, rigorous postoperative pain quality measures.
AHRQ-funded; HS024096; HS027434.
Citation: Joseph JM, Gori D, Curtin C .
Gaps in standardized postoperative pain management quality measures: a systematic review.
Surgery 2022 Feb;171(2):453-58. doi: 10.1016/j.surg.2021.08.004..
Keywords: Pain, Surgery, Quality Measures, Quality of Care, Practice Patterns
Hobson JM, Gilstrap SR, Owens MA
Intersectional HIV and chronic pain stigma: implications for mood, sleep, and pain severity.
This study discusses chronic pain stigma in persons with HIV (PWH) and the consequences for mental and physical health which can lead to poor chronic pain outcome. This cross-sectional study enrolled 91 PWH and chronic pain patients, with six participants disqualified. Participants provided blood to determine CD 4+ count and viral load. They also completed standardized self-report questionnaires that assessed their experiences of HIV and chronic pain stigma, as well as depressive symptoms, experiences of insomnia, and pain severity. Measures used in the questionnaires included the HIV Stigma Mechanisms Scale, the Internalized Stigma of Chronic Pain scale, the Center for Epidemiologic Studies Depression (CED-S) Scale, the Insomnia Severity Index (ISI), and the Brief Pain Inventory Short-Form (BFI-SF). Participants were also questioned on opioid use. Results showed that for intersectional HIV and chronic pain stigma, 38% of participants were categorized as “high”, 28% were categorized as “moderate”, and 34% were categorized as “low”.
AHRQ-funded; HS013852.
Citation: Hobson JM, Gilstrap SR, Owens MA .
Intersectional HIV and chronic pain stigma: implications for mood, sleep, and pain severity.
J Int Assoc Provid AIDS Care 2022 Jan-Dec;21:23259582221077941. doi: 10.1177/23259582221077941..
Keywords: Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions, Social Stigma, Depression
Marcus KL, Kao PC, Ma C
Symptoms and suffering at end of life for children with complex chronic conditions.
The objective of this study was to evaluate symptoms and suffering at end of life for children with noncancer, noncardiac complex chronic conditions (CCCs), as well as parental distress related to their child’s suffering. Nearly one-third of bereaved parents of children with CCCs who completed the survey reported high suffering in their child's final days of life. Parental preparedness was associated with lower perceived suffering. The authors concluded that future research should target symptoms contributing to parent and child distress and assess whether enhancing parent preparedness reduces perceived child suffering.
AHRQ-funded; HS022986.
Citation: Marcus KL, Kao PC, Ma C .
Symptoms and suffering at end of life for children with complex chronic conditions.
J Pain Symptom Manage 2022 Jan; 63(1):88-97. doi: 10.1016/j.jpainsymman.2021.07.010..
Keywords: Children/Adolescents, Chronic Conditions, Palliative Care, Pain
White AEC, Hood-Medland EA, Kravitz RL
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
Physicians and patients report frustration after primary care visits for chronic pain. The need to shift between multiple clinical topics to address competing demands during visits may contribute to this frustration. This study created a novel measure, "visit linearity," to assess visit organization and examined whether visits that required less shifting back and forth between topics were associated with better patient and physician visit experiences.
AHRQ-funded; HS022236.
Citation: White AEC, Hood-Medland EA, Kravitz RL .
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
J Gen Intern Med 2022 Jan;37(1):78-86. doi: 10.1007/s11606-021-06917-z..
Keywords: Opioids, Pain, Chronic Conditions, Primary Care, Medication
Agbalajobi OM, Gmelin T, Moon AM
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
This retrospective cohort study investigated opioid prescribing patterns among patients with chronic liver disease (CLD) at a single medical center. These patients (12,425) were followed for one year from October 2015 to September 2016. Nearly half (47%) were prescribed opioids over a one-year period, with 17% receiving high-risk prescriptions. Characteristics associated with high-risk opioid prescriptions included female gender, Medicaid insurance, cirrhosis and baseline chronic pain, depression, anxiety, substance use disorder, and Charlson comorbidity score. Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions.
AHRQ-funded; HS019461.
Citation: Agbalajobi OM, Gmelin T, Moon AM .
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
PLoS One 2021 Dec 17;16(12):e0261377. doi: 10.1371/journal.pone.0261377..
Keywords: Opioids, Medication, Practice Patterns, Pain, Chronic Conditions
Rumble DD, O'Neal K, Overstreet DS
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
This study compared associations between neighborhood-level socioeconomic status (SES), pain-status (chronic low back pain vs. pain-free), and daily sleep metrics in 117 adults. With neighborhood-level SES gathered from Neighborhood Atlas, and with individuals completing home sleep monitoring for 7 consecutive days/nights, analyses revealed neighborhood-level SES and neighborhood-level SES pain-status interaction significantly impacted objective sleep quality.
AHRQ-funded; HS013852.
Citation: Rumble DD, O'Neal K, Overstreet DS .
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
J Behav Med 2021 Dec;44(6):811-21. doi: 10.1007/s10865-021-00234-w..
Keywords: Sleep Problems, Back Health and Pain, Chronic Conditions, Pain
Cerda M, Wheeler-Martin K, Bruzelius E
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
The authors investigated the impact of pain management clinic laws. They analyzed data on county-level, opioid overdose deaths via the National Vital Statistics System and patients filling long-duration or high-dose opioid prescriptions in the US 2010-2018. Their findings suggested that laws with criminal penalties were associated with intended reductions in high-risk opioid prescribing and some opioid overdoses but raised concerns regarding unintended consequences on heroin/synthetic overdoses.
AHRQ-funded; HS023258.
Citation: Cerda M, Wheeler-Martin K, Bruzelius E .
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
Am J Epidemiol 2021 Dec;190(12):2592-603. doi: 10.1093/aje/kwab192..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Practice Patterns, Policy
Schirle L, Jeffery A, Yaqoob A
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Although electronic health records (EHR) have significant potential for the study of opioid use disorders (OUD), detecting OUD in clinical data is challenging. Models using EHR data to predict OUD often rely on case/control classifications focused on extreme opioid use. IN this study, the investigators discussed two data-driven approaches to identifying the spectrum of problematic opioid use. The investigators concluded that risk scores comprising comorbidities and text offer differing but synergistic insights into characterizing problematic opioid use.
AHRQ-funded; HS026395.
Citation: Schirle L, Jeffery A, Yaqoob A .
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Int J Med Inform 2021 Dec;156:104621. doi: 10.1016/j.ijmedinf.2021.104621..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Health Information Technology (HIT)
Silverberg JI
Validity and reliability of a novel numeric rating scale to measure skin-pain in adults with atopic dermatitis.
Little is known about the measurement properties of numeric rating scales (NRS) for pain in AD. In this study, the investigators evaluated a novel NRS for skin-pain and existing NRS for average overall-pain in adults with AD. Self-administered questionnaires and skin-examination were performed in 463 AD patients (age 18-97 years) in a dermatology practice setting.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Validity and reliability of a novel numeric rating scale to measure skin-pain in adults with atopic dermatitis.
Arch Dermatol Res 2021 Dec;313(10):855-61. doi: 10.1007/s00403-021-02185-3..
Keywords: Skin Conditions, Pain, Quality of Life
Garrett SB, Nicosia F, Thompson N
Barriers and facilitators to older adults' use of nonpharmacologic approaches for chronic pain: a person-focused model.
This study examined the factors that influence older adults’ living with chronic pain use of nonpharmacologic approaches as complements to or substitutes for pharmacologic treatments for pain. The authors conducted 25 semistructured qualitative interviews with adults with multiple morbidities living with chronic pain for 6 months or more. Transcripts were coded to identify factors that hindered or encouraged participants’ use of various nonpharmacologic approaches. Three factors were grouped together: awareness of nonpharmacologic approaches as relevant to their pain, appeal of the approach, and access to the approach.
AHRQ-funded; HS022241.
Citation: Garrett SB, Nicosia F, Thompson N .
Barriers and facilitators to older adults' use of nonpharmacologic approaches for chronic pain: a person-focused model.
Pain 2021 Nov;162(11):2769-79. doi: 10.1097/j.pain.0000000000002260..
Keywords: Elderly, Pain, Chronic Conditions
Goyal MK, Drendel AL, Chamberlain JM
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
The purpose of this study was to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have decreased over time. Findings showed that, as provision of opioid prescriptions declined over time, previously marked racial and/or ethnic disparities in opioid
prescription rates at ED discharge decreased.
prescription rates at ED discharge decreased.
AHRQ-funded; HS020270.
Citation: Goyal MK, Drendel AL, Chamberlain JM .
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
Pediatrics 2021 Nov;148(5):e2021052481. doi: 10.1542/peds.2021-052481..
Keywords: Children/Adolescents, Opioids, Emergency Department, Racial and Ethnic Minorities, Injuries and Wounds, Pain, Medication
McKernan LC, Crofford LJ, Kim A
Electronic delivery of pain education for chronic overlapping pain conditions: a prospective cohort study.
This study’s objective was to examine the impact of educational materials for chronic overlapping pain conditions (COPCs), the feasibility of delivery materials online, and to explore its impact on self-reported self-management applications at 3-month follow-up. This prospective cohort study used individuals from a university-wide active research repository with ≥1 coded diagnostic COPC by ICD-9/10 in the medical record. The authors assessed content awareness after the participants read educational materials pre- and post-exposure to education. A total of 216 individuals were enrolled, with 181 completing both timepoints. Knowledge and understanding of COPCs increased significantly after education and were retained at three months. There was no significant change to symptoms or self-management applications over the three-month period.
AHRQ-funded; HS022990.
Citation: McKernan LC, Crofford LJ, Kim A .
Electronic delivery of pain education for chronic overlapping pain conditions: a prospective cohort study.
Pain Med 2021 Oct 8;22(10):2252-62. doi: 10.1093/pm/pnab018..
Keywords: Education: Patient and Caregiver, Pain, Health Information Technology (HIT), Chronic Conditions
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Researchers examined whether a cognitive behavioral therapy (CBT)-based program intended to increase physical activity despite chronic pain in patients with diabetes delivered by community members trained as peer coaches also improved depressive symptoms and perceived stress. They found that this peer-delivered CBT-based program improved depressive symptoms and stress in individuals with diabetes and chronic pain. They recommended training community members as a feasible strategy for offering CBT-based interventions in rural and under-resourced communities.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Ann Behav Med 2021 Oct 4;55(10):970-80. doi: 10.1093/abm/kaab034..
Keywords: Depression, Behavioral Health, Diabetes, Chronic Conditions, Treatments, Pain, Lifestyle Changes
Keenan KE, Rothberg MB, Herzig SJ
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
This study’s objective was to identify the association between opioid exposure during a medical hospitalization and opioid use 6 to 12 months later. This observational cohort study used electronic health record data from 10 hospitals in the Cleveland Clinic Health System in 2016. Eligible patients were opioid-naïve adults with pain 18 years and older. The authors estimated the odds of long-term opioid use (defined as ≥2 prescriptions for at least 30 pills 6 to 12 months posthospitalization) by opioid exposure during the hospitalization. Among the 2971 patients in the study, 64% received opioids during their hospitalization, and 28% were discharged with opioids. A total of 3% of patients had long-term use with a higher pain score associated with greater odds of long-term use.
AHRQ-funded; HS026215.
Citation: Keenan KE, Rothberg MB, Herzig SJ .
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
South Med J 2021 Oct;114(10):623-29. doi: 10.14423/smj.0000000000001307..
Keywords: Opioids, Hospitalization, Pain, Substance Abuse, Medication
Enzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Bedford T, Adediran T, Haycock NR
Patient and provider acceptability of a patient preauthorized concealed opioid reduction.
Researchers investigated patient and provider acceptance of a concealed opioid reduction for chronic pain. They conducted a cross-sectional survey with patients who are taking or have taken high dose opioids via REDcap, and with providers via a validated questionnaire. They found that patients and providers have positive attitudes toward a concealed reduction of opioid dosages. They concluded that their findings support future randomized controlled trials that compare concealed and overt opioid tapering in patients with chronic pain.
AHRQ-funded; HS022135.
Citation: Bedford T, Adediran T, Haycock NR .
Patient and provider acceptability of a patient preauthorized concealed opioid reduction.
Pain Med 2021 Jul 25;22(7):1651-59. doi: 10.1093/pm/pnaa454..
Keywords: Opioids, Medication, Pain, Chronic Conditions
Pritchard KT, Baillargeon J, Raji Ma
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees.
The purpose of this study was to establish whether non-pharmacological interventions, such as occupational and physical therapy, were associated with a shorter duration of prescription opioid use after hip or knee arthroplasty. The investigators concluded that occupational and physical therapy with home health were associated with a shorter duration of prescription opioid use after hip and knee arthroplasty.
AHRQ-funded; HS026133.
Citation: Pritchard KT, Baillargeon J, Raji Ma .
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees.
Arch Phys Med Rehabil 2021 Jul;102(7):1257-66. doi: 10.1016/j.apmr.2021.01.086..
Keywords: Orthopedics, Surgery, Opioids, Pain, Practice Patterns
Bifulco L, Anderson DR, Blankson ML
Evaluation of a chronic pain screening program implemented in primary care.
The purpose of this study was to evaluate a 2-step process for chronic pain screening and follow-up in primary care. Participants included primary care practitioners and medical assistants from 13 sites who implemented the screening process in primary care, and over 38,000 patients aged 18 or older with a primary care visit during the study’s July 2018-June 2019 time period. Findings showed that a systematic, 2-step process for chronic pain screening and functional assessment in primary care appeared to identify patients with previously undocumented chronic pain and that this process was feasible to implement.
AHRQ-funded; HS025354.
Citation: Bifulco L, Anderson DR, Blankson ML .
Evaluation of a chronic pain screening program implemented in primary care.
JAMA Netw Open 2021 Jul;4(7):e2118495. doi: 10.1001/jamanetworkopen.2021.18495..
Keywords: Pain, Chronic Conditions, Primary Care, Screening
VanderPluym JH, Halker Singh RB, Urtecho M
Acute treatments for episodic migraine in adults: a systematic review and meta-analysis.
Migraine is common and can be associated with significant morbidity, and several treatment options exist for acute therapy. The objective of this study was to evaluate the benefits and harms associated with acute treatments for episodic migraine in adults. The investigators concluded that there are several acute treatments for migraine, with varying strength of supporting evidence. Use of triptans, nonsteroidal anti-inflammatory drugs, acetaminophen, dihydroergotamine, calcitonin gene-related peptide antagonists, lasmiditan, and some nonpharmacologic treatments were associated with improved pain and function.
AHRQ-funded; 290201500013I.
Citation: VanderPluym JH, Halker Singh RB, Urtecho M .
Acute treatments for episodic migraine in adults: a systematic review and meta-analysis.
JAMA 2021 Jun 15;325(23):2357-69. doi: 10.1001/jama.2021.7939..
Keywords: Neurological Disorders, Pain, Chronic Conditions, Treatments
Bernard DM, Encinosa W, Cohen J
AHRQ Author: Bernard DM Encinosa W Cohen J Fang Z
Patient factors that affect opioid use among adults with and without chronic pain.
Investigators sought to determine patient characteristics associated with opioid use among adults with and without chronic pain treatment. Using MEPS data, they found that health-related attitudes affect both adults with and without chronic pain treatment similarly. Adults with self-reliant health attitudes were less likely to start and more likely to discontinue opioid use. Exercise was associated with higher probability of choosing no analgesic treatments over using opioids and also with higher probability of discontinuing opioid use in the year following opioid initiation for those electing to use them.
AHRQ-authored.
Citation: Bernard DM, Encinosa W, Cohen J .
Patient factors that affect opioid use among adults with and without chronic pain.
Res Social Adm Pharm 2021 Jun;17(6):1059-65. doi: 10.1016/j.sapharm.2020.07.036..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions
Overstreet DS, Michl AN, Penn TM
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
The objective of this study was to determine whether quantitative sensory tests of endogenous pain inhibition and facilitation prospectively predict movement-evoked pain and chronic low back pain severity self-reported on a validated questionnaire. Through surveys using the Brief Pain Inventory-Short Form, findings suggested that a pro-nociceptive pain modulatory balance characterized by enhanced pain facilitation may be an important driver of movement-evoked pain severity and poor physical function in individuals with chronic low back pain.
AHRQ-funded; HS013852.
Citation: Overstreet DS, Michl AN, Penn TM .
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
BMC Musculoskelet Disord 2021 May 10;22(1):429. doi: 10.1186/s12891-021-04306-5..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Diagnostic Safety and Quality