National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (4)
- Back Health and Pain (1)
- Behavioral Health (2)
- Care Management (3)
- Children/Adolescents (1)
- Chronic Conditions (5)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Digestive Disease and Health (1)
- Education: Curriculum (1)
- Elderly (3)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospitals (1)
- Long-Term Care (2)
- Medicaid (1)
- Medication (14)
- Medication: Safety (2)
- Mortality (1)
- Nursing Homes (2)
- (-) Opioids (23)
- Orthopedics (1)
- Pain (7)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Patient Self-Management (1)
- Policy (1)
- Practice Patterns (3)
- Pregnancy (1)
- Prevention (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Provider: Pharmacist (1)
- Risk (1)
- Social Stigma (2)
- Substance Abuse (13)
- Surgery (3)
- Teams (1)
- Vulnerable Populations (1)
- Women (1)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedChou R, Korthuis PT, McCarty D
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
This review synthesized evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility. It concluded that higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events.
AHRQ-funded; 290201500009I.
Citation: Chou R, Korthuis PT, McCarty D .
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
Ann Intern Med 2017 Dec 19;167(12):867-75. doi: 10.7326/m17-2224.
.
.
Keywords: Emergency Medical Services (EMS), Evidence-Based Practice, Medication, Opioids, Patient-Centered Outcomes Research
Heslin KC, Owens PL, Karaca Z
AHRQ Author: Heslin KC; Owens PL; Karaca Z; Elixhauser A
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM. It found a sharp increase in opioid-related stays overall during the transition to ICD-10-CM. This may indicate that the new classification system is capturing stays that were missed by ICD-9-CM data.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Karaca Z .
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
Med Care 2017 Nov;55(11):918-23. doi: 10.1097/mlr.0000000000000805.
.
.
Keywords: Critical Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Opioids, Substance Abuse
Tedesco D, Gori D, Desai KR
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
The authors systematically reviewed and meta-analyzed evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. The most commonly performed interventions included in the review were continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. In the meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
AHRQ-funded; HS024096.
Citation: Tedesco D, Gori D, Desai KR .
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg 2017 Oct 18;152(10):e172872. doi: 10.1001/jamasurg.2017.2872.
.
.
Keywords: Care Management, Medication, Opioids, Orthopedics, Pain, Surgery
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Chhatre S, Cook R, Mallik E
Trends in substance use admissions among older adults.
Researchers sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics.
AHRQ-funded; HS024106.
Citation: Chhatre S, Cook R, Mallik E .
Trends in substance use admissions among older adults.
BMC Health Serv Res 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
.
.
Keywords: Behavioral Health, Elderly, Hospitalization, Opioids, Substance Abuse
Horton M, McDonald R, Green TC
A mapping review of take-home naloxone for people released from correctional settings.
The objective of this review is to map research into take-home naloxone (THN) for people released from correctional settings in order to identify further research needs. It concluded that the feasibility of THN in the context of release from a correctional setting has been established, but there is a need for rigorous research into health outcomes and program implementation.
AHRQ-funded; HS024021.
Citation: Horton M, McDonald R, Green TC .
A mapping review of take-home naloxone for people released from correctional settings.
Int J Drug Policy 2017 Aug;46:7-16. doi: 10.1016/j.drugpo.2017.05.015.
.
.
Keywords: Adverse Drug Events (ADE), Medication, Opioids, Substance Abuse, Vulnerable Populations
Carroll JJ, Marshall BDL, Rich JD
Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: a mixed methods study.
This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island. It concluded that among illicit opioid users in Rhode Island, known or suspected fentanyl exposure is common, yet demand for fentanyl is low. Fentanyl-contaminated drugs are generating user interest in effective risk mitigation strategies, including treatment.
AHRQ-funded; HS024021.
Citation: Carroll JJ, Marshall BDL, Rich JD .
Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: a mixed methods study.
Int J Drug Policy 2017 Aug;46:136-45. doi: 10.1016/j.drugpo.2017.05.023.
.
.
Keywords: Opioids, Substance Abuse, Medication, Adverse Drug Events (ADE)
Hanley K, Zabar S, Altshuler L
Opioid vs nonopioid prescribers: variations in care for a standardized acute back pain case.
This paper describes the design and use of an opioid-related unannounced standardized patient case (USP) used in a residency curriculum. Researchers designed and fielded an unannounced standardized patient case involving a patient with acute back pain who requested Vicodin (5/325 mg). They described residents' case management and examined whether their management decisions, including opioid prescribing, were related to their core clinical skills. The case designers found that most Vicodin prescribers did not follow prescribing guidelines, and demonstrated better communication and assessment skills than the nonprescribers. Results suggest the need to guide residents in using a systematic approach to prescribing opioids safely and to develop an acceptable alternative pain management plan when they decide against prescribing.
AHRQ-funded; HS021176.
Citation: Hanley K, Zabar S, Altshuler L .
Opioid vs nonopioid prescribers: variations in care for a standardized acute back pain case.
Subst Abus 2017 Jul-Sep;38(3):324-29. doi: 10.1080/08897077.2017.1319894..
Keywords: Back Health and Pain, Education: Curriculum, Opioids, Practice Patterns
Brummett CM, Waljee JF, Goesling J
New persistent opioid use after minor and major surgical procedures in US adults.
The authors sought to determine the incidence of new persistent opioid use after minor and major surgical procedures. They found that risk factors independently associated with new persistent opioid use included preoperative tobacco use, alcohol and substance abuse disorders, mood disorders, anxiety, and preoperative pain disorders. They concluded that new persistent opioid use after surgery is not significantly different between minor and major surgical procedures but rather associated with behavioral and pain disorders.
AHRQ-funded; HS023313.
Citation: Brummett CM, Waljee JF, Goesling J .
New persistent opioid use after minor and major surgical procedures in US adults.
JAMA Surg 2017 Jun 21;152(6):e170504. doi: 10.1001/jamasurg.2017.0504.
.
.
Keywords: Medication, Opioids, Pain, Patient-Centered Outcomes Research, Surgery
Olfson M, Wall M, Wang S
Service use preceding opioid-related fatality.
The authors analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of non-cancer chronic pain. They found that persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.
AHRQ-funded; HS021112.
Citation: Olfson M, Wall M, Wang S .
Service use preceding opioid-related fatality.
Am J Psychiatry 2017 Jun;175(6):538-44. doi: 10.1176/appi.ajp.2017.17070808.
.
.
Keywords: Chronic Conditions, Opioids, Medicaid, Mortality, Substance Abuse
Lee JS, Hu HM, Brummett CM
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
The researchers sought to evaluate the association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) pain measures and postoperative opioid prescribing in surgical patients, which accounts for nearly 40 percent of surgical prescriptions. They found that postoperative opioid prescribing was not correlated with HCAHPS pain measures.
AHRQ-funded; HS023313.
Citation: Lee JS, Hu HM, Brummett CM .
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
JAMA 2017 May 16;317(19):2013-15. doi: 10.1001/jama.2017.2827.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Opioids, Pain, Patient Experience
Kozhimannil KB, Graves AJ, Jarlenski M
Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.
This study characterized non-medical use (NMU) of prescription opioids among reproductive-age U.S. women, with a focus on pregnancy status. Nearly 1 percent of pregnant women and 2.3 percent of non-pregnant reproductive-age women reported opioid NMU in the past 30 days. Forty-six percent of pregnant women identified a doctor as their source compared with 27.6 percent of non-pregnant women reporting NMU.
AHRQ-funded; HS000029.
Citation: Kozhimannil KB, Graves AJ, Jarlenski M .
Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.
Drug Alcohol Depend 2017 May 1;174:201-08. doi: 10.1016/j.drugalcdep.2017.01.003.
.
.
Keywords: Medication, Opioids, Pregnancy, Substance Abuse, Women
Macmadu A, Carroll JJ, Hadland SE
Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically.
Researchers examined risk factors for exposure to fentanyl-contaminated heroin (FCH) and experiences with FCH use among young adult non-medical prescription opioids (NMPO) users. Several drug use patterns and risk behaviors were associated with FCH exposure, including: regular heroin and cocaine use; diverted pharmaceutical fentanyl use in the prior six months; NMPO use to avoid withdrawal symptoms; regular injection drug use; and prior overdose.
AHRQ-funded; HS024021.
Citation: Macmadu A, Carroll JJ, Hadland SE .
Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically.
Addict Behav 2017 May;68:35-38. doi: 10.1016/j.addbeh.2017.01.014.
.
.
Keywords: Opioids, Medication, Risk, Substance Abuse, Young Adults
Kennedy-Hendricks A, Barry CL, Gollust SE
Social stigma toward persons with prescription opioid use disorder: associations with public support for punitive and public health-oriented policies.
This study examined social stigma toward individuals with prescription opioid use disorder and tested whether stigma was associated with support for various policy interventions. Respondents expressed high levels of stigma toward individuals with prescription opioid use disorder. Higher levels of stigma were associated with greater support for punitive policies and lower support for public health-oriented policies.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Barry CL, Gollust SE .
Social stigma toward persons with prescription opioid use disorder: associations with public support for punitive and public health-oriented policies.
Psychiatr Serv 2017 May;68(5):462-69. doi: 10.1176/appi.ps.201600056.
.
.
Keywords: Medication, Opioids, Policy, Social Stigma, Substance Abuse
Waljee JF, Cron DC, Steiger RM
Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery.
The researchers examined the extent to which preoperative opioid use is correlated with healthcare utilization and costs following elective surgical procedures. They found that compared with non-users, patients using opioids preoperatively were more likely to have a longer hospital stay and were more likely to be discharged to a rehabilitation facility , adjusting for covariates.
AHRQ-funded; HS023313.
Citation: Waljee JF, Cron DC, Steiger RM .
Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery.
Ann Surg 2017 Apr;265(4):715-21. doi: 10.1097/sla.0000000000002117.
.
.
Keywords: Opioids, Surgery, Healthcare Delivery, Healthcare Costs, Adverse Drug Events (ADE)
Green TC, Case P, Fiske H
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
This study examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists. It found that consumer groups differed in awareness of naloxone and availability at pharmacies, but all groups expressed support for the pharmacist's role and preferences for a universal offer of naloxone based on clear criteria.
AHRQ-funded; HS024021.
Citation: Green TC, Case P, Fiske H .
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S19-S27.e4. doi: 10.1016/j.japh.2017.01.013.
.
.
Keywords: Opioids, Provider: Pharmacist, Social Stigma, Substance Abuse
McDonald EM, Kennedy-Hendricks A, McGinty EE
Safe storage of opioid pain relievers among adults living in households with children.
The researchers sought to describe safe storage practices and beliefs among adults who have used a prescription opioid pain reliever (OPR) in the past year; to compare practices and beliefs among those living with younger (<7 years) versus older children (7-17 years). They concluded that OPRs are stored unsafely in many households with children.
AHRQ-funded; HS000029.
Citation: McDonald EM, Kennedy-Hendricks A, McGinty EE .
Safe storage of opioid pain relievers among adults living in households with children.
Pediatrics 2017 Mar;139(3). doi: 10.1542/peds.2016-2161.
.
.
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication: Safety, Medication, Opioids
Korthuis PT, McCarty D, Weimer M
Primary care-based models for the treatment of opioid use disorder: a scoping review.
This article summarizes findings of a technical report for AHRQ describing medication-assisted treatment (MAT) models of care for opioid use disorder, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT into primary care settings that could be considered for adaptation across diverse health care settings.
AHRQ-funded; 290201500009I.
Citation: Korthuis PT, McCarty D, Weimer M .
Primary care-based models for the treatment of opioid use disorder: a scoping review.
Ann Intern Med 2017 Feb 21;166(4):268-78. doi: 10.7326/m16-2149.
.
.
Keywords: Opioids, Primary Care, Primary Care: Models of Care, Substance Abuse, Medication
Fain KM, Alexander GC, Dore DD
Frequency and predictors of analgesic prescribing in U.S. nursing home residents with persistent pain.
The purpose of this study was to quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. The investigators concluded that through 2008, pain remained undertreated in NHs, especially in certain subpopulations, including cognitively impaired and older residents. The authors suggest that changes in pain management practice and policies may be necessary to target these vulnerable residents.
AHRQ-funded; HS022998.
Citation: Fain KM, Alexander GC, Dore DD .
Frequency and predictors of analgesic prescribing in U.S. nursing home residents with persistent pain.
J Am Geriatr Soc 2017 Feb;65(2):286-93. doi: 10.1111/jgs.14512..
Keywords: Care Management, Chronic Conditions, Elderly, Long-Term Care, Medication, Nursing Homes, Opioids, Pain, Practice Patterns
Fain KM, Castillo-Salgado C, Dore DD
Inappropriate fentanyl prescribing among nursing home residents in the United States.
In this cross-sectional study, the investigators quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naive prescribing. The investigators concluded that most nursing home residents initiating transdermal fentanyl did not have persistent pain and many were opioid-naive. They suggest that changes in prescribing practices may be necessary to ensure Food and Drug Administration warnings are followed, particularly for vulnerable subgroups, such as the cognitively impaired.
AHRQ-funded; HS018960.
Citation: Fain KM, Castillo-Salgado C, Dore DD .
Inappropriate fentanyl prescribing among nursing home residents in the United States.
J Am Med Dir Assoc 2017 Feb;18(2):138-44. doi: 10.1016/j.jamda.2016.08.015..
Keywords: Care Management, Chronic Conditions, Elderly, Long-Term Care, Medication, Nursing Homes, Opioids, Pain, Practice Patterns
Beaudoin FL, Gutman R, Merchant RC
Persistent pain after motor vehicle collision: comparative effectiveness of opioids vs nonsteroidal antiinflammatory drugs prescribed from the emergency department-a propensity matched analysis.
This study evaluated the effect of opioid analgesics vs NSAIDs initiated from the ED on the presence of moderate to severe musculoskeletal pain and ongoing opioid use at 6 weeks in a large cohort of adult ED patients presenting to the ED after motor vehicle collision. No difference in risk for moderate to severe musculoskeletal pain at 6 weeks was observed between those discharged with opioid analgesics vs NSAIDs.
AHRQ-funded; HS022998.
Citation: Beaudoin FL, Gutman R, Merchant RC .
Persistent pain after motor vehicle collision: comparative effectiveness of opioids vs nonsteroidal antiinflammatory drugs prescribed from the emergency department-a propensity matched analysis.
Pain 2017 Feb;158(2):289-95. doi: 10.1097/j.pain.0000000000000756.
.
.
Keywords: Comparative Effectiveness, Emergency Department, Medication, Opioids, Pain, Patient-Centered Outcomes Research
Parchman ML, Von Korff M, Baldwin LM
Primary care clinic re-design for prescription opioid management.
The researchers describe a framework comprised of 6 Building Blocks to guide efforts within the primary care clinic setting to address the use of opioids for chronic pain. In response to prescription opioid overuse and the resulting epidemic of overdose and addiction, primary care clinics are making improvements driven by a common set of best practices that address complex challenges of managing chronic opioid therapy patients in primary care settings.
AHRQ-funded; HS023750.
Citation: Parchman ML, Von Korff M, Baldwin LM .
Primary care clinic re-design for prescription opioid management.
J Am Board Fam Med 2017 Jan-Feb;30(1):44-51. doi: 10.3122/jabfm.2017.01.160183.
.
.
Keywords: Chronic Conditions, Opioids, Pain, Substance Abuse, Teams