National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (1)
- Antimicrobial Stewardship (1)
- Back Health and Pain (2)
- Behavioral Health (1)
- Blood Pressure (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (3)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- (-) Chronic Conditions (28)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (4)
- Decision Making (1)
- Diabetes (4)
- Digestive Disease and Health (1)
- Disparities (1)
- Elderly (4)
- Evidence-Based Practice (3)
- Guidelines (1)
- Healthcare Costs (2)
- Healthcare Utilization (1)
- Health Insurance (1)
- Heart Disease and Health (1)
- Hepatitis (1)
- Long-Term Care (2)
- Medicaid (3)
- Medicare (1)
- (-) Medication (28)
- Medication: Safety (1)
- Nursing Homes (2)
- Opioids (6)
- Outcomes (2)
- Pain (5)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (8)
- Patient Adherence/Compliance (7)
- Patient Safety (1)
- Patient Self-Management (1)
- Practice Patterns (2)
- Prevention (1)
- Provider (1)
- Provider: Pharmacist (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- Substance Abuse (1)
- Treatments (2)
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 28 Research Studies DisplayedNdefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
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
Waldfogel JM, Nesbit SA, Dy SM
Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: a systematic review.
This review systematically assessed the effect of pharmacologic treatments of diabetic peripheral neuropathy (DPN) on pain and quality of life. It concluded that for reducing pain, duloxetine and venlafaxine, pregabalin and oxcarbazepine, tricyclic antidepressants, atypical opioids, and botulinum toxin were more effective than placebo. However, quality of life was poorly reported, studies were short-term, drugs had substantial dropout rates, and opioids have significant risks.
AHRQ-funded; 2902015000061.
Citation: Waldfogel JM, Nesbit SA, Dy SM .
Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: a systematic review.
Neurology 2017 May 16;88(20):1958-67. doi: 10.1212/wnl.0000000000003882.
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Keywords: Diabetes, Chronic Conditions, Medication, Quality of Life, Patient-Centered Outcomes Research
Yeung K, Basu A, Marcum ZA
Impact of a value-based formulary in three chronic disease cohorts.
This study assessed the impact of a value based formulary (VBF) on medication adherence and patient and health plan expenditures on 3 chronic disease states: diabetes, hypertension, and hyperlipidemia. The investigators measured medication expenditures from member, health plan, and member-plus-health plan (overall) perspectives and medication adherence as proportion of days covered. They conducted an exploratory analysis of medication utilization classifying medications according to whether co-payments moved up or down in the year following VBF implementation.
AHRQ-funded; HS022982.
Citation: Yeung K, Basu A, Marcum ZA .
Impact of a value-based formulary in three chronic disease cohorts.
Am J Manag Care 2017 Mar; 23(3 Suppl):S46-s53..
Keywords: Chronic Conditions, Health Insurance, Patient Adherence/Compliance, Medication, Healthcare Costs
Lidder AK, Detwiller KY, Price CP
Evaluating metrics of responsiveness using patient-reported outcome measures in chronic rhinosinusitis.
This study compares responsiveness of patient-reported outcome measures (PROMs) used in chronic rhinosinusitis (CRS) to inform the future development of a highly responsive instrument that accurately portrays CRS patients' symptom experiences. For both medical therapy (MT) patients and those undergoing endoscopic sinus surgery after failing MT, CRS-specific PROMs are more responsive to posttreatment clinical changes than general health measures.
AHRQ-funded; HS023011.
Citation: Lidder AK, Detwiller KY, Price CP .
Evaluating metrics of responsiveness using patient-reported outcome measures in chronic rhinosinusitis.
Int Forum Allergy Rhinol 2017 Feb;7(2):128-34. doi: 10.1002/alr.21866.
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Keywords: Chronic Conditions, Medication, Patient-Centered Outcomes Research, Treatments
Shen C, Zhao B, Liu L
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
In this study, the investigators examined financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications. The authors concluded that patients experience quick entry and exit from the coverage gap (also called the donut hole) as a result of the high price of targeted oral anticancer medications. They suggested that closing the donut hole would provide financial relief during the initial month(s) of treatment but will not completely eliminate the financial burden.
AHRQ-funded; HS020263.
Citation: Shen C, Zhao B, Liu L .
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
J Oncol Pract 2017 Feb;13(2):e152-e62. doi: 10.1200/JOP.2016.014639..
Keywords: Cancer, Chronic Conditions, Elderly, Healthcare Costs, Medicare, Medication
Fain KM, Alexander GC, Dore DD
Frequency and predictors of analgesic prescribing in U.S. nursing home residents with persistent pain.
The purpose of this study was to quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. The investigators concluded that through 2008, pain remained undertreated in NHs, especially in certain subpopulations, including cognitively impaired and older residents. The authors suggest that changes in pain management practice and policies may be necessary to target these vulnerable residents.
AHRQ-funded; HS022998.
Citation: Fain KM, Alexander GC, Dore DD .
Frequency and predictors of analgesic prescribing in U.S. nursing home residents with persistent pain.
J Am Geriatr Soc 2017 Feb;65(2):286-93. doi: 10.1111/jgs.14512..
Keywords: Care Management, Chronic Conditions, Elderly, Long-Term Care, Medication, Nursing Homes, Opioids, Pain, Practice Patterns
Fain KM, Castillo-Salgado C, Dore DD
Inappropriate fentanyl prescribing among nursing home residents in the United States.
In this cross-sectional study, the investigators quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naive prescribing. The investigators concluded that most nursing home residents initiating transdermal fentanyl did not have persistent pain and many were opioid-naive. They suggest that changes in prescribing practices may be necessary to ensure Food and Drug Administration warnings are followed, particularly for vulnerable subgroups, such as the cognitively impaired.
AHRQ-funded; HS018960.
Citation: Fain KM, Castillo-Salgado C, Dore DD .
Inappropriate fentanyl prescribing among nursing home residents in the United States.
J Am Med Dir Assoc 2017 Feb;18(2):138-44. doi: 10.1016/j.jamda.2016.08.015..
Keywords: Care Management, Chronic Conditions, Elderly, Long-Term Care, Medication, Nursing Homes, Opioids, Pain, Practice Patterns
Min JY, Ocampo CJ, Stevens WW
Proton pump inhibitors decrease eotaxin-3/CCL26 expression in patients with chronic rhinosinusitis with nasal polyps: possible role of the nongastric H,K-ATPase.
The researchers assessed the effect of type 2 mediators, particularly IL-13 and eotaxin-3, on tissue eosinophilia and disease severity in patients with chronic rhinosinusitis. The results demonstrated that proton pump inhibitors (PPIs) reduce IL-13-induced eotaxin-3 expression by airway epithelial cells. Furthermore, mechanistic studies suggest that the nongastric H,K-ATPase is necessary for IL-13-mediated epithelial responses.
AHRQ-funded; HS023011.
Citation: Min JY, Ocampo CJ, Stevens WW .
Proton pump inhibitors decrease eotaxin-3/CCL26 expression in patients with chronic rhinosinusitis with nasal polyps: possible role of the nongastric H,K-ATPase.
J Allergy Clin Immunol 2017 Jan;139(1):130-41.e11. doi: 10.1016/j.jaci.2016.07.020.
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Keywords: Chronic Conditions, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
McCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Lo Re V, 3rd, Haynes K, Forde KA
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
The researchers aimed to develop a highly sensitive model to identify drug-induced liver injury (DILI) patients at increased risk of acute liver failure (ALF). negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). Their model, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score).
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Haynes K, Forde KA .
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
Clin Gastroenterol Hepatol 2015 Dec;13(13):2360-8. doi: 10.1016/j.cgh.2015.06.020.
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Keywords: Antimicrobial Stewardship, Medication, Chronic Conditions, Adverse Drug Events (ADE), Clinical Decision Support (CDS)
Turner JA, Comstock BA, Standaert CJ
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
The study’s aim was to identify patient characteristics associated with benefits from epidural injections of corticosteroid with lidocaine versus epidural injections of lidocaine only for lumbar spinal stenosis symptoms. It found that among 21 baseline patient characteristics examined, none, including clinician rated spinal stenosis severity, were consistent predictors of benefit from epidural injections of lidocain corticosteroid versus lidocaine only.
AHRQ-funded; HS019222; HS022972.
Citation: Turner JA, Comstock BA, Standaert CJ .
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
Spine J 2015 Nov;15(11):2319-31. doi: 10.1016/j.spinee.2015.06.050..
Keywords: Patient-Centered Outcomes Research, Decision Making, Medication, Back Health and Pain, Chronic Conditions
Ajmera M, Sambamoorthi U, Metzger A
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
The aim of this study was to examine the association between multimorbidity and chronic obstructive pulmonary disease ( COPD) medication receipt among Medicaid beneficiaries with newly diagnosed COPD. It found that in this group 81.9 percen had at least one co-occurring chronic condition. After controlling for subject characteristics, adults with multimorbidity were less likely to receive COPD medications compared with those without any inflammation-related multimorbidity.
AHRQ-funded; HS022444.
Citation: Ajmera M, Sambamoorthi U, Metzger A .
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
Respir Care 2015 Nov;60(11):1592-602. doi: 10.4187/respcare.03788.
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Keywords: Chronic Conditions, Respiratory Conditions, Medication, Medicaid
LaFleur J, Hoop R, Korner E
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
The researchers determined whether selected patient characteristics predicted discontinued therapy for reasons other than lack of efficcacy (non-LOE) using national databases of U.S. veterans. They found that predictors of greatest magnitude included comorbidities of myocardial infarction/congestive heart failure, renal disease, platelets 100/mm or more, Black race, albumin 3.5 mg/dl or more, sleep aid use, and poor persistence with antidepressants and antihypertensive agents.
AHRQ-funded; HS018582.
Citation: LaFleur J, Hoop R, Korner E .
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
Gastroenterol Nurs 2015 Nov-Dec;38(6):417-28. doi: 10.1097/sga.0000000000000214.
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Keywords: Chronic Conditions, Hepatitis, Medication, Patient Adherence/Compliance
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Shah ED, Siegel CA, Chong K
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
The researchers aimed to clarify treatment durability by assessing subject discontinuations from clinical trials in the context of treatment efficacy. They found that for patients with Crohn’s disease, biologic therapies had higher durability than immunomodulators for induction and maintenance therapy.
AHRQ-funded; HS021747.
Citation: Shah ED, Siegel CA, Chong K .
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
Dig Dis Sci 2015 Aug;60(8):2408-18. doi: 10.1007/s10620-015-3618-8..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Comparative Effectiveness
Goldberg DS, Forde KA, Carbonari DM
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
The researchers conducted an assessment of the incidence and outcomes of acute drug-induced liver failure within a large, integrated healthcare system that approximates a population-representative cohort. They found the incident of acute drug-induced liver failure to be 1.61 per million person years with the overwhelming majority being due to over-the-counter medications or products.
AHRQ-funded; HS018372.
Citation: Goldberg DS, Forde KA, Carbonari DM .
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
Gastroenterology 2015 Jun;148(7):1353-61.e3. doi: 10.1053/j.gastro.2015.02.050..
Keywords: Medication, Chronic Conditions, Patient Safety
Ringwalt C, Roberts AW, Gugelmann H
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
The purpose of this study was to examine differences across providers’ specialties in prescriptions filled by white and black Medicaid beneficiaries with chronic noncancer pain (CNCP). It found that race-based differences in beneficiaries’ dispensed opioid prescriptions were more prominent among patients of specialists in obstetrics and gynecology and internal medicine, as well as general practitioners/family medicine physicians.
AHRQ-funded; HS000032.
Citation: Ringwalt C, Roberts AW, Gugelmann H .
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
Pain Med 2015 Apr;16(4):633-40. doi: 10.1111/pme.12555..
Keywords: Chronic Conditions, Disparities, Medicaid, Medication, Opioids, Pain, Racial and Ethnic Minorities
Hansen RA, Voils CI, Farley JF
Prescriber continuity and medication adherence for complex patients.
The purpose of this study was to examine the relationship between number of prescribers, number of conditions, and refill adherence to oral medications among 7,933 veterans who were identified with 1 to 4 cardiometabolic conditions: diabetes, hypertension, dyslipidemia, and/or heart failure. It found that for veterans taking antihypertensive or lipid-lowering medications, having more prescribers involved in care modestly decreased the likelihood of being adherent.
AHRQ-funded; HS019445.
Citation: Hansen RA, Voils CI, Farley JF .
Prescriber continuity and medication adherence for complex patients.
Ann Pharmacother 2015 Mar;49(3):293-302. doi: 10.1177/1060028014563266..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
AHRQ-funded; 290201200014I
Citation: Chou R, Turner JA, Devine EB .
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559..
Keywords: Chronic Conditions, Comparative Effectiveness, Medication, Opioids, Outcomes, Pain, Patient-Centered Outcomes Research
Beadles CA, Farley JF, Ellis AR
Do medical homes increase medication adherence for persons with multiple chronic conditions?
The goal of this study was to assess the association between medical homes and adherence to newly initiated medications among Medicaid enrollees with multiple chronic conditions (MCC). The researchers examined data from North Carolina Medicaid enrollees with MCC and found that adherence to new medications is greater for those enrolled in medical homes.
AHRQ-funded; HS000032; HS019659.
Citation: Beadles CA, Farley JF, Ellis AR .
Do medical homes increase medication adherence for persons with multiple chronic conditions?
Med Care 2015 Feb;53(2):168-76. doi: 10.1097/mlr.0000000000000292..
Keywords: Chronic Conditions, Medication, Medicaid, Patient Adherence/Compliance, Patient-Centered Healthcare
Viswanathan M, Kahwati LC, Golin CE
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
Medication therapy management (MTM) services (also called clinical pharmacy services) aim to reduce medication-related problems and their downstream outcomes. The purpose of this study was to assess the effect of MTM interventions among outpatients with chronic illnesses. The investigators graded the evidence as insufficient for most outcomes because of inconsistency and imprecision that stemmed in part from underlying heterogeneity in populations and interventions.
AHRQ-funded; 290201200008I.
Citation: Viswanathan M, Kahwati LC, Golin CE .
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
JAMA Intern Med 2015 Jan;175(1):76-87. doi: 10.1001/jamainternmed.2014.5841..
Keywords: Medication, Ambulatory Care and Surgery, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Provider: Pharmacist, Provider
McMullen CK, Safford MM, Bosworth HB
Patient-centered priorities for improving medication management and adherence.
The goal of the workshop was to identify and prioritize opportunities to advance PCMM by convening diverse stakeholders involved in prescribing and/or medication taking. A major conclusion was that engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research.
AHRQ-funded; HS021093; HS021094; HS021107.
Citation: McMullen CK, Safford MM, Bosworth HB .
Patient-centered priorities for improving medication management and adherence.
Patient Educ Couns 2015 Jan;98(1):102-10. doi: 10.1016/j.pec.2014.09.015..
Keywords: Centers for Education and Research on Therapeutics (CERTs), Chronic Conditions, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare
Voils CI, Sleath B, Maciejewski ML
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
The researchers sought to understand the reasons why patients have increasing numbers of prescribers of medications and to understand patient perspectives on advantages and disadvantages of having multiple prescribers, including effects on medication supply. They found that, with patients from a Veterans Affairs (VA) Medical Center, multiple prescribers arose through referrals and patients actively seeking non-VA prescribers to maximize timeliness and access to medications, to provide access to medications not on the VA formulary, and to minimize out-of-pocket costs.
AHRQ-funded; HS019445.
Citation: Voils CI, Sleath B, Maciejewski ML .
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
BMC Health Serv Res 2014 Oct 25;14:490. doi: 10.1186/s12913-014-0490-8.
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Keywords: Chronic Conditions, Medication, Diabetes, Blood Pressure, Heart Disease and Health
Makris UE, Abrams RC, Gurland B
Management of persistent pain in the older patient: a clinical review.
The purpose of this study was to 1.) Describe barriers to the management of persistent pain among older adults; 2.) Summarize current management approaches, including pharmacologic and nonpharmacologic modalities; 3.) Present rehabilitative approaches; and 4.) Highlight aspects of the patient-physician relationship that can help to improve treatment outcomes.
AHRQ-funded; HS020648.
Citation: Makris UE, Abrams RC, Gurland B .
Management of persistent pain in the older patient: a clinical review.
JAMA 2014 Aug 27;312(8):825-36. doi: 10.1001/jama.2014.9405..
Keywords: Care Management, Chronic Conditions, Elderly, Medication, Treatments