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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (4)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (1)
- Blood Clots (1)
- Blood Thinners (2)
- Cancer (3)
- Cancer: Breast Cancer (1)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (3)
- Case Study (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Communication (1)
- Comparative Effectiveness (1)
- Decision Making (2)
- Diabetes (1)
- Elderly (2)
- Evidence-Based Practice (4)
- Guidelines (2)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Infectious Diseases (1)
- Long-Term Care (1)
- Maternal Care (1)
- Medical Errors (1)
- (-) Medication (20)
- Medication: Safety (4)
- Neurological Disorders (1)
- Nursing Homes (1)
- Opioids (5)
- Outcomes (1)
- Pain (2)
- Patient-Centered Outcomes Research (2)
- Patient Safety (6)
- Practice Patterns (1)
- Pregnancy (2)
- (-) Prevention (20)
- Provider (1)
- Provider: Pharmacist (1)
- Risk (2)
- Screening (3)
- Stroke (2)
- Substance Abuse (4)
- Tobacco Use (1)
- U.S. Preventive Services Task Force (USPSTF) (3)
- Women (3)
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 20 of 20 Research Studies DisplayedBrown 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
Shoemaker-Hunt SJ, Wyant BE
The effect of opioid stewardship interventions on key outcomes: a systematic review.
In this study, the investigators sought to identify potential patient safety practices to reduce high-risk opioid prescribing. They conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. The investigators concluded that the strength of the evidence was low to moderate that OS efforts decreased numbers of opioid prescriptions, proportion of patients on long-term opioids, or days' supply. The strength of the evidence for OS initiatives producing significant reductions in opioid dosages was moderate.
AHRQ-funded; 233201500013I.
Citation: Shoemaker-Hunt SJ, Wyant BE .
The effect of opioid stewardship interventions on key outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S36-s41. doi: 10.1097/pts.0000000000000710..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Substance Abuse, Prevention
Earl TR, Katapodis ND, Schneiderman SR
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
This paper is a systematic review of the literature published between 2008 to 2018 that studies the effect of interventions to reduce preventable adverse drug effects (ADEs) for adults who are prescribed multiple medications. Two safety practices were examined: 1) deprescribing interventions to reduce polypharmacy; and 2) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce potentially inappropriate medications (PIMS). A total of 26 studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP). Deprescribing interventions included decision support tools, educational interventions, and medication reviews. The STOPP tool most reported changes in PIMS, as well as some economic outcomes. Both methods were found to be effective.
AHRQ-funded; HHSP233201500013I.
Citation: Earl TR, Katapodis ND, Schneiderman SR .
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
J Patient Saf 2020 Sep;16(3S Suppl 1):S23-s35. doi: 10.1097/pts.0000000000000747..
Keywords: Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Screening, Prevention
Brault MA, Spiegelman D, Abdool Karim SS
Integrating and interpreting findings from the latest treatment as prevention trials.
This paper examined findings from some 2018-2019 international studies assessing the effectiveness of reducing HIV incidence by expanding HIV testing, linkage to HIV treatment, and helping persons living with HIV adhere to their medications (called the 90-90-90 strategy). A number of these “treatment as prevention” (TasP) tests had complex results. The studies examined included the TasP/ANRS 12249 study in South Africa, the SEARCH study in Kenya and Uganda, and one comparison (arms A to C) of the HPtn 071 (PopART) study in South Africa and Zambia as well as the Botswana Ya Tsie study. All but the Botswana Ya Tsie study and the second comparison (arms B to C) of PopART did not demonstrate a community impact on HIV incidence. But those two studies indicated significant (30%) reductions in HIV incidence in the intervention communities.
AHRQ-funded; HS023000.
Citation: Brault MA, Spiegelman D, Abdool Karim SS .
Integrating and interpreting findings from the latest treatment as prevention trials.
Curr HIV/AIDS Rep 2020 Jun;17(3):249-58. doi: 10.1007/s11904-020-00492-4..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Implementation, Medication, Screening
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
Kahwati LC, Clark R, Berkman N
Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers sought to update the evidence on screening and treatment of asymptomatic bacterial vaginosis in pregnancy for the USPSTF. They found that the evidence suggests no difference in the incidence of preterm delivery and related outcomes from treatment for asymptomatic bacterial vaginosis in a general obstetric population but was inconclusive for women with a prior preterm delivery. Maternal adverse events from treatment appear to be infrequent and minor, but the evidence about harms from in utero exposure was inconclusive.
AHRQ-funded; 290201500011I.
Citation: Kahwati LC, Clark R, Berkman N .
Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 7;323(13):1293-309. doi: 10.1001/jama.2020.0233..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Prevention, Women, Children/Adolescents, Pregnancy, Maternal Care, Antibiotics, Medication
Zullo AR, Ofori-Asenso R, Wood M
Effects of statins for secondary prevention on functioning and other outcomes among nursing home residents.
Studies examining the effects of statins after acute myocardial infarction (AMI) excluded frail older adults, especially nursing home (NH) residents, and few examined functional outcomes. Older NH residents may benefit less from statins and be particularly susceptible to adverse drug events like myopathy-related functional decline. In this retrospective cohort study, the investigators evaluated the effects of statins on 1-year functional decline, rehospitalization, and death in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Ofori-Asenso R, Wood M .
Effects of statins for secondary prevention on functioning and other outcomes among nursing home residents.
J Am Med Dir Assoc 2020 Apr;21(4):500-07.e8. doi: 10.1016/j.jamda.2020.01.102..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medication, Prevention, Outcomes, Evidence-Based Practice, Patient-Centered Outcomes Research
Pinto D, Prabhakaran S, Tipton E
Why physicians prescribe prophylactic seizure medications after intracerebral hemorrhage: an adaptive conjoint analysis.
Seizures are a morbid complication of intracerebral hemorrhage (ICH) and increase the risk for herniation, status epilepticus, and worse patient outcomes. Prophylactic levetiracetam is administered to approximately 40% of patients with ICH. It is unclear which patients are consciously selected for treatment by physicians. In this study, the investigators sought to determine how patients are selected for treatment with prophylactic levetiracetam after ICH.
AHRQ-funded; HS023437.
Citation: Pinto D, Prabhakaran S, Tipton E .
Why physicians prescribe prophylactic seizure medications after intracerebral hemorrhage: an adaptive conjoint analysis.
J Stroke Cerebrovasc Dis 2020 Apr;29(4):104628. doi: 10.1016/j.jstrokecerebrovasdis.2019.104628..
Keywords: Neurological Disorders, Medication, Prevention, Cardiovascular Conditions, Stroke, Decision Making
Fan T, Fakolade A
AHRQ Author: Fan T
Medication use to reduce risk of breast cancer.
In this case study, a 40-year-old woman comes to her doctor’s office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago. She states that her mother was diagnosed with bilateral breast cancer at 49 years of age and that she would like to discuss her options for reducing the risk of breast cancer. Three questions are posed about risk-reducing medications.
AHRQ-authored
Citation: Fan T, Fakolade A .
Medication use to reduce risk of breast cancer.
Am Fam Physician 2020 Mar 15;101(6):373-74..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Medication, Risk, Prevention, Case Study, Women
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
AHRQ-funded; HS026379.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA .
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
Keywords: Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
Burstein D, Baird J, Bratberg J
Pharmacist attitudes toward pharmacy-based naloxone: a cross-sectional survey study.
This study examined pharmacist attitudes towards recommending pharmacy-based naloxone (PBN). The authors looked at the influence of gender, practice setting, number of years of practice, state location, and PBN involvement. Barriers and facilitators were also assessed. A 71-question survey was mailed to approximately 2900 licensed pharmacists in Massachusetts and Rhode Island and was open from April 5, 2016 until July 13, 2016. Out of those 2900, 402 responded (13%) and 245 were included in the analyses. The majority (79%) identified as White and 127 (51.8%) indicated that they had dispensed naloxone, with 85 having done so in the past 30 days. The results of the cross-sectional survey was used to develop the Opioid Overdose Prevention Attitude (OOPA) scale which consists of 3 subscales: Opioid Overdose Prevention Attitude, Public Health Attitude, and Naxolone Dispensing Attitude. Pharmacists working in a pharmacy that had a standing order or collaborative practice agreement to dispense naxolone without a physician’s prescription had a more positive attitude than other pharmacists.
AHRQ-funded; HS024021.
Citation: Burstein D, Baird J, Bratberg J .
Pharmacist attitudes toward pharmacy-based naloxone: a cross-sectional survey study.
J Am Pharm Assoc 2020 Mar-Apr;60(2):304-10. doi: 10.1016/j.japh.2019.11.004.
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Keywords: Medication, Provider: Pharmacist, Provider, Opioids, Substance Abuse, Prevention
Abraham NS
Antiplatelets, anticoagulants, and colonoscopic polypectomy.
This article is a review of current best practice recommendations focusing on the risk of immediate and delayed postpolypectomy bleeding in the context of drug discontinuation or continuation of antiplatelet and anticoagulant drugs. Data was assessed whether cold snare vs conventional thermal-based polypectomy technology and prophylactic placement of hemostatic clips are endoscopic techniques that are beneficial in reducing polypectomy bleeding. Clinical takeaways are also provided to facilitate safer polypectomy among patients on antiplatelet and anticoagulant agents.
AHRQ-funded; HS025402.
Citation: Abraham NS .
Antiplatelets, anticoagulants, and colonoscopic polypectomy.
Gastrointest Endosc 2020 Feb;91(2):257-65. doi: 10.1016/j.gie.2019.09.033..
Keywords: Blood Thinners, Medication, Medication: Safety, Colonoscopy, Adverse Drug Events (ADE), Adverse Events, Guidelines, Prevention, Patient Safety
Patnode CD, Henderson JT, Thompson JH
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
The researchers reviewed the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. They concluded that behavioral and pharmacotherapy interventions improve rates of smoking cessation among the general adult population, alone or in combination. Data on the effectiveness and safety of electronic nicotine delivery systems are limited.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Henderson JT, Thompson JH .
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Oct 20;163(8):608-21. doi: 10.7326/m15-0171..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Pregnancy, Prevention, Tobacco Use, U.S. Preventive Services Task Force (USPSTF), Women
Hamilton KW, Gerber JS, Moehring R
Point-of-prescription interventions to improve antimicrobial stewardship.
The purpose of this review was to discuss interventions focusing on antimicrobial prescribing at the point of prescription as well as a pilot project to engage unit-based healthcare providers in antimicrobial stewardship.
AHRQ-funded; HS023866.
Citation: Hamilton KW, Gerber JS, Moehring R .
Point-of-prescription interventions to improve antimicrobial stewardship.
Clin Infect Dis 2015 Apr 15;60(8):1252-8. doi: 10.1093/cid/civ018.
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Keywords: Antimicrobial Stewardship, Infectious Diseases, Medication, Patient Safety, Prevention
Hwang CS, Chang HY, Alexander GC
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
The researchers quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids. They found that the market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market.
AHRQ-funded; HS018960.
Citation: Hwang CS, Chang HY, Alexander GC .
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
Pharmacoepidemiol Drug Saf 2015 Feb;24(2):197-204. doi: 10.1002/pds.3723.
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Keywords: Medication, Opioids, Prevention, Substance Abuse
Wong A, Kraus PS, Lau BD
Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
The purpose of this study was to assess patient preferences regarding pharmacological venous thromboembolism prophylaxis. It found that a majority preferred an oral route of administration for prophylaxis. Also, patients preferring subcutaneous injections were less likely to refuse doses of ordered pharmacologic prophylaxis.
AHRQ-funded; HS017952.
Citation: Wong A, Kraus PS, Lau BD .
Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
J Hosp Med 2015 Feb;10(2):108-11. doi: 10.1002/jhm.2282..
Keywords: Comparative Effectiveness, Blood Clots, Medication, Prevention
Freedman JL, Faerber JI, Kang TI
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
The purpose of this study was to gain better knowledge of patient and cancer treatment factors associated with nausea/vomiting (NV) in order to enhance prophylaxis in children being treated for acute myeloid leukemia (AML). It found that treatment-related NV, as evidenced by antiemetic alterations, is more prevalent with increasing age.
AHRQ-funded; HS018425
Citation: Freedman JL, Faerber JI, Kang TI .
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
Pediatr Blood Cancer. 2014 Oct;61(10):1798-805. doi: 10.1002/pbc.25108..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Children/Adolescents, Medication, Prevention
Goldsweig AM, Reid KJ, Gosch K
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
The authors examined dual antiplatelet therapy (DAPT) use in contemporary clinical practice after publication of the results of the landmark randomized clinical trial CHARISMA. They found that use of DAPT is modest in patients with established cardiovascular disease, for whom the CHARISMA trial suggested decreased major adverse cardiovascular events (MACEs), and prescription rates have remained stable over time; use of DAPT in patients with multiple risk factors only, for whom CHARISMA suggested that DAPT may lead to increased MACEs, was low and decreased over time.
AHRQ-funded; HS018781.
Citation: Goldsweig AM, Reid KJ, Gosch K .
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
Am J Manag Care 2014 Aug;20(8):659-65.
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Keywords: Cardiovascular Conditions, Medication, Prevention, Practice Patterns, Risk
Raebel MA, Ellis JL, Schroeder EB
Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study.
The aim of this study was to characterize antihyperglycemic intensification during the first year after initiating oral antihyperglycemic therapy among adult patients with incident diabetes. The researchers found that 43.5 percent of patients with diabetes had treatment intensified within 1 year of starting antihyperglycemic medication. HbA1c of less than 7 percent was achieved in a very high proportion of patients (65.1 percent).
AHRQ-funded; HS019859
Citation: Raebel MA, Ellis JL, Schroeder EB .
Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study.
Pharmacoepidemiol Drug Saf, 2014 Jul;23(7):699-710. doi: 10.1002/pds.3610..
Keywords: Diabetes, Prevention, Medication
Forrester SH, Hepp Z, Roth JA
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
The study objective was to estimate the cost-effectiveness of computerized provider order entry versus traditional paper-based prescribing in reducing medications errors and adverse drug events in the ambulatory setting of mid-sized medical group. Using a decision-analytic model, the researchers found that the adoption of CPOE in the ambulatory setting provides excellent value for the investment.
AHRQ-funded; HS014739
Citation: Forrester SH, Hepp Z, Roth JA .
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
Value Health. 2014 Jun;17(4):340-9. doi: 10.1016/j.jval.2014.01.009..
Keywords: Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Patient Safety, Healthcare Costs, Ambulatory Care and Surgery, Prevention