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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 5 of 5 Research Studies DisplayedSankar A, Everhart AO, Jena AB
Longitudinal patterns in testosterone prescribing after US FDA safety communication in 2014.
This study described changes in testosterone prescribing following a 2014 US Food and Drug Administration (FDA) safety communication and how changes varied by physician characteristics. The authors extracted data from a 20% random sample of Medicare fee-for-service administrative claims data from 2011 through 2019. This unique sample included 1,544,604 unique male beneficiaries who received evaluation and management (E&M) services from 58,819 unique physicians that prescribed testosterone between 2011 and 2013. Patients were classified by presence of coronary artery disease (CAD) and non-age-related hypogonadism. Physician characteristics included specialty and affiliations with teaching hospitals, for-profit hospitals, hospitals in integrated delivery networks, and hospitals in the top decile of case mix index. Among 65,089,560 physician-patient-quarter-year observations, mean (standard deviation) age ranged from 72.16 (5.84 SD) years for observations without CAD or non-age-related hypogonadism to 75.73 (6.92 SD) years with CAD and without non-age-related hypogonadism. Following the safety communication, immediate changes in off-label testosterone prescription levels fell by 0.22 percentage points (pp) for patients with CAD and by -0.16 pp for patients without CAD, with a similar change in on-label prescribing levels. The off-label testosterone prescription quarterly trend increased for patients with CAD and without CAD; on-label testosterone prescription trends declined for both groups. Primary care physicians had larger declines in off-label prescribing then non-primary care physicians, and physicians affiliated with teaching compared to nonteaching hospitals. On-label prescribing found no changes associated with physician and organizational characteristics.
AHRQ-funded; HS025164.
Citation: Sankar A, Everhart AO, Jena AB .
Longitudinal patterns in testosterone prescribing after US FDA safety communication in 2014.
Jt Comm J Qual Patient Saf 2023 Sep; 49(9):458-66. doi: 10.1016/j.jcjq.2023.05.003..
Keywords: Communication, Medication, Practice Patterns
Niederdeppe J, Avery RJ, Liu J
Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?
This study examined associations between estimated exposure to direct consumer-to-advertising (DTCA) for drugs focused on heart disease/cholesterol and diabetes and self-reported exercise and consumption of a variety of unhealthy foods (candy, sugary drinks, alcohol, and fast food). The authors estimated exposure to DTCA by combining data from Kantar Media Intelligence (Kantar) on televised pharmaceutical DTCA airings in the U.S. from January 2003 to August 2016 (n = 7,696,851 airings) with thirteen years of data from the Simmons National Consumer Survey (Simmons), a mailed survey on television viewing patterns. They estimated associations between exposure to advertising (both overall and for advertisements with specific content) and self-reported physical activity and dietary behavior using Simmons data from January 2004 to December 2016 (n = 288,483 respondents from n = 157,621 unique households in the U.S.). They found that higher estimated exposure to DTCA for heart disease and diabetes drugs were not consistently associated with meaningful differences in the frequency of engaging in regular physical activity. However, greater estimated exposure to DTCA for both diseases were linked to small but consistently higher volume of consumption of candy, sugar-sweetened beverages, alcohol, and fast food.
AHRQ-funded; HS025983.
Citation: Niederdeppe J, Avery RJ, Liu J .
Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?
Soc Sci Med 2023 Aug; 330:116062. doi: 10.1016/j.socscimed.2023.116062..
Keywords: Communication, Diabetes, Heart Disease and Health, Medication
Alpert A, Lakdawalla D, Sood N
Prescription drug advertising and drug utilization: the role of Medicare Part D.
The purpose of this paper was to explore how direct-to-consumer advertising (DTCA) for prescription drugs affects use by leveraging a large and plausibly exogenous shock to DTCA influenced by the introduction of Medicare Part D. Part D led to greater increases in advertising in geographic areas with greater concentrations of Medicare beneficiaries. The researchers explored the effect of this increase in advertising on non-elderly individuals to separate the effects of advertising from the direct effects of Part D. The study found that exposure to advertising resulted in large increases in treatment initiation and improved adherence to medication. Advertising also had substantial positive spillover effects on non-advertised generic drugs.
AHRQ-funded; HS025983.
Citation: Alpert A, Lakdawalla D, Sood N .
Prescription drug advertising and drug utilization: the role of Medicare Part D.
J Public Econ 2023 May; 221. doi: 10.1016/j.jpubeco.2023.104860..
Keywords: Communication, Medication, Medicare
DiStefano MJ, Markell JM, Doherty CC
Association between drug characteristics and manufacturer spending on direct-to-consumer advertising.
The purpose of this exploratory cross-sectional study was to pinpoint the attributes of drugs that correlate with a larger portion of promotional expenditure on consumer-targeted advertising. The researchers conducted an examination of drug traits and promotional expenses for the top 150 best-selling branded prescription medications in the US in 2020, using data from IQVIA National Sales Perspectives. IQVIA Channel Dynamics provided promotional spending information. Various drug features were assessed, including 2020 total sales and promotional spending, clinical benefit ratings, number of indications, off-label usage, molecule type, condition treated, administration method, generic availability, FDA approval year, World Health Organization anatomical therapeutic chemical classification, Medicare average annual spending per beneficiary, drug sales percentage, market size, and market competitiveness. Data was obtained from health technology assessment agencies and drug databases. The study found that in 2020, the median proportion of promotional spending allocated to direct-to-consumer advertising was 13.5% with a median promotional spending of $20.9 million and median total sales of $1.51 billion. Sixteen of the top 150 drugs had incomplete data, resulting in a primary study sample of 134 drugs. After adjusting for multiple drug characteristics, the mean proportion of total promotional spending allocated to direct-to-consumer advertising for the remaining 134 drugs was an absolute 14.3% higher for drugs with low added clinical benefit compared to those with high added clinical benefit and an absolute 1.5% higher for each 10% increase in total sales.
AHRQ-funded; HS000029.
Citation: DiStefano MJ, Markell JM, Doherty CC .
Association between drug characteristics and manufacturer spending on direct-to-consumer advertising.
JAMA 2023 Feb 7; 329(5):386-92. doi: 10.1001/jama.2022.23968..
Keywords: Medication, Communication
Becker MW, Kashy DA, Harben A
A novel strategy to optimize critical information on over the counter labels for older adults.
In this article, the authors described two experiments in which they evaluated the impact of over-the-counter (OTC) medication label designs that employ highlighting and warning labels placed on package fronts on the attention and use of critical information by older consumers. In both experiments. participants aged 65 or over were required to access and use critical label information to respond correctly to questions. Highlighting or placing critical information on the front of packaging significantly improved response accuracy. The authors concluded that these results are relevant for regulations which dictate label design to further ease and safety of use of medications for older adults.
AHRQ-funded; HS025386.
Citation: Becker MW, Kashy DA, Harben A .
A novel strategy to optimize critical information on over the counter labels for older adults.
Health Sci Rep 2023 Jan 25; 6(1):e1062. doi: 10.1002/hsr2.1062..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Communication