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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedJiang Y, Mason M, Cho Y
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
The purpose of this study was to explore the tolerance of capecitabine oral chemotherapy among older adults with cancer and investigate factors associated with related side effects and treatment changes. The researchers combined data from electronic health records and a pilot study of patient-reported outcomes, and found that older adults were more likely to experience fatigue and experienced more severe fatigue and hand-foot syndrome (HFS) than younger adults. The severity of fatigue and HFS were associated with the number of outpatient medications and the duration of treatment respectively. Female sex, breast cancer diagnosis, capecitabine monotherapy, and severe HFS were found to be associated with subsequent dose reductions. The study concluded that older adults were less likely to tolerate capecitabine treatment and had different co-occurring side effects compared to younger adults.
AHRQ-funded; HS027846.
Citation: Jiang Y, Mason M, Cho Y .
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
BMC Cancer 2022 Sep 3;22(1):950. doi: 10.1186/s12885-022-10026-3..
Keywords: Elderly, Cancer, Medication, Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT)
Villa-Zapata L, Gómez-Lumbreras A, Horn J
A disproportionality analysis of drug-drug interactions of tizanidine and CYP1A2 inhibitors from the FDA Adverse Event Reporting System (FAERS).
This study’s aim was to examine the occurrence of adverse events reported in the FDA Adverse Event Reporting System (FAERS) involving the combination of tizanidine and drugs that inhibit the metabolic activity of CYP1A2. Tizanidine is used to help control muscle spasticity. From 2004 quarter 1 through 2020 quarter 3 a total of 89 reports were identified mentioning tizanidine, at least one CYP1A2 inhibitor, and one of the adverse events of interest including: hypotension, bradycardia, syncope, shock, cardiorespiratory arrest, and fall or fracture. More than half the reports identified tizanidine as having a suspect or interacting role, and the reports more frequently involved women (65.1%). The median age was 56.1 years. Hypotension had the highest odds for adverse event reports involving tizanidine and a CYP1A2 inhibitor which can lead to falls and fractures.
AHRQ-funded; HS025984.
Citation: Villa-Zapata L, Gómez-Lumbreras A, Horn J .
A disproportionality analysis of drug-drug interactions of tizanidine and CYP1A2 inhibitors from the FDA Adverse Event Reporting System (FAERS).
Drug Saf 2022 Aug;45(8):863-71. doi: 10.1007/s40264-022-01200-4..
Keywords: Health Information Technology (HIT), Medication, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety
Reese T, Wright A, Liu S
Improving the specificity of drug-drug interaction alerts: can it be done?
A lack of accuracy and specificity of medication alerts have an impact on alert fatigue, high rates of override, and harm to the patient. The drugs that activate alerts are frequently grouped inconsistently into value sets, and alerts for drug-drug interactions (DDI) often do not account for the factors that could decrease risk. The purpose of this proof-of-concept study was to identify and bring attention to the inconsistency of drug value sets for activating alerts, as well as provide a method of classifying factors that can be utilized to alter the risk of harm from a DDI. The researchers included 15 well-known DDIs, and utilized 3 drug interaction references to isolate 2 drug value sets as well as order- and patient-related factors for each DDI. The study reported 30 value sets, with 56% of value sets (17) having nonsignificant agreement, with average moderate agreement among the remaining 13 value sets. Thirty-three factors were identified that could decrease risk in 93% (14) of the 15 DDIs. The researchers concluded that the study shows the value of improving the consistency of DDI-alerting drug value sets, and ways in which alert usefulness and specificity can be improved.
AHRQ-funded; HS025984; HS023826.
Citation: Reese T, Wright A, Liu S .
Improving the specificity of drug-drug interaction alerts: can it be done?
Am J Health Syst Pharm 2022 Jun 23;79(13):1086-95. doi: 10.1093/ajhp/zxac045..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Clinical Decision Support (CDS), Health Information Technology (HIT)
Vallamkonda S, Ortega CA, Lo YC
Identifying and reconciling patients' allergy information within the electronic health record.
The authors examined the prevalence of incompleteness, inaccuracy, and redundancy of allergy information within the electronic health record (EHR) for patients with a clinical encounter at any Mass General Brigham facility between January 1 and December 31, 2018. They identified 4 key places in the EHR containing reconcilable allergy information and determined that 45.2% of the patients had an active allergy entry, with 37.1% indicating a need for reconciliation.
AHRQ-funded; HS025375.
Citation: Vallamkonda S, Ortega CA, Lo YC .
Identifying and reconciling patients' allergy information within the electronic health record.
Stud Health Technol Inform 2022 Jun 6;290:120-24. doi: 10.3233/shti220044..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Adverse Drug Events (ADE), Adverse Events
Villa Zapata L, Subbian V, Boyce RD
Overriding drug-drug interaction alerts in clinical decision support systems: a scoping review.
The authors reviewed published data on the rate of Drug-Drug Interactions (DDI) alert overrides and medications involved in the overrides. Among 34 eligible studies, they found that the override rate of DDI alerts ranged from 55% to 98%, with more than half of the studies reporting the most common drug pairs or medications involved in acceptance or overriding of alerts. They recommended decision support systems that take user, drug, and institutional factors into consideration, as well as actionable metrics to better characterize harm associated with overrides.
AHRQ-funded; HS025984; HS023826.
Citation: Villa Zapata L, Subbian V, Boyce RD .
Overriding drug-drug interaction alerts in clinical decision support systems: a scoping review.
Stud Health Technol Inform 2022 Jun 6;290:380-84. doi: 10.3233/shti220101..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medication
Yerneni S, Shah S, Blackley SV
Heterogeneity of drug allergies and reaction lists in two U.S. healthcare systems' electronic health records.
This study compared adverse drug reaction (ADRs) picklists for clinicians in the electronic health record (EHR) allergy list for two different healthcare institutions. The authors used data from the EHRs of patients who visited the emergency department or outpatient clinics at Brigham and Women's Hospital (BWH) and University of Colorado Hospital (UCH) from 2013-2018. They investigated the reactions on each picklist and compared the top 40 reactions at each institution, as well as the top 10 reactions within each drug class. Out of 2,160,116 patients sampled, 30% reported active drug allergies. The most commonly reported drug class allergens were similar between the two institutions, however BWH’s picklist had 48 reactions while UCH’s had 160. Twenty-nine reactions were shared by both picklists. There was a lot more granularity with UCH’s picklist so that body locality, swelling and edema were described in much greater detail than for BWH. These picklists may partially explain variations in reported ADRs across healthcare systems.
AHRQ-funded; HS025375.
Citation: Yerneni S, Shah S, Blackley SV .
Heterogeneity of drug allergies and reaction lists in two U.S. healthcare systems' electronic health records.
Appl Clin Inform 2022 May 26;13(3):741-51. doi: 10.1055/a-1862-9425..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety