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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (21)
- Adverse Events (3)
- Antibiotics (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (5)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- Communication (3)
- Comparative Effectiveness (2)
- Diabetes (2)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (4)
- Electronic Prescribing (E-Prescribing) (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Health Information Technology (HIT) (4)
- Hospital Discharge (1)
- Hospitals (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Maternal Care (1)
- Medical Errors (3)
- Medicare (1)
- Medication (32)
- (-) Medication: Safety (35)
- Mortality (1)
- Neurological Disorders (1)
- Newborns/Infants (2)
- Opioids (3)
- Outcomes (1)
- Patient Adherence/Compliance (2)
- Patient Safety (13)
- Patient Self-Management (1)
- Policy (2)
- Practice-Based Research Network (PBRN) (1)
- Practice Patterns (1)
- Pregnancy (1)
- Provider (1)
- Provider: Pharmacist (2)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (2)
- Sleep Problems (1)
- Stroke (1)
- Substance Abuse (1)
- Surgery (2)
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 35 Research Studies DisplayedMeisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Westover AN, Nakonezny PA, Adinoff B
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
In this study of the impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents, the investigators found that adolescent stimulant medication users, compared to matched nonusers, demonstrated a trend toward decreased heart rate during submaximal exercise (which is potential evidence of chronic adaptation with stimulant exposure). There was no evidence for delayed heart rate recovery in this study, and thus, no evidence for decreased parasympathetic activity during initial exercise recovery.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Adinoff B .
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
J Child Adolesc Psychopharmacol 2016 Dec;26(10):889-99. doi: 10.1089/cap.2016.0064..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Blood Pressure, Medication, Medication: Safety
Cho I, Lee JH, Choi J
National rules for drug-drug interactions: are they appropriate for tertiary hospitals?
This study investigated the potential impact of Korean national drug-drug interactions (DDI) rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Only 0.3 percent of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5 percent, which was much lower than for the overall DDI rules.
AHRQ-funded; HS021094.
Citation: Cho I, Lee JH, Choi J .
National rules for drug-drug interactions: are they appropriate for tertiary hospitals?
J Korean Med Sci 2016 Dec;31(12):1887-96. doi: 10.3346/jkms.2016.31.12.1887.
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Keywords: Adverse Drug Events (ADE), Hospitals, Medication, Medication: Safety
Lipska KJ, Flory JH, Hennessy S
Citizen petition to the US Food and Drug Administration to change prescribing guidelines: The metformin experience.
Although healthcare professionals rarely submit citizen petitions, they can exert a powerful impact on the labeling requirements for drugs. Metformin is one such example. The authors filed 2 petitions to the FDA, asking the FDA to change the label and to relax the renal contraindications. In 2016, the FDA issued a safety communication that partially granted our requests by requiring the manufacturers of metformin to change the labeling of metformin in several ways.
AHRQ-funded; HS023898.
Citation: Lipska KJ, Flory JH, Hennessy S .
Citizen petition to the US Food and Drug Administration to change prescribing guidelines: The metformin experience.
Circulation 2016 Nov 1;134(18):1405-08. doi: 10.1161/circulationaha.116.023041.
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Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Kidney Disease and Health, Diabetes
Gagne JJ, Han X, Hennessy S
Successful comparison of US Food and Drug Administration sentinel analysis tools to traditional approaches in quantifying a known drug-adverse event association.
The authors assessed the extent to which the newly developed, semiautomated Sentinel Propensity Score Matching tool could produce the same results as a customized protocol-driven assessment. They found initial evidence that Sentinel analytic tools can produce findings similar to those produced by a highly customized protocol-driven assessment.
AHRQ-funded; HS022193.
Citation: Gagne JJ, Han X, Hennessy S .
Successful comparison of US Food and Drug Administration sentinel analysis tools to traditional approaches in quantifying a known drug-adverse event association.
Clin Pharmacol Ther 2016 Nov;100(5):558-64. doi: 10.1002/cpt.429.
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Keywords: Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety
Kesselheim AS, Bykov K, Gagne JJ
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
The researchers estimated the risk of seizure-related events associated with refilling antiepileptic drugs (AED) with generic AEDs and the effect of switching between different manufacturers of the same generic drug. They found that among patients on a generic AED, refilling the same AED was associated with an elevated risk of seizure-related event; however, there was no additional risk from switching during that refill to a different manufacturer.
AHRQ-funded; HS022193.
Citation: Kesselheim AS, Bykov K, Gagne JJ .
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
Neurology 2016 Oct 25;87(17):1796-801. doi: 10.1212/wnl.0000000000003259.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Neurological Disorders, Patient Safety, Risk
Green TC, Gilbert M
Counterfeit medications and fentanyl.
In this invited commentary, the authors discuss counterfeit medications and fentanyl, including a research letter in the same issue by Arens et al., which reports on a case series of counterfeit Xanax tablets containing fentanyl and etizolam. They include malice, accident, obfuscation, and economic considerations as reasons why someone would press fentanyl into the shape of a Xanax tablet.
AHRQ-funded; HS024021.
Citation: Green TC, Gilbert M .
Counterfeit medications and fentanyl.
JAMA Intern Med 2016 Oct;176(10):1555-57. doi: 10.1001/jamainternmed.2016.4310.
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Keywords: Medication: Safety, Medication, Patient Safety
Pinyavat T, Warner DO, Flick RP
Summary of the update session on clinical neurotoxicity studies.
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study.
AHRQ-funded; HS022941.
Citation: Pinyavat T, Warner DO, Flick RP .
Summary of the update session on clinical neurotoxicity studies.
J Neurosurg Anesthesiol 2016 Oct;28(4):356-60. doi: 10.1097/ana.0000000000000347.
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Keywords: Newborns/Infants, Children/Adolescents, Medication: Safety, Adverse Drug Events (ADE), Medication
Curtis LM, Mullen RJ, Russell A
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
The researchers tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. They found that written information and physician counseling were independently associated with patient understanding of risk information and that receiving both was most beneficial. They concluded that although an EHR can be a reliable means to deliver tangible, print medication education to patients, it cannot replace physician-patient communication, and that offering both written and spoken information resulted in a synergistic effect for informing patients.
AHRQ-funded; HS017220.
Citation: Curtis LM, Mullen RJ, Russell A .
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
Patient Educ Couns 2016 Sep;99(9):1489-95. doi: 10.1016/j.pec.2016.07.004.
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Keywords: Electronic Health Records (EHRs), Communication, Education: Patient and Caregiver, Medication: Safety, Medication
Zhou L, Dhopeshwarkar N, Blumenthal KG
Drug allergies documented in electronic health records of a large healthcare system.
The authors studied the prevalence of common drug allergies and patient characteristics documented in electronic health records of two large tertiary care hospitals in Boston from 1990 to 2013. They found that drug allergies in general were most prevalent among females and white patients, but that allergies to NSAIDs, ACE inhibitors, and thiazide diuretics were more prevalent in black patients.
AHRQ-funded; HS022728.
Citation: Zhou L, Dhopeshwarkar N, Blumenthal KG .
Drug allergies documented in electronic health records of a large healthcare system.
Allergy 2016 Sep;71(9):1305-13. doi: 10.1111/all.12881.
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Keywords: Adverse Drug Events (ADE), Electronic Health Records (EHRs), Medication: Safety, Medication
Ing C, Sun LS, Friend AF
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
This study compared spinal anesthesia (SA) versus general anesthesia (GA) in infants undergoing pyloromyotomy. It concluded that infants undergoing pyloromyotomy with SA had shorter operating room times and postoperative length of stay, no significant differences in adverse event rates, and decreased exposure to IV and inhaled anesthetics, although SA infants often still required supplemental anesthetics.
AHRQ-funded; HS022941.
Citation: Ing C, Sun LS, Friend AF .
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
Reg Anesth Pain Med 2016 Jul-Aug;41(4):532-7. doi: 10.1097/aap.0000000000000421.
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Keywords: Newborns/Infants, Surgery, Medication, Medication: Safety, Adverse Drug Events (ADE)
Kennedy-Hendricks A, Gielen A, McDonald E
Medication sharing, storage, and disposal practices for opioid medications among US adults.
The authors conducted a national survey among US adults with recent opioid medication use to examine the pervasiveness of sharing opioid medications, medication storage and disposal practices, and the sources of information received. Their findings suggested that current practices related to sharing, storing, and disposing of opioid medications, as well as communication of information on these topics, are suboptimal. They recommended that more research is needed to identify effective strategies to advance safer practices related to opioid medication sharing, storage, and disposal.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Gielen A, McDonald E .
Medication sharing, storage, and disposal practices for opioid medications among US adults.
JAMA Intern Med 2016 Jul;176(7):1027-9. doi: 10.1001/jamainternmed.2016.2543.
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Keywords: Medication: Safety, Medication, Opioids, Patient Safety, Substance Abuse
Maruther NM, Tseng E, Huftless S
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
The purpose of this study was to evaluate the comparative effectiveness and safety of monotherapy and selected metformin-based combinations in adults with type 2 diabetes. It found that the evidence supports metformin as first-line therapy for type 2 diabetes, given its relative safety and beneficial effects on hemoglobin A1c, weight, and cardiovascular mortality (compared with sulfonylureas). AHRQ-funded; 290-201-200007.
AHRQ-funded; 290201200007I.
Citation: Maruther NM, Tseng E, Huftless S .
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
Ann Intern Med 2016 Jun 7;164(11):740-51. doi: 10.7326/m15-2650.
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Keywords: Comparative Effectiveness, Medication, Diabetes, Evidence-Based Practice, Medication: Safety
Dai D, Feinstein JA, Morrison W
Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children's hospitals.
The authors studied the characteristics and prevalence of exposure of pediatric patients to polypharmacy and potential drug-drug interactions in pediatric intensive care units (PICUs). They found that many PICU patients are exposed to substantial polypharmacy and potential drug-drug interactions. Future research should identify the risk of adverse drug events following specific potential drug-drug interaction exposures.
AHRQ-funded; HS018425.
Citation: Dai D, Feinstein JA, Morrison W .
Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children's hospitals.
Pediatr Crit Care Med 2016 May;17(5):e218-28. doi: 10.1097/pcc.0000000000000684.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Intensive Care Unit (ICU), Medication, Medication: Safety
Topaz M, Seger DL, Slight SP
Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience.
The authors aimed to explore the common drug allergy alerts over the last 10 years and the reasons why providers tend to override these alerts. They found that alarmingly, alerts for immune mediated and life threatening reactions with definite allergen and prescribed medication matches were overridden 72.8 percent and 74.1 percent of the time, respectively.
AHRQ-funded; HS022728.
Citation: Topaz M, Seger DL, Slight SP .
Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience.
J Am Med Inform Assoc 2016 May;23(3):601-8. doi: 10.1093/jamia/ocv143.
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Keywords: Electronic Health Records (EHRs), Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety
Tilson H, Hines LE, McEvoy G
AHRQ Author: Helwig AL
Recommendations for selecting drug-drug interactions for clinical decision support.
A work group consisting of 20 experts in pharmacology, drug information, and clinical decision support (CDS) from academia, government agencies, health information vendors, and healthcare organizations was convened. It recommended a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization.
AHRQ-authored.
Citation: Tilson H, Hines LE, McEvoy G .
Recommendations for selecting drug-drug interactions for clinical decision support.
Am J Health Syst Pharm 2016 Apr 15;73(8):576-85. doi: 10.2146/ajhp150565.
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Keywords: Clinical Decision Support (CDS), Adverse Drug Events (ADE), Medication: Safety, Medication, Health Information Technology (HIT)
Farris KB, Salgado TM, Aneese N
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
The researchers sought to quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a comprehensive medication reviews (CMR) among Medicare Part D beneficiaries. They found that worrying about medications doing more harm than good, number of pharmacies where participants obtained their medications from, number of medications, and number of medical conditions predicted intention to obtain a CMR.
AHRQ-funded; HS018353.
Citation: Farris KB, Salgado TM, Aneese N .
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
J Manag Care Spec Pharm 2016 Apr;22(4):388-95. doi: 10.18553/jmcp.2016.22.4.388.
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Keywords: Medication, Medicare, Elderly, Medication: Safety, Patient Adherence/Compliance
Croft L, Ladd J, Doll M
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
To understand how often Clostridium difficile infection (CDI) is related to inappropriate medication use, the researchers evaluated appropriateness of antimicrobial therapy and gastric acid suppression preceding CDI acquired. Of all CDI episodes, 38.0 percent (27 of 71) were preceded by inappropriate gastric acid suppressant medications. For the 40 episodes in which gastric acid suppressant medications were used prior to CDI, 27 (67.5 percent) were inappropriately treated.
AHRQ-funded; HS018111.
Citation: Croft L, Ladd J, Doll M .
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
Infect Control Hosp Epidemiol 2016 Apr;37(4):494-5. doi: 10.1017/ice.2016.2.
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Keywords: Adverse Drug Events (ADE), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication: Safety, Medication
Beeler PE, Orav EJ, Seger DL
Provider variation in responses to warnings: do the same providers run stop signs repeatedly?
Variation in the use of tests and treatments has been demonstrated to be substantial between providers and geographic regions. This study assessed variation between outpatient providers in overriding electronic prescribing warnings. It concluded that the decision to override prescribing warnings shows variation between providers, and the magnitude of variation differs among the clinical domains of the warnings; more variation was observed in areas with more inappropriate overrides.
AHRQ-funded; HS021094.
Citation: Beeler PE, Orav EJ, Seger DL .
Provider variation in responses to warnings: do the same providers run stop signs repeatedly?
J Am Med Inform Assoc 2016 Apr;23(e1):e93-8. doi: 10.1093/jamia/ocv117.
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Keywords: Adverse Drug Events (ADE), Electronic Prescribing (E-Prescribing), Medication: Safety, Medical Errors, Practice Patterns
Zhong W, Feinstein JA, Patel NS
Tall Man lettering and potential prescription errors: a time series analysis of 42 children's hospitals in the USA over 9 years.
This paper evaluated rates of potential look-alike sound-alike (LA-SA) drug errors in the drug management process through to the point of dispensing before and after implementation of Tall Man lettering in 2007. The authors found no statistically significant change in error rate for each of the 11 drug pairs studied. Also, no downward trend in potential LA-SA drug error rates was evident over any time period 2004 onwards. They concluded that implementation of Tall Man lettering was not associated with a reduction in the potential LA-SA error rate.
AHRQ-funded; HS018425.
Citation: Zhong W, Feinstein JA, Patel NS .
Tall Man lettering and potential prescription errors: a time series analysis of 42 children's hospitals in the USA over 9 years.
BMJ Qual Saf 2016 Apr;25(4):233-40. doi: 10.1136/bmjqs-2015-004562.
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Keywords: Adverse Drug Events (ADE), Medication, Medication: Safety, Medical Errors, Patient Safety
Kennelty KA, Witry MJ, Gehring M
A four-phase approach for systematically collecting data and measuring medication discrepancies when patients transition between health care settings.
This article proposes a four-phase approach for systematically collecting medication data and measuring medication discrepancies between a hospital and community pharmacies. Using this phase-based approach, the study team successfully identified and reported medication discrepancies between a hospital and community pharmacies at the patient, medication, and community pharmacy units of analyses.
AHRQ-funded; HS021984.
Citation: Kennelty KA, Witry MJ, Gehring M .
A four-phase approach for systematically collecting data and measuring medication discrepancies when patients transition between health care settings.
Res Social Adm Pharm 2016 Jul-Aug;12(4):548-58. doi: 10.1016/j.sapharm.2015.09.001..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Patient Safety, Provider: Pharmacist
Kozak MA, Melton JR, Gernant SA
A needs assessment of unused and expired medication disposal practices: a study from the Medication Safety Research Network of Indiana.
The investigators sought to describe the extent of the unused and expired medication (UEM) issue in Indiana, identify patient beliefs about UEM, and determine any association between those beliefs and various personal and demographic characteristics. They concluded that there remains a need for more disposal locations for both non-controlled and controlled medication.
AHRQ-funded; HS022119.
Citation: Kozak MA, Melton JR, Gernant SA .
A needs assessment of unused and expired medication disposal practices: a study from the Medication Safety Research Network of Indiana.
Res Social Adm Pharm 2016 Mar-Apr;12(2):336-40. doi: 10.1016/j.sapharm.2015.05.013.
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Keywords: Medication: Safety, Medication, Patient Safety, Provider: Pharmacist, Practice-Based Research Network (PBRN)
Basco WT, Jr., Garner SS, Ebeling M
Evaluating the potential severity of look-alike, sound-alike drug substitution errors in children.
The authors' objective was to determine the degree of potential harm pediatricians ascribe to specific ambulatory look-alike, sound-alike (LASA) drug substitution errors. They concluded that pediatricians have identified LASA drug substitutions that pose a high potential risk of harm to children, thus allowing future efforts to prioritize pediatric LASA errors that can be screened prospectively in outpatient pharmacies.
AHRQ-funded; HS018841.
Citation: Basco WT, Jr., Garner SS, Ebeling M .
Evaluating the potential severity of look-alike, sound-alike drug substitution errors in children.
Acad Pediatr 2016 Mar;16(2):183-91. doi: 10.1016/j.acap.2015.06.014.
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Keywords: Children/Adolescents, Medication, Medication: Safety, Adverse Drug Events (ADE), Children/Adolescents
Downes KJ, Goldstein SL, Vinks AA
Increased vancomycin exposure and nephrotoxicity in children: therapeutic does not mean safe.
The authors argue that a tenuous balance exists between the successful treatment of infection and the safe administration of vancomycin in the most vulnerable patients. Furthermore, prospective controlled trials are needed to identify and validate the optimal pharmacokinetic/pharmacodynamic (PK/PD) targets for vancomycin in children. Also, infectious diseases specialists need to be cognizant of the untoward effects of nephrotoxic acute kidney injury in children.
AHRQ-funded; HS021114.
Citation: Downes KJ, Goldstein SL, Vinks AA .
Increased vancomycin exposure and nephrotoxicity in children: therapeutic does not mean safe.
J Pediatric Infect Dis Soc 2016 Mar;5(1):65-7. doi: 10.1093/jpids/piu122.
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Keywords: Adverse Drug Events (ADE), Antibiotics, Children/Adolescents, Medication, Medication: Safety
Kennedy-Hendricks A, Richey M, McGinty EE
Opioid overdose deaths and Florida's crackdown on pill mills.
The researchers examined the effect on opioid overdose mortality of Florida state laws and law enforcement operations targeting "pill mills." They found that Florida's actions were associated with an estimated 1029 lives saved from prescription opioid overdose over a 34-month period, and estimated reductions in deaths grew over the intervention period.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Richey M, McGinty EE .
Opioid overdose deaths and Florida's crackdown on pill mills.
Am J Public Health 2016 Feb;106(2):291-7. doi: 10.2105/ajph.2015.302953.
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Keywords: Policy, Medication, Medication: Safety, Mortality, Opioids