National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
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- Cardiovascular Conditions (2)
- Care Management (1)
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- Elderly (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 5 of 5 Research Studies DisplayedChou LN, Kuo YF, Raji MA
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
This study compared prescribing rates for potentially inappropriate medications (PIMs) by physicians and nurse practitioners (NPs). The authors used 100% Texas Medicare data to define physician and NP visits in 2016. Rates of visits with a PIM prescription from the same provider was measured by initial and refill visits. There were 24.1 per 1000 visits for PIM prescriptions, 9.0 per 1000 visits for an initial PM and 15.1 per 1000 visits for a refill PIM. Visits to an NP was less likely to result in an initial and refill PIM visit than a visit to a physician. There was a strong association of lower odds of a black enrollee receiving a PIM by an NP than white enrollees. There was also less likelihood of receiving a PIM refill from an NP in older patients and in those with more comorbidities.
AHRQ-funded; HS020642; HS020642.
Citation: Chou LN, Kuo YF, Raji MA .
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
J Am Geriatr Soc 2021 Jul;69(7):1916-24. doi: 10.1111/jgs.17120..
Keywords: Medication: Safety, Medication, Provider: Physician, Provider: Nurse, Hospitalization, Practice Patterns, Ambulatory Care and Surgery
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Fudim M, Kelly JP, Brophy TJ
Trends in treatment for patients hospitalized with heart failure with preserved ejection fraction before and after Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT).
This study examined treatment trends for patients hospitalized for heart failure with preserved ejection fraction (HFpEF) after the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, which investigated spironolactone treatment vs placebo in HFpEF patients. This retrospective analysis looked at discharge prescribing data in the Get With The Guidelines-Heart Failure Registry among patients with left ventricular ejection fraction ≥50% discharged between 2009-2016. About 13% of the cohort of 142,201 patients were prescribed mineralocorticoid receptor antagonists (MRAs) at discharge. MRA prescribing increased modestly over time, but the TOPCAT trial did not seem to have an impact.
AHRQ-funded; HS021092.
Citation: Fudim M, Kelly JP, Brophy TJ .
Trends in treatment for patients hospitalized with heart failure with preserved ejection fraction before and after Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT).
Am J Cardiol 2020 Jun 1;125(11):1655-60. doi: 10.1016/j.amjcard.2020.02.038..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Medication, Hospitalization, Inpatient Care, Practice Patterns
Angraal S, Nuti SV, Masoudi FA
Digoxin use and associated adverse events among older adults.
The authors describe national-level trends of digoxin use, hospitalizations for toxicity, and subsequent outcomes over the past two decades. They found that, while digoxin prescriptions have decreased, the drug is still widely prescribed. However, the rate of hospitalizations for digoxin toxicity and adverse outcomes associated with these hospitalizations have decreased. They concluded that these findings reflect the changing clinical practice of digoxin use, aligned with the changes in clinical guidelines.
AHRQ-funded; HS025164; HS025402; HS025517.
Citation: Angraal S, Nuti SV, Masoudi FA .
Digoxin use and associated adverse events among older adults.
Am J Med 2019 Oct;132(10):1191-98. doi: 10.1016/j.amjmed.2019.04.022.
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Keywords: Medication, Elderly, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Practice Patterns
Williams DJ, Edwards KM, Self WH
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
The 2011 national guidelines for the management of childhood community-acquired pneumonia (CAP) recommended narrow-spectrum antibiotics (e.g., ampicillin) for most children hospitalized with CAP. The researchers assessed the impact of these guidelines on antibiotic prescribing at 3 children’s hospitals. They found that, after publication of national guidelines, third-generation cephalosporin use declined and penicillin/ampicillin use increased among children hospitalized with CAP.
AHRQ-authored; HS022342.
Citation: Williams DJ, Edwards KM, Self WH .
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
Pediatrics 2015 Jul;136(1):44-52. doi: 10.1542/peds.2014-3047..
Keywords: Children/Adolescents, Hospitalization, Guidelines, Medication, Practice Patterns