National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Arthritis (1)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Care Management (1)
- Chronic Conditions (3)
- Comparative Effectiveness (1)
- Data (1)
- Dementia (1)
- Depression (1)
- Diabetes (4)
- Digestive Disease and Health (1)
- Disparities (2)
- (-) Elderly (22)
- Falls (1)
- Healthcare Utilization (1)
- Heart Disease and Health (4)
- Hospital Readmissions (1)
- Injuries and Wounds (1)
- Kidney Disease and Health (1)
- Long-Term Care (2)
- Medicaid (1)
- Medicare (5)
- (-) Medication (22)
- Medication: Safety (1)
- Men's Health (1)
- Nursing Homes (5)
- Opioids (2)
- Organizational Change (1)
- Outcomes (1)
- Pain (2)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (3)
- Patient Safety (3)
- Policy (1)
- Practice Patterns (1)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Vulnerable Populations (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 22 of 22 Research Studies DisplayedSchmajuk G, Tonner C, Miao Y
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
The authors aimed to determine the prevalence, predictors of, and persistence of folic acid use in a population-based cohort of methotrexate (MTX) users with rheumatic diseases. They found that patients who did not see a rheumatologist were 23% less likely to receive folic acid compared to patients who did have a rheumatologist visit during the baseline period, and after 20 months, only 50% of patients continued to receive folic acid. The authors recommend improving patient safety for users of MTX by standardizing workflows for folic acid supplementation.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Tonner C, Miao Y .
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
PLoS One 2016 Dec 15;11(12):e0168369. doi: 10.1371/journal.pone.0168369.
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Keywords: Elderly, Healthcare Utilization, Medication, Arthritis
Raval AD, Mattes MD, Madhavan S
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
The researchers examined the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. They found a significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7 percent versus 6.7 percent.
AHRQ-funded; HS018622.
Citation: Raval AD, Mattes MD, Madhavan S .
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
J Diabetes Res 2016;2016:2656814. doi: 10.1155/2016/2656814.
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Keywords: Cancer: Prostate Cancer, Medication, Elderly, Diabetes, Medicare
Naples JG, Kotlarczyk MP, Perera S
Non-tricyclic and non-selective serotonin reuptake inhibitor antidepressants and recurrent falls in frail older women.
This study determined the risk of recurrent falls associated with antidepressants other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) among frail older women. At least 15 percent of women experienced recurrent falls between 0-6 and 6-12 months. At baseline and 6 months, 18.2 percent and 6.9 percent had a non-TCA/non-SSRI antidepressant, respectively. It concluded that non-TCA/non-SSRI antidepressant exposure significantly increased the risk of recurrent falls.
AHRQ-funded; HS023779.
Citation: Naples JG, Kotlarczyk MP, Perera S .
Non-tricyclic and non-selective serotonin reuptake inhibitor antidepressants and recurrent falls in frail older women.
Am J Geriatr Psychiatry 2016 Dec;24(12):1221-27. doi: 10.1016/j.jagp.2016.08.008.
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Keywords: Medication, Elderly, Falls, Patient Safety
Zullo AR, Dore DD, Gutman R
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
This letter describes common glucose-lowering medication usage patterns for a national cross-section of U.S. adults aged 65 and older residing in nursing home (NH) and community settings from 2007 to 2010. The study results suggest that continued efforts are warranted to improve glucose-lowering medication management and simplify treatment regimens in the NH; that the relative importance of CER questions regarding specific glucose-lowering treatments may differ according to the care setting; and that CER studies of glucose-lowering treatments in older adults must address the combination use of medications, especially in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Gutman R .
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
J Am Geriatr Soc 2016 Nov;64(11):e233-e35. doi: 10.1111/jgs.14485.
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Keywords: Care Management, Chronic Conditions, Diabetes, Elderly, Medication, Nursing Homes
Naples JG, Gellad WF, Hanlon JT
The role of opioid analgesics in geriatric pain management.
This article reviews the epidemiology of opioid use and their effectiveness for chronic noncancer pain (CNCP) in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP.
AHRQ-funded; HS023779.
Citation: Naples JG, Gellad WF, Hanlon JT .
The role of opioid analgesics in geriatric pain management.
Clin Geriatr Med 2016 Nov;32(4):725-35. doi: 10.1016/j.cger.2016.06.006.
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Keywords: Chronic Conditions, Elderly, Medication, Opioids, Pain, Patient Safety
Doll JA, Hellkamp AS, Goyal A
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
The purpose of the study was to examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens among older adults after MI. The investigators found that compared with Medicare-only patients, older adults with dual Medicare-Medicaid eligibility presenting with MI had superior rates of medication adherence but higher rates of postdischarge readmission and adverse cardiovascular outcomes.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Goyal A .
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
JAMA Cardiol 2016 Oct 1;1(7):787-94. doi: 10.1001/jamacardio.2016.2724..
Keywords: Elderly, Medicaid, Medicare, Medication, Heart Disease and Health, Outcomes, Patient Adherence/Compliance
Albrecht JS, Park Y, Hur P
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
The objective of this study was to assess the impact of depression on COPD maintenance medication adherence among of Medicare beneficiaries newly diagnosed with COPD. Average monthly adherence to COPD maintenance medications was low, peaking at 57 percent in the month after first fill and decreasing to 35 percent within 6 months. In the adjusted regression model, depression was associated with decreased adherence to COPD maintenance medications.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Park Y, Hur P .
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
Ann Am Thorac Soc 2016 Sep;13(9):1497-504. doi: 10.1513/AnnalsATS.201602-136OC.
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Keywords: Respiratory Conditions, Elderly, Medication, Patient Adherence/Compliance, Depression
Govani SM, Wiitala WL, Stidham RW
Age disparities in the use of steroid-sparing therapy for inflammatory bowel disease.
The investigators compared the use of steroids and steroid-sparing therapies and rates of complications among elderly and younger patients in a national cohort of veterans with inflammatory bowel disease (IBD). They found that, after starting steroids, fracture rates increased in the elderly patients with IBD, whereas increases in venous thromboembolism and infections after starting steroids affected both age groups. Additonally, elderly veterans were less likely to receive steroids and steroid-sparing medications than younger veterans.
AHRQ-funded; HS024122.
Citation: Govani SM, Wiitala WL, Stidham RW .
Age disparities in the use of steroid-sparing therapy for inflammatory bowel disease.
Inflamm Bowel Dis 2016 Aug;22(8):1923-8. doi: 10.1097/mib.0000000000000817.
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Keywords: Digestive Disease and Health, Disparities, Elderly, Medication, Practice Patterns
Bali V, Chatterjee S, Johnson ML
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
The researchers evaluated comparative safety of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) for the risk of hip fractures. They found no differential risk of hip fractures between paroxetine and other SSRIs.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Johnson ML .
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
J Comp Eff Res 2016 Aug;5(5):461-73. doi: 10.2217/cer-2016-0009.
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Keywords: Medication, Elderly, Injuries and Wounds, Nursing Homes, Patient Safety
Colantonio LD, Kent ST, Kilgore ML
Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.
This paper analyzed the agreement between Medicare claims for lipid-lowering medication (LLM) and LLM use. Many Medicare beneficiaries reporting LLM use or having LLMs in a medication inventory have no claims for these medications.
AHRQ-funded; HS018517.
Citation: Colantonio LD, Kent ST, Kilgore ML .
Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.
Pharmacoepidemiol Drug Saf 2016 Jul;25(7):827-35. doi: 10.1002/pds.3970.
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Keywords: Medicare, Medication, Elderly, Racial and Ethnic Minorities, Data
Patel PA, Liang L, Khazanie P
Antihyperglycemic medication use among Medicare beneficiaries with heart failure, diabetes mellitus, and chronic kidney disease.
The authors sought to investigate the overall use and safety of antihyperglycemic medications (AHMs) among patients with diabetes mellitus, heart failure, and chronic kidney disease. They found that treatment of diabetes mellitus in patients with HF and chronic kidney disease is complex, and these patients are commonly treated with renal contraindicated AHMs, including over 6% receiving a thiazolidinedione, despite known concerns regarding HF. They recommended more research regarding safety and efficacy of various AHMs among HF patients.
AHRQ-funded; HS021092.
Citation: Patel PA, Liang L, Khazanie P .
Antihyperglycemic medication use among Medicare beneficiaries with heart failure, diabetes mellitus, and chronic kidney disease.
Circ Heart Fail 2016 Jul;9(7). doi: 10.1161/circheartfailure.115.002638.
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Keywords: Diabetes, Elderly, Heart Disease and Health, Kidney Disease and Health, Medication
Zullo AR, Dore DD, Daiello L
National trends in treatment initiation for nursing home residents with diabetes mellitus, 2008 to 2010.
The authors studied trends in initiation of glucose-lowering medications in a national cohort of nursing home residents. They found that, between 2008 and 2010, there were substantial decreases in the use of oral glucose-lowering agents and corresponding increases in the use of insulin among long-term residents of US nursing homes.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Daiello L .
National trends in treatment initiation for nursing home residents with diabetes mellitus, 2008 to 2010.
J Am Med Dir Assoc 2016 Jul;17(7):602-8. doi: 10.1016/j.jamda.2016.02.023.
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Keywords: Diabetes, Elderly, Long-Term Care, Medication, Nursing Homes
Chatterjee S, Bali V, Carnahan RM
Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression.
The purpose of this study was to examine the risk of dementia with anticholinergic use among elderly nursing home residents with depression. The study concluded that use of clinically significant anticholinergic medications was associated with a 26% increase in risk of dementia among elderly nursing home residents with depression. With increasing safety concerns, there is a significant need to optimize anticholinergic use, especially for those who are at risk for dementia.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression.
Am J Geriatr Psychiatry 2016 Jun;24(6):485-95. doi: 10.1016/j.jagp.2015.12.011..
Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Medication, Nursing Homes
Baillargeon J, Deer RR, Kuo YF
Androgen therapy and rehospitalization in older men with testosterone deficiency.
This study assessed whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. It concluded that androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency.
AHRQ-funded; HS022134.
Citation: Baillargeon J, Deer RR, Kuo YF .
Androgen therapy and rehospitalization in older men with testosterone deficiency.
Mayo Clin Proc 2016 May;91(5):587-95. doi: 10.1016/j.mayocp.2016.03.016.
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Keywords: Elderly, Hospital Readmissions, Medication, Men's Health, Patient-Centered Outcomes Research
Qato DM, Trivedi AN, Mor V
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
The researchers compared time to discontinuation of rosiglitazone after the safety alert between black and white elderly persons, and across sociodemographic and economic subgroups. They found that white race and a history of low personal income modestly predicted later discontinuation of rosiglitazone after the FDA's safety advisory in 2007.
AHRQ-funded; HS019657.
Citation: Qato DM, Trivedi AN, Mor V .
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
Med Care 2016 Apr;54(4):406-13. doi: 10.1097/mlr.0000000000000502..
Keywords: Medication, Disparities, Elderly, Social Determinants of Health, Vulnerable Populations
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
Booth JN, 3rd, Behring M, Cantor RS
Zolpidem use and motor vehicle collisions in older drivers.
The association between current use of zolpidem-containing medications and motor vehicle collisions (MVCs) was evaluated among drivers of advanced age. Current zolpidem users, specifically women and individuals aged 80 years or more, had higher MVC rates than nonusers. Practitioners should consider behavioral treatment before initiating low doses of zolpidem.
AHRQ-funded; HS013852.
Citation: Booth JN, 3rd, Behring M, Cantor RS .
Zolpidem use and motor vehicle collisions in older drivers.
Sleep Med 2016 Apr;20:98-102. doi: 10.1016/j.sleep.2015.12.004.
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Keywords: Elderly, Medication, Sleep Problems
Chrischilles EA, Schneider KM, Schroeder MC
Association between preadmission functional status and use and effectiveness of secondary prevention medications in elderly survivors of acute myocardial infarction.
The researchers sought to determine whether function-related indicators, derived from preadmission claims data, help explain the frequent practice of forgoing secondary prevention medications observed in Medicare. They found that greater impairment in preadmission functional status, using a measure derived from claims data, was associated with less use of secondary prevention medications after acute myocardial infarction.
AHRQ-funded; HS018381; HS019440.
Citation: Chrischilles EA, Schneider KM, Schroeder MC .
Association between preadmission functional status and use and effectiveness of secondary prevention medications in elderly survivors of acute myocardial infarction.
J Am Geriatr Soc 2016 Mar;64(3):526-35. doi: 10.1111/jgs.13953.
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Keywords: Elderly, Prevention, Medication, Heart Disease and Health
Du XL, Zhang Y, Hardy D
Temporal and geographic variations in the receipt of colony-stimulating factors and Erythropoiesis-stimulating agents in a large retrospective cohort of older women with breast cancer from 2000 to 2009.
The purpose of this study was to use the most recent national data for a large cohort of patients diagnosed with breast cancer to evaluate temporal trend of receiving hematopoietic growth factors and to examine significant factors associated with increasing trends and geographic variations. The receipt of colony-stimulationg factors continued to increase throughout the study period, and pegfilgrastim started to replace filgrastim since 2003. The receipt of erythropoiesis-stimulating agents increased at first, then declined substantially due to the black box warning. There were substantial geographic variations in the use of these hematopoietic growth factors.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Temporal and geographic variations in the receipt of colony-stimulating factors and Erythropoiesis-stimulating agents in a large retrospective cohort of older women with breast cancer from 2000 to 2009.
Am J Ther 2016 Mar-Apr;23(2):e411-21. doi: 10.1097/mjt.0000000000000182.
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Keywords: Cancer: Breast Cancer, Medication, Elderly
Kuo YF, Raji MA, Chen NW
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
The researchers used national Medicare data from 2007-2012 to assess temporal and geographic trends in rates of opioid prescription and relationship to opioid toxicity and different state regulations in Part D Medicare recipients. Their analyses of the Medicare data demonstrated substantial growth in opioid prescriptions from 2007 to 2011 and large variation in opioid prescriptions across states.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Chen NW .
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
Am J Med 2016 Feb;129(2):221.e21-30. doi: 10.1016/j.amjmed.2015.10.002..
Keywords: Chronic Conditions, Elderly, Medicare, Medication, Opioids, Pain
Wang TY, Vora AN, Peng SA
Effectiveness and safety of aldosterone antagonist therapy use among older patients with reduced ejection fraction after acute myocardial infarction.
The purpose of this paper is to describe how aldosterone antagonist treatment is used among older myocardial infarction (MI) patients in routine practice. They found that aldosterone antagonist use was not associated with lower mortality except in symptomatic HF patients, and risks of hyperkalemia were low at 30 days, but significantly higher among patients prescribed aldosterone antagonists, as was risk of acute renal failure compared with patients not prescribed aldosterone antagonists. They concluded that these results underscore the importance of close post-discharge monitoring of this patient population.
AHRQ-funded; HS021092.
Citation: Wang TY, Vora AN, Peng SA .
Effectiveness and safety of aldosterone antagonist therapy use among older patients with reduced ejection fraction after acute myocardial infarction.
J Am Heart Assoc 2016 Jan 21;5(1). doi: 10.1161/jaha.115.002612.
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Keywords: Comparative Effectiveness, Elderly, Medication, Heart Disease and Health, Patient-Centered Outcomes Research
Urick BY, Kaskie BP, Carnahan RM
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
The objectives of this study were to explore surveyor observations of skilled nursing facilities/nursing facilities care practices subsequent to participation the Partnership guidance program and to use a social ecological framework to estimate how these observations were influenced by individual, organizational, and contextual factors. It found substantial variation in surveyor observations of changes to clinical care in response to the Partnership guidance initiative.
AHRQ-funded; HS019355.
Citation: Urick BY, Kaskie BP, Carnahan RM .
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
Res Social Adm Pharm 2016 Jan-Feb;12(1):91-103. doi: 10.1016/j.sapharm.2015.04.006.
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Keywords: Elderly, Nursing Homes, Long-Term Care, Policy, Medication, Organizational Change