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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 6 of 6 Research Studies DisplayedEnzinger 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
Marchetti KA, Oerline M, Hollenbeck BK
Urology workforce changes and implications for prostate cancer care among Medicare enrollees.
The purpose of this study was to characterize national trends in urologist workforce, practice organization, and management of incident prostate cancer. The investigators characterized shifts in urologist membership from smaller, independent groups to larger, multispecialty or hospital-owned practices. They indicated that this trend coincided with higher utilization of observation and surgical treatment for prostate cancer.
AHRQ-funded; HS025707.
Citation: Marchetti KA, Oerline M, Hollenbeck BK .
Urology workforce changes and implications for prostate cancer care among Medicare enrollees.
Urology 2021 Sep;155:77-82. doi: 10.1016/j.urology.2020.12.051..
Keywords: Cancer: Prostate Cancer, Cancer, Workforce, Practice Patterns
Rosko AJ, Gay BL, Reyes-Gastelum D
Surgeons' attitudes on total thyroidectomy vs lobectomy for management of papillary thyroid microcarcinoma.
The incidence of papillary thyroid cancer has increased in the past 25 years without a clear increase in thyroid cancer deaths. Given these findings, there has been a shift toward recommending conservative surgical options, with current management guidelines favoring lobectomy, especially for patients with papillary thyroid microcarcinoma. The aim of this study was to identify surgeons’ attitudes regarding surgical management of microcarcinomas with the hypothesis that surgeons consider other factors, in addition to tumor size, when selecting a surgical procedure.
AHRQ-funded; HS024512.
Citation: Rosko AJ, Gay BL, Reyes-Gastelum D .
Surgeons' attitudes on total thyroidectomy vs lobectomy for management of papillary thyroid microcarcinoma.
JAMA Otolaryngol Head Neck Surg 2021 Jul;147(7):667-69. doi: 10.1001/jamaoto.2021.0525..
Keywords: Cancer, Surgery, Practice Patterns, Provider: Physician
Wallner LP, Banerjee M, Reyes-Gastelum D
Multilevel factors associated with more intensive use of radioactive iodine for low-risk thyroid cancer.
The use of radioactive iodine (RAI) for low-risk thyroid cancer is common, and variation in its use exists, despite the lack of benefit for low-risk disease and potential harms and costs. The objective of this study was to simultaneously assess patient- and physician-level factors associated with patient-reported receipt of RAI for low-risk thyroid cancer. The investigators concluded that physician perspectives and attitudes about using RAI, as well as patient volume, influenced RAI use for low-risk thyroid cancer.
AHRQ-funded; HS024512.
Citation: Wallner LP, Banerjee M, Reyes-Gastelum D .
Multilevel factors associated with more intensive use of radioactive iodine for low-risk thyroid cancer.
J Clin Endocrinol Metab 2021 May 13;106(6):e2402-e12. doi: 10.1210/clinem/dgab139..
Keywords: Cancer, Practice Patterns, Decision Making, Risk
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
Eyrich NW, Sloss KR, Howard RA
Opioid prescribing exceeds consumption following common surgical oncology procedures.
Researchers aimed to compare opioid prescribing to opioid consumption for common surgical oncology procedures. They found that the median quantity of opioid prescribed was significantly larger than consumed following breast biopsy, lumpectomy, and mastectomy or wide local excision. The majority of patients reported receiving education on taking opioids, but only 27% received instructions on proper disposal; 82% of prescriptions filled resulted in unused opioids, and only 11% of these patients safely disposed of them. They concluded that their study demonstrated that opioid prescribing exceeds consumption following common surgical oncology procedures, thus indicating the potential for reductions in prescribing.
AHRQ-funded; HS023313.
Citation: Eyrich NW, Sloss KR, Howard RA .
Opioid prescribing exceeds consumption following common surgical oncology procedures.
J Surg Oncol 2021 Jan;123(1):352-56. doi: 10.1002/jso.26272..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Practice Patterns, Pain