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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 227 Research Studies DisplayedDe Castro GC, Slatnick LR, Shannon M
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
Researchers abstracted episodes of febrile neutropenia (FN) in pediatric patients with cancer occurring at Vanderbilt Children's Hospital and Colorado Children's Hospital to capture time-to-antibiotic (TTA) metrics and clinical outcomes including major complications. Results showed that only 0.6% of episodes required immediate ICU management, with a median TTA of 28 minutes; for the remaining patients, the median TTA was 56 minutes. TTA was not associated with major nor any other complications in adjusted analysis. The researchers concluded that there was no clear evidence that a reduced TTA improves clinical outcomes in pediatric oncology FN and it should not be used as a primary quality measure.
AHRQ-funded; HS025696.
Citation: De Castro GC, Slatnick LR, Shannon M .
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
JCO Oncol Pract 2024 Feb; 20(2):228-38. doi: 10.1200/op.23.00583..
Keywords: Children/Adolescents, Cancer, Antibiotics, Medication
Ramanathan S, Evans CT, Hershow RC
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
The study aimed to evaluate antibiotic prophylaxis adherence and associated adverse drug events (ADEs) in dental settings. A retrospective cohort study of adults with cardiac conditions or prosthetic joints from 2015 to 2017 was conducted. Of 61,124 patients receiving antibiotic prophylaxis, 62 (0.1%) experienced ADEs. Guideline concordance was not linked to ADEs (adjusted OR: 0.78, 95% CI: 0.25-2.46), and this was consistent across different dental settings.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Evans CT, Hershow RC .
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
Front Pharmacol 2024 Jan 16; 15:1249531. doi: 10.3389/fphar.2024.1249531.
Keywords: Antibiotics, Medication, Adverse Drug Events (ADE), Guidelines, Dental and Oral Health, Practice Patterns
Carroll AR, Johnson JA, Stassun JC
Health literacy-informed communication to reduce discharge medication errors in hospitalized children: a randomized clinical trial.
This study’s objective was to test a health literacy-informed communication intervention to decrease liquid medication dosing errors compared with standard counseling in hospitalized children. This parallel, randomized clinical trial was conducted from June 22, 2021, to August 20, 2022, at a tertiary care, US children's hospital. English- and Spanish-speaking caregivers of hospitalized children 6 years or younger prescribed a new, scheduled liquid medication at discharge were included in the analysis. Observed dosing errors were the main outcome measured, and secondary outcomes included caregiver-reported medication knowledge. Among 198 randomized caregivers (mean age 31.4 years; 186 women [93.9%]; 36 [18.2%] Hispanic or Latino and 158 [79.8%] White), the primary outcome was available for 151 (76.3%). The observed mean (SD) percentage dosing error was 1.0% (2.2 percentage points) among the intervention group and 3.3% (5.1 percentage points) among the standard counseling group (absolute difference, 2.3 percentage points). Twenty-four of 79 caregivers in the intervention group (30.4%) measured an incorrect dose compared with 39 of 72 (54.2%) in the standard counseling group. The intervention enhanced caregiver-reported medication knowledge compared with the standard counseling group for medication dose (71 of 76 [93.4%] vs 55 of 69 [79.7%]), duration of administration (65 of 76 [85.5%] vs 49 of 69 [71.0%], and correct reporting of 2 or more medication adverse effects (60 of 76 [78.9%] vs 13 of 69 [18.8%]).
AHRQ-funded; HS026122.
Citation: Carroll AR, Johnson JA, Stassun JC .
Health literacy-informed communication to reduce discharge medication errors in hospitalized children: a randomized clinical trial.
JAMA Netw Open 2024 Jan 2; 7(1):e2350969. doi: 10.1001/jamanetworkopen.2023.50969..
Keywords: Children/Adolescents, Health Literacy, Communication, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Clinician-Patient Communication, Hospital Discharge, Medication: Safety
Devine JW, Tadrous M, Hernandez I
A retrospective cohort study of the 2018 angiotensin receptor blocker recalls and subsequent drug shortages in patients with hypertension.
Researchers compared the risk of adverse events between hypertensive patients who used valsartan and a propensity score-matched group who used nonrecalled angiotensin receptor blockers and angiotensin-converting enzyme inhibitors. Valsartan usage at the time of its recall was associated with higher risks of all-cause hospitalization, emergency department or urgent care use, and the composite of cardiac events within 6 months after the recall. The valsartan recall and shortage affected hypertensive patients. Local- and national-level systems need to be enhanced to protect patients from drug shortages by providing safe and reliable medication alternatives.
AHRQ-funded; HS027985.
Citation: Devine JW, Tadrous M, Hernandez I .
A retrospective cohort study of the 2018 angiotensin receptor blocker recalls and subsequent drug shortages in patients with hypertension.
J Am Heart Assoc 2024 Jan 2; 13(1):e032266. doi: 10.1161/jaha.123.032266.
Keywords: Blood Pressure, Medication, Cardiovascular Conditions
Jolliff A, Coller RJ, Kearney H
An mHealth design to promote medication safety in children with medical complexity.
This study describes an effort to design a health information technology tool to improve medication safety for children with medical complexity (CMC). The study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a co-design process to identify: 1) medication safety challenges experienced by CMC caregivers and, 2) design requirements for a mobile health application to improve medication safety for CMC in the home. Family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program participated in virtual co-design sessions. During these sessions, the facilitator guided 16 co-designers in generating and converging upon medication safety challenges and design requirements. These sessions were recorded and reviewed after conclusion to confirm that all designer comments had been captured. An analysis yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines.
AHRQ-funded; HS028409.
Citation: Jolliff A, Coller RJ, Kearney H .
An mHealth design to promote medication safety in children with medical complexity.
Appl Clin Inform 2024 Jan; 15(1):45-54. doi: 10.1055/a-2214-8000..
Keywords: Children/Adolescents, Medication: Safety, Medication, Health Information Technology (HIT), Chronic Conditions, Telehealth, Caregiving
MohammadiGorji S, Joseph A, Mihandoust S
Anesthesia workspaces for safe medication practices: design guidelines.
The purpose of this study was to create a set of evidence-based design guidelines for the design of anesthesia workspaces to support safer anesthesia medication tasks in operating rooms (ORs). The researchers collected data through literature review, observation, and coding of prerecorded videos of outpatient surgical procedures to identify challenges encountered by anesthesia providers while performing medication tasks. The study findings were summarized into 7 design guidelines, including: 1) locate critical tasks within a primary field of vision, 2) eliminate other staff travel into and through the anesthesia zone, 3) identify and delineate a clear anesthesia zone with adequate space for the anesthesia provider, 4) maximize the ability to reconfigure the anesthesia workspace, 5) minimize workspace clutter from equipment, 6) provide adequate and appropriately positioned surfaces for medication preparation and administration, and 7) optimize lighting of tasks and surfaces.
AHRQ-funded.
Citation: MohammadiGorji S, Joseph A, Mihandoust S .
Anesthesia workspaces for safe medication practices: design guidelines.
HERD 2024 Jan; 17(1):64-83. doi: 10.1177/19375867231190646..
Keywords: Medication: Safety, Medication, Patient Safety
Foot C, Korthuis PT, Tsui JI
Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.
The objective of this secondary analysis of data from two clinical trials comparing buprenorphine and extended-release naltrexone was to estimate the effect of ongoing stimulant use on return to illicit opioid use after initiation of medication for opioid use disorder (MOUD). The findings indicated that people on medication for opioid use disorder who subsequently used stimulants appeared more likely to return to non-prescribed opioids use compared with those without stimulant use; this association appeared stronger among patients who initiated buprenorphine compared with those who initiated extended-release naltrexone.
AHRQ-funded; HS026370.
Citation: Foot C, Korthuis PT, Tsui JI .
Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.
Addiction 2024 Jan; 119(1):149-57. doi: 10.1111/add.16334..
Keywords: Opioids, Substance Abuse, Medication, Behavioral Health
Chase BA, Semenov I, Rubin S
Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: a retrospective clinical and genetic study.
This study’s objective was to evaluate response to anti-calcitonin gene-related peptide (CGRP) migraine preventives in a real-world community cohort of persons living with migraine and to identify clinical and genetic characteristics associated with efficacious response. The authors looked at users of erenumab-aooeb, fremanezumab-vrfm, and galcanezumab-gnl and their reasons for stopping or starting these medications. No difference was seen at either first or second follow-ups between galcanezumab and fremanezumab or fremanezumab and erenumab. There was a decrease in MDM at follow-up that was generally proportional to baseline MDM, larger in females, and increased with months on medication, with the reasons for switching or stopping a preventive varying between medications and was often related to cost or insurance coverage. At both follow-ups, patient tolerance and continued use were high and similar across preventives.
AHRQ-funded; HS024057.
Citation: Chase BA, Semenov I, Rubin S .
Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: a retrospective clinical and genetic study.
Headache 2024 Jan; 64(1):68-92. doi: 10.1111/head.14655.AHRQ-funded; HS024057..
Keywords: Neurological Disorders, Medication
Wolf RM, Hall M, Williams DJ
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
This retrospective cohort study examined associations between pharmacologic restraint use and race and ethnicity among children (aged 5-≤18 years) admitted for mental health conditions to acute care nonpsychiatric children's hospitals. Study period was 2018 to 2022 and was conducted at 41 US children’s hospitals and included a cohort of 61,503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81), Asian (aOR, 0.82), or other race and ethnicity (aOR, 0.68) were less likely to receive pharmacologic restraint, with no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males, except for Hispanic males, and not found in females. Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ .
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
Pediatrics 2024 Jan; 153(1). doi: 10.1542/peds.2023-061353..
Keywords: Disparities, Children/Adolescents, Behavioral Health, Inpatient Care, Hospitals, Medication
Donnelly JP, Seelye SM, Kipnis P
Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events.
Researchers estimated benefits and harms of shortened time-to-antibiotics for sepsis. Their simulation study used a cohort of over 1.5 million hospitalizations via emergency department with more than two systemic inflammatory response syndrome criteria. The results showed that impacts of faster time-to-antibiotics for sepsis varied markedly across simulated hospital types; however, even in worst-case scenarios, new antibiotic-associated adverse events were rare.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Seelye SM, Kipnis P .
Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events.
Ann Am Thorac Soc 2024 Jan; 21(1):94-101. doi: 10.1513/AnnalsATS.202306-505OC..
Keywords: Antibiotics, Medication, Sepsis, Mortality
Cohen TN, Berdahl CT, Coleman BL
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
This study’s objective was to understand the insights conveyed in hospital incident reports about how work system factors affected medication safety during a coronavirus disease-2019 (COVID-19) surge. The authors randomly selected 100 medication safety incident reports from an academic medical center (December 2020 to January 2021), identified near misses and errors, and classified contributing work system factors using the Human Factors Analysis and Classification System-Healthcare. Results showed that among 35 near misses/errors, incident reports described contributing factors (mean 1.3/report) involving skill-based errors (n = 20), communication (n = 8), and tools/technology (n = 4). Seven of these events were linked to COVID-19.
AHRQ-funded; HS027455.
Citation: Cohen TN, Berdahl CT, Coleman BL .
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
J Nurs Care Qual 2024 Jan-Mar; 39(1):51-57. doi: 10.1097/ncq.0000000000000720..
Keywords: Medication: Safety, Medication, Patient Safety, COVID-19, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Liu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Berbakov ME, Hoffins EL, Stone JA
AHRQ-funded; HS028475.
A study team collaborated with Aurora Pharmacy, Inc. to develop Senior Safe, a community pharmacy-based intervention designed to increase awareness of safe over-the-counter medication use for older adults. Senior Safe was adapted through pilot testing and a randomized control trial before a finalized version was provided to Aurora Pharmacy to integrate into all its pharmacy sites. The authors concluded that this multiphase study illustrated that refining an intervention is possible and welcomed by pharmacy staff, but requires time, resources, and funds to create an impactful, sustainable community pharmacy intervention.
AHRQ-funded; HS024490; HS027737.
Citation: Berbakov ME, Hoffins EL, Stone JA .
AHRQ-funded; HS028475.
J Am Pharm Assoc 2024 Jan-Feb; 64(1):159-68. doi: 10.1016/j.japh.2023.11.009.
Keywords: Medication, Medication: Safety, Provider: Pharmacist, Patient Safety, Community-Based Practice
Ferguson WJ, Johnston J, Clarke JG
Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.
Four jail and prison systems partnered with researchers to document their adoption of medication assisted therapy (MAT) for incarcerated individuals with opioid use disorders using their established treatment protocols. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Recommendations included adoption of evidence-based MATs for opioid use disorders in prisons and jails with persistent effort to identify and overcome challenges and dedicated funding to sustain programs.
AHRQ-funded; HS024243.
Citation: Ferguson WJ, Johnston J, Clarke JG .
Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.
Health Justice 2019 Dec 12;7(1):19. doi: 10.1186/s40352-019-0100-2..
Keywords: Opioids, Medication, Substance Abuse, Vulnerable Populations
Horng S, Joseph JW, Calder S
Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.
The purpose of this cohort study was to determine whether a simple visual aid was associated with a reduction in duplicate ordering of tests and medications. An interrupted time series model was used to analyze a series of consecutive patients who visited the emergency department of a large volume academic hospital. The researchers conclude that passive visual cues that provided just-in-time decision support were associated with reductions in unintentional duplicate orders for laboratory and radiology tests but not in unintentional duplicate medication orders.
AHRQ-funded; HS024288.
Citation: Horng S, Joseph JW, Calder S .
Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.
JAMA Netw Open 2019 Dec 2;2(12):e1916499. doi: 10.1001/jamanetworkopen.2019.16499..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Patient-Centered Outcomes Research, Medication
McCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
McCoy RG, Dykhoff HJ, Sangaralingham L
Adoption of new glucose-lowering medications in the U.S.-the case of SGLT2 inhibitors: nationwide cohort study.
This study examined use of new glucose-lowering medications called sodium-glucose cotransporter-2 inhibitors (SGLT2i) that was the most recently approved class of medications for diabetes type 1 and 2 patients. This class of medications have shown additional cardio- and renal-protective benefits as well as lower risk of hypoglycemia. A retrospective analysis of medical and pharmacy claims data from OptumLabs Data Warehouse was conducted for commercially insured and Medicare Advantage adult beneficiaries who filled any glucose-lowering medication from 2013-2016. Among a cohort of over 1 million, only 7.2% initiated a SGLT2i prescription. Patients with other complications, age 75 or older, black, and those with Medicare Advantage were less likely to start a SGLT2i.
AHRQ-funded; HS024075; HS025164; HS025402; HS025517; HS022882.
Citation: McCoy RG, Dykhoff HJ, Sangaralingham L .
Adoption of new glucose-lowering medications in the U.S.-the case of SGLT2 inhibitors: nationwide cohort study.
Diabetes Technol Ther 2019 Dec;21(12):702-12. doi: 10.1089/dia.2019.0213.
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Keywords: Medication, Diabetes, Practice Patterns
RIchmond J, Mangrum R, Wang G
An informed public's views on reducing antibiotic overuse.
The purpose of this study was to understand public attitudes about and recommendations to address antibiotic overuse by employing public deliberation (a method for eliciting informed input on value-laden issues). The investigators concluded that when informed about individual and social consequences of antibiotic overuse, patients may be more receptive to antibiotic prescription limits. They suggest that community-physician-government partnerships are needed to create solutions.
AHRQ-funded; 290201000005C.
Citation: RIchmond J, Mangrum R, Wang G .
An informed public's views on reducing antibiotic overuse.
Health Serv Res 2019 Dec;54(6):1283-94. doi: 10.1111/1475-6773.13175..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Health Literacy, Education: Patient and Caregiver
Stoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events
Salvador J, Bhatt S, Fowler R
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings. This brief report identified key systematic challenges that may directly limit primary care providers' engagement in telementoring models such as Project ECHO.
AHRQ-funded; HS025345.
Citation: Salvador J, Bhatt S, Fowler R .
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
Psychiatr Serv 2019 Dec;70(12):1157-60. doi: 10.1176/appi.ps.201900142..
Keywords: Opioids, Medication, Substance Abuse, Primary Care, Rural Health, Telehealth, Health Information Technology (HIT)
Mafi JN, May FP, Kahn KL
Low-value proton pump inhibitor prescriptions among older adults at a large academic health system.
Researchers sought to characterize the prevalence of potentially low-value proton pump inhibitor (PPI) prescriptions among older adults to inform a quality improvement intervention. Subjects were patients, aged 65 years or older, receiving primary care at a large academic health system in 2018. The researchers found that one in eight older adults were prescribed a PPI, and over one-third of prescriptions were potentially low-value. They conclude that, with most potentially low-value prescribing concentrated among a small subset of primary care physicians, interventions targeting them and/or applying EHR-based automatic stopping rules may protect older adults from harm.
AHRQ-funded; HS024067.
Citation: Mafi JN, May FP, Kahn KL .
Low-value proton pump inhibitor prescriptions among older adults at a large academic health system.
J Am Geriatr Soc 2019 Dec;67(12):2600-05. doi: 10.1111/jgs.16117..
Keywords: Elderly, Medication, Quality Improvement, Quality of Care, Primary Care
Ailabouni NJ, Marcum ZA, Schmader KE
Medication use quality and safety in older adults: 2018 update.
This study identified four key articles from 2018 that address medication use quality and safety for older adults. The first study highlighted a cluster-randomized trial that utilized a pharmacist-led education-based intervention delivered to both patients and doctors to deprescribe four types of inappropriate medications. The second study from the UK examined the association between anticholinergic exposure, overall and by medication class, and dementia risk in 40,770 older adults. The third study was a Swedish longitudinal cohort study examining the association between antihypertensive medications and incident dementia. The fourth and last study was a randomized, double-blind, placebo-controlled trial and examined the effect of daily low-dose aspirin for primary prevention of cardiac events and hemorrhage in 19,144 community-dwelling older adults.
AHRQ-funded; HS022982.
Citation: Ailabouni NJ, Marcum ZA, Schmader KE .
Medication use quality and safety in older adults: 2018 update.
J Am Geriatr Soc 2019 Dec;67(12):2458-62. doi: 10.1111/jgs.16243..
Keywords: Elderly, Medication, Medication: Safety, Patient Safety, Quality of Care, Provider: Pharmacist, Provider
Parikh K, Perry K, Pantor C
Multidisciplinary engagement increases medications in-hand for patients hospitalized with asthma.
Asthma exacerbations in children are a leading cause of missed school days and health care use. Patients discharged from the hospital often do not fill discharge prescriptions and are at risk for future exacerbations. In this study, a multidisciplinary team aimed to increase the percentage of patients discharged from the hospital after an asthma exacerbation with their medications in-hand from 15% to 80%.
AHRQ-funded; HS024554.
Citation: Parikh K, Perry K, Pantor C .
Multidisciplinary engagement increases medications in-hand for patients hospitalized with asthma.
Pediatrics 2019 Dec;144(6). doi: 10.1542/peds.2019-0674..
Keywords: Children/Adolescents, Asthma, Medication, Patient Adherence/Compliance, Teams, Hospital Discharge, Transitions of Care
Tam CA, Dauw CA, Ghani KR
New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment.
The purpose of this study was to measure the incidence of persistent opioid use following ureteroscopy (URS). Over 100 Americans die every day from opioid overdose. Recent studies suggest that many opioid addictions surface after surgery. The investigators concluded that nearly 1 in 16 opioid-naive patients developed new persistent opioid use after URS. New persistent opioid use was associated with the amount of opioid prescribed at the time of URS. The authors suggest that, given these findings, urologists should re-evaluate their post-URS opioid prescribing patterns.
AHRQ-funded; HS024525; HS024728.
Citation: Tam CA, Dauw CA, Ghani KR .
New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment.
Urology 2019 Dec;134:103-08. doi: 10.1016/j.urology.2019.08.042..
Keywords: Opioids, Medication, Substance Abuse, Surgery, Practice Patterns
Rentsch CT, Edelman EJ, Justice AC
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). In this study, the investigators extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. They identified four distinguishable dose trajectories. The authors indicate that their measures could potentially be used in future prevention research, including genetic discovery.
AHRQ-funded; HS021112; HS023258.
Citation: Rentsch CT, Edelman EJ, Justice AC .
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
AIDS Behav 2019 Dec;23(12):3340-49. doi: 10.1007/s10461-019-02608-3..
Keywords: Opioids, Medication, Substance Abuse, Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions