National Healthcare Quality and Disparities Report
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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
201 to 225 of 225 Research Studies DisplayedDownes 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
Hennessy S, Leonard CE, Gagne JJ
Pharmacoepidemiologic methods for studying the health effects of drug-drug interactions.
A drug-drug interaction (DDI) occurs when one or more drugs affect the pharmacokinetics (the body's effect on the drug) and/or pharmacodynamics (the drug's effect on the body) of one or more other drugs. This article discusses aspects of pharmacoepidemiologic research designs that are particularly salient to the design and interpretation of pharmacoepidemiologic studies of DDIs.
AHRQ-funded; HS023898; HS023122.
Citation: Hennessy S, Leonard CE, Gagne JJ .
Pharmacoepidemiologic methods for studying the health effects of drug-drug interactions.
Clin Pharmacol Ther 2016 Jan;99(1):92-100. doi: 10.1002/cpt.277..
Keywords: Medication: Safety, Research Methodologies, Medication
Ahuja V, Sohn MW, Birge JR
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
The purpose of this study was to document variation in the use of rosiglitazone and other glucose- lowering drugs across 21 Veterans Integrated Service Networks. It found that aggregate rosiglitazone use increased monotonically from 7.7 percent, in the quarter it was added to the VA formulary, to a peak of 15.3 percent in the quarter when the FDA issued the safety alert.
AHRQ-funded; HS018542.
Citation: Ahuja V, Sohn MW, Birge JR .
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
J Manag Care Spec Pharm 2015 Dec;21(12):1214-34. doi: 10.18553/jmcp.2015.21.12.1214.
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Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Practice Patterns
Gagne JJ, Kesselheim AS, Choudhry NK
Comparative effectiveness of generic versus brand-name antiepileptic medications.
The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. It concluded that patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.
AHRQ-funded; HS018465.
Citation: Gagne JJ, Kesselheim AS, Choudhry NK .
Comparative effectiveness of generic versus brand-name antiepileptic medications.
Epilepsy Behav 2015 Nov;52(Pt A):14-8. doi: 10.1016/j.yebeh.2015.08.014.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Medication, Medication: Safety, Neurological Disorders, Patient Safety
Culley CM, Perera S, Marcum ZA
Using a clinical surveillance system to detect drug-associated hypoglycemia in nursing home residents.
The authors determined whether a clinical surveillance system could be used to detect drug-associated hypoglycemia events and determine their incidence in nursing home (NH) residents. Their evaluation found a high incidence of drug-associated hypoglycemia in a general NH population.
AHRQ-funded; HS018721.
Citation: Culley CM, Perera S, Marcum ZA .
Using a clinical surveillance system to detect drug-associated hypoglycemia in nursing home residents.
J Am Geriatr Soc 2015 Oct;63(10):2125-9. doi: 10.1111/jgs.13648.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Nursing Homes
Kao DP, Haigney MC, Mehler PS
Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration.
The researchers assessed the relative frequency of reporting of adverse events involving ventricular arrhythmia, cardiac arrest, corrected QT interval prolongation or torsade de pointes to the US Food and Drug Administration between buprenorphine and methadone. They found that in spontaneously reported adverse events between 1969 and June 2011 originating in 196 countries, methadone is associated with disproportionate reporting of cardiac arrhythmias, whereas buprenorphine is not.
AHRQ-funded; HS021138.
Citation: Kao DP, Haigney MC, Mehler PS .
Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration.
Addiction 2015 Sep;110(9):1468-75. doi: 10.1111/add.13013.
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Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Patient Safety
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
Samples H, Mojtabai R
Antidepressant self-discontinuation: results from the collaborative psychiatric epidemiology surveys.
The authors examined the extent and correlates of self-discontinuation of antidepressant medications without physician advice using the Collaborative Psychiatric Epidemiology Surveys. They concluded that physicians prescribing antidepressants need to communicate clearly about the expected benefits of treatment, the minimum duration of use required to experience benefits, and the potential side effects of these medications, particularly to younger patients, those with anxiety disorders, and patients treated in general medical settings, all of whom have increased odds of self-discontinuation.
AHRQ-funded; HS000029.
Citation: Samples H, Mojtabai R .
Antidepressant self-discontinuation: results from the collaborative psychiatric epidemiology surveys.
Psychiatr Serv 2015 May;66(5):455-62. doi: 10.1176/appi.ps.201400021.
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Keywords: Medication, Depression, Medication: Safety, Behavioral Health, Patient Adherence/Compliance
Marcum ZA, Gurwitz JH, Colon-Emeric C
Pills and ills: methodological problems in pharmacological research.
This letter summarizes critical points from a methodology workshop, Pills and Ills: Methodologic Issues in Pharmacologic Research, presented at the 2013 American Geriatrics Society Annual Scientific Meeting. It focuses on two of the most important medication errors in older adults: potentially inappropriate medication use and medication nonadherence.
AHRQ-funded; HS020831.
Citation: Marcum ZA, Gurwitz JH, Colon-Emeric C .
Pills and ills: methodological problems in pharmacological research.
J Am Geriatr Soc 2015 Apr;63(4):829-30. doi: 10.1111/jgs.13371..
Keywords: Medication, Medication: Safety, Elderly, Patient Adherence/Compliance
Radecki RP, Azam A, Doshi PB
Iodinated contrast prior to thrombolysis was not associated with worse intracranial hemorrhage.
The investigators' objective was to assess relative incidence of clinical adverse effects between patients receiving, and not receiving, iodinated contrast prior to thrombolysis. They found that no consistent harms were observed in association with intravenous iodinated contrast prior to recombinant tissue-type plasminogen activator administration, concluding that it is reasonable to continue computed tomographic angiography prior to thrombolysis as clinically indicated.
AHRQ-funded; HS017586.
Citation: Radecki RP, Azam A, Doshi PB .
Iodinated contrast prior to thrombolysis was not associated with worse intracranial hemorrhage.
Acad Emerg Med 2015 Mar;22(3):259-63. doi: 10.1111/acem.12603.
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Keywords: Adverse Drug Events (ADE), Emergency Medical Services (EMS), Medication, Medication: Safety, Stroke
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety
Kozak MA, Gernant SA, Hemmeger HM
Lessons learned in the growth and maturation stages of a community pharmacy practice-based research network: experiences of the Medication Safety Research Network of Indiana (Rx-SafeNet).
In 2012, the authors reported on their early experiences developing the Medication Safety Research Network of Indiana (Rx-SafeNet) after establishing the Network in 2010. In this article, they report on lessons learned over the past 3 years.
AHRQ-funded; HS022119.
Citation: Kozak MA, Gernant SA, Hemmeger HM .
Lessons learned in the growth and maturation stages of a community pharmacy practice-based research network: experiences of the Medication Safety Research Network of Indiana (Rx-SafeNet).
Innov Pharm 2015;6(2).
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Keywords: Community-Based Practice, Medication: Safety, Medication, Provider: Pharmacist, Practice-Based Research Network (PBRN)
Mixon AS, Neal E, Bell S
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
The authors discuss medication adherence in older adults across the continuum of care, describing reasons for nonadherence, methods to assess adherence, and tools to improve adherence, with particular focus on emerging techniques and technologies.
AHRQ-funded; HS019598.
Citation: Mixon AS, Neal E, Bell S .
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
Gerontology 2015;61(1):32-40. doi: 10.1159/000363765.
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Keywords: Elderly, Hospital Discharge, Medication: Safety, Medication, Patient Adherence/Compliance
Hennessy S, Strom BL
Improving postapproval drug safety surveillance: getting better information sooner.
There are often long delays between when a drug is approved and when serious adverse drug events are identified. This article discusses ways to reduce delays in identifying drug-related risks and in providing reassurance about the absence of such risks.
AHRQ-funded; HS018372.
Citation: Hennessy S, Strom BL .
Improving postapproval drug safety surveillance: getting better information sooner.
Annu Rev Pharmacol Toxicol 2015;55:75-87. doi: 10.1146/annurev-pharmtox-011613-135955.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Communication, Medication, Medication: Safety, Patient Safety
Broussard CS, Frey MT, Hernandez-Diaz S
AHRQ Author: Collins Sharp BA
Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention--convened meeting.
The CDC convened an expert meeting in January 2013 to inform clinical decision making for managing health conditions in pregnancy. This report summarized their discussions of best practices for formulating an expert review process, developing evidence summaries and treatment guidance, and disseminating information.
AHRQ-authored.
Citation: Broussard CS, Frey MT, Hernandez-Diaz S .
Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention--convened meeting.
Am J Obstet Gynecol 2014 Sep;211(3):208-14.e1. doi: 10.1016/j.ajog.2014.05.040.
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Keywords: Adverse Drug Events (ADE), Maternal Care, Medication: Safety, Medication, Pregnancy
Petrov ME, Howard VJ, Kleindorfer D
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
The authors investigated the relation between sleep medication use and incident stroke. At the sleep assessment, 9.6% of the participants used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. The authors found that over-the-counter sleep medication use was associated with increased risk of incident stroke; however, there was no significant association with prescription sleep medications. They concluded that over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.
AHRQ-funded; HS013852.
Citation: Petrov ME, Howard VJ, Kleindorfer D .
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2110-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.025.
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Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke, Cardiovascular Conditions, Racial and Ethnic Minorities
Pohl JM, Tanner C, Hamilton A
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
This study, conducted in five safety-net practices, examined the impact of implementing a commercial electronic health records system on medication safety. The authors found 130 "true" drug-drug interaction (DDI) pairs, representing 149,087 visits and 62 providers, with the largest DDI categories being related to antihypertensive medications, which are often prescribed together. They found no significant differences between physicians and nurse practitioners on the rate of DDI pairs.
AHRQ-funded; HS017191.
Citation: Pohl JM, Tanner C, Hamilton A .
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
J Am Assoc Nurse Pract 2014 Aug;26(8):438-44. doi: 10.1002/2327-6924.12089.
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Keywords: Medication: Safety, Medication, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety
Chrischilles EA, Hourcade JP, Doucette W
Personal health records: a randomized trial of effects on elder medication safety.
The purpose of this study was to compare patient-reported medication self-management behaviors and safety indicators among older adult participants invited to use an electronic personal health record (PHR). Among the 16.1 percent of participants who used the PHR frequently, there were significantly more changes in medication use, improved medication reconciliation behaviors, and more recognition of side effects.
AHRQ-funded; HS017034
Citation: Chrischilles EA, Hourcade JP, Doucette W .
Personal health records: a randomized trial of effects on elder medication safety.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):679-86. doi: 10.1136/amiajnl-2013-002284..
Keywords: Elderly, Medication, Medication: Safety, Health Information Technology (HIT), Patient Safety, Patient Self-Management
Gagne JJ, Wang SV, Rassen JA
A modular, prospective, semi-automated drug safety monitoring system for use in a distributed data environment.
The purpose of this study was to develop and test a semi-automated process for conducting routine active safety monitoring for new drugs in a network of electronic health care databases. The system identified serious risks due to some drugs, which were eventually removed from the market years later.
AHRQ-funded; HS018088; HS022193
Citation: Gagne JJ, Wang SV, Rassen JA .
A modular, prospective, semi-automated drug safety monitoring system for use in a distributed data environment.
Pharmacoepidemiol Drug Saf. 2014 Jun;23(6):619-27. doi: 10.1002/pds.3616..
Keywords: Medication: Safety, Health Information Technology (HIT), Patient Safety, Medication
Fain K, Alexander GC
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
The authors comment on a case study analyzing pharmacy claims in order to examine the impact of the iPledge program (an FDA restricted distribution plan that included electronic registration of patients, physicians, and pharmacists plus monitoring of contraceptive use) on contraceptive use for women of childbearing age taking isotretinoin (Accutane). This drug, used for acute acne, could affect fetal development. The limited effectiveness of the program shows the difficulty of changing patient behavior.
AHRQ-funded; HS0189960
Citation: Fain K, Alexander GC .
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
Pharmacoepidemiol Drug Saf. 2013 Dec;22(12):1258-62. doi: 10.1002/pds.3514..
Keywords: Patient Safety, Medication: Safety, Medication, Health Information Technology (HIT), Women
Abramson EL, Pfoh ER, Barron Y
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
This study was conducted to assess the effect of implementing a commercial electronic health record with e-prescribing on rates and types of prescribing errors. Use of e-prescribing resulted in relatively low error rates (6.0 errors per 100 prescriptions). These rates were sustained over time but without further improvement (6.0 versus 4.5 errors per 100) prescriptions).
AHRQ-funded; HS016970.
Citation: Abramson EL, Pfoh ER, Barron Y .
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
Jt Comm J Qual Patient Saf 2013 Dec;39(12):545-52..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Medication: Safety, Medication, Electronic Health Records (EHRs)
Hanlon JT, Schmader KE
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
The objective of this narrative review is to describe finding regarding the reliability of the Medication Appropriateness Index (MAI), a comparison of the MAI with other quality measures of potentially inappropriate prescribing, the predictive value of the MAI with important health outcomes, and the responsiveness of the MAI to change within the framework of randomized controlled trials.
AHRQ-funded; HS018721
Citation: Hanlon JT, Schmader KE .
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
Drugs Aging. 2013 Nov;30(11):893-900. doi: 10.1007/s40266-013-0118-4..
Keywords: Quality of Care, Medication, Outcomes, Quality Measures, Medication: Safety
Katz DF, Sun J, Khatri V
QTc interval screening in an opioid treatment program.
This pilot study supports the feasibility of implementing a population-based electrocardiographic monitoring program in order to decrease the QTc interval in high-risk patients undergoing methadone maintenance in an opioid treatment program. Clinical characteristics alone were inadequate to identify patients in need of electrocardiographic screening.
AHRQ-funded; HS021138
Citation: Katz DF, Sun J, Khatri V .
QTc interval screening in an opioid treatment program.
Am J Cardiol. 2013 Oct 1;112(7):1013-8. doi: 10.1016/j.amjcard.2013.05.037..
Keywords: Opioids, Medication, Substance Abuse, Screening, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Risk, Implementation
Moga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety