National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (32)
- Adverse Events (6)
- Antibiotics (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (6)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- Communication (3)
- Comparative Effectiveness (2)
- Critical Care (1)
- Data (1)
- Diabetes (3)
- Digestive Disease and Health (1)
- Education: Patient and Caregiver (1)
- Elderly (9)
- Electronic Health Records (EHRs) (7)
- Electronic Prescribing (E-Prescribing) (3)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (6)
- Hospital Discharge (1)
- Hospitals (1)
- Implementation (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Long-Term Care (2)
- Maternal Care (1)
- Medical Errors (5)
- Medicare (1)
- Medication (49)
- (-) Medication: Safety (53)
- Mortality (1)
- Neurological Disorders (1)
- Newborns/Infants (2)
- Nursing Homes (1)
- Opioids (6)
- Orthopedics (1)
- Outcomes (2)
- Patient Adherence/Compliance (2)
- Patient Safety (20)
- Patient Self-Management (2)
- Policy (2)
- Practice-Based Research Network (PBRN) (1)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (2)
- Provider (1)
- Provider: Pharmacist (4)
- Quality Measures (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (3)
- Screening (1)
- Sleep Problems (1)
- Stroke (1)
- Substance Abuse (3)
- Surgery (3)
- 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 25 of 53 Research Studies DisplayedGeorge MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
Zhou M, Wang SV, Leonard CE
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Sentinel is a program sponsored by the US Food and Drug Administration to monitor the safety of medical products. This cohort assessment was conducted to evaluate the ability of the Sentinel Propensity Score Matching Tool to reproduce, in an expedited fashion, the known association between glyburide (vs. glipizide) and serious hypoglycemia. The study’s findings were consistent with the literature, and demonstrated the ability of the tool to reproduce this known association in an expedited.
AHRQ-funded; HS022193.
Citation: Zhou M, Wang SV, Leonard CE .
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Epidemiology 2017 Nov;28(6):838-46. doi: 10.1097/ede.0000000000000709..
Keywords: Adverse Drug Events (ADE), Diabetes, Medication: Safety, Medication, Patient Safety
Boyce RD, Jao J, Miller T
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
The purpose of this study was to conduct research to show the value of text mining for automatically identifying suspected bleeding adverse drug events (ADEs) in the emergency department (ED). The investigators found that both models they examined, accurately identify bleeding ADEs using the presence or absence of certain clinical concepts in ED admission notes for older adult patients.
AHRQ-funded; HS024208.
Citation: Boyce RD, Jao J, Miller T .
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
Appl Clin Inform 2017 Oct;8(4):1022-30. doi: 10.4338/aci-2017-02-ra-0036..
Keywords: Adverse Drug Events (ADE), Elderly, Emergency Department, Medication, Medication: Safety
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Nothelle SK, Sharma R, Oakes AH
Determinants of potentially inappropriate medication use in long-term and acute care settings: a systematic review.
The authors searched for studies conducted in the United States that described determinants of Potentially inappropriate medications (PIMs) use in adults >/=60 years of age in a nursing home or residential care facility, in the emergency department (ED), or in the hospital. They concluded that among older adults, those who are on many medications are at increased risk for PIM use across multiple settings.
AHRQ-funded; HS000029.
Citation: Nothelle SK, Sharma R, Oakes AH .
Determinants of potentially inappropriate medication use in long-term and acute care settings: a systematic review.
J Am Med Dir Assoc 2017 Sep;18(9):806.e1-06.e17. doi: 10.1016/j.jamda.2017.06.005.
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Keywords: Medication, Medication: Safety, Long-Term Care, Critical Care, Elderly
Chui MA, Stone JA, Holden RJ
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
This study proposes to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention.
AHRQ-funded; HS024490.
Citation: Chui MA, Stone JA, Holden RJ .
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
Res Social Adm Pharm 2017 Sep - Oct;13(5):930-37. doi: 10.1016/j.sapharm.2016.11.006.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Provider: Pharmacist
Miller GE, Sarpong EM, Davidoff AJ
AHRQ Author: Miller GE, Sarpong EM
Determinants of potentially inappropriate medication use among community-dwelling older adults.
The researchers examined the determinants of potentially inappropriate medication (PIM) use. The multivariate results suggest that poor health status and high-PIM-risk conditions were associated with increased PIM use, while increasing age and educational attainment were associated with lower PIM use. Contrary to expectations, lack of a usual care source of care or supplemental insurance was associated with lower PIM use
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Davidoff AJ .
Determinants of potentially inappropriate medication use among community-dwelling older adults.
Health Serv Res 2017 Aug;52(4):1534-49. doi: 10.1111/1475-6773.12562.
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Keywords: Medication, Elderly, Medication: Safety, Adverse Drug Events (ADE), Medical Errors
Koronkowski MJ, Semla TP, Schmader KE
Recent literature update on medication risk in older adults, 2015-2016.
Medications can pose considerable risk in older adults. This article intended to provide a narrative review of key publications in medication safety for clinicians and researchers committed to improving medication safety in older adults. It annotates four articles addressing this concern from 2016.
AHRQ-funded; HS023779.
Citation: Koronkowski MJ, Semla TP, Schmader KE .
Recent literature update on medication risk in older adults, 2015-2016.
J Am Geriatr Soc 2017 Jul;65(7):1401-05. doi: 10.1111/jgs.14887.
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Keywords: Elderly, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Schroeder SR, Salomon MM, Galanter WL
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
The researchers conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. They found that across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception.
AHRQ-funded; HS021093.
Citation: Schroeder SR, Salomon MM, Galanter WL .
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
BMJ Qual Saf 2017 May;26(5):395-407. doi: 10.1136/bmjqs-2015-005099.
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Keywords: Adverse Drug Events (ADE), Medical Errors, Medication: Safety, Medication, Provider: Pharmacist
Blumenthal KG, Acker WW, Li Y
Allergy entry and deletion in the electronic health record.
The researchers aimed to assess drug allergy entry, deletion, and accumulation, to identify health care professional types recording allergy data, and to assess the reaction types that lead to allergy entry and deletion. They found that of all allergies, 38.2 percent were immune mediated and 29.6 percent included only adverse effect reactions. Unavailable or unknown reactions comprised 32.2 percent of all allergies entered or deleted.
AHRQ-funded; HS022728.
Citation: Blumenthal KG, Acker WW, Li Y .
Allergy entry and deletion in the electronic health record.
Ann Allergy Asthma Immunol 2017 Mar;118(3):380-81. doi: 10.1016/j.anai.2016.12.020.
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Keywords: Data, Electronic Health Records (EHRs), Medication: Safety, Medication, Adverse Drug Events (ADE)
McDonald EM, Kennedy-Hendricks A, McGinty EE
Safe storage of opioid pain relievers among adults living in households with children.
The researchers sought to describe safe storage practices and beliefs among adults who have used a prescription opioid pain reliever (OPR) in the past year; to compare practices and beliefs among those living with younger (<7 years) versus older children (7-17 years). They concluded that OPRs are stored unsafely in many households with children.
AHRQ-funded; HS000029.
Citation: McDonald EM, Kennedy-Hendricks A, McGinty EE .
Safe storage of opioid pain relievers among adults living in households with children.
Pediatrics 2017 Mar;139(3). doi: 10.1542/peds.2016-2161.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication: Safety, Medication, Opioids
Adams KT, Howe JL, Fong A
An analysis of patient safety incident reports associated with electronic health record interoperability.
The study’s objectives were to (1) identify patient safety incident reports that reflect EHR interoperability challenges with other health IT, and (2) perform a detailed analysis of these reports. It found that the majority of EHR interoperability patient safety event (PSE) reports involved interfacing with pharmacy systems (i.e. medication related), followed by laboratory, and radiology. Most of the interoperability challenges in these clinical areas were associated with the EHR receiving information from other health IT systems.
AHRQ-funded; HS023701.
Citation: Adams KT, Howe JL, Fong A .
An analysis of patient safety incident reports associated with electronic health record interoperability.
Appl Clin Inform 2017 Feb;8(2):593-602. doi: 10.4338/ACI-2017-01-RA-0014.
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Keywords: Healthcare Delivery, Electronic Health Records (EHRs), Electronic Prescribing (E-Prescribing), Medication: Safety, Patient Safety
Pannucci CJ, Rondina MT
Should we be following anti-factor Xa levels in patients receiving prophylactic enoxaparin perioperatively?
The authors argue that existing data demonstrate that an individualized regimen of enoxaparin prophylaxis based on patient-level factors might provide an increased margin of effectiveness and safety for individual patients given enoxaparin prophylactically in the perioperative period.
AHRQ-funded; HS024326.
Citation: Pannucci CJ, Rondina MT .
Should we be following anti-factor Xa levels in patients receiving prophylactic enoxaparin perioperatively?
Surgery 2017 Feb;161(2):329-31. doi: 10.1016/j.surg.2016.07.038.
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Keywords: Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety, Prevention
Meisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Westover AN, Nakonezny PA, Adinoff B
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
In this study of the impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents, the investigators found that adolescent stimulant medication users, compared to matched nonusers, demonstrated a trend toward decreased heart rate during submaximal exercise (which is potential evidence of chronic adaptation with stimulant exposure). There was no evidence for delayed heart rate recovery in this study, and thus, no evidence for decreased parasympathetic activity during initial exercise recovery.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Adinoff B .
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
J Child Adolesc Psychopharmacol 2016 Dec;26(10):889-99. doi: 10.1089/cap.2016.0064..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Blood Pressure, Medication, Medication: Safety
Cho I, Lee JH, Choi J
National rules for drug-drug interactions: are they appropriate for tertiary hospitals?
This study investigated the potential impact of Korean national drug-drug interactions (DDI) rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Only 0.3 percent of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5 percent, which was much lower than for the overall DDI rules.
AHRQ-funded; HS021094.
Citation: Cho I, Lee JH, Choi J .
National rules for drug-drug interactions: are they appropriate for tertiary hospitals?
J Korean Med Sci 2016 Dec;31(12):1887-96. doi: 10.3346/jkms.2016.31.12.1887.
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Keywords: Adverse Drug Events (ADE), Hospitals, Medication, Medication: Safety
Lipska KJ, Flory JH, Hennessy S
Citizen petition to the US Food and Drug Administration to change prescribing guidelines: The metformin experience.
Although healthcare professionals rarely submit citizen petitions, they can exert a powerful impact on the labeling requirements for drugs. Metformin is one such example. The authors filed 2 petitions to the FDA, asking the FDA to change the label and to relax the renal contraindications. In 2016, the FDA issued a safety communication that partially granted our requests by requiring the manufacturers of metformin to change the labeling of metformin in several ways.
AHRQ-funded; HS023898.
Citation: Lipska KJ, Flory JH, Hennessy S .
Citizen petition to the US Food and Drug Administration to change prescribing guidelines: The metformin experience.
Circulation 2016 Nov 1;134(18):1405-08. doi: 10.1161/circulationaha.116.023041.
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Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Kidney Disease and Health, Diabetes
Gagne JJ, Han X, Hennessy S
Successful comparison of US Food and Drug Administration sentinel analysis tools to traditional approaches in quantifying a known drug-adverse event association.
The authors assessed the extent to which the newly developed, semiautomated Sentinel Propensity Score Matching tool could produce the same results as a customized protocol-driven assessment. They found initial evidence that Sentinel analytic tools can produce findings similar to those produced by a highly customized protocol-driven assessment.
AHRQ-funded; HS022193.
Citation: Gagne JJ, Han X, Hennessy S .
Successful comparison of US Food and Drug Administration sentinel analysis tools to traditional approaches in quantifying a known drug-adverse event association.
Clin Pharmacol Ther 2016 Nov;100(5):558-64. doi: 10.1002/cpt.429.
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Keywords: Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety
Kesselheim AS, Bykov K, Gagne JJ
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
The researchers estimated the risk of seizure-related events associated with refilling antiepileptic drugs (AED) with generic AEDs and the effect of switching between different manufacturers of the same generic drug. They found that among patients on a generic AED, refilling the same AED was associated with an elevated risk of seizure-related event; however, there was no additional risk from switching during that refill to a different manufacturer.
AHRQ-funded; HS022193.
Citation: Kesselheim AS, Bykov K, Gagne JJ .
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
Neurology 2016 Oct 25;87(17):1796-801. doi: 10.1212/wnl.0000000000003259.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Neurological Disorders, Patient Safety, Risk
Green TC, Gilbert M
Counterfeit medications and fentanyl.
In this invited commentary, the authors discuss counterfeit medications and fentanyl, including a research letter in the same issue by Arens et al., which reports on a case series of counterfeit Xanax tablets containing fentanyl and etizolam. They include malice, accident, obfuscation, and economic considerations as reasons why someone would press fentanyl into the shape of a Xanax tablet.
AHRQ-funded; HS024021.
Citation: Green TC, Gilbert M .
Counterfeit medications and fentanyl.
JAMA Intern Med 2016 Oct;176(10):1555-57. doi: 10.1001/jamainternmed.2016.4310.
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Keywords: Medication: Safety, Medication, Patient Safety
Pinyavat T, Warner DO, Flick RP
Summary of the update session on clinical neurotoxicity studies.
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study.
AHRQ-funded; HS022941.
Citation: Pinyavat T, Warner DO, Flick RP .
Summary of the update session on clinical neurotoxicity studies.
J Neurosurg Anesthesiol 2016 Oct;28(4):356-60. doi: 10.1097/ana.0000000000000347.
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Keywords: Newborns/Infants, Children/Adolescents, Medication: Safety, Adverse Drug Events (ADE), Medication
Curtis LM, Mullen RJ, Russell A
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
The researchers tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. They found that written information and physician counseling were independently associated with patient understanding of risk information and that receiving both was most beneficial. They concluded that although an EHR can be a reliable means to deliver tangible, print medication education to patients, it cannot replace physician-patient communication, and that offering both written and spoken information resulted in a synergistic effect for informing patients.
AHRQ-funded; HS017220.
Citation: Curtis LM, Mullen RJ, Russell A .
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
Patient Educ Couns 2016 Sep;99(9):1489-95. doi: 10.1016/j.pec.2016.07.004.
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Keywords: Electronic Health Records (EHRs), Communication, Education: Patient and Caregiver, Medication: Safety, Medication
Zhou L, Dhopeshwarkar N, Blumenthal KG
Drug allergies documented in electronic health records of a large healthcare system.
The authors studied the prevalence of common drug allergies and patient characteristics documented in electronic health records of two large tertiary care hospitals in Boston from 1990 to 2013. They found that drug allergies in general were most prevalent among females and white patients, but that allergies to NSAIDs, ACE inhibitors, and thiazide diuretics were more prevalent in black patients.
AHRQ-funded; HS022728.
Citation: Zhou L, Dhopeshwarkar N, Blumenthal KG .
Drug allergies documented in electronic health records of a large healthcare system.
Allergy 2016 Sep;71(9):1305-13. doi: 10.1111/all.12881.
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Keywords: Adverse Drug Events (ADE), Electronic Health Records (EHRs), Medication: Safety, Medication
Ing C, Sun LS, Friend AF
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
This study compared spinal anesthesia (SA) versus general anesthesia (GA) in infants undergoing pyloromyotomy. It concluded that infants undergoing pyloromyotomy with SA had shorter operating room times and postoperative length of stay, no significant differences in adverse event rates, and decreased exposure to IV and inhaled anesthetics, although SA infants often still required supplemental anesthetics.
AHRQ-funded; HS022941.
Citation: Ing C, Sun LS, Friend AF .
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
Reg Anesth Pain Med 2016 Jul-Aug;41(4):532-7. doi: 10.1097/aap.0000000000000421.
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Keywords: Newborns/Infants, Surgery, Medication, Medication: Safety, Adverse Drug Events (ADE)
Kennedy-Hendricks A, Gielen A, McDonald E
Medication sharing, storage, and disposal practices for opioid medications among US adults.
The authors conducted a national survey among US adults with recent opioid medication use to examine the pervasiveness of sharing opioid medications, medication storage and disposal practices, and the sources of information received. Their findings suggested that current practices related to sharing, storing, and disposing of opioid medications, as well as communication of information on these topics, are suboptimal. They recommended that more research is needed to identify effective strategies to advance safer practices related to opioid medication sharing, storage, and disposal.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Gielen A, McDonald E .
Medication sharing, storage, and disposal practices for opioid medications among US adults.
JAMA Intern Med 2016 Jul;176(7):1027-9. doi: 10.1001/jamainternmed.2016.2543.
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Keywords: Medication: Safety, Medication, Opioids, Patient Safety, Substance Abuse