National Healthcare Quality and Disparities Report
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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
126 to 150 of 1666 Research Studies DisplayedGartlehner G, Patel SV, Reddy S
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
This US Preventive Services Task Force (USPSTF) recommendation is an updated evidence report and systematic review on the use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions. The reviewers included 20 trials (N = 39,145) and 3 cohort studies (N = 1,155,410) from a dual review of abstracts, full-text articles, and study quality. Harms and benefits were compared for participants using estrogen only compared with estrogen plus progestin. Participants using estrogen only compared with placebo had significantly lower risks for diabetes and fractures, but increased for gallbladder disease over 7.1 years, stroke over 7.2 years, venous thromboembolism over 7.2 years and urinary incontinence over 1 year. For participants using estrogen plus progestin some benefits were found, but there was also an increased risk of harms significantly for invasive breast cancer, gallbladder disease, venous thromboembolism, probable dementia, and urinary incontinence.
AHRQ-funded; 75Q80120D00007.
Citation: Gartlehner G, Patel SV, Reddy S .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 1;328(17):1747-65. doi: 10.1001/jama.2022.18324..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Evidence-Based Practice, Guidelines, Chronic Conditions, Women
Chovatiya R, Silverberg JI
Iatrogenic burden of atopic dermatitis.
The purpose of this study was to characterize the iatrogenic burden of atopic dermatitis (AD) and conduct a qualitative review of key areas that clinicians can address to minimize that burden. The researchers concluded that the multidimensional nature of AD requires a dynamic approach, and researcher recommendations included: encouraging providers to think strategically about the avoidance of itch triggers, slowly incorporating lifestyle changes, and highlighting step-up therapy when trigger avoidance becomes too burdensome for the patient. Out-of-pocket treatment costs should be incorporated into shared decision, polypharmacy should be minimized, and providers should incorporate evidence-based guidelines into their practices.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Silverberg JI .
Iatrogenic burden of atopic dermatitis.
Dermatitis 2022 Nov-Dec;33(6s):S17-s23. doi: 10.1097/der.0000000000000799..
Keywords: Skin Conditions, Quality of Life
Benson NM, Yang Z, Weiss M
Identifying diagnoses of schizophrenia spectrum disorder in large data sets.
The objective of this study was to determine which index diagnoses of schizophrenia spectrum disorder were new diagnoses. Researchers used to the Massachusetts All-Payer Claims Database to identify patients with a schizophrenia spectrum disorder diagnosis in 2016, then reviewed patient care histories to identify previous diagnoses. Their findings show that, of the 7,217 patients aged 15–35 with a diagnosis of schizophrenia spectrum disorder, more than 67 percent had at least 48 months of historical diagnosis data. They conclude that the examination of multiple years of patient history is critical to the identification of new schizophrenia spectrum disorder diagnoses.
AHRQ-funded; HS024725.
Citation: Benson NM, Yang Z, Weiss M .
Identifying diagnoses of schizophrenia spectrum disorder in large data sets.
Psychiatr Serv 2022 Nov;73(11):1210-16. doi: 10.1176/appi.ps.202100696..
Keywords: Behavioral Health
Chovatiya R, Begolka WS, Thibau IJ, R, Begolka WS, Thibau IJ
Impact and associations of atopic dermatitis out-of-pocket health care expenses in the United States.
The purpose of this study was to describe the impact and associations of out of pocket (OOP) health care expenses for atopic dermatitis (AD). The researchers administered a 25-question online survey to 113,502 National Eczema Association members aged 18 years or older. The study found that respondents with monthly OOP expenses over $200 were more likely to have increased AD severity, flares, health care provider visits, prescription polypharmacy, use of step-up therapy, frequent skin infections, and poorer disease control. Respondents with OOP yearly expenditures greater than $1000 had similar associations and additionally increased rates of comorbid asthma, allergic rhinitis, and anxiety/depression. A total of 64.6% of participants reported a harmful household financial impact of OOP expenses. Predictors of harmful impact included severe AD, comorbid asthma, 5 health care provider visits or more in a year, greater than $200 OOP monthly expenditures, and $1000 annual OOP expenditures or more. The study concluded that OOP expenses for AD are associated with increased disease severity and health care utilization and significantly impact household finances.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Begolka WS, Thibau IJ, R, Begolka WS, Thibau IJ .
Impact and associations of atopic dermatitis out-of-pocket health care expenses in the United States.
Dermatitis 2022 Nov-Dec;33(6s):S43-S51. doi: 10.1097/der.0000000000000795..
Keywords: Skin Conditions, Healthcare Costs
Maganty A, Hollenbeck BK, Kaufman SR
Implications of the merit-based incentive payment system for urology practices.
The purpose of this cross-sectional study was to analyze urologist performance in the Medicare merit-based incentive payment system (MIPS) for urology practices for 2017 and 2019 using Medicare data. MIPS scores were estimated by practice organization. The study found that urologists from small practices performed worse in MIPS and had a significantly lower adjusted odds ratio of receiving bonus payments in both 2017 and 2019 compared to larger group practices. Urologists who received penalties in 2017 had greater rates of consolidation by 2019 compared to those who were not penalized. The researchers concluded that smaller urology practices and urology practices caring for a greater percentage of dual eligible beneficiaries typically performed worse in the Medicare merit-based incentive payment system.
AHRQ-funded; HS025707.
Citation: Maganty A, Hollenbeck BK, Kaufman SR .
Implications of the merit-based incentive payment system for urology practices.
Urology 2022 Nov;169:84-91. doi: 10.1016/j.urology.2022.05.052..
Keywords: Payment, Provider Performance, Provider: Physician
Likosky DS, Yang G, Zhang M
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
The purpose of this study was to examine differences in durable ventricular assist device implantation infection rates and associated costs across hospitals. The researchers utilized clinical data for 8,688 patients who received primary durable ventricular assist devices from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) and merged that data with post-implantation 90-day Medicare claims. The primary outcome included infections within 90 days of implantation and Medicare payments. The study found that 27.8% of patients developed 3982 identified infections. The median adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 and differed according to hospital. Total Medicare payments from implantation to 90 days were 9.0% more in high versus low infection tercile hospitals. The researchers concluded that health-care-associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures.
AHRQ-funded; HS026003.
Citation: Likosky DS, Yang G, Zhang M .
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2022 Nov;164(5):1561-68. doi: 10.1016/j.jtcvs.2021.04.074..
Keywords: Healthcare-Associated Infections (HAIs), Medical Devices, Medicare, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Payment, Healthcare Costs
Howard R, Gunaseelan V, Brummett C
New persistent opioid use after inguinal hernia repair.
The purpose of this retrospective cross-sectional study was to characterize the risk factors and incidence of new persistent use of opioids after inguinal hernia repair. During the study period of 208-2016, 59,795 patients met the inclusion criteria. The study found that 1.5% of patients continued filling their opioids prescriptions at least 3 months after their surgery. The greatest risk factor for developing new persistent opioid use after surgery was filling an opioid prescription in the 30 days before surgery. Other risk factors for new persistent opioid use after surgery included having a major postoperative complication, receiving a larger opioid prescription, having more comorbidities, and having certain mental health disorders or pain disorders.
AHRQ-funded; HS025778.
Citation: Howard R, Gunaseelan V, Brummett C .
New persistent opioid use after inguinal hernia repair.
Ann Surg 2022 Nov 1;276(5):e577-e83. doi: 10.1097/sla.0000000000004560..
Keywords: Opioids, Surgery, Medication, Pain
Solomon Y, Rastogi V, Marcaccio CL
Outcomes after transcarotid artery revascularization stratified by preprocedural symptom status.
In this study, researchers examined contemporary perioperative outcomes in patients who underwent transcarotid artery revascularization (TCAR) stratified by specific preprocedural symptom status. Using data from the Vascular Quality Initiative, they found that, after TCAR, compared with asymptomatic status, a recent stroke and a recent hemispheric TIA were associated with higher stroke/death rates, whereas a recent ocular TIA was associated with similar stroke/death rates. In addition, a formerly symptomatic status was associated with higher stroke/death rates compared with an asymptomatic status. The researchers concluded that their findings suggested that classifying patients undergoing TCAR as symptomatic versus asymptomatic may be an oversimplification and that patients' specific preoperative neurologic symptoms should instead be used in risk assessment and outcome reporting for TCAR.
AHRQ-funded; HS027285.
Citation: Solomon Y, Rastogi V, Marcaccio CL .
Outcomes after transcarotid artery revascularization stratified by preprocedural symptom status.
J Vasc Surg 2022 Nov;76(5):1307-15.e1. doi: 10.1016/j.jvs.2022.05.024..
Keywords: Cardiovascular Conditions, Surgery, Stroke, Outcomes
Valentine KD, Lipstein EA, Vo H
Pediatric caregiver version of the Shared Decision Making Process Scale: validity and reliability for ADHD treatment decisions.
This study’s goal was to examine the validity and reliability of a scale for a shared decision making (SDM) Process scale in attention-deficit/hyperactivity disorder (ADHD) treatment decisions. This cross-sectional survey included 498 caregivers of children aged 5-13 diagnosed with ADHD who had made a decision about ADHD medication in the last 2 years. Surveys included the adapted SDM Process scale, decisional conflict, decision regret, and decision involvement. The scale was found to be acceptable and reliable. Scores demonstrated convergent validity, as they were higher for those without decisional conflict than those with decisional conflict and higher for caregivers who stated they made the decision with the provider than those who made the decision themselves. Higher scores were related to less regret, though the magnitude of the relationship was small.
AHRQ-funded; HS025718.
Citation: Valentine KD, Lipstein EA, Vo H .
Pediatric caregiver version of the Shared Decision Making Process Scale: validity and reliability for ADHD treatment decisions.
Acad Pediatr 2022 Nov-Dec;22(8):1503-09. doi: 10.1016/j.acap.2022.07.014..
Keywords: Children/Adolescents, Behavioral Health, Decision Making, Patient-Centered Healthcare
Ostrovsky D, Novack V, Smulowitz PB
Perspectives of emergency clinicians about medical errors resulting in patient harm or malpractice litigation.
This cross-sectional study examined survey responses about medical error outcomes completed by emergency department attending physicians and advanced practice clinicians regarding what might be considered excessive testing. The authors surveyed 1222 clinicians and the mean score was greater for fear of harm to patients than fear of a malpractice suit. This finding was true regardless of clinician subtype, experience, or sex.
AHRQ-funded; HS026730.
Citation: Ostrovsky D, Novack V, Smulowitz PB .
Perspectives of emergency clinicians about medical errors resulting in patient harm or malpractice litigation.
JAMA Netw Open 2022 Nov;5(11):e2241461. doi: 10.1001/jamanetworkopen.2022.41461..
Keywords: Emergency Department, Medical Errors, Adverse Events, Patient Safety
Sneed NM, Azuero A, Morrison SA
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
This study examined whether prediabetes awareness is associated with lower consumption of self-reported added sugar in US adults 20 years and older. Cross-sectional data for 3314 adults with prediabetes were analyzed from 2013-2018 National Health and Nutrition Examination Survey data. Among 3314 adults, 528 reported being aware and 2786 were unaware of their condition. Prediabetes awareness was not significantly associated with added sugar consumption with no differences for age, sex, or race/Hispanic origin.
AHRQ-funded; HS026122.
Citation: Sneed NM, Azuero A, Morrison SA .
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
Ann Epidemiol 2022 Nov;75:21-24. doi: 10.1016/j.annepidem.2022.08.039..
Keywords: Diabetes, Chronic Conditions, Education: Patient and Caregiver, Nutrition, Health Promotion
Holtrop JS, Davis MM
Primary care research is hard to do during COVID-19: challenges and solutions.
This study examined challenges in conducting primary care research during the COVID-19 pandemic. The authors used their experience on over 15 individual projects during the pandemic. They identified 3 key challenges to conducting primary care research: (1) practice delivery trickle-down effects, (2) limited/changing resources and procedures for research, and (3) a generally tense milieu in US society during the pandemic. They presented strategies, informed by a set of questions, to help researchers decide how to address these challenges observed during our studies. They encouraged normalization and self-compassion; and encouraged researchers and funders to embrace pragmatic and adaptive research designs as the circumstances with COVID-19 evolve over time.
AHRQ-funded; HS027080.
Citation: Holtrop JS, Davis MM .
Primary care research is hard to do during COVID-19: challenges and solutions.
Ann Fam Med 2022 Nov-Dec; 20(6):568-72. doi: 10.1370/afm.2889..
Keywords: COVID-19, Primary Care, Health Services Research (HSR), Research Methodologies
Anjorin AC, Marcaccio CL, Patel PB
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
This study’s objective was to determine the differences in 3-year outcomes after open infrainguinal bypass for chronic limb-threatening ischemia (CLTI) stratified by race/ethnicity and explored the potential factors contributing to these differences to help determine reasons why outcomes are worse for racial and ethnic minorities. The authors identified all CLTI patients who had undergone primary open infrainguinal bypass in the Vascular Quality Initiative registry from 2003 to 2017 with linkage to Medicare claims through 2018 for the 3-year outcomes. Primary outcomes were the 3-year rates of major amputation, reintervention, and mortality. They also recorded 30-day major adverse limb events (MALE) defined as major amputation or reintervention. Of the 7108 patients with CLTI 79% were non-Hispanic White, 15% were Black, 1% were Asian, and 6% were Hispanic. Compared with White patients, Black patients had higher rates of 3-year major amputation (Black vs White, 32% vs 19%), reintervention (Black vs White, 61% vs 57%), and 30-day MALE (Black vs White, 8.1% vs 4.9%) but lower mortality (Black vs White, 38% vs 42%). Hispanic patients also experienced higher rates of amputation (Hispanic vs White, 27% vs 19%), reintervention (Hispanic vs White, 70% vs 57%), and MALE (Hispanic vs White, 8.7% vs 4.9%). However, mortality was similar between Hispanic vs White groups. A higher presence of comorbidities in Black and Hispanic patients with CLTI is considered the greatest contributing factors to higher amputation and reintervention rates.
AHRQ-funded; HS027285.
Citation: Anjorin AC, Marcaccio CL, Patel PB .
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
J Vasc Surg 2022 Nov;76(5):1335-46.e7. doi: 10.1016/j.jvs.2022.06.026..
Keywords: Racial and Ethnic Minorities, Disparities, Outcomes, Surgery, Cardiovascular Conditions
Wu W, Bhatraju PK, Cobb N
Radiographic findings and association with clinical severity and outcomes in critically ill patients with COVID-19.
Investigators sought to describe evolution and severity of radiographic findings and to assess association with disease severity and outcomes in critically ill COVID-19 patients. They found that evolution of radiographic features indicates rapid disease progression and correlates with requirement for invasive MV or vasopressors but not mortality, which suggests potential non-pulmonary pathways to death in COVID-19.
AHRQ-funded; HS026369.
Citation: Wu W, Bhatraju PK, Cobb N .
Radiographic findings and association with clinical severity and outcomes in critically ill patients with COVID-19.
Curr Probl Diagn Radiol 2022 Nov-Dec;51(6):884-91. doi: 10.1067/j.cpradiol.2022.04.002..
Keywords: COVID-19, Critical Care, Outcomes
Tourani R, Ma S, Usher M
Robust methods for quantifying the effect of a continuous exposure from observational data.
The purpose of this study was to introduce new clinical medicine methods for estimating the effect of intervening on a continuous exposure that are more expansive and robust towards violations of the existing sets of strict assumptions. The researchers based their methods on the critical observation that changes of exposure in the clinical setting are typically achieved gradually, so effect estimates must be "locally" robust in narrower exposure ranges. The study compared the researcher’s methods with a number of existing methods on three simulated studies with escalating complexity. The researchers also applied the methods to data from 14,000 sepsis patients to estimate the effect of antibiotic administration latency on prolonged hospital stay. The researchers concluded that the proposed methods resulted in good performance in all simulation studies.
AHRQ-funded; HS024532.
Citation: Tourani R, Ma S, Usher M .
Robust methods for quantifying the effect of a continuous exposure from observational data.
IEEE J Biomed Health Inform 2022 Nov;26(11):5728-37. doi: 10.1109/jbhi.2022.3201752..
Keywords: Research Methodologies
Interrante JD, Tuttle MS, Admon LK
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Using maternal discharge records from childbirth hospitalizations in the HCUP National Inpatient Sample, 2007-15, researchers examined differences in rates of severe maternal morbidity and mortality by rural or urban geography, race and ethnicity, and clinical factors among Medicaid-funded births and privately insured hospital births. The highest rate of severe maternal morbidity and mortality occurred among rural Indigenous Medicaid-funded births; births among Black rural and urban residents and among Hispanic urban residents also experienced elevated rates. The researchers concluded that heightened rates of severe maternal morbidity and mortality among Medicaid-funded births indicate an opportunity for state and federal policy responses to address the maternal health challenges faced by Medicaid beneficiaries, including Black, Indigenous, and rural residents
AHRQ-funded; HS027640.
Citation: Interrante JD, Tuttle MS, Admon LK .
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Womens Health Issues 2022 Nov-Dec;32(6):540-49. doi: 10.1016/j.whi.2022.05.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Women, Pregnancy, Mortality, Risk, Racial and Ethnic Minorities, Medicaid
Ng MY, Kapur S, Blizinsky KD
The AI life cycle: a holistic approach to creating ethical AI for health decisions.
This article provides an overview of the reimagined artificial intelligence (AI) lifecycle to create ethical AI for health decisions. The lifecycle is data creation, data acquisition, model development, model evaluation, and model deployment. AI biases in each phase are described and recommendations are made to address each one.
AHRQ-funded; HS027434.
Citation: Ng MY, Kapur S, Blizinsky KD .
The AI life cycle: a holistic approach to creating ethical AI for health decisions.
Nat Med 2022 Nov;28(11):2247-49. doi: 10.1038/s41591-022-01993-y..
Keywords: Health Information Technology (HIT), Decision Making
Eliason Gordon, Gordon SH
The association between postpartum insurance instability and access to postpartum mental health services: evidence from Colorado.
This study assessed the association between postpartum insurance instability and access to postpartum mental health services. The authors used data from the 2018-2019 Colorado Health eMoms survey, which sampled mothers from the 2018 birth certificate files at 3-6 months and 12-14 months postpartum. Respondents were classified at each time point as stably insured or unstable insured based on postpartum insurance status. Of respondents with public coverage at childbirth, 33.2% experienced postpartum insurance changes compared with 9.5% with private coverage. Respondents were more likely to experience unstable postpartum insurance if they were younger, had incomes of less than $50,000, and were of Hispanic ethnicity. Respondents who experienced postpartum insurance instability had lower odds of reporting that they discussed mental health at a postpartum check-up and received postpartum mental health services.
AHRQ-funded; HS000011.
Citation: Eliason Gordon, Gordon SH .
The association between postpartum insurance instability and access to postpartum mental health services: evidence from Colorado.
Womens Health Issues 2022 Nov-Dec;32(6):550-56. doi: 10.1016/j.whi.2022.06.010..
Keywords: Maternal Care, Access to Care, Women, Behavioral Health, Health Insurance
O'Connell J, Grau L, Goins T
The costs of treating all-cause dementia among American Indians and Alaska native adults who access services through the Indian Health Service and Tribal health programs.
This study analyzed the costs of treatment for all-cause dementia among American Indians and Alaska native (AI/AN) adults who access services through the Indian Health Service (IHS) and Tribal health programs. The authors analyzed fiscal year 2013 IHS/Tribal treatment costs for AI/ANs aged 65 and over with dementia and a matched sample without dementia (n= 1842). Mean total treatment costs for adults with dementia were $5400 higher than for adults without dementia ($13,027 versus $7627). The difference in adjusted total treatment costs was $2943, the majority of which was due to the difference in hospital inpatient costs.
AHRQ-funded; 290200600020I.
Citation: O'Connell J, Grau L, Goins T .
The costs of treating all-cause dementia among American Indians and Alaska native adults who access services through the Indian Health Service and Tribal health programs.
Alzheimers Dement 2022 Nov;18(11):2055-66. doi: 10.1002/alz.12603..
Keywords: Dementia, Racial and Ethnic Minorities, Healthcare Costs, Disparities
Russell LB, Huang Q, Lin Y
The electronic health record as the primary data source in a pragmatic trial: a case study.
Electronic health records are a series of overlapping and legacy systems that require time and expertise to use efficiently. Commonly measured patient characteristics are relatively easy to locate for most trial enrollees but less common characteristics are not. Acquiring essential supplementary data - in this trial, state data on hospital admission - can be a lengthy and difficult process.
AHRQ-funded; HS026372.
Citation: Russell LB, Huang Q, Lin Y .
The electronic health record as the primary data source in a pragmatic trial: a case study.
Med Decis Making 2022 Nov;42(8):975-84. doi: 10.1177/0272989x211069980..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies
Williams PH, Gilmartin HM, Leonard C
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
This study’s objective was to examine changes from pre- to post-hospitalization in total, inpatient, and outpatient 30-day healthcare utilization costs for Veterans Affairs Healthcare System Rural Transitions Nurse Program (TNP) enrollees compared to controls. Although findings showed no difference in change in total costs between veterans enrolled in TNP and controls, TNP was associated with a smaller increase in direct inpatient medical costs and a larger increase in direct outpatient medical costs, suggesting a shifting of costs from the inpatient to outpatient setting.
AHRQ-funded; HS024569.
Citation: Williams PH, Gilmartin HM, Leonard C .
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
J Gen Intern Med 2022 Nov;37(14):3529-34. doi: 10.1007/s11606-022-07401-y..
Keywords: Rural Health, Nursing, Transitions of Care, Healthcare Utilization, Healthcare Costs
Mackie TI, Schaefer AJ, Palatucci JS
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
The purpose of this sequential multi-method study was to propose a classification for the procedural elements of informed consent policies based upon existing child welfare policies and then explored whether formal state policies across the United States authorized these elements. The researchers conducted interviews with 58 key informants primarily from state child welfare agencies to identify a classification of procedural elements for informed consent of psychotropic medications. A legislative review of the 50 states and D.C. was then conducted to characterize whether formal policies endorsed each procedural element. Key informants reported five procedural elements in policy, and 23 states endorsed relevant legislation. Only two states specified all five procedural elements, and the content of any procedural elements varied considerably across policies.
AHRQ-funded; HS02198501; HS026001
Citation: Mackie TI, Schaefer AJ, Palatucci JS .
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
Adm Policy Ment Health 2022 Nov;49(6):986-1003. doi: 10.1007/s10488-022-01212-3..
Keywords: Children/Adolescents, Vulnerable Populations, Medication, Behavioral Health, Policy
Pritchard KT, Baillargeon J, Lee WC
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
This serial cross-sectional analysis on trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain used MEPS to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain from 2011 to 2019. A total of unweighted 46,420 respondents, 9643 (20.4% weighted) received surgery and 36,777 (79.6% weighted) did not. The prevalence of nonpharmacologic treatments increased in 2019 for both chronic and surgical pain cohorts, especially with exclusive use compared with 2011. Chiropractors and physical therapists were the most common licensed healthcare professionals used among the cohort who used nonpharmacologic treatment.
AHRQ-funded; T32HS026133.
Citation: Pritchard KT, Baillargeon J, Lee WC .
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
JAMA Netw Open 2022 Nov;5(11):e2240612. doi: 10.1001/jamanetworkopen.2022.40612..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions, Treatments
Rogal SS, Chinman MJ, DeMonte W
Using intervention mapping to develop a novel pain self-management intervention for people with cirrhosis.
The purpose of this study was to design a pain self-management (PSM) intervention for patients with cirrhosis. The LEAP (Liver Education About Pain) intervention is a 12-week, modular intervention delivered by phone via individual and group sessions with a health coach. Participants described barriers to PSM behaviors, including the absence of simple, evidence-based interventions for pain for patients with cirrhosis, inadequate provider knowledge, time, and training, with lack of champions, funding, and communication. Patients described high motivation to treat pain using behavioral methods including meditation, prayer, and exercise. The intervention was designed to address barriers to PSM behaviors for patients with cirrhosis, using behavior change methods that address knowledge, self-efficacy, and outcome expectations.
AHRQ-funded; HS019461.
Citation: Rogal SS, Chinman MJ, DeMonte W .
Using intervention mapping to develop a novel pain self-management intervention for people with cirrhosis.
Dig Dis Sci 2022 Nov;67(11):5063-78. doi: 10.1007/s10620-022-07380-4..
Keywords: Pain, Chronic Conditions, Patient Self-Management
Tracer H, Justus M
AHRQ Author: Tracer H
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. A case study was presented using a 53-year-old-patient with no significant history presenting for a wellness visit. The patient’s 10-year cardiovascular risk and BMI are described. Three multiple-choice questions are presented regarding harms and benefits, and recommendations not to use supplementation to prevent cardiovascular disease and cancer.
AHRQ-authored.
Citation: Tracer H, Justus M .
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
Am Fam Physician 2022 Nov;106(5):565-66..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer, Prevention, Evidence-Based Practice, Guidelines