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- Adverse Drug Events (ADE) (1)
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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 19 of 19 Research Studies DisplayedDalton AF, Golin CE, Morris C
Effect of a patient decision aid on preferences for colorectal cancer screening among older adults: a secondary analysis of a randomized clinical trial.
This research studied the effects of a patient decision aid on preferences for colorectal cancer (CRC) screening among adults aged 76 to 84 years. Participants were recruited from 14 community-based primary care practices who were not up to date with screening and had an appointment within 6 weeks. They were randomized to receive the intervention or control. Among the 424 participants, mean age was 76.8, 248 were women, and 333 were White. There were no statistically significant differences found in patient preferences between the health groups. Additional studies that are appropriately powered were recommended.
AHRQ-funded; HS021133.
Citation: Dalton AF, Golin CE, Morris C .
Effect of a patient decision aid on preferences for colorectal cancer screening among older adults: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2022 Dec;5(12):e2244982. doi: 10.1001/jamanetworkopen.2022.44982..
Keywords: Elderly, Decision Making, Screening, Cancer: Colorectal Cancer, Cancer
Arora S, Fowler ME, Harmon C
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
The purpose of this study was to explore differences in pretreatment frailty between colorectal (CRC), hepatobiliary, and pancreatic cancers. The researchers included adults aged 60 years and higher enrolled in the Cancer and Aging Resilience Evaluation registry. A 44-item Cancer and Aging Resilience Evaluation frailty index was utilized to define frailty, which included geriatric assessment impairments of functional status, cognitive complaints, health-related quality of life, comorbidities, polypharmacy, anxiety, depression, malnutrition, falls, ability to walk one block, and interference in social activities. A total of 505 patients were included in the study: 41.8% with CRC, 35.2% with pancreatic cancer, and 116 23.0% with hepatobiliary cancer. The study found the following prevalence of frailty: 40.6% pancreatic, 34.3% hepatobiliary, and 23.3% CRC. Frailty was linked with higher rates of malnutrition and instrumental activities of daily living impairments in patients with pancreatic cancer and higher number of comorbidities in patients with hepatobiliary cancer. The study concluded that adults aged 60 and over with pancreatic and hepatobiliary cancers are at high-risk of pretreatment frailty.
AHRQ-funded; HS013852.
Citation: Arora S, Fowler ME, Harmon C .
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
JCO Oncol Pract 2022 Nov;18(11):e1796-e806. doi: 10.1200/op.22.00270..
Keywords: Elderly, Cancer, Digestive Disease and Health
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Jiang Y, Mason M, Cho Y
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
The purpose of this study was to explore the tolerance of capecitabine oral chemotherapy among older adults with cancer and investigate factors associated with related side effects and treatment changes. The researchers combined data from electronic health records and a pilot study of patient-reported outcomes, and found that older adults were more likely to experience fatigue and experienced more severe fatigue and hand-foot syndrome (HFS) than younger adults. The severity of fatigue and HFS were associated with the number of outpatient medications and the duration of treatment respectively. Female sex, breast cancer diagnosis, capecitabine monotherapy, and severe HFS were found to be associated with subsequent dose reductions. The study concluded that older adults were less likely to tolerate capecitabine treatment and had different co-occurring side effects compared to younger adults.
AHRQ-funded; HS027846.
Citation: Jiang Y, Mason M, Cho Y .
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
BMC Cancer 2022 Sep 3;22(1):950. doi: 10.1186/s12885-022-10026-3..
Keywords: Elderly, Cancer, Medication, Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bredbeck BC, Mott NM, Wang T
Facility-level variation of low-value breast cancer treatments in older women with early-stage breast cancer: analysis of a statewide claims registry.
The goal of this retrospective cohort study was to determine facility-level variation of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy in older women with early-stage, hormone receptor-positive (HR+) breast cancer who were undergoing breast-conserving surgery (BCS). Researchers used a statewide registry of claims data and included a cohort of women aged 70 or older who were diagnosed with breast cancer and who underwent BCS at 80 hospitals in the Michigan Value Collaborative. They concluded that SLNB and radiotherapy rates remain high with significant variation in utilization at the facility level, and that high utilizers of SLNB are also likely to be high utilizers of radiotherapy.
AHRQ-funded; HS026030.
Citation: Bredbeck BC, Mott NM, Wang T .
Facility-level variation of low-value breast cancer treatments in older women with early-stage breast cancer: analysis of a statewide claims registry.
Ann Surg Oncol 2022 Jul; 29(7):4155-64. doi: 10.1245/s10434-022-11631-z..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Women
Tsang M, DeBoer RJ, Garrett SB
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
The purpose of this study was to examine the potential reasons for and responses to older adults’ under enrollment in phase 1 cancer clinical trials. The researchers conducted 101 in-depth qualitative interviews with 39 adults aged 65 and older with advanced cancer and asked about their experiences with the trials. The data was analyzed to identify the participants’ understanding of clinical research, their perceptions of early phase trials, and their experiences with enrollment in the trials. The study found that participants over the age of 70 were less enthusiastic about participation in clinical trials, although they did not mention age as a limitation to participation. Findings indicated that participation in clinical trials was an interactive, ongoing process, in which older adults relied on their oncologist for guidance and discussion. The researchers concluded that older adults rely on their oncologist to navigate the perceived complexities of phase 1 trial enrollment, and that acknowledgement of those complexities via shared decision-making can help prevent under-enrollment.
AHRQ-funded; HS022241.
Citation: Tsang M, DeBoer RJ, Garrett SB .
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
J Geriatr Oncol 2022 Jun;13(5):594-99. doi: 10.1016/j.jgo.2022.01.012..
Keywords: Elderly, Cancer, Decision Making, Quality of Life
Liu MA, Keeney T, Papaila A
Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis.
The purpose of this study was to examine the association between activities of daily living (ADL) impairment and overall survival in patients 65 and older with advanced non-small-cell lung cancer (NSCLC) receiving care in nursing homes from 2011 to 2015. The researchers examined the association between ADL scores and overall survival among 3,174 patients who received systemic cancer chemotherapy or immunotherapy within 3 months of NSCLC diagnosis; and among patients who did not receive any treatment. The study found that the ADL score was associated with increased risk of death. One standard deviation increase in the ADL score was associated with lower overall survival rate among treated and untreated patients The median overall survival was 3.1 months for patients with an ADL score of less than 14, 2.8 months for patients with an ADL score between 14 and 17, 2.3 months for patients with ADL score between 18-19, and 1.8 months for patients with ADL score of 20+. The researchers concluded that the ADL assessment may be a useful clinical tool in nursing home adults aged 65 and older with advanced non-small-cell lung cancer.
AHRQ-funded; HS000011.
Citation: Liu MA, Keeney T, Papaila A .
Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis.
JCO Oncol Pract 2022 Jun;18(6):e886-e95. doi: 10.1200/op.21.00460..
Keywords: Elderly, Nursing Homes, Cancer: Lung Cancer, Cancer
Di M, Keeney T, Belanger E
Global risk indicator and therapy for older patients with diffuse large B-cell lymphoma: a population-based study.
The objective of this study was to examine the impact of global risk on treatment selection and outcomes among older home care recipients with diffuse large B-cell lymphoma. Researchers selected patients diagnosed with diffuse large B-cell lymphoma who had pretreatment Outcome and Assessment Information Set (OASIS) evaluations from SEER-Medicare. High-risk patients were less likely to receive chemotherapy and were more likely to experience acute mortality, emergency department visits, hospitalization or intensive care unit admission, and had inferior overall survival rates. The researchers concluded that global risk on the basis of OASIS was easily available and offered a potential way to improve patient selection for curative treatment and institution of preventive measures.
AHRQ-funded; HS000011.
Citation: Di M, Keeney T, Belanger E .
Global risk indicator and therapy for older patients with diffuse large B-cell lymphoma: a population-based study.
JCO Oncol Pract 2022 Mar; 18(3):e383-e402. doi: 10.1200/op.21.00513..
Keywords: Elderly, Cancer, Risk
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Decision Making, Clinician-Patient Communication, Communication
Papaleontiou M, Norton EC, Reyes-Gastelum D
Competing causes of death in older adults with thyroid cancer.
Understanding the impact of comorbidities and competing risks of death when caring for older adults with thyroid cancer is key for personalized management. The objective of this study was to determine whether older adults with thyroid cancer are more likely to die from thyroid cancer or other etiologies and determine patient factors associated with each.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Norton EC, Reyes-Gastelum D .
Competing causes of death in older adults with thyroid cancer.
Thyroid 2021 Sep;31(9):1359-65. doi: 10.1089/thy.2020.0929..
Keywords: Elderly, Cancer, Mortality
Medbery RL, Fernandez FG, Kosinski AS
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Researchers sought to identify underlying case mix factors that contribute to variability of 90-day costs of lobectomy for early-stage lung cancer. Using the Society of Thoracic Surgeons General Thoracic Surgery Database, they found that lobectomy is associated with substantial variability of episode-of-care costs. Variability is driven by patient demographic and clinical factors, hospital characteristics, and the occurrence and severity of complications.
AHRQ-funded; R01 HS022279.
Citation: Medbery RL, Fernandez FG, Kosinski AS .
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Ann Thorac Surg 2021 Jun;111(6):1781-90. doi: 10.1016/j.athoracsur.2020.08.073..
Keywords: Cancer: Lung Cancer, Cancer, Healthcare Costs, Surgery, Elderly, Medicare
Panagiotou OA, Keeney T, Ogarek JA
Prevalence of functional limitations and their associations with systemic cancer therapy among older adults in nursing homes with advanced non-small cell lung cancer.
The purpose of this study was to determine the relationship of self-care task disabilities with the use of systemic cancer therapies for advanced non-small cell lung cancer (NSCLC) in nursing home patients. The investigators concluded that systemic cancer therapy was not commonly used in this population and was strongly predicted by disability in self-care tasks.
AHRQ-funded; HS000011.
Citation: Panagiotou OA, Keeney T, Ogarek JA .
Prevalence of functional limitations and their associations with systemic cancer therapy among older adults in nursing homes with advanced non-small cell lung cancer.
J Geriatr Oncol 2021 Jun;12(5):765-70. doi: 10.1016/j.jgo.2021.02.007..
Keywords: Elderly, Cancer: Lung Cancer, Cancer, Nursing Homes
Gibson DC, Raji MA, Baillargeon JG
Regional and temporal variation in receipt of long-term opioid therapy among older breast, colorectal, lung, and prostate cancer survivors in the United States.
The authors investigated the geographical and temporal variation in long-term opioid therapy rates for older cancer survivors using SEER-Medicare data. They found that the annual trends in the receipt of long-term opioid therapy significantly varied by region among older cancer survivors. They indicated that variation in a clinical practice suggested the need for more research and interventions in order to improve efficiency, process, cost, and quality of care.
AHRQ-funded; HS026133.
Citation: Gibson DC, Raji MA, Baillargeon JG .
Regional and temporal variation in receipt of long-term opioid therapy among older breast, colorectal, lung, and prostate cancer survivors in the United States.
Cancer Med 2021 Mar;10(5):1550-61. doi: 10.1002/cam4.3709..
Keywords: Elderly, Cancer, Opioids, Medication
Baskin AS, Wang T, Mott NM
Gaps in online breast cancer treatment information for older women.
This study’s goal was to assess the availability of web-based educational materials targeting older women facing early-stage breast cancer treatment. Routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may not be perceived as desirable by older women. National guidelines allow omission of these treatments for older women. The authors systematically reviewed the top 25 hospital websites ranked as “Best Hospitals for Cancer” by U.S. News & World Report, as well as the websites of four prominent national cancer organizations. Only one national organization and no hospital websites included the recommendation to avoid routine SLNB. Only 2 hospitals and 2 national organizations included information for patients older than 70 years suggesting possible omission of adjuvant radiotherapy.
AHRQ-funded; HS026030.
Citation: Baskin AS, Wang T, Mott NM .
Gaps in online breast cancer treatment information for older women.
Ann Surg Oncol 2021 Feb;28(2):950-57. doi: 10.1245/s10434-020-08961-1..
Keywords: Elderly, Education: Patient and Caregiver, Health Information Technology (HIT), Cancer: Breast Cancer, Cancer, Women
Mott N, Wang T, Miller J
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
In this qualitative study, researchers conducted 30 semi-structured interviews with women age 70 or older without a previous diagnosis of breast cancer in order to elicit perspectives on breast cancer treatment in relation to their medical maximizing-minimizing preferences, as determined by the single-item maximizer-minimizer elicitation question (MM1). They found that medical maximizing-minimizing preferences in older women corresponded with preferences for breast cancer treatment options that guidelines identify as potentially unnecessary.
AHRQ-funded; HS026030.
Citation: Mott N, Wang T, Miller J .
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
Ann Surg Oncol 2021 Feb;28(2):941-49. doi: 10.1245/s10434-020-08924-6..
Keywords: Elderly, Women, Cancer: Breast Cancer, Cancer
Wang T, Baskin A, Miller J
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Guidelines allow for the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women >/= 70 years of age with hormone receptor-positive (HR +) breast cancer. Despite this, national data suggest these procedures have not been widely de-implemented. The objectives of this study were to evaluate trends in SLNB and post-lumpectomy radiotherapy utilization in patients who were eligible for omission and evaluate patient preferences as a target for de-implementation of low-value care.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin A, Miller J .
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Ann Surg Oncol 2021 Feb;28(2):902-13. doi: 10.1245/s10434-020-08823-w..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Healthcare Utilization, Practice Patterns, Women
Osterman CK, Deal AM, McCloskey H
Impairment and longitudinal recovery of older adults treated with radical cystectomy for muscle invasive bladder cancer.
Treatment for muscle invasive bladder cancer includes radical cystectomy, a major surgery that can be associated with significant toxicity. Limited data exist related to changes in patient global health status and recovery following radical cystectomy. In this study, the investigators used geriatric assessment to longitudinally compare health related impairments in older and younger patients with muscle invasive bladder cancer who undergo radical cystectomy.
AHRQ-funded; HS024134.
Citation: Osterman CK, Deal AM, McCloskey H .
Impairment and longitudinal recovery of older adults treated with radical cystectomy for muscle invasive bladder cancer.
J Urol 2021 Jan;205(1):94-99. doi: 10.1097/ju.0000000000001323..
Keywords: Elderly, Cancer, Surgery, Adverse Events, Quality of Life
Vyas A, Madhavan S, Sambamoorthi U
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
The objective of this study is to determine the association between persistence with mammography screening and stage at breast cancer (BC) diagnosis among elderly women. It found that, as compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan S, Sambamoorthi U .
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
Breast Cancer Res Treat 2014 Dec;148(3):645-54. doi: 10.1007/s10549-014-3204-3..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Elderly, Prevention, Screening, Women
Arvold ND, Wang Y, Zigler C
Hospitalization burden and survival among older glioblastoma patients.
The researchers performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007. They found that higher comorbidity score and black race were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation, temozolomide, and extensive surgery were associated with a decreased risk.
AHRQ-funded; HS021991.
Citation: Arvold ND, Wang Y, Zigler C .
Hospitalization burden and survival among older glioblastoma patients.
Neuro Oncol 2014 Nov;16(11):1530-40. doi: 10.1093/neuonc/nou060.
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Keywords: Cancer, Elderly, Hospitalization, Mortality, Quality of Life