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Topics
- Access to Care (1)
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- (-) Practice Patterns (46)
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- Risk (1)
- Screening (2)
- Sex Factors (1)
- Sexual Health (1)
- Shared Decision Making (3)
- Social Determinants of Health (1)
- Substance Abuse (4)
- Surgery (6)
- Teams (1)
- Transitions of Care (1)
- Transplantation (1)
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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 46 Research Studies DisplayedYan CH, Hubbard CC, Lee TA
Impact of hydrocodone rescheduling on dental prescribing of opioids.
In 2014, the United States Drug Enforcement Administration rescheduled hydrocodone’s controlled substance schedule from III to II, introducing increasing regulations in prescribing and dispensing. In the U.S., dentists often prescribe hydrocodone, and these changes in scheduling may have altered dental prescribing of opioids. The purpose of this study was to assess the impact of the hydrocodone rescheduling on dental prescribing of opioids in the United States. Across the 49-month study period, dentists prescribed 50,412,942 opioid prescriptions. Hydrocodone was the most prescribed opioid, followed by codeine, oxycodone, and tramadol. At index, hydrocodone prescribing immediately decreased by -834.8 Rx/1,000 dentists with increased prescribing of codeine, oxycodone, and tramadol. The mean MME increased at index for all opioids except for hydrocodone, and dosages subsequently decreased during the postindex period.
AHRQ-funded; HS025177.
Citation: Yan CH, Hubbard CC, Lee TA .
Impact of hydrocodone rescheduling on dental prescribing of opioids.
JDR Clin Trans Res 2023 Oct; 8(4):402-12. doi: 10.1177/23800844221102830..
Keywords: Opioids, Medication, Dental and Oral Health, Practice Patterns
Sankar 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
Bongiovanni T, Pletcher MJ, Lau C
A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: a randomized controlled trial.
Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) has become a foundational strategy to decrease the use of opioids, but data is lacking to describe recommending utilization when admitting patients using electronic health record systems. The purpose of this study was to assess an electronic health record system to increase ordering of NSAIDs for hospitalized adults. The researchers conducted a cluster randomized controlled trial of clinicians admitting adult patients to a health system over a period of 9-months. Clinicians in the intervention arm were required to actively order or decline NSAIDs; the control arm was provided the same order but without a required response. A total of 20,085 hospitalizations were included. The study found that among the hospitalizations, 52% were admitted by a clinician randomized to the intervention arm. NSAIDs were ordered in 22% of the interventions and 22% of the control admissions. There were no statistically significant differences in NSAID administration, pain scores, or opioid prescribing. There were no differences in clinical harms, with average pain scores of 3.36 in the control group and 3.39 in the intervention group, on a scale of 0-5.
AHRQ-funded; HS026383.
Citation: Bongiovanni T, Pletcher MJ, Lau C .
A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: a randomized controlled trial.
J Hosp Med 2023 Aug; 18(8):685-92. doi: 10.1002/jhm.13153..
Keywords: Pain, Opioids, Medication, Behavioral Health, Practice Patterns
Miller-Rosales C, Busch SH, Meara ER
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
This study examined the extent of screening for opioid use and availability of medications for opioid use disorder (MOUD) in a national cross-section of multi-physician primary care and multispecialty practices. The authors found that a total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Offering of MOUD in a practice was associated with having advanced HIT functionality, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models.
AHRQ-funded; HS024075.
Citation: Miller-Rosales C, Busch SH, Meara ER .
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
Med Care Res Rev 2023 Aug; 80(4):410-22. doi: 10.1177/10775587231162681..
Keywords: Opioids, Substance Abuse, Behavioral Health, Screening, Medication, Practice Patterns
Gupta N, Kucirka L, Semerjian A
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
The purpose of this study was to describe practice patterns regarding female reproductive organ-sparing (ROS) and nerve-sparing radical cystectomy nerve-sparing radical cystectomy (RC) among US urologists. The researchers conducted a cross-sectional survey of members of the Society of Urologic Oncology to evaluate provider-reported frequency of ROS and nerve-sparing RC in premenopausal and postmenopausal patients with non-muscle-invasive bladder cancer that failed intravesical therapy or clinically localized muscle-invasive bladder cancer. The study found that among 101 urologists, 79.2% reported that they routinely resect the uterus/cervix, 67.3% the neurovascular bundle, 48.5% the ovaries, and 18.8% a portion of the vagina when performing RC in premenopausal patients with organ-confined disease. When asked about changes to approach in postmenopausal patients, 70.3% reported that they were less likely to spare the uterus/cervix, 43.6% were less likely to spare the neurovascular bundle, 69.3% were less likely to spare the ovaries, and 22.8% were less likely to spare a portion of the vagina.
AHRQ-funded; HS026120.
Citation: Gupta N, Kucirka L, Semerjian A .
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
Clin Genitourin Cancer 2023 Aug; 21(4):e236-e41. doi: 10.1016/j.clgc.2023.01.010..
Keywords: Practice Patterns, Women, Sexual Health, Surgery, Cancer
Ramanathan S, Evans CT, Hershow RC
Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints.
The objective of this retrospective study was to compare prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-VA settings. Subjects were veteran and non-veteran dental patients with cardiac conditions or prosthetic joints; most were males aged 55 years older. The results showed that VA settings had a higher prevalence of guideline concordant prescribing among those with prosthetic joints, and when assessing dosing errors. The authors recommended that future studies focus on the extent to which integrated electronic health records may be responsible for increased guideline concordant prescribing in the VA setting.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Evans CT, Hershow RC .
Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints.
BMC Infect Dis 2023 Jun 23; 23(1):427. doi: 10.1186/s12879-023-08400-y..
Keywords: Dental and Oral Health, Antibiotics, Medication, Prevention, Cardiovascular Conditions, Practice Patterns
Kim KC, Khouja T, Burgette JM
Trends in dispensed prescriptions for opioids, sedatives, benzodiazepines, gabapentin, and stimulants to children by general dentists, 2012-2019.
This study examined trends in prescription fills for opioids, benzodiazepines, gabapentin, and stimulants to children <18 years from 2012 to 2019 in a national dataset comprising 92% of dispensed outpatient prescriptions by dentists. During this time, 3.8 million children filled prescriptions for high-alert drugs from general dentists. Opioids accounts for 69.4% of high-alert prescriptions, however from 2012 to 2019 fills for opioids, sedatives, benzodiazepines, and stimulants decreased by 65.2%, 43.4%, 43.6% and 89.3%, respectively. Gabapentin prescriptions increased by 8.1%. Older teenagers (15-17 years) received 42.5% of high-alert prescriptions. Low-income counties in Southern states were overrepresented among top-prescribing areas in 2019.
AHRQ-funded; HS025177.
Citation: Kim KC, Khouja T, Burgette JM .
Trends in dispensed prescriptions for opioids, sedatives, benzodiazepines, gabapentin, and stimulants to children by general dentists, 2012-2019.
Pharmacoepidemiol Drug Saf 2023 Jun; 32(6):625-34. doi: 10.1002/pds.5589..
Keywords: Children/Adolescents, Dental and Oral Health, Opioids, Medication, Practice Patterns
Sun EC, Rishel CA, Waljee JF
Association between state limits on opioid prescribing and the incidence of persistent postoperative opioid use among surgical patients.
The objective of this study was to examine whether laws limiting opioid prescribing were associated with reductions in the incidence of persistent postoperative opioid use. Over identified 950,000 privately insured patients who had undergone one of 10 procedures were identified; researchers then estimated the association between persistent postoperative opioid use and whether state opioid prescribing limits were in effect on the day of surgery. The findings suggested that laws limiting opioid prescriptions were not associated with subsequent reductions in persistent postoperative opioid use.
AHRQ-funded; HS026753.
Citation: Sun EC, Rishel CA, Waljee JF .
Association between state limits on opioid prescribing and the incidence of persistent postoperative opioid use among surgical patients.
Ann Surg 2023 Apr;277(4):e759-e65. doi: 10.1097/sla.0000000000005283.
Keywords: Opioids, Medication, Surgery, Substance Abuse, Practice Patterns
Nguyen T, Meille G, Buchmueller T
AHRQ Author: Meille G
Mandatory prescription drug monitoring programs and overlapping prescriptions of opioids and benzodiazepines: evidence from Kentucky.
This AHRQ-authored study examined how overlapping benzodiazepine and opioid prescription rates changed after Kentucky implemented a PDMP mandate in July 2012 in response to the opioid epidemic. The authors conducted an interrupted time series analysis using monthly data from Kentucky's PDMP from 2010 to 2016. They also conducted an individual-level longitudinal analysis that compared changes in utilization patterns after the mandate went into effect to changes in earlier periods during which the mandate was not in effect. The PDMP mandate was associated with an immediate 7.5 % decline in the rate of overlapping benzodiazepine and opioid prescriptions and a significant change in the trend from increasing to decreasing. A single provider was responsible for approximately half of the immediate effect in level terms who was writing overlapping benzodiazepine and opioid prescriptions. Their longitudinal analysis suggests that over one year the mandate reduced initiation of overlapping prescriptions by 29.3 % and reduced continuation of overlapping prescriptions by 9.4 %, with effects of the policy being largest for women and men aged 36-50.
AHRQ-authored.
Citation: Nguyen T, Meille G, Buchmueller T .
Mandatory prescription drug monitoring programs and overlapping prescriptions of opioids and benzodiazepines: evidence from Kentucky.
Drug Alcohol Depend 2023 Feb 1; 243:109759. doi: 10.1016/j.drugalcdep.2022.109759..
Keywords: Opioids, Medication, Practice Patterns
McCoy RG, Dykhoff HJ, Sangaralingham L
Adoption of new glucose-lowering medications in the U.S.-the case of SGLT2 inhibitors: nationwide cohort study.
This study examined use of new glucose-lowering medications called sodium-glucose cotransporter-2 inhibitors (SGLT2i) that was the most recently approved class of medications for diabetes type 1 and 2 patients. This class of medications have shown additional cardio- and renal-protective benefits as well as lower risk of hypoglycemia. A retrospective analysis of medical and pharmacy claims data from OptumLabs Data Warehouse was conducted for commercially insured and Medicare Advantage adult beneficiaries who filled any glucose-lowering medication from 2013-2016. Among a cohort of over 1 million, only 7.2% initiated a SGLT2i prescription. Patients with other complications, age 75 or older, black, and those with Medicare Advantage were less likely to start a SGLT2i.
AHRQ-funded; HS024075; HS025164; HS025402; HS025517; HS022882.
Citation: McCoy RG, Dykhoff HJ, Sangaralingham L .
Adoption of new glucose-lowering medications in the U.S.-the case of SGLT2 inhibitors: nationwide cohort study.
Diabetes Technol Ther 2019 Dec;21(12):702-12. doi: 10.1089/dia.2019.0213.
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Keywords: Medication, Diabetes, Practice Patterns
Tam CA, Dauw CA, Ghani KR
New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment.
The purpose of this study was to measure the incidence of persistent opioid use following ureteroscopy (URS). Over 100 Americans die every day from opioid overdose. Recent studies suggest that many opioid addictions surface after surgery. The investigators concluded that nearly 1 in 16 opioid-naive patients developed new persistent opioid use after URS. New persistent opioid use was associated with the amount of opioid prescribed at the time of URS. The authors suggest that, given these findings, urologists should re-evaluate their post-URS opioid prescribing patterns.
AHRQ-funded; HS024525; HS024728.
Citation: Tam CA, Dauw CA, Ghani KR .
New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment.
Urology 2019 Dec;134:103-08. doi: 10.1016/j.urology.2019.08.042..
Keywords: Opioids, Medication, Substance Abuse, Surgery, Practice Patterns
Hu T, Decker SL, Chou SY
AHRQ Author: Decker SL
The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing.
Researchers tested the effect of the introduction of Medicare Part D on physician prescribing behavior using data on physician visits from the National Ambulatory Medical Care Survey (NAMCS). Subjects were patients aged 60-69. The researchers found a 32% increase in the number of prescription drugs prescribed or continued per visit and a 46% increase in the number of generic drugs prescribed or continued for the elderly after the introduction of Medicare Part D.
AHRQ-authored.
Citation: Hu T, Decker SL, Chou SY .
The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing.
https://www.ncbi.nlm.nih.gov/pubmed/28168448.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicare, Medication, Practice Patterns, Elderly
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Esfandiari NH, Reyes-Gastelum D, Hawley ST
Patient requests for tests and treatments impact physician management of hypothyroidism.
Researchers investigated physician-reported barriers to managing thyroid hormone therapy; randomly surveyed physicians were members of the Endocrine Society, the American Academy of Family Practice, and the American Geriatrics Society. The researchers found that physicians reported patient requests for tests and treatments as a common barrier to appropriate thyroid hormone management. They concluded that understanding physician-reported barriers to thyroid hormone management and factors associated with physician perception that patient requests are a barrier is key to improving patient care.
AHRQ-funded; HS024512.
Citation: Esfandiari NH, Reyes-Gastelum D, Hawley ST .
Patient requests for tests and treatments impact physician management of hypothyroidism.
Thyroid 2019 Nov;29(11):1536-44. doi: 10.1089/thy.2019.0383..
Keywords: Care Management, Provider: Physician, Provider, Practice Patterns
DiBrito SR, Bowring MG, Holscher CM
Acute care surgery for transplant recipients: a national survey of surgeon perspectives and practices.
This study is a survey of acute care surgeons (ACS) and transplant surgeons on their attitudes as to who would feel comfortable operating on transplant patients for nontransplant-related issues. The researchers conducted a national survey of ACS and transplant surgeons and obtained 230 ACS responses and 240 from transplant surgeons. While both ACS and transplant surgeons felt care is better at transplant centers and if the patient requires acute surgery they should be transferred to a transplant center, the ACS still felt comfortable operating and performing laparoscopy on transplant recipients.
Citation: DiBrito SR, Bowring MG, Holscher CM .
Acute care surgery for transplant recipients: a national survey of surgeon perspectives and practices.
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Keywords: Transplantation, Surgery, Provider: Physician, Provider, Practice Patterns
Yarrington ME, Anderson DJ, Dodds Ashley E
Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.
This study’s objective was the quantify the effect of the 2016 FDA “black box” update on the use of fluoroquinolone antibiotics among a cohort of southeastern US hospitals. Fluoroquinolone was given a black box warning after many serious adverse events were reported. Antibiotic use data from 29 southeastern US hospitals over a 5-year period was analyzed. Fluoroquinolone use declined both and before after the FDA advisory update in 2016.
AHRQ-funded; HS023866.
Citation: Yarrington ME, Anderson DJ, Dodds Ashley E .
Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1297-300. doi: 10.1017/ice.2019.247..
Keywords: Antibiotics, Medication, Practice Patterns, Healthcare Utilization, Hospitals, Adverse Drug Events (ADE), Adverse Events
Klueh MP, Sloss KR, Dossett LA
Postoperative opioid prescribing is not my job: a qualitative analysis of care transitions.
This qualitative study aimed to describe transitions of care for postoperative opioid prescribing and to identify barriers and facilitators of ideal transitions for potential intervention targets. Results identified potential interventions aimed at changing physician behaviors regarding transitions of care for postoperative opioid prescribing. Implementation of these interventions could improve coordination of care for patients with persistent postoperative opioid use.
AHRQ-funded; HS026030.
Citation: Klueh MP, Sloss KR, Dossett LA .
Postoperative opioid prescribing is not my job: a qualitative analysis of care transitions.
Surgery 2019 Nov;166(5):744-51. doi: 10.1016/j.surg.2019.05.033..
Keywords: Opioids, Medication, Pain, Transitions of Care, Practice Patterns
Andereck JW, Reuter QR, Allen KC
A quality improvement initiative featuring peer-comparison prescribing feedback reduces emergency department opioid prescribing.
This study compared opioid prescribing rates in emergency departments before and after a quality improvement initiative featuring peer-comparison feedback. All 117 ED prescribers at an urban academic medical center were provided regular feedback on their opioid prescribing rate compared to their de-identified peers. Pre-intervention rates were 8.6% compared to post-intervention at 4.8%.
AHRQ-funded; HS023011.
Citation: Andereck JW, Reuter QR, Allen KC .
A quality improvement initiative featuring peer-comparison prescribing feedback reduces emergency department opioid prescribing.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):669-79. doi: 10.1016/j.jcjq.2019.07.008..
Keywords: Emergency Department, Opioids, Medication, Practice Patterns, Quality Improvement, Quality of Care
Angraal S, Nuti SV, Masoudi FA
Digoxin use and associated adverse events among older adults.
The authors describe national-level trends of digoxin use, hospitalizations for toxicity, and subsequent outcomes over the past two decades. They found that, while digoxin prescriptions have decreased, the drug is still widely prescribed. However, the rate of hospitalizations for digoxin toxicity and adverse outcomes associated with these hospitalizations have decreased. They concluded that these findings reflect the changing clinical practice of digoxin use, aligned with the changes in clinical guidelines.
AHRQ-funded; HS025164; HS025402; HS025517.
Citation: Angraal S, Nuti SV, Masoudi FA .
Digoxin use and associated adverse events among older adults.
Am J Med 2019 Oct;132(10):1191-98. doi: 10.1016/j.amjmed.2019.04.022.
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Keywords: Medication, Elderly, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Practice Patterns
Modi PK, Kaufman SR, Herrel LA
Practice-level adoption of conservative management for prostate cancer.
In this study, the authors describe the longitudinal adoption of conservative management (ie, the absence of treatment) for prostate cancer among urology group practices in the United States and identify group practice features that influence this adoption. The investigators found that there was increasing variation among group practices in the use of conservative management for prostate cancer. They indicated that this underscores the need for a better understanding of practice-level factors that influence prostate cancer management.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Herrel LA .
Practice-level adoption of conservative management for prostate cancer.
J Oncol Pract 2019 Oct;15(10):e863-e69. doi: 10.1200/jop.19.00088.
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Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Care Management
Springer R, Marino M,, Bailey SR
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication-assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion.
AHRQ-funded; HS024270.
Citation: Springer R, Marino M,, Bailey SR .
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
Addiction 2019 Oct;114(10):1775-84. doi: 10.1111/add.14667..
Keywords: Opioids, Medication, Substance Abuse, Medicaid, Practice Patterns, Health Insurance, Access to Care, Policy
Wang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Shared Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Fraze TK, Brewster AL, Lewis VA
Prevalence of screening for food insecurity, housing instability, utility needs, transportation needs, and interpersonal violence by US physician practices and hospitals.
The purpose of this study was to characterize screening for social needs by physician practices and hospitals. The authors indicated that their study's findings suggest: that few US physician practices and hospitals screen patients for all 5 key social needs associated with health outcomes; that practices that serve disadvantaged patients reported higher screening rates.
AHRQ-funded; HS024075.
Citation: Fraze TK, Brewster AL, Lewis VA .
Prevalence of screening for food insecurity, housing instability, utility needs, transportation needs, and interpersonal violence by US physician practices and hospitals.
JAMA Netw Open 2019 Sep 4;2(9):e1911514. doi: 10.1001/jamanetworkopen.2019.11514..
Keywords: Domestic Violence, Nutrition, Practice Patterns, Screening, Social Determinants of Health, Vulnerable Populations
Law AC, Stevens JP, Walkey AJ
Hospital variation in gastrostomy tube use among the critically ill.
This article describes an analysis of hospital variation in gastrostomy tube use among critically ill patients in hospitals. The investigators used the AHRQ National Inpatient Sample Database from 2014. They identified hospitalized patients using ICD-9, Clinical Modification codes consistent with critical illness who received gastrostomy tubes. Overall, the median rate was 2.0 per 100 critically ill patients with no variation between hospital size.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Walkey AJ .
Hospital variation in gastrostomy tube use among the critically ill.
Ann Am Thorac Soc 2019 Sep;16(9):1201-03. doi: 10.1513/AnnalsATS.201903-250RL..
Keywords: Surgery, Critical Care, Practice Patterns, Hospitals
Wilkinson ST, Howard DH, Busch SH
Psychiatric practice patterns and barriers to the adoption of esketamine.
This paper discusses the psychiatric practice patterns and barriers to the adoption of esketamine in the treatment of depression. The authors indicate that the discovery of ketamine’s rapid-acting properties, culminating most recently with the FDA’s approval of esketamine, offers hope to the large numbers of patients whose symptoms do not resolve with traditional treatments. However, they suggest, many traditional psychiatric practices may be reluctant to invest in the costly infrastructure necessary to provide this therapy, especially because of the uncertainty regarding the reimbursement for patient monitoring.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Howard DH, Busch SH .
Psychiatric practice patterns and barriers to the adoption of esketamine.
JAMA 2019 Sep 17;322(11):1039-40. doi: 10.1001/jama.2019.10728.
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Keywords: Depression, Behavioral Health, Practice Patterns, Medication