National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
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- Back Health and Pain (4)
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- (-) Pain (53)
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- Practice Patterns (4)
- Primary Care (3)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (3)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Sickle Cell Disease (3)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Stress (2)
- Substance Abuse (4)
- Surgery (16)
- Teams (1)
- Telehealth (2)
- Transitions of Care (1)
- Treatments (1)
- Women (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 25 of 53 Research Studies DisplayedCrockett KB, Turan B
Moment-to-moment changes in perceived social support and pain for men living with HIV: an experience sampling study.
In this study, the investigators used an experience sampling method (also called Ecological Momentary Assessment) to assess moment-to-moment experiences of pain and social support 3 times a day for 7 days in a sample of 109 men living with HIV. They found that within-persons, experiences of daily social support reduced experiences of pain. Between-persons, attachment style may have influenced how individuals make use of social support in coping with experiences of pain.
AHRQ-funded; HS013852.
Citation: Crockett KB, Turan B .
Moment-to-moment changes in perceived social support and pain for men living with HIV: an experience sampling study.
Pain 2018 Dec;159(12):2503-11. doi: 10.1097/j.pain.0000000000001354..
Keywords: Human Immunodeficiency Virus (HIV), Pain, Quality of Life
Shuman CJ, Xie XJ, Herr KA
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
This article reported on the sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation.
AHRQ-funded; HS010482.
Citation: Shuman CJ, Xie XJ, Herr KA .
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
West J Nurs Res 2018 Dec;40(12):1749-64. doi: 10.1177/0193945917738781..
Keywords: Care Management, Elderly, Evidence-Based Practice, Inpatient Care, Pain, Implementation
Grout RW, Thompson-Fleming R, Carroll AE
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
The objective of this study was to determine the rate of positive pain screenings in pediatric primary care and evaluate the relationship between reported pain and obesity, demographics, and exam findings during routine pediatric encounters. The investigators concluded that pain is common in general pediatric encounters, and occurs more frequently in obese children and those who previously reported pain. Pain reporting may be influenced by seasonal variation and clinic factors.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Grout RW, Thompson-Fleming R, Carroll AE .
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
BMC Pediatr 2018 Nov 21;18(1):363. doi: 10.1186/s12887-018-1335-0..
Keywords: Children/Adolescents, Obesity, Pain, Children/Adolescents, Primary Care
Overstreet DS, Penn TM, Cable ST
Higher habitual dietary caffeine consumption is related to lower experimental pain sensitivity in a community-based sample.
The primary objective of this observational study was to determine whether caffeine consumed habitually as part of a daily diet was associated with experimental pain sensitivity using noxious stimuli in a non-clinical sample of 62 community-dwelling adults between 19 and 77 years old. The investigators indicated that results revealed individuals who habitually consume greater amounts of caffeine as part of their daily diets demonstrated diminished sensitivity to painful stimuli in a laboratory setting.
AHRQ-funded; HS013852.
Citation: Overstreet DS, Penn TM, Cable ST .
Higher habitual dietary caffeine consumption is related to lower experimental pain sensitivity in a community-based sample.
Psychopharmacology (Berl) 2018 Nov;235(11):3167-76. doi: 10.1007/s00213-018-5016-3..
Keywords: Nutrition, Pain
Militello LG, Anders S, Downs SM
Understanding how primary care clinicians make sense of chronic pain.
This research explored how primary care clinicians manage their patients with chronic noncancer pain. They conducted Critical Decision Method interviews with 10 clinicians about 30 individual patients. Findings suggested that clinicians should focus on supporting sensemaking in the content of clinical evidence rather than trying to provide them with rules.
AHRQ-funded; HS023306.
Citation: Militello LG, Anders S, Downs SM .
Understanding how primary care clinicians make sense of chronic pain.
Cogn Technol Work 2018 Nov;20(4):575-84. doi: 10.1007/s10111-018-0491-1..
Keywords: Pain, Chronic Conditions, Opioids, Medication, Decision Making, Primary Care, Care Management
Hilliard PE, Waljee J, Moser S
Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery.
Researchers assessed the prevalence of preoperative opioid use and the characteristics of patients in a broadly representative surgical cohort. They found that patients undergoing lower extremity procedures were most likely to report preoperative opioid use, with 1 in 4 of all patients presenting for surgery reporting such use. They concluded that the data provided important insights into this population and would appear to help guide future preoperative optimization and perioperative opioid-weaning interventions.
AHRQ-funded; HS023313.
Citation: Hilliard PE, Waljee J, Moser S .
Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery.
JAMA Surg 2018 Oct;153(10):929-37. doi: 10.1001/jamasurg.2018.2102..
Keywords: Opioids, Surgery, Pain, Medication, Healthcare Utilization, Orthopedics
Klueh MP, Hu HM, Howard RA
Transitions of care for postoperative opioid prescribing in previously opioid-naive patients in the USA: a retrospective review.
The purpose of this study was to identify specialties prescribing opioids to surgical patients who develop new persistent opioid use. Results showed that, among surgical patients who developed new persistent opioid use, surgeons provided the majority of opioid prescriptions during the first 3 months after surgery, but by 9 to 12 months after surgery, the majority of opioid prescriptions were provided by primary care physicians. Recommendations included enhanced care coordination between surgeons and primary care physicians to allow earlier identification of patients at risk for new persistent opioid use in order to prevent misuse and dependence.
AHRQ-funded; HS023313.
Citation: Klueh MP, Hu HM, Howard RA .
Transitions of care for postoperative opioid prescribing in previously opioid-naive patients in the USA: a retrospective review.
J Gen Intern Med 2018 Oct;33(10):1685-91. doi: 10.1007/s11606-018-4463-1..
Keywords: Transitions of Care, Opioids, Substance Abuse, Surgery, Pain, Medication, Patient-Centered Outcomes Research
Kelley BP, Chung KC, Chung TT
Postoperative ketorolac in breast and body contouring procedures: a nationwide claims analysis.
Nonsteroidal anti-inflammatory drugs are useful alternatives to narcotics for analgesia; however, concerns remain regarding their safety. The authors of this article evaluated ketorolac use and complications, and hypothesized that no association between ketorolac and morbidity exists in patients undergoing body contouring. They concluded that the benefits of ketorolac likely outweigh the risks after surgery. Absolute differences in reoperation rates were low, and improved rates of hospital admission impacted cost savings. The authors advocate postoperative ketorolac once the wound is hemostatic.
AHRQ-funded; HS023313.
Citation: Kelley BP, Chung KC, Chung TT .
Postoperative ketorolac in breast and body contouring procedures: a nationwide claims analysis.
Plast Reconstr Surg 2018 Oct;142(4):472e-80e. doi: 10.1097/prs.0000000000004806..
Keywords: Medication, Pain
Jonassaint CR, Kang C, Abrams DM
Understanding patterns and correlates of daily pain using the Sickle cell disease Mobile Application to Record Symptoms via Technology (SMART).
The authors used a mobile e-diary app to describe day-to-day patterns in sickle cell disease (SCD)-related pain symptoms and to identify the clinical and demographic factors associated with differences in daily pain level among adult patients with SCD. They suggest that future studies of the app would benefit from implementation of strategies to increase engagement. They also conclude that, despite a limited sample size, this study provides strong evidence supporting the use of mobile technology for measuring daily pain and symptoms in SCD.
AHRQ-funded; HS023989.
Citation: Jonassaint CR, Kang C, Abrams DM .
Understanding patterns and correlates of daily pain using the Sickle cell disease Mobile Application to Record Symptoms via Technology (SMART).
Br J Haematol 2018 Oct;183(2):306-08. doi: 10.1111/bjh.14956..
Keywords: Chronic Conditions, Health Information Technology (HIT), Pain, Sickle Cell Disease, Telehealth
Sekhri S, Arora NS, Cottrell H
Probability of opioid prescription refilling after surgery: does initial prescription dose matter?
In this study, the investigators sought to determine the correlation between the probability of postoperative opioid prescription refills and the amount of opioid prescribed, hypothesizing that a greater initial prescription yields a lower probability of refill. The investigators concluded that the probability of refilling prescription opioids after surgery was not correlated with initial prescription strength, suggesting surgeons could prescribe smaller prescriptions without influencing refill requests.
AHRQ-funded; HS023313.
Citation: Sekhri S, Arora NS, Cottrell H .
Probability of opioid prescription refilling after surgery: does initial prescription dose matter?
Ann Surg 2018 Aug;268(2):271-76. doi: 10.1097/sla.0000000000002308..
Keywords: Medication, Opioids, Pain, Practice Patterns, Substance Abuse, Surgery
Jonassaint CR, Rao N, Sciuto A
Abstract animations for the communication and assessment of pain in adults: cross-sectional feasibility study.
The aim of this study was to develop and test Painimation, a novel tool that uses graphic visualizations and animations instead of words or numeric scales to assess pain quality, intensity, and course. The study concluded that using animations may be a faster and more patient-centered method for assessing pain and is not limited by age, literacy level, or language; however, more data are needed to assess the validity of this approach.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Rao N, Sciuto A .
Abstract animations for the communication and assessment of pain in adults: cross-sectional feasibility study.
J Med Internet Res 2018 Aug 3;20(8):e10056. doi: 10.2196/10056..
Keywords: Chronic Conditions, Communication, Pain, Patient-Centered Healthcare
Skolasky RL, Scherer EA, Wegener ST
Does reduction in sciatica symptoms precede improvement in disability and physical health among those treated surgically for intervertebral disc herniation? Analysis of temporal patterns in data from the Spine Patient Outcomes Research Trial.
This study aimed to evaluate pathways for improvements in quality of life during the first year after surgery for IDH by studying temporal relationships between sciatica symptoms, pain-related disability, and physical health. Investigators found that three months after surgery, patients reported reduced sciatica and pain-related disability. Early reduction in pain-related disability is important because path analysis indicated that disability at 3 months was predictive of sciatica and physical health at 1 year.
AHRQ-funded; HS017990; HS016106.
Citation: Skolasky RL, Scherer EA, Wegener ST .
Does reduction in sciatica symptoms precede improvement in disability and physical health among those treated surgically for intervertebral disc herniation? Analysis of temporal patterns in data from the Spine Patient Outcomes Research Trial.
Spine J 2018 Aug;18(8):1318-24. doi: 10.1016/j.spinee.2017.11.016.
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Keywords: Disabilities, Outcomes, Pain, Patient-Centered Outcomes Research, Quality of Life, Surgery
Desai K, Carroll I, Asch SM
Utilization and effectiveness of multimodal discharge analgesia for postoperative pain management.
In this study, the investigators sought to assess the association between discharge multimodal analgesia and postoperative pain outcomes in two diverse health care settings. They evaluated patients undergoing four common surgeries associated with high pain in electronic health records from an academic hospital (AH) and Veterans Health Administration (VHA). The investigators found that a majority of surgical patients received a multimodal pain approach at discharge yet many received only opioids. Multimodal regimen at discharge was associated with better follow-up pain and all-cause readmissions compared to the opioid-only regimen.
AHRQ-funded; HS024096.
Citation: Desai K, Carroll I, Asch SM .
Utilization and effectiveness of multimodal discharge analgesia for postoperative pain management.
J Surg Res 2018 Aug;228:160-69. doi: 10.1016/j.jss.2018.03.029..
Keywords: Care Management, Medication, Opioids, Pain, Surgery
Stevens JP, Dechen T, Schwartzstein R
Prevalence of dyspnea among hospitalized patients at the time of admission.
Dyspnea is an uncomfortable and distressing sensation experienced by hospitalized patients. There is no large-scale study of the prevalence and intensity of patient-reported dyspnea at the time of admission to the hospital. In this study the investigators conducted a prospective cohort study among all consecutive hospitalized patients at a single tertiary care center in Boston, MA. The investigators concluded that dyspnea is a common symptom among all hospitalized patients and that routine documentation of dyspnea is feasible in a large tertiary care center.
AHRQ-funded; HS024288.
Citation: Stevens JP, Dechen T, Schwartzstein R .
Prevalence of dyspnea among hospitalized patients at the time of admission.
J Pain Symptom Manage 2018 Jul;56(1):15-22.e2. doi: 10.1016/j.jpainsymman.2018.02.013..
Keywords: Emergency Department, Hospitalization, Pain
Khor S, Lavallee D, Cizik AM
Development and validation of a prediction model for pain and functional outcomes after lumbar spine surgery.
The purpose of this study was to assess population-level patient-reported outcome (PRO) response after lumbar spine surgery, and develop/validate a prediction tool for PRO improvement. The study concluded that the PRO response prediction tool, informed by population-level data, explained most of the variability in pain reduction and functional improvement after surgery.
AHRQ-funded; HS022959.
Citation: Khor S, Lavallee D, Cizik AM .
Development and validation of a prediction model for pain and functional outcomes after lumbar spine surgery.
JAMA Surg 2018 Jul;153(7):634-42. doi: 10.1001/jamasurg.2018.0072..
Keywords: Chronic Conditions, Outcomes, Pain, Surgery
Graves JM, Fulton-Kehoe D, Jarvik JG
Impact of an advanced imaging utilization review program on downstream health care utilization and costs for low back pain.
Investigators researched the impact of imaging tests such as magnetic resonance imaging (MRI) for lower back pain (LBP) on utilization and duration of workers’ compensation claims. Claims from 76,119 Washington State workers with LBP from 2006 to 2014 were used to see if a policy that implemented prospective utilization review (UR) for early MRI increased costs per claim, disability duration and the proportion of workers who received benefits. Results showed there were noticeable effects from MRI tests, but not computed tomography or surgery utilization.
AHRQ-funded; HS019222.
Citation: Graves JM, Fulton-Kehoe D, Jarvik JG .
Impact of an advanced imaging utilization review program on downstream health care utilization and costs for low back pain.
Med Care 2018 Jun;56(6):520-28. doi: 10.1097/mlr.0000000000000917..
Keywords: Back Health and Pain, Healthcare Utilization, Imaging, Pain
Jonassaint CR, Birenboim A, Jorgensen DR
The association of smartphone-based activity space measures with cognitive functioning and pain sickle cell disease.
This letter describes a study which researched the feasibility of using GPS tracking on smartphones to identify sickle cell disease (SCD) patients aged 18-65 at risk for poor outcomes. The data was used to track physical mobility and activity spaces. Preliminary findings showed that 90% of the phones produced reliable and only 4 phones produced no data. Patients with lower hemoglobin (Hb) levels did have smaller activity spaces.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Birenboim A, Jorgensen DR .
The association of smartphone-based activity space measures with cognitive functioning and pain sickle cell disease.
Br J Haematol 2018 May;181(3):395-97. doi: 10.1111/bjh.14598..
Keywords: Chronic Conditions, Health Information Technology (HIT), Pain, Sickle Cell Disease
McKernan LC, Walsh CG, Reynolds WS
Psychosocial co-morbidities in Interstitial cystitis/bladder pain syndrome (IC/BPS): a systematic review.
Psychosocial factors amplify symptoms of Interstitial Cystitis (IC/BPS). While psychosocial self-management is efficacious in other pain conditions, its impact on an IC/BPS population has rarely been studied. The objective of this review was to learn the prevalence and impact of psychosocial factors on IC/BPS, assess baseline psychosocial characteristics, and offer recommendations for assessment and treatment.
AHRQ-funded; HS022990.
Citation: McKernan LC, Walsh CG, Reynolds WS .
Psychosocial co-morbidities in Interstitial cystitis/bladder pain syndrome (IC/BPS): a systematic review.
Neurourol Urodyn 2018 Mar;37(3):926-41. doi: 10.1002/nau.23421..
Keywords: Pain, Anxiety, Depression, Behavioral Health, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Klinge M, Coppler T, Liebschutz JM
The assessment and management of pain in cirrhosis.
The treatment of pain in patients with cirrhosis is complicated by unpredictable hepatic drug metabolism and a higher risk of adverse drug reactions. The researchers aimed to conduct a scoping review regarding pain management in cirrhosis. As with other populations, a multi-dimensional treatment approach to pain with a focus on physical, behavioral, procedural and pharmacologic treatment is recommended when caring for patients with cirrhosis and pain.
AHRQ-funded; HS022989.
Citation: Klinge M, Coppler T, Liebschutz JM .
The assessment and management of pain in cirrhosis.
Curr Hepatol Rep 2018 Mar;17(1):42-51. doi: 10.1007/s11901-018-0389-7.
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Keywords: Adverse Drug Events (ADE), Care Management, Chronic Conditions, Evidence-Based Practice, Medication, Pain, Patient-Centered Outcomes Research
Zullo AR, Zhang T, Beudoin FL
Pain treatments after hip fracture among older nursing home residents.
In this retrospective cohort study the investigators examined the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. The investigators concluded that a rigorous study addressing the limitations of their study is critical to validate their preliminary findings and provide evidence about the effect of using opioid versus nonopioid analgesics to optimize acute pain in NH residents with a hip fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Beudoin FL .
Pain treatments after hip fracture among older nursing home residents.
J Am Med Dir Assoc 2018 Feb;19(2):174-76. doi: 10.1016/j.jamda.2017.11.008..
Keywords: Opioids, Pain, Nursing Homes, Long-Term Care, Elderly, Medication, Injuries and Wounds, Patient-Centered Outcomes Research, Healthcare Utilization
Tanabe P, Silva S, Bosworth HB
A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD).
Limited evidence guides opioid dosing strategies for acute Sickle Cell (SCD) pain. In this randomized control study, the investigators compared two National Heart, Lung and Blood Institute (NHBLI) recommended opioid dosing strategies (weight-based vs. patient-specific) for emergency department (ED) treatment of acute vaso-occlusive episodes (VOE).
AHRQ-funded; HS019646.
Citation: Tanabe P, Silva S, Bosworth HB .
A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD).
Am J Hematol 2018 Feb;93(2):159-68. doi: 10.1002/ajh.24948..
Keywords: Medication, Opioids, Pain, Sickle Cell Disease
Vakharia PP, Chopra R, Sacotte R
Burden of skin pain in atopic dermatitis.
This study sought to characterize the patient burden of skin pain in AD. It found that twenty-four (16.8 percent) patients thought the skin pain was part of their itch, 16 (11.2 percent) from scratching, and 77 (72.0 percent) from both. Patients with skin pain were more likely to describe their itch using terms that resembled neuropathic pain.
AHRQ-funded; HS023011.
Citation: Vakharia PP, Chopra R, Sacotte R .
Burden of skin pain in atopic dermatitis.
Ann Allergy Asthma Immunol 2017 Dec;119(6):548-52.e3. doi: 10.1016/j.anai.2017.09.076.
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Keywords: Chronic Conditions, Pain, Quality of Life, Skin Conditions
Tedesco D, Gori D, Desai KR
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
The authors systematically reviewed and meta-analyzed evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. The most commonly performed interventions included in the review were continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. In the meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
AHRQ-funded; HS024096.
Citation: Tedesco D, Gori D, Desai KR .
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg 2017 Oct 18;152(10):e172872. doi: 10.1001/jamasurg.2017.2872.
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Keywords: Care Management, Medication, Opioids, Orthopedics, Pain, Surgery
Herbert MS, Goodin BR, Bulls HW
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
This study aimed to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts.
AHRQ-funded; HS013852.
Citation: Herbert MS, Goodin BR, Bulls HW .
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
Clin J Pain 2017 Sep;33(9):820-26. doi: 10.1097/ajp.0000000000000462.
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Keywords: Arthritis, Pain, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Treatments
Hernandez-Boussard T, Graham LA, Desai K
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
The researchers hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. After analyzing National Veterans Affairs Surgical Quality Improvement data on inpatient general, vascular, and orthopedic surgery from 2008 to 2014, they concluded that postoperative pain trajectories identify populations at risk for 30-day readmissions and ED visits, and do not seem to be mediated by postdischarge complications.
AHRQ-funded; HS024096.
Citation: Hernandez-Boussard T, Graham LA, Desai K .
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
Ann Surg 2017 Sep;266(3):516-24. doi: 10.1097/sla.0000000000002372.
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Keywords: Emergency Department, Hospital Readmissions, Pain