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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 8 of 8 Research Studies Displayed
Vaughan Sarrazin MS, Jones M, Mazur A
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
This study evaluated the relative risks of any, gastrointestinal, intracranial, and other bleeding for Veterans Affairs patients who switched to dabigatran after at least 6 months on warfarin. It found that among veterans with atrial fibrillation who switched to dabigatran, dabigatran increased the risk of gastrointestinal hemorrhage by 54% and was not associated with rates of other bleeding or death.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A . Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran. Am J Med. 2014 Dec;127(12):1179-85. doi: 10.1016/j.amjmed.2014.07.024..
Keywords: Blood Thinners, Adverse Events, Patient Safety, Veterans
Meeks DW, Meyer AN, Rose B
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
The researchers described outcomes of peer review within the Department of Veterans Affairs (VA) healthcare system and identified opportunities to leverage peer review data for measurement and improvement of safety. Results showed that the most common process contributing to substandard care was 'timing and appropriateness of treatment'; approximately 16% had diagnosis-related performance concerns. The authors concluded that peer review may be a useful tool for healthcare organizations to assess their sharp end clinical performance, particularly safety events related to diagnostic and treatment errors.
Citation: Meeks DW, Meyer AN, Rose B . Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data. BMJ Qual Saf 2014 Dec;23(12):1023-30. doi: 10.1136/bmjqs-2014-003239.
Keywords: Adverse Events, Medical Errors, Patient Safety, Quality Improvement, Veterans
Voils CI, Sleath B, Maciejewski ML
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
The researchers sought to understand the reasons why patients have increasing numbers of prescribers of medications and to understand patient perspectives on advantages and disadvantages of having multiple prescribers, including effects on medication supply. They found that, with patients from a Veterans Affairs (VA) Medical Center, multiple prescribers arose through referrals and patients actively seeking non-VA prescribers to maximize timeliness and access to medications, to provide access to medications not on the VA formulary, and to minimize out-of-pocket costs.
Citation: Voils CI, Sleath B, Maciejewski ML . Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population. BMC Health Serv Res 2014 Oct 25;14:490. doi: 10.1186/s12913-014-0490-8.
Keywords: Chronic Conditions, Medication, Veterans
Lapham GT, Rubinsky AD, Williams EC
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
The purpose of this study was to evaluate the performance of repeat annual clinical alcohol screening in 4 samples of VA outpatients with 1–4 prior consecutive negative annual screens. It found that among patients with repeated negative clinical alcohol screens, the proportion who subsequently screened positive a year later was low and decreased as patients had more prior negative screens.
Citation: Lapham GT, Rubinsky AD, Williams EC . Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics. Drug Alcohol Depend 2014 Sep 1;142:209-15. doi: 10.1016/j.drugalcdep.2014.06.017..
Keywords: Screening, Alcohol Use, Substance Abuse, Veterans
Schweizer ML, Cullen JJ, Perencevich EN
Costs associated with surgical site infections in Veterans Affairs hospitals.
This study evaluated surgical site infections(SSIs) in 1,756 Veterans Administration patients to determine the excess costs associated with total, deep, and superficial SSIs. It found that the highest risk-adjusted costs occurred with deep SSIs and SSIs associated with neurosurgery patients.
Citation: Schweizer ML, Cullen JJ, Perencevich EN . Costs associated with surgical site infections in Veterans Affairs hospitals. JAMA Surg. 2014 Jun;149(6):575-581. doi:10.1001/jamasurg.2013.4663..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Healthcare Costs, Veterans
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
Citation: Voils CI, Gierisch JM, Yancy WS, Jr. . Differentiating behavior initiation and maintenance: theoretical framework and proof of concept. Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
Keywords: Behavioral Health, Heart Disease and Health, Lifestyle Changes, Nutrition, Veterans
Bates BE, Xie D, Kwong PL
One-year all-cause mortality after stroke: a prediction model.
Using data from Department of Veterans Affairs (VA) national databases, the researchers present and internally validate a 1-year all-cause mortality prediction index after hospitalization for acute stroke. They conclude that a simple index using readily available data that stratifies stroke patients at the time of discharge according to low, moderate, high, and highest likelihood of all-cause 1-year mortality is feasible.
Citation: Bates BE, Xie D, Kwong PL . One-year all-cause mortality after stroke: a prediction model. PM R 2014 Jun;6(6):473-83. doi: 10.1016/j.pmrj.2013.11.006..
Keywords: Stroke, Mortality, Hospitalization, Veterans
Stineman MG, Xie D, Kurichi JE
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
The researchers compared outcomes of veteran patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services after acute stroke using propensity scores. They found that comprehensive rehabilitation services are associated with greater recovery of physical and cognitive independence, improved home discharge likelihood, and improved 1 yr. survival.
Citation: Stineman MG, Xie D, Kurichi JE . Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ. J Rehabil Res Dev 2014;51(7):1143-54. doi: 10.1682/jrrd.2014.03.0084..
Keywords: Comparative Effectiveness, Rehabilitation, Stroke, Patient-Centered Outcomes Research, Veterans