National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Cancer (1)
- Cancer: Lung Cancer (1)
- Care Management (2)
- Children/Adolescents (1)
- Chronic Conditions (7)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Disparities (1)
- Elderly (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Guidelines (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Injuries and Wounds (1)
- Medicare (1)
- (-) Medication (17)
- Medication: Safety (3)
- Obesity (1)
- Opioids (17)
- Orthopedics (1)
- (-) Pain (17)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (2)
- Practice Patterns (5)
- Prevention (2)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Rural Health (1)
- Shared Decision Making (1)
- Substance Abuse (4)
- Surgery (5)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedNavis A, George MC, Nmashie A
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
This study assessed the use of the Safer Opioid Prescribing Evaluation Tool (SOPET) which was designed to improve the implementation of the 2016 Centers for Disease Control Guidelines on the prescription of opioids for chronic pain. Four raters with varying levels of clinical experience were trained to use the SOPET and then used it to evaluate 21 baseline patient scenarios. Inter-rater reliability was measured using intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals for the total SOPET score based on a mean-rating absolute-agreement, two-way random-effects model. Inter-rater reliability was found to be good for the three physician raters (0.92, 0.97, and 0.99). However, inter-rater reliability for the non-physician rater was lower (0.67).
AHRQ-funded; HS025641.
Citation: Navis A, George MC, Nmashie A .
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
Pain Med 2020 Dec 25;21(12):3655-59. doi: 10.1093/pm/pnaa138..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Guidelines, Practice Patterns, Pain, Chronic Conditions, Evidence-Based Practice
Militello LG, Hurley RW, Cook RL
Primary care clinicians' beliefs and strategies for managing chronic pain in an era of a national opioid epidemic.
Investigators sought a better understanding of primary care clinicians’ approaches to managing patients with chronic pain and explored implications for technological and administrative interventions. They found that primary care clinicians’ beliefs about opioid therapy generally align with the clinical evidence but may have some important gaps, suggesting the potential value of interventions that include improved access to research findings, organizational changes to support spending time with patients to develop rapport, and the need for innovative clinical cognitive support.
AHRQ-funded; HS023306.
Citation: Militello LG, Hurley RW, Cook RL .
Primary care clinicians' beliefs and strategies for managing chronic pain in an era of a national opioid epidemic.
J Gen Intern Med 2020 Dec;35(12):3542-48. doi: 10.1007/s11606-020-06178-2..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Provider: Physician, Provider: Clinician, Provider, Care Management
Romman AN, Hsu CM, Chou LN
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
This study looked at trends in opioid prescribing frequency to Medicare Part D enrollees from 2013 to 2017 by medical specialty and provider type. The authors analyzed opioid claims and prescribing trends for specialties accounting for ≥1% of all opioid claims. Pain management specialists increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per provider in 2017. Physical medicine and rehabilitation providers increased claims by 16.9% to 511 mean claims per provider in 2017. All other medical specialties decreased opioid claims during this period, with emergency medicine decreasing the most (-19.9%) and orthopedic surgery (-16%) dropping opioid claims the most of all the other specialties. Overall physician decrease was -5.2%. However opioid claims among dentists (+5.6%) and nonphysician providers (+10.2%) increased during this period.
AHRQ-funded; HS020642.
Citation: Romman AN, Hsu CM, Chou LN .
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
Pain Med 2020 Nov 7;21(7):1400-07. doi: 10.1093/pm/pnz344..
Keywords: Elderly, Opioids, Medication, Medicare, Pain, Chronic Conditions, Practice Patterns
Scherer M, Weiss L, Kamler A M, Weiss L, Kamler A
Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations.
It is widely acknowledged that the growing opioid epidemic and associated increase in overdose deaths necessitates a reexamination of processes and procedures related to an opioid prescription for the treatment of chronic pain. However, the perspectives of patients, including those at the highest risk for opioid-related harms, are largely missing from this reexamination. To partially address the gap, the investigators conducted a pair of one-day public deliberations on opioid prescribing in the context of HIV care.
AHRQ-funded; HS025641.
Citation: Scherer M, Weiss L, Kamler A M, Weiss L, Kamler A .
Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations.
AIDS Care 2020 Nov;32(11):1471-78. doi: 10.1080/09540121.2019.1705962..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Medication, Chronic Conditions, Pain
Brown TJ Keshvani, N Gupta, et al.
Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.
This study examined trends in the use of laxatives for opioid-induced constipation (OIC) in patients prescribed opioids for cancer pain treatment. A retrospective study was conducted of lung cancer patients seen in the Veteran’s Affair system from 2003 to 2016. There were 130,990 individuals included in the analysis. The majority (87%) received no prophylaxis (75%) or received docusate alone while 5% received OIC prophylaxis with the unnecessary addition of docusate. Throughout the study period, laxative prescription significantly decreased while categories of OIC prophylaxis were unchanged. The study concluded that almost 90% received inadequate or inappropriate OIC prophylaxis.
AHRQ-funded; HS022418.
Citation: Brown TJ Keshvani, N Gupta, et al..
Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.
Support Care Cancer 2020 Nov;28(11):5315-21. doi: 10.1007/s00520-020-05364-6..
Keywords: Cancer: Lung Cancer, Cancer, Opioids, Medication, Prevention, Pain
Hernandez-Boussard T, Graham LA, Carroll I
Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.
This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. Utilizing nationwide Veterans Healthcare Administration (VHA) data on four high-volume surgical procedures, the researchers found that patients receiving high perioperative oral morphine equivalents were more likely to return to care for pain-related problems.
AHRQ-funded; HS024096.
Citation: Hernandez-Boussard T, Graham LA, Carroll I .
Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.
Am J Surg 2020 Jun;219(6):969-75. doi: 10.1016/j.amjsurg.2019.06.022..
Keywords: Opioids, Medication, Pain, Substance Abuse, Surgery, Hospital Readmissions
Wolff C, Dowd WN, Ali MM
AHRQ Author: McClellan C
The impact of the abuse-deterrent reformulation of extended-release OxyContin on prescription pain reliever misuse and heroin initiation.
The introduction of abuse-deterrent OxyContin in 2010 was intended to reduce its misuse by making it more tamper resistant. However, some studies have suggested that this reformulation might have had unintended consequences, such as increases in heroin-related deaths. In this study, the investigators used the 2005-2014 cross-sectional U.S. National Survey on Drug Use and Health to explore the impact of this reformulation on intermediate outcomes that precede heroin-related deaths for individuals with a history of OxyContin misuse.
AHRQ-authored.
Citation: Wolff C, Dowd WN, Ali MM .
The impact of the abuse-deterrent reformulation of extended-release OxyContin on prescription pain reliever misuse and heroin initiation.
Addict Behav 2020 Jun;105:106268. doi: 10.1016/j.addbeh.2019.106268..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Prevention, Pain, Substance Abuse
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in emergency department pain management of children with fractures.
Researchers tested the hypotheses that minority children with long-bone fractures are less likely to receive analgesics, to receive opioid analgesics, and to achieve pain reduction. Using data from the Pediatric Emergency Care Applied Research Network Registry, they found that there are differences in process and outcome measures by race and ethnicity in the emergency department management of pain among children with long-bone fractures. Although minority children are more likely to receive analgesics and achieve reduction in pain, they are less likely to receive opioids and achieve optimal pain reduction.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in emergency department pain management of children with fractures.
Pediatrics 2020 May;145(5):e20193370. doi: 10.1542/peds.2019-3370..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Emergency Department, Pain, Injuries and Wounds, Medication, Opioids, Disparities
Marcial LH, Blumenfeld B, Harle C
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
These proceedings report on the AHRQ-sponsored Patient-Centered CDS Learning Network (PCCDS LN) Technical Framework Working Group (TechFWG), which was convened to identify barriers, facilitators, and potential solutions for interoperable clinical decision support, with a specific focus on addressing the opioid epidemic. The key insights were extrapolated to CDS-facilitated care improvement outside of the specific opioid use case. If applied broadly, the recommendations should help advance the availability and impact of interoperable CDS delivered at scale.
AHRQ-funded; HS024849.
Citation: Marcial LH, Blumenfeld B, Harle C .
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
AMIA Annu Symp Proc 2020 Mar 4;2019:637-46..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Opioids, Medication, Pain, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Sobieraj DM, Martinez BK, Miao B
Comparative effectiveness of analgesics to reduce acute pain in the prehospital setting.
The objectives of this study were to assess comparative effectiveness and harms of opioid and nonopioid analgesics for the treatment of moderate to severe acute pain in the prehospital setting. Among the investigators’ conclusions were that as initial analgesia, opioids were no different than ketamine, APAP, and NSAIDs in reducing acute pain in the prehospital setting. Opioids may cause fewer total side effects than ketamine, but more than APAP or NSAIDs.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Martinez BK, Miao B .
Comparative effectiveness of analgesics to reduce acute pain in the prehospital setting.
Prehosp Emerg Care 2020 Mar-Apr;24(2):163-74. doi: 10.1080/10903127.2019.1657213..
Keywords: Opioids, Medication, Pain, Emergency Medical Services (EMS), Comparative Effectiveness, Patient-Centered Outcomes Research
Newberry CI, Casazza GC, Pruitt LC
Prescription patterns and opioid usage in sinonasal surgery.
The goal of this study was to identify factors associated with variable opioid usage and to delineate optimal prescription patterns for sinonasal surgery. The researchers found that patients used 9.3% of their full prescription and only 2.6% required a refill. The amount used was not associated with complexity of endoscopic sinus surgery, type of opiate prescribed, gender, distance living from hospital, or current opioid usage before surgery. They concluded that opioids are overprescribed after sinonasal surgery and that the amount of postoperative opiate prescribed should be greatly reduced and may be based on the specific procedures performed.
AHRQ-funded; HS024638.
Citation: Newberry CI, Casazza GC, Pruitt LC .
Prescription patterns and opioid usage in sinonasal surgery.
Int Forum Allergy Rhinol 2020 Mar;10(3):381-87. doi: 10.1002/alr.22478..
Keywords: Opioids, Medication, Pain, Surgery, Respiratory Conditions, Healthcare Utilization, Practice Patterns, Substance Abuse
De Roo AC, Vu JV, Regenbogen SE
Statewide utilization of multimodal analgesia and length of stay after colectomy.
This study examined statewide utilization of multimodal analgesia after colectomy. Multimodal analgesia shortens length of stay and hastens recovery. The researchers conducted a statewide, 72-hospital collaborative quality initiative and evaluated postoperative analgesia regimens among adult elective colectomy patients between 2012 and 2015. One-third of patients received opioids alone, and 2.8% received one nonopioid pain medication alone. The researchers suggest that these numbers must be improved particularly with the current opioid crisis.
AHRQ-funded; HS000053.
Citation: De Roo AC, Vu JV, Regenbogen SE .
Statewide utilization of multimodal analgesia and length of stay after colectomy.
J Surg Res 2020 Mar;247:264-70. doi: 10.1016/j.jss.2019.10.014..
Keywords: Surgery, Opioids, Medication, Medication: Safety, Practice Patterns, Pain
Heins SE, Castillo RC
The impact of morphine equivalent daily dose threshold guidelines on prescribed dose in a workers' compensation population.
This study evaluated the impact of dissemination Morphine Equivalent Daily Dose (MEDD) guidelines to state workers’ compensation boards to discourage high-dose opioid use among injured workers receiving workers’ compensation. The study used workers compensations claims data from 2010-2013 from 2 guideline states and 3 control states. The policy implementation showed a 9.26 mg decrease in MEDD after adjusting for covariates, state fixed-effects, and time trends. The decreases became more pronounced over the study period.
AHRQ-funded; HS025557.
Citation: Heins SE, Castillo RC .
The impact of morphine equivalent daily dose threshold guidelines on prescribed dose in a workers' compensation population.
Med Care 2020 Mar;58(3):241-47. doi: 10.1097/mlr.0000000000001269..
Keywords: Opioids, Medication, Pain, Chronic Conditions, Practice Patterns, Guidelines
Shoemaker-Hunt SJ, Evans L, Swan H
Study protocol for evaluating Six Building Blocks for opioid management implementation in primary care practices.
AHRQ-funded; 233201500013I.
Citation: Shoemaker-Hunt SJ, Evans L, Swan H .
Study protocol for evaluating Six Building Blocks for opioid management implementation in primary care practices.
Implement Sci Commun 2020 Feb 26;1:16. doi: 10.1186/s43058-020-00008-6..
Keywords: Opioids, Medication, Primary Care, Care Management, Pain, Chronic Conditions
Parchman ML, Ike B, Osterhage KP
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
This paper discusses the barriers and facilitators to implementing changes in opioid prescription in rural areas using the Six Building Blocks evidence-based program to reduce opioid prescription in primary care practices. The program was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. Interviews and focus groups with conducted with the organizations at the end of the program period. Facilitators included a desire to help patients and their community; external pressures to make changes in opioid management; a desire to reduce workplace stress; external support for the clinic; supportive clinic leadership; and receptivity of patients. Barriers included competing demands on clinicians and staff; a culture of clinician autonomy; inadequate data systems; and a lack of patient resources in rural areas.
AHRQ-funded; HS023750.
Citation: Parchman ML, Ike B, Osterhage KP .
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
J Clin Transl Sci 2020 Jan 10;4(5):425-30. doi: 10.1017/cts.2019.448..
Keywords: Opioids, Medication, Rural Health, Primary Care, Primary Care: Models of Care, Implementation, Pain, Chronic Conditions, Healthcare Delivery
Chin KK, Carroll I, Desai K
Integrating adjuvant analgesics into perioperative pain practice: results from an academic medical center.
This study evaluated adjuvant analgesic gabapentin use after total knee arthroplasty (TKA) surgery and its effects on opioid use, pain, and readmissions. This retrospective observational study included 4,046 TKA recipients from 2009 to 2017 using electronic health records from an academic tertiary care medical institute. Overall, there was an 8.72% annual increase in gabapentin use which was associated with a significant decrease in opioid consumption in modeled estimates. Patients receiving gabapentin had similar discharge and follow-up pain scores, and 30-day unplanned readmission rates compared with patients receiving no adjuvant analgesics.
AHRQ-funded; HS024096.
Citation: Chin KK, Carroll I, Desai K .
Integrating adjuvant analgesics into perioperative pain practice: results from an academic medical center.
Pain Med 2020 Jan;21(1):161-70. doi: 10.1093/pm/pnz053..
Keywords: Opioids, Medication, Pain, Surgery, Orthopedics
Raebel MA, Newcomer SR, Reifler LM
Chronic use of opioid medications before and after bariatric surgery.
This study of 11,179 obese patients receiving bariatric surgery found that among the 933 who were using opioids chronically before bariatric surgery, 77 percent continued chronic opioid use in the year following surgery (excluding the first 30 days after surgery). The amount of chronic opioid use was greater postoperatively than preoperatively.
AHRQ-funded; HS019912
Citation: Raebel MA, Newcomer SR, Reifler LM .
Chronic use of opioid medications before and after bariatric surgery.
JAMA. 2013 Oct 2;310(13):1369-76. doi: 10.1001/jama.2013.278344..
Keywords: Medication, Obesity, Opioids, Pain, Substance Abuse, Surgery