National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Antibiotics (2)
- Arthritis (1)
- Autism (1)
- (-) Children/Adolescents (9)
- Clinical Decision Support (CDS) (2)
- Communication (1)
- Diagnostic Safety and Quality (1)
- Emergency Department (1)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Technology (HIT) (1)
- Hospitalization (1)
- Imaging (1)
- Medication (4)
- Patient-Centered Outcomes Research (1)
- Policy (1)
- (-) Practice Patterns (9)
- Primary Care (2)
- Quality Improvement (1)
- Rural Health (1)
- Telehealth (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 9 of 9 Research Studies DisplayedRay KN, Demirci JR, Bogen DL
Optimizing telehealth strategies for subspecialty care: recommendations from rural pediatricians.
The authors elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Rural pediatricians from 17 states described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians, through semistructured telephone interviews, provided recommendations for optimizing individual telehealth strategies.
AHRQ-funded; HS022989.
Citation: Ray KN, Demirci JR, Bogen DL .
Optimizing telehealth strategies for subspecialty care: recommendations from rural pediatricians.
Telemed J E Health 2015 Aug;21(8):622-9. doi: 10.1089/tmj.2014.0186.
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Keywords: Children/Adolescents, Children/Adolescents, Practice Patterns, Rural Health, Telehealth
Bauer NS, Carroll AE, Saha C
Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders.
This study examined whether adding an autism module promoting adherence to clinical guidelines to an existing computer decision support system (CDSS) changed physician knowledge and self-reported clinical practice. It found that a CDSS module to improve primary care management of ASD in pediatric practice led to significant improvements in physician-reported use of validated screening tools to screen for ASDs.
AHRQ-funded; HS018453.
Citation: Bauer NS, Carroll AE, Saha C .
Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders.
Appl Clin Inform 2015;6(3):454-65. doi: 10.4338/aci-2014-09-ra-0084.
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Keywords: Health Information Technology (HIT), Practice Patterns, Clinical Decision Support (CDS), Children/Adolescents, Autism
Williams DJ, Edwards KM, Self WH
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
The 2011 national guidelines for the management of childhood community-acquired pneumonia (CAP) recommended narrow-spectrum antibiotics (e.g., ampicillin) for most children hospitalized with CAP. The researchers assessed the impact of these guidelines on antibiotic prescribing at 3 children’s hospitals. They found that, after publication of national guidelines, third-generation cephalosporin use declined and penicillin/ampicillin use increased among children hospitalized with CAP.
AHRQ-authored; HS022342.
Citation: Williams DJ, Edwards KM, Self WH .
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
Pediatrics 2015 Jul;136(1):44-52. doi: 10.1542/peds.2014-3047..
Keywords: Children/Adolescents, Hospitalization, Guidelines, Medication, Practice Patterns
Hersh AL, Gerber JS, Hicks LA
Lessons learned in antibiotic stewardship: fluoroquinolone use in pediatrics.
For adults, fluoroquinolones are the leading class of antibiotics prescribed in ambulatory care visits, whereas, in children, they are the least frequently prescribed class. This paper highlights the impact of physicians' perception of direct patient harm in antibiotic decision making which has implications for antibiotic stewardship.
AHRQ-funded; HS020921.
Citation: Hersh AL, Gerber JS, Hicks LA .
Lessons learned in antibiotic stewardship: fluoroquinolone use in pediatrics.
J Pediatric Infect Dis Soc 2015 Mar;4(1):57-9. doi: 10.1093/jpids/piu044.
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Keywords: Antibiotics, Children/Adolescents, Medication, Children/Adolescents, Practice Patterns
Hendrix KS, Downs SM, Carroll AE
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
The authors tested whether selectively highlighting clinical decision support prompts in yellow would improve physicians' responsiveness. They found that highlighting reminder prompts did not increase physicians' responsiveness. They suggested possible explanations and offer alternative strategies to increasing physician responsiveness to prompts.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Hendrix KS, Downs SM, Carroll AE .
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
Acad Pediatr 2015 Mar-Apr;15(2):158-64. doi: 10.1016/j.acap.2014.10.009.
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Keywords: Clinical Decision Support (CDS), Children/Adolescents, Primary Care, Practice Patterns, Quality Improvement
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
Fierro JL, Prasad PA, Localio AR
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
The researchers compared practice patterns regarding the diagnosis and management of streptococcal pharyngitis across 25 pediatric primary care practices sharing an electronic health record. They found that only 18 of 222 clinicians wrote 50 percent of all broad-spectrum antibiotic prescriptions for children with group a streptococcus pharyngitis. They suggested targeted interventions to improve adherence to prescribing guidelines.
AHRQ-funded; 290200710013
Citation: Fierro JL, Prasad PA, Localio AR .
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S79-85. doi: 10.1086/677820..
Keywords: Antibiotics, Children/Adolescents, Diagnostic Safety and Quality, Primary Care, Practice Patterns
Johnson EK, Graham DA, Chow JS
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
The researchers describe the national use of computed tomography (CT) versus ultrasound imaging for pediatric patients seen at emergency departments (EDs) for suspected urolithiasis (SU) during the period 2006-2010. Use of CT was much higher than use of ultrasound, although it dropped off after 2007. Lowest CT use was seen at EDs that care for more children.
AHRQ-funded; HS019485
Citation: Johnson EK, Graham DA, Chow JS .
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
J Urol. 2014 Jul;192(1):200-6. doi: 10.1016/j.juro.2014.01.028..
Keywords: Children/Adolescents, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Imaging, Children/Adolescents, Practice Patterns
Larkin I, Ang D, Avorn J
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
The researchers estimated the effect of anti-detailing policies on off-label prescribing of antidepressants and antipsychotics by pediatricians and by child and adolescent psychiatrists in the period January 2006-June 2009. They found that prescriptions for off-label use of promoted drugs fell by 11 percent and that prescriptions for on-label use of promoted drugs fell by 34 percent. Conversely, prescriptions for on-label use of nonpromoted drugs rose by 14 percent, and those for off-label use of nonpromoted drugs rose by 35 percent. They concluded that these results suggest that pharmaceutical sales representatives promoted drugs not approved for pediatric use and that policies that restrict detailing by those representatives reduced such off-label prescribing.
AHRQ-funded; HS018465.
Citation: Larkin I, Ang D, Avorn J .
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
Health Aff 2014 Jun;33(6):1014-23. doi: 10.1377/hlthaff.2013.0939.
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Keywords: Medication, Children/Adolescents, Communication, Policy, Practice Patterns