National Healthcare Quality and Disparities Report
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- Adverse Drug Events (ADE) (1)
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- Pneumonia (1)
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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
1 to 10 of 10 Research Studies DisplayedGoyal P, Gorodeski EZ, Marcum ZA
Cardiac rehabilitation to optimize medication regimens in heart failure.
This paper discusses the use of cardiac rehabilitation (CR) to optimize medication regimens for older adults with heart failure. Challenges in CR are discussed length and strategies were offered for leveraged CR.
AHRQ-funded; HS022982.
Citation: Goyal P, Gorodeski EZ, Marcum ZA .
Cardiac rehabilitation to optimize medication regimens in heart failure.
Clin Geriatr Med 2019 Nov;35(4):549-60. doi: 10.1016/j.cger.2019.06.001..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Medication, Patient-Centered Healthcare, Patient Adherence/Compliance, Chronic Conditions
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Parchman ML, Anderson ML, Dorr DA
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Researchers conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. They concluded that, although they found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Dorr DA .
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S40-s49. doi: 10.1370/afm.2407..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Provider Performance, Quality Measures, Quality of Care, Risk, Evidence-Based Practice, Patient-Centered Healthcare, Chronic Conditions
Mentias A, Shantha G, Adeola O
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
This study examined the role of diabetes and insulin use in the risk of stroke and acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). A cohort of Medicare beneficiaries newly diagnoses with AF from 2011 to 2013 were identified. The cohort was divided into those with diabetes requiring insulin (6.7%), those with diabetes not requiring insulin (31.3%) and non-diabetics (62%). Diabetics requiring insulin were at the greatest risk of stroke and AMI, and diabetics not requiring insulin were at slightly lower risk, but non-diabetics had the lowest risk.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Adeola O .
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
Am Heart J 2019 Aug;214:158-66. doi: 10.1016/j.ahj.2019.05.003..
Keywords: Diabetes, Stroke, Heart Disease and Health, Cardiovascular Conditions, Risk, Chronic Conditions, Elderly
Hajduk AM, Gurwitz JH, Tabada G
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
Researchers sought to determine whether burden of multiple chronic conditions (MCCs) influences the risk of receiving inappropriate vs appropriate device therapies. They studied adults with left ventricular systolic dysfunction receiving an implantable cardioverter-defibrillator (ICD) for primary prevention. In these patients, they found that MCC burden was independently associated with an increased risk of inappropriate but not appropriate device therapies. They recommended considering comorbidity burden when engaging patients in shared decision making about ICD implantation.
AHRQ-funded; 290050033.
Citation: Hajduk AM, Gurwitz JH, Tabada G .
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
J Am Geriatr Soc 2019 Jul;67(7):1370-78. doi: 10.1111/jgs.15839..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Chronic Conditions, Medical Devices, Prevention, Elderly, Risk, Patient-Centered Outcomes Research
Uy V, Hays RD, Xu JJ
Do the unlabeled response categories of the Minnesota Living with Heart Failure Questionnaire satisfy the monotonicity assumption of simple-summated scoring?
Half of the 21-item Minnesota Living with Heart Failure Questionnaire (MLHFQ) response categories are labeled (0 = No, 1 = Very little, 5 = Very much) and half are not (2, 3, and 4). In this study, the investigators hypothesized that the unlabeled response options would not be more likely to be chosen at some place along the scale continuum than other response options and, therefore, not satisfy the monotonicity assumption of simple-summated scoring.
AHRQ-funded; HS019311.
Citation: Uy V, Hays RD, Xu JJ .
Do the unlabeled response categories of the Minnesota Living with Heart Failure Questionnaire satisfy the monotonicity assumption of simple-summated scoring?
Qual Life Res 2020 May;29(5):1349-60. doi: 10.1007/s11136-020-02422-8..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Quality of Life
Assimon MM, Brookhart MA, Flythe JE
Comparative cardiac safety of selective serotonin reuptake inhibitors among individuals receiving maintenance hemodialysis.
This retrospective cohort study compared cardiac safety of selective serotonin reuptake inhibitors (SSRIs) among individuals receiving maintenance hemodialysis. These individuals may be particularly susceptible to lethal cardiac consequences of drug-induced QT prolongation due to a substantial cardiovascular disease burden and their use of many medications. Data from a cohort of Medicare beneficiaries receiving hemodialysis included in the US Renal Data system registry from 2007-2014 was used. Researchers compared the 1-year risk of death among hemodialysis patients taking different SSRIs. Use of higher QT-prolonging potential SSRIs (citalopram, escitalopram) was associated with a higher risk of sudden cardiac death than patients taking lower risk SSRIs (fluoxetine, fluvoxamine, paroxetine, sertraline). The association was higher among elderly individuals, females, patients with conduction disorders, and those treated with other non-SSRI QT-prolonging medications.
AHRQ-funded; HS026801.
Citation: Assimon MM, Brookhart MA, Flythe JE .
Comparative cardiac safety of selective serotonin reuptake inhibitors among individuals receiving maintenance hemodialysis.
J Am Soc Nephrol 2019 Apr;30(4):611-23. doi: 10.1681/asn.2018101032..
Keywords: Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Chronic Conditions
Dunn T, Saeed MJ, Shpigel A
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
This study examined whether the use of preoperative cardiac stress testing of patients undergoing kidney transplantation reduced 30-day- death and myocardial infarction post-transplantation. ESRD patients 40 years or older with primary Medicare insurance between 2006 and 2013 were identified using the United States Renal Data System. In a matched cohort of 17,304 patients, there was little difference in 30-day post-transplantation mortality and myocardial infarction between those receiving a stress test and those who did not.
AHRQ-funded; HS019455.
Citation: Dunn T, Saeed MJ, Shpigel A .
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
PLoS One 2019 Feb;14(2):e0211161. doi: 10.1371/journal.pone.0211161..
Keywords: Transplantation, Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Surgery
Althoff KN, Gebo KA, Moore RD
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Adults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.
AHRQ-funded; 90047713.
Citation: Althoff KN, Gebo KA, Moore RD .
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Lancet HIV 2019 Feb;6(2):e93-e104. doi: 10.1016/s2352-3018(18)30295-9.
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Keywords: Cancer, Cardiovascular Conditions, Chronic Conditions, Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Heart Disease and Health, Risk
Smith GH, Shore S, Allen LA
Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure.
This study examined how prescription costs can greatly impact decision-making in patients with serious medical conditions. Forty-nine patients with heart failure with reduced ejection fracture were recruited and interviewed about a drug sacrubitril-valsartan. The drug is considered effective but can be costly. Most patients (45/49) said they would take the medicine if the out-of-pocket cost was only $5 per month more than their current medication. But if the costs increased to $100 more per month then only 43% would switch to sacrubritil-valsartan. Only 20% of participants said their physician had discussed medication costs in the past year.
AHRQ-funded; HS026081.
Citation: Smith GH, Shore S, Allen LA .
Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure.
J Am Heart Assoc 2019 Jan 8;8(1):e010635. doi: 10.1161/jaha.118.010635..
Keywords: Healthcare Costs, Shared Decision Making, Heart Disease and Health, Cardiovascular Conditions, Medication, Chronic Conditions