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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 985 Research Studies DisplayedKravchenko OV, Boyce RD, Gomez-Lumbreras A
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
This study examined whether there is an association between thromboembolotic events (TEEs) and concomitant use of dexamethasone with either apixaban or rivaroxaban (both direct oral anticoagulants or DOACs) during treatment for COVID-19. The authors used data from the National COVID Cohort Collaborative (N3C) to conduct a nested case-control study. Eligible participants were adults over 18 years who were exposed to a DOAC for 10 or more consecutive days and exposure to dexamethasone at least 5 or more consecutive days. The study did not find a discernible association of TEE in patients concomitantly exposed to dexamethasone and a DOAC.
AHRQ-funded; HS025984.
Citation: Kravchenko OV, Boyce RD, Gomez-Lumbreras A .
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
BMJ Open 2022 Dec 29; 12(12):e066846. doi: 10.1136/bmjopen-2022-066846..
Keywords: COVID-19, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Medication: Safety, Patient Safety
Coburn SB, Lang R, Zhang J
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
The purpose of this study was to describe trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from and identify the predictors of statin initiation. The researchers collected data from 12 United States cohorts between 2001 and 2017. The study found that among 16,409 PWH, 45% met statin eligibility criteria per guidelines for the time period from 2001 to 2017. Statin eligibility ranged from 22% to 25% from 2001 to 2013, and initiation increased from 13% to 45%. In 2014, 51% were statin-eligible, among whom 25% initiated statins, which increased to 32% by 2017. The researchers concluded that there is a substantial statin treatment gap, expanded by the 2013 ACC/AHA guidelines.
AHRQ-funded; 90047713.
Citation: Coburn SB, Lang R, Zhang J .
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
J Acquir Immune Defic Syndr 2022 Dec 15;91(5):469-78. doi: 10.1097/qai.0000000000003083..
Keywords: Medication, Human Immunodeficiency Virus (HIV), Access to Care, Practice Patterns, Cardiovascular Conditions
Herb J, Friedman H, Shrestha S
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy.
The purpose of this study was to understand barriers to early-stage lung cancer care at high-volume academic centers in the US. Researchers conducted semi-structured interviews with patients with suspected or diagnosed early-stage non-small cell lung cancer who had presented to a multidisciplinary clinic at academic institutions over a 6-month period; a qualitative content analysis was then performed using the framework method. Six themes relating to barriers and facilitators to lung-cancer care were identified, and the authors concluded that these factors must be addressed to improve quality of care among lung cancer patients.
AHRQ-funded; HS000032.
Citation: Herb J, Friedman H, Shrestha S .
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy.
Support Care Cancer 2022 Dec 14;31(1):21. doi: 10.1007/s00520-022-07465-w..
Keywords: Cancer: Lung Cancer, Cancer, Access to Care
Peng L, Luo G, Walker A
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
The goals of this study were to compare a single-site, COVID-19 computer diagnosis system that used the Federated Averaging (FedAvg) algorithm with 3-client Federated learning (FL) models, and to evaluate the performance of the four FL variations. Researchers leveraged a FL healthcare collaborative that included data from five US and European healthcare systems encompassing 42 hospitals. They concluded that FedAvg could significantly improve generalization of the model in comparison with other personalization FL algorithms--FedProx, FedBN, and FedAMP--but at the cost of poor internal validity.
AHRQ-funded; HS026379.
Citation: Peng L, Luo G, Walker A .
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
J Am Med Inform Assoc 2022 Dec 13;30(1):54-63. doi: 10.1093/jamia/ocac188..
Keywords: COVID-19, Diagnostic Safety and Quality, Imaging, Hospitals
Badaki-Makun O, Levin S, Debraine A
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
The purpose of this prospective cohort analysis was to determine the performance of Monocyte distribution width (MDW) and other leukocyte parameters as screening tests for SARS-CoV-2 and influenza infection. Researchers conducted an observational study with a cohort analysis consisting of adult patients who underwent complete blood count (CBC) and SARS-CoV-2 or influenza testing in an Emergency Department (ED) between January 2020 and July 2021. The study concluded that MDW, when available as part of a routine complete blood count (CBC) with differential, could be a useful indicator of SARS-CoV-2 or influenza infection.
AHRQ-funded; HS02664002.
Citation: Badaki-Makun O, Levin S, Debraine A .
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
Sci Rep 2022 Dec 13; 12(1):21528. doi: 10.1038/s41598-022-24978-w..
Keywords: COVID-19, Influenza, Respiratory Conditions
Rule A, Melnick ER, Apathy NC
Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures.
The purpose of this study was to compare studies that utilize vendor-derived and investigator-derived measures of electronic health records (EHR) and to evaluate consistency across studies. The researchers reviewed PubMed for articles published between July 2019 and December 2021 that utilized measures of EHR use obtained from EHR event logs. The study found that 102 articles met the criteria for inclusion; of those, 40 utilized vendor-derived measures, 61 utilized investigator-derived measures, and 1 utilized both. Those studies utilizing vendor-derived measures had a greater likelihood of observing EHR use only in ambulatory settings and only by physicians or advanced practice providers compared with those employing investigator-derived measures. Studies utilizing vendor-derived measures also had a greater likelihood of measuring durations of EHR use, but definitions of measures (such as time outside scheduled hours) varied broadly. The researchers concluded that vendor-derived measures are being used more to study EHR use, but only by certain clinical roles. The amount of studies employing event logs to observe EHR use continues to increase, but with lack of consistency in measure definitions and significant differences between studies that utilize vendor-derived and investigator-derived methods.
AHRQ-funded; HS026116.
Citation: Rule A, Melnick ER, Apathy NC .
Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures.
J Am Med Inform Assoc 2022 Dec 13;30(1):144-55. doi: 10.1093/jamia/ocac177..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Liao JM, Wang E, Isidro U
The association between bundled payment participation and changes in medical episode outcomes among high-risk patients.
This research evaluated whether the association between participation in bundled payments for medical conditions and episode outcomes differed for clinically high-risk versus other patients in regard to length of stay (LOS) at skilled nursing facilities (SNFs). Participants included 471,421 Medicare patients hospitalized at bundled payment and propensity-matched non-participating hospitals. Primary outcomes were SNF LOS and 90-day unplanned readmissions. SNF length of stay was differentially lower among frail patients, patients with advanced age (>85 years), and those with prior institutional post-acute care provider utilization compared to non-frail, younger, and patients without prior utilization, respectively. Bundled payment participation was also associated with differentially greater SNF LOS among disabled patients. It was not associated with differential changes in readmissions in any high-risk group but was associated with changes in quality, utilization, and spending measures for some groups.
AHRQ-funded; HS027595.
Citation: Liao JM, Wang E, Isidro U .
The association between bundled payment participation and changes in medical episode outcomes among high-risk patients.
Healthcare 2022 Dec 12; 10(12). doi: 10.3390/healthcare10122510..
Keywords: Payment, Quality Improvement, Quality of Care, Risk, Policy
Fan CA, Hara-Hubbard KK, Barrington WE
The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic.
This article investigated the prevalence of hate incidents across racial and ethnic groups and the relationship between race/ethnicity and hate incidents during the first year of the COVID-19 pandemic. National data was taken from the Understanding America Study COVID-19 Longitudinal Survey. The majority of members of all six marginalized racial and ethnic groups reported at least one hate incident; Asian, AI/AN, Black, and Multiracial groups were shown to have significantly higher odds of experiencing each category of hate incident. All marginalized groups had higher odds of receiving poorer service. The authors concluded that the health community must research and treat hate incidents as a public health issue while recognizing the contexts of structural and interpersonal racism in the U.S.
AHRQ-funded; HS013853.
Citation: Fan CA, Hara-Hubbard KK, Barrington WE .
The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic.
Front Public Health 2022 Dec 12; 10:982029. doi: 10.3389/fpubh.2022.982029..
Keywords: COVID-19, Racial and Ethnic Minorities
Collins CR, Abel MK, Shui A
Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.
This study aimed to assess where the largest opportunities for care improvement lay with the bundled payment reimbursement model and how best to identify patients at high risk of suffering costly complications, including hospital readmission. The authors used a cohort of patients from 2014 and 2016 who met inclusion criteria for the Major Bowel Bundled Payment Program and performed a cost analysis to identify opportunities for improved care efficiency. Using the results, they identified readmissions as a target for improvement and then assessed whether the American College of Surgeons' National Surgical Quality Improvement Program surgical risk calculator (ACS NSQIP SRC) could accurately identify patients within the bundled payment population who were at high risk of readmission using a logistic regression model. Patients who were readmitted within 90-days post-surgery were 2.53 times more likely to be high-cost (>$60,000) then non-readmitted patients. However, the ACS NSQIP SRC did not accurately predict patients at high risk of readmission within the first 30 days post-surgery.
AHRQ-funded; HS024532.
Citation: Collins CR, Abel MK, Shui A .
Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.
Perioper Med 2022 Dec 9;11(1):54. doi: 10.1186/s13741-022-00286-9..
Keywords: Provider Performance, Payment, Hospital Readmissions, Quality Improvement, Quality of Care, Surgery, Medicare, Medicaid
Sexton JB, Adair KC, Cu X
Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: a randomized clinical trial of WISER.
The purpose of this randomized controlled trial was to test the effectiveness of the Web-based Implementation for the Science of Enhancing Resilience (WISER) intervention, a positive psychology program constructed to improve six dimensions of the wellbeing of healthcare workers (HCW). The researchers utilized cohorts comprised of actively employed HCWs across the United States: cohort 1 received WISER web-based intervention in the form of links daily for 10 days exposing them to videos and positive psychology exercises; cohort 2 served as a 14-day waiting list control before receiving the same. The study found that at 1 week, when compared to the control group, WISER significantly improved depressive symptoms, work-life integration, happiness, emotional thriving, and emotional recovery, but not emotional exhaustion. Results of the combined cohort 1, 6, and 12 months revealed that all 6 wellbeing outcomes were significantly improved relative to the baseline. At the 6-month assessment, 87% of partifipants reported favorable impressions of WISER.
AHRQ-funded; HS027837.
Citation: Sexton JB, Adair KC, Cu X .
Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: a randomized clinical trial of WISER.
Front Public Health 2022 Dec 8; 10:1016407. doi: 10.3389/fpubh.2022.1016407..
Keywords: Provider: Health Personnel, Burnout, Stress
Varady NH, Worsham CM, Chen AF
Inappropriate prescribing of opioids for patients undergoing surgery.
This study examined inappropriate prescribing of opioids for patients undergoing surgery, in this instance prescribing them to a patient’s spouse. Among 450,125 opioid-naïve couples with commercial insurance studied, for patients who did not fill perioperative opioid prescriptions themselves, the rate of spousal fills on the day of surgery (DOS) was 2.39 fills per 1,000 surgeries compared with 0.44 fills on all other perioperative days. Increases in spousal fills were not present for patients that filled opioid prescriptions themselves.
AHRQ-funded; HS026753.
Citation: Varady NH, Worsham CM, Chen AF .
Inappropriate prescribing of opioids for patients undergoing surgery.
Proc Natl Acad Sci U S A 2022 Dec 6;119(49):e2210226119. doi: 10.1073/pnas.2210226119..
Keywords: Opioids, Medication, Surgery, Practice Patterns, Provider: Physician
Liao JM, Huang Q, Wang E
Performance of physician groups and hospitals participating in bundled payments among Medicare beneficiaries.
This cohort study compared how physician group practices (PGPs) performed in bundled payments compared with hospitals. The authors used 2011 to 2018 Medicare claims data to compare the association of participants in the Bundled Payments for Care Improvement (BCPI) initiative with episode outcomes. Primary outcome was 90-day total episode spending. The total sampled comprised data from 1,288,781 Medicare beneficiaries, of whom mean age was 76.2 years, 59.7% women, and 85.5% White, with 592,071 individuals receiving care from 6405 physicians in in BPCI-participating PGPs and 24,758 propensity-matched physicians in non-BPCI-participating PGPs. For PGPs, BPCI participation was associated with greater reductions in episode spending for surgical (difference, -$1648 to -$1088) but not for medical episodes (difference, -$410 to $206). Hospital participation in BPCI was associated with greater reductions in episode spending for both surgical ($1345 to -$675) and medical -$1139 to -$386) episodes.
AHRQ-funded; HS027595.
Citation: Liao JM, Huang Q, Wang E .
Performance of physician groups and hospitals participating in bundled payments among Medicare beneficiaries.
JAMA Health Forum 2022 Dec 2; 3(12):e224889. doi: 10.1001/jamahealthforum.2022.4889..
Keywords: Provider Performance, Payment, Hospitals, Medicare, Quality of Care
Beidler LB, Razon N, Lang H
"More than just giving them a piece of paper": interviews with primary care on social needs referrals to community-based organizations.
The purpose of this qualitative study was to describe primary care practice’s referrals to community-based organizations. The researchers utilized semi-structured interviews with 50 healthcare administrators in charge of social care efforts within their organization. Fifty diverse United States healthcare organizations and agencies were included. The study found that social needs referrals were an essential element of administrator’s social care activities. Administrators described the optimal referral program as one which places limited burden on care teams, provides patients with customized referrals, and facilitates closed-loop referrals. The researchers identified three key challenges organizations encounter when trying to implement the optimal referrals program: 1) developing and maintaining resources lists; 2) aligning referrals with patient needs; and 3) measuring the efficacy of referrals. Administrators The study concluded that primary care practice referrals to community-based organizations were used to improve patients' social conditions, but administrators report challenges providing customized and current information to their patients.
AHRQ-funded; HS024075.
Citation: Beidler LB, Razon N, Lang H .
"More than just giving them a piece of paper": interviews with primary care on social needs referrals to community-based organizations.
J Gen Intern Med 2022 Dec;37(16):4160-67. doi: 10.1007/s11606-022-07531-3..
Keywords: Primary Care, Social Determinants of Health, Community-Based Practice, Healthcare Delivery
Rivard SJ, Vitous CA, Bamdad MC
"Their whole lives are going to change": a photo-elicitation study of rectal cancer survivorship.
This novel study aimed to explore the rectal cancer survivor experience and identify the impacts of treatment using photo-elicitation. Patients were instructed to take photographs that showed aspects of life that are now challenges since undergoing treatment and then were interviewed. Twenty patients participated in the study at a cancer center in a tertiary medical center. Three major themes emerged regarding life after rectal cancer and its treatments: physical symptoms, lifestyle changes, and changes over time. Physical symptoms included GI issues, ostomy difficulties, and genitourinary symptoms. Lifestyle changes related to diet, social life, and hobbies as well as major life changes and finances. Finally, patients spoke of improvements after treatment and impact on daily life. A video abstract is included.
AHRQ-funded; HS026772; HS000053.
Citation: Rivard SJ, Vitous CA, Bamdad MC .
"Their whole lives are going to change": a photo-elicitation study of rectal cancer survivorship.
Dis Colon Rectum 2022 Dec;65(12):1456-63. doi: 10.1097/dcr.0000000000002474..
Keywords: Cancer: Colorectal Cancer, Cancer, Quality of Life
Powell KR, Winkler AE, Liu J
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
The objective of this study was to investigate the implementation of telehealth in nursing homes during the COVID-19 pandemic. Researchers conducted a secondary analysis of data from a national survey of nursing home administrative leaders using six survey questions and semi-structured interviews. Their conclusions indicate that training, restructuring teams and tasks, and adaptation of work processes to support communication could improve usability and sustainability of telehealth in nursing homes.
AHRQ-funded; HS02249.
Citation: Powell KR, Winkler AE, Liu J .
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
J Am Geriatr Soc 2022 Dec;70(12):3493-502. doi: 10.1111/jgs.18020..
Keywords: COVID-19, Elderly, Telehealth, Health Information Technology (HIT), Nursing Homes, Implementation
Salwei ME, Carayon P
A sociotechnical systems framework for the application of artificial intelligence in health care delivery.
The purpose of this paper is to characterize the current challenges of incorporating Artificial Intelligence (AI) into clinical healthcare and suggest a sociotechnical systems (STS) approach for AI design and implementation. The authors We explain the STS approach with a case study on the design and implementation of a clinical decision support (CDS).
AHRQ-funded; HS026395; HS022086.
Citation: Salwei ME, Carayon P .
A sociotechnical systems framework for the application of artificial intelligence in health care delivery.
J Cogn Eng Decis Mak 2022 Dec; 16(4):194-206. doi: 10.1177/15553434221097357..
Keywords: Health Information Technology (HIT), Healthcare Delivery
Wachnik AA, Welch-Coltrane JL, Adams MCB
A standardized emergency department order set decreases admission rates and in-patient length of stay for adults patients with sickle cell disease.
The purpose of this 3-year prospective analysis study was to assess a quality improvement project to standardize Emergency Department (ED) care for patients presenting with pain associated with sickle cell disease (SCD). IN 2019 the researchers implemented an ED order set in to improve care and provide adequate management of analgesia. The primary outcome was the overall hospital admission rate for patients after the intervention, and the secondary outcome measures included ED disposition, rate of return to the ED within 72 hours, ED pain scores at admission and discharge, ED treatment time, in-patient length of stay, non-opioid medication use, and opioid medication use. The study found an overall 67% reduction in the hospital admission rate after implementation of the order set and a significant decrease in the percentage admission rate month over month. Time to the first non-opioid analgesic decreased by 71 minutes and there was no change in time to the first opioid medication. The rate of return to the ED within 72 hours did not change and the ED elopement rate did not change. There were significant increases in the prescribing of orally administered acetaminophen, celecoxib, and tizanidine, and intravenous ketamine and ketorolac. ED pain scores at discharge did not change for hospital-admitted and non-admitted patients. The possible reduction in costs was $193,440 during the 12-month observation period, and the average cost per visit decreased by $792. The researchers concluded that the ED order set decreased the rate of hospital admissions and the timeliness of analgesia administration without having a negative impact on the pain of the patients.
AHRQ-funded; HS028584.
Citation: Wachnik AA, Welch-Coltrane JL, Adams MCB .
A standardized emergency department order set decreases admission rates and in-patient length of stay for adults patients with sickle cell disease.
Pain Med 2022 Dec;23(12):2050-60. doi: 10.1093/pm/pnac096..
Keywords: Sickle Cell Disease, Emergency Department, Hospitalization
Anhang Price R, Quigley DD DD, Hargraves JL
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
The purpose of this systematic review study was to explore evidence on survey administration strategies to increase response rates and representativeness of patient surveys. The researchers examined 40 peer-reviewed randomized experiments of administration protocols for patient experience surveys. The study found that when compared to mail-only or telephone-only administration of surveys, mail administration with telephone follow-up provides a median response rate benefit of 13%. Researchers also discovered that while surveys administered only by web usually result in lower response rates than those administered by mail or telephone, the limited evidence for a web-mail-telephone process suggests a potential response rate benefit over a mail-telephone process. Monetary incentives are related with substantial improvements in response rates. The study concluded that mixed-mode survey administration results in increased patient survey response rates than a single mode.
AHRQ-funded; HS025920.
Citation: Anhang Price R, Quigley DD DD, Hargraves JL .
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
Med Care 2022 Dec;60(12):910-18. doi: 10.1097/mlr.0000000000001784..
Keywords: Patient Experience, Research Methodologies, Health Services Research (HSR)
Ramsden SC, Pergjika A, Janssen AC
A systematic review of the effectiveness and safety of droperidol for pediatric agitation in acute care settings.
This systematic review evaluated the effectiveness and safety of droperidol for the management of acute, severe agitation in children in acute care settings. The authors conclude that existing data indicate that droperidol is both effective and safe; however, data are limited by study designs that may introduce bias.
AHRQ-funded; HS026385.
Citation: Ramsden SC, Pergjika A, Janssen AC .
A systematic review of the effectiveness and safety of droperidol for pediatric agitation in acute care settings.
Acad Emerg Med 2022 Dec;29(12):1466-74. doi: 10.1111/acem.14515..
Keywords: Children/Adolescents, Medication, Medication: Safety, Intensive Care Unit (ICU), Patient Safety
Anderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
Keeney T, Lee Lee, Basford JR
Association of function, symptoms, and social support reported in standardized outpatient clinic questionnaires with subsequent hospital discharge disposition and 30-day readmissions.
The objective of this retrospective cohort study was to determine whether patient-reported information which is routinely collected in an outpatient setting was associated with hospital readmission within 30 days of discharge; the need for post-acute care after a subsequent hospital admission was also examined. Participants were patients hospitalized between May 2004 and May 2014 in a Midwestern health system. Six domains of patient-reported information were collected in outpatient clinic settings and linked to electronic health record hospitalization data. These domains were found to be significantly associated with 30-day readmission and placement in a facility. The authors concluded that further research is needed to determine whether these data can be leveraged to guide interventions to address patient needs and improve outcomes.
AHRQ-funded; HS000011.
Citation: Keeney T, Lee Lee, Basford JR .
Association of function, symptoms, and social support reported in standardized outpatient clinic questionnaires with subsequent hospital discharge disposition and 30-day readmissions.
Arch Phys Med Rehabil 2022 Dec;103(12):2383-90. doi: 10.1016/j.apmr.2022.06.004..
Keywords: Hospital Discharge, Hospital Readmissions
Fry BT, Howard RA, Gunaseelan V
Association of postoperative opioid prescription size and patient satisfaction.
The purpose of this prospective cohort study was to assess the relationship between postoperative opioid prescription size and patient-reported satisfaction among surgical patients. The researchers included 1,520 opioid-naive adult patients undergoing laparoscopic cholecystectomy, laparoscopic appendectomy, and minor hernia repair between January 1 and May 31, 2018. The main outcome was patient satisfaction measured on a scale of 0 to 10 and dichotomized into "highly satisfied" (9-10) and "not highly satisfied" (0-8). The explanatory variable of interest was size of opioid prescription at discharge from surgery, converted into milligrams of oral morphine equivalents (OME). The study found that 84.1% of patients were highly satisfied and 15.9% were not highly satisfied. There was no significant association between opioid prescription size and satisfaction. The researchers concluded that in a large cohort of patients undergoing common surgical procedures, there was no association between opioid prescription size at discharge after surgery and patient satisfaction.
AHRQ-funded; HS023313.
Citation: Fry BT, Howard RA, Gunaseelan V .
Association of postoperative opioid prescription size and patient satisfaction.
Ann Surg 2022 Dec 1;276(6):e1064-e69. doi: 10.1097/sla.0000000000004784..
Keywords: Opioids, Surgery, Medication, Patient Experience
McQuillan J, Andersen JA, Berdahl TA
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
The objective of this study was to examine associations between changes in Rheumatoid Arthritis symptoms and depressive symptoms and to test if these associations differed by education, or gender, or race/ethnicity. Data was taken from the National Rheumatoid Arthritis Study, 1988-98. The results indicated that people with Rheumatoid Arthritis experienced increases in depressive symptoms as well as pain, functional disability, and household work disability over the study period. There was no difference noted in the rate of change in depressive symptoms by education, gender, nor race/ethnicity, but the association of functional disability with depressive symptoms was stronger for men than women. The researchers concluded that it is important to monitor and treat both mental and physical health symptoms, and that future research should focus on the collection of data that reflects the educational, gender, and racial/ethnic diversity of people with Rheumatoid Arthritis.
AHRQ-authored.
Citation: McQuillan J, Andersen JA, Berdahl TA .
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
Arthritis Care Res 2022 Dec;74(12):2050-58. doi: 10.1002/acr.24730..
Keywords: Arthritis, Depression, Behavioral Health, Racial and Ethnic Minorities, Sex Factors, Chronic Conditions
Stransky ML, Fuchu P, Prendergast K
Beyond housing for health: using flexible funds to improve maternal and child health.
The purpose of this article is to describe the Upstreaming Housing for Health’s (UHfH) use of a flexible fund. The UHfH was a pilot program developed and implemented to improve housing stability and decrease health inequities among people with high-risk pregnancies and their babies. The flexible fund is a cash transfer policy that served 50 families from 2019 to 2020 and addressed housing stability and material needs that encouraged family stability within the context of their housing. The researchers found that 76% of the families accessed flexible funds for items such as rental assistance, cribs, and breast pumps, with average financial support of $1343 (standard deviation = $625). The researchers advise that cash transfer policies such as the flexible fund have been shown to positively impact family health and well-being around the world.
AHRQ-funded; HS022242.
Citation: Stransky ML, Fuchu P, Prendergast K .
Beyond housing for health: using flexible funds to improve maternal and child health.
J Urban Health 2022 Dec;99(6):1027-32. doi: 10.1007/s11524-022-00686-8..
Keywords: Children/Adolescents, Behavioral Health, Social Determinants of Health, Outcomes
Meyer AND, Singh H, Zimolzak AJ
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
This observational study examined the reasons why fewer cancer diagnoses have been made during the COVID-19 pandemic using electronic health record data from the Department of Veterans Affairs before (March 10, 2019-March 7, 2020) and during (March 8, 2020-March 6, 2021) the pandemic. Electronic triggers were applied to 8,021,406 veterans' electronic health records to identify follow-up delays for abnormal results warranting evaluation for 5 cancers: bladder, breast, colorectal, liver, and lung cancers. Between the prepandemic and pandemic periods, test quantities decreased by 12.6%-27.8%, and proportions of abnormal results lacking follow-up decreased for urinalyses by 0.8%, increased by 2.3% for fecal occult blood tests/fecal immunochemical test and 1.8% for chest imaging, and remained constant for the other diagnostic tests (mammograms for breast cancer and elevated alpha-fetoprotein for liver cancer). This significant decrease in diagnostic testing may have led to reduced cancer rates.
AHRQ-funded; HS027363.
Citation: Meyer AND, Singh H, Zimolzak AJ .
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
Am J Prev Med 2022 Dec;63(6):1026-30. doi: 10.1016/j.amepre.2022.07.004..
Keywords: COVID-19, Cancer, Public Health
