National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Adverse Drug Events (ADE) (23)
- Adverse Events (15)
- Anxiety (1)
- Behavioral Health (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Data (2)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Electronic Health Records (EHRs) (6)
- Emergency Department (1)
- Falls (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (8)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Injuries and Wounds (1)
- Long-Term Care (2)
- Medical Errors (7)
- Medication (21)
- Medication: Safety (13)
- Nursing Homes (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- (-) Patient Safety (23)
- Prevention (3)
- Quality of Care (1)
- Research Methodologies (1)
- Risk (2)
- Transitions of Care (1)
- Transplantation (1)
- Vaccination (1)
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 23 of 23 Research Studies DisplayedZhou S, Kang H, Yao B
An automated pipeline for analyzing medication event reports in clinical settings.
The article describes and evaluates an automated pipeline that is expected to improve the efficiency of analyzing medication event reports. The pipeline assists clinicians in extracting information from reports and generating feedback using classic machine-learning classifiers to compare three attributes taken from the reports: event originating stages, event types, and event causes. The pipeline identifies these attributes and calculates similarity scores based on them. A strategy to measure similarity was created and evaluated by human subjects using a questionnaire.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Yao B .
An automated pipeline for analyzing medication event reports in clinical settings.
BMC Med Inform Decis Mak 2018 Dec 7;18(Suppl 5):113. doi: 10.1186/s12911-018-0687-6..
Keywords: Adverse Drug Events (ADE), Quality of Care, Medication, Patient Safety
Wright A, Aaron S, Seger DL
Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record.
This study examined the effects of conversion from a homegrown electronic health record (EHR) system to a commercial system on the effectiveness of drug-drug interaction (DDI) alert. The EHR system included 3277 clinicians in the before and after studies. There was a marked decrease in the acceptance rate (100 to 8.4% for severe alerts, 29.3 to 7.5% for medium severity) at first. The least severe alerts were then disabled, which lowered the alert burden by 50.5% which rose the acceptance of Tier 1 alerts to 12.7%. However, there was no clear explanation after that why the acceptance rate remained so much lower. The authors believe that workflow factors were probably the predominant reasons.
AHRQ-funded; HS016970.
Citation: Wright A, Aaron S, Seger DL .
Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record.
J Gen Intern Med 2018 Nov;33(11):1868-76. doi: 10.1007/s11606-018-4415-9..
Keywords: Adverse Drug Events (ADE), Medication, Adverse Events, Medical Errors, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Shaker M, Lindholm C, Low J
Summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature.
Epinephrine is first-line treatment for anaphylaxis. The Food and Drug Administration reported that adverse events from epinephrine are infrequent. This paper provides a summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature.
AHRQ-funded; HS024599.
Citation: Shaker M, Lindholm C, Low J .
Summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):2143-45.e4. doi: 10.1016/j.jaip.2018.04.006..
Keywords: Adverse Events, Adverse Drug Events (ADE), Medication, Patient Safety, Prevention
Schiff G, Mirica MM, Dhavle AA
A prescription for enhancing electronic prescribing safety.
The authors review six areas in which electronic prescribing areas can be improved to transform medication ordering quality and safety. They recommend incorporating medication indications into electronic prescribing, establishing a single shared online medication list, implementing an electronic cancellation mechanism for pharmacies, implementing standardized structured and codified prescription instruction, reengineering clinical decision support, and redesigning electronic prescribing to facilitate ordering of nondrug alternatives.
AHRQ-funded; HS023694.
Citation: Schiff G, Mirica MM, Dhavle AA .
A prescription for enhancing electronic prescribing safety.
Health Aff 2018 Nov;37(11):1877-83. doi: 10.1377/hlthaff.2018.0725..
Keywords: Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Healthcare Delivery, Medical Errors, Medication, Medication: Safety, Patient Safety
Wang SV, Maro JC, Baro E
Data mining for adverse drug events with a propensity score-matched tree-based scan statistic.
In this study, the investigators propose a method that combines tree-based scan statistics with propensity score-matched analysis of new initiator cohorts, a robust design for investigations of drug safety. They subsequently conducted plasmode simulations to evaluate performance. The authors suggest that TreeScan with propensity score matching shows promise as a method for screening and prioritization of potential adverse events.
AHRQ-funded; HS022193.
Citation: Wang SV, Maro JC, Baro E .
Data mining for adverse drug events with a propensity score-matched tree-based scan statistic.
Epidemiology 2018 Nov;29(6):895-903. doi: 10.1097/ede.0000000000000907..
Keywords: Adverse Drug Events (ADE), Adverse Events, Patient Safety, Medication, Medication: Safety, Data, Research Methodologies
Prey JE, Polubriaginof F, Grossman LV
Engaging hospital patients in the medication reconciliation process using tablet computers.
Researchers conducted a pilot study to determine whether patients’ use of an electronic home medication review tool on a table computer could improve medication safety before or after hospitalization. Patients were randomized to the tool and out of 76 patients approached, 65 participated. About three-quarters (74%) made changes to their home medication list. Out of that total, 74% of the changes identified had a significant or greater potential severity, and 49% had a greater than 50-50 chance of harm. This medication reconciliation tool showed great potential to improve medication safety during and after hospitalization.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Grossman LV .
Engaging hospital patients in the medication reconciliation process using tablet computers.
J Am Med Inform Assoc 2018 Nov;25(11):1460-69. doi: 10.1093/jamia/ocy115..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Medication, Medication: Safety, Patient and Family Engagement, Patient Safety, Prevention
Bates DW, Singh H
Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.
This paper comments on the progress made in improving patient safety since the 1999 report from The Institute of Medicine titled “To Err is Human” was published. This landmark report highlighted problem areas, and since then there has been a number of effective interventions to prevent hospital-acquired infections and improve medication safety. Additional areas for improvement have also been identified in the past two decades, including outpatient care, diagnostic, errors and the use of health information technology. The authors believe that electronic data developments can help increase patient safety even further.
AHRQ-funded; HS022087; HS017820.
Citation: Bates DW, Singh H .
Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.
Health Aff 2018 Nov;37(11):1736-43. doi: 10.1377/hlthaff.2018.0738..
Keywords: Adverse Drug Events (ADE), Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Medication: Safety, Patient Safety, Prevention
Blumenthal KG, Li Y, Acker WW
Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression.
In this study, the authors used electronic health record (EHR) data to describe prevalences of MDIS and MDAS and to examine associations with anxiety and depression. The investigators concluded that: 1.) while 6% of patients had MDIS, only 1% had MDAS; 2.) MDIS was associated with both anxiety and depression; 3.) patients with both anxiety and depression had an almost twofold increased odds of MDIS; 4.) MDAS was associated with a 40% increased odds of depression, but there was no significant association with anxiety.
AHRQ-funded; HS022728.
Citation: Blumenthal KG, Li Y, Acker WW .
Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression.
Allergy 2018 Oct;73(10):2012-23. doi: 10.1111/all.13440..
Keywords: Adverse Drug Events (ADE), Adverse Events, Anxiety, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Behavioral Health, Patient Safety
Wong A, Plasek JM, Montecalvo SP
Natural language processing and its implications for the future of medication safety: a narrative review of recent advances and challenges.
This review illustrates the fundamentals of natural language processing (NLP) and discusses the application the NLPs to medication safety in four data sources: electronic health records, Internet-based data, published literature, and reporting systems. The benefit of NLP is its time-saving features in association with the automation of medication safety tasks, as well as the potential for near real-time identification of adverse events, such as incidents posted on social media that might otherwise go unanalyzed. However, NLP is limited by a lack of data sharing between health care organizations, which inhibits wider adverse event monitoring across populations. The authors anticipate that future work on NLPs will focus on integrating of data sources from different domains to more quickly identify potential adverse events and to improve clinical decision support regarding patients’ estimated risks for specific adverse events.
AHRQ-funded; HS022728; HS024264; HS025375.
Citation: Wong A, Plasek JM, Montecalvo SP .
Natural language processing and its implications for the future of medication safety: a narrative review of recent advances and challenges.
Pharmacotherapy 2018 Aug;38(8):822-41. doi: 10.1002/phar.2151..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety
Goss FR, Lai KH, Topaz M
A value set for documenting adverse reactions in electronic health records.
In this study, the investigators developed a value set for encoding adverse reactions using a large dataset from one health system, enriched by reactions from 2 large external resources. This integrated value set included clinically important severe and hypersensitivity reactions. The work contributed a value set, harmonized with existing data, to improve the consistency and accuracy of reaction documentation in electronic health records, providing the necessary building blocks for more intelligent clinical decision support for allergies and adverse reactions.
AHRQ-funded; HS022728.
Citation: Goss FR, Lai KH, Topaz M .
A value set for documenting adverse reactions in electronic health records.
J Am Med Inform Assoc 2018 Jun;25(6):661-69. doi: 10.1093/jamia/ocx139..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Medication, Data, Health Information Technology (HIT), Patient Safety
Liu W, Antonelli PJ, Dahm P
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: population-based cohort study.
The objective of this retrospective cohort study was to determine the risk of sudden sensorineural hearing loss (SNHL) associated with use of phosphodiesterase type 5 (PDE5) inhibitors. The investigators found that use of PDE5 inhibitors was associated with a small but significantly increased risk of sudden SNHL.
AHRQ-funded; HS021112.
Citation: Liu W, Antonelli PJ, Dahm P .
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: population-based cohort study.
Pharmacoepidemiol Drug Saf 2018 Jun;27(6):587-95. doi: 10.1002/pds.4405..
Keywords: Risk, Adverse Drug Events (ADE), Adverse Events, Medication, Patient Safety
Wang J, Ali E, Gong Y
An information enhanced framework for reporting medication events.
In this article, the authors describe a proposed framework to discover supportive information from the FDA Adverse Event Reporting System (FAERS), an open data source, to enhance the reporting of insulin-use events. The framework represents a paradigm for developing an information enhanced electronic reporting system.
AHRQ-funded; HS022895.
Citation: Wang J, Ali E, Gong Y .
An information enhanced framework for reporting medication events.
Stud Health Technol Inform 2018;250:169-73..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Medication: Safety, Patient Safety
Kannampallil TG, Manning JD, Chestek DW
Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department.
The authors examined the effect of number of open charts on intercepted wrong-patient medication orders in an emergency department using an interrupted time series analysis of intercepted wrong-patient medication orders in an emergency department during 2010-2016.
AHRQ-funded; HS024945.
Citation: Kannampallil TG, Manning JD, Chestek DW .
Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department.
J Am Med Inform Assoc 2018 Jun;25(6):739-43. doi: 10.1093/jamia/ocx099..
Keywords: Adverse Drug Events (ADE), Emergency Department, Medical Errors, Medication, Medication: Safety, Patient Safety
Lee JL, Dy SM, Gurses AP
Towards a more patient-centered approach to medication safety.
In this perspective, the authors focus their discussion on a patient-centered approach to measurement and describe commonly used health system–oriented medication safety measures for evaluating interventions. They also discuss measures that reflect patient-centeredness in medication safety.
AHRQ-funded; HS024436.
Citation: Lee JL, Dy SM, Gurses AP .
Towards a more patient-centered approach to medication safety.
J Patient Exp 2018 Jun;5(2):83-87. doi: 10.1177/2374373517727532..
Keywords: Adverse Drug Events (ADE), Patient-Centered Healthcare, Patient Safety, Medication: Safety, Medication
Zhou S, Kang H, Yao B
Unveiling originated stages of medication errors: an automated pipeline approach.
Medication error reports collected by Patient Safety Organizations provide an opportunity to analyze and learn from previous cases. However, the current process of analyzing the reports is labor-intensive and time-consuming. To improve the efficiency, the investigators used automated text classification techniques to develop a pipeline for medication error report pre-analysis.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Yao B .
Unveiling originated stages of medication errors: an automated pipeline approach.
Stud Health Technol Inform 2018;250:182-86..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Medication: Safety, Patient Safety
Dore DD, Zullo AR, Mor V
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
This study examined the rate of hip fracture in nursing home residents prescribed nonbenzodiazepine hypnotics. A sample of nursing home residents was used and linked to Medicare and Minimum Data Set (2007-2008) data. The rate of hip fracture was higher in residents aged 90 and above, and lower in residents 70 or below. There was no different by sex.
AHRQ-funded; HS022998.
Citation: Dore DD, Zullo AR, Mor V .
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
J Am Med Dir Assoc 2018 Apr;19(4):328-32.e2. doi: 10.1016/j.jamda.2017.09.015..
Keywords: Injuries and Wounds, Medication, Nursing Homes, Long-Term Care, Adverse Drug Events (ADE), Adverse Events, Falls, Risk, Patient Safety
Smith JC, Chen Q, Denny JC
Evaluation of a novel system to enhance clinicians' recognition of preadmission adverse drug reactions.
This study evaluated whether an automated system, the Adverse Drug Effect Recognizer (ADER), could assist clinicians in detecting and addressing inpatients' ongoing preadmission adverse drug reactions (ADRs). The investigators found that their results indicated that ADER helped physicians recognize ADRs and reduced ordering of suspected ADR-causing medications. They suggest that in hospitals using EHRs, ADER-like systems could improve clinicians' recognition and elimination of ongoing ADRs.
AHRQ-funded; HS023485.
Citation: Smith JC, Chen Q, Denny JC .
Evaluation of a novel system to enhance clinicians' recognition of preadmission adverse drug reactions.
Appl Clin Inform 2018 Apr;9(2):313-25. doi: 10.1055/s-0038-1646963..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Medication, Patient Safety, Health Information Technology (HIT)
Wang SV, Abdurrob A, Spoendlin J
Methods for addressing "innocent bystanders" when evaluating safety of concomitant vaccines.
The need to develop methods for studying the safety of childhood immunization schedules has been recognized by the Institute of Medicine and Department of Health and Human Services. The recommended childhood immunization schedule includes multiple vaccines in a visit. A key concern is safety of concomitant (same day) versus separate day vaccination. This paper addressed a methodological challenge for observational studies using a self-controlled design to investigate the safety of concomitant vaccination.
AHRQ-funded; HS022193.
Citation: Wang SV, Abdurrob A, Spoendlin J .
Methods for addressing "innocent bystanders" when evaluating safety of concomitant vaccines.
Pharmacoepidemiol Drug Saf 2018 Apr;27(4):405-12. doi: 10.1002/pds.4399..
Keywords: Adverse Drug Events (ADE), Adverse Events, Children/Adolescents, Patient Safety, Vaccination
Leonard CE, Brensinger CM, Aquilante CL
Comparative safety of sulfonylureas and the risk of sudden cardiac arrest and ventricular arrhythmia.
This study examined the association between individual antidiabetic sulfonylureas and outpatient-originating sudden cardiac arrest and ventricular arrhythmia (SCA/VA). It concluded that glyburide may be associated with a lower risk of SCA/VA than glipizide, consistent with a very small clinical trial suggesting that glyburide may reduce ventricular tachycardia and isolated ventricular premature complexes.
AHRQ-funded; HS023898.
Citation: Leonard CE, Brensinger CM, Aquilante CL .
Comparative safety of sulfonylureas and the risk of sudden cardiac arrest and ventricular arrhythmia.
Diabetes Care 2018 Apr;41(4):713-22. doi: 10.2337/dc17-0294.
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Keywords: Adverse Drug Events (ADE), Cardiovascular Conditions, Medication, Patient-Centered Outcomes Research, Patient Safety
Kerstenetzky L, Birschbach MJ, Beach KF
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
The authors of this study report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to skilled nurse facilities and long term care pharmacy staff.
AHRQ-funded; HS021984.
Citation: Kerstenetzky L, Birschbach MJ, Beach KF .
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
Res Social Adm Pharm 2018 Feb;14(2):138-45. doi: 10.1016/j.sapharm.2016.12.013..
Keywords: Adverse Drug Events (ADE), Hospital Discharge, Hospitals, Long-Term Care, Medical Errors, Medication, Medication: Safety, Nursing Homes, Patient Safety, Transitions of Care
Arms MA, Fleming J, Sangani DB
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
This longitudinal cohort study examined 3 cohorts (no readmissions, readmissions not due to an adverse drug event, and adverse drug events contributing to readmissions) of adult kidney recipients transplanted between 2005 and 2010 and followed through 2013. The study results demonstrated that adverse drug events may be associated with a significant increase in the risk of hospital readmission after kidney transplant and subsequent graft loss.
AHRQ-funded; HS023754
Citation: Arms MA, Fleming J, Sangani DB .
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
Surgery 2018 Feb;163(2):430-35. doi: 10.1016/j.surg.2017.09.027..
Keywords: Adverse Drug Events (ADE), Patient Safety, Hospital Readmissions, Transplantation
Gray SL, Hart LA, Perera S
Meta-analysis of interventions to reduce adverse drug reactions in older adults.
This review examined the effect of interventions to optimize medication use on adverse drug reactions (ADRs) in older adults. Thirteen randomized controlled trials involving 6,198 older adults were included in the review. It concluded that interventions designed to optimize medication use reduced the risk of any and serious ADRs in older adults.
AHRQ-funded; HS023779.
Citation: Gray SL, Hart LA, Perera S .
Meta-analysis of interventions to reduce adverse drug reactions in older adults.
J Am Geriatr Soc 2018 Feb;66(2):282-88. doi: 10.1111/jgs.15195.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Patient Safety
Sun D, Sarda G, Skube SJ
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Researchers developed and evaluated a phenotyping algorithm to detect Infusion-related reactions (IRRs) for breast cancer patients. They also designed a visualization prototype to render IRR patients' medications, lab tests and vital signs over time. By comparing with the 42 randomly selected doses that are manually labeled by a domain expert, the sensitivity, positive predictive value, specificity, and negative predictive value of the algorithms are 69 percent, 60 percent, 79 percent, and 85 percent, respectively.
AHRQ-funded; HS022085.
Citation: Sun D, Sarda G, Skube SJ .
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Stud Health Technol Inform 2017;245:599-603.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Medication: Safety, Patient Safety