National Healthcare Quality and Disparities Report
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- (-) Adverse Drug Events (ADE) (61)
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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 61 Research Studies DisplayedZhou S, Kang H, Yao B
An automated pipeline for analyzing medication event reports in clinical settings.
The article describes and evaluates an automated pipeline that is expected to improve the efficiency of analyzing medication event reports. The pipeline assists clinicians in extracting information from reports and generating feedback using classic machine-learning classifiers to compare three attributes taken from the reports: event originating stages, event types, and event causes. The pipeline identifies these attributes and calculates similarity scores based on them. A strategy to measure similarity was created and evaluated by human subjects using a questionnaire.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Yao B .
An automated pipeline for analyzing medication event reports in clinical settings.
BMC Med Inform Decis Mak 2018 Dec 7;18(Suppl 5):113. doi: 10.1186/s12911-018-0687-6..
Keywords: Adverse Drug Events (ADE), Quality of Care, Medication, Patient Safety
Lowenstern A, Al-Khatib SM, Sharan L
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
The purpose of this review was to compare the effectiveness of therapies to prevent thromboembolic events and bleeding complications in adults with nonvalvular atrial fibrillation (AF). Two independent reviewers screened citations in order to identify comparative studies of treatments to prevent stroke in adults with nonvalvular AF who reported thromboembolic or bleeding complications, then abstracted data from 220 selected articles, assessed study quality and applicability, and rated the strength of evidence. The article concludes that available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF and had similar benefits across several patient subgroups.
AHRQ-funded; 290201500004I.
Citation: Lowenstern A, Al-Khatib SM, Sharan L .
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
Ann Intern Med 2018 Dec 4;169(11):774-87. doi: 10.7326/m18-1523..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Wright A, Aaron S, Seger DL
Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record.
This study examined the effects of conversion from a homegrown electronic health record (EHR) system to a commercial system on the effectiveness of drug-drug interaction (DDI) alert. The EHR system included 3277 clinicians in the before and after studies. There was a marked decrease in the acceptance rate (100 to 8.4% for severe alerts, 29.3 to 7.5% for medium severity) at first. The least severe alerts were then disabled, which lowered the alert burden by 50.5% which rose the acceptance of Tier 1 alerts to 12.7%. However, there was no clear explanation after that why the acceptance rate remained so much lower. The authors believe that workflow factors were probably the predominant reasons.
AHRQ-funded; HS016970.
Citation: Wright A, Aaron S, Seger DL .
Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record.
J Gen Intern Med 2018 Nov;33(11):1868-76. doi: 10.1007/s11606-018-4415-9..
Keywords: Adverse Drug Events (ADE), Medication, Adverse Events, Medical Errors, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Shaker M, Lindholm C, Low J
Summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature.
Epinephrine is first-line treatment for anaphylaxis. The Food and Drug Administration reported that adverse events from epinephrine are infrequent. This paper provides a summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature.
AHRQ-funded; HS024599.
Citation: Shaker M, Lindholm C, Low J .
Summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):2143-45.e4. doi: 10.1016/j.jaip.2018.04.006..
Keywords: Adverse Events, Adverse Drug Events (ADE), Medication, Patient Safety, Prevention
Schiff G, Mirica MM, Dhavle AA
A prescription for enhancing electronic prescribing safety.
The authors review six areas in which electronic prescribing areas can be improved to transform medication ordering quality and safety. They recommend incorporating medication indications into electronic prescribing, establishing a single shared online medication list, implementing an electronic cancellation mechanism for pharmacies, implementing standardized structured and codified prescription instruction, reengineering clinical decision support, and redesigning electronic prescribing to facilitate ordering of nondrug alternatives.
AHRQ-funded; HS023694.
Citation: Schiff G, Mirica MM, Dhavle AA .
A prescription for enhancing electronic prescribing safety.
Health Aff 2018 Nov;37(11):1877-83. doi: 10.1377/hlthaff.2018.0725..
Keywords: Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Healthcare Delivery, Medical Errors, Medication, Medication: Safety, Patient Safety
Wang SV, Maro JC, Baro E
Data mining for adverse drug events with a propensity score-matched tree-based scan statistic.
In this study, the investigators propose a method that combines tree-based scan statistics with propensity score-matched analysis of new initiator cohorts, a robust design for investigations of drug safety. They subsequently conducted plasmode simulations to evaluate performance. The authors suggest that TreeScan with propensity score matching shows promise as a method for screening and prioritization of potential adverse events.
AHRQ-funded; HS022193.
Citation: Wang SV, Maro JC, Baro E .
Data mining for adverse drug events with a propensity score-matched tree-based scan statistic.
Epidemiology 2018 Nov;29(6):895-903. doi: 10.1097/ede.0000000000000907..
Keywords: Adverse Drug Events (ADE), Adverse Events, Patient Safety, Medication, Medication: Safety, Data, Research Methodologies
Prey JE, Polubriaginof F, Grossman LV
Engaging hospital patients in the medication reconciliation process using tablet computers.
Researchers conducted a pilot study to determine whether patients’ use of an electronic home medication review tool on a table computer could improve medication safety before or after hospitalization. Patients were randomized to the tool and out of 76 patients approached, 65 participated. About three-quarters (74%) made changes to their home medication list. Out of that total, 74% of the changes identified had a significant or greater potential severity, and 49% had a greater than 50-50 chance of harm. This medication reconciliation tool showed great potential to improve medication safety during and after hospitalization.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Grossman LV .
Engaging hospital patients in the medication reconciliation process using tablet computers.
J Am Med Inform Assoc 2018 Nov;25(11):1460-69. doi: 10.1093/jamia/ocy115..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Medication, Medication: Safety, Patient and Family Engagement, Patient Safety, Prevention
Bates DW, Singh H
Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.
This paper comments on the progress made in improving patient safety since the 1999 report from The Institute of Medicine titled “To Err is Human” was published. This landmark report highlighted problem areas, and since then there has been a number of effective interventions to prevent hospital-acquired infections and improve medication safety. Additional areas for improvement have also been identified in the past two decades, including outpatient care, diagnostic, errors and the use of health information technology. The authors believe that electronic data developments can help increase patient safety even further.
AHRQ-funded; HS022087; HS017820.
Citation: Bates DW, Singh H .
Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.
Health Aff 2018 Nov;37(11):1736-43. doi: 10.1377/hlthaff.2018.0738..
Keywords: Adverse Drug Events (ADE), Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Medication: Safety, Patient Safety, Prevention
Blumenthal KG, Li Y, Acker WW
Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression.
In this study, the authors used electronic health record (EHR) data to describe prevalences of MDIS and MDAS and to examine associations with anxiety and depression. The investigators concluded that: 1.) while 6% of patients had MDIS, only 1% had MDAS; 2.) MDIS was associated with both anxiety and depression; 3.) patients with both anxiety and depression had an almost twofold increased odds of MDIS; 4.) MDAS was associated with a 40% increased odds of depression, but there was no significant association with anxiety.
AHRQ-funded; HS022728.
Citation: Blumenthal KG, Li Y, Acker WW .
Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression.
Allergy 2018 Oct;73(10):2012-23. doi: 10.1111/all.13440..
Keywords: Adverse Drug Events (ADE), Adverse Events, Anxiety, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Behavioral Health, Patient Safety
Davis CS, Green TC, Hernandez-Delgado H
Status of US state laws mandating timely reporting of nonfatal overdose.
Timely, actionable, nonfatal overdose data are urgently needed to improve public health response to the overdose crisis. The purpose of this paper was to provide background and catalyze discussion regarding this important issue. The authors briefly report the results of a systematic analysis of state laws mandating reporting of nonfatal overdose, and provide suggestions for improving the collection and use of nonfatal overdose data to improve the public health response to this ongoing epidemic.
AHRQ-funded; HS024021.
Citation: Davis CS, Green TC, Hernandez-Delgado H .
Status of US state laws mandating timely reporting of nonfatal overdose.
Am J Public Health 2018 Sep;108(9):1159-61. doi: 10.2105/ajph.2018.304589..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Opioids, Policy, Public Health, Substance Abuse
Slight SP, Seger DL, Franz C
The national cost of adverse drug events resulting from inappropriate medication-related alert overrides in the United States.
Investigators worked to determine the national cost of adverse drug events (ADEs) in the United States in 2014. They used three different regression models. They used a random sample of 40,990 adult inpatients at the Brigham and Women’s Hospital in Boston with over 1.6 million medication orders. They extrapolated the medication orders using 2014 National Inpatient Sample (NIS) data. They estimated that out of 78.8 million total medication alerts, 5.5 million medication alerts would have been inappropriately overridden resulting in 196,660 ADEs. They estimated it would have cost between $871 million and $1.8 billion for treating these preventable ADEs in the United States.
AHRQ-funded; HS021094.
Citation: Slight SP, Seger DL, Franz C .
The national cost of adverse drug events resulting from inappropriate medication-related alert overrides in the United States.
J Am Med Inform Assoc 2018 Sep;25(9):1183-88. doi: 10.1093/jamia/ocy066..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Drug Events (ADE), Adverse Events, Clinical Decision Support (CDS), Health Information Technology (HIT), Healthcare Costs, Medical Errors, Medication
Katz RB, Toprak M, Wilkinson ST
Concurrent use of ketamine and monoamine oxidase inhibitors in the treatment of depression: a letter to the editor.
This research letter describes the implications of concurrent use of ketamine and monoamine oxidase inhibitors (MAO-Is) in the treatment of depression. There have not been many studies examining this. A literature review was conducted and eight cases total were found. All but one did not experience cardiovascular adverse events and that on patient had comorbid cardiac history. While these results were promising, the authors stressed that it is still unknown if concurrent use is safe and further research is needed.
AHRQ-funded; HS023000.
Citation: Katz RB, Toprak M, Wilkinson ST .
Concurrent use of ketamine and monoamine oxidase inhibitors in the treatment of depression: a letter to the editor.
Gen Hosp Psychiatry 2018 Sep - Oct;54:62-64. doi: 10.1016/j.genhosppsych.2018.05.007..
Keywords: Adverse Drug Events (ADE), Medication, Depression, Behavioral Health
Olfson M, Wall M, Wang S
Risks of fatal opioid overdose during the first year following nonfatal overdose.
This study examined that risks of fatal opioid overdose during the first year following nonfatal overdose. A national retrospective longitudinal cohort of patients- aged 18-64 years, in the Medicaid program, who received a clinical diagnosis of nonfatal opioid overdose-was identified. Repeated overdoses and fatal opioid overdoses were measured with the Medicaid record and the National Death Index and rates of repeat overdose per 1000 person-years and fatal overdose per 100,000 person-years were determined.
AHRQ-funded; HS023258; HS021112.
Citation: Olfson M, Wall M, Wang S .
Risks of fatal opioid overdose during the first year following nonfatal overdose.
Drug Alcohol Depend 2018 Sep 1;190:112-19. doi: 10.1016/j.drugalcdep.2018.06.004..
Keywords: Adverse Drug Events (ADE), Medication, Opioids, Risk
Shetterly Shetterly, S Flory, J
Diagnosis-based cohort augmentation using laboratory results data: the case of chronic kidney disease.
This study used data from FDA’s Sentinel System to determine if augmenting a diagnosis-based chronic kidney disease cohort with patients identified through laboratory results impacted cohort characteristics and outcomes. They divided the cohort into three different groups to compare demographic, clinical, and health care utilization characteristics. They observed mortality rates between the different groups.
AHRQ-funded; HS023898.
Citation: Shetterly Shetterly, S Flory, J .
Diagnosis-based cohort augmentation using laboratory results data: the case of chronic kidney disease.
Pharmacoepidemiol Drug Saf 2018 Aug;27(8):872-77. doi: 10.1002/pds.4583..
Keywords: Diagnostic Safety and Quality, Kidney Disease and Health, Chronic Conditions, Adverse Drug Events (ADE), Medication, Adverse Events
Wong A, Plasek JM, Montecalvo SP
Natural language processing and its implications for the future of medication safety: a narrative review of recent advances and challenges.
This review illustrates the fundamentals of natural language processing (NLP) and discusses the application the NLPs to medication safety in four data sources: electronic health records, Internet-based data, published literature, and reporting systems. The benefit of NLP is its time-saving features in association with the automation of medication safety tasks, as well as the potential for near real-time identification of adverse events, such as incidents posted on social media that might otherwise go unanalyzed. However, NLP is limited by a lack of data sharing between health care organizations, which inhibits wider adverse event monitoring across populations. The authors anticipate that future work on NLPs will focus on integrating of data sources from different domains to more quickly identify potential adverse events and to improve clinical decision support regarding patients’ estimated risks for specific adverse events.
AHRQ-funded; HS022728; HS024264; HS025375.
Citation: Wong A, Plasek JM, Montecalvo SP .
Natural language processing and its implications for the future of medication safety: a narrative review of recent advances and challenges.
Pharmacotherapy 2018 Aug;38(8):822-41. doi: 10.1002/phar.2151..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety
Goss FR, Lai KH, Topaz M
A value set for documenting adverse reactions in electronic health records.
In this study, the investigators developed a value set for encoding adverse reactions using a large dataset from one health system, enriched by reactions from 2 large external resources. This integrated value set included clinically important severe and hypersensitivity reactions. The work contributed a value set, harmonized with existing data, to improve the consistency and accuracy of reaction documentation in electronic health records, providing the necessary building blocks for more intelligent clinical decision support for allergies and adverse reactions.
AHRQ-funded; HS022728.
Citation: Goss FR, Lai KH, Topaz M .
A value set for documenting adverse reactions in electronic health records.
J Am Med Inform Assoc 2018 Jun;25(6):661-69. doi: 10.1093/jamia/ocx139..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Medication, Data, Health Information Technology (HIT), Patient Safety
Trivedi LU, Alvarez CA, Mansi IA
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
The objective of this study was to examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities). The study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. The authors assert that clinicians should not withhold statins, whenever indicated, in patients with epilepsy.
AHRQ-funded; HS022418.
Citation: Trivedi LU, Alvarez CA, Mansi IA .
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
Ann Pharmacother 2018 Jun;52(6):546-53. doi: 10.1177/1060028018756650..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Neurological Disorders, Risk
Liu W, Antonelli PJ, Dahm P
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: population-based cohort study.
The objective of this retrospective cohort study was to determine the risk of sudden sensorineural hearing loss (SNHL) associated with use of phosphodiesterase type 5 (PDE5) inhibitors. The investigators found that use of PDE5 inhibitors was associated with a small but significantly increased risk of sudden SNHL.
AHRQ-funded; HS021112.
Citation: Liu W, Antonelli PJ, Dahm P .
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: population-based cohort study.
Pharmacoepidemiol Drug Saf 2018 Jun;27(6):587-95. doi: 10.1002/pds.4405..
Keywords: Risk, Adverse Drug Events (ADE), Adverse Events, Medication, Patient Safety
Wang J, Ali E, Gong Y
An information enhanced framework for reporting medication events.
In this article, the authors describe a proposed framework to discover supportive information from the FDA Adverse Event Reporting System (FAERS), an open data source, to enhance the reporting of insulin-use events. The framework represents a paradigm for developing an information enhanced electronic reporting system.
AHRQ-funded; HS022895.
Citation: Wang J, Ali E, Gong Y .
An information enhanced framework for reporting medication events.
Stud Health Technol Inform 2018;250:169-73..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Medication: Safety, Patient Safety
Kannampallil TG, Manning JD, Chestek DW
Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department.
The authors examined the effect of number of open charts on intercepted wrong-patient medication orders in an emergency department using an interrupted time series analysis of intercepted wrong-patient medication orders in an emergency department during 2010-2016.
AHRQ-funded; HS024945.
Citation: Kannampallil TG, Manning JD, Chestek DW .
Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department.
J Am Med Inform Assoc 2018 Jun;25(6):739-43. doi: 10.1093/jamia/ocx099..
Keywords: Adverse Drug Events (ADE), Emergency Department, Medical Errors, Medication, Medication: Safety, Patient Safety
Lee JL, Dy SM, Gurses AP
Towards a more patient-centered approach to medication safety.
In this perspective, the authors focus their discussion on a patient-centered approach to measurement and describe commonly used health system–oriented medication safety measures for evaluating interventions. They also discuss measures that reflect patient-centeredness in medication safety.
AHRQ-funded; HS024436.
Citation: Lee JL, Dy SM, Gurses AP .
Towards a more patient-centered approach to medication safety.
J Patient Exp 2018 Jun;5(2):83-87. doi: 10.1177/2374373517727532..
Keywords: Adverse Drug Events (ADE), Patient-Centered Healthcare, Patient Safety, Medication: Safety, Medication
Zhou S, Kang H, Yao B
Unveiling originated stages of medication errors: an automated pipeline approach.
Medication error reports collected by Patient Safety Organizations provide an opportunity to analyze and learn from previous cases. However, the current process of analyzing the reports is labor-intensive and time-consuming. To improve the efficiency, the investigators used automated text classification techniques to develop a pipeline for medication error report pre-analysis.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Yao B .
Unveiling originated stages of medication errors: an automated pipeline approach.
Stud Health Technol Inform 2018;250:182-86..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Medication: Safety, Patient Safety
Chen Y, Lairson DR, Chan W
Risk of adverse events associated with front-line anti-myeloma treatment in Medicare patients with multiple myeloma.
This study aims to examine the risks of adverse events associated with anti-multiple myeloma (MM) therapies in a large population-based cohort of elderly patients with MM. It found that novel agents significantly increased the risk of anemia, peripheral neuropathy, and thromboembolic events. Combination therapies consisting of proteasome inhibitor plus immunomodulatory drugs were associated with significantly higher risk for anemia, neutropenia and thromboembolic events.
AHRQ-funded; HS018956.
Citation: Chen Y, Lairson DR, Chan W .
Risk of adverse events associated with front-line anti-myeloma treatment in Medicare patients with multiple myeloma.
Ann Hematol 2018 May;97(5):851-63. doi: 10.1007/s00277-018-3238-4.
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Keywords: Adverse Drug Events (ADE), Cancer, Treatments, Medication, Risk
Sun D, Simon GJ, Skube S
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
Cardiotoxicity is a relatively common and particularly important adverse event caused by chemotherapy for breast cancer patients. The authors of this study propose three phenotyping algorithms to assess breast cancer patients' susceptibility to cardiotoxicity caused by five first-line antineoplastic drugs. The study demonstrates the potential utility of causal phenotyping.
AHRQ-funded; HS022085.
Citation: Sun D, Simon GJ, Skube S .
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
AMIA Annu Symp Proc 2018 Apr 16;2017:1655-64..
Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Risk