National Healthcare Quality and Disparities Report
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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 7 of 7 Research Studies DisplayedKeller SC, Caballero TM, Tamma PD
AHRQ Author: Miller MA
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
This cohort study evaluated the effectiveness of the AHRQ Safety Program for Improving Antibiotic Use aimed to improve antibiotic prescribing in ambulatory practices by engaging clinicians and staff to incorporate antibiotic stewardship into practice culture, communication, and decision-making. The study ran from December 2019 through November 2020. A total of 389 ambulatory care practices with over 6.5 million visits to 5483 clinicians were compared from the baseline to completion of the program. Participants included 82 primary care practices, 103 urgent care practices, 34 federally supported practices, 21 pediatric-only practices, 39 pediatric urgent care practices, 21 pediatric-only practices, and 14 other practice types. Of the 389 practices who completed the program, 75% submitted completed data. Visits per practice per month decreased from a mean of 1624 at baseline to a nadir of 906 early in the COVID-19 pandemic (April 2020) and were 1797 at the end of the program. Total antibiotic prescribing decreased from 18.2% of visits at baseline to 9.5% at completion of the program. Acute respiratory infection (ARI) visits per practice per month decreased from a baseline of 321 to a nadir of 76 early in the pandemic (May 2020) and gradually increased through completion of the program (n = 239). Antibiotic prescribing for ARIs decreased from 39.2% at baseline to 24.7% at completion of the program.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Caballero TM, Tamma PD .
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
JAMA Netw Open 2022 Jul;5(7):e2220512. doi: 10.1001/jamanetworkopen.2022.20512..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, COVID-19, Public Health, Respiratory Conditions
Bramante CT, Ingraham NE, Murray TA
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
This study examined whether metformin use by patients with diagnosed with type 2 diabetes had reduced mortality when hospitalized for COVID-19. Pharmacy claims data from UnitedHealth Group’s Clinical Discovery Claims Database was used. Patient data were included if they were aged 18 years or older; had type 2 diabetes or obesity (defined based on claims); at least 6 months of continuous enrolment in 2019; and admission to hospital for COVID-19 confirmed by PCR; manual chart review by UHG; or reported from the hospital to UHG. Metformin was not associated with significant reduction in mortality among men, but there was an association with decreased mortality in women.
AHRQ-funded; HS026379.
Citation: Bramante CT, Ingraham NE, Murray TA .
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
Lancet Healthy Longev 2021 Jan;2(1):e34-e41. doi: 10.1016/s2666-7568(20)30033-7..
Keywords: COVID-19, Hospitalization, Medication, Mortality, Risk, Diabetes, Chronic Conditions, Public Health, Infectious Diseases
Buxbaum JD, Chernew ME, Fendrick AM
Contributions of public health, pharmaceuticals, and other medical care to US life expectancy changes, 1990-2015.
This study examined the contributions of public health, pharmaceuticals, and other medical care to increases in US life expectancy by 3.3 years from 1990 to 2015. Vital statistics data and cause-deletion analysis was used to identify the conditions most responsible. They found that 12 conditions most responsible for changing life expectance explained 2.9 years of net improvement. Ischemic heart disease prevention was the largest positive contributor to life expectancy, with accidental poisoning or drug overdose the largest negative contributor. Life expectancy improvement was attributed to public health 45%, 35% to pharmaceuticals, 13% to other medical care, and -7% was attributable to other/unknown factors.
AHRQ-funded; HS000055.
Citation: Buxbaum JD, Chernew ME, Fendrick AM .
Contributions of public health, pharmaceuticals, and other medical care to US life expectancy changes, 1990-2015.
Health Aff 2020 Sep;39(9):1546-56. doi: 10.1377/hlthaff.2020.00284..
Keywords: Public Health, Medication, Mortality
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
Feldman AG, Hsu EK, Mack CL
The importance of prioritizing pre and posttransplant immunizations in an era of vaccine refusal and epidemic outbreaks.
This paper discusses the prevalence of vaccine-preventable outbreaks occurring both nationally and internationally. Rates of vaccine hesitancy and refusal have been increasing which leads to decreased herd immunity. This poses greater risk to immunosuppressed transplant recipients, and currently 1 in 6 pediatric solid organ transplant recipients are hospitalized with a vaccine-preventable infection in the first 5 years posttransplant. This often results in significant morbidity, mortality, and increased hospitalization costs. Surprisingly, many transplant recipients are not up-to-date on age appropriate immunizations at the time of transplant and thereafter. The authors feel that immunizations must be prioritized in both pre and posttransplant care. They call for more research to understand how to monitor immune response to vaccines in immunosuppressed patients and when to optimally immunize patients posttransplant. They also recommend reexamination of the administration of live vaccines posttransplant.
AHRQ-funded; HS026510.
Citation: Feldman AG, Hsu EK, Mack CL .
The importance of prioritizing pre and posttransplant immunizations in an era of vaccine refusal and epidemic outbreaks.
Transplantation 2020 Jan;104(1):33-38. doi: 10.1097/tp.0000000000002936..
Keywords: Vaccination, Medication, Emergency Preparedness, Public Health, Transplantation
Davis CS, Green TC, Hernandez-Delgado H
Status of US state laws mandating timely reporting of nonfatal overdose.
Timely, actionable, nonfatal overdose data are urgently needed to improve public health response to the overdose crisis. The purpose of this paper was to provide background and catalyze discussion regarding this important issue. The authors briefly report the results of a systematic analysis of state laws mandating reporting of nonfatal overdose, and provide suggestions for improving the collection and use of nonfatal overdose data to improve the public health response to this ongoing epidemic.
AHRQ-funded; HS024021.
Citation: Davis CS, Green TC, Hernandez-Delgado H .
Status of US state laws mandating timely reporting of nonfatal overdose.
Am J Public Health 2018 Sep;108(9):1159-61. doi: 10.2105/ajph.2018.304589..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Opioids, Policy, Public Health, Substance Abuse
Kravitz RL, Bell RA
Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications.
This analysis takes the form of a critical, integrative synthesis of research from the fields of medicine, marketing, public health, and health communications. The authors conclude that the problem is not a lack of information: rather, it is knowing what information to trust.
AHRQ-funded; 290200810015C
Citation: Kravitz RL, Bell RA .
Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications.
BMC Med Inform Decis Making 2013;13 Suppl 3:S5. doi: 10.1186/1472-6947-13-s3-s5..
Keywords: Communication, Education: Patient and Caregiver, Health Promotion, Medication, Public Health