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AHRQ Research Studies Date
Topics
- Access to Care (5)
- Adverse Drug Events (ADE) (1)
- Alcohol Use (1)
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- Children/Adolescents (7)
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- Low-Income (1)
- Medicaid (4)
- (-) Medication (19)
- Medication: Safety (1)
- Opioids (4)
- Patient Adherence/Compliance (2)
- Patient Experience (1)
- Patient Safety (2)
- Policy (1)
- Quality Measures (1)
- Racial and Ethnic Minorities (1)
- Social Determinants of Health (1)
- Substance Abuse (5)
- Telehealth (1)
- Trauma (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 19 of 19 Research Studies DisplayedHughes PM, Carda-Auten J, DiRosa EA
"You can get a couple of ramen noodle packs for a Buspar(Ⓡ)": a qualitative examination of medication access, policy, and procedures in southern jails.
Over10 million people are being incarcerated every year in the US, and jails are required to provide health care to them, a substantial percentage of whom require medications. However, not much is known about the medication prescription, acquisition, and administration process for incarcerated persons in jails. The purpose of this study was to characterize access to medication and related medication policies and procedures in jails. The researchers administered semi-structured interviews with administrators and health workers from 34 jails (of 125 contacted) across 5 states in the southeastern US. The qualitative interview guide encompassed all facets of healthcare in jails from entry to release, but the current study focused only on medications. The study found that 4 processes characterized medication utilization from intake to release: 1) jail entry and health screening, 2) pharmacy and medication protocols, 3) protocols specific to medication dispensing and administration, and 4) medications upon release. Many jails had processes for utilizing medications brought to the jail from home, although some jails did not agree to use those medications. Researchers discovered that contracted healthcare providers were the primary medication decision-makers in jails, and most medications were obtained from contract pharmacies. The study also found almost all jails banned narcotics, but other medication restrictions varied by jail. Most jails charged a copay for medications. Study participants shared a variety of privacy practices related to the distribution of medication, as well as approaches to the prevention of diversion of medications away from intended recipients and into the prison population. Transition planning for pre-release medication management processes ranged from no planning to sending additional prescriptions to the patient's pharmacy.
AHRQ-funded; HS000032.
Citation: Hughes PM, Carda-Auten J, DiRosa EA .
"You can get a couple of ramen noodle packs for a Buspar(Ⓡ)": a qualitative examination of medication access, policy, and procedures in southern jails.
Res Social Adm Pharm 2023 Sep; 19(9):1298-306. doi: 10.1016/j.sapharm.2023.05.013..
Keywords: Medication, Vulnerable Populations, Access to Care
Sun CJ, Shato T, Steinbaugh A
Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM.
The goal of this study was to investigate how social support was provided and sought by gay, bisexual, and other men who have sex with men (GBMSM) within a technology-based antiretroviral therapy (ART) adherence intervention. Participants used the messaging feature in to discuss and exchange support around HIV treatment and care. The most salient HIV treatment and care issues were lab results, upcoming tests, ART adherence and side effects, regimen changes, and relationships with healthcare providers. The authors concluded that this analysis provided an opportunity to understand how participants informally interact with one another, how they seek and provide social support online, and their relevant personal issues.
AHRQ-funded; HS022981.
Citation: Sun CJ, Shato T, Steinbaugh A .
Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM.
AIDS Care 2023 Jan;35(1):7-15. doi: 10.1080/09540121.2022.2038364.
Keywords: Patient Adherence/Compliance, Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Medication, Vulnerable Populations
Grove LR, Rao N, Domino ME
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
This study’s goal was to inform efforts to increase prescriptions of medications for opioid use disorder (MOUD) among Medicaid beneficiaries. A retrospective study of North Carolina licensed physicians, physician assistants, and nurse practitioners was conducted to estimate Medicaid participation prevalence among clinicians authorized to prescribe buprenorphine and to estimate the association between clinician characteristics and OUD care delivery to Medicaid beneficiaries. Outcomes looked for were indicators of any Medicaid professional claims and Medicaid claims data for buprenorphine and naltrexone. Licensure data from 2018 was merged with 2019 US Drug Enforcement Administration to identify clinicians who used the DEA waiver required to prescribe buprenorphine (n = 1714). Services by waivered clinicians to Medicare beneficiaries ranged from 67% of behavioral health clinicians to 82.9% of specialist physicians. Prevalence of prescribing buprenorphine to Medicaid beneficiaries ranged from 30.3% among specialist physicians to 51.6% among behavioral health clinicians.
AHRQ-funded; HS000032.
Citation: Grove LR, Rao N, Domino ME .
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
Addiction 2022 Nov;117(11):2855-63. doi: 10.1111/add.15854..
Keywords: Opioids, Substance Abuse, Behavioral Health, Vulnerable Populations, Medication, Access to Care, Medicaid
Mackie TI, Schaefer AJ, Palatucci JS
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
The purpose of this sequential multi-method study was to propose a classification for the procedural elements of informed consent policies based upon existing child welfare policies and then explored whether formal state policies across the United States authorized these elements. The researchers conducted interviews with 58 key informants primarily from state child welfare agencies to identify a classification of procedural elements for informed consent of psychotropic medications. A legislative review of the 50 states and D.C. was then conducted to characterize whether formal policies endorsed each procedural element. Key informants reported five procedural elements in policy, and 23 states endorsed relevant legislation. Only two states specified all five procedural elements, and the content of any procedural elements varied considerably across policies.
AHRQ-funded; HS02198501; HS026001
Citation: Mackie TI, Schaefer AJ, Palatucci JS .
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
Adm Policy Ment Health 2022 Nov;49(6):986-1003. doi: 10.1007/s10488-022-01212-3..
Keywords: Children/Adolescents, Vulnerable Populations, Medication, Behavioral Health, Policy
Bowden CF, Simmel C, Mendez A
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
The purpose of this study was to examine stakeholders' perspectives of the relationship between psychotropic medications and trauma informed care (TIC) for youth in foster care. The researchers recruited foster caseworkers, prescribing clinicians, caregivers, and alumni of the foster care system and conducted semi-structured individual and group interviews. Data were recorded and transcribed verbatim and analyzed using a directed content analysis approach. Five themes emerged across the recorded and transcribed data within stakeholder groups: 1) acknowledging trauma; 2) role of psychotropic medication; 3) psychosocial resources; 4) additional supports; and, 5) training and education. Stakeholders identified TIC as an important component of mental health services for youth in foster care. Most stakeholders felt that psychotropic medication was overused in treating trauma. Respondents suggested including additional supportive team members to help guide youth through the mental health treatment system and stated the importance of support from individuals with common lived experiences. The study concluded that there is a need for: improved training and education for stakeholders, additional sources of support for youth in foster care, and an overall system that emphasizes trauma-sensitive clinical interactions and psychosocial supports.
AHRQ-funded; HS02600101A1.
Citation: Bowden CF, Simmel C, Mendez A .
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
Adm Policy Ment Health 2022 Sep;49(5):821-33. doi: 10.1007/s10488-022-01203-4..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Trauma, Medication
Lillie KM, Shaw J, Jansen KJ
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). The investigators concluded that younger patients and those with co-occurring substance use remained at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people.
AHRQ-funded; HS023207.
Citation: Lillie KM, Shaw J, Jansen KJ .
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
J Addict Med 2021 Jul-Aug 01;15(4):297-302. doi: 10.1097/adm.0000000000000757..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Racial and Ethnic Minorities, Vulnerable Populations
Simmel C, Bowden CF, Neese-Todd S
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
AHRQ-funded; HS026001.
Citation: Simmel C, Bowden CF, Neese-Todd S .
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
Am J Orthopsychiatry 2021;91(2):258-70. doi: 10.1037/ort0000532..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Medication, Patient Experience
Mackie TI, Cook S, Crystal S
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
This study examined a multimodal antipsychotic intervention implemented by a specialized Medicaid managed care organization (MMCO) for youths in foster care with routine mental health screening, health passports, elective psychiatric consultation line, and retrospective drug utilization reviews to determine whether this multimodal intervention significantly reduced antipsychotic dispensing for youths with conditions without US Food and Drug Administration (FDA)-approved indications. Findings showed that MMCO implementation significantly reduced antipsychotic medications without FDA-indicated conditions prescribed to youths, while not significantly affecting antipsychotic medications prescribed to youths with FDA-indicated conditions.
AHRQ-funded; HS026001.
Citation: Mackie TI, Cook S, Crystal S .
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
J Am Acad Child Adolesc Psychiatry 2020 Jan;59(1):166-76.e3. doi: 10.1016/j.jaac.2019.04.022..
Keywords: Children/Adolescents, Behavioral Health, Medication, Vulnerable Populations, Medicaid, Health Insurance
Ferguson WJ, Johnston J, Clarke JG
Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.
Four jail and prison systems partnered with researchers to document their adoption of medication assisted therapy (MAT) for incarcerated individuals with opioid use disorders using their established treatment protocols. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Recommendations included adoption of evidence-based MATs for opioid use disorders in prisons and jails with persistent effort to identify and overcome challenges and dedicated funding to sustain programs.
AHRQ-funded; HS024243.
Citation: Ferguson WJ, Johnston J, Clarke JG .
Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.
Health Justice 2019 Dec 12;7(1):19. doi: 10.1186/s40352-019-0100-2..
Keywords: Opioids, Medication, Substance Abuse, Vulnerable Populations
McManus KA, Debolt C, Elwood S
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
This study examined low-income HIV patients’ perspective on the Virginia AIDS Drug Assistance Program (ADAP) Affordable Care Act (ACA) implementation. Patients were recruited at three HIV clinics in Virginia with the goal of enrolling greater than 5% of those who were eligible for the Qualified Health Plan (QHP). The recruitment goals were met with 53 patients enrolled. Two-thirds of patients were recruited to the QHP via case managers and social workers at the HIV clinics. Concerns about privacy using the mail-order pharmacy was the biggest barrier with 9 out of 10 participants. Otherwise, most participants had positive perceptions of the QHP.
AHRQ-funded; HS024196.
Citation: McManus KA, Debolt C, Elwood S .
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
AIDS Res Hum Retroviruses 2019 Aug;35(8):734-45. doi: 10.1089/aid.2018.0254..
Keywords: Human Immunodeficiency Virus (HIV), Access to Care, Medication, Low-Income, Vulnerable Populations
Hill LM, Golin CE, Gottfredson NC
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
The purpose of this study was to identify the mechanisms involved with antiretroviral therapy (ART) non-adherence among people living with HIV (PLHIV) after release from prison. Results showed that, on average, study participants achieved 79% ART adherence. Greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Results suggested that depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
AHRQ-funded; HS000032.
Citation: Hill LM, Golin CE, Gottfredson NC .
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
AIDS Behav 2019 Aug;23(8):2037-47. doi: 10.1007/s10461-018-2355-3..
Keywords: Behavioral Health, Depression, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Substance Abuse, Vulnerable Populations
Lindau ST
CommunityRx, an e-prescribing system connecting people to community resources.
CommunityRx is an e-prescribing system that make it easier for patients in communities to connect with health resources. NowPow, LLC is an information technology enterprise that is part of CommunityRx. NowPow participated in AHRQ’s EvidenceNow grants program and worked with hundreds of small Midwestern primary care practices in the Healthy Hearts in the Heartland study. By 2018, over 1600 youths had been employed (many for the first-time) and generated annual asset census for Chicago, New York, and two rural areas of North Carolina. CommunityRx has been successful in providing health resource information to lower-income communities such as Chicago’s South Side. They also found that half of people who received a HealtheRx e-prescription use the information to help others.
AHRQ-funded; HS023921.
Citation: Lindau ST .
CommunityRx, an e-prescribing system connecting people to community resources.
Am J Public Health 2019 Apr;109(4):546-47. doi: 10.2105/ajph.2019.304986..
Keywords: Access to Care, Community-Based Practice, Electronic Prescribing (E-Prescribing), Evidence-Based Practice, Health Information Technology (HIT), Medication, Vulnerable Populations
Weitzman ER, Magane KM, Wisk LE
Alcohol use and alcohol-interactive medications among medically vulnerable youth.
Information about the prevalence of alcohol use among youth with chronic medical conditions (YCMCs) who take alcohol-interactive (AI) medications is scant. This study attempts to address gaps and inform interventions by quantifying simultaneous exposure to alcohol use and AI medications among YCMCs. Participants were adolescents with a variety of chronic conditions: type 1 diabetes, juvenile idiopathic arthritis, moderate persistent asthma, cystic fibrosis, attention-deficit/hyperactivity disorder, inflammatory bowel disease. Participants completed an electronic survey designed to measure prevalence of exposure to AI medications and associations with alcohol usage in the past year. Many of the participants reported alcohol use, but drinking was less likely among those who took AI medications. The authors conclude that perceptions about alcohol-medication interference mediated the association between drinking and AI medication exposure.
AHRQ-funded; HS022986.
Citation: Weitzman ER, Magane KM, Wisk LE .
Alcohol use and alcohol-interactive medications among medically vulnerable youth.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2017-4026..
Keywords: Alcohol Use, Children/Adolescents, Chronic Conditions, Medication, Medication: Safety, Patient Safety, Vulnerable Populations
Leckman-Westin E, Finnerty M, Scholle SH
Differences in Medicaid antipsychotic medication measures among children with SSI, foster care, and income-based aid.
This study examined the application of 6 quality measures for antipsychotic medication prescribing in children and adolescents receiving Medicaid. While indicators of overuse were more common in those with Supplemental Security Income and foster care groups, access to follow-up, metabolic monitoring, and psychosocial services was somewhat better for these children. However, substantial quality shortfalls existed for all groups, particularly metabolic screening and monitoring.
AHRQ-funded; HS020503; HS019937; HS021112.
Citation: Leckman-Westin E, Finnerty M, Scholle SH .
Differences in Medicaid antipsychotic medication measures among children with SSI, foster care, and income-based aid.
J Manag Care Spec Pharm 2018 Mar;24(3):238-46. doi: 10.18553/jmcp.2018.24.3.238.
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Keywords: Children/Adolescents, Medicaid, Medication, Quality Measures, Vulnerable Populations
Sadasivaiah S, Smith DE, Goldman S
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
A multidisciplinary team designed an EHR-facilitated medication reconciliation program by which pharmacy technicians engaged newly admitted patients and their caregivers at the bedside to develop and electronically document the best possible medication history (BPMH). They found that, by optimizing not only the health information technology platform but also the operational processes, the program achieved a nearly 80 percent generation of BPMH completed by a highly trained pharmacy technician.
AHRQ-funded; HS022561; HS023558.
Citation: Sadasivaiah S, Smith DE, Goldman S .
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
BMJ Open Qual 2017 Oct 21;6(2):e000102. doi: 10.1136/bmjoq-2017-000102.
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Keywords: Electronic Health Records (EHRs), Medication, Patient Safety, Urban Health, Vulnerable Populations
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.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Substance Abuse, Vulnerable Populations
Beckman AL, Bilinski A, Boyko R
New hepatitis C drugs are very costly and unavailable to many state prisoners.
This study found that in the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively).
AHRQ-funded; HS000055.
Citation: Beckman AL, Bilinski A, Boyko R .
New hepatitis C drugs are very costly and unavailable to many state prisoners.
Health Aff 2016 Oct;35(10):1893-901. doi: 10.1377/hlthaff.2016.0296.
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Keywords: Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Qato DM, Trivedi AN, Mor V
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
The researchers compared time to discontinuation of rosiglitazone after the safety alert between black and white elderly persons, and across sociodemographic and economic subgroups. They found that white race and a history of low personal income modestly predicted later discontinuation of rosiglitazone after the FDA's safety advisory in 2007.
AHRQ-funded; HS019657.
Citation: Qato DM, Trivedi AN, Mor V .
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
Med Care 2016 Apr;54(4):406-13. doi: 10.1097/mlr.0000000000000502..
Keywords: Medication, Disparities, Elderly, Social Determinants of Health, Vulnerable Populations
Vanderwerker L, Akincigil A, Olfson M
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
The researchers investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. They found that foster care youths had higher rates of externalizing disorders than the comparison group and greater antipsychotic use. Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates.
AHRQ-funded; HS017918; HS019937; HS021112.
Citation: Vanderwerker L, Akincigil A, Olfson M .
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
Psychiatr Serv 2014 Oct;65(10):1281-4. doi: 10.1176/appi.ps.201300455.
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Keywords: Children/Adolescents, Medication, Medicaid, Vulnerable Populations, Behavioral Health