Search all AHRQ sites
Menu
SHARE:
AHRQ Research Studies
Sign up: 
AHRQ Research Studies Email updates
Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 24 of 24 Research Studies DisplayedAhuja V, Sohn MW, Birge JR
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
The purpose of this study was to document variation in the use of rosiglitazone and other glucose- lowering drugs across 21 Veterans Integrated Service Networks. It found that aggregate rosiglitazone use increased monotonically from 7.7 percent, in the quarter it was added to the VA formulary, to a peak of 15.3 percent in the quarter when the FDA issued the safety alert.
AHRQ-funded; HS018542.
Citation: Ahuja V, Sohn MW, Birge JR .
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
J Manag Care Spec Pharm 2015 Dec;21(12):1214-34. doi: 10.18553/jmcp.2015.21.12.1214.
.
.
Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Veterans, Practice Patterns
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.
.
.
Keywords: Chronic Conditions, Hepatitis, Medication, Patient Adherence/Compliance, Veterans
Heslin KC, Gable A, Dobalian A
Special services for women in substance use disorders treatment: how does the Department of Veterans Affairs compare with other providers?
The researchers examined the prevalence of programs and key services for women in VA facilities in a survey of 14,311 substance use disorder treatment facilities. Approximately 31 percent of facilities had special programs exclusively for women. Although the VA had the lowest prevalence of programs for women, at 19.1 percent, it offered a significantly higher average number of key services for women.
AHRQ-authored.
Citation: Heslin KC, Gable A, Dobalian A .
Special services for women in substance use disorders treatment: how does the Department of Veterans Affairs compare with other providers?
Womens Health Issues 2015 Nov-Dec;25(6):666-72. doi: 10.1016/j.whi.2015.07.005.
.
.
Keywords: Veterans, Substance Abuse, Women, Healthcare Delivery
Price LE, Shea K, Gephart S
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
This article described the developments in research associated with the VHA's transition into the world of Big Data analytics through Corporate Data Warehouse (CDW) utilization. The authors found that the most commonly-occurring research topics are pharmacy/medications, systems issues, and weight management/obesity. They concluded that, despite the potential benefit of data mining techniques to improve patient care and services, the CDW and alternative analytical approaches are underutilized by researchers and clinicians.
AHRQ-funded; HS022908.
Citation: Price LE, Shea K, Gephart S .
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
Nurs Adm Q 2015 Oct-Dec;39(4):311-8. doi: 10.1097/naq.0000000000000118.
.
.
Keywords: Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing, Veterans
LaFleur J, DuVall SL, Wilson T
Analysis of osteoporosis treatment patterns with bisphosphonates and outcomes among postmenopausal veterans.
This study evaluated bisphosphonate change behaviors (switching, discontinuing, or reinitiating) over time, as well as fractures and costs, among a large, national cohort of postmenopausal veterans. It found that most bisphosphonate patients discontinue treatment at some point, which did not significantly increase the risk of fracture in this majority non-high risk population. Bisphosphonate change behaviors were associated with significantly lower osteoporosis costs, but significantly higher total costs.
AHRQ-funded; HS018582.
Citation: LaFleur J, DuVall SL, Wilson T .
Analysis of osteoporosis treatment patterns with bisphosphonates and outcomes among postmenopausal veterans.
Bone 2015 Sep;78:174-85. doi: 10.1016/j.bone.2015.04.022..
Keywords: Osteoporosis, Medication, Elderly, Injuries and Wounds, Veterans
Lapham GT, Rubinsky AD, Shortreed SM
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
This study sought to determine if differences in how brief intervention (BI) was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. It found that the association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Shortreed SM .
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
Drug Alcohol Depend 2015 Aug 1;153:159-66. doi: 10.1016/j.drugalcdep.2015.05.027..
Keywords: Alcohol Use, Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse, Veterans
Ricci KA, Griffin AR, Heslin KC
Evacuate or shelter-in-place? The role of corporate memory and political environment in hospital-evacuation decision making.
This study was conducted to identify factors that most heavily influenced the decisions to evacuate the Manhattan Veterans Administration Medical Center before Hurricane Irene in 2011 and Hurricane Sandy in 2012. The researchers conducted semi-structured interviews with 11 senior leaders on the processes and factors that influenced their evacuation decisions.
AHRQ-authored
Citation: Ricci KA, Griffin AR, Heslin KC .
Evacuate or shelter-in-place? The role of corporate memory and political environment in hospital-evacuation decision making.
Prehosp Disaster Med. 2015 Jun;30(3):233-8. doi: 10.1017/s1049023x15000229..
Keywords: Emergency Preparedness, Decision Making, Veterans, Hospitals
Ripley DC, Kwong PL, Vogel WB
How does geographic access affect in-hospital mortality for veterans with acute ischemic stroke?
This study examined the relationship between estimated travel time to admitting hospital and mortality for veterans with acute ischemic stroke. It found that even after adjusting for the confounding effects of patient, treatment, and facility characteristics, travel time from home to admitting VAMC was significantly associated with inhospital mortality.
AHRQ-funded; HS018540.
Citation: Ripley DC, Kwong PL, Vogel WB .
How does geographic access affect in-hospital mortality for veterans with acute ischemic stroke?
Med Care 2015 Jun;53(6):501-9. doi: 10.1097/mlr.0000000000000366..
Keywords: Stroke, Mortality, Access to Care, Veterans
Storzbach D, O'Neil ME, Roost SM
Comparing the neuropsychological test performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress symptoms.
The purpose of this paper was to compare neuropsychological test performance of veterans with and without mild traumatic brain injury (MTBI), blast exposure, and posttraumatic stress disorder (PTSD) symptoms. The authors found that, although some mild neurocognitive effects were associated with blast exposure, these neurocognitive effects might be better explained by PTSD symptom severity rather than blast exposure or MTBI history alone.
AHRQ-funded; HS022981; HS019456.
Citation: Storzbach D, O'Neil ME, Roost SM .
Comparing the neuropsychological test performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress symptoms.
J Int Neuropsychol Soc 2015 May;21(5):353-63. doi: 10.1017/s1355617715000326.
.
.
Keywords: Brain Injury, Behavioral Health, Neurological Disorders, Veterans
Jump RL, Heath B, Crnich CJ
Knowledge, beliefs, and confidence regarding infections and antimicrobial stewardship: a survey of Veterans Affairs providers who care for older adults.
The reseasrchers conducted an anonymous survey of providers who care for older adults from 10 Veterans Affairs long-term-care facilities to assess their knowledge, beliefs, and confidence toward treating infections and antimicrobial stewardship. They found that the average score on 5 questions assessing knowledge was 3.6 out of 5.0, thus supporting a need for education regarding the care of older adults with infections.
AHRQ-funded; HS023866.
Citation: Jump RL, Heath B, Crnich CJ .
Knowledge, beliefs, and confidence regarding infections and antimicrobial stewardship: a survey of Veterans Affairs providers who care for older adults.
Am J Infect Control 2015 Mar;43(3):298-300. doi: 10.1016/j.ajic.2014.11.017.
.
.
Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Long-Term Care, Medication, Veterans
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, Veterans
Pershing S, Pal Chee C, Asch SM
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
The researchers compared the diffusion of 2 injectable drugs for macular degeneration in fee-for-service Medicare versus the Veterans Affairs systems during 2005-2011. Although physicians under Medicare had a direct financial incentive to prescribe the more expensive drug, by 2009, more than 60 percent of injections were for the less expensive drug. Under the VA, both drugs were used about equally, particularly from 2009 to 2011.
AHRQ-funded; HS018434
Citation: Pershing S, Pal Chee C, Asch SM .
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
Health Aff. 2015 Feb;34(2):229-38. doi: 10.1377/hlthaff.2014.1032..
Keywords: Healthcare Costs, Elderly, Medicare, Medication, Veterans
Pershing S, Pal Chee C, Asch SM
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
The researchers examined the diffusion of new biologics ranibizumab and bevacizumab, both for the treatment of macular degeneration but differing in price, in fee-for-service Medicare and Veterans Affairs (VA) systems during 2005-11, in part to assess the impact that differing financial incentives had on prescribing. Their analysis indicated that there are opportunities in both the VA and Medicare to adopt more value-conscious treatment patterns and that multiple mechanisms exist to influence utilization.
AHRQ-funded; HS018434.
Citation: Pershing S, Pal Chee C, Asch SM .
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
Health Aff 2015 Feb;34(2):229-38. doi: 10.1377/hlthaff.2014.1032.
.
.
Keywords: Healthcare Costs, Eye Disease and Health, Medicare, Medication, Veterans
Navarro-Millan I, Yang S, DuVall SL
Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.
The researchers studied the association of serum lipids, inflammation, and seropositivity on coronary heart disease (CHD) and stroke in patients with rheumatoid arthritis. They found that in the study population of predominantly male veterans, higher levels of erythrocyte sedimentation rate and C-reactive protein were associated with increased risk of heart attack and stroke, and higher levels of HDL-C were inversely associated with heart attack and stroke.
AHRQ-funded; HS018517
Citation: Navarro-Millan I, Yang S, DuVall SL .
Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.
Ann Rheum Dis. 2016 Feb;75(2):341-7. doi: 10.1136/annrheumdis-2013-204987..
Keywords: Stroke, Cardiovascular Conditions, Arthritis, Veterans
Chang SH, Luo S, O'Brian KK
Association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma in US veterans with diabetes mellitus: a population-based retrospective cohort study.
The authors assessed the association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma. They found that metformin use was associated with a reduced risk of progression to multiple myeloma.
AHRQ-funded; HS022330.
Citation: Chang SH, Luo S, O'Brian KK .
Association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma in US veterans with diabetes mellitus: a population-based retrospective cohort study.
Lancet Haematol 2015 Jan;2(1):e30-6. doi: 10.1016/s2352-3026(14)00037-4.
.
.
Keywords: Diabetes, Medication, Outcomes, Risk, Veterans
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety, Veterans
Vaughan Sarrazin MS, Jones M, Mazur A
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
This study evaluated the relative risks of any, gastrointestinal, intracranial, and other bleeding for Veterans Affairs patients who switched to dabigatran after at least 6 months on warfarin. It found that among veterans with atrial fibrillation who switched to dabigatran, dabigatran increased the risk of gastrointestinal hemorrhage by 54% and was not associated with rates of other bleeding or death.
AHRQ-funded; HS021992
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
Am J Med. 2014 Dec;127(12):1179-85. doi: 10.1016/j.amjmed.2014.07.024..
Keywords: Blood Thinners, Adverse Events, Patient Safety, Veterans
Meeks DW, Meyer AN, Rose B
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
The researchers described outcomes of peer review within the Department of Veterans Affairs (VA) healthcare system and identified opportunities to leverage peer review data for measurement and improvement of safety. Results showed that the most common process contributing to substandard care was 'timing and appropriateness of treatment'; approximately 16% had diagnosis-related performance concerns. The authors concluded that peer review may be a useful tool for healthcare organizations to assess their sharp end clinical performance, particularly safety events related to diagnostic and treatment errors.
AHRQ-funded; HS022087.
Citation: Meeks DW, Meyer AN, Rose B .
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
BMJ Qual Saf 2014 Dec;23(12):1023-30. doi: 10.1136/bmjqs-2014-003239.
.
.
Keywords: Adverse Events, Medical Errors, Patient Safety, Quality Improvement, Veterans
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.
.
.
Keywords: Chronic Conditions, Medication, Veterans
Lapham GT, Rubinsky AD, Williams EC
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
The purpose of this study was to evaluate the performance of repeat annual clinical alcohol screening in 4 samples of VA outpatients with 1–4 prior consecutive negative annual screens. It found that among patients with repeated negative clinical alcohol screens, the proportion who subsequently screened positive a year later was low and decreased as patients had more prior negative screens.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Williams EC .
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
Drug Alcohol Depend 2014 Sep 1;142:209-15. doi: 10.1016/j.drugalcdep.2014.06.017..
Keywords: Screening, Alcohol Use, Substance Abuse, Veterans
Schweizer ML, Cullen JJ, Perencevich EN
Costs associated with surgical site infections in Veterans Affairs hospitals.
This study evaluated surgical site infections(SSIs) in 1,756 Veterans Administration patients to determine the excess costs associated with total, deep, and superficial SSIs. It found that the highest risk-adjusted costs occurred with deep SSIs and SSIs associated with neurosurgery patients.
AHRQ-funded; HS021992
Citation: Schweizer ML, Cullen JJ, Perencevich EN .
Costs associated with surgical site infections in Veterans Affairs hospitals.
JAMA Surg. 2014 Jun;149(6):575-581. doi:10.1001/jamasurg.2013.4663..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Healthcare Costs, Veterans
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
AHRQ-funded; HS000079.
Citation: Voils CI, Gierisch JM, Yancy WS, Jr. .
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
.
.
Keywords: Behavioral Health, Heart Disease and Health, Lifestyle Changes, Nutrition, Veterans
Bates BE, Xie D, Kwong PL
One-year all-cause mortality after stroke: a prediction model.
Using data from Department of Veterans Affairs (VA) national databases, the researchers present and internally validate a 1-year all-cause mortality prediction index after hospitalization for acute stroke. They conclude that a simple index using readily available data that stratifies stroke patients at the time of discharge according to low, moderate, high, and highest likelihood of all-cause 1-year mortality is feasible.
AHRQ-funded; HS018540.
Citation: Bates BE, Xie D, Kwong PL .
One-year all-cause mortality after stroke: a prediction model.
PM R 2014 Jun;6(6):473-83. doi: 10.1016/j.pmrj.2013.11.006..
Keywords: Stroke, Mortality, Hospitalization, Veterans
Stineman MG, Xie D, Kurichi JE
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
The researchers compared outcomes of veteran patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services after acute stroke using propensity scores. They found that comprehensive rehabilitation services are associated with greater recovery of physical and cognitive independence, improved home discharge likelihood, and improved 1 yr. survival.
AHRQ-funded; HS018540.
Citation: Stineman MG, Xie D, Kurichi JE .
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
J Rehabil Res Dev 2014;51(7):1143-54. doi: 10.1682/jrrd.2014.03.0084..
Keywords: Comparative Effectiveness, Rehabilitation, Stroke, Patient-Centered Outcomes Research, Veterans
