National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Alcohol Use (1)
- Children/Adolescents (2)
- Chronic Conditions (3)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (3)
- Disparities (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Guidelines (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (1)
- Hospitalization (2)
- Medicaid (3)
- Medical Errors (1)
- Medication (19)
- Medication: Safety (1)
- Newborns/Infants (1)
- Obesity (1)
- (-) Opioids (21)
- Outcomes (3)
- Pain (11)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Safety (2)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (2)
- Prevention (1)
- Primary Care (1)
- Provider: Pharmacist (1)
- Racial and Ethnic Minorities (1)
- Substance Abuse (7)
- Surgery (3)
- Treatments (1)
- Women (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 21 of 21 Research Studies DisplayedMeisel ZF, Smith RJ
Engaging patients around the risks of opioid misuse in the emergency.
The authors of this editorial considered a number of different types of strategies to increase patient awareness of risks and benefits associated with alternative pain management strategies in the ED. These include traditional education, communicating risks, shared decisionmaking, community interventions and “sticky” narratives. They conclude that patients, families and communities must be included in order to navigate the tight¬rope walk between providing adequate pain control and mitigating misuse and dependency.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Smith RJ .
Engaging patients around the risks of opioid misuse in the emergency.
Pain Manag 2015 Sep;5(5):323-6. doi: 10.2217/pmt.15.31..
Keywords: Emergency Department, Opioids, Pain, Patient and Family Engagement
Conover MM, Howell JO, Wu JM
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
The researchers compared the incidence of opioid-managed pelvic pain within 12 months after hysteroscopic and laparoscopic sterilization. They found that among women without recent history of childbirth, there was no compelling evidence of a clinically meaningful increase in the incidence of pelvic pain requiring opioids during the year after hysteroscopic sterilization.
AHRQ-funded; HS017950.
Citation: Conover MM, Howell JO, Wu JM .
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
Pharmacoepidemiol Drug Saf 2015 Aug;24(8):875-84. doi: 10.1002/pds.3766..
Keywords: Comparative Effectiveness, Medication, Opioids, Pain, Women
Bachhuber MA, McGinty EE, Kennedy-Hendricks A
Messaging to increase public support for naloxone distribution policies in the United States: results from a randomized survey experiment.
The investigators conducted a web-based survey (GfK Knowledge Panel) about barriers to public support for naloxone distribution. They concluded that public support for naloxone distribution can be improved through education and sympathetic portrayals of the population who stands to benefit from these policies.
AHRQ-funded; HS000029.
Citation: Bachhuber MA, McGinty EE, Kennedy-Hendricks A .
Messaging to increase public support for naloxone distribution policies in the United States: results from a randomized survey experiment.
PLoS One 2015 Jul;10(7):e0130050. doi: 10.1371/journal.pone.0130050.
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Keywords: Medication, Opioids, Policy, Substance Abuse
Basco WT, Ebeling M, Garner SS
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
This study estimated the frequency of potential overdoses among outpatient opioid-containing prescriptions. It found that, overall, 2.7 percent of the prescriptions contained potential overdose quantities, and the average excess amount dispensed was 48% above expected. Younger ages were associated with higher frequencies of potential overdose.
AHRQ-funded; HS015679.
Citation: Basco WT, Ebeling M, Garner SS .
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
Clin Pediatr 2015 Jul;54(8):738-44. doi: 10.1177/0009922815586050..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Newborns/Infants, Medication, Medication: Safety, Newborns/Infants, Opioids, Patient Safety
Jules-Elysee KM, Goon AK, Westrich GH
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
This randomized, double-blind, placebo-controlled study compared the use of patient-controlled epidural analgesia (PCEA) with use of a multimodal pain regimen including periarticular injection (PAI). It found that PAI did not decrease the time to discharge and was associated with higher pain scores and greater opioid consumption but lower ORSDS scores compared with PCEA.
AHRQ-funded; HS021734.
Citation: Jules-Elysee KM, Goon AK, Westrich GH .
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
J Bone Joint Surg Am 2015 May 20;97(10):789-98. doi: 10.2106/jbjs.n.00698..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Hughes HK, Korthuis PT, Saha S
A mixed methods study of patient-provider communication about opioid analgesics.
The researchers sought to describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. They found that pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients.
AHRQ-funded; 290010012; HS013903.
Citation: Hughes HK, Korthuis PT, Saha S .
A mixed methods study of patient-provider communication about opioid analgesics.
Patient Educ Couns 2015 Apr;98(4):453-61. doi: 10.1016/j.pec.2014.12.003..
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Keywords: Communication, Medication, Opioids, Pain, Clinician-Patient Communication
Ringwalt C, Roberts AW, Gugelmann H
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
The purpose of this study was to examine differences across providers’ specialties in prescriptions filled by white and black Medicaid beneficiaries with chronic noncancer pain (CNCP). It found that race-based differences in beneficiaries’ dispensed opioid prescriptions were more prominent among patients of specialists in obstetrics and gynecology and internal medicine, as well as general practitioners/family medicine physicians.
AHRQ-funded; HS000032.
Citation: Ringwalt C, Roberts AW, Gugelmann H .
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
Pain Med 2015 Apr;16(4):633-40. doi: 10.1111/pme.12555..
Keywords: Chronic Conditions, Disparities, Medicaid, Medication, Opioids, Pain, Racial and Ethnic Minorities
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
AHRQ-funded; 290201200014I
Citation: Chou R, Turner JA, Devine EB .
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559..
Keywords: Chronic Conditions, Comparative Effectiveness, Medication, Opioids, Outcomes, Pain, Patient-Centered Outcomes Research
Hwang CS, Chang HY, Alexander GC
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
The researchers quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids. They found that the market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market.
AHRQ-funded; HS018960.
Citation: Hwang CS, Chang HY, Alexander GC .
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
Pharmacoepidemiol Drug Saf 2015 Feb;24(2):197-204. doi: 10.1002/pds.3723.
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Keywords: Medication, Opioids, Prevention, Substance Abuse
Salihu HM, Mogos MF, Salinas-Miranda AA
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
AHRQ-funded; HS019997.
Citation: Salihu HM, Mogos MF, Salinas-Miranda AA .
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
Am J Perinatol 2015 Feb;32(3):289-98. doi: 10.1055/s-0034-1384642..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medication, Opioids, Pregnancy
Jackson H, Mandell K, Johnson K
Cost-effectiveness of injectable extended-release naltrexone compared with methadone maintenance and buprenorphine maintenance treatment for opioid dependence.
The authors estimated the cost-effectiveness of injectable extended-release naltrexone (XR-NTX) compared with methadone maintenance and buprenorphine maintenance treatment for adult males enrolled in treatment for opioid dependence in the United States from the perspective of state-level addiction treatment payers. They found that XR-NTX is a cost-effective medication for treating opioid dependence if state addiction treatment payers are willing to pay at least $72 per opioid-free day.
AHRQ-funded; HS000083.
Citation: Jackson H, Mandell K, Johnson K .
Cost-effectiveness of injectable extended-release naltrexone compared with methadone maintenance and buprenorphine maintenance treatment for opioid dependence.
Subst Abus 2015;36(2):226-31. doi: 10.1080/08897077.2015.1010031.
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Keywords: Healthcare Costs, Medication, Opioids, Substance Abuse, Treatments
Topaz M, Seger DL, Lai K
High override rate for opioid drug-allergy interaction alerts: current trends and recommendations for future.
This paper examined trends in drug-allergy interaction (DAI) alert overrides for opioid medications - the most commonly triggered alerts in the computerized provider order entry (CPOE). Allergic reactions included a high proportion of non-immune mediated opioid reactions. The DAI alert override rate was high for immune-mediated and life-threatening reactions. Exact allergy-medication matches were overridden less frequently compared to non-exact matches within allergy groups.
AHRQ-funded; HS022728.
Citation: Topaz M, Seger DL, Lai K .
High override rate for opioid drug-allergy interaction alerts: current trends and recommendations for future.
Stud Health Technol Inform 2015;216:242-6.
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Keywords: Opioids, Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Medication, Patient Safety, Medical Errors
Turner L, Kruszewski SP, Alexander GC
Trends in the use of buprenorphine by office-based physicians in the United States, 2003-2013.
This study used descriptive statistics to examine trends in buprenorphine utilization from 2003 to 2013. The use of buprenorphine products to treat opioid dependence has increased significantly and has shifted to greater use by primary care physicians, indicating a rapidly changing face of opioid maintenance therapy in the United States.
AHRQ-funded; HS018960.
Citation: Turner L, Kruszewski SP, Alexander GC .
Trends in the use of buprenorphine by office-based physicians in the United States, 2003-2013.
Am J Addict 2015 Jan;24(1):24-9. doi: 10.1111/ajad.12174..
Keywords: Healthcare Utilization, Medication, Opioids, Primary Care, Substance Abuse
Raebel MA, Newcomer SR, Bayliss EA
Chronic opioid use emerging after bariatric surgery.
The purpose of this study was to determine opioid use the year after bariatric surgery among patients who did not use opioids chronically pre-surgery and to identify pre-surgery characteristics associated with chronic opioid use after surgery. It found that patients dispensed 60 to 119 days’ supply during the pre-surgery year were 13.23 to 14.29 times more likely to use opioids chronically post-surgery than patients without opioid use pre-surgery.
AHRQ-funded; HS019912.
Citation: Raebel MA, Newcomer SR, Bayliss EA .
Chronic opioid use emerging after bariatric surgery.
Pharmacoepidemiol Drug Saf 2014 Dec;23(12):1247-57. doi: 10.1002/pds.3625..
Keywords: Medication, Obesity, Opioids, Pain, Substance Abuse, Surgery
Kilaru AS, Gadsden SM, Perrone J
How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.
This qualitative study of emergency physicians attempted to gain insight into the adoption, use, and perceived relevance of opioid-prescribing guidelines. Most of the 61 participants interviewed in a convenience sample had a positive perspective on the intent and role of such guidelines and used them most commonly as communication tools with patients.
AHRQ-funded; HS021956.
Citation: Kilaru AS, Gadsden SM, Perrone J .
How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.
Ann Emerg Med 2014 Nov;64(5):482-89.e1. doi: 10.1016/j.annemergmed.2014.03.015.
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Keywords: Emergency Medical Services (EMS), Opioids, Pain, Guidelines, Practice Patterns
Werth SR, Sachdeva N, Roberts AW
North Carolina Medicaid recipient management lock-in program: the pharmacist's perspective.
The objectives of this study were (a) evaluate pharmacists’ perceptions of the implementation of the North Carolina (NC) recipient management lock-in program (MLIP) and (b) determine how the beliefs and attitudes of pharmacists could promote or inhibit its success. It concluded that, although possible improvements were identified, the NC MLIP has strong potential for success as it utilizes pharmacists’ medication gate-keeping role, while minimizing the effort required for successful implementation.
AHRQ-funded; HS000032.
Citation: Werth SR, Sachdeva N, Roberts AW .
North Carolina Medicaid recipient management lock-in program: the pharmacist's perspective.
J Manag Care Spec Pharm 2014 Nov;20(11):1122-9..
Keywords: Medicaid, Medication, Opioids, Provider: Pharmacist, Substance Abuse
Hartung DM, McCarty D, Fu R
Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
The authors evaluated cost and utilization outcomes between extended-release naltrexone (XR-NTX) and other pharmacotherapies for treatment of alcohol and opioid dependence. They found that alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone, with healthcare utilization and costs being generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.
AHRQ-funded; HS019456.
Citation: Hartung DM, McCarty D, Fu R .
Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
J Subst Abuse Treat 2014 Aug;47(2):113-21. doi: 10.1016/j.jsat.2014.03.007.
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Keywords: Alcohol Use, Comparative Effectiveness, Medication, Opioids, Substance Abuse
Desai RJ, Hernandez-Diaz S, Bateman BT
Increase in prescription opioid use during pregnancy among Medicaid-enrolled women.
The researchers reported the prevalence of prescription opioid use and evaluated the trends in a large cohort of Medicaid-enrolled pregnant women. They observed high and increasing number of filled prescriptions for opioids during pregnancy among Medicaid-enrolled women and recommended further safety evaluations of these drugs and their effects on the developing fetus.
AHRQ-funded; HS018533.
Citation: Desai RJ, Hernandez-Diaz S, Bateman BT .
Increase in prescription opioid use during pregnancy among Medicaid-enrolled women.
Obstet Gynecol 2014 May;123(5):997-1002. doi: 10.1097/aog.0000000000000208.
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Keywords: Healthcare Utilization, Medicaid, Medication, Opioids, Pregnancy
Kim DH, Lin Y, Goytizolo EA
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
In a study of pain relief for patients recovering from a total knee arthroplasty, researchers found that adductor canal block (ACB) results in less motor impairment for quadriceps muscles after surgery than femoral nerve block (FNB) and it provides a comparable level of pain relief. The prospective, randomized, controlled study included 46 patients receiving ACB and 47 receiving FNB.
AHRQ-funded; HS021734
Citation: Kim DH, Lin Y, Goytizolo EA .
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
Anesthesiology. 2014 Mar;120(3):540-50. doi: 10.1097/ALN.0000000000000119..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Nuckols TK, Anderson L, Popescu I
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
This review evaluated the quality and content of guidelines on the use of opioids for chronic pain. Despite limited evidence and variable development methods, it concluded that recent guidelines on chronic pain agree on several opioid risk mitigation strategies, including upper dosing thresholds; cautions with certain medications; attention to drug–drug and drug–disease interactions; and use of risk assessment tools, treatment agreements, and urine drug testing.
AHRQ-funded; HS017954.
Citation: Nuckols TK, Anderson L, Popescu I .
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
Ann Intern Med 2014 Jan 7;160(1):38-47. doi: 10.7326/0003-4819-160-1-201401070-00732..
Keywords: Opioids, Pain, Guidelines, Medication, Evidence-Based Practice, Chronic Conditions