National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (24)
- (-) Adverse Events (25)
- Antibiotics (1)
- Blood Clots (2)
- Blood Thinners (7)
- Brain Injury (1)
- Cardiovascular Conditions (2)
- Case Study (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Colonoscopy (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Dementia (1)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
- Elderly (3)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (1)
- Falls (1)
- Genetics (1)
- Guidelines (3)
- Health Information Technology (HIT) (2)
- Injuries and Wounds (2)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (3)
- Medical Errors (2)
- Medication (25)
- (-) Medication: Safety (25)
- Neurological Disorders (4)
- Newborns/Infants (1)
- Nursing Homes (1)
- Opioids (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Patient Safety (20)
- Policy (1)
- Prevention (2)
- Public Health (1)
- Risk (5)
- Screening (1)
- Surgery (2)
- Treatments (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 25 Research Studies DisplayedBarnes GD
Combining antiplatelet and anticoagulant therapy in cardiovascular disease.
The author describes results of a number of randomized clinical trials that have explored different combinations of anticoagulation plus antiplatelet agents aimed at minimizing bleeding risk while preserving low thrombotic event rates. Findings include shorter courses with fewer antithrombotic agents as being effective, particularly when direct oral anticoagulants are combined with clopidogrel. Combined use of very low-dose rivaroxaban plus aspirin also demonstrated benefit in atherosclerotic diseases, including coronary and peripheral artery disease. Use of proton pump inhibitor therapy while patients were taking multiple antithrombotic agents had the potential to further reduce upper gastrointestinal bleeding risk in select populations. The author recommends that applying this evidence to patients with multiple thrombotic conditions will help to avoid costly and life-threatening adverse medication events.
AHRQ-funded; HS026874; HS026322.
Citation: Barnes GD .
Combining antiplatelet and anticoagulant therapy in cardiovascular disease.
Hematology Am Soc Hematol Educ Program 2020 Dec 4;2020(1):642-48. doi: 10.1182/hematology.2020000151..
Keywords: Blood Thinners, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Cardiovascular Conditions
Salmasian H, Blanchfield BB, Joyce K
Association of display of patient photographs in the electronic health record with wrong-patient order entry errors.
Wrong-patient order entry (WPOE) errors have a high potential for harm; these errors are particularly frequent wherever workflows are complex and multitasking and interruptions are common, such as in the emergency department (ED). The purpose of this study was to evaluate whether the use of noninterruptive display of patient photographs in the banner of the electronic health record (EHR) is associated with a decreased rate of WPOE errors.
AHRQ-funded; HS024713.
Citation: Salmasian H, Blanchfield BB, Joyce K .
Association of display of patient photographs in the electronic health record with wrong-patient order entry errors.
AMA Netw Open 2020 Nov 2;3(11):e2019652. doi: 10.1001/jamanetworkopen.2020.19652..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Patient Safety, Diagnostic Safety and Quality
Toce MS, Michelson K, Hudgins J
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
Opioid-reduction policies have been enacted by US states to address the opioid epidemic. Evidence of an association between policy implementation and decreased rates of pediatric opioid poisoning provides further justification for expanded implementation of these policies. The purpose of this study was to examine the association of 3 state-level opioid-reduction policies with the rate of opioid poisoning in children and adolescents.
AHRQ-funded; HS026503.
Citation: Toce MS, Michelson K, Hudgins J .
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
JAMA Pediatr 2020 Oct;174(10):961-68. doi: 10.1001/jamapediatrics.2020.1980..
Keywords: Children/Adolescents, Opioids, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Policy
Feldman AG, Parsons JA, Dutmer CM
Subacute liver failure following gene replacement therapy for spinal muscular atrophy type 1.
This paper reports on two cases of transient, drug-induced liver failure after gene replacement therapy using an adeno-associated virus vector containing the survival motor neuron 1 gene.
AHRQ-funded; HS026510.
Citation: Feldman AG, Parsons JA, Dutmer CM .
Subacute liver failure following gene replacement therapy for spinal muscular atrophy type 1.
J Pediatr 2020 Oct;225:252-58.e1. doi: 10.1016/j.jpeds.2020.05.044..
Keywords: Newborns/Infants, Neurological Disorders, Genetics, Treatments, Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Patient Safety, Case Study
Bacon O, Hoffman L
System-level patient safety practices that aim to reduce medication errors associated with infusion pumps: an evidence review.
This literature review looked at studies that discuss 2 system-level patient safety practices (PSPs) that aim to reduce medication errors associated with infusion pumps. The first practice focuses on implementing structured process changes and redesigning workflows to improve efficiencies with pump use; and the other focuses on investing in initial and ongoing staff training on the correct use, maintenance, and monitoring of infusion pumps. Two databases were searched, with only four studies reporting medication administration errors, procedural errors, or deviations from hospital policy. Mixed results were found on examining process outcomes related to pump handling. Two studies found an increase in nurses’ adherence to using the medication safety software library because of education, with a resulting decrease in medication errors and adverse safety events.
AHRQ-funded; HHSP233201500013I.
Citation: Bacon O, Hoffman L .
System-level patient safety practices that aim to reduce medication errors associated with infusion pumps: an evidence review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S42-s47. doi: 10.1097/pts.0000000000000722..
Keywords: Adverse Drug Events (ADE), Adverse Events, Patient Safety, Medication: Safety, Medication
Earl TR, Katapodis ND, Schneiderman SR
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
This paper is a systematic review of the literature published between 2008 to 2018 that studies the effect of interventions to reduce preventable adverse drug effects (ADEs) for adults who are prescribed multiple medications. Two safety practices were examined: 1) deprescribing interventions to reduce polypharmacy; and 2) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce potentially inappropriate medications (PIMS). A total of 26 studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP). Deprescribing interventions included decision support tools, educational interventions, and medication reviews. The STOPP tool most reported changes in PIMS, as well as some economic outcomes. Both methods were found to be effective.
AHRQ-funded; HHSP233201500013I.
Citation: Earl TR, Katapodis ND, Schneiderman SR .
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
J Patient Saf 2020 Sep;16(3S Suppl 1):S23-s35. doi: 10.1097/pts.0000000000000747..
Keywords: Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Screening, Prevention
Abraham NS, Yang EH, Noseworthy PA
Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention.
The goal of this study was to compare gastrointestinal bleeding (GIB) rates associated with clopidogrel, prasugrel, and ticagrelor using national medical and pharmacy claims data from privately insured and Medicare Advantage enrollees. Findings showed that, in the first year following percutaneous coronary intervention for acute coronary syndrome, ticagrelor and prasugrel were associated with fewer GIB events compared with clopidogrel.
AHRQ-funded; HS025402.
Citation: Abraham NS, Yang EH, Noseworthy PA .
Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention.
Aliment Pharmacol Ther 2020 Aug;52(4):646-54. doi: 10.1111/apt.15790..
Keywords: Medication: Safety, Medication, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Cardiovascular Conditions, Surgery
Assimon MM, Wang L, Pun PH
Use of QT prolonging medications by hemodialysis patients and individuals without end-stage kidney disease.
Investigators characterized the extent and patterns of QT-interval prolonging medication use by adult hemodialysis patients and individuals without end-stage kidney disease annually from 2012 to 2016. They found that hemodialysis patients used QT prolonging medications with known torsades de pointes risk more extensively than individuals without end-stage kidney disease. They recommended future studies evaluating the cardiac safety of these drugs in the hemodialysis population.
AHRQ-funded; HS026801.
Citation: Assimon MM, Wang L, Pun PH .
Use of QT prolonging medications by hemodialysis patients and individuals without end-stage kidney disease.
J Am Heart Assoc 2020 Jul 7;9(13):e015969. doi: 10.1161/jaha.120.015969..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Risk
Villa Zapata L, Hansten PD, Horn JR
Evidence of clinically meaningful drug-drug interaction with concomitant use of colchicine and clarithromycin.
Colchicine is currently approved for the treatment of gout and familial Mediterranean fever, among other conditions. Clarithromycin, a strong inhibitor of CYP3A4 and P-glycoprotein, dramatically increases colchicine's half-life, augmenting the risk of a life-threatening adverse reaction when used inadvertently with colchicine. The aim of this study was to examine the evidence and clinical implications of concomitant use of colchicine and clarithromycin.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Horn JR .
Evidence of clinically meaningful drug-drug interaction with concomitant use of colchicine and clarithromycin.
Drug Saf 2020 Jul;43(7):661-68. doi: 10.1007/s40264-020-00930-7..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Liberman JS, Slagle JM, Whitney G
Incidence and classification of nonroutine events during anesthesia care.
A nonroutine event is any aspect of clinical care perceived by clinicians or trained observers as a deviation from optimal care based on the context of the clinical situation. The authors sought to delineate the incidence and nature of intraoperative nonroutine events during anesthesia care. The investigators concluded that nonroutine event-containing cases were commonly associated with patient impact and injury. They indicated that nonroutine event monitoring in conjunction with traditional error reporting may enhance understanding of potential intraoperative failure modes to guide prospective safety interventions.
AHRQ-funded; HS011375.
Citation: Liberman JS, Slagle JM, Whitney G .
Incidence and classification of nonroutine events during anesthesia care.
Anesthesiology 2020 Jul;133(1):41-52. doi: 10.1097/aln.0000000000003336..
Keywords: Medication: Safety, Medication, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Surgery
Villa Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Nanji KC, Merry AF, Shaikh SD KC, Merry AF, Shaikh SD
Global PRoMiSe (Perioperative Recommendations for Medication Safety): protocol for a mixed-methods study.
Medication errors (MEs), which occur commonly in the perioperative period, have the potential to cause patient harm or death. Many published recommendations exist for preventing perioperative MEs; however, many of these recommendations conflict and are often not applicable to middle-income and low-income countries. The goal of this study was to develop and disseminate consensus-based recommendations for perioperative medication safety that were tailored to country income level.
AHRQ-funded; HS024764.
Citation: Nanji KC, Merry AF, Shaikh SD KC, Merry AF, Shaikh SD .
Global PRoMiSe (Perioperative Recommendations for Medication Safety): protocol for a mixed-methods study.
BMJ Open 2020 Jun 30;10(6):e038313. doi: 10.1136/bmjopen-2020-038313..
Keywords: Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Stone CA, Stollings JL, Lindsell CJ
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Patients admitted to a medical ICU (MICU) often have chronic illnesses or altered immunity, increasing their need for immediate antibiotic use. In this study, the investigators sought to determine whether MICU patients with low-risk penicillin allergy history could be challenged directly with amoxicillin to have their allergy label safely removed during an acute inpatient stay.
Citation: Stone CA, Stollings JL, Lindsell CJ .
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Am J Respir Crit Care Med 2020 Jun 15;201(12):1572-75. doi: 10.1164/rccm.202001-0089LE..
Keywords: Intensive Care Unit (ICU), Antibiotics, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk, Diagnostic Safety and Quality
Vyles D, Antoon JW, Norton A
Children with reported penicillin allergy: public health impact and safety of delabeling.
The objectives of this study were to: 1.) Review the relevant literature related to children with reported penicillin allergy 2.) Highlight the different ways in which children could be delabeled and 3.) Evaluate the public health impact that a penicillin allergy has for children. The investigators concluded that penicillin allergy was overdiagnosed, often incorrectly, and the label was frequently first applied during childhood.
AHRQ-funded; HS026395.
Citation: Vyles D, Antoon JW, Norton A .
Children with reported penicillin allergy: public health impact and safety of delabeling.
Ann Allergy Asthma Immunol 2020 Jun;124(6):558-65. doi: 10.1016/j.anai.2020.03.012..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Public Health
Yang AD, Hewitt DB, Blay E
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
The aims of this study were to: (1) measure the rate of failure to provide defect-free postoperative venous thromboembolism (VTE) chemoprophylaxis, (2) identify reasons for failure to provide defect-free VTE chemoprophylaxis, and (3) examine patient- and hospital-level factors associated with failure. The investigators concluded that in contrast to SCIP-VTE-2, their novel quality measure unmasked VTE chemoprophylaxis failures in 18% of colectomies. They found that most failures were due to patient refusals or ordering errors.
AHRQ-funded; HS024516.
Citation: Yang AD, Hewitt DB, Blay E .
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
Ann Surg 2020 Jun;271(6):1072-79. doi: 10.1097/sla.0000000000003124..
Keywords: Patient Adherence/Compliance, Guidelines, Blood Clots, Blood Thinners, Medication, Medication: Safety, Patient Safety, Adverse Events
Kurani S, Jeffery MM, Thorsteinsdottir B
Use of potentially nephrotoxic medications by U.S. adults with chronic kidney disease: NHANES, 2011-2016.
This study looked at the prevalence of potentially inappropriate medication (PIM) use by US adults by chronic kidney disease (CKD) stage and self-reported CKD awareness. A cross-sectional analysis of National Health and Nutrition Examination Surveys, 2011-2016 was conducted using a cohort of non-pregnant CKD adults with stages 3a, 3b, or 4-5 CKD. Analyses were adjusted for sex, age, race/ethnicity, education, comorbidities, and insurance type. More than 50% of US adults were taking PIM(s) for all CKD stages and awareness categories, but rates were highest among CKD-unaware patients with stages 4-5 CKD. Proton pump inhibitors, opioids, metformin, sulfonylureas, and NSAIDS were used frequently in all CKD stages. NSAIDS were used less frequently when the patient was CKD-aware.
AHRQ-funded; HS025164; HS025402; HS025517.
Citation: Kurani S, Jeffery MM, Thorsteinsdottir B .
Use of potentially nephrotoxic medications by U.S. adults with chronic kidney disease: NHANES, 2011-2016.
J Gen Intern Med 2020 Apr;35(4):1092-101. doi: 10.1007/s11606-019-05557-8..
Keywords: Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Chronic Conditions, Patient Safety
Banerji A, Lai KH, Li Y
Natural language processing combined with ICD-9-CM codes as a novel method to study the epidemiology of allergic drug reactions.
Researchers sought to develop and validate a novel informatics method based on natural language processing (NLP) in combination with ICD-9-CM codes that identifies allergic drug reactions in the electronic health record. They found that using NLP with ICD-9-CM codes improved identification of allergic drug reactions, and they concluded that the resulting decrease in manual chart review effort will facilitate large epidemiology studies of this understudied area.
AHRQ-funded; HS024264; HS025375.
Citation: Banerji A, Lai KH, Li Y .
Natural language processing combined with ICD-9-CM codes as a novel method to study the epidemiology of allergic drug reactions.
J Allergy Clin Immunol Pract 2020 Mar;8(3):1032-38.e1. doi: 10.1016/j.jaip.2019.12.007..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Probst MA, Gupta M, Hendey GW
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
In this study, the investigators determined the prevalence of significant intracranial injury among adults with blunt head trauma who are receiving preinjury anticoagulant or antiplatelet medications. The investigators concluded that patients receiving preinjury warfarin or a combination of aspirin and clopidogrel were at increased risk for significant intracranial injury, but not those receiving aspirin alone. They suggested that clinicians should have a low threshold for neuroimaging when evaluating patients receiving warfarin or a combination of aspirin and clopidogrel.
AHRQ-funded; HS009699.
Citation: Probst MA, Gupta M, Hendey GW .
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
Ann Emerg Med 2020 Mar;75(3):354-64. doi: 10.1016/j.annemergmed.2019.10.004..
Keywords: Brain Injury, Injuries and Wounds, Blood Thinners, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk
Abraham NS
Antiplatelets, anticoagulants, and colonoscopic polypectomy.
This article is a review of current best practice recommendations focusing on the risk of immediate and delayed postpolypectomy bleeding in the context of drug discontinuation or continuation of antiplatelet and anticoagulant drugs. Data was assessed whether cold snare vs conventional thermal-based polypectomy technology and prophylactic placement of hemostatic clips are endoscopic techniques that are beneficial in reducing polypectomy bleeding. Clinical takeaways are also provided to facilitate safer polypectomy among patients on antiplatelet and anticoagulant agents.
AHRQ-funded; HS025402.
Citation: Abraham NS .
Antiplatelets, anticoagulants, and colonoscopic polypectomy.
Gastrointest Endosc 2020 Feb;91(2):257-65. doi: 10.1016/j.gie.2019.09.033..
Keywords: Blood Thinners, Medication, Medication: Safety, Colonoscopy, Adverse Drug Events (ADE), Adverse Events, Guidelines, Prevention, Patient Safety
Greene RA, Zullo AR, Mailloux CM
Effect of best practice advisories on sedation protocol compliance and drug-related hazardous condition mitigation among critical care patients.
This study’s goal was to determine whether best practice advisories improved sedation protocol compliance and could mitigate propofol-related hazardous conditions in adult ICUs. Two adult ICUs at two academic medical centers that shared the same sedation protocol were used to identify adults admitted between 2016 to January 31 2018 who received a continuous infusion of propofol. A total of 1,394 patients were included in the study cohort. The best practice advisory improved sedation protocol compliance and resulted in providers discontinuing propofol an average of 16.6 hours sooner than pre-best practice advisory.
AHRQ-funded; HS022998.
Citation: Greene RA, Zullo AR, Mailloux CM .
Effect of best practice advisories on sedation protocol compliance and drug-related hazardous condition mitigation among critical care patients.
Crit Care Med 2020 Feb;48(2):185-91. doi: 10.1097/ccm.0000000000004116..
Keywords: Critical Care, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Guidelines, Intensive Care Unit (ICU)
Abraham NS, Noseworthy PA, Inselman J
Risk of gastrointestinal bleeding increases with combinations of antithrombotic agents and patient age.
This study investigated whether age of patient and time frame increased the risk of gastrointestinal bleeding (GIB) in elderly patients being treated with anticoagulants, antiplatelets, or a combination of both therapies. This retrospective analysis used nationwide claims data from privately insured and Medicare Advantage enrollees who received anticoagulant and/or antiplatelet agents from October 1, 2010, through May 31, 2017. The final cohort included 311,211 patients who had a primary diagnosis of atrial fibrillation, ischemic heart disease, or venous thromboembolism. There was no significant different in the proportion of patients with GIB after anticoagulant or antiplatelet monotherapy, but combination therapy increased GIB risk. Advancing age was also associated with increasing 1-year probability of FIB, especially patients older than 75 years taking combination therapy.
AHRQ-funded; HS025402.
Citation: Abraham NS, Noseworthy PA, Inselman J .
Risk of gastrointestinal bleeding increases with combinations of antithrombotic agents and patient age.
Clin Gastroenterol Hepatol 2020 Feb;18(2):337-46.e19. doi: 10.1016/j.cgh.2019.05.017..
Keywords: Adverse Drug Events (ADE), Medication, Adverse Events, Medication: Safety, Elderly, Blood Thinners, Blood Clots, Digestive Disease and Health
Flory JH, Hennessy S, Bailey CJ
Reports of lactic acidosis attributed to metformin, 2015-2018.
This study examined the effects of allowing patients with mild-moderate chronic kidney disease to use metformin. The researchers examined rates of reports of metformin-associated lactic acidosis (MALA) to FDA’s Adverse Event Reporting System (FAERS). Publicly available data from 2015 to 2018 was analyzed. Reports from the US increased from 111 in 2015 to 243 in 2018. However due to a lack of a denominator or control group they could not conclude US MALA rates have increased. The authors also concluded that while the increased reports deserve attention, further study is needed.
AHRQ-funded; HS023898.
Citation: Flory JH, Hennessy S, Bailey CJ .
Reports of lactic acidosis attributed to metformin, 2015-2018.
Diabetes Care 2020 Jan;43(1):244-46. doi: 10.2337/dc19-0923.
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Keywords: Kidney Disease and Health, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events
Kesselheim AS, Bykov K, Gagne JJ
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
The researchers estimated the risk of seizure-related events associated with refilling antiepileptic drugs (AED) with generic AEDs and the effect of switching between different manufacturers of the same generic drug. They found that among patients on a generic AED, refilling the same AED was associated with an elevated risk of seizure-related event; however, there was no additional risk from switching during that refill to a different manufacturer.
AHRQ-funded; HS022193.
Citation: Kesselheim AS, Bykov K, Gagne JJ .
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
Neurology 2016 Oct 25;87(17):1796-801. doi: 10.1212/wnl.0000000000003259.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Neurological Disorders, Patient Safety, Risk
Gagne JJ, Kesselheim AS, Choudhry NK
Comparative effectiveness of generic versus brand-name antiepileptic medications.
The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. It concluded that patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.
AHRQ-funded; HS018465.
Citation: Gagne JJ, Kesselheim AS, Choudhry NK .
Comparative effectiveness of generic versus brand-name antiepileptic medications.
Epilepsy Behav 2015 Nov;52(Pt A):14-8. doi: 10.1016/j.yebeh.2015.08.014.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Medication, Medication: Safety, Neurological Disorders, Patient Safety
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety