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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (1)
- Ambulatory Care and Surgery (2)
- Behavioral Health (1)
- Care Management (1)
- Children/Adolescents (2)
- Chronic Conditions (4)
- Clinician-Patient Communication (1)
- Communication (3)
- Comparative Effectiveness (2)
- Disparities (1)
- Elderly (2)
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- Medication (25)
- Medication: Safety (4)
- Mortality (3)
- Newborns/Infants (1)
- (-) Opioids (29)
- Outcomes (2)
- Pain (12)
- Palliative Care (1)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (1)
- Patient Safety (5)
- Policy (3)
- Practice Patterns (1)
- Pregnancy (2)
- Prevention (2)
- Primary Care (3)
- Provider (1)
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- Social Stigma (1)
- Substance Abuse (12)
- 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 25 of 29 Research Studies DisplayedMeisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Ducoffe AR, York A, Hu DJ
AHRQ Author: Perfetto D
National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use.
This article focuses on recommendations from the Adverse Drug Events (ADE) Action Plan to help guide safer opioid use in healthcare delivery settings. Its aim is to discuss current federal methods in place to prevent opioid ADEs while also providing evidence to encourage providers and hospitals to innovate new systems and practices to increase prevention.
AHRQ-authored.
Citation: Ducoffe AR, York A, Hu DJ .
National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use.
Pain Med 2016 Dec;17(12):2291-304. doi: 10.1093/pm/pnw106.
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Keywords: Prevention, Opioids, Patient Safety, Ambulatory Care and Surgery, Adverse Drug Events (ADE)
Banerjee G, Edelman EJ, Barry DT
Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study.
The researchers estimated the influence of non-medical use of prescription opioids on heroin initiation among US veterans receiving medical care. Using a multivariable Cox regression model, they found that non-medical use of prescription opioids was associated positively and independently with heroin initiation.
AHRQ-funded; HS021112; HS023258.
Citation: Banerjee G, Edelman EJ, Barry DT .
Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study.
Addiction 2016 Nov;111(11):2021-31. doi: 10.1111/add.13491.
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Keywords: Medication, Opioids, Substance Abuse
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.
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Keywords: Care Management, Medication, Mortality, Substance Abuse, Opioids, Patient-Centered Outcomes Research
Naples JG, Gellad WF, Hanlon JT
The role of opioid analgesics in geriatric pain management.
This article reviews the epidemiology of opioid use and their effectiveness for chronic noncancer pain (CNCP) in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP.
AHRQ-funded; HS023779.
Citation: Naples JG, Gellad WF, Hanlon JT .
The role of opioid analgesics in geriatric pain management.
Clin Geriatr Med 2016 Nov;32(4):725-35. doi: 10.1016/j.cger.2016.06.006.
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Keywords: Chronic Conditions, Elderly, Medication, Opioids, Pain, Patient Safety
Kennedy-Hendricks A, McGinty EE, Barry CL
Effects of competing narratives on public perceptions of opioid pain reliever addiction during pregnancy.
The researchers tested the effects of narratives portraying a woman with opioid pain reliever addiction during pregnancy on beliefs about people addicted to opioid pain relievers, perceptions of treatment effectiveness, policy attitudes, and emotional responses. They found that the extent to which narratives portraying successfully treated addiction affected public attitudes depended on the socioeconomic status of the woman portrayed.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, McGinty EE, Barry CL .
Effects of competing narratives on public perceptions of opioid pain reliever addiction during pregnancy.
J Health Polit Policy Law 2016 Oct;41(5):873-916. doi: 10.1215/03616878-3632230.
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Keywords: Opioids, Pain, Pregnancy, Social Stigma, Substance Abuse
Kennedy-Hendricks A, Busch SH, McGinty EE
Primary care physicians' perspectives on the prescription opioid epidemic.
The authors aimed to determine primary care physicians' perceptions of the seriousness of the prescription opioid epidemic, its causes, groups responsible for addressing it, attitudes toward individuals with prescription opioid use disorder, beliefs about the effectiveness of addiction treatments, and support for various policies. They found that respondents largely attributed the causes to individual-oriented factors and certain physician-oriented factors, and that respondents believed that individuals with prescription opioid use disorder and physicians were primarily responsible for addressing the problem. The researchers also found that negative attitudes toward people with prescription opioid use disorder were prevalent, but a majority believed that treatment could be effective.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Busch SH, McGinty EE .
Primary care physicians' perspectives on the prescription opioid epidemic.
Drug Alcohol Depend 2016 Aug 1;165:61-70. doi: 10.1016/j.drugalcdep.2016.05.010.
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Keywords: Behavioral Health, Medication, Opioids, Primary Care, Substance Abuse
Kennedy-Hendricks A, Gielen A, McDonald E
Medication sharing, storage, and disposal practices for opioid medications among US adults.
The authors conducted a national survey among US adults with recent opioid medication use to examine the pervasiveness of sharing opioid medications, medication storage and disposal practices, and the sources of information received. Their findings suggested that current practices related to sharing, storing, and disposing of opioid medications, as well as communication of information on these topics, are suboptimal. They recommended that more research is needed to identify effective strategies to advance safer practices related to opioid medication sharing, storage, and disposal.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Gielen A, McDonald E .
Medication sharing, storage, and disposal practices for opioid medications among US adults.
JAMA Intern Med 2016 Jul;176(7):1027-9. doi: 10.1001/jamainternmed.2016.2543.
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Keywords: Medication: Safety, Medication, Opioids, Patient Safety, Substance Abuse
Penti B, Liebschutz JM, Kopcza B
Novel peer review method for improving controlled substance prescribing in primary care.
The authors sought to determine if peer feedback through a chart review tool (CRT) can impact opioid prescribing for patients with chronic noncancer pain in an outpatient family medicine clinic at an urban, safety-net teaching hospital. They reviewed 99 patient charts from 14 physicians over 1 year. They found that the mean dose of opioids decreased 2.6 mg morphine equivalent dose (MED)/day from time of chart review until the end of the project, compared to a 6.9 mg MED/day increase that occurred from 12 months prior to chart review to the time of chart review, and 14 patients were taken off of opioids after the chart review.
AHRQ-funded; HS022242.
Citation: Penti B, Liebschutz JM, Kopcza B .
Novel peer review method for improving controlled substance prescribing in primary care.
J Opioid Manag 2016 Jul-Aug;12(4):269-79. doi: 10.5055/jom.2016.0342.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Primary Care, Practice Patterns
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.
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Keywords: Guidelines, Mortality, Opioids, Patient-Centered Outcomes Research, Substance Abuse
McGinty EE, Kennedy-Hendricks A, Baller J
Criminal activity or treatable health condition? News media framing of opioid analgesic abuse in the United States, 1998-2012.
The authors conducted an analysis of the volume and content of news media coverage of opioid analgesic abuse over a 15-year period from 1998 to 2012. They found that news media more often frame the problem as a criminal justice issue, rather than a public health crisis. The most frequently mentioned cause of the problem was illegal drug dealing, and the most frequently mentioned solutions were law enforcement solutions. Prevention-oriented approaches were mentioned more frequently in the latter years of the study period, but few of the news stories overall mentioned expanding substance abuse treatment, and even fewer mentioned expanding access to evidence-based medication-assisted treatments.
AHRQ-funded; HS000029.
Citation: McGinty EE, Kennedy-Hendricks A, Baller J .
Criminal activity or treatable health condition? News media framing of opioid analgesic abuse in the United States, 1998-2012.
Psychiatr Serv 2016 Apr;67(4):405-11. doi: 10.1176/appi.ps.201500065.
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Keywords: Communication, Medication, Opioids, Substance Abuse
Kennedy-Hendricks A, Richey M, McGinty EE
Opioid overdose deaths and Florida's crackdown on pill mills.
The researchers examined the effect on opioid overdose mortality of Florida state laws and law enforcement operations targeting "pill mills." They found that Florida's actions were associated with an estimated 1029 lives saved from prescription opioid overdose over a 34-month period, and estimated reductions in deaths grew over the intervention period.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Richey M, McGinty EE .
Opioid overdose deaths and Florida's crackdown on pill mills.
Am J Public Health 2016 Feb;106(2):291-7. doi: 10.2105/ajph.2015.302953.
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Keywords: Policy, Medication, Medication: Safety, Mortality, Opioids
Waljee JF, Zhong L, Hou H
The use of opioid analgesics following common upper extremity surgical procedures: a national, population-based study.
The authors examined the use of opioids following outpatient upper extremity procedures to discern the variation by procedure type and patient factors. They found that current opioid users are more likely to require postoperative opioid analgesics for routine procedures and more likely to receive inappropriate prescriptions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Zhong L, Hou H .
The use of opioid analgesics following common upper extremity surgical procedures: a national, population-based study.
Plast Reconstr Surg 2016 Feb;137(2):355e-64e. doi: 10.1097/01.prs.0000475788.52446.7b..
Keywords: Ambulatory Care and Surgery, Medication, Opioids, Pain, Surgery
Kuo YF, Raji MA, Chen NW
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
The researchers used national Medicare data from 2007-2012 to assess temporal and geographic trends in rates of opioid prescription and relationship to opioid toxicity and different state regulations in Part D Medicare recipients. Their analyses of the Medicare data demonstrated substantial growth in opioid prescriptions from 2007 to 2011 and large variation in opioid prescriptions across states.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Chen NW .
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
Am J Med 2016 Feb;129(2):221.e21-30. doi: 10.1016/j.amjmed.2015.10.002..
Keywords: Chronic Conditions, Elderly, Medicare, Medication, Opioids, Pain
Barry CL, Kennedy-Hendricks A, Gollust SE
Understanding Americans' views on opioid pain reliever abuse.
Using a public opinion survey, the authors examined Americans' personal experience with opioid pain reliever use and abuse, and views about the seriousness of the problem, factors causing it, responsibility for addressing it and support for policies to resolve it. Fifty-eight percent of respondents ranked the problem as serious, on a par with other major health concerns. Individual-orientated factors, including a lack of understanding about how easy it is to become addicted and improper storage and disposal ranked highest as causes, and those abusing opioid pain relievers and their physicians were viewed as most responsible for solving the problem. Of the policies recommended to curb the epidemic, 14 out of 16 were supported by a majority of Americans.
AHRQ-funded; HS000029.
Citation: Barry CL, Kennedy-Hendricks A, Gollust SE .
Understanding Americans' views on opioid pain reliever abuse.
Addiction 2016 Jan;111(1):85-93. doi: 10.1111/add.13077.
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Keywords: Medication, Opioids, Pain, Substance Abuse
Meisel ZF, Smith RJ
Engaging patients around the risks of opioid misuse in the emergency.
The authors of this editorial considered a number of different types of strategies to increase patient awareness of risks and benefits associated with alternative pain management strategies in the ED. These include traditional education, communicating risks, shared decisionmaking, community interventions and “sticky” narratives. They conclude that patients, families and communities must be included in order to navigate the tight¬rope walk between providing adequate pain control and mitigating misuse and dependency.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Smith RJ .
Engaging patients around the risks of opioid misuse in the emergency.
Pain Manag 2015 Sep;5(5):323-6. doi: 10.2217/pmt.15.31..
Keywords: Emergency Department, Opioids, Pain, Patient and Family Engagement
Conover MM, Howell JO, Wu JM
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
The researchers compared the incidence of opioid-managed pelvic pain within 12 months after hysteroscopic and laparoscopic sterilization. They found that among women without recent history of childbirth, there was no compelling evidence of a clinically meaningful increase in the incidence of pelvic pain requiring opioids during the year after hysteroscopic sterilization.
AHRQ-funded; HS017950.
Citation: Conover MM, Howell JO, Wu JM .
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
Pharmacoepidemiol Drug Saf 2015 Aug;24(8):875-84. doi: 10.1002/pds.3766..
Keywords: Comparative Effectiveness, Medication, Opioids, Pain, Women
Bachhuber MA, McGinty EE, Kennedy-Hendricks A
Messaging to increase public support for naloxone distribution policies in the United States: results from a randomized survey experiment.
The investigators conducted a web-based survey (GfK Knowledge Panel) about barriers to public support for naloxone distribution. They concluded that public support for naloxone distribution can be improved through education and sympathetic portrayals of the population who stands to benefit from these policies.
AHRQ-funded; HS000029.
Citation: Bachhuber MA, McGinty EE, Kennedy-Hendricks A .
Messaging to increase public support for naloxone distribution policies in the United States: results from a randomized survey experiment.
PLoS One 2015 Jul;10(7):e0130050. doi: 10.1371/journal.pone.0130050.
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Keywords: Medication, Opioids, Policy, Substance Abuse
Basco WT, Ebeling M, Garner SS
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
This study estimated the frequency of potential overdoses among outpatient opioid-containing prescriptions. It found that, overall, 2.7 percent of the prescriptions contained potential overdose quantities, and the average excess amount dispensed was 48% above expected. Younger ages were associated with higher frequencies of potential overdose.
AHRQ-funded; HS015679.
Citation: Basco WT, Ebeling M, Garner SS .
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
Clin Pediatr 2015 Jul;54(8):738-44. doi: 10.1177/0009922815586050..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Newborns/Infants, Medication, Medication: Safety, Newborns/Infants, Opioids, Patient Safety
Jules-Elysee KM, Goon AK, Westrich GH
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
This randomized, double-blind, placebo-controlled study compared the use of patient-controlled epidural analgesia (PCEA) with use of a multimodal pain regimen including periarticular injection (PAI). It found that PAI did not decrease the time to discharge and was associated with higher pain scores and greater opioid consumption but lower ORSDS scores compared with PCEA.
AHRQ-funded; HS021734.
Citation: Jules-Elysee KM, Goon AK, Westrich GH .
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
J Bone Joint Surg Am 2015 May 20;97(10):789-98. doi: 10.2106/jbjs.n.00698..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Hughes HK, Korthuis PT, Saha S
A mixed methods study of patient-provider communication about opioid analgesics.
The researchers sought to describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. They found that pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients.
AHRQ-funded; 290010012; HS013903.
Citation: Hughes HK, Korthuis PT, Saha S .
A mixed methods study of patient-provider communication about opioid analgesics.
Patient Educ Couns 2015 Apr;98(4):453-61. doi: 10.1016/j.pec.2014.12.003..
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Keywords: Communication, Medication, Opioids, Pain, Clinician-Patient Communication
Ringwalt C, Roberts AW, Gugelmann H
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
The purpose of this study was to examine differences across providers’ specialties in prescriptions filled by white and black Medicaid beneficiaries with chronic noncancer pain (CNCP). It found that race-based differences in beneficiaries’ dispensed opioid prescriptions were more prominent among patients of specialists in obstetrics and gynecology and internal medicine, as well as general practitioners/family medicine physicians.
AHRQ-funded; HS000032.
Citation: Ringwalt C, Roberts AW, Gugelmann H .
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
Pain Med 2015 Apr;16(4):633-40. doi: 10.1111/pme.12555..
Keywords: Chronic Conditions, Disparities, Medicaid, Medication, Opioids, Pain, Racial and Ethnic Minorities
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
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
Hwang CS, Chang HY, Alexander GC
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
The researchers quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids. They found that the market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market.
AHRQ-funded; HS018960.
Citation: Hwang CS, Chang HY, Alexander GC .
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
Pharmacoepidemiol Drug Saf 2015 Feb;24(2):197-204. doi: 10.1002/pds.3723.
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Keywords: Medication, Opioids, Prevention, Substance Abuse