National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (2)
- Arthritis (2)
- Back Health and Pain (6)
- Behavioral Health (1)
- Cancer (3)
- Cancer: Breast Cancer (1)
- Care Management (2)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- Children/Adolescents (1)
- Chronic Conditions (21)
- Clinician-Patient Communication (2)
- Communication (2)
- Comparative Effectiveness (2)
- Depression (3)
- Diabetes (1)
- Diagnostic Safety and Quality (3)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Emergency Department (3)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Guidelines (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Technology (HIT) (2)
- Health Status (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (2)
- Injuries and Wounds (2)
- Lifestyle Changes (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (18)
- Medication: Safety (1)
- Neurological Disorders (1)
- Obesity (1)
- Opioids (20)
- Orthopedics (4)
- Outcomes (1)
- (-) Pain (39)
- Palliative Care (2)
- Patient-Centered Outcomes Research (2)
- Patient Experience (1)
- Patient Safety (1)
- Patient Self-Management (1)
- Policy (1)
- Practice Patterns (7)
- Primary Care (4)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Screening (1)
- Skin Conditions (1)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Substance Abuse (4)
- Surgery (6)
- Treatments (2)
- 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 39 Research Studies DisplayedAgbalajobi OM, Gmelin T, Moon AM
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
This retrospective cohort study investigated opioid prescribing patterns among patients with chronic liver disease (CLD) at a single medical center. These patients (12,425) were followed for one year from October 2015 to September 2016. Nearly half (47%) were prescribed opioids over a one-year period, with 17% receiving high-risk prescriptions. Characteristics associated with high-risk opioid prescriptions included female gender, Medicaid insurance, cirrhosis and baseline chronic pain, depression, anxiety, substance use disorder, and Charlson comorbidity score. Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions.
AHRQ-funded; HS019461.
Citation: Agbalajobi OM, Gmelin T, Moon AM .
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
PLoS One 2021 Dec 17;16(12):e0261377. doi: 10.1371/journal.pone.0261377..
Keywords: Opioids, Medication, Practice Patterns, Pain, Chronic Conditions
Rumble DD, O'Neal K, Overstreet DS
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
This study compared associations between neighborhood-level socioeconomic status (SES), pain-status (chronic low back pain vs. pain-free), and daily sleep metrics in 117 adults. With neighborhood-level SES gathered from Neighborhood Atlas, and with individuals completing home sleep monitoring for 7 consecutive days/nights, analyses revealed neighborhood-level SES and neighborhood-level SES pain-status interaction significantly impacted objective sleep quality.
AHRQ-funded; HS013852.
Citation: Rumble DD, O'Neal K, Overstreet DS .
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
J Behav Med 2021 Dec;44(6):811-21. doi: 10.1007/s10865-021-00234-w..
Keywords: Sleep Problems, Back Health and Pain, Chronic Conditions, Pain
Cerda M, Wheeler-Martin K, Bruzelius E
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
The authors investigated the impact of pain management clinic laws. They analyzed data on county-level, opioid overdose deaths via the National Vital Statistics System and patients filling long-duration or high-dose opioid prescriptions in the US 2010-2018. Their findings suggested that laws with criminal penalties were associated with intended reductions in high-risk opioid prescribing and some opioid overdoses but raised concerns regarding unintended consequences on heroin/synthetic overdoses.
AHRQ-funded; HS023258.
Citation: Cerda M, Wheeler-Martin K, Bruzelius E .
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
Am J Epidemiol 2021 Dec;190(12):2592-603. doi: 10.1093/aje/kwab192..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Practice Patterns, Policy
Schirle L, Jeffery A, Yaqoob A
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Although electronic health records (EHR) have significant potential for the study of opioid use disorders (OUD), detecting OUD in clinical data is challenging. Models using EHR data to predict OUD often rely on case/control classifications focused on extreme opioid use. IN this study, the investigators discussed two data-driven approaches to identifying the spectrum of problematic opioid use. The investigators concluded that risk scores comprising comorbidities and text offer differing but synergistic insights into characterizing problematic opioid use.
AHRQ-funded; HS026395.
Citation: Schirle L, Jeffery A, Yaqoob A .
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Int J Med Inform 2021 Dec;156:104621. doi: 10.1016/j.ijmedinf.2021.104621..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Health Information Technology (HIT)
Silverberg JI
Validity and reliability of a novel numeric rating scale to measure skin-pain in adults with atopic dermatitis.
Little is known about the measurement properties of numeric rating scales (NRS) for pain in AD. In this study, the investigators evaluated a novel NRS for skin-pain and existing NRS for average overall-pain in adults with AD. Self-administered questionnaires and skin-examination were performed in 463 AD patients (age 18-97 years) in a dermatology practice setting.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Validity and reliability of a novel numeric rating scale to measure skin-pain in adults with atopic dermatitis.
Arch Dermatol Res 2021 Dec;313(10):855-61. doi: 10.1007/s00403-021-02185-3..
Keywords: Skin Conditions, Pain, Quality of Life
Garrett SB, Nicosia F, Thompson N
Barriers and facilitators to older adults' use of nonpharmacologic approaches for chronic pain: a person-focused model.
This study examined the factors that influence older adults’ living with chronic pain use of nonpharmacologic approaches as complements to or substitutes for pharmacologic treatments for pain. The authors conducted 25 semistructured qualitative interviews with adults with multiple morbidities living with chronic pain for 6 months or more. Transcripts were coded to identify factors that hindered or encouraged participants’ use of various nonpharmacologic approaches. Three factors were grouped together: awareness of nonpharmacologic approaches as relevant to their pain, appeal of the approach, and access to the approach.
AHRQ-funded; HS022241.
Citation: Garrett SB, Nicosia F, Thompson N .
Barriers and facilitators to older adults' use of nonpharmacologic approaches for chronic pain: a person-focused model.
Pain 2021 Nov;162(11):2769-79. doi: 10.1097/j.pain.0000000000002260..
Keywords: Elderly, Pain, Chronic Conditions
Goyal MK, Drendel AL, Chamberlain JM
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
The purpose of this study was to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have decreased over time. Findings showed that, as provision of opioid prescriptions declined over time, previously marked racial and/or ethnic disparities in opioid
prescription rates at ED discharge decreased.
prescription rates at ED discharge decreased.
AHRQ-funded; HS020270.
Citation: Goyal MK, Drendel AL, Chamberlain JM .
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
Pediatrics 2021 Nov;148(5):e2021052481. doi: 10.1542/peds.2021-052481..
Keywords: Children/Adolescents, Opioids, Emergency Department, Racial and Ethnic Minorities, Injuries and Wounds, Pain, Medication
McKernan LC, Crofford LJ, Kim A
Electronic delivery of pain education for chronic overlapping pain conditions: a prospective cohort study.
This study’s objective was to examine the impact of educational materials for chronic overlapping pain conditions (COPCs), the feasibility of delivery materials online, and to explore its impact on self-reported self-management applications at 3-month follow-up. This prospective cohort study used individuals from a university-wide active research repository with ≥1 coded diagnostic COPC by ICD-9/10 in the medical record. The authors assessed content awareness after the participants read educational materials pre- and post-exposure to education. A total of 216 individuals were enrolled, with 181 completing both timepoints. Knowledge and understanding of COPCs increased significantly after education and were retained at three months. There was no significant change to symptoms or self-management applications over the three-month period.
AHRQ-funded; HS022990.
Citation: McKernan LC, Crofford LJ, Kim A .
Electronic delivery of pain education for chronic overlapping pain conditions: a prospective cohort study.
Pain Med 2021 Oct 8;22(10):2252-62. doi: 10.1093/pm/pnab018..
Keywords: Education: Patient and Caregiver, Pain, Health Information Technology (HIT), Chronic Conditions
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Researchers examined whether a cognitive behavioral therapy (CBT)-based program intended to increase physical activity despite chronic pain in patients with diabetes delivered by community members trained as peer coaches also improved depressive symptoms and perceived stress. They found that this peer-delivered CBT-based program improved depressive symptoms and stress in individuals with diabetes and chronic pain. They recommended training community members as a feasible strategy for offering CBT-based interventions in rural and under-resourced communities.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Ann Behav Med 2021 Oct 4;55(10):970-80. doi: 10.1093/abm/kaab034..
Keywords: Depression, Behavioral Health, Diabetes, Chronic Conditions, Treatments, Pain, Lifestyle Changes
Keenan KE, Rothberg MB, Herzig SJ
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
This study’s objective was to identify the association between opioid exposure during a medical hospitalization and opioid use 6 to 12 months later. This observational cohort study used electronic health record data from 10 hospitals in the Cleveland Clinic Health System in 2016. Eligible patients were opioid-naïve adults with pain 18 years and older. The authors estimated the odds of long-term opioid use (defined as ≥2 prescriptions for at least 30 pills 6 to 12 months posthospitalization) by opioid exposure during the hospitalization. Among the 2971 patients in the study, 64% received opioids during their hospitalization, and 28% were discharged with opioids. A total of 3% of patients had long-term use with a higher pain score associated with greater odds of long-term use.
AHRQ-funded; HS026215.
Citation: Keenan KE, Rothberg MB, Herzig SJ .
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
South Med J 2021 Oct;114(10):623-29. doi: 10.14423/smj.0000000000001307..
Keywords: Opioids, Hospitalization, Pain, Substance Abuse, Medication
Enzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Bedford T, Adediran T, Haycock NR
Patient and provider acceptability of a patient preauthorized concealed opioid reduction.
Researchers investigated patient and provider acceptance of a concealed opioid reduction for chronic pain. They conducted a cross-sectional survey with patients who are taking or have taken high dose opioids via REDcap, and with providers via a validated questionnaire. They found that patients and providers have positive attitudes toward a concealed reduction of opioid dosages. They concluded that their findings support future randomized controlled trials that compare concealed and overt opioid tapering in patients with chronic pain.
AHRQ-funded; HS022135.
Citation: Bedford T, Adediran T, Haycock NR .
Patient and provider acceptability of a patient preauthorized concealed opioid reduction.
Pain Med 2021 Jul 25;22(7):1651-59. doi: 10.1093/pm/pnaa454..
Keywords: Opioids, Medication, Pain, Chronic Conditions
Pritchard KT, Baillargeon J, Raji Ma
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees.
The purpose of this study was to establish whether non-pharmacological interventions, such as occupational and physical therapy, were associated with a shorter duration of prescription opioid use after hip or knee arthroplasty. The investigators concluded that occupational and physical therapy with home health were associated with a shorter duration of prescription opioid use after hip and knee arthroplasty.
AHRQ-funded; HS026133.
Citation: Pritchard KT, Baillargeon J, Raji Ma .
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees.
Arch Phys Med Rehabil 2021 Jul;102(7):1257-66. doi: 10.1016/j.apmr.2021.01.086..
Keywords: Orthopedics, Surgery, Opioids, Pain, Practice Patterns
Bifulco L, Anderson DR, Blankson ML
Evaluation of a chronic pain screening program implemented in primary care.
The purpose of this study was to evaluate a 2-step process for chronic pain screening and follow-up in primary care. Participants included primary care practitioners and medical assistants from 13 sites who implemented the screening process in primary care, and over 38,000 patients aged 18 or older with a primary care visit during the study’s July 2018-June 2019 time period. Findings showed that a systematic, 2-step process for chronic pain screening and functional assessment in primary care appeared to identify patients with previously undocumented chronic pain and that this process was feasible to implement.
AHRQ-funded; HS025354.
Citation: Bifulco L, Anderson DR, Blankson ML .
Evaluation of a chronic pain screening program implemented in primary care.
JAMA Netw Open 2021 Jul;4(7):e2118495. doi: 10.1001/jamanetworkopen.2021.18495..
Keywords: Pain, Chronic Conditions, Primary Care, Screening
VanderPluym JH, Halker Singh RB, Urtecho M
Acute treatments for episodic migraine in adults: a systematic review and meta-analysis.
Migraine is common and can be associated with significant morbidity, and several treatment options exist for acute therapy. The objective of this study was to evaluate the benefits and harms associated with acute treatments for episodic migraine in adults. The investigators concluded that there are several acute treatments for migraine, with varying strength of supporting evidence. Use of triptans, nonsteroidal anti-inflammatory drugs, acetaminophen, dihydroergotamine, calcitonin gene-related peptide antagonists, lasmiditan, and some nonpharmacologic treatments were associated with improved pain and function.
AHRQ-funded; 290201500013I.
Citation: VanderPluym JH, Halker Singh RB, Urtecho M .
Acute treatments for episodic migraine in adults: a systematic review and meta-analysis.
JAMA 2021 Jun 15;325(23):2357-69. doi: 10.1001/jama.2021.7939..
Keywords: Neurological Disorders, Pain, Chronic Conditions, Treatments
Bernard DM, Encinosa W, Cohen J
AHRQ Author: Bernard DM Encinosa W Cohen J Fang Z
Patient factors that affect opioid use among adults with and without chronic pain.
Investigators sought to determine patient characteristics associated with opioid use among adults with and without chronic pain treatment. Using MEPS data, they found that health-related attitudes affect both adults with and without chronic pain treatment similarly. Adults with self-reliant health attitudes were less likely to start and more likely to discontinue opioid use. Exercise was associated with higher probability of choosing no analgesic treatments over using opioids and also with higher probability of discontinuing opioid use in the year following opioid initiation for those electing to use them.
AHRQ-authored.
Citation: Bernard DM, Encinosa W, Cohen J .
Patient factors that affect opioid use among adults with and without chronic pain.
Res Social Adm Pharm 2021 Jun;17(6):1059-65. doi: 10.1016/j.sapharm.2020.07.036..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions
Overstreet DS, Michl AN, Penn TM
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
The objective of this study was to determine whether quantitative sensory tests of endogenous pain inhibition and facilitation prospectively predict movement-evoked pain and chronic low back pain severity self-reported on a validated questionnaire. Through surveys using the Brief Pain Inventory-Short Form, findings suggested that a pro-nociceptive pain modulatory balance characterized by enhanced pain facilitation may be an important driver of movement-evoked pain severity and poor physical function in individuals with chronic low back pain.
AHRQ-funded; HS013852.
Citation: Overstreet DS, Michl AN, Penn TM .
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
BMC Musculoskelet Disord 2021 May 10;22(1):429. doi: 10.1186/s12891-021-04306-5..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Diagnostic Safety and Quality
Griesemer I, Hausmann LR, Arbeeva L
Discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training randomized controlled trial.
This study evaluated the interaction between discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training (PCST) randomized controlled trial. The authors evaluated the interactions for 164 participants in linear regression models predicting depressive symptoms. There was a significant interaction between personal discrimination and experimental condition on depressive symptoms. Discrimination was associated with depressive symptoms among the control group but not among those who received PCST.
AHRQ-funded; HS000032.
Citation: Griesemer I, Hausmann LR, Arbeeva L .
Discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training randomized controlled trial.
J Health Care Poor Underserved 2021;32(1):145-55. doi: 10.1353/hpu.2021.0014..
Keywords: Racial and Ethnic Minorities, Pain, Arthritis, Orthopedics, Patient Experience, Depression
Kim HS, Ciolino JD, Lancki N
A prospective observational study of emergency department-initiated physical therapy for acute low back pain.
The purpose of this study was to compare patient-reported outcomes in patients receiving emergency department-initiated physical therapy and patients receiving usual care for acute low back pain. Findings showed that emergency department-initiated physical therapy for low back pain was associated with greater improvement in functioning and lower use of high-risk medications over 3 months.
AHRQ-funded; HS023011.
Citation: Kim HS, Ciolino JD, Lancki N .
A prospective observational study of emergency department-initiated physical therapy for acute low back pain.
Phys Ther 2021 Mar 3;101(3). doi: 10.1093/ptj/pzaa219..
Keywords: Emergency Department, Back Health and Pain, Pain, Chronic Conditions
Agarwal AK, Lee D, Ali Z
Patient-reported opioid consumption and pain intensity after common orthopedic and urologic surgical procedures with use of an automated text messaging system.
This prospective study looked at the number of opioid tablets taken compared to the number prescribed after orthopedic and urologic surgery at a large urban academic health center in Pennsylvania from May to December 2019 with the use of an automated text messaging system. Of the 919 study participants, 80.7% (742) underwent orthopedic procedures and 19.2% underwent urologic procedures. Among those who underwent orthopedic procedures, 384 were women, 491 were White, and the median age was 48 years; with almost 70% outpatient procedures. Among those who underwent urologic procedures, 84.8% were men, 80.7% were White, and the median age was 56 years; 62% had an outpatient procedure. Orthopedic patients were prescribed an average of 20 tablets and urologic patients 7 tablets. The majority of patients (64.1%) used less than half of the amount prescribed, and 256 orthopedic and 77 urologic patients did not use any opioids. The findings suggest that clinicians can tailor prescriptions to limit excess quantities of prescribed opioids.
AHRQ-funded; HS026372.
Citation: Agarwal AK, Lee D, Ali Z .
Patient-reported opioid consumption and pain intensity after common orthopedic and urologic surgical procedures with use of an automated text messaging system.
JAMA Netw Open 2021 Mar;4(3):e213243. doi: 10.1001/jamanetworkopen.2021.3243..
Keywords: Opioids, Medication, Pain, Orthopedics, Surgery
Wyse JJ, Lovejoy J, Holloway J
Patients' perceptions of the pathways linking chronic pain with problematic substance use.
This study examined how patients with chronic pain perceive their relationship between their substance use disorder (SUD) and chronic pain. About one-half of patients with SUDs experience chronic pain. The authors conducted qualitative interviews with 34 patients involved in SUD treatment who were also diagnosed with chronic pain. The interviews revealed 3 primary pathways. One group described SUD as development independently from their experiences of chronic pain. A second group described turning to substances to self-manage or cope with the chronic pain. A third group described encounters with opioid medications as the causal agent.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Lovejoy J, Holloway J .
Patients' perceptions of the pathways linking chronic pain with problematic substance use.
Pain 2021 Mar;162(3):787-93. doi: 10.1097/j.pain.0000000000002077..
Keywords: Opioids, Substance Abuse, Medication, Pain, Chronic Conditions
Fenton JJ, Jerant A, Franks P
Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial.
This paper describes the protocol that will be used for an upcoming randomized control trial to determine the effectiveness of teaching clinicians how to advise watchful waiting when patients request low-value spinal imaging for acute low back pain. The authors will recruit 8-10 primary care and urgent care clinics in Sacramento, California. The study will last 3-6 months and during this time clinicians in the intervention group with receive 3 visits with standardized patient instructors (SPIs) portraying patients with acute back pain. The SPIs will instruct clinicians in a 3-step model emphasizing trust, empathic communication, and negotiation of a watchful waiting approach. The primary outcome looked for will a decreased post-intervention rate of spinal imaging among actual patients with acute back pain compared to the rate of imaging during the baseline period. Secondary outcomes will include use of targeted communication techniques during a follow-up visit with an SP.
AHRQ-funded; HS026415.
Citation: Fenton JJ, Jerant A, Franks P .
Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial.
Trials 2021 Feb 27;22(1):167. doi: 10.1186/s13063-021-05106-x..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Imaging, Diagnostic Safety and Quality, Clinician-Patient Communication, Communication
McCarthy DM, Kim HS, Hur SI
Patient-reported opioid pill consumption after an ed visit: how many pills are people using?
This study examined opioid use patterns after an emergency department (ED) visit. The study was conducted at an urban academic emergency department and included patients 18 years or older, not chemically using opioids, and had been newly prescribed hydrocodone-acetaminophen. They were asked to complete and return a 10-day medication diary. Two-hundred sixty patients returned completed medication diaries that included treatment for different conditions. The mean age was 45 years and 59% of the sample was female. The median number of pills prescribed was 12. Patients with renal colic used the least number of pills and patients with back pain used the most. Almost all (92.5%) of patients had leftover pills by the end of the 10 days.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Kim HS, Hur SI .
Patient-reported opioid pill consumption after an ed visit: how many pills are people using?
Pain Med 2021 Feb 23;22(2):292-302. doi: 10.1093/pm/pnaa048..
Keywords: Opioids, Medication, Emergency Department, Practice Patterns, Pain
Hood-Medland EA, White AEC, Kravitz RL
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
This study looked at primary care visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience with patients taking opioids for chronic pain. The study analyzed 83 video-recorded US primary care visits at a single academic medical center in California. A total of 49 family medicine and internal resident physicians and 83 patients were filmed. The authors developed a coding scheme that assessed the presence of agenda setting, distinct visit opening styles, and the number of total topics, major topics, surprise patient topics, and returns to prior topics discusses. They identified 2 visit opening styles with agenda setting (agenda eliciting, agenda reframing) and 3 non-agenda opening styles (open-ended question, patient launch, physician launch). Only 11% of visits included agenda setting and was associated with fewer surprise patient topics than visits without agenda setting.
AHRQ-funded; HS022236.
Citation: Hood-Medland EA, White AEC, Kravitz RL .
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
BMC Fam Pract 2021 Jan 4;22(1):4. doi: 10.1186/s12875-020-01317-4..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Clinician-Patient Communication, Communication, Ambulatory Care and Surgery
Wyse J, Simmons A, Ramachandran B
"I don't mind doing what it takes to be safe." Patient perspectives of urine drug testing for pain.
This study sought to uncover patients’ beliefs regarding UDT and its implications for the patient–clinician relationship. Urine drug testing (UDT) is a standard recommendation for those prescribed long-term opioid therapy (LTOT) for pain but remains underutilized. Clinician fears regarding negative patient perceptions have been identified as a barrier to conducting UDT; however, little is known about patient perspectives of UDT.
AHRQ-funded; HS026370.
Citation: Wyse J, Simmons A, Ramachandran B .
"I don't mind doing what it takes to be safe." Patient perspectives of urine drug testing for pain.
J Gen Intern Med 2021 Jan;36(1):243-44. doi: 10.1007/s11606-020-05688-3..
Keywords: Pain, Chronic Conditions, Opioids, Medication, Medication: Safety, Patient Safety, Substance Abuse