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
226 to 250 of 304 Research Studies DisplayedHartung DM, Hall J, Haverly SN
Pharmacists' role in opioid safety: a focus group investigation.
This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Using focus groups, results showed that pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing; and that patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
Citation: Hartung DM, Hall J, Haverly SN .
Pharmacists' role in opioid safety: a focus group investigation.
Pain Med 2018 Sep;19(9):1799-806. doi: 10.1093/pm/pnx139..
Keywords: Provider: Pharmacist, Opioids, Medication: Safety, Medication, Patient Safety
Davis CS, Green TC, Hernandez-Delgado H
Status of US state laws mandating timely reporting of nonfatal overdose.
Timely, actionable, nonfatal overdose data are urgently needed to improve public health response to the overdose crisis. The purpose of this paper was to provide background and catalyze discussion regarding this important issue. The authors briefly report the results of a systematic analysis of state laws mandating reporting of nonfatal overdose, and provide suggestions for improving the collection and use of nonfatal overdose data to improve the public health response to this ongoing epidemic.
AHRQ-funded; HS024021.
Citation: Davis CS, Green TC, Hernandez-Delgado H .
Status of US state laws mandating timely reporting of nonfatal overdose.
Am J Public Health 2018 Sep;108(9):1159-61. doi: 10.2105/ajph.2018.304589..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Opioids, Policy, Public Health, Substance Abuse
Olfson M, Wall M, Wang S
Risks of fatal opioid overdose during the first year following nonfatal overdose.
This study examined that risks of fatal opioid overdose during the first year following nonfatal overdose. A national retrospective longitudinal cohort of patients- aged 18-64 years, in the Medicaid program, who received a clinical diagnosis of nonfatal opioid overdose-was identified. Repeated overdoses and fatal opioid overdoses were measured with the Medicaid record and the National Death Index and rates of repeat overdose per 1000 person-years and fatal overdose per 100,000 person-years were determined.
AHRQ-funded; HS023258; HS021112.
Citation: Olfson M, Wall M, Wang S .
Risks of fatal opioid overdose during the first year following nonfatal overdose.
Drug Alcohol Depend 2018 Sep 1;190:112-19. doi: 10.1016/j.drugalcdep.2018.06.004..
Keywords: Adverse Drug Events (ADE), Medication, Opioids, Risk
Marshall BDL, Green TC, Elston B
The effectiveness of internet- and field-based methods to recruit young adults who use prescription opioids nonmedically.
This study researched the effectiveness of field- and Internet-based methods to recruit young adults who are nonmedical prescription opioid (NMPO) users into intervention and treatment. Data was analyzed from the Rhode Island Young Adult Prescription Drug Study (RAPiDS). Internet-based recruitment was more successful (60.1%). Out of 198 eligible participants, median age was 25, and the majority were male, white, and resided in an urban area. Field-based recruited participants were more likely to be homeless, have been incarcerated and engage in daily NMPO use.
AHRQ-funded; HS024021.
Citation: Marshall BDL, Green TC, Elston B .
The effectiveness of internet- and field-based methods to recruit young adults who use prescription opioids nonmedically.
Subst Use Misuse 2018 Aug 24;53(10):1688-99. doi: 10.1080/10826084.2018.1425725.
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Keywords: Health Information Technology (HIT), Medication, Opioids, Substance Abuse, Young Adults
Sekhri S, Arora NS, Cottrell H
Probability of opioid prescription refilling after surgery: does initial prescription dose matter?
In this study, the investigators sought to determine the correlation between the probability of postoperative opioid prescription refills and the amount of opioid prescribed, hypothesizing that a greater initial prescription yields a lower probability of refill. The investigators concluded that the probability of refilling prescription opioids after surgery was not correlated with initial prescription strength, suggesting surgeons could prescribe smaller prescriptions without influencing refill requests.
AHRQ-funded; HS023313.
Citation: Sekhri S, Arora NS, Cottrell H .
Probability of opioid prescription refilling after surgery: does initial prescription dose matter?
Ann Surg 2018 Aug;268(2):271-76. doi: 10.1097/sla.0000000000002308..
Keywords: Medication, Opioids, Pain, Practice Patterns, Substance Abuse, Surgery
Olfson M, Crystal S, Wall M
Causes of death after nonfatal opioid overdose.
The purpose of this study was to describe all-cause mortality rates, selected cause-specific mortality rates, and standardized mortality rate ratios (SMRs) of adults during their first year after nonfatal opioid overdose. In a US national cohort of adults who had experienced a nonfatal opioid overdose, a marked excess of deaths was attributable to a wide range of substance use-associated, mental health, and medical conditions, underscoring the importance of closely coordinating the substance use, mental health, and medical care of this patient population.
AHRQ-funded; HS021112.
Citation: Olfson M, Crystal S, Wall M .
Causes of death after nonfatal opioid overdose.
JAMA Psychiatry 2018 Aug;75(8):820-27. doi: 10.1001/jamapsychiatry.2018.1471..
Keywords: Behavioral Health, Mortality, Opioids, Patient-Centered Healthcare, Substance Abuse
Desai K, Carroll I, Asch SM
Utilization and effectiveness of multimodal discharge analgesia for postoperative pain management.
In this study, the investigators sought to assess the association between discharge multimodal analgesia and postoperative pain outcomes in two diverse health care settings. They evaluated patients undergoing four common surgeries associated with high pain in electronic health records from an academic hospital (AH) and Veterans Health Administration (VHA). The investigators found that a majority of surgical patients received a multimodal pain approach at discharge yet many received only opioids. Multimodal regimen at discharge was associated with better follow-up pain and all-cause readmissions compared to the opioid-only regimen.
AHRQ-funded; HS024096.
Citation: Desai K, Carroll I, Asch SM .
Utilization and effectiveness of multimodal discharge analgesia for postoperative pain management.
J Surg Res 2018 Aug;228:160-69. doi: 10.1016/j.jss.2018.03.029..
Keywords: Care Management, Medication, Opioids, Pain, Surgery
Lee JS, Parashar V, Miller JB
Opioid prescribing after curative-intent surgery: a qualitative study using the theoretical domains framework.
To identify targets for intervention, researchers performed a qualitative study of opioid prescribing after curative-intent surgery using the Theoretical Domains Framework, a well-established implementation science method for identifying factors influencing healthcare provider behavior. They concluded that key determinants of opioid prescribing behavior after curative-intent surgery include environmental and social factors. Interventions targeting these factors are likely to improve opioid prescribing in surgical oncology.
AHRQ-funded; HS023313.
Citation: Lee JS, Parashar V, Miller JB .
Opioid prescribing after curative-intent surgery: a qualitative study using the theoretical domains framework.
Ann Surg Oncol 2018 Jul;25(7):1843-51. doi: 10.1245/s10434-018-6466-x.
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Keywords: Medication, Opioids, Practice Patterns, Surgery
Basco WT, Roberts JR, Ebeling M
Indications for use of combination acetaminophen/opioid drugs in infants <6 months old.
This study examined the use of combination acetaminophen/opioid drugs in infants 0-6 months old. In most cases it is not considered appropriate for children under 2 years and for respiratory diagnosis is not appropriate at all. Pharmacy claims from the South Carolina Medicaid prescriptions database from January 2011 through August 2012 was evaluated. The data was given to researchers in de-identified format from 3 Medicaid files. No newborns (aged <1 month) were given these combination drugs. They calculated that 1 in 5 prescriptions were given for an inappropriate indication, and 1 in 10 for respiratory diagnosis.
AHRQ-funded; HS015679.
Citation: Basco WT, Roberts JR, Ebeling M .
Indications for use of combination acetaminophen/opioid drugs in infants <6 months old.
Clin Pediatr 2018 Jun;57(6):741-44. doi: 10.1177/0009922817730349..
Keywords: Opioids, Newborns/Infants, Medication, Patient Safety
Axeen S, Seabury SA, Menchine M
Emergency department contribution to the prescription opioid epidemic.
The investigators used MEPS data to characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, to estimate trends in opioid prescribing by site of care, and to examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. During the study period, they found that the relative contribution of EDs to the prescription opioid problem was modest and declining. They therefore recommended that further efforts to reduce the quantity of opioids prescribed focus on office-based settings.
AHRQ-funded; HS024251.
Citation: Axeen S, Seabury SA, Menchine M .
Emergency department contribution to the prescription opioid epidemic.
Ann Emerg Med 2018 Jun;71(6):659-67.e3. doi: 10.1016/j.annemergmed.2017.12.007..
Keywords: Behavioral Health, Emergency Department, Medical Expenditure Panel Survey (MEPS), Medication, Opioids, Practice Patterns, Substance Abuse
Raji MA, Kuo YF, Adhikari D
Decline in opioid prescribing after federal rescheduling of hydrocodone products.
This study examined differences in opioid prescribing by patient characteristics and variation in hydrocodone combination product (HCP) prescribing attributed to states, before and after the 2014 Drug Enforcement Administration's reclassification of HCP from schedule III to the more restrictive schedule II. It found that HCP prescribing decreased by 26 percent from June 2013 to June 2015; the rate of prescriptions for any opioid decreased by 11 percent.
AHRQ-funded; HS022134.
Citation: Raji MA, Kuo YF, Adhikari D .
Decline in opioid prescribing after federal rescheduling of hydrocodone products.
Pharmacoepidemiol Drug Saf 2018 May;27(5):513-19. doi: 10.1002/pds.4376.
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Keywords: Policy, Opioids, Practice Patterns, Policy
Kuo YF, Raji MA, Liaw V
Opioid prescriptions in older Medicare beneficiaries after the 2014 federal rescheduling of hydrocodone products.
The authors sought to examine how an October 2014 Drug Enforcement Administration policy reclassified hydrocodone product from schedule III to II has affected older adults. They found that the 2014 change in hydrocodone from schedule III to schedule II was associated with modest decreases in rates of opioid use in the elderly. They also found an unexpected increase in opioid-related hospitalizations without documented opioid prescriptions, which may represent an increase in illegal use.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Liaw V .
Opioid prescriptions in older Medicare beneficiaries after the 2014 federal rescheduling of hydrocodone products.
J Am Geriatr Soc 2018 May;66(5):945-53. doi: 10.1111/jgs.15332.
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Keywords: Elderly, Medicare, Opioids, Policy, Practice Patterns
Gold LS, Hansen RN, Avins AL
Associations of early opioid use with patient-reported outcomes and health care utilization among older adults with low back pain.
The objective of this study was to compare outcomes and health care utilization of older patients who did versus did not fill opioid prescriptions within 90 days of initiating care for low back pain. Among older patients with new back pain visits, filling 2 or more opioid prescriptions within 90 days of the visit was associated with similar back pain-related outcomes but increased likelihood of filling opioid prescriptions 18 to 24 months later compared with matched patients who did not fill early opioid prescriptions.
AHRQ-funded; HS019222; HS022972.
Citation: Gold LS, Hansen RN, Avins AL .
Associations of early opioid use with patient-reported outcomes and health care utilization among older adults with low back pain.
Clin J Pain 2018 Apr;34(4):297-305. doi: 10.1097/ajp.0000000000000557.
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Keywords: Back Health and Pain, Elderly, Healthcare Utilization, Patient-Centered Outcomes Research, Opioids
Marsh JC, Park K, Lin YA
Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007-2014.
This study uses National Survey on Drug Use and Health (NSDUH) data to study gender differences in trends for heroin use and nonmedical prescription opioid use from 2007-2014. There has been a steady decline in nonmedical prescription heroin use but a notable increase in heroin use during this period for both men and women. However, women are increasing heroin use at a faster rate than men but their nonmedical prescription opioid use is not decreasing as fast as men. The researchers conclude that more study is needed on gender differences in use and treatment access.
AHRQ-funded; HS000084.
Citation: Marsh JC, Park K, Lin YA .
Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007-2014.
J Subst Abuse Treat 2018 Apr;87:79-85. doi: 10.1016/j.jsat.2018.01.001..
Keywords: Medication, Opioids, Sex Factors, Substance Abuse
Howard R, Waljee J, Brummett C
Reduction in opioid prescribing through evidence-based prescribing guidelines.
The authors evaluated the effect of evidence-based postoperative prescribing guidelines in an effort to reduce overprescribing. The post-intervention group received opioid prescriptions for reduced dosages compared to the pre-intervention group. In the post-intervention group, 2.5% requested refills compared with 4.1% in the pre-intervention group. The authors indicated that this work will be used as a template for statewide practice transformation, which may serve as a platform for other states.
AHRQ-funded; HS023313.
Citation: Howard R, Waljee J, Brummett C .
Reduction in opioid prescribing through evidence-based prescribing guidelines.
JAMA Surg 2018 Mar;153(3):285-87. doi: 10.1001/jamasurg.2017.4436.
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Keywords: Evidence-Based Practice, Guidelines, Opioids, Practice Patterns, Surgery
Zullo AR, Zhang T, Beudoin FL
Pain treatments after hip fracture among older nursing home residents.
In this retrospective cohort study the investigators examined the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. The investigators concluded that a rigorous study addressing the limitations of their study is critical to validate their preliminary findings and provide evidence about the effect of using opioid versus nonopioid analgesics to optimize acute pain in NH residents with a hip fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Beudoin FL .
Pain treatments after hip fracture among older nursing home residents.
J Am Med Dir Assoc 2018 Feb;19(2):174-76. doi: 10.1016/j.jamda.2017.11.008..
Keywords: Opioids, Pain, Nursing Homes, Long-Term Care, Elderly, Medication, Injuries and Wounds, Patient-Centered Outcomes Research, Healthcare Utilization
Tanabe P, Silva S, Bosworth HB
A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD).
Limited evidence guides opioid dosing strategies for acute Sickle Cell (SCD) pain. In this randomized control study, the investigators compared two National Heart, Lung and Blood Institute (NHBLI) recommended opioid dosing strategies (weight-based vs. patient-specific) for emergency department (ED) treatment of acute vaso-occlusive episodes (VOE).
AHRQ-funded; HS019646.
Citation: Tanabe P, Silva S, Bosworth HB .
A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD).
Am J Hematol 2018 Feb;93(2):159-68. doi: 10.1002/ajh.24948..
Keywords: Medication, Opioids, Pain, Sickle Cell Disease
Kim HS, McCarthy DM, Hoppe JA
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
This study examined attitudes of emergency department residents, attending physicians, and pharmacists from three hospitals on coprescribing benzodiazepines and opioids. There is mounting evidence that this increases overdose risk. Focus groups were conducted using semistructured interviews which were audio-recorded and transcribed. Participants were reluctant to admit coprescribing and said when they did that specific discharge instructions were provided. The decision was also influenced by a provider’s belief in the efficacy of combination therapy as well as self-imposed pressure to escalate care or avoid hospital admission. They did not like the idea of using computerized alerts, but were support of pharmacist-assisted interventions.
AHRQ-funded; HS023011; HS000078.
Citation: Kim HS, McCarthy DM, Hoppe JA .
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
Acad Emerg Med 2018 Jan;25(1):15-24. doi: 10.1111/acem.13273..
Keywords: Emergency Department, Guidelines, Medication, Opioids, Practice Patterns, Provider: Clinician, Provider: Pharmacist, Provider: Physician
Chou R, Korthuis PT, McCarty D
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
This review synthesized evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility. It concluded that higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events.
AHRQ-funded; 290201500009I.
Citation: Chou R, Korthuis PT, McCarty D .
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
Ann Intern Med 2017 Dec 19;167(12):867-75. doi: 10.7326/m17-2224.
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Keywords: Emergency Medical Services (EMS), Evidence-Based Practice, Medication, Opioids, Patient-Centered Outcomes Research
Heslin KC, Owens PL, Karaca Z
AHRQ Author: Heslin KC; Owens PL; Karaca Z; Elixhauser A
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM. It found a sharp increase in opioid-related stays overall during the transition to ICD-10-CM. This may indicate that the new classification system is capturing stays that were missed by ICD-9-CM data.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Karaca Z .
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
Med Care 2017 Nov;55(11):918-23. doi: 10.1097/mlr.0000000000000805.
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Keywords: Critical Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Opioids, Substance Abuse
Tedesco D, Gori D, Desai KR
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
The authors systematically reviewed and meta-analyzed evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. The most commonly performed interventions included in the review were continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. In the meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
AHRQ-funded; HS024096.
Citation: Tedesco D, Gori D, Desai KR .
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg 2017 Oct 18;152(10):e172872. doi: 10.1001/jamasurg.2017.2872.
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Keywords: Care Management, Medication, Opioids, Orthopedics, Pain, Surgery
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Chhatre S, Cook R, Mallik E
Trends in substance use admissions among older adults.
Researchers sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics.
AHRQ-funded; HS024106.
Citation: Chhatre S, Cook R, Mallik E .
Trends in substance use admissions among older adults.
BMC Health Serv Res 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
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Keywords: Behavioral Health, Elderly, Hospitalization, Opioids, Substance Abuse
Horton M, McDonald R, Green TC
A mapping review of take-home naloxone for people released from correctional settings.
The objective of this review is to map research into take-home naloxone (THN) for people released from correctional settings in order to identify further research needs. It concluded that the feasibility of THN in the context of release from a correctional setting has been established, but there is a need for rigorous research into health outcomes and program implementation.
AHRQ-funded; HS024021.
Citation: Horton M, McDonald R, Green TC .
A mapping review of take-home naloxone for people released from correctional settings.
Int J Drug Policy 2017 Aug;46:7-16. doi: 10.1016/j.drugpo.2017.05.015.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Substance Abuse, Vulnerable Populations